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Kellum A, Jagiello-Gruszfeld A, Bondarenko I, Rafi R, Giangiulio P, Messam C, Mostafa Kamel Y. Hepatobiliary (HB) safety of eltrombopag administered after carboplatin+paclitaxel (Carb+Pac) in patients (pts) with solid tumors. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20667] [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
e20667 Background: Eltrombopag is an oral, small molecule, non-peptide, TPO-receptor agonist studied for the treatment of thrombocytopenia (TCP) due to various causes, including chemotherapy (CT)-induced TCP and is approved for the treatment of chronic ITP in the US. Since eltrombopag is excreted primarily through the liver and liver function is an important safety parameter, HB lab values and AEs were analyzed in a double-blind, placebo (pbo)-controlled, multicenter ph II study. Methods: The safety of eltrombopag was evaluated in adults with advanced solid tumors (mainly NSCLC and ovarian). Pts received up to 8 cycles of Carb (AUC 5–6 IV) + Pac (175–225 mg/m2 IV), both administered on day 1 q 21 days. 183 pts were randomized to eltrombopag 50, 75, 100mg, or pbo (1:1:1:1). Eltrombopag or pbo were taken from Day 2 - 11 in each cycle of CT. Results: Baseline characteristics, prior medical conditions and number of CT cycles during the study were similar between the treatment groups. At baseline, one pt reported liver metastases (75mg group). Similar numbers of pts had HB lab abnormalities in all groups ( table ). Additionally, HB AEs (34 AEs) occurred in 15 pts across all treatment groups ( table ). Conclusions: In this study, eltrombopag did not increase the incidence of HB AEs or HB lab abnormalities compared to pbo. [Table: see text] [Table: see text]
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Affiliation(s)
- A. Kellum
- Hematology & Oncology Associates at BridgePoint, Tupelo, MO; ZOZ MSWiA, Olsztyn, Poland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; GlaxoSmithKline, Collegeville, PA; GlaxoSmithKline, Stockley Park, United Kingdom
| | - A. Jagiello-Gruszfeld
- Hematology & Oncology Associates at BridgePoint, Tupelo, MO; ZOZ MSWiA, Olsztyn, Poland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; GlaxoSmithKline, Collegeville, PA; GlaxoSmithKline, Stockley Park, United Kingdom
| | - I. Bondarenko
- Hematology & Oncology Associates at BridgePoint, Tupelo, MO; ZOZ MSWiA, Olsztyn, Poland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; GlaxoSmithKline, Collegeville, PA; GlaxoSmithKline, Stockley Park, United Kingdom
| | - R. Rafi
- Hematology & Oncology Associates at BridgePoint, Tupelo, MO; ZOZ MSWiA, Olsztyn, Poland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; GlaxoSmithKline, Collegeville, PA; GlaxoSmithKline, Stockley Park, United Kingdom
| | - P. Giangiulio
- Hematology & Oncology Associates at BridgePoint, Tupelo, MO; ZOZ MSWiA, Olsztyn, Poland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; GlaxoSmithKline, Collegeville, PA; GlaxoSmithKline, Stockley Park, United Kingdom
| | - C. Messam
- Hematology & Oncology Associates at BridgePoint, Tupelo, MO; ZOZ MSWiA, Olsztyn, Poland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; GlaxoSmithKline, Collegeville, PA; GlaxoSmithKline, Stockley Park, United Kingdom
| | - Y. Mostafa Kamel
- Hematology & Oncology Associates at BridgePoint, Tupelo, MO; ZOZ MSWiA, Olsztyn, Poland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; GlaxoSmithKline, Collegeville, PA; GlaxoSmithKline, Stockley Park, United Kingdom
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Robert NJ, Dieras V, Glaspy J, Brufsky A, Bondarenko I, Lipatov O, Perez E, Yardley D, Zhou X, Phan S. RIBBON-1: Randomized, double-blind, placebo-controlled, phase III trial of chemotherapy with or without bevacizumab (B) for first-line treatment of HER2-negative locally recurrent or metastatic breast cancer (MBC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1005] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [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
1005 Background: B in combination with weekly paclitaxel or docetaxel (D) as 1st-line therapy for MBC has improved progression-free survival (PFS) compared with the respective taxane alone in two large Phase III trials. This study investigated the addition of B to standard 1st-line chemotherapy regimens for MBC. Methods: Patients were randomized in 2:1 ratio to receive B + chemotherapy or placebo (pl) + chemotherapy. Prior to randomization, investigators chose capecitabine (Cap) (2000 mg/m2 x 14d), taxane (T) (nab-paclitaxel [260 mg/m2] or D [75 or 100 mg/m2], q3wk), or anthracycline (Ant)-based chemotherapy (q3wk). B or pl was administered at 15 mg/kg q3wk. Key eligibility criteria included MBC or locally-recurrent disease, no