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Chi KN, Armstrong AJ, Krause BJ, Herrmann K, Rahbar K, de Bono JS, Adra N, Garje R, Michalski JM, Kempel MM, Fizazi K, Morris MJ, Sartor O, Brackman M, DeSilvio M, Wilke C, Holder G, Tagawa ST. Safety Analyses of the Phase 3 VISION Trial of [ 177Lu]Lu-PSMA-617 in Patients with Metastatic Castration-resistant Prostate Cancer. Eur Urol 2024; 85:382-391. [PMID: 38185538 DOI: 10.1016/j.eururo.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND AND OBJECTIVE [177Lu]Lu-PSMA-617 (177Lu-PSMA-617) plus the standard of care (SoC) significantly improved overall survival and radiographic progression-free survival versus SoC alone in patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer in the VISION trial. We evaluated the safety of additional cycles of 177Lu-PSMA-617 and the impact of longer observation time for patients receiving 177Lu-PSMA-617 plus SoC. METHODS VISION was an international, open-label study. Patients were randomised 2:1 to receive 177Lu-PSMA-617 plus SoC or SoC alone. The incidence of treatment-emergent adverse events (TEAEs) was assessed in prespecified subgroups of patients who received ≤4 cycles versus 5-6 cycles of treatment and during each cycle of treatment. The TEAE incidence was also adjusted for treatment exposure to calculate the incidence per 100 patient-treatment years of observation. This analysis was performed for the first occurrence of TEAEs. KEY FINDINGS AND LIMITATIONS The any-grade TEAE incidence was similar in cycles 1-4 and cycles 5-6. TEAE frequency was similar across all cycles of 177Lu-PSMA-617 treatment. No additional safety concerns were reported for patients who received >4 cycles. The exposure-adjusted safety analysis revealed that the overall TEAE incidence was similar between arms, but distinct trends for different TEAE types were noted and the incidence of events associated with 177Lu-PSMA-617 remained higher in the 177Lu-PSMA-617 arm. CONCLUSIONS AND CLINICAL IMPLICATIONS Longer exposure to 177Lu-PSMA-617 plus SoC was not associated with a higher toxicity risk, and the extended time for safety observation could account for the higher TEAE incidence in comparison to SoC alone. The findings support a favourable benefit-risk profile for 6 cycles of 177Lu-PSMA-617 in this setting and the use of up to 6 cycles of 177Lu-PSMA-617 in patients who are clinically benefiting from and tolerating this therapy. PATIENT SUMMARY For patients with metastatic prostate cancer no longer responding to hormone therapy, an increase in the number of cycles of treatment with a radioactive compound called 177Lu-PSMA-617 from four to six had no additional adverse side effects.
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Affiliation(s)
- Kim N Chi
- British Columbia Cancer, Vancouver Prostate Centre, Vancouver, Canada.
| | - Andrew J Armstrong
- Duke Cancer Institute Center for Prostate & Urologic Cancers, Duke University, Durham, NC, USA
| | - Bernd J Krause
- Department of Nuclear Medicine, Rostock University Medical Center, Rostock, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), University Hospital Essen, Essen, Germany
| | - Kambiz Rahbar
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Johann S de Bono
- Division of Clinical Studies, The Institute of Cancer Research and The Royal Marsden Hospital, London, UK
| | - Nabil Adra
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Rohan Garje
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Jeff M Michalski
- Department of Radiation Oncology, Washington University, St. Louis, MO, USA
| | - Mette M Kempel
- Department of Oncology and Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
| | - Karim Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris-Saclay, Villejuif, France
| | - Michael J Morris
- Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Oliver Sartor
- Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA, USA
| | | | | | | | | | - Scott T Tagawa
- Hematology and Medical Oncology Department, Weill Cornell Medicine, New York, NY, USA
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Socié G, Niederwieser D, von Bubnoff N, Mohty M, Szer J, Or R, Garrett J, Prahallad A, Wilke C, Zeiser R. Prognostic value of blood biomarkers in steroid-refractory or steroid-dependent acute graft-versus-host disease: a REACH2 analysis. Blood 2023; 141:2771-2779. [PMID: 36827620 PMCID: PMC10646803 DOI: 10.1182/blood.2022018579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/05/2022] [Revised: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 02/26/2023] Open
Abstract
Systemic steroids are the standard first-line treatment for acute graft-versus-host disease (aGVHD), but ∼50% of patients become steroid-refractory or dependent (SR/D). Ruxolitinib is the only Food and Drug Administration- and European Medicines Agency-approved therapy for patients with SR/D aGVHD. In the phase 3 REACH2 trial (NCT02913261), ruxolitinib demonstrated superior efficacy in SR/D aGVHD, with a significantly higher overall response rate (ORR) on day 28, durable ORR on day 56, and longer median overall survival compared with the best available therapy (BAT). Identifying biomarkers and clinical characteristics associated with increased probability of response can guide treatment decisions. In this exploratory analysis of the REACH2 study (first biomarker study), we developed baseline (pretreatment) and day 14 models to identify patient characteristics and biomarkers (12 aGVHD-associated cytokines/chemokines, 6 immune cell types, and 3 inflammatory proteins) before and during treatment, which affected the probability of response at day 28. Treatment with ruxolitinib, conditioning, skin involvement, and age were strongly associated with an increased likelihood of response in the ≥1 model. Lower levels of most aGVHD and immune cell markers at baseline were associated with an increased probability of response. In the day 14 model, levels of aGVHD markers at day 14, rather than changes from baseline, affected the probability of response. For both models, the bias-corrected area under the receiver operating characteristic values (baseline, 0.73; day 14, 0.80) indicated a high level of correspondence between the fitted and actual outcomes. Our results suggest potential prognostic value of selected biomarkers and patient characteristics.
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Affiliation(s)
- Gerard Socié
- Assistance Publique Hôpitaux de Paris, Hématologie-Transplantation, Hôpital St Louis, Université de Paris-Cité, Paris, France and INSERM Unité Mixte de Recherche 976, Paris, France
| | | | - Nikolas von Bubnoff
- Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Mohamad Mohty
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France, Université Sorbonne, Paris, France and INSERM Unité Mixte de Recherche 938, Paris, France
| | - Jeff Szer
- Clinical Haematology, Peter MacCallum Cancer Centre & The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Reuven Or
- Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem, Israel
| | | | | | | | - Robert Zeiser
- Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - REACH2 investigators
- Assistance Publique Hôpitaux de Paris, Hématologie-Transplantation, Hôpital St Louis, Université de Paris-Cité, Paris, France and INSERM Unité Mixte de Recherche 976, Paris, France
- Division of Hematology and Oncology, University of Leipzig, Leipzig, Germany
- Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France, Université Sorbonne, Paris, France and INSERM Unité Mixte de Recherche 938, Paris, France
- Clinical Haematology, Peter MacCallum Cancer Centre & The Royal Melbourne Hospital, Melbourne, VIC, Australia
- Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem, Israel
- Novartis Pharmaceuticals Corporation, Cambridge, MA
- Novartis Pharma AG, Basel, Switzerland
- Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
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Verachi P, Gobbo F, Martelli F, Falchi M, di Virgilio A, Sarli G, Wilke C, Bruederle A, Prahallad A, Arciprete F, Zingariello M, Migliaccio AR. Preclinical studies on the use of a P-selectin-blocking monoclonal antibody to halt progression of myelofibrosis in the Gata1 low mouse model. Exp Hematol 2023; 117:43-61. [PMID: 36191885 PMCID: PMC10450205 DOI: 10.1016/j.exphem.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 01/10/2023]
Abstract
The bone marrow (BM) and spleen from patients with myelofibrosis (MF), as well as those from the Gata1low mouse model of the disease contain increased number of abnormal megakaryocytes. These cells express high levels of the adhesion receptor P-selectin on their surface, which triggers a pathologic neutrophil emperipolesis, leading to increased bioavailability of transforming growth factor-β (TGF-β) in the microenvironment and disease progression. With age, Gata1low mice develop a phenotype similar to that of patients with MF, which is the most severe of the Philadelphia-negative myeloproliferative neoplasms. We previously demonstrated that Gata1low mice lacking the P-selectin gene do not develop MF. In the current study, we tested the hypothesis that pharmacologic inhibition of P-selectin may normalize the phenotype of Gata1low mice that have already developed MF. To test this hypothesis, we have investigated the phenotype expressed by aged Gata1low mice treated with the antimouse monoclonal antibody RB40.34, alone and also in combination with ruxolitinib. The results indicated that RB40.34 in combination with ruxolitinib normalizes the phenotype of Gata1low mice with limited toxicity by reducing fibrosis and the content of TGF-β and CXCL1 (two drivers of fibrosis in this model) in the BM and spleen and by restoring hematopoiesis in the BM and the architecture of the spleen. In conclusion, we provide preclinical evidence that treatment with an antibody against P-selectin in combination with ruxolitinib may be more effective than ruxolitinib alone to treat MF in patients.
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Affiliation(s)
- Paola Verachi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Francesca Gobbo
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy; Department of Veterinary Medical Sciences, University of Bologna, Italy
| | - Fabrizio Martelli
- National Center for Preclinical and Clinical Research and Evaluation of Pharmaceutical Drugs, Istituto Superiore di Sanità, Rome, Italy
| | - Mario Falchi
- National Center for HIV/AIDS Research, Istituto Superiore di Sanità, Rome, Italy
| | - Antonio di Virgilio
- Center for Animal Experimentation and Well-being, Istituto Superiore di Santà, Rome, Italy
| | - Giuseppe Sarli
- Department of Veterinary Medical Sciences, University of Bologna, Italy
| | | | | | | | - Francesca Arciprete
- Unit of Microscopic and Ultrastructural Anatomy, University Campus Bio-Medico, Rome, Italy
| | - Maria Zingariello
- Unit of Microscopic and Ultrastructural Anatomy, University Campus Bio-Medico, Rome, Italy
| | - Anna Rita Migliaccio
- Unit of Microscopic and Ultrastructural Anatomy, University Campus Bio-Medico, Rome, Italy; Altius Institute for Biomedical Sciences, Seattle, WA, USA.
