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Mirhadi S, Zhang W, Pham NA, Karimzadeh F, Pintilie M, Tong J, Taylor P, Krieger J, Pitcher B, Sykes J, Wybenga-Groot L, Fladd C, Xu J, Wang T, Cabanero M, Li M, Weiss J, Sakashita S, Zaslaver O, Yu M, Caudy AA, St-Pierre J, Hawkins C, Kislinger T, Liu G, Shepherd FA, Tsao MS, Moran MF. Mitochondrial Aconitase ACO2 Links Iron Homeostasis with Tumorigenicity in Non-Small Cell Lung Cancer. Mol Cancer Res 2023; 21:36-50. [PMID: 36214668 PMCID: PMC9808373 DOI: 10.1158/1541-7786.mcr-22-0163] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 03/01/2022] [Revised: 08/08/2022] [Accepted: 10/03/2022] [Indexed: 02/03/2023]
Abstract
The ability of a patient tumor to engraft an immunodeficient mouse is the strongest known independent indicator of poor prognosis in early-stage non-small cell lung cancer (NSCLC). Analysis of primary NSCLC proteomes revealed low-level expression of mitochondrial aconitase (ACO2) in the more aggressive, engrafting tumors. Knockdown of ACO2 protein expression transformed immortalized lung epithelial cells, whereas upregulation of ACO2 in transformed NSCLC cells inhibited cell proliferation in vitro and tumor growth in vivo. High level ACO2 increased iron response element binding protein 1 (IRP1) and the intracellular labile iron pool. Impaired cellular proliferation associated with high level ACO2 was reversed by treatment of cells with an iron chelator, whereas increased cell proliferation associated with low level ACO2 was suppressed by treatment of cells with iron. Expression of CDGSH iron-sulfur (FeS) domain-containing protein 1 [CISD1; also known as mitoNEET (mNT)] was modulated by ACO2 expression level and inhibition of mNT by RNA interference or by treatment of cells with pioglitazone also increased iron and cell death. Hence, ACO2 is identified as a regulator of iron homeostasis and mNT is implicated as a target in aggressive NSCLC. IMPLICATIONS FeS cluster-associated proteins including ACO2, mNT (encoded by CISD1), and IRP1 (encoded by ACO1) are part of an "ACO2-Iron Axis" that regulates iron homeostasis and is a determinant of a particularly aggressive subset of NSCLC.
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Affiliation(s)
- Shideh Mirhadi
- Program in Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Wen Zhang
- Program in Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Nhu-An Pham
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | | | - Melania Pintilie
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jiefei Tong
- Program in Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Paul Taylor
- Program in Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jonathan Krieger
- SPARC BioCentre, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bethany Pitcher
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jenna Sykes
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | | | - Christopher Fladd
- SPARC BioCentre, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jing Xu
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Tao Wang
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Michael Cabanero
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Ming Li
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jessica Weiss
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Shingo Sakashita
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Olga Zaslaver
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Man Yu
- Program in Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Amy A. Caudy
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Julie St-Pierre
- Department of Biochemistry, Rosalind and Morris Goodman Cancer Centre, McGill University, Montreal, Québec, Canada.,Department of Biochemistry, Microbiology, and Immunology and Ottawa Institute of Systems Biology, University of Ottawa, Ottawa, Ontario, Canada
| | - Cynthia Hawkins
- Program in Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Thomas Kislinger
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Geoffrey Liu
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, Division of Medical Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Frances A. Shepherd
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Medicine, Division of Medical Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Ming-Sound Tsao
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathology, University of Toronto, Toronto, Ontario, Canada.,Corresponding Authors: Michael F. Moran, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada. Phone: 647-235-6435; E-mail: ; and Ming-Sound Tsao, Princess Margaret Cancer Research Tower, 101 College Street, Toronto, ON M5G 1L7, Canada. Phone: 416-340-4737; E-mail:
| | - Michael F. Moran
- Program in Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,SPARC BioCentre, Hospital for Sick Children, Toronto, Ontario, Canada.,Corresponding Authors: Michael F. Moran, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada. Phone: 647-235-6435; E-mail: ; and Ming-Sound Tsao, Princess Margaret Cancer Research Tower, 101 College Street, Toronto, ON M5G 1L7, Canada. Phone: 416-340-4737; E-mail:
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Fan Y, Drilon A, Chiu CH, Bowles D, Loong H, Siena S, Goto K, Krzakowski M, Ahn MJ, Murakami H, Dziadziuszko R, Zeuner H, Pitcher B, Cheick D, Krebs M. MA13.04 Entrectinib in Patients with ROS1 Fusion-Positive (ROS1-fp) NSCLC: Updated Efficacy and Safety Analysis. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.150] [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: 11/26/2022]
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Krzakowski MJ, Lu S, Cousin S, Smit EF, Springfeld C, Goto K, Garrido P, Chung CH, Lin JJ, Bray VJ, Pitcher B, Zeuner H, Patel S, Bordogna W, Gelderblom H. Updated analysis of the efficacy and safety of entrectinib in patients (pts) with locally advanced/metastatic NTRK fusion-positive ( NTRK-fp) solid tumors. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.3099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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
3099 Background: NTRK gene fusions, coding for chimeric TRK proteins, are oncogenic drivers in many solid tumors. In an integrated analysis of three phase 1/2 trials (ALKA-372-001 [EudraCT 2012-000148-88]; STARTRK-1 [NCT02097810]; STARTRK-2 [NCT02568267]), entrectinib, a potent CNS-active TRK inhibitor, showed durable systemic and intracranial responses in pts with NTRK-fp solid tumors. We report updated data from a larger cohort with longer follow-up (clinical cutoff 2 Aug 2021). Methods: Pts with locally advanced/metastatic NTRK-fp solid tumors and ≥12 months’ follow-up from first tumor assessment were efficacy evaluable. The safety cohort also included pts from TAPISTRY (NCT04589845). Tumor responses were assessed by blinded independent central review (BICR) per RECIST v1.1 at Week 4 and every 8 weeks thereafter. Primary endpoints: objective response rate (ORR) and duration of response (DoR). Progression-free survival (PFS), overall survival (OS), intracranial (IC)-ORR and safety were also assessed. Results: The efficacy-evaluable cohort comprised 150 adults (vs 121 previously) with 17 different solid tumor types. Median age was 58.5 years; 91% of pts had ECOG PS 0–1 and 37% had received ≥2 prior lines of therapy. Median survival follow-up was 30.6 months. ORR was 61.3% (n = 92/150; 95% CI: 53.1–69.2), including 25 complete responses. Responses were observed in all tumor types with n>1 (Table). Median DoR, PFS and OS were 20.0 months (95% CI 13.2–31.1), 13.8 months (95% CI 10.1–20.0), and 37.1 months (95% CI 27.2–not estimable [NE]), respectively. In pts with and without investigator-assessed baseline CNS metastases (n = 31 / n = 119), ORR was 61.3% (95% CI 42.2–78.2) and 61.3% (95% CI 52.0–70.1) respectively. IC-ORR was 69.2% (n = 9/13) in pts with BICR-assessed measurable CNS metastases; median IC-DoR was 17.2 months (7.4–NE). In the safety population (N = 235: all treated pts), most treatment-related adverse events (TRAEs) were grade 1/2 and not serious; the most frequent were dysgeusia (36.6%), diarrhea (29.8%) and weight increase (28.5%). TRAEs led to dose interruption, reduction and discontinuation in 32.8%, 24.3% and 7.2% of pts, respectively. Conclusions: In this updated analysis, entrectinib continued to demonstrate deep and durable responses and was well tolerated in pts with NTRK-fp solid tumors with or without baseline CNS metastases. Clinical trial information: STARTRK-2 [NCT02568267]. [Table: see text]
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Affiliation(s)
- Maciej Jerzy Krzakowski
- Lung and Thoracic Cancer Department, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Shun Lu
- Department of Medical Oncology, Shanghai Chest Hospital, Jiao Tong University, Shanghai, China
| | - Sophie Cousin
- Early Phase Clinical Trials Unit and Thoracic Unit, Institut Bergonié, Bordeaux, France
| | - Egbert F. Smit
- Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Christoph Springfeld
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Pilar Garrido
- Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
| | | | | | - Victoria J. Bray
- Medical Oncology Department, Liverpool Hospital, Liverpool, NSW, Australia
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Demetri GD, De Braud F, Drilon A, Siena S, Patel MR, Cho BC, Liu SV, Ahn MJ, Chiu CH, Lin JJ, Goto K, Lee J, Bazhenova L, John T, Fakih M, Chawla SP, Dziadziuszko R, Seto T, Heinzmann S, Pitcher B, Chen D, Wilson TR, Rolfo C. Correction: Updated Integrated Analysis of the Efficacy and Safety of Entrectinib in Patients with NTRK Fusion-Positive Solid Tumors. Clin Cancer Res 2022; 28:2196. [PMID: 35553647 DOI: 10.1158/1078-0432.ccr-22-1108] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Demetri GD, De Braud F, Drilon A, Siena S, Patel MR, Cho BC, Liu SV, Ahn MJ, Chiu CH, Lin JJ, Goto K, Lee J, Bazhenova L, John T, Fakih M, Chawla SP, Dziadziuszko R, Seto T, Heinzmann S, Pitcher B, Chen D, Wilson TR, Rolfo C. Updated Integrated Analysis of the Efficacy and Safety of Entrectinib in Patients With NTRK Fusion-Positive Solid Tumors. Clin Cancer Res 2022; 28:1302-1312. [PMID: 35144967 PMCID: PMC9365368 DOI: 10.1158/1078-0432.ccr-21-3597] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [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: 10/08/2021] [Revised: 11/25/2021] [Accepted: 01/20/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Entrectinib potently inhibits tropomyosin receptor kinases (TRKAs)/B/C and ROS1, and previously induced deep [objective response rate (ORR) 57.4%] and durable [median duration of response (DoR) 10.4 months] responses in adults with NTRK fusion-positive solid tumors from three phase I/II trials. This article expands prior reports with additional patients and longer follow-up. PATIENTS AND METHODS Patients with locally advanced/metastatic NTRK fusion-positive solid tumors and ≥12 months' follow-up were included. Primary endpoints were ORR and DoR by blinded independent central review (BICR); secondary endpoints included progression-free survival (PFS), intracranial efficacy, and safety. The safety-evaluable populations included all patients who had received ≥1 entrectinib dose. RESULTS At clinical cut-off (August 31, 2020), the efficacy-evaluable population comprised 121 adults with 14 tumor types and ≥30 histologies. Median follow-up was 25.8 months; 61.2% of patients had a complete (n = 19) or partial response (n = 55). Median DoR was 20.0 months [95% confidence interval (CI), 13.0-38.2]; median PFS was 13.8 months (95% CI, 10.1-19.9). In 11 patients with BICR-assessed measurable central nervous system (CNS) disease, intracranial ORR was 63.6% (95% CI, 30.8-89.1) and median intracranial DoR was 22.1 (95% CI, 7.4-not estimable) months. The safety profile of entrectinib in adults and pediatric patients was aligned with previous reports. Most treatment-related adverse events (TRAEs) were grade 1/2 and manageable/reversible with dose modifications. TRAE-related discontinuations occurred in 8.3% of patients. CONCLUSIONS With additional clinical experience, entrectinib continues to demonstrate durable systemic and intracranial responses and can address the unmet need of a CNS-active treatment in patients with NTRK fusion-positive solid tumors.
