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Van Der Steen N, Pauwels P, Gil-Bazo I, Castañon E, Raez L, Cappuzzo F, Rolfo C. cMET in NSCLC: Can We Cut off the Head of the Hydra? From the Pathway to the Resistance. Cancers (Basel) 2015; 7:556-73. [PMID: 25815459 PMCID: PMC4491670 DOI: 10.3390/cancers7020556] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/19/2015] [Accepted: 03/05/2015] [Indexed: 01/05/2023] Open
Abstract
In the last decade, the tyrosine kinase receptor cMET, together with its ligand hepatocyte growth factor (HGF), has become a target in non-small cell lung cancer (NSCLC). Signalization via cMET stimulates several oncological processes amongst which are cell motility, invasion and metastasis. It also confers resistance against several currently used targeted therapies, e.g., epidermal growth factor receptor (EGFR) inhibitors. In this review, we will discuss the basic structure of cMET and the most important signaling pathways. We will also look into aberrations in the signaling and the effects thereof in cancer growth, with the focus on NSCLC. Finally, we will discuss the role of cMET as resistance mechanism.
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Affiliation(s)
- Nele Van Der Steen
- Center for Oncological Research Antwerp, University of Antwerp, Universiteitsplein 1, Wilrijk 2610, Belgium; E-Mails: (N.V.D.S.); (P.P.)
| | - Patrick Pauwels
- Center for Oncological Research Antwerp, University of Antwerp, Universiteitsplein 1, Wilrijk 2610, Belgium; E-Mails: (N.V.D.S.); (P.P.)
- Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Wilrijkstraat 10, Edegem 2650, Belgium
| | - Ignacio Gil-Bazo
- Department of Oncology, Clínica Universidad de Navarra, Pamplona 31008, Spain; E-Mails: (I.G.-B.); (E.C.)
| | - Eduardo Castañon
- Department of Oncology, Clínica Universidad de Navarra, Pamplona 31008, Spain; E-Mails: (I.G.-B.); (E.C.)
- Phase I-Early Clinical Trials Unit, Oncology Department, Antwerp University Hospital, Wilrijkstraat 10, Edegem 2650, Belgium
| | - Luis Raez
- Thoracic Oncology Program, Memorial Cancer Institute, Memorial Health Care System, Pembroke Pines, FL 33024, USA; E-Mail:
| | - Federico Cappuzzo
- Thoracic Oncology Program, Memorial Cancer Institute, Memorial Health Care System, Pembroke Pines, FL 33024, USA; E-Mail:
| | - Christian Rolfo
- Center for Oncological Research Antwerp, University of Antwerp, Universiteitsplein 1, Wilrijk 2610, Belgium; E-Mails: (N.V.D.S.); (P.P.)
- Phase I-Early Clinical Trials Unit, Oncology Department, Antwerp University Hospital, Wilrijkstraat 10, Edegem 2650, Belgium
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +32-3-821-3646; Fax: +32-3-825-1592
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Rolfo C, Sortino G, Smits E, Passiglia F, Bronte G, Castiglia M, Russo A, Santos ES, Janssens A, Pauwels P, Raez L. Immunotherapy: is a minor god yet in the pantheon of treatments for lung cancer? Expert Rev Anticancer Ther 2014; 14:1173-87. [PMID: 25148289 DOI: 10.1586/14737140.2014.952287] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Immunotherapy has been studied for many years in lung cancer without significant results, making the majority of oncologists quite skeptical about its possible application for non-small cell lung cancer treatment. However, the recent knowledge about immune escape and subsequent 'cancer immunoediting' has yielded the development of new strategies of cancer immunotherapy, heralding a new era of lung cancer treatment. Cancer vaccines, including both whole-cell and peptide vaccines have been tested both in early and advanced stages of non-small cell lung cancer. New immunomodulatory agents, including anti-CTLA4, anti-PD1/PDL1 monoclonal antibodies, have been investigated as monotherapy in metastatic lung cancer. To date, these treatments have shown impressive results of efficacy and tolerability in early clinical trials, leading to testing in several large, randomized Phase III trials. As these results will be confirmed, these drugs will be available in the near future, offering new exciting therapeutic options for lung cancer treatment.