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Wilke C, Lahiff N, Badihi G, Donnellan E, Hobaiter C, Machanda Z, Mundry R, Pika S, Soldati A, Wrangham R, Zuberbűhler K, Slocombe K. Referential gestures are not ubiquitous in wild chimpanzees: alternative functions for exaggerated loud scratch gestures. Anim Behav 2022. [DOI: 10.1016/j.anbehav.2022.04.007] [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: 11/29/2022]
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Rugo HS, André F, Yamashita T, Cerda H, Toledano I, Stemmer SM, Jurado JC, Juric D, Mayer I, Ciruelos EM, Iwata H, Conte P, Campone M, Wilke C, Mills D, Lteif A, Miller M, Gaudenzi F, Loibl S. Time course and management of key adverse events during the randomized phase III SOLAR-1 study of PI3K inhibitor alpelisib plus fulvestrant in patients with HR-positive advanced breast cancer. Ann Oncol 2020; 31:1001-1010. [PMID: 32416251 DOI: 10.1016/j.annonc.2020.05.001] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Alpelisib (α-selective phosphatidylinositol 3-kinase inhibitor) plus fulvestrant is approved in multiple countries for men and postmenopausal women with PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer following progression on or after endocrine therapy. A detailed understanding of alpelisib's safety profile should inform adverse event (AE) management and enhance patient care. PATIENTS AND METHODS AEs in the phase III SOLAR-1 trial were assessed in patients with and without PIK3CA mutations. The impact of protocol-specified AE-management recommendations was evaluated, including an amendment to optimize hyperglycemia and rash management. RESULTS Patients were randomly assigned to receive fulvestrant plus alpelisib (n = 284) or placebo (n = 287). The most common grade 3/4 AEs with alpelisib were hyperglycemia (grade 3, 32.7%; grade 4, 3.9%), rash (grade 3, 9.9%), and diarrhea (grade 3, 6.7%). Median time to onset of grade ≥3 toxicity was 15 days (hyperglycemia, based on fasting plasma glucose), 13 days (rash), and 139 days (diarrhea). Metformin alone or in combination with other antidiabetic agents was used by most patients (87.1%) with hyperglycemia. Preventive anti-rash medication resulted in lower incidence (any grade, 26.7% versus 64.1%) and severity of rash (grade 3, 11.6% versus 22.7%) versus no preventative medication. Discontinuations due to grade ≥3 AEs were lower following more-detailed AE management guidelines (7.9% versus 18.1% previously). Patients with PIK3CA mutations had a median alpelisib dose intensity of 248 mg/day. Median progression-free survival with alpelisib was 12.5 and 9.6 months for alpelisib dose intensities of ≥248 mg/day and <248 mg/day, respectively, compared with 5.8 months with placebo. CONCLUSIONS Hyperglycemia and rash occurred early during alpelisib treatment, while diarrhea occurred at a later time point. Early identification, prevention, and intervention, including concomitant medications and alpelisib dose modifications, resulted in less severe toxicities. Reductions in treatment discontinuations and improved progression-free survival at higher alpelisib dose intensities support the need for optimal AE management. CLINICALTRIALS. GOV ID NCT02437318.
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Affiliation(s)
- H S Rugo
- Department of Medicine, Division of Hematology and Oncology, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, USA.
| | - F André
- Department of Medical Oncology, INSERM U981, Gustave Roussy, Université Paris-Sud, Villejuif, France
| | - T Yamashita
- Department of Breast and Endocrine Surgery, Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - H Cerda
- Clinica RedSalud Vitacura, Santiago, Chile
| | | | - S M Stemmer
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - J C Jurado
- Hospital Universitario Canarias, S/C Tenerife, Islas Canarias, Spain
| | - D Juric
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, USA
| | - I Mayer
- Department of Medicine, Hematology and Oncology, Vanderbilt University, Nashville, USA
| | - E M Ciruelos
- Medical Oncology Department, Breast Cancer Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - H Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - P Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padua and Medical Oncology 2, Istituto Oncologico Veneto, IRCCS, Padua, Italy
| | - M Campone
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, St Herblain, France
| | - C Wilke
- Novartis Pharma AG, Basel, Switzerland
| | - D Mills
- Novartis Pharma AG, Basel, Switzerland
| | - A Lteif
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - M Miller
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | | | - S Loibl
- Department of Medicine and Research, German Breast Group, Neu-Isenburg; Centre for Haematology and Oncology Bethanien, Frankfurt, Germany
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Zeiser R, von Bubnoff N, Butler J, Mohty M, Niederwieser D, Or R, Szer J, Wagner EM, Zuckerman T, Mahuzier B, Xu J, Wilke C, Gandhi KK, Socié G. Ruxolitinib for Glucocorticoid-Refractory Acute Graft-versus-Host Disease. N Engl J Med 2020; 382:1800-1810. [PMID: 32320566 DOI: 10.1056/nejmoa1917635] [Citation(s) in RCA: 373] [Impact Index Per Article: 93.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Acute graft-versus-host disease (GVHD) remains a major limitation of allogeneic stem-cell transplantation; not all patients have a response to standard glucocorticoid treatment. In a phase 2 trial, ruxolitinib, a selective Janus kinase (JAK1 and JAK2) inhibitor, showed potential efficacy in patients with glucocorticoid-refractory acute GVHD. METHODS We conducted a multicenter, randomized, open-label, phase 3 trial comparing the efficacy and safety of oral ruxolitinib (10 mg twice daily) with the investigator's choice of therapy from a list of nine commonly used options (control) in patients 12 years of age or older who had glucocorticoid-refractory acute GVHD after allogeneic stem-cell transplantation. The primary end point was overall response (complete response or partial response) at day 28. The key secondary end point was durable overall response at day 56. RESULTS A total of 309 patients underwent randomization; 154 patients were assigned to the ruxolitinib group and 155 to the control group. Overall response at day 28 was higher in the ruxolitinib group than in the control group (62% [96 patients] vs. 39% [61]; odds ratio, 2.64; 95% confidence interval [CI], 1.65 to 4.22; P<0.001). Durable overall response at day 56 was higher in the ruxolitinib group than in the control group (40% [61 patients] vs. 22% [34]; odds ratio, 2.38; 95% CI, 1.43 to 3.94; P<0.001). The estimated cumulative incidence of loss of response at 6 months was 10% in the ruxolitinib group and 39% in the control group. The median failure-free survival was considerably longer with ruxolitinib than with control (5.0 months vs. 1.0 month; hazard ratio for relapse or progression of hematologic disease, non-relapse-related death, or addition of new systemic therapy for acute GVHD, 0.46; 95% CI, 0.35 to 0.60). The median overall survival was 11.1 months in the ruxolitinib group and 6.5 months in the control group (hazard ratio for death, 0.83; 95% CI, 0.60 to 1.15). The most common adverse events up to day 28 were thrombocytopenia (in 50 of 152 patients [33%] in the ruxolitinib group and 27 of 150 [18%] in the control group), anemia (in 46 [30%] and 42 [28%], respectively), and cytomegalovirus infection (in 39 [26%] and 31 [21%]). CONCLUSIONS Ruxolitinib therapy led to significant improvements in efficacy outcomes, with a higher incidence of thrombocytopenia, the most frequent toxic effect, than that observed with control therapy. (Funded by Novartis; REACH2 ClinicalTrials.gov number, NCT02913261.).
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Affiliation(s)
- Robert Zeiser
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Nikolas von Bubnoff
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Jason Butler
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Mohamad Mohty
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Dietger Niederwieser
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Reuven Or
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Jeff Szer
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Eva M Wagner
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Tsila Zuckerman
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Bruyère Mahuzier
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Judith Xu
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Celine Wilke
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Kunal K Gandhi
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
| | - Gérard Socié
- From the Department of Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg (R.Z.), the Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck (N.B.), the Department of Hematology and Oncology, University of Leipzig, Leipzig (D.N.), and the Department of Hematology, Oncology, and Pneumology, University Medical Center Mainz, Mainz (E.M.W.) - all in Germany; the Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD (J.B.), and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC (J.S.) - all in Australia; Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Sorbonne and INSERM Unité Mixte de Recherche (UMR) 938 (M.M.), and AP-HP, Hématologie-Transplantation, Hôpital St. Louis, Université de Paris and INSERM UMR 976 (G.S.), Paris, and Novartis Pharma, Rueil-Malmaison (B.M.) - all in France; the Cancer Immunotherapy and Immunobiology Research Center, Hadassah University Hospital, Jerusalem (R.O.), and the Hematology Institute and Bone Marrow Transplantation, Clinical Research Institute at Rambam, Rambam Health Care Campus, Haifa (T.Z.) - both in Israel; Novartis Pharmaceuticals, East Hanover, NJ (J.X., K.K.G.); and Novartis Pharma, Basel, Switzerland (C.W.)
