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Buti S, Puligandla M, Bersanelli M, DiPaola RS, Manola J, Taguchi S, Haas NB. Validation of a new prognostic model to easily predict outcome in renal cell carcinoma: the GRANT score applied to the ASSURE trial population. Ann Oncol 2018; 29:1604. [PMID: 29608641 DOI: 10.1093/annonc/mdx799] [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: 11/12/2022] Open
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Buti S, Puligandla M, Bersanelli M, DiPaola RS, Manola J, Taguchi S, Haas NB. Validation of a new prognostic model to easily predict outcome in renal cell carcinoma: the GRANT score applied to the ASSURE trial population. Ann Oncol 2017; 28:2747-2753. [PMID: 28945839 PMCID: PMC5815563 DOI: 10.1093/annonc/mdx492] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background Prognostic scores have been developed to estimate the risk of recurrence and the probability of survival after nephrectomy for renal cell carcinoma (RCC). The use of these tools, despite being helpful to plan a customized schedule of follow-up, to the patient's tailored counselling and to select individuals who could potentially benefit from adjuvant treatment, currently is not routine, due to their relative complexity and to the lack of histological data (i.e. necrosis). Patients and methods We developed a simple score called GRade, Age, Nodes and Tumor (GRANT) based on four easily obtained parameters: Fuhrman grade, age, pathological nodal status and pathological tumor size. Patients with 0 or 1 factor are classified as favorable risk, whereas patients with two or more risk factors as unfavorable risk. The large population of RCC patients from the ASSURE adjuvant trial was used as independent dataset for this external validation, to investigate the prognostic value of the new score in terms of disease-free survival and overall survival and to evaluate its possible application as predictive tool. Statistical analyses were carried out by the Department of Biostatistics & Computational Biology, Dana-Farber Cancer Institute (Boston, USA) for the ASSURE trial patients' population. Results The performance of the new model is similar to that of the already validated score systems, but its strength, compared with the others already available, is the ease and clarity of its calculation, with great speed of use during the clinical practice. Limitations are the use of the Fuhrman nuclear grade, not valid for rare histologies, and the TNM classification modifications over time. Conclusion The GRANT score demonstrated its potential usefulness for clinical practice. ClinicalTrials.gov Identifier for the ASSURE trial NCT00326898.
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Affiliation(s)
- S Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - M Puligandla
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston
| | - M Bersanelli
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
| | - R S DiPaola
- Medical Oncology Unit, Medical Center, University of Kentucky, Lexington, USA
| | - J Manola
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston
| | - S Taguchi
- Department of Urology, The University of Tokyo, Tokyo, Japan
| | - N B Haas
- Abramson Cancer Center, Philadelphia, USA
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Harshman L, Drake C, Haas N, Manola J, Puligandla M, Signoretti S, Cella D, Gupta R, Bhatt R, Van Allen E, Lara P, Choueiri T, Kapoor A, Heng D, Shuch B, Jewett M, George D, Michaelson D, Carducci M, McDermott D, Allaf M. Transforming the Perioperative Treatment Paradigm in Non-Metastatic RCC-A Possible Path Forward. Kidney Cancer 2017; 1:31-40. [PMID: 30334002 PMCID: PMC6179104 DOI: 10.3233/kca-170010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 12/14/2022]
Abstract
In 2017, there is no adjuvant systemic therapy proven to increase overall survival in non-metastatic renal cell carcinoma (RCC). The anti-PD-1 antibody nivolumab improves overall survival in metastatic treatment refractory RCC and is generally tolerable. Mouse solid tumor models have revealed a benefit with a short course of neoadjuvant PD-1 blockade compared to adjuvant therapy. Two ongoing phase 2 studies of perioperative nivolumab in RCC patients have shown preliminary feasibility and safety with no surgical delays or complications. The recently opened PROSPER RCC trial (A Phase 3 RandOmized Study Comparing PERioperative Nivolumab vs. Observation in Patients with Localized Renal Cell Carcinoma Undergoing Nephrectomy; EA8143) will examine if the addition of perioperative nivolumab to radical or partial nephrectomy can improve clinical outcomes in patients with high risk localized and locally advanced RCC. With the goal of increasing cure and recurrence-free survival (RFS) rates in non-metastatic RCC, we are executing a three-pronged, multidisciplinary approach of presurgical priming with nivolumab followed by resection and adjuvant PD-1 blockade. We plan to enroll 766 patients with clinical stage ≥T2 or node positive M0 RCC of any histology in this global, randomized, unblinded, phase 3 National Clinical Trials Network study. The investigational arm will receive two doses of nivolumab 240 mg IV prior to surgery followed by adjuvant nivolumab for 9 months. The control arm will undergo the current standard of care: surgical resection followed by observation. Patients are stratified by clinical T stage, node positivity, and histology. The trial is powered to detect a 14.4% absolute benefit in the primary endpoint of RFS from the ASSURE historical control of 55.8% to 70.2% at 5 years (HR = 0.70). The study is also powered to detect a significant overall survival benefit (HR 0.67). Key safety, feasibility, and quality of life endpoints are incorporated. PROSPER RCC exemplifies team science with a host of planned correlative work to investigate the impact of the baseline immune milieu and changes after neoadjuvant priming on clinical outcomes.
