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Piringer G, Gruenberger T, Thaler J, Kührer I, Kaczirek K, Längle F, Viragos-Toth I, Amann A, Eisterer W, Függer R, Andel J, Pichler A, Stift J, Sölkner L, Gnant M, Öfner D. LM02 trial Perioperative treatment with panitumumab and FOLFIRI in patients with wild-type RAS, potentially resectable colorectal cancer liver metastases-a phase II study. Front Oncol 2023; 13:1231600. [PMID: 37621684 PMCID: PMC10446765 DOI: 10.3389/fonc.2023.1231600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 08/26/2023] Open
Abstract
Background Twenty percent of colorectal cancer liver metastases (CLMs) are initially resectable with a 5-year survival rate of 25%-40%. Perioperative folinic acid, 5-fluorouracil, oxaliplatin (FOLFOX) increases progression-free survival (PFS). In advanced disease, the addition of targeting therapies results in an overall survival (OS) advantage. The aim of this study was to evaluate panitumumab and FOLFIRI as perioperative therapy in resectable CLM. Methods Patients with previously untreated, wild-type Rat sarcoma virus (RAS), and resectable CLM were included. Preoperative four and postoperative eight cycles of panitumumab and folinic acid, 5-fluorouracil, irinotecan (FOLFIRI) were administered. Primary objectives were efficacy and safety. Secondary endpoints included PFS and OS. Results We enrolled 36 patients in seven centers in Austria (intention-to-treat analyses, 35 patients). There were 28 men and seven women, and the median age was 66 years. About 91.4% completed preoperative therapy and 82.9% underwent liver resection. The R0 resection rate was 82.7%. Twenty patients started and 12 patients completed postoperative chemotherapy. The objective radiological response rate after preoperative therapy was 65.7%. About 20% and 5.7% of patients had stable disease and progressive disease, respectively. The most common grade 3 adverse events were diarrhea, rash, and leukopenia during preoperative therapy. One patient died because of sepsis, and one had a pulmonary embolism grade 4. After surgery, two patients died because of hepatic failure. Most common grade 3 adverse events during postoperative therapy were skin toxicities/rash and leukopenia/neutropenia, and the two grade 4 adverse events were stroke and intestinal obstruction. Median PFS was 13.2 months. The OS rate at 12 and 24 months were 85.6% and 73.3%, respectively. Conclusions Panitumumab and FOLFIRI as perioperative therapy for resectable CLM result in a radiological objective response rate in 65.7% of patients with a manageable grade 3 diarrhea rate of 14.3%. Median PFS was 13.2 months, and the 24-month OS rate was 73.3%. These data are insufficient to widen the indication of panitumumab from the unresectable setting to the setting of resectable CLM.
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Affiliation(s)
- Gudrun Piringer
- Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Wels, Austria
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Thomas Gruenberger
- Department of Surgery, Clinic Favoriten, Hepato-Pancreato-Biliary Center, Health Network Vienna and Sigmund Freud University, Vienna, Austria
| | - Josef Thaler
- Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Wels, Austria
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Irene Kührer
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Klaus Kaczirek
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Friedrich Längle
- Department of Surgery, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
| | - Istvan Viragos-Toth
- Department of Surgery, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
| | - Arno Amann
- Department of Haematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Wolfgang Eisterer
- Department of Internal Medicine and Oncology, Klinikum Klagenfurt, Klagenfurt, Austria
| | - Reinhold Függer
- Department of General and Visceral Surgery, Congregation Hospital, Linz, Austria
| | - Johannes Andel
- Department of Internal Medicine II, Landeskrankenhaus Steyr, Steyr, Austria
| | - Angelika Pichler
- Department of Hematology and Oncology, Landeskrankenhaus Hochsteiermark, Leoben, Austria
| | - Judith Stift
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Lidija Sölkner
- Department of Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria
| | - Michael Gnant
- Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Dietmar Öfner
- Department of Visceral-, Transplant- and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
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Cepero A, Luque C, Cabeza L, Perazzoli G, Quiñonero F, Mesas C, Melguizo C, Prados J. Antibody-Functionalized Nanoformulations for Targeted Therapy of Colorectal Cancer: A Systematic Review. Int J Nanomedicine 2022; 17:5065-5080. [PMID: 36345508 PMCID: PMC9635983 DOI: 10.2147/ijn.s368814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/21/2022] [Indexed: 11/06/2022] Open
Abstract
The failure of chemotherapeutic treatment in colorectal cancer (CRC), the second most mortal cancer worldwide, is associated with several drug limitations, such as non-selective distribution, short half-life, and development of multiple resistances. One of the most promising strategies in CRC therapy is the development of delivery systems based on nanomaterials that can transport antitumor agents to the tumor site more efficiently, increasing accumulation within the tumor and thus the antitumor effect. In addition to taking advantage of the increased permeability and retention effect (EPR) of solid tumors, these nanoformulations can be conjugated with monoclonal antibodies that recognize molecular markers that are specifically over-expressed on CRC cells. Active targeting of nanoformulations reduces the adverse effects associated with the cytotoxic activity of drugs in healthy tissues, which will be of interest for improving the quality of life of cancer patients in the future. This review focuses on in vitro and in vivo studies of drug delivery nanoformulations functionalized with monoclonal antibodies for targeted therapy of CRC.