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Affiliation(s)
- George D. Demetri
- Dana-Farber Cancer Institute and Ludwig Center at Harvard Medical School, Boston, Massachusetts
| | - Filippo De Braud
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Alexander Drilon
- Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, New York
| | - Salvatore Siena
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy,Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Manish R. Patel
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | | | | | - Myung-Ju Ahn
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chao-Hua Chiu
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Koichi Goto
- National Cancer Center Hospital East, Kashiwa, Japan
| | - Jeeyun Lee
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | - Thomas John
- Peter MacCallum Cancer Center, and Olivia Newton-John Cancer Centre, Austin Health, Melbourne, Australia
| | - Marwan Fakih
- City of Hope Comprehensive Cancer Center, Duarte, California
| | | | - Rafal Dziadziuszko
- Department of Oncology and Radiotherapy and Early Clinical Trials Unit, Medical University of Gdansk, Gdansk, Poland
| | - Takashi Seto
- National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | | | - David Chen
- Genentech Inc., South San Francisco, California
| | | | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York.,Corresponding Author: Christian Rolfo, Center for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1079, New York, NY 10029. Phone: 212-842-7227; E-mail:
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Drilon A, Chiu CH, Fan Y, Cho BC, Lu S, Ahn MJ, Krebs MG, Liu SV, John T, Otterson GA, Tan DS, Patil T, Dziadziuszko R, Massarelli E, Seto T, Doebele RC, Pitcher B, Kurtsikidze N, Heinzmann S, Siena S. Long-Term Efficacy and Safety of Entrectinib in ROS1 Fusion-Positive Non-Small Cell Lung Cancer. JTO Clin Res Rep 2022; 3:100332. [PMID: 35663414 PMCID: PMC9160474 DOI: 10.1016/j.jtocrr.2022.100332] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Alexander Drilon
- Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, New York
| | - Chao-Hua Chiu
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yun Fan
- Zhejiang Cancer Hospital, Hangzhou, People’s Republic of China
| | - Byoung Chul Cho
- Division of Medical Oncology, Yonsei Cancer Center, Seoul, Republic of Korea
| | - Shun Lu
- Department of Medical Oncology, Shanghai Lung Cancer Center, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Myung-Ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Matthew G. Krebs
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and The Christie National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | | | - Thomas John
- Department of Medical Oncology, Peter MacCallum Cancer Center, and Olivia Newton-John Cancer Centre, Austin Health, Melbourne, Australia
| | - Gregory A. Otterson
- Arthur G. James Cancer Hospital, and Richard J. Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - Daniel S.W. Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Duke–National University of Singapore (NUS) Medical School, Singapore
| | - Tejas Patil
- Division of Medical Oncology, Department of Medicine, University of Colorado, Aurora, Colorado
| | - Rafal Dziadziuszko
- Department of Oncology and Radiotherapy and Early Clinical Trials Center, Medical University of Gdansk, Gdansk, Poland
| | - Erminia Massarelli
- Department of Medical Oncology & Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Takashi Seto
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Robert C. Doebele
- Division of Medical Oncology, Department of Medicine, University of Colorado, Aurora, Colorado
| | | | | | - Sebastian Heinzmann
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Salvatore Siena
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Corresponding author. Address for correspondence: Salvatore Siena, MD, Department of Oncology and Hemato-Oncology, Università degli Studi di Milano (La Statale), Ospedale Niguarda, Piazza Ospedale Maggiore 2, 20146 Milano, Italy.
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Gogas H, Dréno B, Larkin J, Demidov L, Stroyakovskiy D, Eroglu Z, Francesco Ferrucci P, Pigozzo J, Rutkowski P, Mackiewicz J, Rooney I, Voulgari A, Troutman S, Pitcher B, Guo Y, Yan Y, Castro M, Mulla S, Flaherty K, Arance A. Cobimetinib plus atezolizumab in BRAF V600 wild-type melanoma: primary results from the randomized phase III IMspire170 study. Ann Oncol 2020; 32:384-394. [PMID: 33309774 DOI: 10.1016/j.annonc.2020.12.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Emerging data suggest that the combination of MEK inhibitors and immunotherapeutic agents may result in improved efficacy in melanoma. We evaluated whether combining MEK inhibition and immune checkpoint inhibition was more efficacious than immune checkpoint inhibition alone in patients with previously untreated BRAFV600 wild-type advanced melanoma. PATIENTS AND METHODS IMspire170 was an international, randomized, open-label, phase III study. Patients were randomized 1 : 1 to receive cobimetinib (60 mg, days 1-21) plus anti-programmed death-ligand 1 atezolizumab (840 mg every 2 weeks) in 28-day cycles or anti-programmed death-1 pembrolizumab (200 mg every 3 weeks) alone until loss of clinical benefit, unacceptable toxicity, or consent withdrawal. The primary outcome was progression-free survival (PFS), assessed by an independent review committee in the intention-to-treat population. RESULTS Between 11 December 2017, and 29 January 2019, 446 patients were randomized to receive cobimetinib plus atezolizumab (n = 222) or pembrolizumab (n = 224). Median follow-up was 7.1 months [interquartile range (IQR) 4.8-9.9] for cobimetinib plus atezolizumab and 7.2 months (IQR 4.9-10.1) for pembrolizumab. Median PFS was 5.5 months [95% confidence interval (CI) 3.8-7.2] with cobimetinib plus atezolizumab versus 5.7 months (95% CI 3.7-9.6) with pembrolizumab [stratified hazard ratio 1.15 (95% CI 0.88-1.50); P = 0.30]. Hazard ratios for PFS were consistent across prespecified subgroups. In exploratory biomarker analyses, higher tumor mutational burden was associated with improved clinical outcomes in both treatment arms. The most common grade 3-5 adverse events (AEs) were increased blood creatine phosphokinase (10.0% with cobimetinib plus atezolizumab versus 0.9% with pembrolizumab), diarrhea (7.7% versus 1.9%), rash (6.8% versus 0.9%), hypertension (6.4% versus 3.7%), and dermatitis acneiform (5.0% versus 0). Serious AEs occurred in 44.1% of patients with cobimetinib plus atezolizumab and 20.8% with pembrolizumab. CONCLUSION Cobimetinib plus atezolizumab did not improve PFS compared with pembrolizumab monotherapy in patients with BRAFV600 wild-type advanced melanoma.
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Affiliation(s)
- H Gogas
- First Department of Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
| | - B Dréno
- Dermatology Department, CHU Nantes, CIC 1413, CRCINA, University Nantes, Nantes, France
| | - J Larkin
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - L Demidov
- N.N. Blokhin Russian Cancer Research Center, Ministry of Health, Moscow, Russia
| | - D Stroyakovskiy
- Moscow City Oncology Hospital #62 of Moscow Healthcare Department, Moscow Oblast, Russia
| | - Z Eroglu
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | | | - J Pigozzo
- Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - J Mackiewicz
- Department of Medical and Experimental Oncology, Poznan University of Medical Sciences, and Department of Diagnostics and Cancer Immunology, Greater Poland Cancer Center, Poznan, Poland
| | - I Rooney
- Genentech, Inc., South San Francisco, USA
| | - A Voulgari
- Roche Products Ltd, Welwyn Garden City, UK
| | - S Troutman
- Genentech, Inc., South San Francisco, USA
| | - B Pitcher
- Hoffmann-La Roche Ltd., Mississauga, Canada
| | - Y Guo
- Genentech, Inc., South San Francisco, USA
| | - Y Yan
- Genentech, Inc., South San Francisco, USA
| | - M Castro
- Genentech, Inc., South San Francisco, USA
| | - S Mulla
- Hoffmann-La Roche Ltd., Mississauga, Canada
| | - K Flaherty
- Massachusetts General Hospital Cancer Center, Boston, USA
| | - A Arance
- Department of Medical Oncology and IDIBAPS, Hospital Clínic Barcelona, Barcelona, Spain
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Krebs M, De Braud F, Siena S, Drilon A, Doebele R, Patel M, Cho B, Liu S, Ahn MJ, Chiu CH, Farago A, Lin CC, Karapetis C, Li YC, Barlesi F, Simmons B, Pitcher B, Dziadziuszko R. 1287P Efficacy and safety of entrectinib in locally advanced/metastatic ROS1 fusion-positive NSCLC: An updated integrated analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1601] [Citation(s) in RCA: 2] [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: 10/23/2022] Open
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Rolfo CD, De Braud FG, Doebele RC, Drilon AE, Siena S, Patel M, Cho BC, Liu SV, Ahn MJ, Chiu CH, Farago AF, Goto K, Lee J, Bazhenova L, John T, Fakih M, Simmons BP, Pitcher B, Huang X, Demetri GD. Efficacy and safety of entrectinib in patients (pts) with NTRK-fusion positive (NTRK-fp) solid tumors: An updated integrated analysis. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.3605] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
3605 Background: NTRK gene fusions lead to transcription of chimeric TRK proteins with overexpressed kinase function. Entrectinib is a potent inhibitor of TRKA/B/C. In phase 1/2 studies (ALKA, STARTRK-1, STARTRK-2; EudraCT 2012-000148-88; NCT02097810; NCT02568267), entrectinib was effective in pts with NTRK-fp solid tumors. We present updated data in a larger population with longer follow-up. Methods: In this integrated analysis of adult pts from 3 phase 1/2 trials (data cut-off 31 Oct 2018), tumors were assessed by blinded independent central review (BICR) with RECIST v1.1 (end of cycle 1; then every 8 wks). Primary endpoints were overall response rate (ORR) and duration of response (DOR). Secondary endpoints were progression-free survival (PFS), overall survival (OS), efficacy in pts with/without baseline CNS disease, and safety. Results: There were 74 evaluable pts with advanced/metastatic NTRK-fp solid tumors (Table). Median duration of survival follow-up in all pts was 14.2 mo (range 0.1–29.7). BICR ORR was 63.5% (95% CI 51.5–74.4), with 5 complete responses (6.8%). Median BICR DOR was 12.9 mo (95% CI 9.3–NE); median BICR PFS was 11.2 mo (95% CI 8.0–15.7); median OS was 23.9 mo (16.0–NE). In pts with no baseline CNS disease (investigator-assessed; n=55), BICR ORR was 65.5% (95% CI 51.4–77.8) and median BICR DOR in responders was 12.9 mo (95% CI 9.3–NE). In pts with baseline CNS disease (investigator-assessed; n=19), BICR ORR was 57.9% (95% CI 33.5–79.8) and median BICR DOR in responders was 6.0 mo (95% CI 4.2–NE). Safety was in line with that previously reported; the most common ≥grade 3 treatment-related AEs were weight gain (8, 7.1%), anemia (8, 7.1%), and fatigue (7, 6.2%). Conclusions: In this updated analysis, including more pts and longer follow-up, entrectinib continued to demonstrate clinically meaningful responses in pts with NTRK-fp solid tumors, with and without baseline CNS disease. Clinical trial information: NCT02097810, NCT02568267 . [Table: see text]
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Affiliation(s)
| | - Filippo G. De Braud
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Salvatore Siena
- Grande Ospedale Metropolitano Niguarda, and Università degli Studi di Milano, Milan, Italy
| | - Manish Patel
- University of Minnesota, Department of Medicine, Minneapolis, MN
| | - Byoung Chul Cho
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Myung-Ju Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chao-Hua Chiu
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Koichi Goto
- National Cancer Center Hospital East, Kashiwa, Japan
| | - Jeeyun Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - Tom John
- Olivia Newton-John Cancer Research Institute, Austin Hospital, Heidelberg, Australia
| | - Marwan Fakih
- City of Hope National Medical Center, Duarte, CA
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10
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Subbiah V, Puzanov I, Blay JY, Chau I, Lockhart AC, Raje NS, Wolf J, Baselga J, Meric-Bernstam F, Roszik J, Diamond EL, Riely GJ, Sherman EJ, Riehl T, Pitcher B, Hyman DM. Pan-Cancer Efficacy of Vemurafenib in BRAF V600-Mutant Non-Melanoma Cancers. Cancer Discov 2020; 10:657-663. [PMID: 32029534 PMCID: PMC7196502 DOI: 10.1158/2159-8290.cd-19-1265] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 01/30/2023]
Abstract
BRAF V600 mutations occur in a wide range of tumor types, and RAF inhibition has become standard in several of these cancers. Despite this progress, BRAF V600 mutations have historically been considered a clear demonstration of tumor lineage context-dependent oncogene addiction, based predominantly on the insensitivity to RAF inhibition in colorectal cancer. However, the true broader activity of RAF inhibition pan-cancer remains incompletely understood. To address this, we conducted a multicohort "basket" study of the BRAF inhibitor vemurafenib in non-melanoma BRAF V600 mutation-positive solid tumors. In total, 172 patients with 26 unique cancer types were treated, achieving an overall response rate of 33% and median duration of response of 13 months. Responses were observed in 13 unique cancer types, including historically treatment-refractory tumor types such as cholangiocarcinoma, sarcoma, glioma, neuroendocrine carcinoma, and salivary gland carcinomas. Collectively, these data demonstrate that single-agent BRAF inhibition has broader clinical activity than previously recognized. SIGNIFICANCE: These data suggest that BRAF V600 mutations lead to oncogene addiction and are clinically actionable in a broad range of non-melanoma cancers, including tumor types in which RAF inhibition is not currently considered standard of care.See related commentary by Ribas and Lo, p. 640.This article is highlighted in the In This Issue feature, p. 627.