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Affiliation(s)
- L.C. Harshman
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - C.G. Drake
- Division of Hematology/Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA
| | - N.B. Haas
- Division of Hematology/Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - J. Manola
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - M. Puligandla
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - S. Signoretti
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
| | - D. Cella
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - R.T. Gupta
- Departments of Radiology and Surgery and The Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - R. Bhatt
- Division of Hematology-Oncology and Cancer Biology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - E. Van Allen
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - P. Lara
- University of California Davis School of Medicine, Sacramento, CA, USA
| | - T.K. Choueiri
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - A. Kapoor
- Division of Urology, McMaster University, Hamilton, ON, Canada
| | - D.Y.C. Heng
- Tom Baker Cancer Center, Calgary, AB, Canada
| | - B. Shuch
- Division of Urology, Yale Cancer Institute, New Haven, CT, USA
| | - M. Jewett
- Departments of Surgery(Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON, Canada
| | - D. George
- Duke University Departments of Medicine, Surgery, and Pharmacology and Cancer Biology, Division of Medical Oncology, The Duke Cancer Institute, Durham, NC, USA
| | - D. Michaelson
- Genitourinary Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - M.A. Carducci
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - D. McDermott
- Division of Hematology-Oncology and Cancer Biology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - M. Allaf
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
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George S, von Mehren M, Heinrich MC, Wang Q, Corless CL, Butrynski JE, Morgan JA, Wagner AJ, Choy E, Tap WD, Manola J, Yap JT, Van Den Abbeele AD, Solomon S, Fletcher JA, Demetri GD. A multicenter phase II study of regorafenib in patients (pts) with advanced gastrointestinal stromal tumor (GIST), after therapy with imatinib (IM) and sunitinib (SU). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bhatt RS, Manola J, Bullock AJ, Zhang L, Haas NB, Pins M, Atkins MB, DiPaola RS. Host-mediated changes in patients receiving antiangiogenic therapy for resected RCC. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4557] [Citation(s) in RCA: 2] [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: 11/20/2022] Open
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Rich TA, Manola J, Cella D, Cruciani RA, Fisch M. An evaluation of serum cytokine levels and fatigue and depression in ECOG E4Z02. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9046] [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: 11/20/2022] Open
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Weiss M, Manola J, Thompson MA, Thomas ML, Fisch M. A prospective, observational study of medication use among outpatients with common solid tumors. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9055] [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: 11/20/2022] Open
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Marrari A, Hornick JL, Ramaiya NH, Manola J, Wagner AJ. Expression of MGMT and response to treatment with temozolomide in patients with leiomyosarcoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Aisner J, Manola J, Dakhil SR, Stella PJ, Schiller JH. Randomized phase II study of vandetanib (V), docetaxel (D), and carboplatin (C) followed by maintenance V or placebo (P) in patients with stage IIIb, IV, or recurrent non-small cell lung cancer (NSCLC): PrECOG PrE0501—Update on maintenance treatment, progression-free survival (PFS), and overall survival (OS). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7560] [Citation(s) in RCA: 3] [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: 11/20/2022] Open
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Van Den Abbeele AD, Tanaka Y, Locascio T, Sakellis C, Heinrich MC, von Mehren M, Choy E, Tap WD, Manola J, Demetri GD, George S, Yap JT. Assessment of regorafenib activity with FDG-PET/CT in a multicenter phase II study in patients (pts) with advanced gastrointestinal stromal tumor (GIST) following failure of standard therapy (Rx). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Patil S, Manola J, Elson P, Bro W, Negrier S, Escudier B, Bukowski RM, Motzer RJ. Risk factor migration and survival: Analysis from international dataset of 3,748 metastatic renal cell carcinoma (mRCC) patients treated on clinical trials. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4554] [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: 11/20/2022] Open
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Fisch M, Lee J, Weiss M, Wagner LI, Chang VT, Cella D, Manola J, Minasian LM, McCaskill-Stevens WJ, Mendoza TR, Cleeland CS. Prospective and observational study of pain and analgesic prescribing in medical oncology outpatients with breast, colorectal, lung, or prostate cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6008] [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: 11/20/2022] Open
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Wagner LI, Zickl L, Smith ML, Cella D, Coles C, Patrick-Miller LJ, Manola J, Fisch M. Prospective assessment of symptom burden among cancer survivors with common solid tumors: Results from ECOG trial E2Z02. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9137] [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: 11/20/2022] Open
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Aisner J, Manola J, Dakhil S, Stella P, Schiller J. 410 Vandetanib, docetaxel and carboplatin followed by maintenance vandetanib or placebo in patients with stage IIIB, IV or recurrent non-small cell lung cancer (NSCLC): a randomized phase II study (PrE0502) by PrECOG, LLC (NCT006872970). EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)72117-0] [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: 11/15/2022] Open
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Hamann HA, Lee J, Schiller JH, Horn L, Cleeland CS, Manola J, Wagner LI, Chang VT, Fisch M. Clinician perceptions of care difficulty and quality of life for lung cancer patients: Results from the ECOG SOAPP study (E2Z02). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Tevaarwerk A, Lee J, Sesto MC, Buhr KA, Cleeland CS, Manola J, Wagner LI, Chang VT, Fisch M. Predictors of employment (empl) outcomes in outpatients (pts) with common solid tumors: A secondary analysis from E2Z02 (ECOG's SOAPP study). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Haas N, Manola J, Pins M, Liu G, McDermott D, Nanus D, Heath E, Wilding G, Dutcher J. ECOG 8802: Phase II trial of doxorubicin (Dox) and gemcitabine (Gem) in metastatic renal cell carcinoma (RCC) with sarcomatoid features. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5038] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5038 Background: Patients (pts) with RCC containing sarcomatoid features have poor prognoses.Cytokine therapy is ineffective, and experience with mTor inhibitors or multi-targeted tyrosine kinase inhibitors is early. We evaluated Dox/Gem in these pts with locally advanced or metastatic disease to confirm previous activity of this regimen in a single institution trial. Methods: Pts received Dox 50mg/m2 IV push and Gem 1500mg/m2 IV over 30 minutes every 2 weeks (with G-CSF 5 mcg/kg/d days 2 or 3 to 10 or pegfilgrastim 6 mg day 2) until disease progression or unacceptable toxicity. Dose reductions occurred for low granulocytes and or platelets, mucositis, cardiac toxicity, or other grade 3 - 4 toxicities. Dox was discontinued after a cumulative dose of 450 mg/m2 unless pt had normal cardiac function. The study targeted a promising response rate (RR) of 20% vs. 5%, with 90% power and 8% Type I error. A 2-stage design was used; >4 responses were needed for efficacy. Results: From February 2004 to April 2007, 39 pts with RCC of sarcomatoid (47%) or mixed histology (53%) containing sarcomatoid features were accrued by ECOG (n = 35), NCCTG (n = 2), and CALGB (n = 2). 1 pt withdrew before treatment. Pts were mostly male (81%), with cT3/T4 (68%), node negative (61%), M1 (58%) disease at diagnosis and ECOG PS 0–1. Metastases included lung (71%) and lymph nodes (58%). Pts received a median 6.5 cycles (range, 1 - 16). Treatment was moderately tolerable: grade 4 neutropenia (3 pts, 1 with fever), grade 4 dyspnea (1 pt), grade 4 peristomal infection (1 pt). 2 of 38 pts stopped treatment due to toxicity. 1 complete and 5 partial responses (PR) were observed (16%, 90% CI 7.1–28.8%). A 7th patient had an unconfirmed PR and an eighth patient had > 50 percent decrease in tumor burden after an initial progression. 9 patients had stable disease. Two pts are alive without progression (1 with a PFS of 2.5 years), 1 is alive with progression, and 35 patients have died. Median PFS is 3.5 months (95% CI 2.8–5.2 mos). Median OS is 8.8 mos (6.1–11.1 mos). Conclusions: Dox/Gem met efficacy criteria in RCC with sarcomatoid features. A TKI/Gem regimen in ECOG is planned. No significant financial relationships to disclose.