prior cytotoxic treatment, ECOG PS 0 or 1, HER2-negative disease and no CNS metastases. The primary endpoint was investigator-assessed PFS. Secondary endpoints included overall survival (OS), objective response rate (ORR), independent review of PFS, and safety. At progression, all patients were eligible for B with 2nd line chemotherapy. The Cap cohort and the pooled T or Ant (T + Ant) cohort were independently powered and analyzed in parallel using two-sided stratified log-rank test (Cap: 80% power to detect HR=0.75; T + Ant: 90% power to detect HR=0.7). Results: RIBBON-1 enrolled 1237 patients (Cap, 615; T, 307; Ant, 315) from 12/05 to 8/07 in 22 countries with a median follow-up of 15.6 months in the Cap cohort and 19.2 months in the T + Ant cohort. The results are summarized below. OS data are limited with only 33% of events. Safety was consistent with results of prior B trials. Conclusions: The addition of B to Cap, T; or Ant-based chemotherapy regimens used in 1st-line treatment of MBC resulted in statistically-significant improvement in PFS with a safety profile comparable to prior Phase III studies. [Table: see text] [Table: see text]
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Affiliation(s)
- N. J. Robert
- Fairfax-Northern Virginia Hematology-Oncology, Fairfax, VA; Institut Curie, Paris, France; UCLA TORI, Los Angeles, CA; University of Pittsburgh, Pittsburgh, PA; State Medical Academy, Dnipropetrovsk, Ukraine, Bashkirian Republican Clinical Oncology, Ufa, Russian Federation; Mayo Clinic, Jacksonville, FL; Sarah Cannon Cancer Center, Nashville, TN; Genentech, Inc., South San Francisco, CA
| | - V. Dieras
- Fairfax-Northern Virginia Hematology-Oncology, Fairfax, VA; Institut Curie, Paris, France; UCLA TORI, Los Angeles, CA; University of Pittsburgh, Pittsburgh, PA; State Medical Academy, Dnipropetrovsk, Ukraine, Bashkirian Republican Clinical Oncology, Ufa, Russian Federation; Mayo Clinic, Jacksonville, FL; Sarah Cannon Cancer Center, Nashville, TN; Genentech, Inc., South San Francisco, CA
| | - J. Glaspy
- Fairfax-Northern Virginia Hematology-Oncology, Fairfax, VA; Institut Curie, Paris, France; UCLA TORI, Los Angeles, CA; University of Pittsburgh, Pittsburgh, PA; State Medical Academy, Dnipropetrovsk, Ukraine, Bashkirian Republican Clinical Oncology, Ufa, Russian Federation; Mayo Clinic, Jacksonville, FL; Sarah Cannon Cancer Center, Nashville, TN; Genentech, Inc., South San Francisco, CA
| | - A. Brufsky
- Fairfax-Northern Virginia Hematology-Oncology, Fairfax, VA; Institut Curie, Paris, France; UCLA TORI, Los Angeles, CA; University of Pittsburgh, Pittsburgh, PA; State Medical Academy, Dnipropetrovsk, Ukraine, Bashkirian Republican Clinical Oncology, Ufa, Russian Federation; Mayo Clinic, Jacksonville, FL; Sarah Cannon Cancer Center, Nashville, TN; Genentech, Inc., South San Francisco, CA
| | - I. Bondarenko
- Fairfax-Northern Virginia Hematology-Oncology, Fairfax, VA; Institut Curie, Paris, France; UCLA TORI, Los Angeles, CA; University of Pittsburgh, Pittsburgh, PA; State Medical Academy, Dnipropetrovsk, Ukraine, Bashkirian Republican Clinical Oncology, Ufa, Russian Federation; Mayo Clinic, Jacksonville, FL; Sarah Cannon Cancer Center, Nashville, TN; Genentech, Inc., South San Francisco, CA
| | - O. Lipatov
- Fairfax-Northern Virginia Hematology-Oncology, Fairfax, VA; Institut Curie, Paris, France; UCLA TORI, Los Angeles, CA; University of Pittsburgh, Pittsburgh, PA; State Medical Academy, Dnipropetrovsk, Ukraine, Bashkirian Republican Clinical Oncology, Ufa, Russian Federation; Mayo Clinic, Jacksonville, FL; Sarah Cannon Cancer Center, Nashville, TN; Genentech, Inc., South San Francisco, CA
| | - E. Perez
- Fairfax-Northern Virginia Hematology-Oncology, Fairfax, VA; Institut Curie, Paris, France; UCLA TORI, Los Angeles, CA; University of Pittsburgh, Pittsburgh, PA; State Medical Academy, Dnipropetrovsk, Ukraine, Bashkirian Republican Clinical Oncology, Ufa, Russian Federation; Mayo Clinic, Jacksonville, FL; Sarah Cannon Cancer Center, Nashville, TN; Genentech, Inc., South San Francisco, CA
| | - D. Yardley
- Fairfax-Northern Virginia Hematology-Oncology, Fairfax, VA; Institut Curie, Paris, France; UCLA TORI, Los Angeles, CA; University of Pittsburgh, Pittsburgh, PA; State Medical Academy, Dnipropetrovsk, Ukraine, Bashkirian Republican Clinical Oncology, Ufa, Russian Federation; Mayo Clinic, Jacksonville, FL; Sarah Cannon Cancer Center, Nashville, TN; Genentech, Inc., South San Francisco, CA
| | - X. Zhou
- Fairfax-Northern Virginia Hematology-Oncology, Fairfax, VA; Institut Curie, Paris, France; UCLA TORI, Los Angeles, CA; University of Pittsburgh, Pittsburgh, PA; State Medical Academy, Dnipropetrovsk, Ukraine, Bashkirian Republican Clinical Oncology, Ufa, Russian Federation; Mayo Clinic, Jacksonville, FL; Sarah Cannon Cancer Center, Nashville, TN; Genentech, Inc., South San Francisco, CA
