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Tong TML, Fiocco M, van Duijn-de Vreugd JJ, Lutjeboer J, Speetjens FM, Tijl FGJ, Sitsen ME, Zoethout RWM, Martini CH, Vahrmeijer AL, van der Meer RW, van Rijswijk CSP, van Erkel AR, Kapiteijn E, Burgmans MC. Correction to: Quality of Life Analysis of Patients Treated with Percutaneous Hepatic Perfusion for Uveal Melanoma Liver Metastases. Cardiovasc Intervent Radiol 2024:10.1007/s00270-024-03733-w. [PMID: 38709262 DOI: 10.1007/s00270-024-03733-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Affiliation(s)
- T M L Tong
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - M Fiocco
- Mathematical Institute, Leiden University, Leiden, The Netherlands
- Medical Statistics Section, Department of Biomedical Data Science, Leiden University Medical Center, Leiden, The Netherlands
| | - J J van Duijn-de Vreugd
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - J Lutjeboer
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - F M Speetjens
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - F G J Tijl
- Department of Extra Corporal Circulation, Leiden University Medical Center, Leiden, The Netherlands
| | - M E Sitsen
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - R W M Zoethout
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - C H Martini
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - A L Vahrmeijer
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - R W van der Meer
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - C S P van Rijswijk
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - A R van Erkel
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - E Kapiteijn
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - M C Burgmans
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
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Tong TML, Fiocco M, van Duijn-de Vreugd JJ, Lutjeboer J, Speetjens FM, Tijl FGJ, Sitsen ME, Zoethout RWM, Martini CH, Vahrmeijer AL, van der Meer RW, van Rijswijk CSP, van Erkel AR, Kapiteijn E, Burgmans MC. Quality of Life Analysis of Patients Treated with Percutaneous Hepatic Perfusion for Uveal Melanoma Liver Metastases. Cardiovasc Intervent Radiol 2024:10.1007/s00270-024-03713-0. [PMID: 38587534 DOI: 10.1007/s00270-024-03713-0] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/12/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE Percutaneous hepatic perfusion with melphalan (M-PHP) is a minimally invasive therapy with proven efficacy in patients with uveal melanoma (UM) liver metastases. M-PHP is associated with a short hospital admission time and limited systemic side effects. In this study, we assessed quality of life (QoL) in UM patients treated with M-PHP. MATERIALS AND METHODS A prospective, single-center study including 24 patients treated with M-PHP for UM metastases to the liver. QoL questionnaires were collected at baseline, on day 2/3 after M-PHP, and on day 7 and day 21 after M-PHP, according to study protocol. The results were scored according to EORTC-QLQ C30 global health status (GHS), functional scales, and symptom scales. The difference in scores at baseline and subsequent time points was analyzed with the Wilcoxon signed-rank test and multiple testing Bonferroni correction. Adverse events (AE) were registered up to 30 days after M-PHP according to CTCAE v5.0. RESULTS Twenty-four patients (14 males; median age 63.0 years) completed 96 questionnaires. Most scores on all scales declined on day 2/3 after M-PHP. On day 21 after M-PHP, 12 out of 15 scores returned to baseline, including median GHS scores. Three variables were significantly worse on day 21 compared to baseline: fatigue (6-33; p = 0.002), physical functioning (100 vs 86.7; p = 0.003), and role functioning (100 vs 66.7; p = 0.001). Grade 3/4 AEs consisted mainly of hematological complications, such as leukopenia and thrombopenia. CONCLUSION M-PHP causes fatigue and a decline in physical and role functioning in the 1st weeks after treatment, but GHS returns to baseline levels within 21 days. LEVEL OF EVIDENCE 3: Cohort study.
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Affiliation(s)
- T M L Tong
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - M Fiocco
- Mathematical Institute, Leiden University, Leiden, The Netherlands
- Medical Statistics Section, Department of Biomedical Data Science, Leiden University Medical Center, Leiden, The Netherlands
| | - J J van Duijn-de Vreugd
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - J Lutjeboer
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - F M Speetjens
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - F G J Tijl
- Department of Extra Corporal Circulation, Leiden University Medical Center, Leiden, The Netherlands
| | - M E Sitsen
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - R W M Zoethout
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - C H Martini
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - A L Vahrmeijer
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - R W van der Meer
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - C S P van Rijswijk
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - A R van Erkel
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - E Kapiteijn
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - M C Burgmans
- Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
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Borgers JSW, Burgers FH, Schina A, Van Not OJ, van den Eertwegh AJM, Blank CU, Aarts MJB, van den Berkmortel FWPJ, de Groot JWB, Hospers GAP, Kapiteijn E, Piersma D, van Rijn RS, Boer AMSD, van der Veldt AAM, Vreugdenhil G, Boers-Sonderen MJ, Wouters MWJM, Suijkerbuijk KPM, van Thienen JV, Haanen JBAG. Seasonal variation of anti-PD-1 outcome in melanoma-Results from a Dutch patient cohort. Pigment Cell Melanoma Res 2024; 37:15-20. [PMID: 37554041 DOI: 10.1111/pcmr.13117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/28/2023] [Revised: 06/09/2023] [Accepted: 07/22/2023] [Indexed: 08/10/2023]
Abstract
Despite the improved survival rates of patients with advanced stage melanoma since the introduction of ICIs, many patients do not have (long-term) benefit from these treatments. There is evidence that the exposome, an accumulation of host-extrinsic factors including environmental influences, could impact ICI response. Recently, a survival benefit was observed in patients with BRAF wild-type melanoma living in Denmark who initiated immunotherapy in summer as compared to winter. As the Netherlands lies in close geographical proximity to Denmark and has comparable seasonal differences, a Dutch validation cohort was established using data from our nationwide melanoma registry. In this study, we did not observe a similar seasonal difference in overall survival and are therefore unable to confirm the Danish findings. Validation of either the Dutch or Danish findings in (combined) patient cohorts from other countries would be necessary to determine whether this host-extrinsic factor influences the response to ICI-treatment.
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Affiliation(s)
- J S W Borgers
- Department of Medical Oncology, Antoni van Leeuwenhoek-The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - F H Burgers
- Department of Medical Oncology, Antoni van Leeuwenhoek-The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A Schina
- National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - O J Van Not
- Dutch Institute for Clinical Auditing, Leiden, The Netherlands
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A J M van den Eertwegh
- Department of Medical Oncology, Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - C U Blank
- Department of Medical Oncology, Antoni van Leeuwenhoek-The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M J B Aarts
- Department of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | | | - G A P Hospers
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - E Kapiteijn
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - D Piersma
- Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - R S van Rijn
- Department of Internal Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | | | - A A M van der Veldt
- Department of Medical Oncology and Radiology & Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - G Vreugdenhil
- Department of Internal Medicine, Maxima Medical Center, Veldhoven, The Netherlands
| | - M J Boers-Sonderen
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M W J M Wouters
- Dutch Institute for Clinical Auditing, Leiden, The Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Surgical Oncology, Antoni van Leeuwenhoek-The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - K P M Suijkerbuijk
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J V van Thienen
- Department of Medical Oncology, Antoni van Leeuwenhoek-The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J B A G Haanen
- Department of Medical Oncology, Antoni van Leeuwenhoek-The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Egeler MD, van de Poll-Franse LV, Tissier R, Rogiers A, Boers-Sonderen MJ, van den Eertwegh AJ, Hospers GA, de Groot JWB, Aarts MJB, Kapiteijn E, Piersma D, Vreugdenhil G, van der Veldt AA, Suijkerbuijk KPM, Neyns B, Janssen KJ, Blank CU, Retèl VP, Boekhout AH. Health-state utilities in long-term advanced melanoma survivors comparable with the general population. Qual Life Res 2023; 32:2517-2525. [PMID: 37079262 DOI: 10.1007/s11136-023-03427-9] [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] [Accepted: 04/16/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Checkpoint inhibitors have been shown to substantially improve the survival of patients with advanced melanoma. With this growing group of survivors treated with immunotherapies, assessing their health-state utilities is essential and can be used for the calculation of quality-adjusted life years and for cost-effectiveness analyses. Therefore, we evaluated the health-state utilities in long-term advanced melanoma survivors. METHODS Health-state utilities were evaluated in a cohort of advanced melanoma survivors 24-36 months (N = 37) and 36-plus months (N = 47) post-ipilimumab monotherapy. In addition, the health-state utilities of the 24-36 months survivor group were assessed longitudinally, and utilities of the combined survival groups (N = 84) were compared with a matched control population (N = 168). The EQ-5D was used to generate health-state utility values, and quality-of-life questionnaires were used to establish correlations and influencing factors of utility scores. RESULTS Health-state utility scores were similar between the 24-36 months'- and the 36-plus months' survival group (0.81 vs 0.86; p = .22). In survivors, lower utility scores were associated with symptoms of depression (β = - .82, p = .022) and fatigue burden (β = - .29, p = .007). Utility scores did not significantly change after 24-36 months of survival, and the utilities of survivors were comparable to the matched control population (0.84 vs 0.87; p = .07). DISCUSSION Our results show that long-term advanced melanoma survivors treated with ipilimumab monotherapy experience relatively stable and high health-state utility scores.