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Affiliation(s)
- Christian Rolfo
- Oncology Department, Phase I - Early Clinical Trials Unit, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium
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Rocha-Lima CM, Bayraktar S, Macintyre J, Raez L, Flores AM, Ferrell A, Rubin EH, Poplin EA, Tan AR, Lucarelli A, Zojwalla N. A phase 1 trial of E7974 administered on day 1 of a 21-day cycle in patients with advanced solid tumors. Cancer 2012; 118:4262-70. [PMID: 22294459 DOI: 10.1002/cncr.27428] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 12/19/2011] [Accepted: 12/09/2011] [Indexed: 01/04/2023]
Abstract
BACKGROUND E7974, a synthetic analog of hemiasterlin, interacts with the tubulin molecule and overcomes resistance to other antitubulin drugs (taxanes and vinca alkaloids). METHODS In a phase 1 study, E7974 was given intravenously over a 2- to 5-minute infusion on day 1 of every 21-day cycle. Adult patients with advanced refractory solid tumors who had adequate organ function and Eastern Cooperative Oncology Group performance status 0 to 2 were eligible for this study. A modified Fibonacci schema was used. The maximal tolerated dose (MTD) was the dose where <2 of 6 patients developed a dose-limiting toxicity (DLT). RESULTS Twenty-eight patients (19 men and 9 women; median age, 64 years) treated at different cohort dose levels (0.18 mg/m(2) , 0.27 mg/m(2) , 0.36 mg/m(2) , 0.45 mg/m(2) , and 0.56 mg/m(2) ) received a total of 66 courses of E7974. The MTD was established at 0.45 mg/m(2) , where 1 of 6 patients experienced DLT (grade 4 febrile neutropenia). Of the 17 refractory colon cancer patients with a median of 3 prior treatments, stable disease was seen in 7 patients (41%). There were no tumor responses. Median progression-free survival was 1.2 months, and median overall survival was 6.7 months. In pharmacokinetic analysis, E7974 was characterized by a fast and moderately large distribution (37.95-147.93 L), slow clearance (2.23-7.15 L/h), and moderate to slow elimination (time to half-life, 10.4-30.5 hours). CONCLUSIONS This study shows that E7974 once every 21-day cycle shows antitumor activity in patients with refractory solid tumors. The recommended phase 2 dose is 0.45 mg/m(2).
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Affiliation(s)
- Caio M Rocha-Lima
- Department of Medical Oncology, University of Miami and Sylvester Comprehensive Cancer Center, Miami, Florida, USA.
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Abramowitz M, Santos E, Raez L, Weed D, Mahmoud O, Sperry J, Wright J, Sargi Z, Lally B. Has Survival for Patients with Squamous Cell Carcinoma of the Head and Neck Treated with Radiotherapy Improved Over Time? Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schreiber TH, Raez L, Rosenblatt JD, Podack ER. Tumor immunogenicity and responsiveness to cancer vaccine therapy: the state of the art. Semin Immunol 2010; 22:105-12. [PMID: 20226686 DOI: 10.1016/j.smim.2010.02.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 02/15/2010] [Indexed: 12/21/2022]
Abstract
Despite enormous effort, promising pre-clinical data in animal studies and over 900 clinical trials in the United States, no cancer vaccine has ever been approved for clinical use. Over the past decade a great deal of progress has been in both laboratory and clinical studies defining the interactions between developing tumors and the immune system. The results of these studies provide a rationale that may help explain the failure of recent therapeutic cancer vaccines in terms of vaccine principles, in selecting which tumors are the most appropriate to target and instruct the design and implementation of state-of-the-art cancer vaccines.
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Affiliation(s)
- Taylor H Schreiber
- Departmentof Microbiology and Immunology, University of Miami Leonard Miller School of Medicine, Miami, FL 33101, United States
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56
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Lee MJ, Adjei A, Bonomi P, Raez L, Drabkin H, Bodkin D, Trepel J. Abstract B206: Pharmacokinetic and pharmacodynamic analysis of patients treated with the histone deacetylase inhibitor entinostat in combination with erlotinib. Mol Cancer Ther 2009. [DOI: 10.1158/1535-7163.targ-09-b206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Histone deacetylase (HDAC) inhibition results in hyperacetylation of protein substrates leading to re-expression of silenced genes as well as down-regulation of certain actively transcribed genes. Entinostat (ENT) is a novel oral benzamide HDACi characterized by its selectivity for class 1 HDACs as well as a unique pharmacokinetic (PK) and pharmacodynamic (PD) profile. Preclinical data demonstrated ENT synergizes with epidermal growth factor receptor inhibitors (EGFRi) to inhibit growth of non-small cell lung cancer (NSCLC) cells through a) targeting of EGFR gene and protein expression; b) down-regulation of EGFR mediated signaling transduction pathway and c) alteration of the tumor phenotype to resensitize cancer cells to EGFRi. This led to the initiation of a clinical study ENCORE-403 (clinical trials.gov ID NCT00750698) investigating whether ENT could affect acquired resistance to the EGFRi, erotinib (ERB). We report here the initial findings on PK and PD analysis from a study of 8 patients treated with the ENT/ERB combination.