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Rugo H, André F, Yamashita T, Cerda H, Toledano I, Stemmer S, Cruz Jurado J, Juric D, Mayer I, Ciruelos E, Iwata H, Conte P, Campone M, Wilke C, Mills D, Lorenzo I, Miller M, Loibl S. Alpelisib (ALP) + fulvestrant (FUL) for patients with hormone receptor–positive (HR+), HER2− advanced breast cancer (ABC): Management and time course of key adverse events of special interest (AESIs) in SOLAR-1. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Iwata H, Yamashita T, Inoue K, Takahashi M, Masuda N, Yamauchi T, Yamamoto Y, Takano T, Niikura N, Nakayama T, Takashima S, Matsumoto K, Sagara Y, Fujii T, Hattori T, Sekiguchi R, Wilke C. Alpelisib (ALP)+fulvestrant (FUL) in patients from Japan with advanced breast cancer: Subgroup analysis of SOLAR-1 trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz374.001] [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: 11/13/2022] Open
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Juric D, Loibl S, Andre F, Mingorance JID, Forget F, Levy C, Masuda N, Campone M, Conte PF, Iwata H, Mayer IA, Rugo HS, Wilke C, Ridolfi A, Lteif A, Ciruelos E. Alpelisib (ALP) with fulvestrant (FUL) in patients (pts) with PIK3CA-mutated hormone receptor-positive (HR+), human epidermal growth factor receptor-2-negative (HER2-) advanced breast cancer (ABC): Primary or secondary resistance to prior endocrine therapy (ET) in the SOLAR-1 trial. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.1038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1038 Background: A contributor to ETR, phosphatidylinositol 3-kinase (PI3K) pathway hyperactivation can result from mutations to PIK3CA; ~40% of pts with HR+, HER2– ABC exhibit tumors with this mutation. Use of the oral α-specific PI3K inhibitor ALP + FUL significantly improved progression-free survival (PFS) in pts with a PIK3CA mutation (HR 0.65; 95% CI, 0.50-0.85; P<0.001) in SOLAR-1, which included both ET sensitive (ETS) and ETR pts (Table). ETS pts were later excluded by a protocol amendment. ETR was further defined as primary (1R) or secondary (2R) per ESMO criteria in both 1L and 2L pts. This subgroup analysis evaluated pts with a PIK3CA mutation based on tx line and endocrine status. Methods: SOLAR-1 was a phase 3, randomized, double-blind study of ALP 300 mg QD or PBO Q28d + FUL 500 mg Q28d + C1d15 in men and postmenopausal women with HR+, HER2– ABC whose disease progressed on/after an aromatase inhibitor. PFS was estimated by Kaplan-Meier method and median PFS (mPFS) presented by tx arm. A stratified Cox proportional hazards model estimated HR and 2-sided 95% CI. Results: Of 341 pts in the PIK3CA mutant cohort, 39 (11%) were ETS; 302 (89%) were ETR. mPFS in the ALP vs PBO arms was 22.1 vs 19.1 mo (HR 0.87; 95% CI, 0.35-2.17) for ETS pts and 9.4 vs 4.2 mo (HR 0.64; 95% CI, 0.48-0.84) for ETR pts. For ETR pts, mPFS for 1L (n=138) was 9.0 vs 4.7 mo (HR 0.69; 95% CI, 0.46-1.05) and for 2L (n=161) was 10.9 vs 3.7 mo (HR 0.61; 95% CI, 0.42-0.89). Conclusions: In SOLAR-1, mPFS was improved with ALP + FUL vs PBO + FUL across ETR pts in 1L and 2L. Representation of ETS pts was low in SOLAR-1, which included more ETR pts. Analysis of the PI3K pathway in ETS pts is warranted in future studies. Clinical trial information: NCT02437318. [Table: see text]
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Affiliation(s)
- Dejan Juric
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Sibylle Loibl
- German Breast Group (GBG) and Centre for Haematology and Oncology Bethanien, Frankfurt, Neu-Isenburg, Germany
| | | | | | | | - Christelle Levy
- Centre François Baclesse, Department of Medical Oncology, Caen, France
| | | | - Mario Campone
- Institut de Cancérologie de l'Ouest, René Gauducheau, St Herblain, France
| | | | | | | | - Hope S. Rugo
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA
| | | | - Antonia Ridolfi
- Novartis Pharmaceuticals Corporation, Rueil-Malmaison, France
| | - Agnes Lteif
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - Eva Ciruelos
- Breast Cancer Unit, University Hospital, Madrid, Spain
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Mayer IA, Rugo HS, Loibl S, Safra T, Park YH, Krivorotko P, Iwata H, Andre F, Conte PF, Ciruelos E, Juric D, Park J, Wilke C, Mills D, Lteif A, Campone M. Patient-reported outcomes (PROs) in patients (pts) with PIK3CA-mutated hormone receptor-positive (HR+), human epidermal growth factor receptor-2–negative (HER2–) advanced breast cancer (ABC) from SOLAR-1. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.1039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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
1039 Background: Approximately 40% of pts with HR+, HER2– ABC have tumors with a PIK3CA mutation, resulting in phosphatidylinositol 3-kinase (PI3K) pathway hyperactivation. Use of the oral α-specific PI3K inhibitor alpelisib (ALP) + fulvestrant (FUL) in SOLAR-1 significantly improved (vs placebo [PBO] + FUL) both progression-free survival (PFS) (median 11.0 vs 5.7 mo, respectively; HR 0.65; 95% CI, 0.50-0.85; P< 0.001) and objective response rate (ORR) (measurable disease: 36% vs 16%; P< 0.001) in the PIK3CA mutant cohort. In addition to primary efficacy and safety measures, PROs offer valuable insight into therapeutic benefit by measuring whether quality of life (QoL) is maintained during treatment. Methods: Postmenopausal women or men with HR+, HER2– ABC whose disease progressed on/after an aromatase inhibitor were randomized to receive ALP 300 mg once daily or PBO, + FUL 500 mg every 28 days + Cycle 1, Day 15. Secondary objectives included PROs using the EORTC QLQ-C30, EQ-5D-5L, and BPI-SF scales. PROs were collected at screening, every 8 wk for 18 mo then every 12 wk thereafter, at end of treatment, and during follow-up for efficacy. Linear mixed effects models were used to assess score changes from baseline. Time to 10% deterioration (TTD), an established measure of clinically meaningful change in QoL, was compared between the treatment arms’ survival distribution using Kaplan-Meier methodology. Results: At baseline, 93% of pts in the PIK3CA mutant cohort (n = 341) completed questionnaires; ≥75% completed them post-baseline. Adjusted mean changes from baseline in EORTC global health status/QoL scores were < 10% for all visits through wk 96 for both arms, with a mean difference between arms of < 3% for all visits. There was no difference between arms in TTD in global health/QoL status (HR 1.03; 95% CI, 0.72-1.48). Analysis of TTD in EORTC physical, social, and emotional functioning scores revealed no meaningful differences between arms. Conclusions: In addition to significantly improving PFS and ORR, overall QoL was maintained in pts treated with ALP + FUL. Clinical trial information: NCT02437318.
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Affiliation(s)
| | - Hope S. Rugo
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Sibylle Loibl
- German Breast Group (GBG) and Centre for Haematology and Oncology Bethanien, Frankfurt, Neu-Isenburg, Germany
| | - Tamar Safra
- Tel Aviv Sorasky Medical Center, Tel Aviv, Israel
| | | | - Petr Krivorotko
- "National Medical Research Center of Oncology na N.N. Petrov" Ministry of Healthcare of Russian Federation, St. Petersburg, Russian Federation
| | | | | | | | - Eva Ciruelos
- Breast Cancer Unit, University Hospital, Madrid, Spain
| | - Dejan Juric
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Jinhee Park
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | | | - David Mills
- Novartis Pharmaceuticals Corporation, Basel, Switzerland
| | - Agnes Lteif
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - Mario Campone
- Institut de Cancérologie de l'Ouest, René Gauducheau, St Herblain, France
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André F, Ciruelos E, Rubovszky G, Campone M, Loibl S, Rugo HS, Iwata H, Conte P, Mayer IA, Kaufman B, Yamashita T, Lu YS, Inoue K, Takahashi M, Pápai Z, Longin AS, Mills D, Wilke C, Hirawat S, Juric D. Alpelisib for PIK3CA-Mutated, Hormone Receptor-Positive Advanced Breast Cancer. N Engl J Med 2019; 380:1929-1940. [PMID: 31091374 DOI: 10.1056/nejmoa1813904] [Citation(s) in RCA: 1329] [Impact Index Per Article: 265.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND PIK3CA mutations occur in approximately 40% of patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer. The PI3Kα-specific inhibitor alpelisib has shown antitumor activity in early studies. METHODS In a randomized, phase 3 trial, we compared alpelisib (at a dose of 300 mg per day) plus fulvestrant (at a dose of 500 mg every 28 days and once on day 15) with placebo plus fulvestrant in patients with HR-positive, HER2-negative advanced breast cancer who had received endocrine therapy previously. Patients were enrolled into two cohorts on the basis of tumor-tissue PIK3CA mutation status. The primary end point was progression-free survival, as assessed by the investigator, in the cohort with PIK3CA-mutated cancer; progression-free survival was also analyzed in the cohort without PIK3CA-mutated cancer. Secondary end points included overall response and safety. RESULTS A total of 572 patients underwent randomization, including 341 patients with confirmed tumor-tissue PIK3CA mutations. In the cohort of patients with PIK3CA-mutated cancer, progression-free survival at a median follow-up of 20 months was 11.0 months (95% confidence interval [CI], 7.5 to 14.5) in the alpelisib-fulvestrant group, as compared with 5.7 months (95% CI, 3.7 to 7.4) in the placebo-fulvestrant group (hazard ratio for progression or death, 0.65; 95% CI, 0.50 to 0.85; P<0.001); in the cohort without PIK3CA-mutated cancer, the hazard ratio was 0.85 (95% CI, 0.58 to 1.25; posterior probability of hazard ratio <1.00, 79.4%). Overall response among all the patients in the cohort without PIK3CA-mutated cancer was greater with alpelisib-fulvestrant than with placebo-fulvestrant (26.6% vs. 12.8%); among patients with measurable disease in this cohort, the percentages were 35.7% and 16.2%, respectively. In the overall population, the most frequent adverse events of grade 3 or 4 were hyperglycemia (36.6% in the alpelisib-fulvestrant group vs. 0.7% in the placebo-fulvestrant group) and rash (9.9% vs. 0.3%). Diarrhea of grade 3 occurred in 6.7% of patients in the alpelisib-fulvestrant group, as compared with 0.3% of those in the placebo-fulvestrant group; no diarrhea of grade 4 was reported. The percentages of patients who discontinued alpelisib and placebo owing to adverse events were 25.0% and 4.2%, respectively. CONCLUSIONS Treatment with alpelisib-fulvestrant prolonged progression-free survival among patients with PIK3CA-mutated, HR-positive, HER2-negative advanced breast cancer who had received endocrine therapy previously. (Funded by Novartis Pharmaceuticals; SOLAR-1 ClinicalTrials.gov number, NCT02437318.).
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Affiliation(s)
- Fabrice André
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Eva Ciruelos
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Gabor Rubovszky
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Mario Campone
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Sibylle Loibl
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Hope S Rugo
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Hiroji Iwata
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Pierfranco Conte
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Ingrid A Mayer
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Bella Kaufman
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Toshinari Yamashita
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Yen-Shen Lu
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Kenichi Inoue
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Masato Takahashi
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Zsuzsanna Pápai
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Anne-Sophie Longin
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - David Mills
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Celine Wilke
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Samit Hirawat
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
| | - Dejan Juric
- From Institut Gustave Roussy, INSERM Unité 981, Université Paris-Sud, Villejuif (F.A.), Institut de Cancérologie de l'Ouest, St. Herblain (M.C.), and Novartis Pharma, Paris (A.-S.L.) - all in France; Hospital Universitario 12 de Octubre, Madrid (E.C.); National Institute of Oncology (G.R.) and Duna Medical Center (Z.P.), Budapest, Hungary; German Breast Group, Neu-Isenburg, and Center for Hematology and Oncology Bethanien, Frankfurt - both in Germany (S.L.); UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Aichi Cancer Center, Nagoya (H.I.), Kanagawa Cancer Center, Yokohama (T.Y.), Saitama Cancer Center, Saitama (K.I.), and National Hospital Organization Hokkaido Cancer Center, Sapporo (M.T.) - all in Japan; Istituto Oncologico Veneto and the Departments of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy (P.C.); Vanderbilt University, Nashville (I.A.M.); Chaim Sheba Medical Center, Tel Hashomer, Israel (B.K.); National Taiwan University Hospital, Taipei (Y.-S.L.); Novartis Pharma, Basel, Switzerland (D.M., C.W.); Novartis Pharmaceuticals, East Hanover, NJ (S.H.); and Massachusetts General Hospital Cancer Center, Boston (D.J.)