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Affiliation(s)
- N. Haas
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Advocate Lutheran General Hospital, Chicago, IL; University of Wisconsin, Madison, WI; Beth Israel Deaconess Medical Center, Boston, MA; New York Presbyterian Hospital, New York, NY; Karmanos Cancer Institute, Detroit, MI; Our Lady of Mercy, Bronx, NY
| | - J. Manola
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Advocate Lutheran General Hospital, Chicago, IL; University of Wisconsin, Madison, WI; Beth Israel Deaconess Medical Center, Boston, MA; New York Presbyterian Hospital, New York, NY; Karmanos Cancer Institute, Detroit, MI; Our Lady of Mercy, Bronx, NY
| | - M. Pins
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Advocate Lutheran General Hospital, Chicago, IL; University of Wisconsin, Madison, WI; Beth Israel Deaconess Medical Center, Boston, MA; New York Presbyterian Hospital, New York, NY; Karmanos Cancer Institute, Detroit, MI; Our Lady of Mercy, Bronx, NY
| | - G. Liu
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Advocate Lutheran General Hospital, Chicago, IL; University of Wisconsin, Madison, WI; Beth Israel Deaconess Medical Center, Boston, MA; New York Presbyterian Hospital, New York, NY; Karmanos Cancer Institute, Detroit, MI; Our Lady of Mercy, Bronx, NY
| | - D. McDermott
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Advocate Lutheran General Hospital, Chicago, IL; University of Wisconsin, Madison, WI; Beth Israel Deaconess Medical Center, Boston, MA; New York Presbyterian Hospital, New York, NY; Karmanos Cancer Institute, Detroit, MI; Our Lady of Mercy, Bronx, NY
| | - D. Nanus
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Advocate Lutheran General Hospital, Chicago, IL; University of Wisconsin, Madison, WI; Beth Israel Deaconess Medical Center, Boston, MA; New York Presbyterian Hospital, New York, NY; Karmanos Cancer Institute, Detroit, MI; Our Lady of Mercy, Bronx, NY
| | - E. Heath
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Advocate Lutheran General Hospital, Chicago, IL; University of Wisconsin, Madison, WI; Beth Israel Deaconess Medical Center, Boston, MA; New York Presbyterian Hospital, New York, NY; Karmanos Cancer Institute, Detroit, MI; Our Lady of Mercy, Bronx, NY
| | - G. Wilding
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Advocate Lutheran General Hospital, Chicago, IL; University of Wisconsin, Madison, WI; Beth Israel Deaconess Medical Center, Boston, MA; New York Presbyterian Hospital, New York, NY; Karmanos Cancer Institute, Detroit, MI; Our Lady of Mercy, Bronx, NY
| | - J. Dutcher
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; Dana-Farber Cancer Institute, Boston, MA; Advocate Lutheran General Hospital, Chicago, IL; University of Wisconsin, Madison, WI; Beth Israel Deaconess Medical Center, Boston, MA; New York Presbyterian Hospital, New York, NY; Karmanos Cancer Institute, Detroit, MI; Our Lady of Mercy, Bronx, NY
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Rich TA, Fisch MJ, Manola J, Cella D, Ansari B, Koc M, Cruciani R. Analysis of cytokines in ECOG E4Z02: A phase III randomized study of l-carnitine supplementation for fatigue in patients with cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9635 Background: The purpose of the study was to investigate associations between fatigue, depression and pain and serum levels of proinflammatory cytokines among pts randomized to l-carnitine supplementation or placebo. Methods: 376 cancer pts with normal hemoglobin and fatigue assessed as moderate or severe were randomized to 4 wks of supplementation with oral carnitine (n=189) or placebo (n=187) 1000 mg bid. Serum levels of 10 inflammatory cytokines and growth factors were measured with Luminex bead ELISA at baseline and 4 wks for 98 pts. Wilcoxon rank sum tests were used to compare cytokine levels between arms and between pts with/without symptoms. Multivariable models of fatigue, depression and pain at 4 wks were examined, adjusting for treatment arm, baseline symptoms and baseline cytokine levels. Results: There were no statistically significant differences in cytokine levels between pts with or without severe fatigue, pain, or depression at baseline. Levels of IL-1rα were higher at baseline among pts randomized to placebo (p=0.01) and increased after 4 wks, while levels among pts randomized to l-carnitine declined (p <0.001). Levels of IFN-γ, TGF-α, IL-6, and TNF-α decreased more among pts randomized to placebo (p=0.008, p=0.006, p=0.01, and p=0.05, respectively). Pts with severe pain at 4 wks had greater declines in levels of EGF, IFN-γ, IL-1α, and IL-1rα than pts without (p=0.05, 0.05, 0.02 and 0.03, respectively). Reductions in IL-1α and TGF-α predicted lower pain severity at 4 wks (p=0.02 and p=0.04, respectively). Conclusions: Levels of proinflammatory cytokines or EGFR ligands failed to distinguish between patients with moderate vs. severe fatigue or levels of depression and pain (severe vs. not) prior to treatment intervention. Lower levels of IL-1α and TGF-α appear to be associated with improvement of pain severity but are not associated with treatment. Mechanisms for these findings require exploration. No significant financial relationships to disclose.
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Affiliation(s)
- T. A. Rich
- University of Virginia Health Sciences, Charlottesville, VA; M. D. Anderson Cancer Center, Houston, TX; ECOG, Boston, MA; Northwestern University, Chicago, IL; Beth Israel Medical Center, New York, NY
| | - M. J. Fisch
- University of Virginia Health Sciences, Charlottesville, VA; M. D. Anderson Cancer Center, Houston, TX; ECOG, Boston, MA; Northwestern University, Chicago, IL; Beth Israel Medical Center, New York, NY
| | - J. Manola
- University of Virginia Health Sciences, Charlottesville, VA; M. D. Anderson Cancer Center, Houston, TX; ECOG, Boston, MA; Northwestern University, Chicago, IL; Beth Israel Medical Center, New York, NY
| | - D. Cella
- University of Virginia Health Sciences, Charlottesville, VA; M. D. Anderson Cancer Center, Houston, TX; ECOG, Boston, MA; Northwestern University, Chicago, IL; Beth Israel Medical Center, New York, NY
| | - B. Ansari
- University of Virginia Health Sciences, Charlottesville, VA; M. D. Anderson Cancer Center, Houston, TX; ECOG, Boston, MA; Northwestern University, Chicago, IL; Beth Israel Medical Center, New York, NY
| | - M. Koc
- University of Virginia Health Sciences, Charlottesville, VA; M. D. Anderson Cancer Center, Houston, TX; ECOG, Boston, MA; Northwestern University, Chicago, IL; Beth Israel Medical Center, New York, NY
| | - R. Cruciani
- University of Virginia Health Sciences, Charlottesville, VA; M. D. Anderson Cancer Center, Houston, TX; ECOG, Boston, MA; Northwestern University, Chicago, IL; Beth Israel Medical Center, New York, NY
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Fisch M, Lee JW, Manola J, Wagner L, Chang V, Gilman P, Lear K, Baez L, Cleeland C. Survey of disease and treatment-related symptoms in outpatients with invasive cancer of the breast, prostate, lung, or colon/rectum (E2Z02, the SOAPP study). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9619 Background: The full spectrum and impact of symptoms experienced by ambulatory patients (pts) in medical oncology clinics throughout their care trajectory is poorly understood. Methods: This large prospective study by the Eastern Cooperative Oncology Group (ECOG) enrolled pts with invasive cancer of the breast, prostate, colon/rectum or lung regardless of phase of care or stage of disease. The study was conducted between 3/06 and 5/08 at multiple academic (n=7) and community (n=32) medical oncology clinics. Pre-defined sampling algorithms were used to reduce selection bias. At baseline and again 4 weeks later, pts completed a 25-item measure of symptoms and functional interference (M.D. Anderson Symptom Inventory-ECOG). Patients’ providers simultaneously prioritized their symptoms. Results: 3124 patients were enrolled (90% from community clinics) and 3077 were analyzable with 1524 breast (50%), 715 colorectal (23%), 518 lung (17%), and 320 prostate (10%) pts. The most prevalent moderate-to-severe symptoms of the full cohort at baseline (B) and follow-up (F) were: fatigue (B34% to F32%), disturbed sleep (B27% to F21%), drowsiness (B22% to F21%), hair loss (B20% to F19%), pain (B19% to F18%), dry mouth (B19% to F15%), and numbness/tingling (B19% to F17%). At baseline, 40% of the cohort had at least 3 moderate-to-severe symptoms and 36% had this attribute at follow-up. Clinician perception of symptoms was strongly correlated with patient symptom survey results regardless of disease site, race, or ethnicity. Of the 849 pts receiving anti-cancer treatment for metastatic disease, half had 2 or more metastatic sites with 75% receiving cytotoxic chemotherapy. Clinicians judged lung cancer patients’ symptoms to be the most difficult to manage (p<0.01). Conclusions: Non-pain symptoms, particularly fatigue and sleep disturbance, are a major source of symptom distress in ambulatory medical oncology practice. Overall, symptom burden remains substantial and difficult to resolve. These data will help guide future interventional studies. No significant financial relationships to disclose.