Materials and Methods: Previously ERB-treated relapsed NSCLC patients were continued on ERB. ENT at 10 mg was added to ongoing ERB regimen on days 1 and 15 of a 28-day cycle. Blood samples for PK analysis and correlative studies were obtained on C1D1 (pre-entinostat dose), C1D2 (4–36hrs post entinostat dose), C1D8, C1D15 (pre-entinostat dose) and C2D15 (for PK only). Gene expression in 8 patients was measured by RT-PCR and effects on protein lysine acetylation (7 patients) and peripheral blood monocytes were measured by multi-parameter flow cytometry.
Results: Initiation of ENT/ERB combination led to induction of protein lysine acetylation of at least 2 fold in 6 of 7 patients for whom samples were available. The lack of acetylation induction in the 7th patient was consistent with PK analysis which indicated no detectable levels of entinostat in this patient. Lysine acetylation was measured in CD14+ monocytes, CD56+ NK cells and CD3+ T cells. The acetylation pattern and magnitude of induction was consistent in all three cell types. In addition, 4 of the 6 patients maintained elevated acetylation levels at 7 days and 3 of the 6 at 14 days after the first dose of entinostat. Initial analysis of gene expression was focused on the previously identified HDACi target p21. Similar to lysine acetylation, p21 expression was increased by 30–80% of the pre-treatment level in 4 of the 6 patients with increased acetylation; and in 3 patients, elevated p21 expression was detectable on C1D15. Analysis of the combination treatment effects on circulating endothelial cell progenitors (CEPs), apoptotic circulating endothelial cells (CECs), regulatory T cells (Tregs), and myeloid derived suppressor cells (MDSC) was carried out to determine potential anti-angiogenic (CEP, CEC) and immunomodulatory (Treg, MDSC) activity and will be reported.
Conclusions: Results from acetylation and gene expression analysis demonstrate that 10mg ENT induces a prolonged effect (up to 2 weeks) on up-regulation of a key gene in the cell cycle and importantly that the ENT/ERB combination does not alter the prolonged PD effects of entinostat. Investigations are ongoing into the mechanism of ENT/ERB combination and potential for clinical benefit to NSCLC patients.
Citation Information: Mol Cancer Ther 2009;8(12 Suppl):B206.
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Affiliation(s)
| | - Alex Adjei
- 2 Roswell Park Cancer Institute, Buffalo, NY
| | | | - Luis Raez
- 4 Sylvester Comprehensive Cancer Center University of Miami, Miami, FL
| | - Harry Drabkin
- 5 Medical University of South Carolina, Charleston, SC
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Alencar AJ, Blaya M, Raez L, Farfan N, Lopes G, Walker G, Flores A, Macintyre J, Rocha-Lima C. Gemcitabine in combination with oxaliplatin as second-line therapy of advanced and metastatic NSCLC. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18157 Background: Single agent gemcitabine is active as second line therapy in NSCLC. Oxaliplatin may be non-cross resistant with the other platinum-containing agents used as first-line therapy in NSCLC. The combination of gemcitabine and oxaliplatin (GEMOX) is synergistic in pre-clinical models. Methods: A phase II, non-randomized trial was designed to assess the efficacy and tolerability of gemcitabine 1,000 mg/m2 over 100 min in combination with oxaliplatin 100 mg/m2 over 2 hours both given on days 1 and 15 of each 28-day cycle. Patients with NSCLC were eligible if they had progressed after first line treatment. Primary endpoint was tumor response rate. Planned sample size is 30 patients over a period of 2 years. Functional Assessment of Cancer Therapy- Lung (FACT-L) v.4 questionaire was used to assess quality of life of patients on therapy. Results: Twenty-two patients have been enrolled. 13 males (59%) and 9 females (41%). 