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Affiliation(s)
- M D Egeler
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
| | - L V van de Poll-Franse
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research On Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - R Tissier
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - A Rogiers
- Department of Psychiatry, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - M J Boers-Sonderen
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A J van den Eertwegh
- Department of Medical Oncology, Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - G A Hospers
- Department of Medical Oncology, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - M J B Aarts
- Department of Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - E Kapiteijn
- Leiden University Medical Centre, Leiden, The Netherlands
| | - D Piersma
- Medical Spectrum Twente, Enschede, The Netherlands
| | - G Vreugdenhil
- Department of Internal Medicine, Maxima Medical Centre, Eindhoven, The Netherlands
| | - A A van der Veldt
- Departments of Medical Oncology and Radiology & Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - K P M Suijkerbuijk
- Department of Medical Oncology, University Medical Cancer Center, Utrecht, The Netherlands
| | - B Neyns
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - K J Janssen
- Bristol-Myers Squibb, Utrecht, The Netherlands
| | - C U Blank
- Department of Medical Oncology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - V P Retèl
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Health Technology & Services Research, University of Twente, Enschede, The Netherlands
| | - A H Boekhout
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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Piperno-Neumann S, Carlino MS, Boni V, Loirat D, Speetjens FM, Park JJ, Calvo E, Carvajal RD, Nyakas M, Gonzalez-Maffe J, Zhu X, Shirley MD, Ramkumar T, Fessehatsion A, Burks HE, Yerramilli-Rao P, Kapiteijn E. A phase I trial of LXS196, a protein kinase C (PKC) inhibitor, for metastatic uveal melanoma. Br J Cancer 2023; 128:1040-1051. [PMID: 36624219 PMCID: PMC10006169 DOI: 10.1038/s41416-022-02133-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Up to 50% of patients with uveal melanoma develop metastases (MUM) with a poor prognosis and median overall survival of approximately 1 year. METHODS This phase I study evaluated the safety, tolerability, pharmacokinetics, pharmacodynamics and efficacy of the oral protein kinase C inhibitor LXS196 in 68 patients with MUM (NCT02601378). Patients received LXS196 doses ranging from 100-1000 mg once daily (QD; n = 38) and 200-400 mg twice daily (BID; n = 30). RESULTS First cycle dose-limiting toxicities (DLTs) were observed in 7/38 (18.4%) QD and 2/17 (11.8%) BID patients. Hypotension was the most common DLT, occurring at doses ≥500 mg/day, and manageable with LXS196 interruption and dose reduction. Median duration of exposure to LXS196 was 3.71 months (range: 1.81-15.28) for QD and 4.6 months (range: 0.33-58.32) for BID dosing. Clinical activity was observed in 6/66 (9.1%) evaluable patients achieving response (CR/PR), with a median duration of response of 10.15 months (range: 2.99-41.95); 45/66 had stable disease (SD) per RECIST v1.1. At 300 mg BID, the recommended dose for expansion, 2/18 (11.1%) evaluable patients achieved PR and 12/18 (66.7%) had SD. CONCLUSION These results suggest manageable toxicity and encouraging clinical activity of single-agent LXS196 in patients with MUM.
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Affiliation(s)
| | - M S Carlino
- Blacktown and Westmead Hospitals, Sydney, NSW, Australia.,Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - V Boni
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | | | - F M Speetjens
- Leiden University Medical Center, Leiden, The Netherlands
| | - J J Park
- Blacktown and Westmead Hospitals, Sydney, NSW, Australia
| | - E Calvo
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - R D Carvajal
- Columbia University Irving Medical Center, New York, NY, USA
| | - M Nyakas
- Oslo University Hospital, Oslo, Norway
| | | | - X Zhu
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - M D Shirley
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - T Ramkumar
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - A Fessehatsion
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - H E Burks
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | | | - E Kapiteijn
- Leiden University Medical Center, Leiden, The Netherlands
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Joode K, Groen H, van den Heuvel M, Kloover J, van der Meer F, Stigt J, van der Leest C, Van Den Borne B, de Wijn R, Hurkmans D, van den Heuvel D, van Doorn T, Pinedo B, Kapiteijn E, Debets R, Verdegaal E, van der Burg S, Groten J, Aerts J, Mathijssen R. 31P The IOpener study: Tyrosine kinase activity profiling to predict response to immune checkpoint inhibitors in patients with advanced stage non-small cell lung cancer. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Versluis J, Elens R, Reijers I, Menzies A, Van der Veldt A, Kapiteijn E, Rozeman E, Klop M, Van Houdt W, Saw R, Zuur C, Pennington T, van de Wiel B, Scolyer R, Broeks A, van Akkooi A, Long G, Blank C. 791MO Clinical and tumor characteristics of patients (pts) with recurrence after pathologic response upon neoadjuvant ipilimumab (IPI) + nivolumab (NIVO) in stage III melanoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.917] [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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de Joode K, Suijkerbuijk K, de Groot J, Van der Veldt A, Westgeest H, de Wijn R, Hurkmans D, van den Heuvel D, Schmidt K, van Doorn T, Pinedo H, Groten J, Verdegaal E, van der Burg S, Aerts J, Debets R, Kapiteijn E, Mathijssen R. 860P The IOpener study: Tyrosine kinase activity in peripheral lymphocytes to predict durable response to immune checkpoint inhibition in patients with advanced melanoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.986] [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] Open
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Dimitriou F, Hassel J, Orloff M, Hughes I, Kapiteijn E, Mehmi I, Montazeri K, Johnson D, Grover P, Gerard C, Simeone E, Gaudy Marqueste C, Cheng P, Long G, Carvajal R, Dummer R. 832P Treatment sequence with tebentafusp (tebe) and anti-PD1/ipilimumab (PD1+IPI) in HLA-A2*02:01 patients (pts) with metastatic uveal melanoma (mUM). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.958] [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: 11/25/2022] Open
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van Laar S, Kapiteijn E, Gombert K, Guchelaar HJ, Zwaveling J. 812P Early experiences in adjuvant treatment of melanoma: Real-world data on tolerability, safety and efficacy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.938] [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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van Not O, Van Den Eertwegh F, Haanen J, van Rijn R, Aarts M, Van den Berkmortel F, Blank C, Boers-Sonderen M, de Groot J, Hospers G, Kapiteijn E, De Meza M, Piersma D, Stevense-den Boer M, Van der Veldt A, Vreugdenhil G, Wouters M, Blokx W, Suijkerbuijk K. 859P The influence of hematologic malignancies on response to immune checkpoint inhibition in patients with advanced melanoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.985] [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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Tong TML, van der Kooij MK, Speetjens FM, van Erkel AR, van der Meer RW, Lutjeboer J, van Persijn van Meerten EL, Martini CH, Zoethout RWM, Tijl FGJ, Blank CU, Burgmans MC, Kapiteijn E. Combining Hepatic Percutaneous Perfusion with Ipilimumab plus Nivolumab in advanced uveal melanoma (CHOPIN): study protocol for a phase Ib/randomized phase II trial. Trials 2022; 23:137. [PMID: 35152908 PMCID: PMC8842930 DOI: 10.1186/s13063-022-06036-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/16/2022] [Indexed: 12/23/2022] Open
Abstract
Background While immune checkpoint inhibition (ICI) has revolutionized the treatment of metastatic cutaneous melanoma, no standard treatments are available for patients with metastatic uveal melanoma (UM). Several locoregional therapies are effective in the treatment of liver metastases, such as percutaneous hepatic perfusion with melphalan (M-PHP). The available literature suggests that treatment with ICI following locoregional treatment of liver UM metastases can result in clinical response. We hypothesize that combining M-PHP with ICI will lead to enhanced antigen presentation and increased immunomodulatory effect, improving control of both hepatic and extrahepatic disease. Methods Open-label, single-center, phase Ib/randomized phase II trial, evaluating the safety and efficacy of the combination of M-PHP with ipilimumab (anti-CTLA-4 antibody) and nivolumab (anti-PD-1 antibody) in patients with unresectable hepatic metastases of UM in first-line treatment, with or without the limited extrahepatic disease. The primary objective is to determine the safety, toxicity, and efficacy of the combination regimen, defined by maximum tolerated dose (MTD) and progression-free survival (PFS) at 1 year. Secondary objectives include overall survival (OS) and overall response rate (ORR). A maximum of 88 patients will be treated in phase I and phase II combined. Baseline characteristics will be described with descriptive statistics (t-test, chi-square test). To study the association between risk factors and toxicity, a logistic regression model will be applied. PFS and OS will be summarized using Kaplan-Meier curves. Discussion This is the first trial to evaluate this treatment combination by establishing the maximum tolerated dose and evaluating the efficacy of the combination treatment. M-PHP has shown to be a safe and effective treatment for UM patients with liver metastases and became the standard treatment option in our center. The combination of ICI with M-PHP is investigated in the currently described trial which might lead to a better treatment response both in and outside the liver. Trial Registration This trial was registered in the US National Library of Medicine with identifier NCT04283890. Registered as per February 2020 - Retrospectively registered. EudraCT registration number: 2018-004248-49. Local MREC registration number: NL60508.058.19.