| | - S. Phan
- Fairfax-Northern Virginia Hematology-Oncology, Fairfax, VA; Institut Curie, Paris, France; UCLA TORI, Los Angeles, CA; University of Pittsburgh, Pittsburgh, PA; State Medical Academy, Dnipropetrovsk, Ukraine, Bashkirian Republican Clinical Oncology, Ufa, Russian Federation; Mayo Clinic, Jacksonville, FL; Sarah Cannon Cancer Center, Nashville, TN; Genentech, Inc., South San Francisco, CA
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O'Byrne KJ, Bondarenko I, Barrios C, Eschbach C, Martens U, Hotko Y, Kortsik C, Celik I, Stroh C, Pirker R. Molecular and clinical predictors of outcome for cetuximab in non-small cell lung cancer (NSCLC): Data from the FLEX study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8007] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [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
8007 Background: The multinational, randomized, phase III FLEX study compared cisplatin/vinorelbine (CT) plus the EGFR- antibody, cetuximab (Erbitux), with CT alone in the 1st-line treatment of patients (pts) with advanced EGFR-expressing NSCLC and demonstrated a statistically significant OS benefit for the cetuximab combination. We hypothesized that KRAS mutation status is predictive for cetuximab efficacy and enables optimal use of cetuximab. The relationship between early-onset acne-like rash (ie rash that developed ≤21 days of treatment initiation) and OS time of pts treated with CT and cetuximab was also evaluated. Methods: Archived tumor samples from 554/1125 pts were available. Genomic DNA derived from formalin-fixed paraffin embedded tumor tissue was analyzed for KRAS using an LNA-mediated qPCR clamping assay capable of detecting oncogenic mutations at codons 12 and 13. The Kaplan-Meier method was used to estimate OS time and PFS time in pts with KRAS wild-type (wt) and mutant (mt) tumors for each treatment arm. All pts treated with cisplatin/vinorelbine plus cetuximab who were alive at 21 days were included in a landmark analysis evaluating the relationship between early-onset acne-like rash and OS time. Results: KRAS results were obtained from 379 pts. A KRAS mutation was detected in 72 (19%) pts. The comparison of the cetuximab treatment effects in pts with KRAS wt tumors and pts with KRAS mt tumors showed no marked differences with regard to OS or PFS. A total of 518 pts were included in the landmark analysis. Pts treated with cetuximab who developed early acne-like rash of any grade (grade 1–3; 56%, n=290) had a longer median OS than those without acne-like rash (n=228) (median [95% CI]: 15.0 months [12.8–16.4] vs 8.8 months [7.6–11.1]; HR [95% CI]: 0.63 [0.52–0.77]; p<0.001). Analysis of EGFR FISH is ongoing and results will be presented. Conclusions: Clinical data from the FLEX study do not support the hypothesis that KRAS mutation status is predictive for cetuximab efficacy when combined with 1st- line chemotherapy in advanced NSCLC, whereas early acne-like rash of any grade appears to be associated with better outcome in pts treated with platinum-based chemotherapy plus cetuximab in this setting. [Table: see text]
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Affiliation(s)
- K. J. O'Byrne
- St James's Hospital, Dublin, Ireland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; Hospital São Lucas, Porto Alegre, Brazil; Asklepios Klinik Harburg, Hamburg, Germany; University Medical Center I, Freiburg, Germany; Uzhgorod National University, Uzhgorod, Ukraine; Katholisches Klinikum Mainz, Mainz, Germany; Merck KGaA, Darmstadt, Germany; Medical University of Vienna, Vienna, Austria
| | - I. Bondarenko
- St James's Hospital, Dublin, Ireland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; Hospital São Lucas, Porto Alegre, Brazil; Asklepios Klinik Harburg, Hamburg, Germany; University Medical Center I, Freiburg, Germany; Uzhgorod National University, Uzhgorod, Ukraine; Katholisches Klinikum Mainz, Mainz, Germany; Merck KGaA, Darmstadt, Germany; Medical University of Vienna, Vienna, Austria
| | - C. Barrios
- St James's Hospital, Dublin, Ireland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; Hospital São Lucas, Porto Alegre, Brazil; Asklepios Klinik Harburg, Hamburg, Germany; University Medical Center I, Freiburg, Germany; Uzhgorod National University, Uzhgorod, Ukraine; Katholisches Klinikum Mainz, Mainz, Germany; Merck KGaA, Darmstadt, Germany; Medical University of Vienna, Vienna, Austria
| | - C. Eschbach
- St James's Hospital, Dublin, Ireland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; Hospital São Lucas, Porto Alegre, Brazil; Asklepios Klinik Harburg, Hamburg, Germany; University Medical Center I, Freiburg, Germany; Uzhgorod National University, Uzhgorod, Ukraine; Katholisches Klinikum Mainz, Mainz, Germany; Merck KGaA, Darmstadt, Germany; Medical University of Vienna, Vienna, Austria