15 Hispanic (68%), 4 Caucasian (18%), and 3 African-American (13%). Median age is 55 yrs. Histologic subtypes are as follows: adenocarcinoma, 12; NSCLC not otherwise specified 7; squamous cell carcinoma, 3. Nine patients had an ECOG performance status (PS) of 0 (41%) and 13 had a PS of 1 (59%). Two patients were never smokers. A total of 56 cycles have been administered (median 2, range 1 to 6). GEMOX as second-line therapy was given to 18 patients (81%), third-line to 4 patients (18%). Two patients died on study from disease progression leading to respiratory and multi-organ failure. The following Grade 3 and 4 adverse events were seen in 2 patients each: fatigue, dyspnea, anemia, and multi-organ failure. Cancer pain was seen in 1 patient. Twenty patients are available for assessment of response. Two patients had a confirmed partial response (10%) and another eight had stable disease (40%). Preliminary results of FACT-L analysis in 19 pts shows improvement in Lung Cancer Subscale (LCS) score in 25% of the patients after 2 cycles of therapy. Conclusions: Combination gemcitabine and oxaliplatin is active and well tolerated as second line treatment for NSCLC. Improvement of LCS score after 2 cycles suggests a clinical benefit that is beyond the observed response rate of 10%. No significant financial relationships to disclose.
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Affiliation(s)
| | - M. Blaya
- U Miami Jackson Mem Hosp, Miami, FL
| | - L. Raez
- U Miami Jackson Mem Hosp, Miami, FL
| | | | - G. Lopes
- U Miami Jackson Mem Hosp, Miami, FL
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Biagioli M, Raez L, Takita C, Rocha-Lima C, Roman E, Zimmerman Z, Kar M, Farfan N, Markoe A. 2493. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Storch I, Jorda M, Thurer R, Raez L, Rocha-Lima C, Vernon S, Ribeiro A. Advantage of EUS Trucut biopsy combined with fine-needle aspiration without immediate on-site cytopathologic examination. Gastrointest Endosc 2006; 64:505-11. [PMID: 16996340 DOI: 10.1016/j.gie.2006.02.056] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2005] [Accepted: 02/20/2006] [Indexed: 02/08/2023]
Abstract
BACKGROUND Endoscopic ultrasonographically guided fine-needle aspiration (EUS-FNA) is a safe and accurate method for obtaining diagnostic material from lesions within and immediately adjacent to the upper GI tract. OBJECTIVE To determine whether EUS Trucut biopsy (EUS-TCB) (Quickcore, Wilson-Cook, Winstom Salem, NC) can increase the accuracy of EUS-guided tissue sampling when combined with FNA when no cytopathologist is present. DESIGN Retrospective case review. SETTING University-based referral practice. PATIENTS All patients who had lesions that were accessible through the esophagus or stomach and that were greater than 20 mm and amenable to Trucut biopsy were included. INTERVENTIONS A total of 41 patients underwent both EUS-FNA and TCB with a separate pathologist evaluating each specimen. MAIN OUTCOME MEASUREMENTS The diagnostic performance of FNA, TCB, and its combination were compared. RESULTS The overall accuracy in our series was as follows: FNA, 76%; TCB, 76% (P not significant); and combination of FNA and TCB, 95% (P = .007). In the 26 patients with malignant diagnoses, the accuracy of combination was 100% versus 77% for FNA (P = .03). The median number of passes with the FNA and TCB was 4.4 (range 2-8) and 2.8 (range 2-5), respectively. One patient in the series had fever and chest pain after EUS biopsy. LIMITATIONS Retrospective study. CONCLUSION In our series EUS-TCB accuracy was equal to FNA when no on-site cytopathologist is present. TCB was helpful in the diagnosis of pancreatic masses, gastric submucosal lesions, lymphoma, and necrotic tumors. A 100% accuracy of FNA + TCB was seen in patients with malignant diseases and in patients who had failed or been refused biopsy by other modalities in the past. More data are needed before the exact role of TCB in the absence of on-site cytopathology can be accurately defined.