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Franken MG, Leeneman B, Aarts MJB, van Akkooi ACJ, van den Berkmortel FWPJ, Boers-Sonderen MJ, van den Eertwegh AJM, de Groot JWB, Hospers GAP, Kapiteijn E, Piersma D, van Rijn RS, Suijkerbuijk KPM, van der Veldt AAM, Westgeest HM, Wouters MWJM, Haanen JBAG, Uyl-de Groot CA. Trends in survival and costs in metastatic melanoma in the era of novel targeted and immunotherapeutic drugs. ESMO Open 2021; 6:100320. [PMID: 34856511 PMCID: PMC8639434 DOI: 10.1016/j.esmoop.2021.100320] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 10/08/2021] [Accepted: 11/01/2021] [Indexed: 11/17/2022] Open
Abstract
Background The objective of this study was to evaluate trends in survival and health care costs in metastatic melanoma in the era of targeted and immunotherapeutic drugs. Materials and methods Data on survival and health care resource use were retrieved from the Dutch Melanoma Treatment Registry. The Kaplan–Meier method was used to estimate overall survival. Health care costs and budget impact were computed by applying unit costs to individual patient resource use. All outcomes were stratified by year of diagnosis. Results Baseline characteristics were balanced across cohort years. The percentage of patients receiving systemic treatment increased from 73% in 2013 to 90% in 2018. Patients received on average 1.85 [standard deviation (SD): 1.14] lines of treatment and 41% of patients received at least two lines of treatment. Median survival increased from 11.8 months in 2013 [95% confidence interval (CI): 10.7-13.7 months] to 21.1 months in 2018 (95% CI: 18.2 months-not reached). Total mean costs were €100 330 (SD: €103 699); systemic treatments accounted for 84% of the total costs. Costs for patients who received systemic treatment [€118 905 (SD: €104 166)] remained reasonably stable over the years even after the introduction of additional (combination of) novel drugs. From mid-2013 to 2018, the total budget impact for all patients was €452.79 million. Conclusion Our study shows a gain in survival in the era of novel targeted and immunotherapeutic drugs. These novel drugs came, however, along with substantial health care costs. Further insights into the cost-effectiveness of the novel drugs are crucial for ensuring value for money in the treatment of patients with metastatic melanoma. The median survival of patients with metastatic melanoma increased from 11.8 months in 2013 to 21.1 months in 2018. The gain in survival came along with substantial health care costs; health care costs were on average €100 300 per patient. Costs were much higher for patients with systemic treatment (€118 905) than for patients without systemic treatment (€8316). Costs for patients who received systemic treatment remained stable even after the introduction of additional novel drugs. Insights into the cost-effectiveness of the novel drugs are crucial for ensuring value for money in metastatic melanoma.
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Affiliation(s)
- M G Franken
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - B Leeneman
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - M J B Aarts
- Department of Medical Oncology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A C J van Akkooi
- Department of Surgical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | | | - M J Boers-Sonderen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A J M van den Eertwegh
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - G A P Hospers
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - E Kapiteijn
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - D Piersma
- Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - R S van Rijn
- Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - K P M Suijkerbuijk
- Department of Medical Oncology, UMC Utrecht Cancer Center, Utrecht, The Netherlands
| | - A A M van der Veldt
- Department of Medical Oncology and Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - H M Westgeest
- Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands
| | - M W J M Wouters
- Department of Surgical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, The Netherlands; Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - J B A G Haanen
- Department of Medical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - C A Uyl-de Groot
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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14
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Vos J, Traets J, Qiao X, Seignette I, Wouters M, Hooijberg E, Broeks A, Van Der Wal J, Klop M, Schreuder P, Karakullukcu B, van Poelgeest M, Kapiteijn E, Blank C, Haanen J, Zuur C. 23P A comprehensive analysis of the mucosal melanoma immune microenvironment. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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15
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van der Ziel D, Derks M, Kapiteijn E, Bastiaannet E, Louwman M, vandenBos F, Mooijaart S, Portielje J, de Glas N. Time trends in treatment strategies and survival of older versus younger patients with synchronous metastasized melanoma – a population-based study in the Netherlands Cancer Registry. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00336-2] [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: 11/27/2022]
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Suijkerbuijk KPM, Haanen JBAG, Boers-Sonderen MJ, Hospers GAP, Blank CU, van den Berkmortel FWPJ, de Groot JWB, Piersma D, Aarts MJB, van Rijn RS, Vreugdenhil G, Westgeest HM, Kapiteijn E, van der Veldt AAM, van den Eertwegh AJM. Survival of stage IV melanoma in Belgium and the Netherlands. J Eur Acad Dermatol Venereol 2021; 36:e118-e119. [PMID: 34536304 DOI: 10.1111/jdv.17668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/11/2021] [Indexed: 12/31/2022]
Affiliation(s)
- K P M Suijkerbuijk
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J B A G Haanen
- Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M J Boers-Sonderen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - G A P Hospers
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - C U Blank
- Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | | | - D Piersma
- Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - M J B Aarts
- Department of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - R S van Rijn
- Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - G Vreugdenhil
- Department of Internal Medicine, Maxima Medical Center, Eindhoven, The Netherlands
| | - H M Westgeest
- Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands
| | - E Kapiteijn
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - A A M van der Veldt
- Departments of Medical Oncology and Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A J M van den Eertwegh
- Department of Medical Oncology, Amsterdam UMC, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Fouchardiere CDL, Fugazzola L, Taylor J, Appetecchia M, Besic N, Bongiovanni A, Buffet C, Costante G, Gay S, Grande E, Kapiteijn E, Krajewska J, Kroiss M, Morreau H, Netea-Maier R, Peeters R, Soares P, Sykiotis G, Blay JY, Locati L. 1750P Molecular genotyping in refractory thyroid cancers: Results of a European survey. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.896] [Citation(s) in RCA: 1] [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: 11/26/2022] Open
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18
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Breeschoten J, Van den Eertwegh A, de Wreede L, Hilarius D, van Zwet E, Haanen J, Blank C, Aarts M, Van den Berkmortel F, de Groot J, Hospers G, Kapiteijn E, Piersma D, van Rijn R, Stevense M, Van der Veldt A, Vreugdenhil G, Boers-Sonderen M, Suijkerbuijk K, Wouters M. 1081P Hospital variation in cancer treatments and survival outcomes of advanced melanoma patients: Nation-wide quality assurance in the Netherlands. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1466] [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] Open
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Mulder EEAP, de Joode K, Litière S, Ten Tije AJ, Suijkerbuijk KPM, Boers-Sonderen MJ, Hospers GAP, de Groot JWB, van den Eertwegh AJM, Aarts MJB, Piersma D, van Rijn RS, Kapiteijn E, Vreugdenhil G, van den Berkmortel FWPJ, Hoop EOD, Franken MG, Ryll B, Rutkowski P, Sleijfer S, Haanen JBAG, van der Veldt AAM. Early discontinuation of PD-1 blockade upon achieving a complete or partial response in patients with advanced melanoma: the multicentre prospective Safe Stop trial. BMC Cancer 2021; 21:323. [PMID: 33765967 PMCID: PMC7993897 DOI: 10.1186/s12885-021-08018-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 03/09/2021] [Indexed: 12/26/2022] Open
Abstract
Background The introduction of programmed cell death protein 1 (PD-1) blockers (i.e. nivolumab and pembrolizumab) has significantly improved the prognosis of patients with advanced melanoma. However, the long treatment duration (i.e. two years or longer) has a high impact on patients and healthcare systems in terms of (severe) toxicity, health-related quality of life (HRQoL), resource use, and healthcare costs. While durable tumour responses have been observed and PD-1 blockade is discontinued on an individual basis, no consensus has been reached on the optimal treatment duration. The objective of the Safe Stop trial is to evaluate whether early discontinuation of first-line PD-1 blockade is safe in patients with advanced and metastatic melanoma who achieve a radiological response. Methods The Safe Stop trial is a nationwide, multicentre, prospective, single-arm, interventional study in the Netherlands. A total of 200 patients with advanced and metastatic cutaneous melanoma and a confirmed complete response (CR) or partial response (PR) according to response evaluation criteria in solid tumours (RECIST) v1.1 will be included to early discontinue first-line monotherapy with nivolumab or pembrolizumab. The primary objective is the rate of ongoing responses at 24 months after discontinuation of PD-1 blockade. Secondary objectives include best overall and duration of response, need and outcome of rechallenge with PD-1 blockade, and changes in (serious) adverse events and HRQoL. The impact of treatment discontinuation on healthcare resource use, productivity losses, and hours of informal care will also be assessed. Results will be compared to those from patients with CR or PR who completed 24 months of treatment with PD-1 blockade and had an ongoing response at treatment discontinuation. It is hypothesised that it is safe to early stop first-line nivolumab or pembrolizumab at confirmed tumour response while improving HRQoL and reducing costs. Discussion From a patient, healthcare, and economic perspective, shorter treatment duration is preferred and overtreatment should be prevented. If early discontinuation of first-line PD-1 blockade appears to be safe, early discontinuation of PD-1 blockade may be implemented as the standard of care in a selected group of patients. Trial registration The Safe Stop trial has been registered in the Netherlands Trial Register (NTR), Trial NL7293 (old NTR ID: 7502), https://www.trialregister.nl/trial/7293. Date of registration September 30, 2018.