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Affiliation(s)
- Ana Cepero
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, 18100, Spain,Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, 18071, Spain,Biosanitary Institute of Granada (ibs.GRANADA), SAS-University of Granada, Granada, 18014, Spain
| | - Cristina Luque
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, 18100, Spain,Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, 18071, Spain,Biosanitary Institute of Granada (ibs.GRANADA), SAS-University of Granada, Granada, 18014, Spain
| | - Laura Cabeza
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, 18100, Spain,Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, 18071, Spain,Biosanitary Institute of Granada (ibs.GRANADA), SAS-University of Granada, Granada, 18014, Spain
| | - Gloria Perazzoli
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, 18100, Spain,Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, 18071, Spain
| | - Francisco Quiñonero
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, 18100, Spain,Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, 18071, Spain,Biosanitary Institute of Granada (ibs.GRANADA), SAS-University of Granada, Granada, 18014, Spain
| | - Cristina Mesas
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, 18100, Spain,Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, 18071, Spain,Biosanitary Institute of Granada (ibs.GRANADA), SAS-University of Granada, Granada, 18014, Spain
| | - Consolación Melguizo
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, 18100, Spain,Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, 18071, Spain,Biosanitary Institute of Granada (ibs.GRANADA), SAS-University of Granada, Granada, 18014, Spain,Correspondence: Consolación Melguizo, Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, 18100, Spain, Tel +34-958-249833, Email
| | - Jose Prados
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, 18100, Spain,Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, 18071, Spain,Biosanitary Institute of Granada (ibs.GRANADA), SAS-University of Granada, Granada, 18014, Spain
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Wiśniewska M, Wiśniewski M, Lewandowska MA. Personalized and targeted therapies. PHYSICAL SCIENCES REVIEWS 2021. [DOI: 10.1515/psr-2019-0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Biomarker is defined as indicator of normal or pathogenic biological process or response to an intervention or exposure. There are several categories of biomarkers but predictive biomarkers play the most important role in the treatment of neoplasms. In some cancers there may be more than one potential biomarker, and their identification determines the treatment of the patient. Identification of predictive biomarkers allows the development of novel targeted therapies resulting in tailored treatment. In this chapter we discuss most important predictive biomarkers used in contemporary oncology for which there is approved therapies.
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Affiliation(s)
- Magdalena Wiśniewska
- Department of Oncology and Brachytherapy , Collegium Medicum Bydgoszcz, Nicolaus Copernicus University , Toruń , Poland
- Department of Clinical Oncology , Oncology Centre , Bydgoszcz , Poland
| | - Michał Wiśniewski
- Outpatient Chemotherapy Department , Oncology Centre , Bydgoszcz , Poland
| | - Marzena A. Lewandowska
- Department of Thoracic Surgery and Tumors , Collegium Medicum Bydgoszcz, Nicolaus Copernicus University , Toruń , Poland
- Oncology Centre , Bydgoszcz , Poland
- Department of Molecular Oncology and Genetics , Innovative Medical Forum Oncology Centre , Bydgoszcz , Poland
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Irinotecan-Still an Important Player in Cancer Chemotherapy: A Comprehensive Overview. Int J Mol Sci 2020; 21:ijms21144919. [PMID: 32664667 PMCID: PMC7404108 DOI: 10.3390/ijms21144919] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/09/2020] [Accepted: 07/11/2020] [Indexed: 02/06/2023] Open
Abstract
Irinotecan has been used in the treatment of various malignancies for many years. Still, the knowledge regarding this drug is expanding. The pharmacogenetics of the drug is the crucial component of response to irinotecan. Furthermore, new formulations of the drug are introduced in order to better deliver the drug and avoid potentially life-threatening side effects. Here, we give a comprehensive overview on irinotecan’s molecular mode of action, metabolism, pharmacogenetics, and toxicity. Moreover, this article features clinically used combinations of the drug with other anticancer agents and introduces novel formulations of drugs (e.g., liposomal formulations, dendrimers, and nanoparticles). It also outlines crucial mechanisms of tumor cells’ resistance to the active metabolite, ethyl-10-hydroxy-camptothecin (SN-38). We are sure that the article will constitute an important source of information for both new researchers in the field of irinotecan chemotherapy and professionals or clinicians who are interested in the topic.
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