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Affiliation(s)
- Vivek Subbiah
- The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Igor Puzanov
- Roswell Park Cancer Institute, Buffalo, New York
| | | | - Ian Chau
- Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - A Craig Lockhart
- University of Miami, Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Noopur S Raje
- Massachusetts General Hospital, Boston, Massachusetts
| | | | - José Baselga
- Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
| | | | - Jason Roszik
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Eli L Diamond
- Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
| | - Gregory J Riely
- Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
| | - Eric J Sherman
- Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
| | - Todd Riehl
- Genentech, Inc., South San Francisco, California
| | | | - David M Hyman
- Memorial Sloan Kettering Cancer Center, New York, New York.
- Weill Cornell Medical College, New York, New York
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11
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Diamond EL, Subbiah V, Lockhart AC, Blay JY, Puzanov I, Chau I, Raje NS, Wolf J, Erinjeri JP, Torrisi J, Lacouture M, Elez E, Martínez-Valle F, Durham B, Arcila ME, Ulaner G, Abdel-Wahab O, Pitcher B, Makrutzki M, Riehl T, Baselga J, Hyman DM. Vemurafenib for BRAF V600-Mutant Erdheim-Chester Disease and Langerhans Cell Histiocytosis: Analysis of Data From the Histology-Independent, Phase 2, Open-label VE-BASKET Study. JAMA Oncol 2019; 4:384-388. [PMID: 29188284 DOI: 10.1001/jamaoncol.2017.5029] [Citation(s) in RCA: 234] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance The histiocytic neoplasms Erdheim-Chester disease (ECD) and Langerhans cell histiocytosis (LCH) are highly enriched for BRAF V600 mutations and have been previously shown to be responsive to treatment with vemurafenib, an inhibitor of the BRAF V600 kinase. However, the long-term efficacy and safety of prolonged vemurafenib use in these patients are not defined. Here we analyze the final efficacy and safety data for vemurafenib in patients with ECD and LCH enrolled in the VE-BASKET study. Objective To determine the efficacy and safety of vemurafenib in adults with ECD or LCH enrolled in the VE-BASKET study. Design, Setting, and Participants The VE-BASKET study was an open-label, nonrandomized, multicohort study for patients with nonmelanoma cancers harboring the BRAF V600 mutation. Patients with BRAF V600-mutant ECD or LCH were enrolled in an "other solid tumor" cohort of the VE-BASKET study, and they were enrolled in the present study. Interventions Patients received vemurafenib, 960 mg, twice daily continuously until disease progression, study withdrawal, or occurrence of intolerable adverse effects. Main Outcomes and Measures The primary end point was confirmed objective response rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1). Secondary end points included progression-free survival (PFS), overall survival (OS), metabolic response by modified positron-emission tomography (PET) Response Criteria in Solid Tumors (PERCIST) using 18F-fluorodeoxyglucose (FDG)-PET/computed tomography (CT), and safety. Results A total of 26 patients from the VE-BASKET trial (22 with ECD, 4 with LCH) were included in the present study (14 women and 12 men; median age, 61 years; age range, 51-74 years). The confirmed ORR was 61.5% (95% CI, 40.6%-79.8%) in the overall cohort and 54.5% (95% CI, 32.2%-75.6%) in patients with ECD. All evaluable patients achieved stable disease or better. The median PFS and OS had not been reached in the overall cohort at study closure despite a median follow-up of 28.8 months; 2-year PFS was 86% (95% CI, 72%-100%), and 2-year OS was 96% (95% CI, 87%-100%). All 15 patients evaluated by FDG-PET/CT achieved a metabolic response, including 12 patients (80%) with a complete metabolic response. The most common adverse events (AEs) in the overall cohort included arthralgia, maculopapular rash, fatigue, alopecia, prolonged QT interval, skin papilloma, and hyperkeratosis. Hypertension and dermatologic AEs occurred at higher rates than those reported in metastatic melanoma. Conclusions and Relevance In this study, vemurafenib had prolonged efficacy in patients with BRAF V600-mutant ECD and LCH and warrants consideration as a new standard of care for these patients.
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Affiliation(s)
- Eli L Diamond
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | | | - A Craig Lockhart
- Sylvester Comprehensive Cancer Center and University of Miami Miller School of Medicine, Miami
| | | | - Igor Puzanov
- Roswell Park Cancer Institute, Buffalo, New York
| | - Ian Chau
- Royal Marsden Hospital, Sutton, Surrey, England
| | | | | | - Joseph P Erinjeri
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Jean Torrisi
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Mario Lacouture
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Elena Elez
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO) and Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ferran Martínez-Valle
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO) and Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Benjamin Durham
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Maria E Arcila
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Gary Ulaner
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Omar Abdel-Wahab
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | | | | | - Todd Riehl
- Genentech Inc, South San Francisco, California
| | - José Baselga
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - David M Hyman
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
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12
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Hellmann MD, Kim TW, Lee CB, Goh BC, Miller WH, Oh DY, Jamal R, Chee CE, Chow LQM, Gainor JF, Desai J, Solomon BJ, Das Thakur M, Pitcher B, Foster P, Hernandez G, Wongchenko MJ, Cha E, Bang YJ, Siu LL, Bendell J. Phase Ib study of atezolizumab combined with cobimetinib in patients with solid tumors. Ann Oncol 2019; 30:1134-1142. [PMID: 30918950 PMCID: PMC6931236 DOI: 10.1093/annonc/mdz113] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Preclinical evidence suggests that MEK inhibition promotes accumulation and survival of intratumoral tumor-specific T cells and can synergize with immune checkpoint inhibition. We investigated the safety and clinical activity of combining a MEK inhibitor, cobimetinib, and a programmed cell death 1 ligand 1 (PD-L1) inhibitor, atezolizumab, in patients with solid tumors. PATIENTS AND METHODS This phase I/Ib study treated PD-L1/PD-1-naive patients with solid tumors in a dose-escalation stage and then in multiple, indication-specific dose-expansion cohorts. In most patients, cobimetinib was dosed once daily orally for 21 days on, 7 days off. Atezolizumab was dosed at 800 mg intravenously every 2 weeks. The primary objectives were safety and tolerability. Secondary end points included objective response rate, progression-free survival, and overall survival. RESULTS Between 27 December 2013 and 9 May 2016, 152 patients were enrolled. As of 4 September 2017, 150 patients received ≥1 dose of atezolizumab, including 14 in the dose-escalation cohorts and 136 in the dose-expansion cohorts. Patients had metastatic colorectal cancer (mCRC; n = 84), melanoma (n = 22), non-small-cell lung cancer (NSCLC; n = 28), and other solid tumors (n = 16). The most common all-grade treatment-related adverse events (AEs) were diarrhea (67%), rash (48%), and fatigue (40%), similar to those with single-agent cobimetinib and atezolizumab. One (<1%) treatment-related grade 5 AE occurred (sepsis). Forty-five (30%) and 23 patients (15%) had AEs that led to discontinuation of cobimetinib and atezolizumab, respectively. Confirmed responses were observed in 7 of 84 patients (8%) with mCRC (6 responders were microsatellite low/stable, 1 was microsatellite instable), 9 of 22 patients (41%) with melanoma, and 5 of 28 patients (18%) with NSCLC. Clinical activity was independent of KRAS/BRAF status across diseases. CONCLUSIONS Atezolizumab plus cobimetinib had manageable safety and clinical activity irrespective of KRAS/BRAF status. Although potential synergistic activity was seen in mCRC, this was not confirmed in a subsequent phase III study. CLINICALTRIALS.GOV IDENTIFIER NCT01988896 (the investigators in the NCT01988896 study are listed in the supplementary Appendix, available at Annals of Oncology online).
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Affiliation(s)
- M D Hellmann
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA.
| | - T-W Kim
- Department of Oncology, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - C B Lee
- UNC Lineberger Comprehensive Cancer Center, Division of Hematology and Oncology, University of North Carolina at Chapel Hill, USA
| | - B-C Goh
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, National University Hospital, Singapore
| | - W H Miller
- Segal Cancer Center, Jewish General Hospital, Department of Medicine, Division of Experimental Medicine, McGill University, Montreal, Canada
| | - D-Y Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - R Jamal
- Department of Hematology-Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), University of Montreal, Montréal, Canada
| | - C-E Chee
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, National University Hospital, Singapore
| | - L Q M Chow
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle
| | - J F Gainor
- Massachusetts General Hospital Cancer Center and Department of Medicine, Massachusetts General Hospital, Boston, USA
| | - J Desai
- Department of Medical Oncology, Royal Melbourne Hospital, University of Melbourne, Melbourne
| | - B J Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Center, Melbourne, Australia
| | - M Das Thakur
- Oncology Biomarker Development, Genentech, Inc., South San Francisco, USA
| | - B Pitcher
- Biostatistics, Hoffmann-La Roche Ltd, Mississuaga, Canada
| | - P Foster
- Product Development Oncology, Genentech, Inc., South San Francisco, USA
| | - G Hernandez
- Oncology Biomarker Development, Genentech, Inc., South San Francisco, USA
| | - M J Wongchenko
- Oncology Biomarker Development, Genentech, Inc., South San Francisco, USA
| | - E Cha
- Product Development Oncology, Genentech, Inc., South San Francisco, USA
| | - Y-J Bang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - L L Siu
- Department of Medicine, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada
| | - J Bendell
- Drug Development Unit Nashville, Sarah Cannon Research Institute/Tennessee Oncology, Nashville, USA
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13
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Subbiah V, Gervais R, Riely G, Hollebecque A, Blay JY, Felip E, Schuler M, Gonçalves A, Italiano A, Keedy V, Chau I, Puzanov I, Raje NS, Meric-Bernstam F, Makrutzki M, Riehl T, Pitcher B, Baselga J, Hyman DM. Efficacy of Vemurafenib in Patients With Non-Small-Cell Lung Cancer With BRAF V600 Mutation: An Open-Label, Single-Arm Cohort of the Histology-Independent VE-BASKET Study. JCO Precis Oncol 2019; 3:1800266. [PMID: 32914022 PMCID: PMC7446432 DOI: 10.1200/po.18.00266] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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] [Accepted: 02/25/2019] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To study whether BRAF V600 mutations in non–small-cell lung cancer (NSCLC) may indicate sensitivity to the BRAF inhibitor vemurafenib, we included a cohort of patients with NSCLC in the vemurafenib basket (VE-BASKET) study. On the basis of observed early clinical activity, we expanded the cohort of patients with NSCLC. We present results from this cohort. METHODS This open-label, histology-independent, phase II study included six prespecified cohorts, including patients with NSCLC, and a seventh all-comers cohort. Patients received vemurafenib (960 mg two times per day) until disease progression or unacceptable toxicity. The primary end point of the final analysis was objective response rate (Response Evaluation Criteria in Solid Tumors, version 1.1). Secondary end points included progression-free survival, overall survival, and safety. Because the prespecified clinical benefit endpoint was met in the initial NSCLC cohort, the cohort was expanded. RESULTS Sixty-two patients with BRAF V600–mutant NSCLC were enrolled and treated: 13% (n = 8) had received no prior systemic therapy, and 87% (n = 54) had received prior therapies. The objective response rate was 37.1% (95% CI, 25.2% to 50.3%) overall, 37.5% (95% CI, 8.5% to 75.5%) in previously untreated patients, and 37.0% (24.3% to 51.3%) in previously treated patients. Median progression-free survival was 6.5 months (95% CI, 5.2 to 9.0 months), and median overall survival was 15.4 months (95% CI, 9.6 to 22.8 months). The most common all-grade adverse event was nausea (40%). The safety profile of vemurafenib was similar to that observed in melanoma studies. CONCLUSION Vemurafenib showed promising activity in patients with NSCLC harboring BRAF V600 mutations. The safety profile of vemurafenib was similar to previous observations in patients with melanoma. Our results suggest a role for single-agent BRAF inhibition in patients with NSCLC and BRAF V600 mutations.