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Affiliation(s)
- Ian Storch
- Division of Gastroenterology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, Florida 33101, USA
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Roman E, Raez L, Biagioli M, Harvey M, Blaya M, Tolba K, Bathia R, Markoe A. Re-irradiation with concurrent chemotherapy for recurrent head and neck cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.5559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5559 Background: Despite aggressive therapy, over 70% of locally advanced squamous cell carcinomas of the head and neck (SCCHN) fail primary treatment. Salvage therapy with surgery, chemotherapy or brachytherapy alone or in combination has a 30–40% response rate, but few long-term survivors. Re-irradiation with concurrent chemotherapy for SCCHN has recently become a well established approach after two consecutive cooperative group studies were reported. Intensity Modulated Radiation Therapy (IMRT) is a new and safer way to deliver radiation therapy. This retrospective review evaluated the potential benefit and toxicity using every other week IMRT with concurrent chemotherapy. Design: Thirty-seven patients with locally recurrent SCCHN were evaluated. All patients received re-irradiation with IRMT every other week with concurrent weekly carboplatin (median AUC= 2) or cisplatin (60–100 mg/m2) ± 5-FU (800–1000 mg/m2) or paclitaxel 175mg/m2 every three weeks. Patients received 6000 cGy at 200 cGy per fraction. Results: The median follow-up time was 12 months. The overall response rate was 75.7% with a complete response (CR) and partial response (PR) of 56.8% and 18.9%, respectively. Among complete responders, 33% recurred locally in a median time of 5 months. The Kaplan-Meier estimate of disease-free survival, progression-free survival, and overall survival at 48 months is 58%, 45%, and 28%, respectively. At the time of last follow-up, 51.4% of patients were still alive and 27.8% of patients had no evidence of disease. Grade 3 or 4 acute toxicities occurred in 20% of patients of which 13.3% were hematologic requiring either growth factors or delay in chemotherapy. No deaths occurred during the course of treatment. Long-term complications consisted of one patient with an esophageal stricture requiring repeated dilations, 2 patients with chronic dysphagia, and 2 patients developing a pharyngeal-cutaneous fistula, one of which died from a carotid blowout occurring 6 months after treatment. Conclusions: IMRT delivered every other week with concurrent platinum based chemotherapy produces good responses with only moderate toxicity in patients previously treated with radiation therapy for recurrent head and neck cancer. No significant financial relationships to disclose.
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Affiliation(s)
| | - L. Raez
- University of Miami, Miami, FL
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61
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Davila E, Lilenbaum R, Raez L, Seigel L, Tseng J, Graham P. Phase II trial of oxaliplatin and gemcitabine with bevacizumab in first-line advanced non-small cell lung cancer (NSCLC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.17009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
17009 Background: Oxaliplatin-Gemcitabine (GemOx) is an active and well tolerated. Bevacizumab (BV) prolongs survival when combined with carboplatin-paclitaxel. This phase II trial evaluates the efficacy of GemOx + BV as 1st line therapy for advanced NSCLC patients. Methods: Pts with stage IIIB (effusion) and IV non-squamous NSCLC, ECOG PS 0 or 1, no CNS metastasis, and no other contraindications to BV, are eligible. Prior therapy for earlier-stage disease allowed if completed at least 12 months before enrollment. Treatment consists of Gem 1000 mg/m2 on d1 and 8, Ox 130 mg/m2 on d1, and BV 15 mg/kg on d1, repeated every 3 wks for a total 4 cycles. Pts who respond or have stable disease receive BV maintenance until progression. Main endpoints are response rate (RR), grade (Gr) 3–4 toxicities, time to progression (TTP), and overall survival (OS). Results: As of 12/05, 26 out of 50 projected pts have been enrolled from 4 institutions. M/F 17/9; median age 65y (45,81); IIIB/IV 3/23; PS 0/1 8/18. Median F/U time is 3.7 months. 