| | - U. Martens
- St James's Hospital, Dublin, Ireland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; Hospital São Lucas, Porto Alegre, Brazil; Asklepios Klinik Harburg, Hamburg, Germany; University Medical Center I, Freiburg, Germany; Uzhgorod National University, Uzhgorod, Ukraine; Katholisches Klinikum Mainz, Mainz, Germany; Merck KGaA, Darmstadt, Germany; Medical University of Vienna, Vienna, Austria
| | - Y. Hotko
- St James's Hospital, Dublin, Ireland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; Hospital São Lucas, Porto Alegre, Brazil; Asklepios Klinik Harburg, Hamburg, Germany; University Medical Center I, Freiburg, Germany; Uzhgorod National University, Uzhgorod, Ukraine; Katholisches Klinikum Mainz, Mainz, Germany; Merck KGaA, Darmstadt, Germany; Medical University of Vienna, Vienna, Austria
| | - C. Kortsik
- St James's Hospital, Dublin, Ireland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; Hospital São Lucas, Porto Alegre, Brazil; Asklepios Klinik Harburg, Hamburg, Germany; University Medical Center I, Freiburg, Germany; Uzhgorod National University, Uzhgorod, Ukraine; Katholisches Klinikum Mainz, Mainz, Germany; Merck KGaA, Darmstadt, Germany; Medical University of Vienna, Vienna, Austria
| | - I. Celik
- St James's Hospital, Dublin, Ireland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; Hospital São Lucas, Porto Alegre, Brazil; Asklepios Klinik Harburg, Hamburg, Germany; University Medical Center I, Freiburg, Germany; Uzhgorod National University, Uzhgorod, Ukraine; Katholisches Klinikum Mainz, Mainz, Germany; Merck KGaA, Darmstadt, Germany; Medical University of Vienna, Vienna, Austria
| | - C. Stroh
- St James's Hospital, Dublin, Ireland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; Hospital São Lucas, Porto Alegre, Brazil; Asklepios Klinik Harburg, Hamburg, Germany; University Medical Center I, Freiburg, Germany; Uzhgorod National University, Uzhgorod, Ukraine; Katholisches Klinikum Mainz, Mainz, Germany; Merck KGaA, Darmstadt, Germany; Medical University of Vienna, Vienna, Austria
| | - R. Pirker
- St James's Hospital, Dublin, Ireland; Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine; Hospital São Lucas, Porto Alegre, Brazil; Asklepios Klinik Harburg, Hamburg, Germany; University Medical Center I, Freiburg, Germany; Uzhgorod National University, Uzhgorod, Ukraine; Katholisches Klinikum Mainz, Mainz, Germany; Merck KGaA, Darmstadt, Germany; Medical University of Vienna, Vienna, Austria
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Bokemeyer C, Bondarenko I, Makhson A, Hartmann JT, Aparicio J, de Braud F, Donea S, Ludwig H, Schuch G, Stroh C, Loos AH, Zubel A, Koralewski P. Fluorouracil, leucovorin, and oxaliplatin with and without cetuximab in the first-line treatment of metastatic colorectal cancer. J Clin Oncol 2008; 27:663-71. [PMID: 19114683 DOI: 10.1200/jco.2008.20.8397] [Citation(s) in RCA: 1202] [Impact Index Per Article: 75.1] [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
PURPOSE This randomized study assessed whether the best overall response rate (ORR) of cetuximab combined with oxaliplatin, leucovorin, and fluorouracil (FOLFOX-4) was superior to that of FOLFOX-4 alone as first-line treatment for metastatic colorectal cancer. The influence of KRAS mutation status was investigated. PATIENTS AND METHODS Patients received cetuximab (400 mg/m(2) initial dose followed by 250 mg/m(2)/wk thereafter) plus FOLFOX-4 (oxaliplatin 85 mg/m(2) on day 1, plus leucovorin 200 mg/m(2) and fluorouracil as a 400 mg/m(2) bolus followed by a 600 mg/m(2) infusion during 22 hours on days 1 and 2; n = 169) or FOLFOX-4 alone (n = 168). Treatment was continued until disease progression or unacceptable toxicity. KRAS mutation status was assessed in the subset of patients with assessable tumor samples (n = 233). RESULTS The confirmed ORR for cetuximab plus FOLFOX-4 was higher than with FOLFOX-4 alone (46% v 36%). A statistically significant increase in the odds for a response with the addition of cetuximab to FOLFOX-4 could not be established (odds ratio = 1.52; P = .064). In patients with KRAS wild-type tumors, the addition of cetuximab to FOLFOX-4 was associated with a clinically significant increased chance of response (ORR = 61% v 37%; odds ratio = 2.54; P = .011) and a lower risk of disease progression (hazard ratio = 0.57; P = .0163) compared with FOLFOX-4 alone. Cetuximab plus FOLFOX-4 was generally well tolerated. CONCLUSION KRAS mutational status was shown to be a highly predictive selection criterion in relation to the treatment decision regarding the addition of cetuximab to FOLFOX-4 for previously untreated patients with metastatic colorectal cancer.