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Loibl S, Conte P, Campone M, Mayer I, Lu YS, Denduluri N, Wilke C, Ridolfi A, André F. Response rate by geographic region in patients with hormone receptor-positive, human epidermal growth factor receptor-2–negative advanced breast cancer from the SOLAR-1 trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz100.004] [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: 11/12/2022] Open
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André F, Ciruelos E, Rubovszky G, Campone M, Loibl S, Rugo H, Iwata H, Conte P, Mayer I, Kaufman B, Yamashita T, Lu YS, Inoue K, Takahashi M, Pápai Z, Longin AS, Mills D, Wilke C, Hirawat S, Juric D. Alpelisib (ALP) + fulvestrant (FUL) for advanced breast cancer (ABC): Results of the phase III SOLAR-1 trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rodon J, Curigliano G, Delord JP, Harb W, Azaro A, Han Y, Wilke C, Donnet V, Sellami D, Beck T. A Phase Ib, open-label, dose-finding study of alpelisib in combination with paclitaxel in patients with advanced solid tumors. Oncotarget 2018; 9:31709-31718. [PMID: 30167089 PMCID: PMC6114962 DOI: 10.18632/oncotarget.25854] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/12/2018] [Indexed: 11/25/2022] Open
Abstract
Phosphatidylinositol 3-kinase (PI3K) pathway activation is associated with resistance to paclitaxel in solid tumors. We assessed the safety and activity of alpelisib, an oral, selective PI3K p110α inhibitor, plus paclitaxel in patients with advanced solid tumors. This Phase Ib, multicenter, open-label, dose-finding study, with a planned dose-expansion phase of alpelisib once daily (QD) plus fixed-dose paclitaxel, recruited patients with advanced solid tumors. For the dose-finding phase, the primary objective was determination of maximum tolerated and/or recommended Phase II dose of alpelisib plus paclitaxel, and the secondary objectives included the assessment of safety for this combination. From March 2014 to August 2016, 19 patients with advanced solid tumors were treated with alpelisib QD (300 mg, n=6; 250 mg, n=4; 150 mg, n=9) plus paclitaxel (80 mg/m2, per standard of care). During dose finding, five of 12 (41.7%) evaluable patients for MTD determination experienced dose-limiting toxicities: alpelisib 300 mg, Grade 2 hyperglycemia (n=1); alpelisib 250 mg, Grade 2 hyperglycemia (n=1), Grade 4 hyperglycemia and Grade 3 acute kidney injury (n=1); and alpelisib 150 mg, Grade 2 hyperglycemia (n=1) and Grade 4 leukopenia (n=1). The MTD of alpelisib when administered with paclitaxel was 150 mg QD. Most frequent all-grade AEs were diarrhea (73.7%; Grade 3/4 10.5%) and hyperglycemia (57.9%; Grade 3/4 31.6%). The planned dose-expansion phase was not initiated. Alpelisib plus paclitaxel has a challenging safety profile in patients with advanced solid tumors. This study was closed following the completion of the dose-finding phase. Clinical trial registration: ClinicalTrials.gov NCT02051751.
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Affiliation(s)
- Jordi Rodon
- Molecular Therapeutics Research Unit, Department of Medical Oncology, Vall d'Hebron University Hospital, Centro Cellex, 08035, Barcelona, Spain
| | - Giuseppe Curigliano
- Division of Early Drug Development for Innovative Therapies, Department of Hematology and Oncology, University of Milano, Istituto Europeo di Oncologia, 20141, Milan, Italy
| | - Jean-Pierre Delord
- Clinical Research Unit, Institut Claudius Regaud, 31052, Toulouse, France
| | - Wael Harb
- Horizon Oncology Center, 47905, Lafayette, IN, USA
| | - Analia Azaro
- Molecular Therapeutics Research Unit, Department of Medical Oncology, Vall d'Hebron University Hospital, Centro Cellex, 08035, Barcelona, Spain
| | - Yu Han
- Novartis Pharmaceuticals Corporation, 07936, East Hanover, NJ, USA
| | - Celine Wilke
- Novartis Pharma AG, Postfach, CH-4002, Basel, Switzerland
| | | | - Dalila Sellami
- Novartis Pharmaceuticals Corporation, 07936, East Hanover, NJ, USA
| | - Thaddeus Beck
- Highlands Oncology Group, 72703, Fayetteville, AR, USA
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Wawro M, Müller H, Wilke C, Weichert F. Registration of Biplane Angiography and Intravascular Ultrasound for 3D Vessel Reconstruction. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1633891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Abstract:
If planned and applied correctly, intra-vascular brachytherapy (IVB) can significantly reduce the risk of restenosis after interventional treatment of stenotic arteries.
Objectives:
In order to facilitate computer-based IVB planning, a three-dimensional reconstruction of the stenotic artery based on intravascular ultrasound (IVUS) sequences is desirable.
Methods:
To attain a 3D reconstruction, the frames of the IVUS sequence are properly aligned in space and completed with additional intermediate frames generated by interpolation. The alignment procedure uses additional information that is obtained from biplane X-ray angiography performed simultaneously during the capturing of the IVUS sequence. After IVUS images and biplane angiography data are acquired from the patient, the vessel-wall borders and the IVUS catheter are detected by an active contour algorithm. Next, the twist between adjacent IVUS frames is determined by a sequential triangulation method combined with stochastic analysis.
Results:
The above procedure results in a 3D volume-model of the vessel, which also contains information from the IVUS modality. This data is sufficient for computer-based intravascular brachytherapy planning.
Conclusion:
The proposed methodology can be used to improve the current state-of-the-art IVB treatment planning by enabling computerized dosage computations on a highly accurate 3D model.
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Sellami D, Dharan B, Wilke C, Scherer SJ, Hirawat S. Circulating tumor DNA as a novel tool to shape clinical trial designs with the potential to impact outcomes: a focus on PI3K inhibitors. Ann Oncol 2017; 28:2882-2887. [PMID: 28950291 DOI: 10.1093/annonc/mdx480] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Affiliation(s)
- D Sellami
- Department of Oncology Global Development, Novartis Pharmaceuticals Corporation, East Hanover, USA.
| | - B Dharan
- Department of Oncology Global Development, Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - C Wilke
- Department of Oncology Global Development, Novartis Pharma AG, Basel, Switzerland
| | - S J Scherer
- Department of Academic Medical Innovation, Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - S Hirawat
- Department of Oncology Global Development, Novartis Pharmaceuticals Corporation, East Hanover, USA
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Rugo HS, Andre F, Rubovszky G, Kaufman B, Inoue K, Takahashi M, Shimizu S, Ciruelos EM, Campone M, Conte PF, Iwata H, Loibl S, Mayer IA, Juric D, Longin AS, Mills D, Wilke C, Sellami DB. A phase 3 study of alpelisib (ALP) plus fulvestrant (FUL) in men and postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) ABC progressing on or after aromatase inhibitor (AI) therapy: SOLAR-1. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.tps1111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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
TPS1111 Background: Patients (pts) with HR+ breast cancer (BC) often havedysregulatedphosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) pathway, which further leads to resistance to endocrine therapy (ET). In a phase 1 study, alpelisib (BYL719), a PI3Kα-specific inhibitor in combination with fulvestrant (FUL) has demonstrated antitumor activity in pts with estrogen receptor-positive, HER2– advanced BC (ABC) with PIK3CA-altered tumors. SOLAR-1 (NCT02437318) aims to assess the efficacy of ALP + FUL in PIK3CA-mutant and non-mutant tumors in HR+, HER2– ABC setting. Methods: SOLAR-1 is a phase 3, randomized, double-blind study conducted in men and postmenopausal women with HR+, HER2– ABC. Pts are randomly (1:1) allocated to oral alpelisib/placebo (300 mg qd) and intramuscular FUL (500 mg) until disease progression or treatment (tx) discontinuation. Stratification factors are presence of liver and/or lung metastases and prior use of CDK4/6 inhibitors. The eligibility criteria for the targeted BC patient population are shown in the Table. The primary endpoint is progression-free survival (PFS; RECIST v1.1; local assessment), while overall survival (OS) is a key secondary endpoint in the PIK3CA-mutant cohort. Other secondary endpoints are PFS and OS in the PIK3CA non-mutant cohort, the association between PFS and baseline PIK3CAstatus in ctDNA, overall response rate, clinical benefit rate, and safety. Recruitment of the planned 560 pts is currently ongoing. Clinical trial information: NCT02437318. [Table: see text]
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Affiliation(s)
- Hope S. Rugo
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Fabrice Andre
- Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | | | | | - Masato Takahashi
- National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Satoru Shimizu
- Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | | | - Mario Campone
- Institut de Cancérologie de l'Ouest - René Gauducheau, Saint-Herblain, France
| | - Pier Franco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Medical Oncology 2, Instituto Oncologico Veneto IRCCS, Padova, Italy
| | | | | | | | - Dejan Juric
- Massachusetts General Hospital Cancer Center, Boston, MA
| | | | - David Mills
- Novartis Pharmaceuticals AG, Basel, Switzerland
| | - Celine Wilke
- Novartis Pharmaceuticals Corporation, Basel, Switzerland
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18
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Andre F, Kaufman B, Juric D, Ciruelos EM, Iwata H, Mayer IA, Rugo HS, Conte P, Liobl S, Rubovszky G, Inoue K, Tesch H, Lu YS, Ryvo L, Longin AS, Mills D, Wilke C, Germa C, Campone M. Abstract OT2-01-04: SOLAR-1: A phase III study of alpelisib and fulvestrant in men and postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) advanced breast cancer (BC) progressing on or after aromatase inhibitor (AI) therapy. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot2-01-04] [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: The phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) pathway is often dysregulated in HR+ BC and is associated with resistance to endocrine therapy (ET). Alpelisib (BYL719; PI3Kα-specific inhibitor) and fulvestrant showed signs of antitumor activity in patients (pts) with estrogen receptor-positive (ER+), HER2– advanced BC (phase I), especially in PIK3CA-altered tumors (Janku et al. SABCS 2014, PD5-5).