24 pts are evaluable for toxicity: 1Gr3 ANC; 1Gr3 and 4 PLT; no FN.3 Gr3 diarrhea and 2 Gr3 N/V; 1Gr3 and 4 hypophosphatemia; 1 pt had ischemic bowel after the 1st cycle, recovered fully and was removed from study; 1 pt died of liver failure in the 1st cycle. No bleeding complications have occurred. 22 pts are evaluable for RR (ITT): 7 PR (31%); 8 SD (36%). TTP and OS data not yet available. Conclusions: This is the first report of GemOx in combination with BV in advanced NSCLC. This regimen has minimal hematologic toxicity but selected non-hematologic toxicities are noted. Activity appears promising and merits further investigation. Accrual is ongoing. [Table: see text]
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Affiliation(s)
- E. Davila
- Mount Sinai CCOP, Miami Beach, FL; Sylvester Cancer Center, Miami, FL; M. D. Anderson Orlando, Orlando, FL
| | - R. Lilenbaum
- Mount Sinai CCOP, Miami Beach, FL; Sylvester Cancer Center, Miami, FL; M. D. Anderson Orlando, Orlando, FL
| | - L. Raez
- Mount Sinai CCOP, Miami Beach, FL; Sylvester Cancer Center, Miami, FL; M. D. Anderson Orlando, Orlando, FL
| | - L. Seigel
- Mount Sinai CCOP, Miami Beach, FL; Sylvester Cancer Center, Miami, FL; M. D. Anderson Orlando, Orlando, FL
| | - J. Tseng
- Mount Sinai CCOP, Miami Beach, FL; Sylvester Cancer Center, Miami, FL; M. D. Anderson Orlando, Orlando, FL
| | - P. Graham
- Mount Sinai CCOP, Miami Beach, FL; Sylvester Cancer Center, Miami, FL; M. D. Anderson Orlando, Orlando, FL
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Fanucchi M, Fossella F, Fidias P, Natale R, Belt R, Govindan R, Raez L, Schiller J, Kashala O, Kelly K. O-084 Phase 2 study of bortezomib±docetaxel in advanced non-smallcell lung cancer (NSCLC). Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80217-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Fanucchi MP, Fossella F, Fidias P, Natale RB, Belt RJ, Carbone DP, Govindan R, Raez L, Robert F, Schiller J. Bortezomib ± docetaxel in previously treated patients with advanced non-small cell lung cancer (NSCLC): A phase 2 study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7034] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. P. Fanucchi
- Winship Cancer Institute, Emory Univ, Atlanta, GA; MD Anderson Cancer Ctr, Houston, TX; MA Gen Hosp, Boston, MA; Cedars-Sinai Comprehensive Cancer Ctr, Los Angeles, CA; Kansas City Oncology Hematology Group, Kansas City, MO; Vanderbilt Univ Clin Trials Ctr, Nashville, TN; Washington Univ at St. Louis, St Louis, MO; Sylvester Comprehensive Cancer Ctr, Miami, FL; Univ of Alabama Comprehensive Cancer Ctr, Birmingham, AL; Univ of Wisconsin Comprehensive Cancer Ctr, Madison, WI
| | - F. Fossella
- Winship Cancer Institute, Emory Univ, Atlanta, GA; MD Anderson Cancer Ctr, Houston, TX; MA Gen Hosp, Boston, MA; Cedars-Sinai Comprehensive Cancer Ctr, Los Angeles, CA; Kansas City Oncology Hematology Group, Kansas City, MO; Vanderbilt Univ Clin Trials Ctr, Nashville, TN; Washington Univ at St. Louis, St Louis, MO; Sylvester Comprehensive Cancer Ctr, Miami, FL; Univ of Alabama Comprehensive Cancer Ctr, Birmingham, AL; Univ of Wisconsin Comprehensive Cancer Ctr, Madison, WI
| | - P. Fidias
- Winship Cancer Institute, Emory Univ, Atlanta, GA; MD Anderson Cancer Ctr, Houston, TX; MA Gen Hosp, Boston, MA; Cedars-Sinai Comprehensive Cancer Ctr, Los Angeles, CA; Kansas City Oncology Hematology Group, Kansas City, MO; Vanderbilt Univ Clin Trials Ctr, Nashville, TN; Washington Univ at St. Louis, St Louis, MO; Sylvester Comprehensive Cancer Ctr, Miami, FL; Univ of Alabama Comprehensive Cancer Ctr, Birmingham, AL; Univ of Wisconsin Comprehensive Cancer Ctr, Madison, WI
| | - R. B. Natale
- Winship Cancer Institute, Emory Univ, Atlanta, GA; MD Anderson Cancer Ctr, Houston, TX; MA Gen Hosp, Boston, MA; Cedars-Sinai Comprehensive Cancer Ctr, Los Angeles, CA; Kansas City Oncology Hematology Group, Kansas City, MO; Vanderbilt Univ Clin Trials Ctr, Nashville, TN; Washington Univ at St. Louis, St Louis, MO; Sylvester Comprehensive Cancer Ctr, Miami, FL; Univ of Alabama Comprehensive Cancer Ctr, Birmingham, AL; Univ of Wisconsin Comprehensive Cancer Ctr, Madison, WI