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Affiliation(s)
- E E A P Mulder
- Department of Medical Oncology, Erasmus Medical Centre Cancer Institute, Rotterdam, The Netherlands.,Department of Surgical Oncology, Erasmus Medical Centre Cancer Institute, Rotterdam, The Netherlands
| | - K de Joode
- Department of Medical Oncology, Erasmus Medical Centre Cancer Institute, Rotterdam, The Netherlands
| | - S Litière
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - A J Ten Tije
- Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands
| | - K P M Suijkerbuijk
- Department of Medical Oncology, University Medical Centre Utrecht Cancer Centre, Utrecht, The Netherlands
| | - M J Boers-Sonderen
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - G A P Hospers
- Department of Medical Oncology, University Medical Centre Groningen, Groningen, The Netherlands
| | - J W B de Groot
- Department of Medical Oncology, Isala Oncological Centre, Zwolle, The Netherlands
| | - A J M van den Eertwegh
- Department of Medical Oncology, Amsterdam University Medical Centre - location VU, Amsterdam, The Netherlands
| | - M J B Aarts
- Department of Medical Oncology, Maastricht University Medical Centre +, Maastricht, The Netherlands
| | - D Piersma
- Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - R S van Rijn
- Department of Internal Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - E Kapiteijn
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - G Vreugdenhil
- Department of Internal Medicine, Máxima Medical Centre, Veldhoven, The Netherlands
| | | | - E Oomen-de Hoop
- Department of Medical Oncology, Erasmus Medical Centre Cancer Institute, Rotterdam, The Netherlands
| | - M G Franken
- Institute for Medical Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - B Ryll
- Melanoma Patient Network Europe, Uppsala, Sweden
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - S Sleijfer
- Department of Medical Oncology, Erasmus Medical Centre Cancer Institute, Rotterdam, The Netherlands
| | - J B A G Haanen
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - A A M van der Veldt
- Department of Medical Oncology, Erasmus Medical Centre Cancer Institute, Rotterdam, The Netherlands. .,Department of Radiology & Nuclear Medicine, Erasmus Medical Centre Cancer Institute, Rotterdam, The Netherlands.
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20
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Boekhout AH, Rogiers A, Jozwiak K, Boers-Sonderen MJ, van den Eertwegh AJ, Hospers GA, de Groot JWB, Aarts MJB, Kapiteijn E, ten Tije AJ, Piersma D, Vreugdenhil G, van der Veldt AA, Suijkerbuijk KPM, Rozeman EA, Neyns B, Janssen KJ, van de Poll-Franse LV, Blank CU. Health-related quality of life of long-term advanced melanoma survivors treated with anti-CTLA-4 immune checkpoint inhibition compared to matched controls. Acta Oncol 2021; 60:69-77. [PMID: 32924708 DOI: 10.1080/0284186x.2020.1818823] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Checkpoint inhibitors have changed overall survival for patients with advanced melanoma. However, there is a lack of data on health-related quality of life (HRQoL) of long-term advanced melanoma survivors, years after treatment. Therefore, we evaluated HRQoL in long-term advanced melanoma survivors and compared the study outcomes with matched controls without cancer. MATERIAL AND METHODS Ipilimumab-treated advanced melanoma survivors without evidence of disease and without subsequent systemic therapy for a minimum of two years following last administration of ipilimumab were eligible for this study. The European Organization for Research and Treatment of Cancer quality of life questionnaire Core 30 (EORTC QLQ-C30), the Multidimensional Fatigue Inventory (MFI), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-Melanoma questionnaire (FACT-M) were administered. Controls were individually matched for age, gender, and educational status. Outcomes of survivors and controls were compared using generalized estimating equations, and differences were interpreted as clinically relevant according to published guidelines. RESULTS A total of 89 survivors and 265 controls were analyzed in this study. After a median follow-up of 39 (range, 17-121) months, survivors scored significantly lower on physical (83.7 vs. 89.8, difference (diff) = -5.80, p=.005), role (83.5 vs. 90, diff = -5.97, p=.02), cognitive (83.7 vs. 91.9, diff = -8.05, p=.001), and social functioning (86.5 vs. 95.1, diff = -8.49, p= <.001) and had a higher symptom burden of fatigue (23.0 vs. 15.5, diff = 7.48, p=.004), dyspnea (13.3 vs. 6.7, diff = 6.47 p=.02), diarrhea (7.9 vs. 4.0, diff = 3.78, p=.04), and financial impact (10.5 vs. 2.5, diff = 8.07, p=.001) than matched controls. Group differences were indicated as clinically relevant. DISCUSSION Compared to matched controls, long-term advanced melanoma survivors had overall worse functioning scores, more physical symptoms, and financial difficulties. These data may contribute to the development of appropriate survivorship care.
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Affiliation(s)
- A. H. Boekhout
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - A. Rogiers
- Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - K. Jozwiak
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - M. J. Boers-Sonderen
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - G. A. Hospers
- Department of Medical Oncology, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - M. J. B. Aarts
- Department of Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - E. Kapiteijn
- Leiden University Medical Centre, Leiden,The Netherlands
| | - A. J. ten Tije
- Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands
| | - D. Piersma
- Medical Spectrum Twente, Enschede,The Netherlands
| | - G. Vreugdenhil
- Department of Internal Medicine, Maxima Medical Centre, Eindhoven,The Netherlands
| | | | - K. P. M. Suijkerbuijk
- Department of Medical Oncology, University Medical Cancer Center, Utrecht, The Netherlands
| | - E. A. Rozeman
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - B. Neyns
- Universitair Ziekenhuis Brussel, Brussel, Belgium
| | | | - L. V. van de Poll-Franse
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - C. U. Blank
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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21
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van Zeijl MCT, de Wreede LC, van den Eertwegh AJM, Wouters MWJM, Jochems A, Schouwenburg MG, Aarts MJB, van Akkooi ACJ, van den Berkmortel FWPJ, de Groot JWB, Hospers GAP, Kapiteijn E, Piersma D, van Rijn RS, Suijkerbuijk KPM, Ten Tije AJ, van der Veldt AAM, Vreugdenhil G, van der Hoeven JJM, Haanen JBAG. Survival outcomes of patients with advanced melanoma from 2013 to 2017: Results of a nationwide population-based registry. Eur J Cancer 2020; 144:242-251. [PMID: 33373869 DOI: 10.1016/j.ejca.2020.11.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 10/15/2020] [Accepted: 11/15/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The treatment landscape has completely changed for advanced melanoma. We report survival outcomes and the differential impact of prognostic factors over time in daily clinical practice. METHODS From a Dutch nationwide population-based registry, patients with advanced melanoma diagnosed from 2013 to 2017 were analysed (n = 3616). Because the proportional hazards assumption was violated, a multivariable Cox model restricted to the first 6 months and a multivariable landmark Cox model from 6 to 48 months were used to assess overall survival (OS) of cases without missing values. The 2017 cohort was excluded from this analysis because of the short follow-up time. RESULTS Median OS of the 2013 and 2016 cohort was 11.7 months (95% confidence interval [CI]: 10.4-13.5) and 17.7 months (95% CI: 14.9-19.8), respectively. Compared with the 2013 cohort, the 2016 cohort had superior survival in the Cox model from 0 to 6 months (hazard ratio [HR] = 0.55 [95% CI: 0.43-0.72]) and in the Cox model from 6 to 48 months (HR = 0.68 [95% CI: 0.57-0.83]). Elevated lactate dehydrogenase levels, distant metastases in ≥3 organ sites, brain and liver metastasis and Eastern Cooperative Oncology Group performance score of ≥1 had stronger association with inferior survival from 0 to 6 months than from 6 to 48 months. BRAF-mutated melanoma had superior survival in the first 6 months (HR = 0.50 [95% CI: 0.42-0.59]). CONCLUSION(S) Prognosis for advanced melanoma in the Netherlands has improved from 2013 to 2016. Prognostic importance of most evaluated factors was higher in the first 6 months after diagnosis. BRAF-mutated melanoma was only associated with superior survival in the first 6 months.