Methods: SOLAR-1 (NCT02437318) is a phase III, randomized, double-blind study in men and postmenopausal women with HR+, HER2– advanced BC. Pts are assigned to 1 of 2 cohorts based on PIK3CA tumor status (mutant vs non-mutant), and randomized 1:1 to oral alpelisib/placebo (300 mg once daily) and intramuscular fulvestrant (500 mg on Day 1 and 15 of Cycle 1; Day 1 of Cycles ≥2 [28-day cycles]) until disease progression or discontinuation. Randomization is stratified by presence of liver and/or lung metastases and prior CDK4/6 inhibitor therapy. Key inclusion criteria: recurrence or progression on or after AI therapy, ≥1 measurable lesion (RECIST v1.1) or predominantly lytic bone lesion, and ECOG performance status ≤1. Key exclusion criteria: symptomatic visceral disease or disease burden precluding ET, acute pancreatitis ≤1 year prior to screening or history of chronic pancreatitis, and prior therapy with fulvestrant, chemotherapy (except [neo]adjuvant), or PI3K/AKT/mTOR inhibitors.
The primary and key secondary endpoints are progression-free survival (PFS; RECIST v1.1; local assessment) and overall survival (OS), respectively, in the PIK3CA-mutant cohort. Other secondary endpoints include PFS and OS in the PIK3CA non-mutant cohort, PFS (Blinded Independent Central Review; RECIST v1.1), the association between PFS and baseline PIK3CA status in circulating tumor DNA, overall response rate, clinical benefit rate, safety, and pharmacokinetics. The primary endpoint will be analyzed by a stratified log-rank test at one-sided 2% level of significance.
Recruitment of the planned 560 pts is ongoing.
Citation Format: Andre F, Kaufman B, Juric D, Ciruelos EM, Iwata H, Mayer IA, Rugo HS, Conte P, Liobl S, Rubovszky G, Inoue K, Tesch H, Lu Y-S, Ryvo L, Longin A-S, Mills D, Wilke C, Germa C, Campone M. SOLAR-1: A phase III study of alpelisib and fulvestrant in men and postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) advanced breast cancer (BC) progressing on or after aromatase inhibitor (AI) therapy [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT2-01-04.
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Affiliation(s)
- F Andre
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - B Kaufman
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - D Juric
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - EM Ciruelos
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - H Iwata
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - IA Mayer
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - HS Rugo
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - P Conte
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - S Liobl
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - G Rubovszky
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - K Inoue
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - H Tesch
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - Y-S Lu
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - L Ryvo
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - A-S Longin
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - D Mills
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - C Wilke
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - C Germa
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
| | - M Campone
- Institut Gustave Roussy, Villejuif, France; The Chaim Sheba Medical Center, Ramat-Gan, Israel; Massachusetts General Hospital, Boston, MA; Hospital Universitario 12 de Octubre, Madrid, Spain; Aichi Cancer Center Hospital, Nagoya, Japan; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Padova and Istituto Oncologico Veneto, Padova, Italy; GBG Forschungs GmbH, Neu-Isenburg, Germany; Országos Onkológiai Intézet, Budapest, Hungary; Saitama Cancer Center, Saitama, Japan; Onkologische Gemeinschaftspraxis, Frankfurt, Germany; National Taiwan University Hospital, Taipei City, Taiwan; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Novartis Pharma S.A.S., Cedex, France; Novartis Pharma AG, Basel, Switzerland; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Institut de Cancérologie de l'Ouest Site Centre René Gauducheau, Saint-Herblain, France
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Iwata H, Rubovszky G, Loibl S, Ciruelos E, Campone M, Juric D, Rugo H, Mayer I, Conte P, Kaufman B, Inoue K, Tesch H, Li YS, Mingorance I, Ryvo L, Iwase H, Longin AS, Mills D, Wilke C, André F. 137TiP A phase III study of alpelisib and fulvestrant for hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) advanced breast cancer (ABC) progressing on or after aromatase inhibitor (AI) therapy (SOLAR-1). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw577.020] [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: 11/13/2022] Open
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Iwata H, Rubovszky G, Loibl S, Ciruelos E, Campone M, Juric D, Rugo H, Mayer I, Conte P, Kaufman B, Inoue K, Tesch H, Li YS, Mingorance I, Ryvo L, Iwase H, Longin AS, Mills D, Wilke C, Andre F. 137TiP A phase III study of alpelisib and fulvestrant for hormone receptor-positive (HR1), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) progressing on or after aromatase inhibitor (AI) therapy (SOLAR-1). Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00295-7] [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: 11/29/2022] Open
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Rodón J, Curigliano G, Delord JP, Harb W, Azaro A, Donnet V, Han Y, Blumenstein L, Wilke C, Beck J. A phase Ib dose-finding study of alpelisib (ALP; BYL719) and paclitaxel (PTX) in advanced solid tumors (aST). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw368.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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André F, Kaufman B, Juric D, Ciruelos E, Iwata H, Mayer I, Conte P, Rugo H, Loibl S, Rubovszky G, Tesch H, Inoue K, Lu YS, Ryvo L, Longin AS, Mills D, Wilke C, Germa C, Campone M. A phase III study of alpelisib and fulvestrant in men and postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) advanced breast cancer (BC) progressing on or after aromatase inhibitor (AI) therapy (SOLAR-1). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ignatiadis M, Zardavas D, Lemort M, Wilke C, Vanderbeeken MC, D’Hondt V, De Azambuja E, Gombos A, Lebrun F, Dal Lago L, Bustin F, Maetens M, Ameye L, Veys I, Michiels S, Paesmans M, Larsimont D, Sotiriou C, Nogaret JM, Piccart M, Awada A. Feasibility Study of EndoTAG-1, a Tumor Endothelial Targeting Agent, in Combination with Paclitaxel followed by FEC as Induction Therapy in HER2-Negative Breast Cancer. PLoS One 2016; 11:e0154009. [PMID: 27454930 PMCID: PMC4959730 DOI: 10.1371/journal.pone.0154009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/27/2016] [Indexed: 11/23/2022] Open
Abstract
Background EndoTAG-1, a tumor endothelial targeting agent has shown activity in metastatic triple-negative breast cancer (BC) in combination with paclitaxel. Methods HER2-negative BC patients candidates for neoadjuvant chemotherapy were scheduled to receive 12 cycles of weekly EndoTAG-1 22mg/m2 plus paclitaxel 70mg/m2 followed by 3 cycles of FEC (Fluorouracil 500mg/m2, Epirubicin 100mg/m2, Cyclophosphamide 500mg/m2) every 3 weeks followed by surgery. Primary endpoint was percent (%) reduction in Magnetic Resonance Imaging (MRI) estimated Gadolinium (Gd) enhancing tumor volume at the end of EndoTAG-1 plus paclitaxel administration as compared to baseline. Safety, pathological complete response (pCR) defined as no residual tumor in breast and axillary nodes at surgery and correlation between % reduction in MRI estimated tumor volume and pCR were also evaluated. Results Fifteen out of 20 scheduled patients were included: Six patients with estrogen receptor (ER)-negative/HER2-negative and 9 with ER-positive/HER2-negative BC. Nine patients completed treatment as per protocol. Despite premedication and slow infusion rates, grade 3 hypersensitivity reactions to EndoTAG-1 were observed during the 1st, 2nd, 3rd and 6th weekly infusion in 4 patients, respectively, and required permanent discontinuation of the EndoTAG-1. Moreover, two additional patients stopped EndoTAG-1 plus paclitaxel after 8 and 9 weeks due to clinical disease progression. Two patients had grade 3 increases in transaminases and 1 patient grade 4 neutropenia. pCR was achieved in 5 of the 6 ER-/HER2- and in none of the 9 ER+/HER2- BC patients. The mean % reduction in MRI estimated tumor volume at the end of EndoTAG-1 plus paclitaxel treatment was 81% (95% CI, 66% to 96%, p<0.001) for the 15 patients that underwent surgery; 96% for patients with pCR and 73% for patients with no pCR (p = 0.04). Conclusions The EndoTAG-1 and paclitaxel combination showed promising preliminary activity as preoperative treatment, especially in ER-/HER2- patients. Further studies are warranted with need of premedication optimization. Trial Registration ClinicalTrials.gov NCT01537536
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Affiliation(s)
- Michail Ignatiadis
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- * E-mail:
| | | | - Marc Lemort
- Department of Radiology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Veronique D’Hondt
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Evandro De Azambuja
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Andrea Gombos
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Fabienne Lebrun
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Lissandra Dal Lago
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Fanny Bustin
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Marion Maetens
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Lieveke Ameye
- Department of Biostatistics, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Isabelle Veys
- Department of Surgery, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Stefan Michiels
- Service de Biostatistique et d’Epidémiologie, Gustave Roussy, Univ. Paris-Sud, Villejuif, France
| | - Marianne Paesmans
- Department of Radiology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Denis Larsimont
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Christos Sotiriou
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean-Marie Nogaret
- Department of Surgery, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Martine Piccart
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- Breast International Group (BIG aisbl), Brussels, Belgium
| | - Ahmad Awada
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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Baselga J, Curigliano G, Martín M, André F, Beck JT, Tortora G, Wilke C, Charbonnier L, Blumenstein L, Donnet V, Fazio N. Abstract CT061: A phase Ib study of alpelisib (BYL719) + everolimus ± exemestane in patients with advanced solid tumors or HR+/HER2-breast cancer. Clin Trials 2016. [DOI: 10.1158/1538-7445.am2016-ct061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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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Andre F, Campone M, Ciruelos EM, Iwata H, Loibl S, Rugo HS, Wilke C, Mills D, Chol M, Longin AS, Juric D. SOLAR-1: A phase III study of alpelisib + fulvestrant in men and postmenopausal women with HR+/HER2– advanced breast cancer (BC) progressing on or after prior aromatase inhibitor therapy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.tps618] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Mario Campone
- Cancer Institute of the West (ICO), Centre René Gauducheau, Medical Oncology Department, Saint-Herblain, France
| | | | | | | | - Hope S. Rugo
- University of California, San Francisco, San Francisco, CA
| | | | | | | | | | - Dejan Juric
- Massachusetts General Hospital Cancer Center, Boston, MA
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Lebok P, Kopperschmidt V, Kluth M, Hube-Magg C, Özden C, B T, Hussein K, Mittenzwei A, Lebeau A, Witzel I, Wölber L, Mahner S, Jänicke F, Geist S, Paluchowski P, Wilke C, Heilenkötter U, Simon R, Sauter G, Terracciano L, Krech R, von d Assen A, Müller V, Burandt E. Partial PTEN deletion is linked to poor prognosis in breast cancer. BMC Cancer 2015; 15:963. [PMID: 26672755 PMCID: PMC4682275 DOI: 10.1186/s12885-015-1770-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [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: 02/09/2015] [Accepted: 10/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Deletions of chromosome 10q23, including the PTEN (phosphatase and tensin homolog) locus, are known to occur in breast cancer, but systematic analyses of its clinical relevance are lacking. METHODS We thus analyzed a tissue microarray (TMA) with 2,197 breast cancers by fluorescence in-situ hybridization (FISH) using a PTEN-specific probe. RESULTS PTEN deletions were detected in 19% of no special type, 9% of lobular, 4% of tubular cancers and 46% in carcinomas with medullary features. 98.7% of deletions were heterozygous and only 1.3% were homozygous. PTEN deletion was significantly linked to advanced tumor stage (p=0.0054), high-grade (p<0.0001), high tumor cell proliferation (Ki67 Labeling Index; p<0.0001), and shortened overall survival (p=0.0090). PTEN deletions were inversely associated with features of luminal type breast cancers (ER/PR positivity; p<0.0001 each, and CCND1 amplification; p=0.0020). PTEN deletions were also strongly linked to amplification of genes involved in the PTEN/AKT pathway such as MYC (p=0.0430) and HER2 (p=0.0065). Remarkably the combined analysis of MYC, HER2, CCND1 and PTEN aberrations suggested that aberrations of multiple PTEN/AKT pathway genes have a strong additive effect on breast cancer prognosis. While cancers with one of these aberrations behaved only marginally different from cancers with none, disease outcome was markedly worse in cancers with two or more aberrations as compared to those with only one aberration (p=0.0002). In addition, the particularly poor prognosis of patients with HER2 amplification and PTEN deletions challenges the concept of PTEN deletions interfering with trastuzumab therapy. CONCLUSION PTEN deletion occurs in a relevant fraction of breast cancers, and is linked to aggressive tumor behavior. Reduced PTEN function cooperates with MYC and HER2 activation in conferring aggressive phenotype to cancer cells.