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Bokemeyer C, Bondarenko I, Makhson A, Hartmann JT, Aparicio J, de Braud F, Donea S, Ludwig H, Schuch G, Stroh C, Loos AH, Zubel A, Koralewski P. Fluorouracil, leucovorin, and oxaliplatin with and without cetuximab in the first-line treatment of metastatic colorectal cancer. J Clin Oncol 2008. [PMID: 19114683 DOI: 10.1200/jco.2008.20.839] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PURPOSE This randomized study assessed whether the best overall response rate (ORR) of cetuximab combined with oxaliplatin, leucovorin, and fluorouracil (FOLFOX-4) was superior to that of FOLFOX-4 alone as first-line treatment for metastatic colorectal cancer. The influence of KRAS mutation status was investigated. PATIENTS AND METHODS Patients received cetuximab (400 mg/m(2) initial dose followed by 250 mg/m(2)/wk thereafter) plus FOLFOX-4 (oxaliplatin 85 mg/m(2) on day 1, plus leucovorin 200 mg/m(2) and fluorouracil as a 400 mg/m(2) bolus followed by a 600 mg/m(2) infusion during 22 hours on days 1 and 2; n = 169) or FOLFOX-4 alone (n = 168). Treatment was continued until disease progression or unacceptable toxicity. KRAS mutation status was assessed in the subset of patients with assessable tumor samples (n = 233). RESULTS The confirmed ORR for cetuximab plus FOLFOX-4 was higher than with FOLFOX-4 alone (46% v 36%). A statistically significant increase in the odds for a response with the addition of cetuximab to FOLFOX-4 could not be established (odds ratio = 1.52; P = .064). In patients with KRAS wild-type tumors, the addition of cetuximab to FOLFOX-4 was associated with a clinically significant increased chance of response (ORR = 61% v 37%; odds ratio = 2.54; P = .011) and a lower risk of disease progression (hazard ratio = 0.57; P = .0163) compared with FOLFOX-4 alone. Cetuximab plus FOLFOX-4 was generally well tolerated. CONCLUSION KRAS mutational status was shown to be a highly predictive selection criterion in relation to the treatment decision regarding the addition of cetuximab to FOLFOX-4 for previously untreated patients with metastatic colorectal cancer.
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Bokemeyer C, Bondarenko I, Hartmann JT, De Braud FG, Volovat C, Nippgen J, Stroh C, Celik I, Koralewski P. KRAS status and efficacy of first-line treatment of patients with metastatic colorectal cancer (mCRC) with FOLFOX with or without cetuximab: The OPUS experience. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4000] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bokemeyer C, Staroslawska E, Makhson A, Bondarenko I, Hartmann J, Shelygin Y, Kolesnik O, Volovat C, Zubel A, Koralewski P. 3004 ORAL Cetuximab plus 5-FU/FA/oxaliplatin (FOLFOX-4) in the first-line treatment of metastastic colorectal cancer (mCRC): a large-scale phase II study, OPUS. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70932-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bokemeyer C, Bondarenko I, Makhson A, Hartmann JT, Aparicio J, Zampino M, Donea S, Ludwig H, Zubel A, Koralewski P. Cetuximab plus 5-FU/FA/oxaliplatin (FOLFOX-4) versus FOLFOX-4 in the first-line treatment of metastatic colorectal cancer (mCRC): OPUS, a randomized phase II study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4035] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [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
4035 Background: FOLFOX-4 is a standard first-line treatment for patients (pts) with mCRC. The IgG1 monoclonal antibody cetuximab has proven activity in combination with cytotoxic chemotherapy. Excellent response rates (RRs) have been reported with first-line cetuximab and FOLFOX-4. This randomized, controlled study was conducted to compare RRs of FOLFOX-4 + cetuximab vs FOLFOX-4. Methods: Pts with previously untreated epidermal growth factor receptor (EGFR)-expressing mCRC not resectable with curative intent were eligible. They were randomized 1:1, stratified by ECOG performance status (PS) (0–1 vs 2), to either Group A (cetuximab 400 mg/m2 initial dose then 250 mg/m2/week plus FOLFOX-4 every 2 weeks [oxaliplatin 85 mg/m2 day (d) 1; FA 200 mg/m2 d1, 2; 5-FU 400 mg/m2 bolus + 600 mg/m2 infusion over 22 h, d1, 2]) or Group B (FOLFOX-4 only). The primary objective was the best confirmed RR assessed by independent review; secondary objectives were progression- free survival (PFS), overall survival (OS), the R0 resection rate after metastatic surgery of curative intent and safety. Results: Between July 2005 and March 2006, 337 pts were randomized and treated in more than 70 centers in Europe. 