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Affiliation(s)
- M. Fisch
- University of Texas M. D. Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; VA New Jersey Healthcare System, East Orange, NJ; Mainline Hematology/Oncology Associates, Wynnewood, PA; Fox Chase Cancer Center, Philadelphia, PA; San Juan Minority-Based CCOP, San Juan, PR
| | - J. W. Lee
- University of Texas M. D. Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; VA New Jersey Healthcare System, East Orange, NJ; Mainline Hematology/Oncology Associates, Wynnewood, PA; Fox Chase Cancer Center, Philadelphia, PA; San Juan Minority-Based CCOP, San Juan, PR
| | - J. Manola
- University of Texas M. D. Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; VA New Jersey Healthcare System, East Orange, NJ; Mainline Hematology/Oncology Associates, Wynnewood, PA; Fox Chase Cancer Center, Philadelphia, PA; San Juan Minority-Based CCOP, San Juan, PR
| | - L. Wagner
- University of Texas M. D. Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; VA New Jersey Healthcare System, East Orange, NJ; Mainline Hematology/Oncology Associates, Wynnewood, PA; Fox Chase Cancer Center, Philadelphia, PA; San Juan Minority-Based CCOP, San Juan, PR
| | - V. Chang
- University of Texas M. D. Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; VA New Jersey Healthcare System, East Orange, NJ; Mainline Hematology/Oncology Associates, Wynnewood, PA; Fox Chase Cancer Center, Philadelphia, PA; San Juan Minority-Based CCOP, San Juan, PR
| | - P. Gilman
- University of Texas M. D. Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; VA New Jersey Healthcare System, East Orange, NJ; Mainline Hematology/Oncology Associates, Wynnewood, PA; Fox Chase Cancer Center, Philadelphia, PA; San Juan Minority-Based CCOP, San Juan, PR
| | - K. Lear
- University of Texas M. D. Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; VA New Jersey Healthcare System, East Orange, NJ; Mainline Hematology/Oncology Associates, Wynnewood, PA; Fox Chase Cancer Center, Philadelphia, PA; San Juan Minority-Based CCOP, San Juan, PR
| | - L. Baez
- University of Texas M. D. Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; VA New Jersey Healthcare System, East Orange, NJ; Mainline Hematology/Oncology Associates, Wynnewood, PA; Fox Chase Cancer Center, Philadelphia, PA; San Juan Minority-Based CCOP, San Juan, PR
| | - C. Cleeland
- University of Texas M. D. Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; VA New Jersey Healthcare System, East Orange, NJ; Mainline Hematology/Oncology Associates, Wynnewood, PA; Fox Chase Cancer Center, Philadelphia, PA; San Juan Minority-Based CCOP, San Juan, PR
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Hurwitz M, Zheng H, Nagaraja G, Bausero M, Manola J, Kaur P, Asea A. Radiation Therapy Induces Circulating Serum Heat Shock Proteins in Prostate Cancer Patients: Clinical Findings and Laboratory Correlates. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Ross RW, Manola J, Oh WK, Ryan C, Kim J, Rastarhuyeva I, Yap JT, Van Den Abbeele AD, Kantoff PW, Taplin M. Phase I trial of RAD001 (R) and docetaxel (D) in castration resistant prostate cancer (CRPC) with FDG-PET assessment of RAD001 activity. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5069] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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22
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Burtness BA, Manola J, Axelrod R, Argiris A, Forastiere AA. A randomized phase II study of ixabepilone (BMS-247550) given daily x 5 days every 3 weeks or weekly in patients with metastatic or recurrent squamous cell cancer of the head and neck: an Eastern Cooperative Oncology Group study. Ann Oncol 2008; 19:977-83. [PMID: 18296423 DOI: 10.1093/annonc/mdm591] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Ixabepilone is a tubulin-polymerizing agent with potential activity in squamous cell carcinoma of the head and neck (SCCHN). Patients were eligible who had incurable, measurable SCCHN and less than two prior regimens for metastatic/recurrent disease. Eastern Cooperative Oncology Group performance status of less than or equal to one and adequate renal/hepatic/hematological function were required. Patients were randomly assigned to receive ixabepilone 6 mg/m(2)/day x 5 days every 21 days (arm A) or 20 mg/m(2) on days 1, 8, and 15 of a 28-day cycle (arm B). Each arm accrued taxane-naive and -exposed strata in a two-stage design. The primary end point was response. Eighty-five eligible patients entered; there was one response in a taxane-exposed patient among 32 patients on arm A. Five of 35 taxane-naive patients on arm B had partial responses (14%). No taxane-exposed patient on arm B responded. Common grades 3 and 4 toxic effects were fatigue, neutropenia, and sensory/motor neuropathy. Median survival for arm A taxane-naive and taxane-exposed patients is 5.6 and 6.5 months; for arm B, taxane-naive and taxane-exposed patients is 7.8 and 6.5 months. Weekly ixabepilone 20 mg/m(2) is active in taxane-naive patients with SCCHN. A high incidence of motor and sensory grade 3 neuropathy resulted at this dose and schedule. Further development of ixabepilone in previously treated head and neck cancer is not warranted on the basis of these data.
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Affiliation(s)
- B A Burtness
- Department of Medical Oncology, Division of Medical Sciences, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA.
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23
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Hurwitz M, Hansen J, Prokopios-Davos S, Manola J, Hynynen K, Bornstein B, Topulos G, Kaplan I. Hyperthermia Combined With Radiation in Treatment of Locally Advanced Prostate Cancer: Long-term Results of DFCI 94-153. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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He Z, Sun Z, Liu G, Manola J, Loehrer P. Prolonged survival in patients with persistently elevated tumor markers after chemotherapy for nonseminomatous germ cell cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5051 Background: Persistently elevated levels of either AFP or HCG or both after chemotherapy are thought to represent residual viable disease while the normalization of tumor markers predicts favorable outcomes. This study was to evaluate the clinical implication of tumor marker normalization for disseminated nonseminomatous germ cell tumors (GCTs). Methods: This was a retrospective data analysis from two prospective randomized trials (ECOG E4887 and E3887). In E4887, 178 patients with minimal- or moderate-stage disease (Indiana stage) were randomized to receive three cycles of cisplatin plus etoposide with/without bleomycin. In E3887, 304 patients with advanced disseminated GCTs were randomized to receive four cycles of bleomycin, etoposide and cisplatin versus the combination of etoposide, ifosfamide and cisplatin. AFP and HCG were assessed at baseline and after each cycle of chemotherapy. Tumor marker normalization was defined as AFP or HCG normalized after completing chemotherapy. OS and PFS curves were estimated by the Kaplan-Meier method. Multivariate and univariate models, stratified on International Germ Cell Consensus Classification (IGCCCG), were used to assess the impact of marker normalization for patients with abnormal markers at study entry. Results: Median follow-up is 14.8 years. About 40% to 60% of Patients with persistently elevated AFP or HCG after chemotherapy have prolonged PFS and/or OS. In IGCCCG poor risk patients, 35% to 55% of them with persistently elevated AFP or HCG after chemotherapy have prolonged PFS and/or OS. There is a statistically significant difference in OS associated with AFP normalization in both multivariate (p=0.008, HR=0.51 with 95% CI=0.31–0.84) and univariate analysis (p=0.0008, HR=0.43 with 95% CI=0.26–0.71). However, there was no statistically significant difference in OS associated with normalization of HCG in both multivariate analysis (p=0.52, HR=0.84 with 95% CI=0.50–1.41) and univariate analysis (p=0.29, HR=0.76 with 95% CI=0.46–1.26). Conclusions: Patients with persistently elevated AFP or HCG after chemotherapy may still have prolonged PFS and/or OS. Normalization of AFP but not HCG is associated with better OS in patients with disseminated nonseminomatous GCTs. No significant financial relationships to disclose.