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Affiliation(s)
- Vivek Subbiah
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Gregory Riely
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Enriqueta Felip
- Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | | | | | | | - Ian Chau
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | | | | | | | | | | | - Jose Baselga
- Memorial Sloan Kettering Cancer Center, New York, NY.,Weill Cornell Medical College, New York, NY
| | - David M Hyman
- Memorial Sloan Kettering Cancer Center, New York, NY.,Weill Cornell Medical College, New York, NY
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Lasala J, Iniesta-Donate M, Pitcher B, Cain K, Mena G, Cata J, Siverand A, Suki T, Meyer L, Ramirez P. Effect of anesthesia technique on intra-operative and post-operative morphine equivalent daily dose (MEDD) in open gynecologic surgery in an enhanced recovery after surgery (ERAS) pathway. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2019.03.028] [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: 12/01/2022]
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15
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Lee J, Pitcher B, Kelsey C. Are Higher Doses of Consolidation Radiation Therapy Necessary for Diffuse Large B-Cell Lymphoma Eith Osseous Involvement. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.233] [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: 11/16/2022]
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16
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Kaley T, Touat M, Subbiah V, Hollebecque A, Rodon J, Lockhart AC, Keedy V, Bielle F, Hofheinz RD, Joly F, Blay JY, Chau I, Puzanov I, Raje NS, Wolf J, DeAngelis LM, Makrutzki M, Riehl T, Pitcher B, Baselga J, Hyman DM. BRAF Inhibition in BRAFV600-Mutant Gliomas: Results From the VE-BASKET Study. J Clin Oncol 2018; 36:3477-3484. [PMID: 30351999 PMCID: PMC6286161 DOI: 10.1200/jco.2018.78.9990] [Citation(s) in RCA: 213] [Impact Index Per Article: 35.5] [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] [Indexed: 01/09/2023] Open
Abstract
Purpose BRAFV600 mutations are frequently found in several glioma subtypes, including pleomorphic xanthoastrocytoma (PXA) and ganglioglioma and much less commonly in glioblastoma. We sought to determine the activity of vemurafenib, a selective inhibitor of BRAFV600, in patients with gliomas that harbor this mutation. Patients and Methods The VE-BASKET study was an open-label, nonrandomized, multicohort study for BRAFV600-mutant nonmelanoma cancers. Patients with BRAFV600-mutant glioma received vemurafenib 960 mg twice per day continuously until disease progression, withdrawal, or intolerable adverse effects. Key end points included confirmed objective response rate by RECIST version 1.1, progression-free survival, overall survival, and safety. Results Twenty-four patients (median age, 32 years; 18 female and six male patients) with glioma, including malignant diffuse glioma (n = 11; six glioblastoma and five anaplastic astrocytoma), PXA (n = 7), anaplastic ganglioglioma (n = 3), pilocytic astrocytoma (n = 2), and high-grade glioma, not otherwise specified (n = 1), were treated. Confirmed objective response rate was 25% (95% CI, 10% to 47%) and median progression-free survival was 5.5 months (95% CI, 3.7 to 9.6 months). In malignant diffuse glioma, best response included one partial response and five patients with stable disease, two of whom had disease stabilization that lasted more than 1 year. In PXA, best response included one complete response, two partial responses, and three patients with stable disease. Additional partial responses were observed in patients with pilocytic astrocytoma and anaplastic ganglioglioma (one each). The safety profile of vemurafenib was generally consistent with that of previously published studies. Conclusion Vemurafenib demonstrated evidence of durable antitumor activity in some patients with BRAFV600-mutant gliomas, although efficacy seemed to vary qualitatively by histologic subtype. Additional study is needed to determine the optimal use of vemurafenib in patients with primary brain tumors and to identify the mechanisms driving differential responses across histologic subsets.
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Affiliation(s)
- Thomas Kaley
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Mehdi Touat
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Vivek Subbiah
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Antoine Hollebecque
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Jordi Rodon
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - A Craig Lockhart
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Vicki Keedy
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Franck Bielle
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Ralf-Dieter Hofheinz
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Florence Joly
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Jean-Yves Blay
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Ian Chau
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Igor Puzanov
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Noopur S Raje
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Jurgen Wolf
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Lisa M DeAngelis
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Martina Makrutzki
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Todd Riehl
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Bethany Pitcher
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - Jose Baselga
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
| | - David M Hyman
- Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Memorial Sloan Kettering Cancer Center; Thomas Kaley, Lisa M. DeAngelis, Jose Baselga, and David M. Hyman, Weill Cornell Medical College, New York; Igor Puzanov, Roswell Park Cancer Institute, Buffalo, NY; Mehdi Touat and Antoine Hollebecque, Institut Gustave Roussy, Villejuif; Franck Bielle, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; Florence Joly, Centre François Baclesse, Caen; Jean-Yves Blay, Centre Léon Bérard, Lyon, France; Vivek Subbiah, MD Anderson Cancer Center, Houston, TX; Jordi Rodon, Vall d'Hebron University Hospital, Barcelona, Spain; A. Craig Lockhart, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Vicki Keedy, Vanderbilt University Medical Center, Nashville, TN; Ralf-Dieter Hofheinz, Universitätsmedizin Mannheim, Mannheim; Jurgen Wolf, Universitätsklinikum Köln, Cologne, Germany; Ian Chau, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom; Noopur S. Raje, Massachusetts General Hospital, Boston, MA; Martina Makrutzki, F Hoffmann-La Roche, Basel, Switzerland; Todd Riehl, Genentech, South San Francisco, CA; and Bethany Pitcher, F Hoffmann-La Roche, Mississauga, Ontario, Canada
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Raje N, Chau I, Hyman DM, Ribrag V, Blay JY, Tabernero J, Elez E, Wolf J, Yee AJ, Kaiser M, Landau H, Michot JM, Hollebecque A, Veronese L, Makrutzki M, Pitcher B, Puzanov I, Baselga J. Vemurafenib in Patients With Relapsed Refractory Multiple Myeloma Harboring BRAF V600 Mutations: A Cohort of the Histology-Independent VE-BASKET Study. JCO Precis Oncol 2018; 2:1800070. [PMID: 32913989 DOI: 10.1200/po.18.00070] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Noopur Raje
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Ian Chau
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - David M Hyman
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Vincent Ribrag
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Jean-Yves Blay
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Josep Tabernero
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Elena Elez
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Jürgen Wolf
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Andrew J Yee
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Martin Kaiser
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Heather Landau
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Jean-Marie Michot
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Antoine Hollebecque
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Luisa Veronese
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Martina Makrutzki
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Bethany Pitcher
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Igor Puzanov
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Jose Baselga
- and Massachusetts General Hospital, Boston, MA; and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Memorial Sloan Kettering Cancer Center, New York; Roswell Park Cancer Institute, Buffalo, NY; and Institut Gustave Roussy, Villejuif; Centre Leon-Berard, Lyon, France; and , Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain; University Hospital Köln, Köln, Germany; and F. Hoffmann-La Roche Ltd, Basel, Switzerland; and F. Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
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18
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Bendell JC, Bang YJ, Chee CE, Ryan DP, McRee AJ, Chow LQ, Desai J, Wongchenko M, Yan Y, Pitcher B, Foster P, Cha E, Grossman W, Kim TW. A phase Ib study of safety and clinical activity of atezolizumab (A) and cobimetinib (C) in patients (pts) with metastatic colorectal cancer (mCRC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.560] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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
560 Background: The majority of pts with mCRC have microsatellite stable (MSS) tumors with minimal response to PD-L1/PD-1 blockade. MEK inhibition upregulates tumor major histocompatibility complex-I expression, promotes intratumoral T-cell accumulation and improves anti–PD-L1 responses (Ebert, Immunity. 2016), supporting clinical evaluation of combined anti–PD-L1 (A) plus MEKi (C) in pts with mCRC. Methods: Pts with chemotherapy-refractory or locally advanced mCRC were evaluated. A was administered IV q2w at 800 mg. C was dosed PO daily at 20 to 60 mg during dose escalation and 60 mg during dose expansion (14/14 or 21/7 d on/off schedule). Primary endpoints were safety and tolerability. Investigator-assessed ORR and PFS by RECIST v1.1 and OS were secondary endpoints. Microsatellite instability (MSI) status was locally reported and centrally confirmed by NGS-based scoring. Results: As of May 10, 2017, 84 pts (57 KRASmt, 25 KRASwt, 2 unknown) were enrolled and evaluable. 66 pts had received 5+ prior therapies; 38 had known MSI status at baseline (MSS [n = 29], MSI-low [n = 8], MSI-H [n = 1]). A + C combination was tolerable. Treatment-related Gr 1-2 and Gr 3-4 AEs occurred at 60% and 37%, respectively. The most frequent related Gr 3-4 AEs were increased blood CPK, rash, diarrhea and fatigue (5% each). No treatment-related Gr 5 AEs occurred. 13% and 24% of pts experienced AEs leading to A and C withdrawal, respectively. Median follow-up was 14.3 mo (range, 0.5-29.8). Confirmed PR was observed in 7 pts (8%; locally reported MSS [n = 3], MSI-low [n = 1], MSI unknown [n = 3]). Median DOR was 14.8 mo (95% CI: 6.0, NE); DCR (PR + SD) was 31%. Median PFS was 1.9 mo (95% CI: 1.8, 2.3); median OS was 10.0 mo (95% CI: 6.2, 14.1). The 6-mo and 1-y OS rates were 65% (95% CI: 54, 76) and 46% (95% CI: 34, 58), respectively. Molecular determinants and immune biomarkers of response will be presented. Conclusions: A + C demonstrated a tolerable safety profile and improvements in OS vs those reported with SOC in heavily pretreated pts with mCRC. Objective responses observed in pts with MSS/MSI-low mCRC were durable, suggesting benefit of this novel combination in a pt population refractory to immune therapies. Clinical trial information: NCT01988896.
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Affiliation(s)
| | - Yung-Jue Bang
- Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, Republic of (South)
| | - Cheng Ean Chee
- National University Cancer Institute Singapore, Singapore, Singapore
| | | | | | | | - Jayesh Desai
- Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | | | | | | | | | | | - Tae Won Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Republic of (South)
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19
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Martin P, Jung SH, Pitcher B, Bartlett NL, Blum KA, Shea T, Hsi ED, Ruan J, Smith SE, Leonard JP, Cheson BD. A phase II trial of lenalidomide plus rituximab in previously untreated follicular non-Hodgkin's lymphoma (NHL): CALGB 50803 (Alliance). Ann Oncol 2017; 28:2806-2812. [PMID: 28945884 PMCID: PMC5789808 DOI: 10.1093/annonc/mdx496] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This multicenter, phase II trial tested the tolerability and efficacy of lenalidomide plus rituximab in patients with previously untreated follicular lymphoma (FL). PATIENTS AND METHODS Patients with grade 1-3a FL, stage 3-4 or bulky stage 2, FL international prognostic index (FLIPI) 0-2, and no prior therapy were eligible to receive rituximab 375 mg/m2 weekly during cycle 1 and day 1 of cycles 4, 6, 8, and 10, plus lenalidomide 20-25 mg on days 1-21 for twelve 28-day cycles. The primary objectives were to evaluate response rates [complete (CR) and overall] and time to progression. Secondary objectives included toxicity, response according to polymorphisms in FcgR2A and FcgR3A, and changes in circulating pro-angiogenic cells. RESULTS From October 2010 to September 2011, 66 patients were enrolled. Median age was 53 years, 34 were female, 15 had bulky disease, 21 were FLIPI 0-1, 43 FLIPI 2, and 2 FLIPI 3. One patient withdrew before receiving treatment. Fifty-one patients completed 12 cycles of lenalidomide. Reasons for discontinuation included withdrawal (n = 6), adverse events (n = 6), progression (n = 2). Grade 3-4 hematologic toxicity included neutropenia (21%), lymphopenia (9%), and thrombocytopenia (2%), infection (11%), and rash (8%). Grade 1-2 toxicity included fatigue (78%), diarrhea (37%), rash (32%), and febrile neutropenia in one patient. The overall response rate was 95%; the CR rate was 72% (95% confidence interval, 60% to 83%). With a median follow-up of 5 years, the 2- and 5-year progression-free survival were 86% and 70%, respectively, and the 5-year overall survival was 100%. There was no association between CR rate or PFS and FLIPI, histological grade, bulky disease, FcgR2A/FcgR3A polymorphism, or change in circulating endothelial cell/hematopoietic progenitor cell. CONCLUSION Lenalidomide plus rituximab was associated with low rates of grade 3-4 toxicity, yielded a CR rate and PFS similar to chemotherapy-based treatment and may represent a reasonable alternative to immunochemotherapy in previously untreated FL. CLINICALTRIALS.GOV IDENTIFIER NCT01145495.