181 (53.7%) pts were male; the median age of all pts was 61.0 years [24–82]; 305 (90.5%) pts had an ECOG PS of 0 or 1, and 32 (9.5%) of 2. The best overall confirmed RR was 45.6% in A and 35.7% in B. For pts with ECOG PS 0–1, RR was 49.0% in A and 36.8% in B (Odds Ratio 1.648, 95%CI [1.043- 2.604]). PFS and OS results are not yet available. The most common grade 3/4 adverse events were neutropenia (27.6% in A; 31.5% in B), diarrhea (7.1 and 6.0%), leucopenia (7.1 and 5.4%) and rash (9.4%, in A only). Conclusions: The addition of cetuximab increased the RR of FOLFOX-4 in first-line treatment of mCRC. Grade 3/4 adverse events, with the exception of skin rash, were not significantly more frequent in the cetuximab arm. No significant financial relationships to disclose.
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Affiliation(s)
- C. Bokemeyer
- University Hospital Hamburg, Hamburg, Germany; City Clinical Hospital #4, Dnepropetrovsk, Ukraine; Moscow City Oncology Hospital #62, Moscow, Russian Federation; Universitätsklinikum Tübingen, Tübingen, Germany; Hospital Universitario La Fé, Valencia, Spain; Istituto Europeo di Oncologia, Milan, Italy; Institut Oncologic Al. Trestioreanu Bucuresti, Bucharest, Romania; Wilhelminenspital der Stadt Wien, Vienna, Austria; Merck KGaA, Darmstadt, Germany; Wojewódzki Szpital Specjalistyczny Oddziac, Krakow, Poland
| | - I. Bondarenko
- University Hospital Hamburg, Hamburg, Germany; City Clinical Hospital #4, Dnepropetrovsk, Ukraine; Moscow City Oncology Hospital #62, Moscow, Russian Federation; Universitätsklinikum Tübingen, Tübingen, Germany; Hospital Universitario La Fé, Valencia, Spain; Istituto Europeo di Oncologia, Milan, Italy; Institut Oncologic Al. Trestioreanu Bucuresti, Bucharest, Romania; Wilhelminenspital der Stadt Wien, Vienna, Austria; Merck KGaA, Darmstadt, Germany; Wojewódzki Szpital Specjalistyczny Oddziac, Krakow, Poland
| | - A. Makhson
- University Hospital Hamburg, Hamburg, Germany; City Clinical Hospital #4, Dnepropetrovsk, Ukraine; Moscow City Oncology Hospital #62, Moscow, Russian Federation; Universitätsklinikum Tübingen, Tübingen, Germany; Hospital Universitario La Fé, Valencia, Spain; Istituto Europeo di Oncologia, Milan, Italy; Institut Oncologic Al. Trestioreanu Bucuresti, Bucharest, Romania; Wilhelminenspital der Stadt Wien, Vienna, Austria; Merck KGaA, Darmstadt, Germany; Wojewódzki Szpital Specjalistyczny Oddziac, Krakow, Poland
| | - J. T. Hartmann
- University Hospital Hamburg, Hamburg, Germany; City Clinical Hospital #4, Dnepropetrovsk, Ukraine; Moscow City Oncology Hospital #62, Moscow, Russian Federation; Universitätsklinikum Tübingen, Tübingen, Germany; Hospital Universitario La Fé, Valencia, Spain; Istituto Europeo di Oncologia, Milan, Italy; Institut Oncologic Al. Trestioreanu Bucuresti, Bucharest, Romania; Wilhelminenspital der Stadt Wien, Vienna, Austria; Merck KGaA, Darmstadt, Germany; Wojewódzki Szpital Specjalistyczny Oddziac, Krakow, Poland
| | - J. Aparicio
- University Hospital Hamburg, Hamburg, Germany; City Clinical Hospital #4, Dnepropetrovsk, Ukraine; Moscow City Oncology Hospital #62, Moscow, Russian Federation; Universitätsklinikum Tübingen, Tübingen, Germany; Hospital Universitario La Fé, Valencia, Spain; Istituto Europeo di Oncologia, Milan, Italy; Institut Oncologic Al. Trestioreanu Bucuresti, Bucharest, Romania; Wilhelminenspital der Stadt Wien, Vienna, Austria; Merck KGaA, Darmstadt, Germany; Wojewódzki Szpital Specjalistyczny Oddziac, Krakow, Poland
| | - M. Zampino
- University Hospital Hamburg, Hamburg, Germany; City Clinical Hospital #4, Dnepropetrovsk, Ukraine; Moscow City Oncology Hospital #62, Moscow, Russian Federation; Universitätsklinikum Tübingen, Tübingen, Germany; Hospital Universitario La Fé, Valencia, Spain; Istituto Europeo di Oncologia, Milan, Italy; Institut Oncologic Al. Trestioreanu Bucuresti, Bucharest, Romania; Wilhelminenspital der Stadt Wien, Vienna, Austria; Merck KGaA, Darmstadt, Germany; Wojewódzki Szpital Specjalistyczny Oddziac, Krakow, Poland
| | - S. Donea