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Affiliation(s)
- Z. He
- Univ of Wisconsin, Madison, WI; Dana-Farber Cancer Institute, Boston, MA; ECOG Statistical Center, Boston, MA; Indiana University Medical Center, Indianapolis, IN
| | - Z. Sun
- Univ of Wisconsin, Madison, WI; Dana-Farber Cancer Institute, Boston, MA; ECOG Statistical Center, Boston, MA; Indiana University Medical Center, Indianapolis, IN
| | - G. Liu
- Univ of Wisconsin, Madison, WI; Dana-Farber Cancer Institute, Boston, MA; ECOG Statistical Center, Boston, MA; Indiana University Medical Center, Indianapolis, IN
| | - J. Manola
- Univ of Wisconsin, Madison, WI; Dana-Farber Cancer Institute, Boston, MA; ECOG Statistical Center, Boston, MA; Indiana University Medical Center, Indianapolis, IN
| | - P. Loehrer
- Univ of Wisconsin, Madison, WI; Dana-Farber Cancer Institute, Boston, MA; ECOG Statistical Center, Boston, MA; Indiana University Medical Center, Indianapolis, IN
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Chen RC, Zietman AL, D’Amico AV, Kaplan I, Clark JA, Manola J, Talcott JA. Using patient-reported outcomes for technology assessment (TA) and quality improvement (QI) in prostate cancer brachytherapy. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5139 Background: Despite their sensitivity, validity and increasing prominence in clinical reports, patient-reported outcomes have played little role in TA and QI. We used our validated disease-specific instrument to compare outcomes after alternative brachytherapy techniques for early prostate cancer, both experimental vs. standard technique and between implementations of the standard technique. Methods: One radiation oncologist performed experimental MRI-guided brachytherapy (MRB) on protocol and 2 performed standard ultrasound-guided brachytherapy (USB1 and USB2). We prospectively measured urinary and bowel function of 237 men before brachytherapy and at 1, 3 and 12 months after treatment. Each symptom index is scored from 0 (no dysfunction) to 100 (maximum dysfunction). We report outcomes both as mean change in scale score from baseline and as the distribution of functional categories, grouped by pretreatment functional level: normal, intermediate, and poor (severe dysfunction). Results: Among all patients, MRB caused less urinary obstruction/irritation at 3 months after treatment than ultrasound-guided brachytherapy (mean score change 9.2 vs. 23.6, p<.001). Significant differences in outcome also existed between USB1 and USB2 (19.5 vs. 29.0, p=.01). When baseline function was normal, 15% of MRB patients reported severe 3-month dysfunction, compared to 50% of USB1 and 71% of USB2 patients ( Table ). Outcomes of patients with pretreatment urinary dysfunction differed less. Preliminary results documenting inferior outcomes prompted modification of the USB2 brachytherapy technique, producing a trend toward improved outcomes in small patient numbers (mean score change: 30.4 vs. 22.8, p=.25). Bowel symptom outcomes varied less. Conclusions: Patient-reported outcomes can provide sensitive and valid indicators of TA and QI that may contribute to optimal patient-centered care. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- R. C. Chen
- Harvard Radiation Oncology Program, Boston, MA; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Boston University School of Public Health, Boston, MA; MGH Cancer Center, Boston, MA
| | - A. L. Zietman
- Harvard Radiation Oncology Program, Boston, MA; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Boston University School of Public Health, Boston, MA; MGH Cancer Center, Boston, MA
| | - A. V. D’Amico
- Harvard Radiation Oncology Program, Boston, MA; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Boston University School of Public Health, Boston, MA; MGH Cancer Center, Boston, MA
| | - I. Kaplan
- Harvard Radiation Oncology Program, Boston, MA; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Boston University School of Public Health, Boston, MA; MGH Cancer Center, Boston, MA
| | - J. A. Clark
- Harvard Radiation Oncology Program, Boston, MA; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Boston University School of Public Health, Boston, MA; MGH Cancer Center, Boston, MA
| | - J. Manola
- Harvard Radiation Oncology Program, Boston, MA; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Boston University School of Public Health, Boston, MA; MGH Cancer Center, Boston, MA
| | - J. A. Talcott
- Harvard Radiation Oncology Program, Boston, MA; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Boston University School of Public Health, Boston, MA; MGH Cancer Center, Boston, MA
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Abstract
5102 Background: Atrasentan, an oral selective endothelin A receptor antagonist, demonstrated activity in patients with RCC included in Phase I studies. Based on these preliminary findings, a phase II study was undertaken in patients with measurable or nonmeasurable (bone only) metastatic RCC. Methods: Patients with locally recurrent or metastatic disease were stratified on disease status (measurable or bone only metastases) and prior immunotherapy. Eligible patients also had no prior chemotherapy, no more than 1 prior immunotherapy, and ECOG PS 0, 1, or 2. Prior nephrectomy was permitted. Patients received atrasentan 10 mg/day po until progression or unacceptable toxicity. Standard RECIST criteria were used to assess response. The primary endpoint was the progression-free rate at 6 months. Rates of 25% among patients treated with prior immunotherapy and 45% among patients with no prior immunotherapy were considered promising. A two-stage design was used for cohorts with no prior immunotherapy. Results: Between July 2003 and July 2005, 98 patients were registered. Four patients were ineligible and 1 withdrew before treatment. Median duration of treatment was 10 weeks (range, 2 to 107 weeks). Toxicities were mild, with 73% of patients reporting no Grade 3 or higher treatment- related adverse events. Grade 4 adverse events included neutropenia (n=3), dyspnea (n=2), thrombosis and supraventricular arrhythmia (n=1 each). Six-month progression-free rates (90% CI) were 14% (6 - 25%), 0% (0 - 39%), 12% (3 - 28%) and 17% (5 - 38%) respectively for patients with prior immunotherapy and measurable disease (n=44), prior immunotherapy and bone metastases only (n=6), no prior immunotherapy and measurable disease (n=25), and no prior immunotherapy and bone metastases only (n=18). Median progression-free survival was 2.3 months (95% CI, 2.0 - 3.5 months). Conclusions: While well-tolerated, atrasentan did not yield 6-month progression-free rates that would support its use as first-line monotherapy in patients with advanced RCC. No significant financial relationships to disclose.