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Affiliation(s)
- P Martin
- Department of Medicine, Weill Cornell Medicine, New York.
| | - S-H Jung
- Alliance Statistics and Data Center, Duke University Medical Center, Durham
| | - B Pitcher
- Alliance Statistics and Data Center, Duke University Medical Center, Durham
| | - N L Bartlett
- Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis
| | - K A Blum
- The Ohio State University Medical Center, Columbus
| | - T Shea
- Oncology, University of North Carolina at Chapel Hill, Chapel Hill
| | - E D Hsi
- Clinical Pathology, Cleveland Clinic, Cleveland
| | - J Ruan
- Department of Medicine, Weill Cornell Medicine, New York
| | - S E Smith
- Alliance Protocol Office, University of Chicago, Chicago
| | - J P Leonard
- Department of Medicine, Weill Cornell Medicine, New York
| | - B D Cheson
- Hematology/Oncology, Georgetown University Hospital, Washington, USA
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20
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Labbé C, Cabanero M, Korpanty GJ, Tomasini P, Doherty MK, Mascaux C, Jao K, Pitcher B, Wang R, Pintilie M, Leighl NB, Feld R, Liu G, Bradbury PA, Kamel-Reid S, Tsao MS, Shepherd FA. Prognostic and predictive effects of TP53 co-mutation in patients with EGFR-mutated non-small cell lung cancer (NSCLC). Lung Cancer 2017; 111:23-29. [PMID: 28838393 DOI: 10.1016/j.lungcan.2017.06.014] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 06/15/2017] [Accepted: 06/20/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION TP53 mutations are common in non-small cell lung cancer (NSCLC) and have been reported as prognostic of poor outcome. The impact of TP53 co-mutations in epidermal growth factor receptor (EGFR)-mutated NSCLC is unclear. MATERIALS AND METHODS Tissue from 105 patients with EGFR-mutated NSCLC at Princess Margaret Cancer Centre was analyzed by next-generation or Sanger sequencing to determine TP53 mutational status. Associations between TP53 status and baseline patient and tumor characteristics, treatments and outcomes (relapse-free survival [RFS] after surgical resection, overall survival [OS], overall response rate [ORR] and progression-free survival [PFS] on EGFR tyrosine kinase inhibitors [TKIs]), were investigated. RESULTS Dual TP53/EGFR mutations were found in 43/105 patients (41%). Among 76 patients who underwent surgical resection, neither RFS (HR 0.99, CI 0.56-1.75, p=0.96) nor OS (HR 1.39, CI 0.70-2.77; p=0.35) was associated with TP53 status. Sixty patients (24 TP53 MUT; 36 TP53 WT) received first-generation EGFR TKIs for advanced disease. ORR was not significantly different (TP53 MUT 54%, WT 66%, p=0.42). There was a non-significant trend towards shorter PFS on EGFR TKIs with TP53 mutation (HR 1.74, CI 0.98-3.10, p=0.06). When limited to TP53 missense mutations (n=17), PFS was significantly shorter (HR 1.91, CI 1.01-3.60, p=0.04). Among 11 evaluable patients treated with T790M inhibitors, ORR was not significantly different (TP53 MUT 3/3 [100%], WT 7/8 [88%]). CONCLUSIONS Patients with dual TP53/EGFR mutations, especially missense mutations, had marginally lower response rates and shorter PFS when treated with EGFR TKI therapy. Larger datasets are required to validate these observations.
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Affiliation(s)
- Catherine Labbé
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada; Division of Respirology and Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Ste-Foy, Québec, QC, G1V 4G5, Canada.
| | - Michael Cabanero
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
| | - Grzegorz J Korpanty
- Canadian Cancer Trials Group, Queen's University, 10 Stuard Street, Kingston, ON, K7L 3N6, Canada.
| | - Pascale Tomasini
- Aix-Marseille University, Public Assistance, Marseille Hospitals, 80 Rue Brochier, 13005 Marseille, France.
| | - Mark K Doherty
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
| | - Céline Mascaux
- Aix-Marseille University, Public Assistance, Marseille Hospitals, 80 Rue Brochier, 13005 Marseille, France.
| | - Kevin Jao
- Division of Medical Oncology and Hematology, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montreal, QC, H4J 1C5, Canada.
| | - Bethany Pitcher
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
| | - Rick Wang
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
| | - Melania Pintilie
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
| | - Natasha B Leighl
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
| | - Ronald Feld
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
| | - Geoffrey Liu
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
| | - Penelope Ann Bradbury
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
| | - Suzanne Kamel-Reid
- Department of Pathology, University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada.
| | - Ming-Sound Tsao
- Department of Pathology, University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada.
| | - Frances A Shepherd
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
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Scott D, Pitcher B, Liu Y, Boyle M, Mottok A, Said J, Chadburn A, Lai R, Jung S, Bartlett N, Leonard J, Kaplan L, Hsi E. HIGH PROLIFERATION (MCL35 ASSAY) IS ASSOCIATED WITH INFERIOR OUTCOMES IN PATIENTS TREATED WITH INTENSIVE REGIMENS-A CORRELATIVE STUDY FROM THE CALGB 50403 (ALLIANCE) TRIAL. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- D.W. Scott
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
| | - B. Pitcher
- Alliance Statistics and Data Center; Duke University; Durham NC USA
| | - Y. Liu
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
| | - M. Boyle
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
| | - A. Mottok
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
| | - J. Said
- Pathology and Laboratory Medicine; UCLA School of Medicine; Los Angeles CA USA
| | - A. Chadburn
- Pathology and Cell Biology; Weill Cornell Medical College; New York NY USA
| | - R. Lai
- Laboratory Medicine and Pathology; University Alberta; Edmonton AB Canada
| | - S. Jung
- Alliance Statistics and Data Center; Duke University; Durham NC USA
| | - N.L. Bartlett
- Department of Medicine; Washington University School of Medicine; St. Louis MO USA
| | - J.P. Leonard
- Department of Medicine; Weill Cornell Medical College; New York NY USA
| | - L.D. Kaplan
- Adult Lymphoma Program; UCSF; San Francisco CA USA
| | - E.D. Hsi
- Department of Laboratory Medicine; Cleveland Clinic; Cleveland OH USA
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Martin P, Jung S, Pitcher B, Bartlett N, Blum K, Shea T, Ruan J, Smith S, Leonard J, Cheson B. FINAL RESULTS OF CALGB 50803 (ALLIANCE): A PHASE 2 TRIAL OF LENALIDOMIDE PLUS RITUXIMAB IN PATIENTS WITH PREVIOUSLY UNTREATED FOLLICULAR LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- P. Martin
- Medicine; Weill Cornell Medicine; New York USA
| | - S. Jung
- Alliance Statistics and Data Center; Duke University Medical Center; Durham USA
| | - B. Pitcher
- Alliance Statistics and Data Center; Duke University Medical Center; Durham USA
| | - N.L. Bartlett
- Medicine; Washington University School of Medicine; St. Louis USA
| | - K.A. Blum
- Medicine; The Ohio State University; Columbus USA
| | - T. Shea
- Medicine; University of North Carolina at Chapel Hill; Chapel Hill USA
| | - J. Ruan
- Medicine; Weill Cornell Medicine; New York USA
| | - S.E. Smith
- Alliance Protocol Office; University of Chicago; Chicago USA
| | | | - B.D. Cheson
- Medicine; Georgetown University Hospital; Washington D.C. USA
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Subbiah V, Gervais R, Riely GJ, Hollebecque A, Blay JY, Felip E, Schuler MH, Goncalves A, Italiano A, Keedy VL, Chau I, Puzanov I, Raje N, Makrutzki M, Riehl T, Pitcher B, Hyman DM, Baselga J. Efficacy of vemurafenib in patients (pts) with non-small cell lung cancer (NSCLC) with BRAFV600 mutation. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.9074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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
9074 Background: BRAFV600 mutations occur in 1–2% of pts with NSCLC. We previously reported the efficacy of vemurafenib, a selective BRAFV600 inhibitor, in BRAF mutation-positive non-melanoma tumors (VE-BASKET study). We now present final data for the expanded NSCLC cohort. Methods: This open-label, histology-independent, phase 2 study included 6 prespecified cohorts (including NSCLC) plus one ‘all-others’ cohort. Pts received vemurafenib (960 mg bid) until disease progression or unacceptable toxicity. The primary endpoint was objective response rate (RECIST v1.1). Secondary endpoints included best overall response rate, duration of response (DoR), progression-free survival (PFS), and overall survival (OS). Because the pre-specified clinical benefit endpoint was met in the initial NSCLC cohort, the cohort was expanded. ClinicalTrials.gov identifier NCT01524978. Results: Database lock was 12 Jan 2017. Of 208 pts enrolled at 25 centers worldwide, 62 pts had NSCLC: median age 65 years; 56% male; 13% had no prior systemic therapy; 50% had ≥2 prior therapies. Responses were seen in previously treated and untreated pts (Table). The most common all-grade adverse event (AE) was nausea (40%); grade 3–5 AEs included keratoacanthoma (15%) and squamous cell carcinoma of the skin (15%). Six pts discontinued vemurafenib due to AEs; two had non-treatment-related fatal AEs. Conclusions: Vemurafenib showed evidence of encouraging efficacy in pts with NSCLC with BRAFV600 mutation, with prolonged PFS in previously untreated pts; median OS was not estimable due to ongoing responses. The safety profile of vemurafenib was similar to that seen in melanoma studies. Our results suggest a role for BRAF inhibition in NSCLC with BRAF mutations. Clinical trial information: NCT01524978. [Table: see text]
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Affiliation(s)
- Vivek Subbiah
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | | - Anthony Goncalves
- Aix Marseille University, CNRS, INSERM, Institut Paoli-Calmettes, Departement of Medical Oncology, CRCM, Marseille, France
| | | | | | - Ian Chau
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | | | | | | | | | | | - Jose Baselga
- Memorial Sloan-Kettering Cancer Center, New York, NY
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Miller WH, Kim TM, Lee CB, Flaherty KT, Reddy S, Jamal R, Chow LQ, Rooney IA, Pitcher B, Cha E, Infante JR. Atezolizumab (A) + cobimetinib (C) in metastatic melanoma (mel): Updated safety and clinical activity. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.3057] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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
3057 Background: A, an anti–programmed death-ligand 1 (PD-L1) monoclonal antibody, inhibits PD-L1/programmed death-1 (PD-1) and PD-L1/B7.1 binding and shows promising clinical activity in patients (pts) with cutaneous mel (objective response rate [ORR] 33%; median progression-free survival [mPFS] 5.5 months; Hodi et al SMR 2014). C promotes intratumoral T-cell infiltration, major histocompatibility complex 1 upregulation, and PD-L1 expression via targeted MEK inhibition in preclinical models (Ebert et al Immunity 2016) and tumor biopsy specimens (Bendell et al ASCO 2016). Therefore, clinical benefits may be enhanced by combining A + C vs A. This Phase Ib dose-escalation and -expansion study (NCT01988896) suggested higher ORR/disease control rate (DCR, ORR + stable disease) and longer PFS may be achieved with A + C vs A or C alone in mel. We present updated safety and efficacy data. Methods: Oral C, escalated 20 mg→40 mg→60 mg, was given qd for 21 days followed by 7 days off. Intravenous (IV) A was given at 800 mg q2w. Tumor-specific expansion cohorts were enrolled at maximum tolerated doses (C 60 mg/d 21/7; A 800 mg IV q2w). No prior anti–PD-L1 or –PD-1 therapy was allowed. Results: Data cut-off was Oct 12, 2016; 22 patients were safety-evaluable (two ocular, 20 non-ocular [ten each BRAF-mutant and -wild-type]). Median safety follow-up was 14.4 months (range 2.1–23.2). Adverse events (AEs) were experienced in all pts (diarrhea [20 pts, 90.9%] and rash [15 pts, 68.2%] were most common); related grade (G)3–4 AEs in 54.5% (diarrhea [three pts, 13.6%] and dermatitis acneiform [two pts, 9.1%] were most common; no related G5 AEs); related serious AEs in 13.6%. All were manageable. One pt discontinued A + C due to an AE. RECIST v1.1-confirmed ORR was 45.0% in pts with non-ocular mel (median duration of response was not reached); DCR was 75.0%; mPFS was 12.0 months (95% CI 2.8–not evaluable). ORR was similar for pts with BRAF-mutant and wild-type mel. Conclusions: Updated results confirm previous findings that suggest higher ORR/DCR and longer PFS may be achieved with A + C vs A or C monotherapy for mel. Together with biomarker data from other cohorts, our data suggest that the immune contexture may be altered by C, enhancing A activity. Clinical trial information: NCT01988896.