| | - R. J. Belt
- Winship Cancer Institute, Emory Univ, Atlanta, GA; MD Anderson Cancer Ctr, Houston, TX; MA Gen Hosp, Boston, MA; Cedars-Sinai Comprehensive Cancer Ctr, Los Angeles, CA; Kansas City Oncology Hematology Group, Kansas City, MO; Vanderbilt Univ Clin Trials Ctr, Nashville, TN; Washington Univ at St. Louis, St Louis, MO; Sylvester Comprehensive Cancer Ctr, Miami, FL; Univ of Alabama Comprehensive Cancer Ctr, Birmingham, AL; Univ of Wisconsin Comprehensive Cancer Ctr, Madison, WI
| | - D. P. Carbone
- Winship Cancer Institute, Emory Univ, Atlanta, GA; MD Anderson Cancer Ctr, Houston, TX; MA Gen Hosp, Boston, MA; Cedars-Sinai Comprehensive Cancer Ctr, Los Angeles, CA; Kansas City Oncology Hematology Group, Kansas City, MO; Vanderbilt Univ Clin Trials Ctr, Nashville, TN; Washington Univ at St. Louis, St Louis, MO; Sylvester Comprehensive Cancer Ctr, Miami, FL; Univ of Alabama Comprehensive Cancer Ctr, Birmingham, AL; Univ of Wisconsin Comprehensive Cancer Ctr, Madison, WI
| | - R. Govindan
- Winship Cancer Institute, Emory Univ, Atlanta, GA; MD Anderson Cancer Ctr, Houston, TX; MA Gen Hosp, Boston, MA; Cedars-Sinai Comprehensive Cancer Ctr, Los Angeles, CA; Kansas City Oncology Hematology Group, Kansas City, MO; Vanderbilt Univ Clin Trials Ctr, Nashville, TN; Washington Univ at St. Louis, St Louis, MO; Sylvester Comprehensive Cancer Ctr, Miami, FL; Univ of Alabama Comprehensive Cancer Ctr, Birmingham, AL; Univ of Wisconsin Comprehensive Cancer Ctr, Madison, WI
| | - L. Raez
- Winship Cancer Institute, Emory Univ, Atlanta, GA; MD Anderson Cancer Ctr, Houston, TX; MA Gen Hosp, Boston, MA; Cedars-Sinai Comprehensive Cancer Ctr, Los Angeles, CA; Kansas City Oncology Hematology Group, Kansas City, MO; Vanderbilt Univ Clin Trials Ctr, Nashville, TN; Washington Univ at St. Louis, St Louis, MO; Sylvester Comprehensive Cancer Ctr, Miami, FL; Univ of Alabama Comprehensive Cancer Ctr, Birmingham, AL; Univ of Wisconsin Comprehensive Cancer Ctr, Madison, WI
| | - F. Robert
- Winship Cancer Institute, Emory Univ, Atlanta, GA; MD Anderson Cancer Ctr, Houston, TX; MA Gen Hosp, Boston, MA; Cedars-Sinai Comprehensive Cancer Ctr, Los Angeles, CA; Kansas City Oncology Hematology Group, Kansas City, MO; Vanderbilt Univ Clin Trials Ctr, Nashville, TN; Washington Univ at St. Louis, St Louis, MO; Sylvester Comprehensive Cancer Ctr, Miami, FL; Univ of Alabama Comprehensive Cancer Ctr, Birmingham, AL; Univ of Wisconsin Comprehensive Cancer Ctr, Madison, WI
| | - J. Schiller
- Winship Cancer Institute, Emory Univ, Atlanta, GA; MD Anderson Cancer Ctr, Houston, TX; MA Gen Hosp, Boston, MA; Cedars-Sinai Comprehensive Cancer Ctr, Los Angeles, CA; Kansas City Oncology Hematology Group, Kansas City, MO; Vanderbilt Univ Clin Trials Ctr, Nashville, TN; Washington Univ at St. Louis, St Louis, MO; Sylvester Comprehensive Cancer Ctr, Miami, FL; Univ of Alabama Comprehensive Cancer Ctr, Birmingham, AL; Univ of Wisconsin Comprehensive Cancer Ctr, Madison, WI
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64
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Abstract
Small Cell Lung Cancer (SCLC) is highly sensitive to chemotherapy and radiotherapy. However, despite initial responses, relapses are common and most patients eventually succumb to this disease. Patients with limited-disease SCLC represent approximately 30% of all patients with SCLC, and are potentially curable when treated with combined chemotherapy and thoracic radiotherapy (TRT). Chemotherapy consists of four cycles of the combination of cisplatin and etoposide (PE). Thoracic radiotherapy should be started with the first or second cycle of chemotherapy, and preferably administered twice daily for 3 weeks. Prophylactic cranial irradiation (PCI) is recommended for patients who achieve a complete response. Surgery is of limited value in SCLC, except in patients who present with a solitary pulmonary nodule. Approximately 20% to 25% of patients with limited disease (LD)-SCLC can be cured with this aggressive approach. Newer treatment modalities are currently under investigation.