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Affiliation(s)
- M C T van Zeijl
- Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands; Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333ZA, the Netherlands
| | - L C de Wreede
- Department of Biomedical Data Sciences, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333ZC, the Netherlands
| | - A J M van den Eertwegh
- Department of Medical Oncology, Amsterdam UMC, Location VU Medical Center (VUmc), Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, 1081 HV, the Netherlands
| | - M W J M Wouters
- Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands; Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, the Netherlands
| | - A Jochems
- Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands; Department of Medical Oncology, Haaglanden Medisch Centrum, Lijnbaan 32, Den Haag, 2512VA, the Netherlands
| | - M G Schouwenburg
- Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, the Netherlands
| | - M J B Aarts
- Department of Medical Oncology, Maastricht University Medical Center, P. Debyelaan 25, Maastricht, 6229 HX, the Netherlands
| | - A C J van Akkooi
- Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, the Netherlands
| | - F W P J van den Berkmortel
- Department of Medical Oncology, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, Sittard-Geleen, 6162BG, the Netherlands
| | - J W B de Groot
- Department of Medical Oncology, Isala Clinics, Dokter van Heesweg 2, Zwolle, 8025AB, the Netherlands
| | - G A P Hospers
- Department of Medical Oncology, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713GZ, the Netherlands
| | - E Kapiteijn
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333ZA, the Netherlands
| | - D Piersma
- Department of Internal Medicine, Medisch Spectrum Twente, Koningsplein 1, Enschede, 7512KZ, the Netherlands
| | - R S van Rijn
- Department of Internal Medicine, Medical Center Leeuwarden, Henri Dunantweg 2, Leeuwarden, 8934AD, the Netherlands
| | - K P M Suijkerbuijk
- Department of Medical Oncology, University Medical Center Utrecht, Cancer Center, Heidelberglaan 100, Utrecht, 3584CX, the Netherlands
| | - A J Ten Tije
- Department of Internal Medicine, Amphia Hospital, Molengracht 21, Breda, 4818CK, the Netherlands
| | - A A M van der Veldt
- Department of Medical Oncology, Erasmus MC Cancer Institute, 's-Gravendijkwal 230, Rotterdam, 3015CE, the Netherlands
| | - G Vreugdenhil
- Department of Internal Medicine, Maxima Medical Center, De Run 4600, Eindhoven, 5504DB, the Netherlands
| | - J J M van der Hoeven
- Department of Medical Oncology, Radboudumc, Geert Grooteplein Zuid 10, Nijmegen, 6525GA, the Netherlands
| | - J B A G Haanen
- Divisions of Medical Oncology and Molecular Oncology & Immunology, the Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, the Netherlands.
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Breeschoten J, Wouters M, Hilarius D, Haanen J, Blank C, Aarts M, Van den Berkmortel F, de Groot J, Hospers G, Kapiteijn E, Piersma D, Van Rijn R, Suijkerbuijk K, Blokx W, Tije AT, Van der Veldt A, Vreugdenhil G, Boers-Sonderen M, van den Eertwegh A. 37P First-line BRAF/MEK-inhibitors versus anti-PD-1 monotherapy in BRAFV600-mutant advanced melanoma patients: A propensity-matched survival analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.524] [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] Open
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Spagnolo F, Dalmasso B, Helgadottir H, Höiom V, van Doorn R, Kapiteijn E, Potrony M, Puig S, Queirolo P, Ghiorzo P. 1130P BRAF and MEK inhibition in CDKN2A germline carriers and BRAF mutant melanoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1253] [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: 10/23/2022] Open
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Van Den Heuvel N, Reijers I, Versluis J, Rozeman E, Jóźwiak K, Blommers K, Saw R, Suijkerbuijk K, Kapiteijn E, Van der Veldt A, Hospers G, Spillane A, Pennington T, Wouters M, Menzies A, van Akkooi A, de Poll-Franse LV, Long G, Blank C, Boekhout A. 1085P Health-related quality of life in stage III melanoma patients treated with neoadjuvant ipilimumab and nivolumab followed by index lymph node excision only versus therapeutic lymph node dissection: 24-week results of the PRADO trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1209] [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: 10/23/2022] Open
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Newbold K, Schoeffski P, Hasan B, Locati L, Godbert Y, de la Fouchardiere C, Bastholt L, Fassnacht M, Reed N, Lalami Y, Chougnet C, Schvartz C, Kapiteijn E, Schlumberger M, Sents W, Sauve N, Leboulleux S. 1919P Nintedanib (BIBF1120) after first line therapy in progressive medullary thyroid cancer: A multicenter EORTC prospective randomized double-blind phase II study (NCT01788982). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1407] [Citation(s) in RCA: 1] [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: 11/27/2022] Open
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Versluis J, Hendriks A, Weppler A, Brown L, de Joode K, Suijkerbuijk K, Zimmer L, Kapiteijn E, Allayous C, Johnson D, Hepner A, Mangana J, Bhave P, Jansen Y, Trojaniello C, Atkinson V, Storey L, de Vries E, Blank C, Jalving M. 1080MO The value of local therapy in treatment of solitary melanoma progression upon immune checkpoint inhibition. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1204] [Citation(s) in RCA: 1] [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: 10/23/2022] Open
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Ismail R, de Boer A, van Dartel M, Hilarius D, van Zeijl M, van den Eertwegh F, Aarts M, Van den Berkmortel F, Boers-Sonderen M, de Groot J, Haanen J, Hospers G, Kapiteijn E, Piersma D, van Rijn R, Suijkerbuijk K, Tije AT, Van der Veldt A, Vreugdenhil G, Wouters M. 1103P Long-term survival of real-world advanced melanoma patients treated with targeted therapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1226] [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: 11/27/2022] Open
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Breugom A, Bastiaannet E, Guren M, Kørner H, Boelens P, Dekker F, Kapiteijn E, Gelderblom H, Larsen I, Liefers G, van de Velde C. Treatment strategies and overall survival for incurable metastatic colorectal cancer – A EURECCA international comparison including 21,196 patients from the Netherlands and Norway. Eur J Surg Oncol 2020; 46:1167-1173. [DOI: 10.1016/j.ejso.2020.02.005] [Citation(s) in RCA: 4] [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] [Received: 09/26/2019] [Revised: 01/15/2020] [Accepted: 02/10/2020] [Indexed: 12/26/2022] Open
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Aydemirli MD, Kapiteijn E, Ferrier KRM, Ottevanger PB, Links TP, van der Horst-Schrivers ANA, Broekman KE, Groenwold RHH, Zwaveling J. Effectiveness and toxicity of lenvatinib in refractory thyroid cancer: Dutch real-life data. Eur J Endocrinol 2020; 182:131-138. [PMID: 31751307 DOI: 10.1530/eje-19-0763] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [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] [Received: 09/25/2019] [Accepted: 11/14/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The SELECT trial showed progression-free survival (PFS) benefit for lenvatinib for advanced radioiodine-refractory differentiated thyroid cancer (RAI-refractory or RR-DTC) patients, on which current clinical practice is based. We assessed whether the effectiveness and toxicity of lenvatinib in real-life clinical practice in the Netherlands were comparable to the pivotal SELECT trial. METHODS From three Dutch centres Electronic Health Records (EHRs) of patients treated in the lenvatinib compassionate use program or as standard of care were reviewed and checked for SELECT eligibility criteria. Baseline characteristics, safety, and efficacy measures were compared and PFS and overall survival (OS) were calculated. Furthermore, PFS was compared to estimates of PFS reported in other studies. RESULTS A total of 39 DTC patients with a median age of 62 years were analysed. Of these, 27 patients (69%) did not fulfil the SELECT eligibility criteria. The most common grade ≥3 toxicities were hypertension (n = 11, 28%), diarrhoea (n = 7, 18%), vomiting (n = 4, 10%), and gallbladder disease (n = 3, 8%). Median PFS and median OS were 9.7 (95% confidence interval (CI): 4.0-15.5) and 18.3 (95% CI: 4.9-31.7) months, respectively, response rate was 38% (95% CI: 23-54%). PFS in the Dutch real-life situation was comparable to previous real-life studies, but inferior to PFS as shown in the SELECT trial (P = 0.04). CONCLUSIONS PFS in our non-trial population was significantly shorter than in the SELECT trial population. In the interpretation of results, differences in the real-life population and the SELECT study population regarding patient characteristics should be taken into account.