- University Hospital Hamburg, Hamburg, Germany; City Clinical Hospital #4, Dnepropetrovsk, Ukraine; Moscow City Oncology Hospital #62, Moscow, Russian Federation; Universitätsklinikum Tübingen, Tübingen, Germany; Hospital Universitario La Fé, Valencia, Spain; Istituto Europeo di Oncologia, Milan, Italy; Institut Oncologic Al. Trestioreanu Bucuresti, Bucharest, Romania; Wilhelminenspital der Stadt Wien, Vienna, Austria; Merck KGaA, Darmstadt, Germany; Wojewódzki Szpital Specjalistyczny Oddziac, Krakow, Poland
| | - H. Ludwig
- University Hospital Hamburg, Hamburg, Germany; City Clinical Hospital #4, Dnepropetrovsk, Ukraine; Moscow City Oncology Hospital #62, Moscow, Russian Federation; Universitätsklinikum Tübingen, Tübingen, Germany; Hospital Universitario La Fé, Valencia, Spain; Istituto Europeo di Oncologia, Milan, Italy; Institut Oncologic Al. Trestioreanu Bucuresti, Bucharest, Romania; Wilhelminenspital der Stadt Wien, Vienna, Austria; Merck KGaA, Darmstadt, Germany; Wojewódzki Szpital Specjalistyczny Oddziac, Krakow, Poland
| | - A. Zubel
- University Hospital Hamburg, Hamburg, Germany; City Clinical Hospital #4, Dnepropetrovsk, Ukraine; Moscow City Oncology Hospital #62, Moscow, Russian Federation; Universitätsklinikum Tübingen, Tübingen, Germany; Hospital Universitario La Fé, Valencia, Spain; Istituto Europeo di Oncologia, Milan, Italy; Institut Oncologic Al. Trestioreanu Bucuresti, Bucharest, Romania; Wilhelminenspital der Stadt Wien, Vienna, Austria; Merck KGaA, Darmstadt, Germany; Wojewódzki Szpital Specjalistyczny Oddziac, Krakow, Poland
| | - P. Koralewski
- University Hospital Hamburg, Hamburg, Germany; City Clinical Hospital #4, Dnepropetrovsk, Ukraine; Moscow City Oncology Hospital #62, Moscow, Russian Federation; Universitätsklinikum Tübingen, Tübingen, Germany; Hospital Universitario La Fé, Valencia, Spain; Istituto Europeo di Oncologia, Milan, Italy; Institut Oncologic Al. Trestioreanu Bucuresti, Bucharest, Romania; Wilhelminenspital der Stadt Wien, Vienna, Austria; Merck KGaA, Darmstadt, Germany; Wojewódzki Szpital Specjalistyczny Oddziac, Krakow, Poland
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Sowers MR, Greendale GA, Bondarenko I, Finkelstein JS, Cauley JA, Neer RM, Ettinger B. Endogenous hormones and bone turnover markers in pre- and perimenopausal women: SWAN. Osteoporos Int 2003; 14:191-7. [PMID: 12730778 DOI: 10.1007/s00198-002-1329-4] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.5] [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: 01/14/2002] [Accepted: 09/11/2002] [Indexed: 10/20/2022]
Abstract
We tested the hypothesis that higher serum osteocalcin and urinary N-telopeptide of type I collagen (NTx) concentrations would be found in women with increasing cycle irregularity or increased follicle stimulating hormone concentrations. We studied 2,375 pre- and early perimenopausal women from the Study of Women's Health Across the Nation (SWAN), aged 42-52 years, who self-identified their race/ethnic origin as African-American (28.3%), Caucasian (49.4%), Japanese (10.5%) or Chinese (11.8%). Outcome measures were serum osteocalcin, a measure of bone formation, and NTx, a measure of bone resorption. The explanatory variables were menopausal status, based on self-reported regularity of menstrual bleeding, and circulating endogenous hormone concentrations including estradiol (E(2)), testosterone (T), sex hormone binding globulin (SHBG) and follicle stimulating hormone (FSH) concentrations. Additionally, we evaluated the association of the bone turnover markers with the Free Androgen Index (FAI) and the Free Estradiol Index (FEI), ratios of total testosterone and estradiol concentrations to SHBG, respectively. Higher FSH concentrations were associated with higher NTx concentrations ( beta=0.003, partial r2=2.1%, p<0.0001), both before and after adjusting for other covariates (total explained variability of 9%). Higher FSH concentrations were also associated with higher osteocalcin concentrations ( beta=-0.216, partial r2=4.1%, p<0.0001, total explained variability of 15.4%). There were no significant associations of the bone turnover markers with other endogenous hormones, following adjustment for covariates. Mean osteocalcin and NTx values were not significantly different in premenopausal women compared to early perimenopausal women. In these pre- and early perimenopausal women, higher FSH concentrations, but not other serum reproductive hormone concentrations, are positively associated with greater bone turnover prior to the last menstrual period.