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Affiliation(s)
- P Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - V Kopperschmidt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - M Kluth
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - C Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - C Özden
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Taskin B
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - K Hussein
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - A Mittenzwei
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - A Lebeau
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - I Witzel
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - L Wölber
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - S Mahner
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - F Jänicke
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - S Geist
- Department of Gynecology, Regio Clinic Pinneberg, Pinneberg, Germany.
| | - P Paluchowski
- Department of Gynecology, Regio Clinic Pinneberg, Pinneberg, Germany.
| | - C Wilke
- Department of Gynecology, Regio Clinic Elmshorn, Elmshorn, Germany.
| | - U Heilenkötter
- Department of Gynecology, Clinical Centre Itzehoe, Itzehoe, Germany.
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - L Terracciano
- Department of Pathology, Basel University Clinics, Basel, Switzerland.
| | - R Krech
- Institute of Pathology, Clinical Centre Osnabrück, Osnabrück, Germany.
| | | | - V Müller
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - E Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Lebok P, Mittenzwei A, Kluth M, Özden C, Taskin B, Hussein K, Möller K, Hartmann A, Lebeau A, Witzel I, Mahner S, Wölber L, Jänicke F, Geist S, Paluchowski P, Wilke C, Heilenkötter U, Simon R, Sauter G, Terracciano L, Krech R, von der Assen A, Müller V, Burandt E. 8p deletion is strongly linked to poor prognosis in breast cancer. Cancer Biol Ther 2015; 16:1080-7. [PMID: 25961141 DOI: 10.1080/15384047.2015.1046025] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Deletions of chromosome 8p occur frequently in breast cancers, but analyses of its clinical relevance have been limited to small patient cohorts and provided controversial results. A tissue microarray with 2,197 breast cancers was thus analyzed by fluorescence in-situ hybridization using an 8p21 probe in combination with a centromere 8 reference probe. 8p deletions were found in 50% of carcinomas with no special type, 67% of papillary, 28% of tubular, 37% of lobular cancers and 56% of cancers with medullary features. Deletions were always heterozygous. 8p deletion was significantly linked to advanced tumor stage (P < 0.0001), high-grade (P < 0.0001), high tumor cell proliferation (Ki67 Labeling Index; P < 0.0001), and shortened overall survival (P < 0.0001). For example, 8p deletion was seen in 32% of 290 grade 1, 43% of 438 grade 2, and 65% of 427 grade 3 cancers. In addition, 8p deletions were strongly linked to amplification of MYC (P < 0.0001), HER2 (P < 0.0001), and CCND1 (p = 0.001), but inversely associated with ER receptor expression (p = 0.0001). Remarkably, 46.5% of 8p-deleted cancers harbored amplification of at least one of the analyzed genes as compared to 27.5% amplifications in 8p-non-deleted cancers (P < 0.0001). In conclusion, 8p deletion characterizes a subset of particularly aggressive breast cancers. As 8p deletions are easy to analyze, this feature appears to be highly suited for future DNA based prognostic breast cancer panels. The strong link of 8p deletion with various gene amplifications raises the possibility of a role for regulating genomic stability.
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Key Words
- 8p
- ER, estrogen receptor
- FISH
- FISH, fluorescence in situ hybridization
- HER2, human epidermal growth factor receptor 2
- Ki67LI, Ki67 Labeling index
- LOH, loss of heterozygosity
- NGS, next generation sequencing
- NST, no special type
- PR, progesterone receptor
- TMA, tissue microarray
- breast cancer
- deletion
- pN, nodal stage
- pT, pathological tumor stage
- prognosis
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Affiliation(s)
- P Lebok
- a Institute of Pathology; University Medical Center Hamburg-Eppendorf ; Hamburg , Germany
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Eckmann-Scholz C, Wilke C, Acil Y, Alkatout I, Salmassi A. Macrophage colony-stimulating factor (M-CSF) im Erst-Trimester-Screening bei auffälligem Schwangerschaftsverlauf. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388053] [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: 10/24/2022] Open
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Wilke C, Heß J, Pitea A, Schmidl D, Klymenko S, Zitzelsberger H, Unger K. 932: Comparative global characterisation of microRNA-expression in radiation-associated and sporadic breast carcinomas. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50831-3] [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: 10/25/2022]
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Biallas B, Froböse I, Zöller M, Wilke C. Analyse der Arbeitsfähigkeit und gesundheitsbezogenen Lebensqualität im Rahmen bewegungsbezogener Maßnahmen der betrieblichen Gesundheitsförderung in einem mittelständischen Unternehmen. Gesundheitswesen 2014; 77:357-61. [DOI: 10.1055/s-0034-1372625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- B. Biallas
- Zentrum für Gesundheit durch Bewegung und Sport, Deutsche Sporthochschule Köln, Köln
| | - I. Froböse
- Institut für Bewegungstherapie und bewegungsorientierte Prävention und Rehabilitation, Deutsche Sporthochschule Köln, Köln
| | - M. Zöller
- Institut für Bewegungstherapie und bewegungsorientierte Prävention und Rehabilitation, Deutsche Sporthochschule Köln, Köln
| | - C. Wilke
- Institut für Bewegungstherapie und bewegungsorientierte Prävention und Rehabilitation, Deutsche Sporthochschule Köln, Köln
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Awada A, Bondarenko IN, Bonneterre J, Nowara E, Ferrero JM, Bakshi AV, Wilke C, Piccart M. A randomized controlled phase II trial of a novel composition of paclitaxel embedded into neutral and cationic lipids targeting tumor endothelial cells in advanced triple-negative breast cancer (TNBC). Ann Oncol 2014; 25:824-831. [PMID: 24667715 DOI: 10.1093/annonc/mdu025] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND EndoTAG-1, composed of paclitaxel embedded in liposomal membranes targeting tumor endothelial cells, was evaluated for safety and efficacy in advanced triple-negative breast cancer (TNBC). PATIENTS AND METHODS One hundred and forty patients were treated with weekly EndoTAG-1 (22 mg/m(2)) plus paclitaxel (70 mg/m(2)), twice weekly EndoTAG-1 (2× 44 mg/m(2)), or weekly paclitaxel (90 mg/m(2)) for greater than or equal to four cycles (3-week treatment + 1-week rest) or until progression/toxicity. Primary end point was progression-free survival (PFS) rate evaluated centrally after four cycles of therapy (week 16). The study was not powered for intergroup comparisons. RESULTS The PFS rate at week 16 was 59.1% [one-sided 95% CI: 45.6, ∞] on combination treatment, 34.2% [21.6, ∞] on EndoTAG-1, and 48.0% [30.5, ∞] on paclitaxel. Median PFS reached 4.2, 3.4, and 3.7 months, respectively. After complete treatment (week 41 analysis), median overall survival (OS) was 13.0, 11.9, and 13.1 months for the modified Intention-to-Treat (ITT) population and 15.1, 12.5, and 8.9 months for the per-protocol population, respectively. The clinical benefit rate was 53%, 31%, and 36% for the treatment groups. Safety analysis revealed known toxicities of the drugs with slight increases of grade 3/4 neutropenia on combination therapy. CONCLUSION Treatment of advanced TNBC with a combination of EndoTAG-1 and standard paclitaxel [Taxol® (Bristol-Myers Squibb GmbH), or equivalent generic formulation] was well tolerated and showed antitumor efficacy. The positive trend needs to be confirmed in a randomized phase III trial. STUDY REGISTRATION European Clinical Trials Database: EudraCT number 2006-002221-23. ClinicalTrials.gov identifier: NCT00448305.