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Affiliation(s)
- M D Aydemirli
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - E Kapiteijn
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - K R M Ferrier
- Department of Pharmacology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - P B Ottevanger
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - T P Links
- Department of Endocrinology, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - K E Broekman
- Department of Medical Oncology, University Medical Centre Groningen, Groningen, The Netherlands
| | - R H H Groenwold
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - J Zwaveling
- Department of Clinical Pharmacology and Toxicology, Leiden University Medical Centre, Leiden, The Netherlands
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Butler M, Robert C, Negrier S, In G, Walker J, Krajsova I, Atkinson V, Hansson J, Kapiteijn E, Loquai C, Shaw H, Cheng T, Mansard S, Grob J, Guidoboni M, Mehta M, Ascierto P, Diab A. ILLUMINATE 301: A randomized phase III study of tilsotolimod in combination with ipilimumab compared with ipilimumab alone in patients with advanced melanoma following progression on or after anti-PD-1 therapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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van Zeijl M, Wouters MWJM, van den Eertwegh A, de Wreede L, Aarts M, van Akkooi A, Van den Berkmortel FWPJ, de Groot J, Boers-Sonderen M, van der Hoeven J, Hospers G, Kapiteijn E, Piersma D, van Rijn R, Suijkerbuijk K, Ten Tije A, Van der Veldt A, Vreugdenhil G, Haanen JBAG. Real-world outcomes of ipilimumab plus nivolumab for advanced melanoma in the Netherlands. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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32
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Boekhout A, Rogiers A, Jozwiak K, Boers-Sonderen M, van den Eertwegh A, Hospers G, de Groot J, Aarts M, Kapiteijn E, Ten Tije A, Piersma D, Vreugdenhil G, Van der Veldt A, Suijkerbuijk K, Rozeman E, Neyns B, Janssen K, van de Poll-Franse L, Blank C. Health-related quality of life of advanced melanoma survivors treated with CTLA-4 immune checkpoint inhibition: A matched cohort study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz262.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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van der Velden DL, Hoes LR, van der Wijngaart H, van Berge Henegouwen JM, van Werkhoven E, Roepman P, Schilsky RL, de Leng WWJ, Huitema ADR, Nuijen B, Nederlof PM, van Herpen CML, de Groot DJA, Devriese LA, Hoeben A, de Jonge MJA, Chalabi M, Smit EF, de Langen AJ, Mehra N, Labots M, Kapiteijn E, Sleijfer S, Cuppen E, Verheul HMW, Gelderblom H, Voest EE. The Drug Rediscovery protocol facilitates the expanded use of existing anticancer drugs. Nature 2019; 574:127-131. [DOI: 10.1038/s41586-019-1600-x] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 08/14/2019] [Indexed: 12/19/2022]
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van der Tuin K, Ventayol Garcia M, Corver WE, Khalifa MN, Ruano Neto D, Corssmit EPM, Hes FJ, Links TP, Smit JWA, Plantinga TS, Kapiteijn E, van Wezel T, Morreau H. Targetable gene fusions identified in radioactive iodine refractory advanced thyroid carcinoma. Eur J Endocrinol 2019; 180:235-241. [PMID: 30668525 DOI: 10.1530/eje-18-0653] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 08/30/2018] [Accepted: 01/21/2019] [Indexed: 12/12/2022]
Abstract
Objective Gene alterations leading to activation of the MAPK pathway are of interest for targeted therapy in patients with advanced radioactive iodine refractory (RAI-R) thyroid carcinoma. Due to technical reasons gene fusion analysis in RNA isolated from formalin-fixed tumor tissues has till now been limited. The objective of the present study was to identify targetable gene rearrangements in RNA isolated from formalin-fixed RAI-R thyroid carcinomas. Design Retrospective study in 132 patients with RAI-R thyroid carcinoma (59 papillary-, 24 follicular-, 35 Hürthle cell- and 14 anaplastic thyroid carcinoma). Methods Total nucleic acid (undivided DNA and RNA) was isolated from formalin-fixed tissue. Extensive gene fusion analysis was performed in all samples that tested negative for pathogenic BRAF, NRAS, HRAS and KRAS variants. Results Seven targetable gene fusions were identified in the remaining 60 samples without known DNA variants. This includes frequently reported gene fusions such as CCDC6/RET (PTC1), PRKAR1A/RET (PTC2) and ETV6/NTRK3 , and gene fusions that are less common in thyroid cancer (TPM3/NTRK1, EML4/ALK and EML4/NTRK3). Of note, most gene fusions were detected in papillary thyroid carcinoma and MAPK-associated alterations in Hürthle cell carcinomas are rare (2/35). Conclusion Targetable gene fusions were found in 12% of RAI-R thyroid carcinoma without DNA variants and can be effectively identified in formalin-fixed tissue. These gene fusions might provide a preclinical rationale to include specific kinase inhibitors in the treatment regimen for these patients. The latter intends to restore iodine transport and/or take advantage of the direct effect on tumor cell vitality once progressive disease is seen.
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Affiliation(s)
- K van der Tuin
- Department of Clinical Genetics, Division of Endocrinology, Leiden University Medical Centre, Leiden, the Netherlands
| | - M Ventayol Garcia
- Department of Pathology, Division of Endocrinology, Leiden University Medical Centre, Leiden, the Netherlands
| | - W E Corver
- Department of Pathology, Division of Endocrinology, Leiden University Medical Centre, Leiden, the Netherlands
| | - M N Khalifa
- Department of Pathology, Division of Endocrinology, Leiden University Medical Centre, Leiden, the Netherlands
| | - D Ruano Neto
- Department of Pathology, Division of Endocrinology, Leiden University Medical Centre, Leiden, the Netherlands
| | - E P M Corssmit
- Department of Medicine, Division of Endocrinology, Leiden University Medical Centre, Leiden, the Netherlands
| | - F J Hes
- Department of Clinical Genetics, Division of Endocrinology, Leiden University Medical Centre, Leiden, the Netherlands
| | - T P Links
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J W A Smit
- Department of Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - T S Plantinga
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - E Kapiteijn
- Department of Oncology, Leiden University Medical Centre, Leiden, the Netherlands
| | - T van Wezel
- Department of Pathology, Division of Endocrinology, Leiden University Medical Centre, Leiden, the Netherlands
| | - H Morreau
- Department of Pathology, Division of Endocrinology, Leiden University Medical Centre, Leiden, the Netherlands
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van der Valk M, Hilling D, Meershoek-Klein Kranenbarg E, Peeters K, Kapiteijn E, Tsonaka R, Van de Velde C, Marang- van de Mheen P. Quality of life after curative resection for rectal cancer in patients treated with adjuvant chemotherapy compared with observation: results of the randomized phase III SCRIPT trial. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.114] [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: 10/27/2022] Open
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36
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van der Kooij M, Verdegaal E, Visser M, De Bruin L, Van der Minne C, Santegoets S, Welters M, Haanen J, Kapiteijn E, van der Burg S. Successful use of interferon-alpha and adoptive T cell therapy for metastatic melanoma patients failing other treatment options. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy485.001] [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: 11/14/2022] Open
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van Zeijl M, Wouters M, van den Eertwegh A, Aarts M, van Akkooi A, van den Berkmortel F, Franken M, de Groot J, Herbschleb K, van der Hoeven J, Hospers G, Kapiteijn E, Piersma D, van Rijn R, Suijkerbuijk K, Ten Tije A, Van der Veldt A, Vreugdenhil G, Haanen J. Outcomes of anti-PD1 antibodies for advanced melanoma in real-world population. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.032] [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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Krajewska J, Robinson B, Keam B, Capdevila J, Klochikhin A, Gan H, Kapiteijn E, Elisei R, Partyka J, Borgman A, Schlumberger M. A noninferiority trial of cabozantinib (C) comparing 60 mg vs 140 mg orally per day to evaluate the efficacy and safety in patients (pts) with progressive, metastatic medullary thyroid cancer (MTC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy302.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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39
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Ascierto P, Arenberger P, Atkinson V, Hansson J, Kapiteijn E, Loquai C, Negrier S, Shaw H, Tarhini A, Walker J, Geib J, Rahimian S, Swann S, Diab A. ILLUMINATE 301: A randomized phase III comparison of IMO-2125 with ipilimumab (ipi) versus ipi alone in subjects with anti PD 1 refractory melanoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.062] [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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40
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Kwakman JJM, Vink G, Vestjens JH, Beerepoot LV, de Groot JW, Jansen RL, Opdam FL, Boot H, Creemers GJ, van Rooijen JM, Los M, Vulink AJE, Schut H, van Meerten E, Baars A, Hamberg P, Kapiteijn E, Sommeijer DW, Punt CJA, Koopman M. Feasibility and effectiveness of trifluridine/tipiracil in metastatic colorectal cancer: real-life data from The Netherlands. Int J Clin Oncol 2017; 23:482-489. [PMID: 29204933 PMCID: PMC5951890 DOI: 10.1007/s10147-017-1220-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/22/2017] [Indexed: 02/07/2023]
Abstract