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Affiliation(s)
- Luis Raez
- Mount Sinai Comprehensive Cancer Center, 4306 Alton Road Miami Beach, FL 33140, USA
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Bathe OF, Levi D, Caldera H, Franceschi D, Raez L, Patel A, Raub WA, Benedetto P, Reddy R, Hutson D, Sleeman D, Livingstone AS, Levi JU. Radical resection of periampullary tumors in the elderly: evaluation of long-term results. World J Surg 2000; 24:353-8. [PMID: 10658072 DOI: 10.1007/s002689910056] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Increasingly, patients of advanced age are coming for evaluation of periampullary tumors. Although several studies have demonstrated the safety of resecting periampullary tumors in older patients, few long-term survival data have been reported. Between 1983 and 1992 various periampullary masses were resected in 70 patients over age 65 (range 65-87 years). Total pancreatectomy was performed in 11 patients, and 59 patients underwent pancreaticoduodenectomy. The mean duration of hospitalization was 17 +/- 15 days. Major complications occurred in 27 patients (39%), and operative mortality rate was 8.5%. Overall median survival was 24 months; and 5-year survival was 25%. Perioperative outcome was compared in patients aged 65 to 74 years and in patients > or =75 years old. The older age group required longer periods in the surgical intensive care unit postoperatively, but the long-term survival was similar in the two age groups. Radical resection with the intent to cure periampullary tumors is safe in selected patients of advanced age, and long-term survival is in the range of expected survival for younger patients with the same tumors.
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Affiliation(s)
- O F Bathe
- Department of Surgery, Division of Surgical Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Florida 33136, USA
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66
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Raez L, Cabral L, Cai JP, Landy H, Sfakianakis G, Byrne GE, Hurley J, Scerpella E, Jayaweera D, Harrington WJ. Treatment of AIDS-related primary central nervous system lymphoma with zidovudine, ganciclovir, and interleukin 2. AIDS Res Hum Retroviruses 1999; 15:713-9. [PMID: 10357467 DOI: 10.1089/088922299310809] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIDS-related primary central nervous system lymphoma (AIDS PCNSL) is a rapidly fatal disease. Conventional therapeutic modalities offer little and new approaches are needed. Previous work has shown that zidovudine (AZT) in combination with other agents is active in retroviral lymphomas. Epstein-Barr virus (EBV) is detected in tumor tissue and cerebrospinal fluid of AIDS PCNSL patients. In a preliminary in vitro study we found that an Epstein-Barr virus-positive B cell line underwent apoptosis on coculture with AZT. This effect was accentuated by the addition of ganciclovir (GCV). We treated five patients with AIDS PCNSL with a regimen consisting of parenteral zidovudine (1.6 g twice daily), ganciclovir (5 mg/kg twice daily), and interleukin 2 (2 million units twice daily). Four of five had an excellent response. Two patients are alive and free of disease 22 and 13 months later; another responded on two separate occasions, 5 months apart, and the last patient responded with a 70-80% regression of tumor but could not be maintained on therapy owing to myelosuppression. We conclude that parenteral zidovudine, ganciclovir, and interleukin 2 is an active combination for AIDS-related central nervous system lymphoma.
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Affiliation(s)
- L Raez
- Division of Hematology/Oncology, University of Miami School of Medicine/Jackson Memorial Hospital, Florida 33136, USA
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