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Affiliation(s)
- A Awada
- Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium.
| | - I N Bondarenko
- Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine
| | - J Bonneterre
- Oscar Lambret Center of Fight Against Cancer, Lille, France
| | - E Nowara
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - J M Ferrero
- Antoine Lacassagne Center of Fight Against Cancer, Nice, France
| | - A V Bakshi
- Kaushalya Medical Foundation, Thane, India
| | - C Wilke
- Medigene AG, Martinsried, Germany
| | - M Piccart
- Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium
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Beck TF, Wilke C, Wirxel B, Endres D, Lindner A, Giese MA. Me - Not Me - Or In Between? Comparison of Causal Inference Models for Agency attribution in goal-directed actions. J Vis 2013. [DOI: 10.1167/13.9.745] [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: 11/24/2022] Open
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Ignatiadis M, Lemort M, Wilke C, Vanderbeeken MC, D'hondt V, Gombos A, De Azambuja E, Lebrun F, Dal Lago L, Maetens M, Ameye L, Veys I, Michiels S, Paesmans M, Larsimont D, Sotiriou C, Nogaret JM, Piccart-Gebhart MJ, Awada A. Feasibility study of cationic liposome-encapsulated paclitaxel in combination with paclitaxel followed by FEC as induction therapy in HER2-negative breast cancer. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e12008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e12008 Background: Cationic liposome-encapsulated paclitaxel , a tumor endothelial targeting agent (composition of paclitaxel combined with neutral and cationic lipids) has shown activity in metastatic triple-negative breast cancer (BC) in combination with paclitaxel (Awada et al. ESMO2010). No data exist in the non-metastatic setting. Methods: HER2-negative BC candidates for neoadjuvant chemotherapy were scheduled to receive 12 cycles of weeklycationic liposome-encapsulated paclitaxel 22mg/m2 plus paclitaxel 70mg/m2 followed by 3 cycles of FEC (Fluorouracil 500mg/m2, Epirubicin 100mg/m2, Cyclophosphamide 500mg/m2) every 3 weeks followed by surgery. Primary endpoint was percent (%) reduction in Magnetic Resonance Imaging (MRI) estimated tumor volume at the end of cationic liposome-encapsulated paclitaxel plus paclitaxel administration as compared to baseline. Safety, pathological complete response (pCR) defined as no residual tumor in breast and axillary nodes at surgery and correlation between % reduction in MRI estimated tumor volume and pCR were also evaluated. Results: Six patients with estrogen receptor (ER)-negative/HER2-negative and 9 with ER-positive/HER2-negative BC were included. Nine patients completed treatment as per protocol. Despite premedication and slow infusion rates, grade 3 hypersensitivity reactions to cationic liposome-encapsulated paclitaxel were observed during the 1st, 2nd, 3rd and 6th weekly infusion in 4 patients, respectively and required permanent discontinuation of the cationic liposome-encapsulated paclitaxel . Two patients stopped cationic liposome-encapsulated paclitaxel plus paclitaxel after 8 and 9 weeks due to clinical disease progression, two patients had grade 3 increase in transaminases and 1 patient grade 4 neutropenia. PCR was observed in 5 of the 6 ER-/HER2- and in none of the 8 ER+/HER2- BC patients. The median % reduction in MRI estimated tumor volume at the end of cationic liposome-encapsulated paclitaxel plus paclitaxel treatment was 90% (95% Confidence Interval: 69-99%), (p<0.001, sign test) for the 14 patients that underwent surgery; 99% (CI:87-100%) for patients with pCR and 84% (CI:50-95%) for patients with no pCR. Conclusions: The cationic liposome-encapsulated paclitaxel and paclitaxel combination showed promising preliminary activity as preoperative treatment, especially in ER-/HER2- patients. Further studies are warranted with need of premedication optimization. Clinical trial information: NCT01537536.
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Affiliation(s)
| | - Marc Lemort
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Veronique D'hondt
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Evandro De Azambuja
- Institut Jules Bordet, Brussels, Université Libre de Bruxelles, Ixelles, Belgium, Brussels, Belgium
| | | | | | - Marion Maetens
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Lieveke Ameye
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Isabelle Veys
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Stefan Michiels
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Marianne Paesmans
- Institut Jules Bordet, Université Libre de Bruxelles, Ixelles, Belgium, Brussels, Belgium
| | - Denis Larsimont
- Jules Bordet Institute, Department of Pathology, Brussels, Belgium
| | | | | | | | - Ahmad Awada
- Medical Oncology Clinic, Jules Bordet Institute, Brussels, Belgium
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Brandt C, Kozakov R, Testrich H, Golubovskii YB, Wilke C. Spatial relaxation of selective laser perturbations in a glow discharge plasma. Phys Rev E Stat Nonlin Soft Matter Phys 2013; 87:013103. [PMID: 23410442 DOI: 10.1103/physreve.87.013103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Indexed: 06/01/2023]
Abstract
An effect of a nonlocal plasma response caused by local laser radiation exciting atoms in resonant and metastable states is observed in a dc neon glow discharge. Starting at the perturbed position, spatially damped oscillations in the direction of the anode effecting all plasma quantities are created. Depending on the excitation of resonant or metastable atoms, the oscillations are phase-shifted by π. If the laser excites in particular a cycling transition, no nonlocal plasma response is observed. The relaxation of the plasma is investigated by means of visible light measurements using a line camera in the vicinity of the axial perturbation position. The effect is modeled in terms of nonlocal electron kinetics by solving the spatially inhomogeneous electron Boltzmann equation.
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Affiliation(s)
- C Brandt
- Center for Energy Research, University of California-San Diego, La Jolla, California 92093-0417, USA.
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Trebst C, Berthele A, Jarius S, Kümpfel T, Schippling S, Wildemann B, Wilke C. [Diagnosis and treatment of neuromyelitis optica. Consensus recommendations of the Neuromyelitis Optica Study Group]. Nervenarzt 2012; 82:768-77. [PMID: 21174070 DOI: 10.1007/s00115-010-3192-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C Trebst
- Neurologische Klinik, Medizinische Hochschule Hannover, Hannover.
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Waldmann A, Adrich S, Eisemann N, Fauteck H, Grande-Nagel I, Schaefer FKW, Vorkefeld M, Warnecke C, Weidner K, Wilke C, Katalinic A. [Structure and process quality of quality-assured mamma diagnostics in Schleswig-Holstein]. ROFO-FORTSCHR RONTG 2011; 184:113-21. [PMID: 22161233 DOI: 10.1055/s-0031-1281983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE To demonstrate the structure and process quality of quality-assured mamma diagnostics (QuaMaDi) by means of quality indicators as defined in the European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis and in the National Guideline on Early Detection of Cancer in Germany. Furthermore, spatial differences and changes in the chronological sequence were analyzed. MATERIALS AND METHODS We used administrative data as documented in the time period 2006 - 2009 in QuaMaDi in Schleswig-Holstein (SH), Germany, and analyzed quality indicators as defined in the abovementioned guidelines (absolute and relative frequencies, 95 % confidence intervals). RESULTS Each year approximately 6 % of all women age 20 or older living in SH are examined using QuaMaDi. Only minor differences regarding age and clinical data were seen between the patients in the four regions of SH. Reference values for the quality indicators are largely reached (i. e., proportion of women with breast density ACR 3 or 4 plus additional ultrasound = 96.2 %; proportion with repeated mammography = 0.2 %). Spatial differences are only minor. In the chronological sequence, quality indicators improve, if they did not reach the reference values in the beginning, or indicate a high and constant quality. CONCLUSION With regard to those quality indicators that were computable, reference values as defined in the guidelines were reached in 9 of 12 cases. In one case the difference between the observed value and the reference values is system-immanent and in another case the difference is less than four percentage points (reference value 90 %).
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Affiliation(s)
- A Waldmann
- Institut für Klinische Epidemiologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck.
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Beck TF, Wilke C, Wirxel B, Endres D, Lindner A, Giese MA. Me or Not Me: Causal Inference of Agency in goal-directed actions. J Vis 2011. [DOI: 10.1167/11.11.955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Astolfi L, De Vico Fallani F, Toppi J, Cincotti F, Mattia D, Salinari S, Vecchiato G, Wilke C, Yuan H, He B, Babiloni F. S2.3 Neural basis of cooperation and defection during social interaction: a neuroelectrical hyperscanning study. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60010-2] [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: 11/17/2022]
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Astolfi L, Cincotti F, Mattia D, De Vico Fallani F, Salinari S, Vecchiato G, Toppi J, Wilke C, Doud A, Yuan H, He B, Babiloni F. Imaging the social brain: multi-subjects EEG recordings during the "Chicken's game". Annu Int Conf IEEE Eng Med Biol Soc 2011; 2010:1734-7. [PMID: 21096409 DOI: 10.1109/iembs.2010.5626708] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this study we measured simultaneously by EEG hyperscannings the neuroelectric activity in 6 couples of subjects during the performance of the "Chicken's game", derived from game theory. The simultaneous recording of the EEG in couples of interacting subjects allows to observe and model directly the neural signature of human interactions in order to understand the cerebral processes generating and generated by social cooperation or competition. Results suggested that the one of the most consistently activated structure in this particular social interaction paradigm is the left orbitofrontal cortex. Connectivity results also showed a significant involvement of the orbitofrontal regions of both hemispheres across the observed population. Taken together, results confirms that the study of the brain activities in humans during social interactions can take benefit from the simultaneous acquisition of brain activity during such interaction.
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Affiliation(s)
- L Astolfi
- Dep. of Computer Science of the Univ. of Rome "Sapienza", Italy.
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Astolfi L, Cincotti F, Mattia D, De Vico Fallani F, Salinari S, Vecchiato G, Toppi J, Wilke C, Doud A, Yuan H, He B, Babiloni F. Simultaneous estimation of cortical activity during social interactions by using EEG hyperscannings. Annu Int Conf IEEE Eng Med Biol Soc 2011; 2010:2814-7. [PMID: 21096219 DOI: 10.1109/iembs.2010.5626555] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In this paper we show how the possibility of recording simultaneously the cerebral neuroelectric activity in different subjects (EEG hyperscanning) during the execution of different tasks could return useful information about the "internal" cerebral state of the subjects. We present the results obtained by EEG hyperscannings during ecological task (such as the execution of a card game) as well as that obtained in a series of couples of subjects during the performance of the Prisoner's Dilemma Game. The simultaneous recordings of couples of interacting subjects allows to observe and to model directly the neural signature of human interactions in order to understand the cerebral processes generating and generated by social cooperation or competition. Results obtained in a study of different groups recorded during the card game revealed a larger activity in prefrontal and anterior cingulated cortex in different frequency bands for the player that leads the game when compared to other players. Results collected in a population of 10 subjects during the performance of the Prisoner's Dilemma suggested that the most consistently activated structure is the orbitofrontal region (roughly described by the Brodmann area 10) during the condition of competition in both the tasks. It could be speculated whether the pattern of cortical connectivity between different cortical areas in different subjects could be employed as a tool for assessing the outcome of the task in advance.