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Affiliation(s)
- Wilson H. Miller
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Tae Min Kim
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Carrie B. Lee
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | | | | - Rahima Jamal
- Notre-Dame Hospital, CHUM, University of Montreal, CHUM Research Centre (CRCHUM), Montreal, QC, Canada
| | | | | | | | | | - Jeffrey R. Infante
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN
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Hyman DM, Kaley TJ, Hollebecque A, Subbiah V, Rodon Ahnert J, Lockhart AC, Keedy VL, Hofheinz R, Joly Lobbedez F, Blay JY, Chau I, Puzanov I, Raje N, Wolf J, Makrutzki M, Riehl T, Pitcher B, Baselga J. Vemurafenib in patients with BRAFV600 mutant glioma: A cohort of the histology-independent VE-basket study. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.2004] [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
2004 Background: Recurrent malignant gliomas (MG) are a universally fatal disease in desperate need of better therapies. Pleiomorphic xanthoastrocytomas (PXA) and juvenile pilocytic astrocytomas (JPA) typically have better outcomes, although when recurrent, also represent an aggressive disease with no proven effective chemotherapy. BRAFV600 alterations have been identified in a substantial proportion of gliomas, including glioblastoma (GBM), astrocytoma, PXA, and JPA. The phase 2, open-label, histology-independent VE-BASKET study of vemurafenib, a selective BRAFV600 kinase inhibitor, in patients with BRAF mutation-positive non-melanoma tumors, included those with gliomas in the ‘all-others’ cohort. We now report final data for patients with recurrent gliomas. Methods: Patients received vemurafenib (960 mg bid) until disease progression or unacceptable toxicity. The primary endpoint was investigator-assessed response rate; secondary endpoints included clinical benefit rate (confirmed complete or partial response or stable disease lasting ≥6 months), progression-free survival (PFS), overall survival (OS), and toxicity. ClinicalTrials.gov NCT01524978. Results: 24 patients (median age 32 years; 18 female, 6 male) with glioma were treated, including mg (n = 11; 6 GBM and 5 anaplastic astrocytoma [AA]), PXA (n = 7), anaplastic ganglioglioma (AG, n = 3), JPA (n = 2), and unknown (n = 1). In patients with mg (n = 11), best response included PR (n = 1; AA), SD (n = 5), PD (n = 3), and unknown (n = 2). Two patients with mg had durable SD lasting 12.9 months (GBM) and 14.9 months (AA). In patients with PXA (n = 7), best response included CR (n = 1), PR (n = 2), SD (n = 3), and PD (n = 1). Additionally, 1 patient with JPA and 1 with AG achieved a PR. The most frequent AEs included arthralgia (67%), melanocytic nevus (38%), palmar-plantar erythrodysesthesia (38%), photosensitivity reaction (38%) and alopecia (33%). Conclusions: Vemurafenib demonstrated activity in patients with BRAFV600 mutant glioma. The safety profile was similar to that seen in previous melanoma studies. Survival data will be presented. Clinical trial information: NCT01524978.
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Affiliation(s)
| | | | | | - Vivek Subbiah
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - A. Craig Lockhart
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | | | - Ralf Hofheinz
- University Medical Center Mannheim, Mannheim, Germany
| | | | | | - Ian Chau
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | | | | | | | | | | | - Jose Baselga
- Memorial Sloan-Kettering Cancer Center, New York, NY
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26
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Sullivan RJ, Gonzalez R, Lewis KD, Hamid O, Infante JR, Patel MR, Hodi FS, Wallin J, Pitcher B, Cha E, Roberts L, Ballinger M, Hwu P. Atezolizumab (A) + cobimetinib (C) + vemurafenib (V) in BRAFV600-mutant metastatic melanoma (mel): Updated safety and clinical activity. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.3063] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [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
3063 Background: Targeted inhibition of MEK with C and BRAF with V in BRAFV600-mutant mel can lead to both anticancer immune activation and direct tumor cell death. A, an anti–PD-L1 monoclonal antibody, inhibits PD-L1/PD-1 signaling. Combining C + V with A may enhance antitumor activity, potentially leading to improved clinical responses and durability. Preliminary data from this phase Ib study (NCT01656642) showed that A + C + V had a manageable safety profile and promising antitumor activity in patients (pts) with untreated BRAFV600-mutant unresectable/metastatic mel, with increases in CD8-positive T-cell infiltration observed after C + V (Sullivan et al SMR 2016). We present updated safety and efficacy data. Methods: Pts received A + C + V after a 28-day run-in with C + V. A was given at 800 mg q2w, C at 60 mg qd for the first 21 days of each 28-day cycle, and V at 960 mg bid during day 1–21 of run-in and 720 mg thereafter. Safety was evaluated in pts who had ≥1 dose of A; efficacy, in pts who had ≥1 dose of A by the data cutoff date and received ≥1 dose of A, C, or V by the dosed-by date. Results: Thirty-four patients were treated and evaluated for both safety and efficacy. Median survival follow-up was 7.1 months (range 2.5–19.9). Elevated AST/ALT, diarrhea, arthralgia, fatigue, photosensitivity, pyrexia, nausea, flu-like symptoms, maculopapular rash, and pruritus were reported as A- and/or C- and/or V-related in > 20% of pts at any grade (G). A/C/V-related G3–4 adverse events (AEs) were seen in 15 pts (44.1%) with the triple combination (none G5). Three serious AEs were A-related. All AEs were manageable and reversible. Elevated ALT/AST (three pts each) and rash (one pt) led to discontinuation of any drug. Unconfirmed RECIST V1.1 responses were observed in 29 pts (85.3%; six complete, 23 partial). Three pts with confirmed partial responses had resolution of target lesions. Twenty of the 29 responding patients continue to respond at the time of the data cutoff. Conclusions: Updated results confirm preliminary findings that A + C + V has a manageable safety profile and promising antitumor activity in pts with BRAFV600-mutant metastatic mel. Continued exploration of A + C + V is warranted. Clinical trial information: NCT01656642.
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Affiliation(s)
| | - Rene Gonzalez
- University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - Karl D. Lewis
- University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - Omid Hamid
- The Angeles Clinic and Research Institute, Los Angeles, CA
| | - Jeffrey R. Infante
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN
| | - Manish R. Patel
- Florida Cancer Specialists and Research Institute/Sarah Cannon Research Institute, Sarasota, FL
| | | | | | | | | | | | | | - Patrick Hwu
- The University of Texas MD Anderson Cancer Center, Houston, TX
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27
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Thompson R, Lu Y, Potvin M, Holmes J, Di Prospero L, Keller B, Szumacher E, Liszewski B, Catton P, Giuliani M, Pitcher B, Pintilie M, Bissonnette JP. Hazards and incidents: Detection and learning in radiation medicine, a comparison of 2 educational interventions. Pract Radiat Oncol 2017; 7:e431-e438. [PMID: 28377137 DOI: 10.1016/j.prro.2017.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/16/2017] [Accepted: 02/19/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE Interprofessional, educational live simulations were compared with group discussion-based exercises in terms of their ability to improve radiation medicine trainees' ability to detect hazards and incidents and understand behaviors that may prevent them. METHODS AND MATERIALS Trainees and recent graduates of radiation therapy, medical physics, and radiation oncology programs were recruited and randomized to either a simulation-based or group discussion-based training intervention. Participants engaged in hazard and incident detection, analysis, and a discussion of potential preventive measures and the concept of the "highly reliable team." A video examination tool modeled on actual incidents, using 5-minute videos created by faculty, students, and volunteers, was created to test hazard and incident recognition ability before and after training. Hazard and incident detection sensitivity and specificity analyses were conducted, and a survey of the participants' and facilitators' perceptions was conducted. RESULTS Twenty-seven participants were assigned to the simulation (n = 15) or discussion group (n = 12). Hazard and incident-detection sensitivity ranged from 0.04 to 0.56 before and 0.04 to 0.35 after training for the discussion and simulation groups, respectively. The pre- and posttraining difference in sensitivity between groups was 0.03 (P = .75) for the minimum and 0.33 (P = .034) for the maximum reaction time. Participant perceptions of the training's educational value in a variety of domains ranged from a mean score of 6.58 to 8.17 and 7 to 8.07 for the discussion and simulation groups, respectively. Differences were not statistically significant. Twenty-six of the 27 participants indicated that they would recommend this event to a colleague. CONCLUSIONS Participants' ability to detect hazards and incidents as portrayed in 5-minute videos in this study was low both before and after training, and simulation-based training was not superior to discussion-based training. However, levels of satisfaction and perceptions of the training's educational value were high, especially with simulation-based training.
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Affiliation(s)
- Robert Thompson
- Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Department of Radiation Oncology, Odette Cancer Centre, Toronto, Ontario, Canada
| | - Yilan Lu
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Marc Potvin
- Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Michener Institute, University Health Network, Toronto, Ontario, Canada
| | - Jordan Holmes
- Michener Institute, University Health Network, Toronto, Ontario, Canada
| | - Lisa Di Prospero
- Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Department of Radiation Oncology, Odette Cancer Centre, Toronto, Ontario, Canada
| | - Brian Keller
- Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Department of Radiation Oncology, Odette Cancer Centre, Toronto, Ontario, Canada
| | - Ewa Szumacher
- Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Department of Radiation Oncology, Odette Cancer Centre, Toronto, Ontario, Canada
| | - Brian Liszewski
- Department of Radiation Oncology, Odette Cancer Centre, Toronto, Ontario, Canada
| | - Pamela Catton
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Meredith Giuliani
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Bethany Pitcher
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Melania Pintilie
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jean-Pierre Bissonnette
- Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Techna Institute, Toronto, Ontario, Canada.
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28
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Ottolino-Perry K, Chamma E, Blackmore KM, Lindvere-Teene L, Starr D, Tapang K, Rosen CF, Pitcher B, Panzarella T, Linden R, DaCosta RS. Improved detection of clinically relevant wound bacteria using autofluorescence image-guided sampling in diabetic foot ulcers. Int Wound J 2017; 14:833-841. [PMID: 28244218 DOI: 10.1111/iwj.12717] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 11/22/2016] [Accepted: 12/20/2016] [Indexed: 01/13/2023] Open
Abstract
Clinical wound assessment involves microbiological swabbing of wounds to identify and quantify bacterial species, and to determine microbial susceptibility to antibiotics. The Levine swabbing technique may be suboptimal because it samples only the wound bed, missing other diagnostically relevant areas of the wound, which may contain clinically significant bacteria. Thus, there is a clinical need to improve the reliability of microbiological wound sampling. To address this, a handheld portable autofluorescence (AF) imaging device that detects bacteria in real time, without contrast agents, was developed. Here, we report the results of a clinical study evaluating the use of real-time AF imaging to visualise bacteria in and around the wound bed and to guide swabbing during the clinical assessment of diabetic foot ulcers, compared with the Levine technique. We investigated 33 diabetic foot ulcers (n = 31 patients) and found that AF imaging more accurately identified the presence of moderate and/or heavy bacterial load compared with the Levine technique (accuracy 78% versus 52%, P = 0·048; adjusted diagnostic odds ratio 7·67, P < 0·00022 versus 3·07, P = 0·066) and maximised the effectiveness of bacterial load sampling, with no significant impact on clinical workflow. AF imaging may help clinicians better identify the wound areas with clinically significant bacteria, and maximise sampling of treatment-relevant pathogens.
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Affiliation(s)
| | - Emilie Chamma
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario Canada
| | - Kristina M Blackmore
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario Canada
| | - Liis Lindvere-Teene
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario Canada
| | | | - Kim Tapang
- Hyperbaric Medicine, Judy Dan Research & Treatment Centre, Toronto, Ontario Canada
| | - Cheryl F Rosen
- Department of Dermatology, Toronto Western Hospital, University Health Network, Toronto, Ontario Canada
| | - Bethany Pitcher
- Department of Biostatistics, University Health Network, Toronto, Ontario Canada
| | - Tony Panzarella
- Department of Biostatistics, University Health Network, Toronto, Ontario Canada
| | - Ron Linden
- Hyperbaric Medicine, Judy Dan Research & Treatment Centre, Toronto, Ontario Canada
| | - Ralph S DaCosta
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario Canada.,Techna Institute, Toronto, Ontario Canada
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29
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Lohse I, Kumareswaran R, Cao P, Pitcher B, Gallinger S, Bristow RG, Hedley DW. Effects of Combined Treatment with Ionizing Radiation and the PARP Inhibitor Olaparib in BRCA Mutant and Wild Type Patient-Derived Pancreatic Cancer Xenografts. PLoS One 2016; 11:e0167272. [PMID: 28033382 PMCID: PMC5199060 DOI: 10.1371/journal.pone.0167272] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 10/28/2016] [Indexed: 02/07/2023] Open
Abstract
Background The BRCA2 gene product plays an important role in DNA double strand break repair. Therefore, we asked whether radiation sensitivity of pancreatic cancers developing in individuals with germline BRCA2 mutations can be enhanced by agents that inhibit poly (ADP-ribose) polymerase (PARP). Methods We compared the sensitivity of two patient-derived pancreatic cancer xenografts, expressing a truncated or wild type BRCA 2, to ionizing radiation alone or in combination with olaparib (AZD-2281). Animals were treated with either a single dose of 12Gy, 7 days of olaparib or 7 days of olaparib followed by a single dose of 12Gy. Response was assessed by tumour growth delay and the activation of damage response pathways. Results The BRCA2 mutated and wild type tumours showed similar radiation sensitivity, and treatment with olaparib did not further sensitize either model when compared to IR alone. Conclusions While PARP inhibition has been shown to be effective in BRCA-mutated breast and ovarian cancers, it is less well established in pancreatic cancer patients. Our results show no radiosensitization in a germline BRCA 2 mutant and suggest that combining PARP inhibition and IR may not be beneficial in BRCA 2 related pancreatic tumors.