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Affiliation(s)
- J. Manola
- Dana-Farber Cancer Institute, Boston, MA; Johns Hopkins Kimmel Cancer Center, Baltimore, MD; Lehigh Valley Hospital, Allentown, PA; University of Wisconsin, Madison, WI; Metro Minnesota CCOP, St. Louis Park, MN
| | - M. Carducci
- Dana-Farber Cancer Institute, Boston, MA; Johns Hopkins Kimmel Cancer Center, Baltimore, MD; Lehigh Valley Hospital, Allentown, PA; University of Wisconsin, Madison, WI; Metro Minnesota CCOP, St. Louis Park, MN
| | - S. Nair
- Dana-Farber Cancer Institute, Boston, MA; Johns Hopkins Kimmel Cancer Center, Baltimore, MD; Lehigh Valley Hospital, Allentown, PA; University of Wisconsin, Madison, WI; Metro Minnesota CCOP, St. Louis Park, MN
| | - G. Liu
- Dana-Farber Cancer Institute, Boston, MA; Johns Hopkins Kimmel Cancer Center, Baltimore, MD; Lehigh Valley Hospital, Allentown, PA; University of Wisconsin, Madison, WI; Metro Minnesota CCOP, St. Louis Park, MN
| | - S. Rousey
- Dana-Farber Cancer Institute, Boston, MA; Johns Hopkins Kimmel Cancer Center, Baltimore, MD; Lehigh Valley Hospital, Allentown, PA; University of Wisconsin, Madison, WI; Metro Minnesota CCOP, St. Louis Park, MN
| | - G. Wilding
- Dana-Farber Cancer Institute, Boston, MA; Johns Hopkins Kimmel Cancer Center, Baltimore, MD; Lehigh Valley Hospital, Allentown, PA; University of Wisconsin, Madison, WI; Metro Minnesota CCOP, St. Louis Park, MN
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Oh WK, Manola J, Ross RW, Berkowitz A, Ryan CW, Eilers KM, Beer TM. A phase II trial of docetaxel plus carboplatin in hormone refractory prostate cancer (HRPC) patients who have progressed after prior docetaxel chemotherapy: Preliminary results. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.14533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
14533 Background: Treatment options for HRPC patients who progress after docetaxel chemotherapy are limited. Carboplatin may enhance the efficacy of docetaxel chemotherapy. Methods: We prospectively treated HRPC patients with documented PSA or radiographic progression during a minimum of 2 cycles of docetaxel-based chemotherapy or within 45 days of completing therapy. No prior platinum was allowed, though patients may have received other prior chemotherapy. Patients received docetaxel 60 mg/m2 and carboplatin AUC (4) every 21 days until progression or unacceptable toxicity. Measurable response was assessed by RECIST criteria. PSA declines were assessed per PSA Working Group; 2 patients were not evaluable as they received only 1 cycle of therapy but are included in the denominator. Results: Interim data is available on the 1st stage of patients (n = 16) enrolled in this ongoing phase II trial. Median age was 69 years (range 46–81), 94% white. Baseline performance status was 0 or 1 in 88%. Prior therapies included antiandrogens (80%) and ketoconazole (47%); docetaxel was used alone (33%), with estramustine (33%) or another agent (33%). Median PSA at baseline was 44 ng/ml (range 4.9–4801). Patients received a median of 3 cycles of docetaxel/carboplatin (range 1–12+). PSA declines of ≥50% were noted in 3 of 16 patients (19%, 90% C.I. 5–42%). In addition, 5 patients had SD, suggesting clinical benefit in 50% (90% C.I. 28–72%). Of 10 patients with measurable disease at baseline, 2 (20%; 90% C.I. 4–51%) had confirmed PR. Therapy was well-tolerated, with no treatment-related deaths and five grade 3 toxicities, including anemia (1), leukopenia (3) and hyperglycemia (1). Median time to progression was 2.7 months (range 0–13.4); median survival was 11.7 months (95% C.I. 6.7–14.0). Conclusions: In preliminary analyses, docetaxel plus carboplatin demonstrated encouraging activity in patients who progressed after docetaxel-based therapy. PSA declines ≥50% were seen in 19%; measurable responses in 20%. Accrual is ongoing. Final analyses will include correlation of response to serum markers of neuroendocrine differentiation. (Supported by BMS). No significant financial relationships to disclose.
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Affiliation(s)
- W. K. Oh
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR
| | - J. Manola
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR
| | - R. W. Ross
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR
| | - A. Berkowitz
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR
| | - C. W. Ryan
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR
| | - K. M. Eilers
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR
| | - T. M. Beer
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR
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Pomerantz M, Manola J, Taplin M, Bubley G, Inman M, Lowell J, Kantoff P, Oh WK. Phase II study of low dose (LD) and high dose (HD) premarin in androgen independent prostate cancer (AIPC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4560 Background: Estrogens, including DES, transdermal estradiol, estramustine and PC-SPES, have shown antitumor activity in AIPC. We tested two doses of Premarin to determine efficacy and safety of this commonly available estrogen. Methods: Patients with progressive AIPC were eligible. Prior estrogen use, significant cardiac or thromboembolic disease, and concurrent steroids were not allowed. Patients were randomized to Premarin 1.25 mg once (LD) or 3 times (HD) daily. Prophylactic breast irradiation was encouraged and warfarin 1 mg daily was required, unless contraindicated. After the first stage of accrual, the LD arm was closed because of limited activity, while the HD arm continued to the 2nd stage. Results: 46 patients were enrolled; 17 patients were randomized to LD Premarin, 29 patients assigned to HD Premarin by randomization or direct assignment. One patient withdrew consent prior to therapy. Median follow up is 5.3 months. Median age was 69 years (range 52–86) and median PSA 84.6 ng/ml (range 2.5–794.1). 19 patients (41%) had measurable disease. PSA declines ≥ 50% were seen in 0% (95% C.I., 0–19.5) and 32.1% (95% C.I., 15.9–52.4) of patients treated with LD and HD premarin. 1 patient treated with HD Premarin had a partial measurable response (8.3%; 95% C.I., 0.2–38.5). Median time to progression was 3.3 and 3.2 months in the LD and HD arms, respectively. Premarin was well tolerated in 45 evaluable patients. One grade 4 toxicity was noted, a stroke in the LD arm. Grade 3 toxicity was rare with 1 allergic reaction, 2 DVTs and 3 episodes of GI toxicity in one patient. Two patients experienced grade 3 elevations in PT requiring modification of warfarin dose. No significant gynecomastia was reported. Analysis of serially drawn hormone levels and molecular correlates of treatment response is pending. Conclusions: HD Premarin is associated with a 32.1% PSA response rate, while no responses were seen with LD Premarin. A measurable response was noted in 1 of 12 patients treated with HD Premarin. Toxicity was modest, though thromboembolism was seen even with prophylactic warfarin. Ongoing studies are evaluating molecular and clinical predictors of response. No significant financial relationships to disclose.