Background The RECOURSE trial showed clinical efficacy for trifluridine/tipiracil for refractory metastatic colorectal cancer patients. We assessed the feasibility and effectiveness of trifluridine/tipiracil in daily clinical practice in The Netherlands. Methods Medical records of patients from 17 centers treated in the trifluridine/tipiracil compassionate use program were reviewed and checked for RECOURSE eligibility criteria. Baseline characteristics, safety, and survival times were compared, and prespecified baseline characteristics were tested in multivariate analyses for prognostic significance on overall survival (OS). Results A total of 136 patients with a median age of 62 years were analyzed. Forty-three patients (32%) did not meet the RECOURSE eligibility criteria for not having received all prior standard treatments (n = 35, 26%) and/or ECOG performance status (PS) 2 (n = 12, 9%). The most common grade ≥3 toxicities were neutropenia (n = 44, 32%), leukopenia (n = 8, 6%), anemia (n = 7, 5%), and fatigue (n = 7, 5%). Median progression-free survival (PFS) and median OS were 2.1 (95% CI, 1.8–2.3) and 5.4 months (95% CI, 4.0–6.9), respectively. Patients with ECOG PS 2 had a worse median OS (3.2 months) compared to patients with ECOG PS 0–1 (5.9 months). ECOG PS, KRAS-mutation status, white blood cell count, serum lactate dehydrogenase, and alkaline phosphatase were prognostic factors for OS. Conclusions Our data show that treatment with trifluridine/tipiracil in daily clinical practice is feasible and safe. Differences in patient characteristics between our population and the RECOURSE study population should be taken into account in the interpretation of survival data. Our results argue against the use of trifluridine/tipiracil in patients with ECOG PS 2. Funding Johannes J.M. Kwakman received an unrestricted research grant from Servier.
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Affiliation(s)
- Johannes J M Kwakman
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Room F4-224, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
- Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - G Vink
- Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, The Netherlands
| | - J H Vestjens
- Department of Internal Medicine, Viecuri Hospital, Tegelseweg 210, 5912 BL, Venlo, The Netherlands
| | - L V Beerepoot
- Department of Medical Oncology, Elisabeth-TweeSteden Hospital, Doctor Deelenlaan 5, 5042 AD, Tilburg, The Netherlands
| | - J W de Groot
- Department of Medical Oncology, Isala Clinics, Dokter van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - R L Jansen
- Department of Medical Oncology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - F L Opdam
- Department of Medical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - H Boot
- Department of Gastroenterology and Hepatology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - G J Creemers
- Department of Medical Oncology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | - J M van Rooijen
- Department of Medical Oncology, Martini Hospital, Van Swietenplein 1, 9728 NT, Groningen, The Netherlands
| | - M Los
- Department of Medical Oncology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands
| | - A J E Vulink
- Department of Medical Oncology, Reinier de Graaf Gasthuis, Reinier de Graafweg 5, 2625 AD, Delft, The Netherlands
| | - H Schut
- Department of Medical Oncology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ, Den Bosch, The Netherlands
| | - E van Meerten
- Department of Medical Oncology, Erasmus Medical Center, Erasmus University, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - A Baars
- Department of Medical Oncology, Hospital Gelderse Vallei Ede, Willy Brandtlaan 10, 6716 RP, Ede, The Netherlands
| | - P Hamberg
- Department of Medical Oncology, Franciscus Gasthuis, Kleiweg 500, 3045 PM, Rotterdam, The Netherlands
| | - E Kapiteijn
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - D W Sommeijer
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Room F4-224, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Medical Oncology, Flevo Hospital, Hospitaalweg 1, 1315 RA, Almere, The Netherlands
| | - C J A Punt
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Room F4-224, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - M Koopman
- Department of Medical Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Rozeman E, Prevoo W, Meier M, Sikorska K, van de Wiel B, Broeks A, van Tinteren H, Kapiteijn E, Thienen J, Haanen J, Blank C. Combined radiofrequency ablation and ipilimumab in uveal melanoma: Results from the SECIRA-UM trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx377.006] [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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Boekhout A, Hauptmann M, van den Eertwegh A, Hospers G, de Groot J, Aarts M, Kapiteijn E, Ten Tije A, Piersma D, Kruit W, Suijkerbuijk K, Berkmortel F, Vreugdenhil G, Koornstra R, Fiets E, Lees M, Janssen K, van den Poll-Franse L, Blank C. Late physical, psychological and social consequences of ipilimumab treatment in advanced melanoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx377.045] [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: 11/14/2022] Open
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43
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van der Kooij MK, Joosse A, Speetjens FM, Hospers GAP, Bisschop C, de Groot JWB, Koornstra R, Blank CU, Kapiteijn E. Anti-PD1 treatment in metastatic uveal melanoma in the Netherlands. Acta Oncol 2017; 56:101-103. [PMID: 27911126 DOI: 10.1080/0284186x.2016.1260773] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- M. K. van der Kooij
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - A. Joosse
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - F. M. Speetjens
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - G. A. P. Hospers
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - C. Bisschop
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | | | - R. Koornstra
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - C. U. Blank
- Department of Medical Oncology, Netherlands Cancer Institute (NKI-AVL), Amsterdam, The Netherlands
| | - E. Kapiteijn
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
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44
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Jochems A, Schouwenburg M, Aarts M, van den Berkmortel F, van den Eertwegh A, Groenewegen G, de Groot JW, Haanen J, Hospers G, Kapiteijn E, Koornstra R, Kruit W, Leeneman B, Louwman M, Piersma D, van Rijn R, Ten Tije A, Vreugdenhil G, Wouters M, van der Hoeven J. Real-world survival results of metastatic melanoma patients treated with ipilimumab in the Netherlands. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw379.16] [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: 11/14/2022] Open
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45
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Schouwenburg M, Jochems A, Aarts M, Berkmortel F, Eertwegh A, Franken M, Groenewegen G, de Groot JW, Haanen J, Hospers G, Kapiteijn E, Koornstra R, Kruit W, Louwman M, Piersma D, van Rijn R, Ten Tije A, Vreugdenhil G, Wouters M, van der Hoeven J. Survival in BRAF-mutant metastatic melanoma in the real-world setting: results from the Dutch Melanoma Treatment Registry. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw379.34] [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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Willemsen A, van Herpen C, Schneider T, de Wit D, Kapiteijn E, van Erp N. The influence of old age on everolimus exposure in patients with cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.41] [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: 11/15/2022] Open
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Breugom A, Bastiaannet E, Guren M, Kørner H, Boelens P, Dekker F, Kapiteijn E, Gelderblom H, Larsen I, Liefers G, Van de Velde C. 52. Resection of the primary tumour for asymptomatic incurable metastatic colorectal cancer – A EURECCA international comparison. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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de Wit D, Schneider TC, Moes DJAR, Roozen CFM, den Hartigh J, Gelderblom H, Guchelaar HJ, van der Hoeven JJ, Links TP, Kapiteijn E, van Erp NP. Everolimus pharmacokinetics and its exposure-toxicity relationship in patients with thyroid cancer. Cancer Chemother Pharmacol 2016; 78:63-71. [PMID: 27169792 PMCID: PMC4921118 DOI: 10.1007/s00280-016-3050-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 04/27/2016] [Indexed: 12/16/2022]
Abstract
Background Everolimus is a mTOR inhibitor used for the treatment of different solid malignancies. Many patients treated with the registered fixed 10 mg dose once daily are in need of dose interruptions, reductions or treatment discontinuation due to severe adverse events. This study determined the correlation between systemic everolimus exposure and toxicity. Additionally, the effect of different covariates on everolimus pharmacokinetics (PK) was explored. Methods Forty-two patients with advanced thyroid carcinoma were treated with 10 mg everolimus once daily. Serial pharmacokinetic sampling was performed on days 1 and 15. Subsequently, a population PK model was developed using NONMEM to estimate individual PK values used for analysis of an exposure–toxicity relationship. Furthermore, this model was used to investigate the influence of patient characteristics and genetic polymorphisms in genes coding for enzymes relevant in everolimus PK. Results Patients who required a dose reduction (n = 18) due to toxicity at any time during treatment had significant higher everolimus exposures [mean AUC0–24 (SD) 600 (274) vs. 395 (129) µg h/L, P = 0.008] than patients without a dose reduction (n = 22). A significant association between everolimus exposure and stomatitis was found in the four-level ordered logistic regression analysis (P = 0.047). The presence of at least one TTT haplotype in the ABCB1 gene was associated with a 21 % decrease in everolimus exposure. Conclusion The current study showed that dose reductions and everolimus-induced stomatitis were strongly associated with systemic everolimus drug exposure in patients with cancer. Our findings confirm observations from another study in patients with cancer and show us that everolimus is a good candidate for individualized dosing in patients with cancer. ClinicalTrial.gov number NCT01118065. Electronic supplementary material The online version of this article (doi:10.1007/s00280-016-3050-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- D de Wit
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - T C Schneider
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - D J A R Moes
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - C F M Roozen
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - J den Hartigh
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - H Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - H J Guchelaar
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - J J van der Hoeven
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - T P Links
- Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands
| | - E Kapiteijn
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - N P van Erp
- Department of Clinical Pharmacy, Radboud University Medical Center, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.