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Affiliation(s)
- Ines Lohse
- Ontario Cancer Institute and Campbell Family Cancer Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Ramya Kumareswaran
- Ontario Cancer Institute and Campbell Family Cancer Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Pinjiang Cao
- Ontario Cancer Institute and Campbell Family Cancer Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Bethany Pitcher
- Ontario Cancer Institute and Campbell Family Cancer Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Steven Gallinger
- Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, Toronto, Ontario, Canada
- Translational Research Initiative in Pancreas Cancer, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Robert G. Bristow
- Ontario Cancer Institute and Campbell Family Cancer Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - David W. Hedley
- Ontario Cancer Institute and Campbell Family Cancer Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Department of Medical Oncology and Haematology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
- * E-mail:
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30
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Chowdhury S, Yung E, Pintilie M, Muaddi H, Chaib S, Yeung M, Fusciello M, Sykes J, Pitcher B, Hagenkort A, McKee T, Vellanki R, Chen E, Bristow RG, Wouters BG, Koritzinsky M. MATE2 Expression Is Associated with Cancer Cell Response to Metformin. PLoS One 2016; 11:e0165214. [PMID: 27959931 PMCID: PMC5154501 DOI: 10.1371/journal.pone.0165214] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 09/16/2016] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND There is great interest in repurposing the commonly prescribed anti-diabetic drug metformin for cancer therapy. Intracellular uptake and retention of metformin is affected by the expression of organic cation transporters (OCT) 1-3 and by multidrug and toxic compound extrusion (MATE) 1-2. Inside cells, metformin inhibits mitochondrial function, which leads to reduced oxygen consumption and inhibition of proliferation. Reduced oxygen consumption can lead to improved tumor oxygenation and radiation response. PURPOSE Here we sought to determine if there is an association between the effects of metformin on inhibiting oxygen consumption, proliferation and expression of OCTs and MATEs in a panel of 19 cancer cell lines. RESULTS There was relatively large variability in the anti-proliferative response of different cell lines to metformin, with a subset of cell lines being very resistant. In contrast, all cell lines demonstrated sensitivity to the inhibition of oxygen consumption by metformin, with relatively small variation. The expression of OCT1 correlated with expression of both OCT2 and OCT3. OCT1 and OCT2 were relatively uniformly expressed, whereas expression of OCT3, MATE1 and MATE2 showed substantial variation across lines. There were statistically significant associations between resistance to inhibition of proliferation and MATE2 expression, as well as between sensitivity to inhibition of oxygen consumption and OCT3 expression. One cell line (LNCaP) with high OCT3 and low MATE2 expression in concert, had substantially higher intracellular metformin concentration than other cell lines, and was exquisitely sensitive to both anti-proliferative and anti-respiratory effects. In all other cell lines, the concentration of metformin required to inhibit oxygen consumption acutely in vitro was substantially higher than that achieved in the plasma of diabetic patients. However, administering anti-diabetic doses of metformin to tumor-bearing mice resulted in intratumoral accumulation of metformin and reduced hypoxic tumor fractions. CONCLUSIONS All cancer cells are susceptible to inhibition of oxygen consumption by metformin, which results in reduced hypoxic tumor fractions beneficial for the response to radiotherapy. High MATE2 expression may result in resistance to the anti-proliferative effect of metformin and should be considered as a negative predictive biomarker in clinical trials.
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Affiliation(s)
- Sanjana Chowdhury
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Eric Yung
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Melania Pintilie
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Hala Muaddi
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Selim Chaib
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- University of Maastricht, Maastricht, The Netherlands
| | - ManTek Yeung
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Manlio Fusciello
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- University of Maastricht, Maastricht, The Netherlands
| | - Jenna Sykes
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Bethany Pitcher
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Anna Hagenkort
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- University of Maastricht, Maastricht, The Netherlands
| | - Trevor McKee
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Ravi Vellanki
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Eric Chen
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Robert G. Bristow
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Bradly G. Wouters
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- University of Maastricht, Maastricht, The Netherlands
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Marianne Koritzinsky
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
- * E-mail:
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31
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Lee G, Dinniwell R, Fyles T, Conrad T, Han K, Levin W, Liu F, Lofgren S, Koch-Fitsialos A, Devins G, Emad N, Pitcher B, Panzarella T, Koch A. Patient Experience Survey of Early-Stage Breast Cancer Patients Undergoing Whole-Breast Radiation Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1629] [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: 10/20/2022]
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32
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Wu L, Allo G, John T, Li M, Tagawa T, Opitz I, Anraku M, Yun Z, Pintilie M, Pitcher B, Liu G, Feld R, Johnston MR, de Perrot M, Tsao MS. Patient-Derived Xenograft Establishment from Human Malignant Pleural Mesothelioma. Clin Cancer Res 2016; 23:1060-1067. [PMID: 27683181 DOI: 10.1158/1078-0432.ccr-16-0844] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 08/19/2016] [Accepted: 09/06/2016] [Indexed: 11/16/2022]
Abstract
Purpose: Malignant pleural mesothelioma (MPM) is a rare but aggressive disease with few therapeutic options. The tumor-stromal interface is important in MPM, but this is lost in cell lines, the main model used for preclinical studies. We sought to characterize MPM patient-derived xenografts (PDX) to determine their suitability as preclinical models and whether tumors that engraft reflect a more aggressive biological phenotype.Experimental Design: Fresh tumors were harvested from extrapleural pneumonectomy, decortication, or biopsy samples of 50 MPM patients and implanted subcutaneously into immunodeficient mice and serially passaged for up to five generations. We correlated selected mesothelioma biomarkers between PDX and patient tumors, and PDX establishment with the clinical pathologic features of the patients, including their survival. DNA of nine PDXs was profiled using the OncoScan FFPE Express platform. Ten PDXs were treated with cisplatin and pemetrexed.Results: A PDX was formed in 20 of 50 (40%) tumors implanted. Histologically, PDX models closely resembled the parent tumor. PDX models formed despite preoperative chemotherapy and radiotherapy. In multivariable analysis, patients whose tumors formed a PDX had significantly poorer survival when the model was adjusted for preoperative treatment (HR, 2.46; 95% confidence interval, 1.1-5.52; P = 0.028). Among 10 models treated with cisplatin, seven demonstrated growth inhibition. Genomic abnormalities seen in nine PDX models were similar to that previously reported.Conclusions: Patients whose tumors form PDX models have poorer clinical outcomes. MPM PDX tumors closely resemble the genotype and phenotype of parent tumors, making them valuable models for preclinical studies. Clin Cancer Res; 23(4); 1060-7. ©2016 AACR.
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Affiliation(s)
- Licun Wu
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, University Health Network, Toronto, Ontario, Canada
| | - Ghassan Allo
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada
| | - Thomas John
- Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia.,LaTrobe University School of Cancer Medicine, Austin Health, Melbourne, Australia
| | - Ming Li
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Tetsuzo Tagawa
- Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, University Health Network, Toronto, Ontario, Canada
| | - Isabelle Opitz
- Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, University Health Network, Toronto, Ontario, Canada
| | - Masaki Anraku
- Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, University Health Network, Toronto, Ontario, Canada
| | - Zhihong Yun
- Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, University Health Network, Toronto, Ontario, Canada
| | - Melania Pintilie
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Bethany Pitcher
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Geoffrey Liu
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ron Feld
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael R Johnston
- Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marc de Perrot
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada. .,Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, University Health Network, Toronto, Ontario, Canada
| | - Ming-Sound Tsao
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada. .,Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada
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Deotare U, Shaheen M, Brandwein JM, Pitcher B, Kamel-Reid S, Yee KWL, Schimmer A, Minden MD, Gupta V, Schuh AC. Predictive value of molecular remissions postconsolidation chemotherapy in patients with Core Binding Factor Acute Myeloid Leukemia (CBF-AML) - a single center analysis. Hematol Oncol 2016; 35:810-813. [PMID: 27597292 DOI: 10.1002/hon.2341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 06/13/2016] [Accepted: 07/13/2016] [Indexed: 11/11/2022]
Abstract
We analyzed the outcome of 80 sequential patients with core binding factor acute myeloid leukemia and evaluated the influence of molecular monitoring by quantitative reverse transcriptase polymerase chain reaction. With a median follow-up of 5 years, the estimated 5-year relapse-free survival and overall survival were 58% and 66%, respectively. Patients who were in molecular remission at the completion of consolidation chemotherapy had a 21% risk of relapse, while the relapse risk for those in molecular remission at the end of 2 years was 5.5%. Our data indicate that postconsolidation molecular remission does not necessarily preclude disease relapse and further monitoring is required. In contrast, molecular negativity by quantitative reverse transcriptase polymerase chain reaction at the end of 2 years is associated with a low risk of relapse.
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Affiliation(s)
- Uday Deotare
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Marwan Shaheen
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Joseph M Brandwein
- Division of Hematology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Bethany Pitcher
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Suzanne Kamel-Reid
- Molecular Diagnostics, Department of Pathobiology and Laboratory Medicine, University Health Network, Toronto, Ontario, Canada
| | - Karen W L Yee
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Aaron Schimmer
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Mark D Minden
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Vikas Gupta
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Andre C Schuh
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
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Goody RB, MacKay H, Pitcher B, Oza A, Siu LL, Kim J, Wong RKS, Chen E, Swallow C, Knox J, Kassam Z, Cummings B, Feld R, Hedley D, Liu G, Krzyzanowska MK, Dinniwell R, Brade AM, Dawson LA, Pintilie M, Ringash J. Phase 1/2 Study of the Addition of Cisplatin to Adjuvant Chemotherapy With Image Guided High-Precision Radiation Therapy for Completely Resected Gastric Cancer. Int J Radiat Oncol Biol Phys 2016; 96:994-1002. [PMID: 27745984 DOI: 10.1016/j.ijrobp.2016.08.034] [Citation(s) in RCA: 2] [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] [Received: 05/13/2016] [Revised: 08/16/2016] [Accepted: 08/23/2016] [Indexed: 01/07/2023]
Abstract
PURPOSE Locoregional recurrence is common after surgery for gastric cancer. Adjuvant therapy improves outcomes but with toxicity. This phase 1/2 study investigated infusional 5-fluorouracil (5-FU) in combination with biweekly cisplatin delivered concurrently with image guided high-precision radiation therapy. METHODS AND MATERIALS Eligible patients had completely resected stage IB to IV (Union for International Cancer Control TNM 6th edition) nonmetastatic gastric adenocarcinoma. Treatment constituted 12 weeks of infusional 5-FU (200 mg/m2/day) with cisplatin added in a standard 3 + 3 dose escalation protocol (0, 20, 30, and 40 mg/m2) during weeks 1, 3, 5, and 7, and an additional week 9 dose in the final cohort. Radiation therapy (45 Gy in 25 fractions) was delivered during weeks 3 to 7. Maximum tolerated dose (MTD) was determined in phase 1 and confirmed in phase 2. RESULTS Among the 55 patients (median age, 54 years; range 28-77 years; 55% male), the median follow-up time was 3.0 years (range, 0.3-5.3 years). Five patients in phase 1 experienced dose-limiting toxicity, and MTD was determined as 4 cycles of 40 mg/m2 cisplatin. Twenty-seven patients were treated at MTD. Acute grade 3 to 4 toxicity rate was 37.0% at MTD and 29.1% across all dose levels. No treatment-related deaths occurred. Fourteen patients experienced recurrent disease. The 2-year overall survival (OS) and relapse-free survival were 85% and 74%, respectively. Median OS has not been reached. Quality of life (QOL) was impaired during treatment, but most scores recovered by 4 weeks. CONCLUSION Cisplatin can be safely delivered with 5-FU-based chemoradiation therapy. Acute toxicity was acceptable, and patient-reported QOL showed the regimen was tolerable. Outcomes are encouraging and justify further study of this regimen.