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Affiliation(s)
- M. Pomerantz
- Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA
| | - J. Manola
- Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA
| | - M. Taplin
- Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA
| | - G. Bubley
- Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA
| | - M. Inman
- Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA
| | - J. Lowell
- Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA
| | - P. Kantoff
- Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA
| | - W. K. Oh
- Dana-Farber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA
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Dreicer R, Li S, Manola J, Haas N, Roth B, Wilding G. Phase II trial of epothilone B analogue BMS-247550 in advanced carcinoma of the urothelium (E3800): A trial of the Eastern Cooperative Oncology Group. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4543 Background: Patients (pts) with advanced urothelial carcinoma who progress following first line therapy have limited effective therapeutic options. The epothilones are a class of antineoplastics with a broad range of antitumor activity. We evaluated BMS-247550 in pts with advanced urothelial cancer having received 1 prior systemic therapy regimen. Methods: Pts with TCC or mixed histologies containing TCC received BMS-247550 40 mg/m2 IV over 3 hours on day 1 of a 3-week cycle. Dose modifications occured for low granulocytes and/or platelets, mucositis, sensory neuropathy, and other Grade 3 or 4 toxicities. Pts remained on treatment until disease progression or unacceptable toxicity. Standard ECOG response criteria were used. Results: Total accrual (allowing for ineligible pts) was 45 pts, of whom 17 had received prior taxanes. One pt was ineligible (2 prior regimens) and was excluded from this analysis. Sixteen pts are still being evaluated for eligibility. The pt cohort was 82% male and 86% Caucasian. The median age was 63 (range 37–81), 70%, 7% and 23% had 1, 2 and 3 MSKCC risk factors respectively. Eighty-two % of pts had distant metastatic disease at study entry. A median of 2 cycles were administered (range, 1–8). The most common reasons for discontinuing treatment were progressive disease (65%) and toxicity (25%). Twelve pts experienced grade 4 toxicity, including leukopenia (n = 5), neutropenia (n = 9), ventricular arrhythmia, hypotension, DIC, stomatitis, elevated bilirubin, dyspnea, febrile neutropenia, hypoxia, acidosis, and elevated creatinine (n = 1 patient each). One pt died of cardiac failure following numerous grade 4 toxicities, including neutropenic infection. Two other deaths due to progressive disease occurred while pts were receiving treatment. Response information is available for 37 of 44 potentially eligible pts. There have been 5 partial responses, 3 among pts who had previously received taxanes, 17 pts had stable disease for at least 6 weeks. Conclusions: BMS-247550 has modest activity in pts with previously treated advanced TCC of the urothelium, but at the cost of modest-significant toxicity. Activity in pts previously treated with paclitaxel is of interest, however its ultimate utility remains undefined. [Table: see text]
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Affiliation(s)
- R. Dreicer
- Cleveland Clinic, Cleveland, OH; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of Wisconsin Cancer Center, Madison, WI
| | - S. Li
- Cleveland Clinic, Cleveland, OH; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of Wisconsin Cancer Center, Madison, WI
| | - J. Manola
- Cleveland Clinic, Cleveland, OH; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of Wisconsin Cancer Center, Madison, WI
| | - N. Haas
- Cleveland Clinic, Cleveland, OH; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of Wisconsin Cancer Center, Madison, WI
| | - B. Roth
- Cleveland Clinic, Cleveland, OH; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of Wisconsin Cancer Center, Madison, WI
| | - G. Wilding
- Cleveland Clinic, Cleveland, OH; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; Vanderbilt-Ingram Cancer Center, Nashville, TN; University of Wisconsin Cancer Center, Madison, WI
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Hurwitz M, Kaplan I, Hansen J, Prokopios-Davos S, Topulos G, Wishnow K, Manola J, Bornstein B, Hynynen K. Hyperthermia Combined with Radiation in Treatment of Locally Advanced Prostate Cancer Is Associated with a Favorable Toxicity Profile. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.558] [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]
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Garcia-Carbonero R, Supko JG, Maki RG, Manola J, Ryan DP, Harmon D, Puchalski TA, Goss G, Seiden MV, Waxman A, Quigley MT, Lopez T, Sancho MA, Jimeno J, Guzman C, Demetri GD. Ecteinascidin-743 (ET-743) for chemotherapy-naive patients with advanced soft tissue sarcomas: multicenter phase II and pharmacokinetic study. J Clin Oncol 2005; 23:5484-92. [PMID: 16110008 DOI: 10.1200/jco.2005.05.028] [Citation(s) in RCA: 152] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the response rate, toxicity profile, and pharmacokinetics of ecteinascidin-743 (ET-743) as first-line therapy in patients with unresectable advanced soft tissue sarcoma (STS). PATIENTS AND METHODS Thirty-six patients with STS were enrolled onto the study between September 1999 and August 2000. Patients were treated with 1.5 mg/m2 of ET-743 given as a 24-hour continuous intravenous (IV) infusion every 21 days. Pharmacokinetic sampling was performed in 23 patients. RESULTS One complete and five partial responses were achieved in 35 assessable patients for an overall response rate of 17.1% (95% CI, 6.6% to 33.6%). In addition, one patient had a minor response, leading to an overall clinical benefit of 20%. Neutropenia and transaminitis were the main grade 3 to 4 toxicities, which occurred in 33% and 36% of the patients. The estimated 1-year progression-free and overall survival rates were 21% (95% CI, 11% to 41%) and 72% (95% CI, 59% to 88%), respectively. Total body clearance (L/h) was not significantly correlated with body-surface area (r = -0.28; P = .21). Mild hepatic impairment or the extent of prior cytotoxic therapy does not seem to contribute significantly to the high interpatient variability (49%) in the clearance of this drug. Severity of treatment-related toxicity was not correlated with pharmacokinetic variables. CONCLUSION ET-743 demonstrates clinical activity as first-line therapy against STS with acceptable toxicity. Additional studies to establish empirical dosing guidelines may be necessary to improve the safety of the drug in patients with varying degrees of hepatic dysfunction and definitively establish the role of ET-743 for patients with these malignancies.