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Klein Hesselink EN, Steenvoorden D, Kapiteijn E, Corssmit EP, van der Horst-Schrivers ANA, Lefrandt JD, Links TP, Dekkers OM. Therapy of endocrine disease: response and toxicity of small-molecule tyrosine kinase inhibitors in patients with thyroid carcinoma: a systematic review and meta-analysis. Eur J Endocrinol 2015; 172:R215-25. [PMID: 25572389 DOI: 10.1530/eje-14-0788] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [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: 12/13/2022]
Abstract
CONTEXT Many tyrosine kinase inhibitors (TKIs) have been studied in patients with thyroid carcinoma (TC). However, the effect and toxicity of various TKIs in differentiated TC (DTC) and medullary TC (MTC) patients have not been directly compared. The aim of the present systematic review and meta-analysis was to systematically summarize response and toxicity of TKIs in TC patients. METHODS All major databases were systematically searched for publications on TKIs in TC. Primary endpoint was objective response; secondary endpoints were clinical benefit, percentage TKI dose reduction/discontinuation, hand-foot syndrome, diarrhea, and nausea/vomiting. Meta-analysis was performed using an exact likelihood approach and a logistic regression. Pooled percentages and 95% CIs were reported. RESULTS In total, 22 publications were included. For DTC patients, gefitinib induced no objective responses. Pooled percentage was highest for pazopanib, 49 (95% CI 33-64)%, and was 17 (95% CI 12-24)% for sorafenib. For MTC, gefitinib and imatinib induced no objective responses, whereas sunitinib induced objective response in 43 (95% CI 14-77)%. For vandetanib and cabozantinib, these numbers were 40 (95% CI 34-46)% and 27 (95% CI 22-32)% respectively. Clinical benefit was found in 53 (95% CI 48-59)% of DTC patients on sorafenib, and in 84 (95% CI 79-88)% and 55 (95% CI 49-61)% of MTC patients on vandetanib and cabozantinib respectively. All TKIs were associated with considerable toxicity. CONCLUSION The currently studied TKIs show a modest response, while side effects are not negligible. Therefore, we suggest to solely consider TKIs in TC patients with rapid progressive disease, for whom the benefits of treatment outweigh toxicity.
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Affiliation(s)
- E N Klein Hesselink
- Department of EndocrinologyDepartment of Internal MedicineDivision of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsDepartments of EndocrinologyMedical OncologyClinical EpidemiologyC7-99, Leiden University Medical Center, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands Department of EndocrinologyDepartment of Internal MedicineDivision of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsDepartments of EndocrinologyMedical OncologyClinical EpidemiologyC7-99, Leiden University Medical Center, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - D Steenvoorden
- Department of EndocrinologyDepartment of Internal MedicineDivision of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsDepartments of EndocrinologyMedical OncologyClinical EpidemiologyC7-99, Leiden University Medical Center, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - E Kapiteijn
- Department of EndocrinologyDepartment of Internal MedicineDivision of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsDepartments of EndocrinologyMedical OncologyClinical EpidemiologyC7-99, Leiden University Medical Center, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - E P Corssmit
- Department of EndocrinologyDepartment of Internal MedicineDivision of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsDepartments of EndocrinologyMedical OncologyClinical EpidemiologyC7-99, Leiden University Medical Center, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - A N A van der Horst-Schrivers
- Department of EndocrinologyDepartment of Internal MedicineDivision of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsDepartments of EndocrinologyMedical OncologyClinical EpidemiologyC7-99, Leiden University Medical Center, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - J D Lefrandt
- Department of EndocrinologyDepartment of Internal MedicineDivision of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsDepartments of EndocrinologyMedical OncologyClinical EpidemiologyC7-99, Leiden University Medical Center, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - T P Links
- Department of EndocrinologyDepartment of Internal MedicineDivision of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsDepartments of EndocrinologyMedical OncologyClinical EpidemiologyC7-99, Leiden University Medical Center, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - O M Dekkers
- Department of EndocrinologyDepartment of Internal MedicineDivision of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsDepartments of EndocrinologyMedical OncologyClinical EpidemiologyC7-99, Leiden University Medical Center, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands Department of EndocrinologyDepartment of Internal MedicineDivision of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsDepartments of EndocrinologyMedical OncologyClinical EpidemiologyC7-99, Leiden University Medical Center, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands
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Schneider TC, de Wit D, Links TP, van Erp NP, van der Hoeven JJM, Gelderblom H, van Wezel T, van Eijk R, Morreau H, Guchelaar HJ, Kapiteijn E. Beneficial Effects of the mTOR Inhibitor Everolimus in Patients with Advanced Medullary Thyroid Carcinoma: Subgroup Results of a Phase II Trial. Int J Endocrinol 2015; 2015:348124. [PMID: 26294908 PMCID: PMC4532868 DOI: 10.1155/2015/348124] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 06/17/2015] [Indexed: 11/17/2022] Open
Abstract
Objective. Until recently, advanced medullary thyroid cancer (MTC) had few treatment options except surgery. The mTOR inhibitor everolimus has shown encouraging results in neuroendocrine tumors. As part of a prospective phase II study, we analyzed the safety and efficacy of everolimus in advanced MTC. Methods. Seven patients with per RECIST 1.1 documented advanced MTC were included and received everolimus 10 mg daily. The primary objective was determining treatment efficacy. Secondary endpoints included progression-free survival (PFS), overall survival (OS), toxicity, and pharmacokinetics (PK). Results. Median follow-up duration was 28 weeks (17-147). Five patients (71%) showed SD, of which 4 (57%) showed SD >24 weeks. Median PFS and OS were 33 (95%CI: 8-56) and 30 (95%CI: 15-45) weeks, respectively. Toxicity was predominantly grade 1/2 and included mucositis (43%), fatigue (43%), and hypertriglyceridemia (43%). Four MTCs harbored the somatic RET mutation c.2753T>C, p.Met918Thr. The best clinical response was seen in a MEN2A patient. PK characteristics were consistent with phase I data. One patient exhibited extensive toxicity accompanying elevated everolimus plasma concentrations. Conclusions. This study suggests that everolimus exerts clinically relevant antitumor activity in patients with advanced MTC. Given the high level of clinical benefit and the relatively low toxicity profile, further investigation of everolimus in these patients is warranted.
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Affiliation(s)
- T. C. Schneider
- Department of Medical Oncology, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
| | - D. de Wit
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
| | - T. P. Links
- Department of Endocrinology, University Medical Center Groningen, 9700 RB Groningen, Netherlands
| | - N. P. van Erp
- Department of Clinical Pharmacy, Radboud University Nijmegen Medical Center, 6525 GA Nijmegen, Netherlands
| | - J. J. M. van der Hoeven
- Department of Medical Oncology, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
| | - H. Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
| | - T. van Wezel
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
| | - R. van Eijk
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
| | - H. Morreau
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
| | - H. J. Guchelaar
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
| | - E. Kapiteijn
- Department of Medical Oncology, Leiden University Medical Center, 2333 ZA Leiden, Netherlands
- *E. Kapiteijn:
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