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Affiliation(s)
- L Astolfi
- Dep. of Computer Science of the Univ. of Rome "Sapienza", IRCCS "Fondazione Santa Lucia", Italy.
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Astolfi L, De Vico Fallani F, Cincotti F, Mattia D, Vecchiato G, Toppi J, Salinari S, Wilke C, Yuan H, He B, Babiloni F. P10-13 Study of the cortical activity from simultaneous multi-subject EEG recordings. Clin Neurophysiol 2010. [DOI: 10.1016/s1388-2457(10)60666-9] [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: 11/30/2022]
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Astolfi L, Cincotti F, Mattia D, De Vico Fallani F, Salinari S, Marciani MG, Wilke C, Doud A, Yuan H, He B, Babiloni F. Estimation of the cortical activity from simultaneous multi-subject recordings during the prisoner's dilemma. Annu Int Conf IEEE Eng Med Biol Soc 2010; 2009:1937-9. [PMID: 19964016 DOI: 10.1109/iembs.2009.5333456] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
One of the most challenging questions open in Neuroscience today is the characterization of the brain responses during social interaction. A major limitation of the approaches used in most of the studies performed so far is that only one of the participating brains is measured each time. The "interaction" between cooperating, competing or communicating brains is thus not measured directly, but inferred by independent observations aggregated by cognitive models and assumptions that link behavior and neural activation. In this paper, we present the results of the simultaneous neuroelectric recording of 5 couples of subjects engaged in cooperative games (EEG hyperscanning). The simultaneous recordings of couples of interacting subjects allows to observe and model directly the neural signature of human interactions in order to understand the cerebral processes generating and generated by social cooperation or competition. We used a paradigm called Prisoner's dilemma derived from the game theory. Results collected in a population of 10 subjects suggested that the most consistently activated structure in social interaction paradigms is the orbitofrontal region (roughly described by the Brodmann area 10) during the condition of competition.
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Affiliation(s)
- L Astolfi
- Department of Computer Science of the Univiversity of Rome, Sapienza, Rome, Italy.
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Hutchings L, Augustyn C, Cockcroft A, Van der Lingen C, Coetzee J, Leslie RW, Tarr RJ, Oosthuizen H, Lipinski MR, Roberts MR, Wilke C, Crawford R, Shannon LJ, Mayekiso M. Marine fisheries monitoring programmes in South Africa. S AFR J SCI 2010. [DOI: 10.4102/sajs.v105i5/6.85] [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: 11/01/2022] Open
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Wilke C, van Drongelen W, Kohrman M, He B. Identification of epileptogenic foci from causal analysis of ECoG interictal spike activity. Clin Neurophysiol 2009; 120:1449-56. [PMID: 19616474 DOI: 10.1016/j.clinph.2009.04.024] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2008] [Revised: 03/31/2009] [Accepted: 04/02/2009] [Indexed: 11/26/2022]
Abstract
OBJECTIVE In patients with intractable epilepsy, the use of interictal spikes as surrogate markers of the epileptogenic cortex has generated significant interest. Previous studies have suggested that the cortical generators of the interictal spikes are correlated with the epileptogenic cortex as identified from the ictal recordings. We hypothesize that causal analysis of the functional brain networks during interictal spikes are correlated with the clinically-defined epileptogenic zone. METHODS We employed a time-varying causality measure, the adaptive directed transfer function (ADTF), to identify the cortical sources of the interictal spike activity in eight patients with medically intractable neocortical-onset epilepsy. The results were then compared to the foci identified by the epileptologists. RESULTS In all eight patients, the majority of the ADTF-calculated source activity was observed within the clinically-defined SOZs. Furthermore, in three of the five patients with two separate epileptogenic foci, the calculated source activity was correlated with both cortical sites. CONCLUSIONS The ADTF method identified the cortical sources of the interictal spike activity as originating from the same cortical locations as the recorded ictal activity. SIGNIFICANCE Evaluation of the sources of the cortical networks obtained during interictal spikes may provide information as to the generators underlying the ictal activity.
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Affiliation(s)
- C Wilke
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN 55455, USA
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Jolly M, Pickard AS, Wilke C, Mikolaitis RA, Teh LS, McElhone K, Fogg L, Block J. Lupus-specific health outcome measure for US patients: the LupusQoL-US version. Ann Rheum Dis 2009; 69:29-33. [DOI: 10.1136/ard.2008.094763] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Patient-reported outcomes are valuable for the management of chronic diseases like systematic lupus erythematosus (SLE), but no measures have been validated for use in US-based patients with SLE.Objectives:To adapt and assess the validity and reliability of an SLE-specific quality of life (QoL) measure developed in the United Kingdom, the LupusQoL, for use in US-based patients with SLE.Methods:Debriefing interviews of subjects with SLE guided the language modifications of the tool. The LupusQoL-US, SF-36 and EQ5D were administered. Internal consistency (ICR) and test–retest (TRT) reliability, convergent and discriminative validity were examined. Factor analyses were performed.Results:The mean (SD) age of the 185 subjects with SLE was 42.5 (12.9) years. ICR and TRT of the eight domains ranged from 0.85 to 0.94 and 0.68 to 0.92, respectively. Related domains on the SF-36 correlated with the LupusQoL domains (physical health and physical function r = 0.73, physical health and role physical r = 0.57, emotional health and mental health r = 0.72, emotional health and role emotional r = 0.48, pain and bodily pain r = 0.66, fatigue and vitality r = 0.70, planning and social functioning r = 0.58). Most LupusQoL-US domains could discriminate between subjects with varied disease activity and damage. Principal component analysis disclosed five factors in the US version, with physical function, pain and planning items loading on one factor.Conclusions:These data provide evidence to support the psychometric properties of the LupusQoL-US, suggesting its utility as an assessment tool for patients with SLE in the USA.
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Wilke C, Röttger H, Adler L. Vortäuschung eines akuten zentralen Schwindelsyndroms mit internuklärer Ophthalmoplegie durch Überlagerung eines Duane-Syndroms mit einer Neuritis vestibularis. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086880] [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: 10/21/2022]
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Yamawaki N, Wilke C, Hue L, Liu Z, He B. Enhancement of classification accuracy of a time-frequency approach for an EEG-based brain-computer interface. Methods Inf Med 2007; 46:155-9. [PMID: 17347747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVES The aim of this paper is to develop a new algorithm to enhance the performance of EEG-based brain-computer interface (BCI). METHODS We improved our time-frequency approach of classification of motor imagery (MI) tasks for BCI applications. The approach consists of Laplacian filtering, band-pass filtering and classification by correlation of time-frequency-spatial patterns. RESULTS AND CONCLUSIONS Through off-line analysis of data collected during a "cursor control" experiment, we evaluated the capability of our new method to reveal major features of the EEG control for enhancement of MI classification accuracy. The pilot results in a human subject are promising, with an accuracy rate of 96.1%.
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Affiliation(s)
- N Yamawaki
- Department of Biomedical Engineering, University of Minnesota, 7-105 NHH, 312 Church Street S.E., Minneapolis, MN 55455, USA
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Yamawaki N, Wilke C, Hue L, Liu Z, He B. Enhancement of Classification Accuracy of a Time-frequency Approach for an EEG-based Brain-computer Interface. Methods Inf Med 2007. [DOI: 10.1055/s-0038-1625398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Objectives
: The aim of this paper is to develop a new algorithm to enhance the performance of EEG-based brain-computer interface (BCI).
Methods
: We improved our time-frequency approach of classification of motor imagery (MI) tasks for BCI applications. The approach consists of Laplacian filtering, band-pass filtering and classification by correlation of time-frequency-spatial patterns.
Results and Conclusions
: Through off-line analysis of data collected during a “cursor control" experiment, we evaluated the capability of our new method to reveal major features of the EEG control for enhancement of MI classification accuracy. The pilot results in a human subject are promising, with an accuracy rate of 96.1%.
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Kiank C, Holtfreter B, Starke A, Mundt A, Wilke C, Schütt C. Stress susceptibility predicts the severity of immune depression and the failure to combat bacterial infections in chronically stressed mice. Brain Behav Immun 2006; 20:359-68. [PMID: 16330179 DOI: 10.1016/j.bbi.2005.10.151] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2005] [Revised: 09/23/2005] [Accepted: 10/24/2005] [Indexed: 11/30/2022] Open
Abstract
Chronic psychological stress has been suggested to play a role in disorders in which the immune system unexpectedly fails to respond in a protective manner. Chronic combined acoustic and restraint stress compromises the anti-bacterial defense mechanisms of female BALB/c mice. The immunodeficiency is characterized by an apoptotic loss of lymphocytes, reduced ex vivo-inducibility of TNF but increased inducibility of IL10, reduced T-cell proliferation, and impaired phagocyte functions. Stressed mice develop depression-like behavior that was monitored by a stress severity score (SSS). Besides a strain (BALB/c>CBA) and gender (male>female) dependent susceptibility to chronic stress, inbred mice have an individual coping ability. Importantly, the individual SSS strongly correlates with Escherichia coli dissemination after infection as well as with IL10-inducibility and circulating corticosterone levels of each animal.
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Affiliation(s)
- C Kiank
- Department of Immunology, University of Greifswald, Germany
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Fukuyama T, Kozakov R, Testrich H, Wilke C. Spatiotemporal synchronization of coupled oscillators in a laboratory plasma. Phys Rev Lett 2006; 96:024101. [PMID: 16486580 DOI: 10.1103/physrevlett.96.024101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2005] [Indexed: 05/06/2023]
Abstract
The spatiotemporal synchronization between two plasma instabilities of autonomous glow discharge tubes is observed experimentally. For this purpose, two tubes are placed separately and two chaotic waves interact with each other through a coupler. When the coupling strength is changed, the coupled oscillators exhibit synchronization in time and space. This is the first experimental evidence of spatiotemporal synchronization by mutual chaotic wave interaction in plasma.
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Affiliation(s)
- T Fukuyama
- Faculty of Education, Ehime University, Matsuyama, Ehime 790-8577, Japan
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