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Affiliation(s)
- M R Sowers
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA.
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Sowers MR, Finkelstein JS, Ettinger B, Bondarenko I, Neer RM, Cauley JA, Sherman S, Greendale GA. The association of endogenous hormone concentrations and bone mineral density measures in pre- and perimenopausal women of four ethnic groups: SWAN. Osteoporos Int 2003; 14:44-52. [PMID: 12577184 DOI: 10.1007/s00198-002-1307-x] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.0] [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] [Indexed: 10/26/2022]
Abstract
We evaluated bone mineral density (BMD), hormone concentrations and menstrual cycle status to test the hypothesis that greater variations in reproductive hormones and menstrual bleeding patterns in mid-aged women might engender an environment permissive for less bone. We studied 2336 women, aged 42-52 years, from the Study of Women's Health Across the Nation (SWAN) who self-identified as African-American (28.2%), Caucasian (49.9%), Japanese (10.5%) or Chinese (11.4%). Outcome measures were lumbar spine, femoral neck and total hip BMD by dual-energy X-ray densitometry (DXA). Explanatory variables were estradiol, testosterone, sex hormone binding globulin (SHBG) and follicle stimulating hormone (FSH) from serum collected in the early follicular phase of the menstrual cycle or menstrual status [premenopausal (menses in the 3 months prior to study entry without change in regularity) or early perimenopause (menstrual bleeding in the 3 months prior to study entry but some change in the regularity of cycles)]. Total testosterone and estradiol concentrations were indexed to SHBG for the Free Androgen Index (FAI) and the Free Estradiol Index (FEI). Serum logFSH concentrations were inversely correlated with BMD (r = -10 for lumbar spine [95% confidence interval (CI): -0.13, -0.06] and r = -0.08 for femoral neck (95% CI: -0.11, -0.05). Lumbar spine BMD values were approximately 0.5% lower for each successive FSH quartile. There were no significant associations of BMD with serum estradiol, total testosterone, FEI or FAI, respectively, after adjusting for covariates. BMD tended to be lower (p values = 0.009 to 0.06, depending upon the skeletal site) in women classified as perimenopausal versus premenopausal, after adjusting for covariates. Serum FSH but not serum estradiol, testosterone or SHBG were significantly associated with BMD in a multiethnic population of women classified as pre- versus perimenopausal, supporting the hypothesis that alterations in hormone environment are associated with BMD differences prior to the final menstrual period.
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Affiliation(s)
- M R Sowers
- Rm 3073, SPH-I Department of Epidemiology, School of Public Health, University of Michigan, 109 Observatory Street, Ann Arbor, MI 48109, USA
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Treiger B, Bondarenko I, Van Malderen H, Van Grieken R. Elucidating the composition of atmospheric aerosols through the combined hierarchical, non-hierarchical and fuzzy clustering of large electron probe microanalysis data sets. Anal Chim Acta 1995. [DOI: 10.1016/0003-2670(95)00405-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Treiger B, Bondarenko I, Van Espen P, Van Grieken R, Adams F. Classification of mineral particles by non-linear mapping of electron microprobe energy dispersive X-ray spectra. Analyst 1994. [DOI: 10.1039/an9941900971] [Citation(s) in RCA: 3] [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: 11/21/2022]
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Treiger B, Van Malderen H, Bondarenko I, Van Espen P, Van Grieken R. Studying aerosol samples by non-linear mapping of electron probe microanalysis data. Anal Chim Acta 1993. [DOI: 10.1016/0003-2670(93)80014-c] [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: 11/30/2022]
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Bondarenko I, Castaldini A, Cavallini A. The Recombination Activity of Dislocations in Deformed Silicon at Low Excitation Levels. ACTA ACUST UNITED AC 1993. [DOI: 10.1002/pssa.2211370213] [Citation(s) in RCA: 3] [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: 11/09/2022]
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