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Chawla SP, Van Tine BA, Pollack SM, Ganjoo KN, Elias AD, Riedel RF, Attia S, Choy E, Okuno SH, Agulnik M, von Mehren M, Livingston MB, Keedy VL, Verschraegen CF, Philip T, Bohac GC, Yurasov S, Yakovich A, Lu H, Chen M, Maki RG. Phase II Randomized Study of CMB305 and Atezolizumab Compared With Atezolizumab Alone in Soft-Tissue Sarcomas Expressing NY-ESO-1. J Clin Oncol 2021; 40:1291-1300. [PMID: 34260265 DOI: 10.1200/jco.20.03452] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE CMB305 is a heterologous prime-boost vaccination regimen created to prime NY-ESO-1-specific CD8 T-cell populations and then activate the immune response with a potent TLR-4 agonist. This open-label randomized phase II trial was designed to investigate the efficacy and safety of adding the CMB305 regimen to atezolizumab (anti-programmed death ligand-1 therapy) in comparison with atezolizumab alone in patients with synovial sarcoma or myxoid liposarcoma. PATIENTS AND METHODS Patients with locally advanced, relapsed, or metastatic synovial sarcoma or myxoid liposarcoma (any grade) were randomly assigned to receive CMB305 with atezolizumab (experimental arm) or atezolizumab alone (control arm). The primary end points were progression-free survival (PFS) and overall survival (OS) analyzed using the Kaplan-Meier method. Safety and immune responses were assessed. RESULTS A total of 89 patients were enrolled; 55.1% had received ≥ 2 prior lines of chemotherapy. Median PFS was 2.6 months and 1.6 months in the combination and control arms, respectively (hazard ratio, 0.9; 95% CI, 0.6 to 1.3). Median OS was 18 months in both treatment arms. Patients treated with combination therapy had a significantly higher rate of treatment-induced NY-ESO-1-specific T cells (P = .01) and NY-ESO-1-specific antibody responses (P < .0001). In a post hoc analysis of all dosed patients, OS was longer (36 months) in the subset who developed anti-NY-ESO-1 T-cell immune response (hazard ratio, 0.3; P = .02). CONCLUSION Although the combination of CMB305 and atezolizumab did not result in significant increases in PFS or OS compared with atezolizumab alone, some patients demonstrated evidence of an anti-NY-ESO-1 immune response and appeared to fare better by imaging than those without such an immune response. Combining prime-boost vaccines such as CMB305 with anti-programmed death ligand-1 therapies merits further evaluation in other clinical contexts.
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Affiliation(s)
| | - Brian A Van Tine
- Siteman Cancer Center, Washington University School of Medicine in St Louis, St Louis, MO
| | - Seth M Pollack
- Fred Hutchinson Cancer Research Center, Seattle, WA.,Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | | | | | | | - Edwin Choy
- Massachusetts General Hospital, Boston, MA
| | | | - Mark Agulnik
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL.,City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | | | - Vicki L Keedy
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
| | | | | | - G Chet Bohac
- Immune Design Corp, South San Francisco, CA.,MacroGenics Inc, Rockville, MD
| | - Sergey Yurasov
- Immune Design Corp, South San Francisco, CA.,Nuvation Bio Inc, San Francisco, CA
| | - Adam Yakovich
- Immune Design Corp, South San Francisco, CA.,Replimune Group Inc, Woburn, MA
| | - Hailing Lu
- Immune Design Corp, South San Francisco, CA.,Seattle Genetics Inc, Bothell, WA
| | - Michael Chen
- Immune Design Corp, South San Francisco, CA.,Sangamo Therapeutics Inc, Brisbane, CA
| | - Robert G Maki
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Mouysset JL, Freier B, van den Bosch J, Levaché CB, Bols A, Tessen HW, Belton L, Bohac GC, Terwey JH, Tonini G. Hemoglobin levels and quality of life in patients with symptomatic chemotherapy-induced anemia: the eAQUA study. Cancer Manag Res 2016; 8:1-10. [PMID: 26855598 PMCID: PMC4725626 DOI: 10.2147/cmar.s88110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To assess hemoglobin (Hb) outcomes and fatigue-related quality-of-life (QoL) (electronic assessment) in patients with solid tumors and symptomatic chemotherapy-induced anemia receiving cytotoxic chemotherapy and darbepoetin alfa (DA) or another erythropoiesis-stimulating agent according to European indication. METHODS eAQUA was a Phase IV prospective observational study. The primary outcome (assessed in the primary analysis set [PAS]: patients receiving one or more DA dose who had baseline and week 9 assessments for Hb and QoL) was the proportion of patients receiving DA having both Hb increases ≥1 g/dL and improved QoL between baseline and week 9. Functional Assessment of Cancer Therapy-Fatigue (FACT-F) subscale scores were anchored to fatigue visual analog scale scores to determine the minimally important difference for improved QoL. Overall data/data over time are reported for the full analysis set (patients receiving one or more erythropoiesis-stimulating agent dose, n=1,158); week 9 data (ie, data relating to the primary and secondary outcomes) are reported for the PAS (n=510). Baseline and safety data are included for both the full analysis set and PAS. RESULTS In the PAS, 69% of patients had stage IV disease and 96% were fatigued. The minimally important difference in FACT-F change score for QoL improvement was 3.5. From baseline to week 9, 32% (95% confidence interval: 28%-36%) of patients had both improved QoL and an Hb increase ≥1 g/dL; proportions were similar across the most common tumor types. At week 9, 49% and 58% of patients had improved QoL or Hb increases ≥1 g/dL, respectively; 70% and 76% had QoL or Hb improvements between baseline and study end, respectively. In the PAS, 16% of patients required transfusions and 32% required iron supplementation. Few patients (<1%) reported adverse drug reactions. CONCLUSION In this study, patients with solid tumors receiving DA per European indication for symptomatic chemotherapy-induced anemia had clinically meaningful improvements in Hb and QoL.
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Affiliation(s)
- Jean-Loup Mouysset
- Department of Medical Oncology, Clinique Rambot Provencale, Aix en Provence, France
| | - Beata Freier
- Clinical Oncology, Wojewodzki Szpital Specjalistyczny, Wroclaw, Poland
| | - Joan van den Bosch
- Department of Internal Medicine/Oncology, Albert Schweitzer Ziekenhuis locatie Dordwijk, Dordrecht, the Netherlands
| | - Charles Briac Levaché
- Radiotherapy Service, Medical Oncology, Polyclinique Francheville, Périgueux, France
| | - Alain Bols
- Central Pharmacy, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | | | - G Chet Bohac
- Clinical Research, Amgen Inc., Thousand Oaks, CA, USA
| | - Jan-Henrik Terwey
- Medical Development - Oncology, Amgen (Europe) GmbH, Zug, Switzerland
| | - Giuseppe Tonini
- Department of Medical Oncology, Università Campus Bio-Medico, Roma, Italy
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