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Affiliation(s)
- Rebecca B Goody
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Helen MacKay
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Bethany Pitcher
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Amit Oza
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Lillian L Siu
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - John Kim
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Rebecca K S Wong
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Eric Chen
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Carol Swallow
- Department of Surgical Oncology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Knox
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Zahra Kassam
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada; Department of Radiation Oncology, Stronach Regional Cancer Centre, Newmarket, Ontario, Canada
| | - Bernard Cummings
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Ron Feld
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - David Hedley
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Geoffrey Liu
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Monika K Krzyzanowska
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Robert Dinniwell
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Anthony M Brade
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Laura A Dawson
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Melania Pintilie
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jolie Ringash
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
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Labbe C, Korpanty G, Tomasini P, Doherty M, Mascaux C, Jao K, Pitcher B, Pintilie M, Leighl NB, Feld R, Liu G, Bradbury PA, Kamel-Reid S, Tsao MS, Shepherd FA. Prognostic and predictive effects of TP53 mutation in patients with EGFR-mutated non-small cell lung cancer (NSCLC). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.11585] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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)
| | | | - Pascale Tomasini
- Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Mark Doherty
- Department of Medical Oncology, University College Hospital Galway, Galway, Ireland
| | - Celine Mascaux
- Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Kevin Jao
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Bethany Pitcher
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Melania Pintilie
- Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Natasha B. Leighl
- Princess Margaret Cancer Centre, University Health Network, Division of Medical Oncology and Hematology, Toronto, ON, Canada
| | - Ronald Feld
- Princess Margaret Hospital, Toronto, ON, Canada
| | - Geoffrey Liu
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | - Suzanne Kamel-Reid
- Department of Pathology and Laboratory Medicine, University Health Network, Toronto, ON, Canada
| | - Ming Sound Tsao
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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36
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Korpanty G, Dodd A, McGrath E, Pitcher B, Borgida A, Holter S, Dhani NC, Hedley DW, Gallinger S, Cleary SP, Greig PD, McGilvray IM, Moulton CA, Wei ACC, Brierley JD, Dawson LA, Kim J, Moore MJ. Smoking status and treatment outcome in patients with pancreatic cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e15676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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)
| | - Anna Dodd
- Princess Margaret Hospital, Toronto, ON, Canada
| | | | - Bethany Pitcher
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Ayelet Borgida
- Princess Margaret Cancer Centre, University Health Network, Ontario Cancer Institute, University of Toronto, Mount Sinai Hospital-Lunenfeld Research Institute, Toronto, ON, Canada
| | - Spring Holter
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, ON, Canada
| | - Neesha C. Dhani
- Princess Margaret Cancer Centre, University Health Network, Division of Medical Oncology and Hematology, Toronto, ON, Canada
| | - David W. Hedley
- Ontario Cancer Institute, Princess Margaret Hospital, Toronto, ON, Canada
| | - Steven Gallinger
- Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, ON, Canada
| | - Sean P. Cleary
- Princess Margaret Cancer Centre, University Health Network, Ontario Cancer Institute, University of Toronto, Mount Sinai Hospital-Lunenfeld Research Institute, Toronto, ON, Canada
| | - Paul D Greig
- Toronto General Hospital, University of Toronto, Toronto, ON, Canada
| | - Ian M McGilvray
- Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, ON, Canada
| | - Carol-Anne Moulton
- Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Alice Chia-chi Wei
- Department of Surgery, Toronto General Hospital, University of Toronto, Toronto, ON, Canada
| | - James D. Brierley
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | - John Kim
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Malcolm J. Moore
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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37
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Kimmick G, Pitcher B, Mandelblatt J, Clapp J, Ballman K, Barginear M, Freedman R, Artz A, Klepin H, Lafky J, Hopkins J, Winer E, Hudis C, Muss H, Cohen H, Jatoi A, Hurria A. Abstract P6-09-10: All-cause survival estimates compared to observed survival in older women with breast cancer in CALGB 49907 and 369901 (Alliance A151503). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-09-10] [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: 11/16/2022]
Abstract
Abstract
Background: Older adults represent 50% or more of all newly diagnosed cancer patients annually; these patients have multiple morbidities, complicating treatment decision-making.. Discussions about the risks and benefits of cancer treatments might be improved by having data on estimated all-cause survival. ePrognosis (http://eprognosis.ucsf.edu/carey2.php) is an online tool validated in older adults without cancer. We compared survival estimates using ePrognosis to observed survival in a population of women with early stage breast cancer who volunteered for cooperative group studies.
Methods: Participants in CALGB 49907 (n=194) and 369901 (n=809) who were age 70+ were included (total n=1003). Both studies had comparable eligibility: primary, newly diagnosed, invasive, non-metastatic breast cancer. In 49907, eligibly also included PS 0-2; in 369901 there were no PS restrictions, but women who failed a screening cognitive exam were excluded. The Carey 2-year Index from ePrognosis was used to estimate all-cause 2-year survival, based on age, sex, and daily function. Function (needing help from another person to bath and shop for groceries, difficulty walking several blocks and pushing or pulling a heavy object) was derived from the EORTC QLC-30. The Carey index from ePrognosis generates scores from 1-10, with higher scores indicating higher probability of death. Kaplan-Meier methods were used to obtain point estimates and confidence intervals for the observed 2-yr survival. A two sided z-test was used to test the hypothesis that the observed survival rate is equivalent to the predicted survival rate.
Results: At two years from study entry, 921 women were alive; 56 had died, and 26 were lost to follow-up/withdrawn. The population was, on average, 76 years old (SD 4.8), primarily white (89.3%), and the majority had hormone receptor positive tumors (79.4%). In our population, the Carey 2-years index predicated survival was not significantly different than observed rates in the 0-2 points and underestimated the survival rates for patients who had 3-6 points and 7-10 points.
ePrognosis Prediction49907 & 369901 PatientsPointsPredicted Probability of SurvivalNNumber of DeathsObserved Probability of Overall Survival at 2 years (%, 95% CI)p-value0-295%5332595% (93-97%)0.7433-688%4272394% (92-96%)<0.0017-1064%43881% (65-90%)0.017
Conclusions: In this population of older women with breast cancer, using a few readily available data items, ePrognosis provided accurate survival estimates for women with a low probability of death (0-2 points) and underestimated all-cause survival in women with an increased probability of death (3-10 points). Further studies are needed to assess the validity of this tool in samples of cancer patients with higher risks of 2-year mortality. Extended follow-up to validate the tools in predicting 5- and 10-year all-cause and non-cancer mortality risk will further contribute to decision making in older patients.
Citation Format: Kimmick G, Pitcher B, Mandelblatt J, Clapp J, Ballman K, Barginear M, Freedman R, Artz A, Klepin H, Lafky J, Hopkins J, Winer E, Hudis C, Muss H, Cohen H, Jatoi A, Hurria A. All-cause survival estimates compared to observed survival in older women with breast cancer in CALGB 49907 and 369901 (Alliance A151503). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-09-10.
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Affiliation(s)
- G Kimmick
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - B Pitcher
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - J Mandelblatt
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - J Clapp
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - K Ballman
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - M Barginear
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - R Freedman
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - A Artz
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - H Klepin
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - J Lafky
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - J Hopkins
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - E Winer
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - C Hudis
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - H Muss
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - H Cohen
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - A Jatoi
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
| | - A Hurria
- Duke University Medical Center, Durham, NC; Georgetown University; North Shore Health System; Dana Farber Cancer Institute; University of Chicago; Wake Forest University School of Medicine; Mayo Clinic; Forsyth Regional Cancer Center; Memorial Sloan Kettering Cancer Center; UNC Lineberger Comprehensive Cancer Center; City of Hope
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Goody RB, Mackay H, Pitcher B, Oza AM, Brierley JD, Kim JHJ, Wong R, Kassam Z, Swallow CJ, Cummings B, Dinniwell RE, Knox JJ, Brade AM, Dawson LA, Pintilie M, Ringash J. Prospective evaluation of quality of life (QOL) during a phase I/II study of adjuvant chemotherapy with image-guided high-precision radiotherapy for completely resected gastric cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.4_suppl.164] [Citation(s) in RCA: 2] [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
164 Background: Adjuvant chemoradiotherapy improves overall and relapse free survival in patients with completely resected gastric cancer, but confers toxicity. This prospective phase I/II clinical trial assessed the toxicity, efficacy and QOL when adding bi-weekly cisplatin to adjuvant chemoradiotherapy with infusional 5-fluorouracil (5-FU). Phase I data showed promising outcomes with acceptable toxicity. Methods: Treatment comprised 45 Gy in 25 fractions of image-guided 3D-CRT or IMRT concurrently with weeks 3-7 of 12 weeks of infusional 5-FU. Cisplatin (up to bi-weekly) was added in a standard dose-escalation protocol. Patients completed the EORTC QLQ-C30 at baseline, end of radiotherapy, 4 weeks post chemotherapy and at 1 and 2 years. Results: Among 55 participants (mean age 54, range 28 to 77; 55% male; median follow-up 3.03 years), QOL compliance ranged from 93% at baseline to 70% at 4 weeks post-treatment. Maximal tolerable dose of cisplatin was 40 mg/m2 bi-weekly for 4 cycles. OS and DFS rates are 85% and 74% respectively at 2 years. Mean scores for global QOL (median difference = -25, p < 0.0001), role and social functioning, fatigue, nausea and vomiting, and appetite declined at completion of radiation; physical functioning showed a statistically significant decline of borderline clinical importance (median difference = -6.7, p <.0001). All scales recovered by 4 weeks after chemotherapy except fatigue, which returned to baseline by one year. Conclusions: Adjuvant gastric chemoradiotherapy incorporating cisplatin worsened global QOL, fatigue, nausea and vomiting and appetite. Most scales recovered by 4 weeks post-chemotherapy. This regimen is tolerable not only by observer rated toxicity, but also by patient reported QOL measures. Clinical trial information: NCT00188266.
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Affiliation(s)
- Rebecca Barbara Goody
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Helen Mackay
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Bethany Pitcher
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Amit M. Oza
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - James D. Brierley
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Joon-Hyung J. Kim
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Rebecca Wong
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Zahra Kassam
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Carol Jane Swallow
- Department of Surgical Oncology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Bernard Cummings
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | - Jennifer J. Knox
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Anthony M. Brade
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | - Melania Pintilie
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Jolie Ringash
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
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da Cunha Santos G, Wyeth T, Reid A, Saieg MA, Pitcher B, Pintilie M, Kamel-Reid S, Tsao MS. A proposal for cellularity assessment for EGFR mutational analysis with a correlation with DNA yield and evaluation of the number of sections obtained from cell blocks for immunohistochemistry in non-small cell lung carcinoma. J Clin Pathol 2016; 69:607-11. [DOI: 10.1136/jclinpath-2015-203437] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 11/06/2015] [Indexed: 01/02/2023]
Abstract
AimsDifferent approaches have been described for reporting specimen adequacy for epidermal growth factor receptor (EGFR) mutation analysis. We aimed: (1) to conduct cellularity assessment and to investigate its association with DNA yield, (2) to compare the H&E slides taken before and after the thick sections (curls) obtained for EGFR testing and (3) to evaluate the number of ancillary studies performed.MethodsCell block (CB) slides of 110 non-small cell lung carcinoma cases submitted to EGFR analysis from 2010 to 2012 were reviewed for total cellularity (ranges 1–100, 100–250, 250–500, 500–750, 750–1000 and >1000 cells), tumour cellularity (ranges 1–50, 50–100, 100–300 and >300 cells) and the percentage of tumour cells. Precurl and postcurl H&E slides were compared using the three criteria. The number of immunohistochemistry (IHC) markers and special stains and DNA yield were recorded.ResultsDNA yield was significantly associated with the total cellularity, number and percentage of tumour cells. For 46 cases with precurl and postcurl slides, only three (6.5%) were classified as being different and in two of them the postcurl slide had greater cellularity than the precurl. IHC was performed in 83 cases, with a minimum of 1 and a maximum of 11 markers (median of 3) per case.ConclusionsAn association between the total cellularity and the tumour cellularity with the DNA yield was demonstrated using the ranges described. Evaluation of a postcurl slide is an unnecessary practice. The majority of the CB had sufficient material for ancillary studies (up to 11 markers) and mutation testing.
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