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Affiliation(s)
- R Garcia-Carbonero
- Dana-Farber Cancer Institute, Harvard Medical School, 44 Binney St, Boston, Massachusetts 02115, USA
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van den Abbeele A, Melenevsky Y, de Vries D, Manola J, Dileo P, Tetrault R, Baum C, Badawi R, Demetri G. Imaging kinase target inhibition with SU11248 by FDG-PET in patients (pts) with imatinib-resistant gastrointestinal stromal tumors (I-R GIST). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. van den Abbeele
- Dana-Farber Cancer Inst, Boston, MA; Pfizer Inc, La Jolla, CA; UC Davis Medcl Ctr, Sacramento, CA
| | - Y. Melenevsky
- Dana-Farber Cancer Inst, Boston, MA; Pfizer Inc, La Jolla, CA; UC Davis Medcl Ctr, Sacramento, CA
| | - D. de Vries
- Dana-Farber Cancer Inst, Boston, MA; Pfizer Inc, La Jolla, CA; UC Davis Medcl Ctr, Sacramento, CA
| | - J. Manola
- Dana-Farber Cancer Inst, Boston, MA; Pfizer Inc, La Jolla, CA; UC Davis Medcl Ctr, Sacramento, CA
| | - P. Dileo
- Dana-Farber Cancer Inst, Boston, MA; Pfizer Inc, La Jolla, CA; UC Davis Medcl Ctr, Sacramento, CA
| | - R. Tetrault
- Dana-Farber Cancer Inst, Boston, MA; Pfizer Inc, La Jolla, CA; UC Davis Medcl Ctr, Sacramento, CA
| | - C. Baum
- Dana-Farber Cancer Inst, Boston, MA; Pfizer Inc, La Jolla, CA; UC Davis Medcl Ctr, Sacramento, CA
| | - R. Badawi
- Dana-Farber Cancer Inst, Boston, MA; Pfizer Inc, La Jolla, CA; UC Davis Medcl Ctr, Sacramento, CA
| | - G. Demetri
- Dana-Farber Cancer Inst, Boston, MA; Pfizer Inc, La Jolla, CA; UC Davis Medcl Ctr, Sacramento, CA
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Kaufman HL, Wang W, Manola J, Dipaola RS, Ko YJ, Sweeney CJ, Whiteside T, Schlom J, Wilding G, Weiner LM. Phase II prime/boost vaccination using poxviruses expressing PSA in hormone dependent prostate cancer: Follow-up clinical results from ECOG 7897. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4501] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- H. L. Kaufman
- Columbia Univ, New York, NY; Dana-Farber Cancer Inst, Boston, MA; The Cancer Institute of New Jersey, New Brunswick, NJ; Beth Israel Deaconess Medcl Ctr, Boston, MA; Indiana Univ Medcl Ctr, Indianapolis, IN; Univ of Pittsburgh, Pittsburgh, PA; National Cancer Institute, Bethesda, MD; Univ of Wisconsin, Madison, WI; Fox Chase Cancer Ctr, Philadelphia, PA
| | - W. Wang
- Columbia Univ, New York, NY; Dana-Farber Cancer Inst, Boston, MA; The Cancer Institute of New Jersey, New Brunswick, NJ; Beth Israel Deaconess Medcl Ctr, Boston, MA; Indiana Univ Medcl Ctr, Indianapolis, IN; Univ of Pittsburgh, Pittsburgh, PA; National Cancer Institute, Bethesda, MD; Univ of Wisconsin, Madison, WI; Fox Chase Cancer Ctr, Philadelphia, PA
| | - J. Manola
- Columbia Univ, New York, NY; Dana-Farber Cancer Inst, Boston, MA; The Cancer Institute of New Jersey, New Brunswick, NJ; Beth Israel Deaconess Medcl Ctr, Boston, MA; Indiana Univ Medcl Ctr, Indianapolis, IN; Univ of Pittsburgh, Pittsburgh, PA; National Cancer Institute, Bethesda, MD; Univ of Wisconsin, Madison, WI; Fox Chase Cancer Ctr, Philadelphia, PA
| | - R. S. Dipaola
- Columbia Univ, New York, NY; Dana-Farber Cancer Inst, Boston, MA; The Cancer Institute of New Jersey, New Brunswick, NJ; Beth Israel Deaconess Medcl Ctr, Boston, MA; Indiana Univ Medcl Ctr, Indianapolis, IN; Univ of Pittsburgh, Pittsburgh, PA; National Cancer Institute, Bethesda, MD; Univ of Wisconsin, Madison, WI; Fox Chase Cancer Ctr, Philadelphia, PA
| | - Y.-J. Ko
- Columbia Univ, New York, NY; Dana-Farber Cancer Inst, Boston, MA; The Cancer Institute of New Jersey, New Brunswick, NJ; Beth Israel Deaconess Medcl Ctr, Boston, MA; Indiana Univ Medcl Ctr, Indianapolis, IN; Univ of Pittsburgh, Pittsburgh, PA; National Cancer Institute, Bethesda, MD; Univ of Wisconsin, Madison, WI; Fox Chase Cancer Ctr, Philadelphia, PA
| | - C. J. Sweeney
- Columbia Univ, New York, NY; Dana-Farber Cancer Inst, Boston, MA; The Cancer Institute of New Jersey, New Brunswick, NJ; Beth Israel Deaconess Medcl Ctr, Boston, MA; Indiana Univ Medcl Ctr, Indianapolis, IN; Univ of Pittsburgh, Pittsburgh, PA; National Cancer Institute, Bethesda, MD; Univ of Wisconsin, Madison, WI; Fox Chase Cancer Ctr, Philadelphia, PA
| | - T. Whiteside
- Columbia Univ, New York, NY; Dana-Farber Cancer Inst, Boston, MA; The Cancer Institute of New Jersey, New Brunswick, NJ; Beth Israel Deaconess Medcl Ctr, Boston, MA; Indiana Univ Medcl Ctr, Indianapolis, IN; Univ of Pittsburgh, Pittsburgh, PA; National Cancer Institute, Bethesda, MD; Univ of Wisconsin, Madison, WI; Fox Chase Cancer Ctr, Philadelphia, PA
| | - J. Schlom
- Columbia Univ, New York, NY; Dana-Farber Cancer Inst, Boston, MA; The Cancer Institute of New Jersey, New Brunswick, NJ; Beth Israel Deaconess Medcl Ctr, Boston, MA; Indiana Univ Medcl Ctr, Indianapolis, IN; Univ of Pittsburgh, Pittsburgh, PA; National Cancer Institute, Bethesda, MD; Univ of Wisconsin, Madison, WI; Fox Chase Cancer Ctr, Philadelphia, PA
| | - G. Wilding
- Columbia Univ, New York, NY; Dana-Farber Cancer Inst, Boston, MA; The Cancer Institute of New Jersey, New Brunswick, NJ; Beth Israel Deaconess Medcl Ctr, Boston, MA; Indiana Univ Medcl Ctr, Indianapolis, IN; Univ of Pittsburgh, Pittsburgh, PA; National Cancer Institute, Bethesda, MD; Univ of Wisconsin, Madison, WI; Fox Chase Cancer Ctr, Philadelphia, PA
| | - L. M. Weiner
- Columbia Univ, New York, NY; Dana-Farber Cancer Inst, Boston, MA; The Cancer Institute of New Jersey, New Brunswick, NJ; Beth Israel Deaconess Medcl Ctr, Boston, MA; Indiana Univ Medcl Ctr, Indianapolis, IN; Univ of Pittsburgh, Pittsburgh, PA; National Cancer Institute, Bethesda, MD; Univ of Wisconsin, Madison, WI; Fox Chase Cancer Ctr, Philadelphia, PA
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Talcott JA, Clark JA, Manola J, Zietman AL, Kaplan I, D’Amico AV, Coen J, Mitchell SP, Reilly CE. Using patient-reported outcomes to assess prostate brachytherapy technique. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. A. Talcott
- MA Gen Hosp, Boston, MA; Boston Univ Sch of Public Health, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Beth Israel Deaconess Hosp, Boston, MA; Brigham & Women’s Hosp, Boston, MA
| | - J. A. Clark
- MA Gen Hosp, Boston, MA; Boston Univ Sch of Public Health, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Beth Israel Deaconess Hosp, Boston, MA; Brigham & Women’s Hosp, Boston, MA
| | - J. Manola
- MA Gen Hosp, Boston, MA; Boston Univ Sch of Public Health, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Beth Israel Deaconess Hosp, Boston, MA; Brigham & Women’s Hosp, Boston, MA
| | - A. L. Zietman
- MA Gen Hosp, Boston, MA; Boston Univ Sch of Public Health, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Beth Israel Deaconess Hosp, Boston, MA; Brigham & Women’s Hosp, Boston, MA
| | - I. Kaplan
- MA Gen Hosp, Boston, MA; Boston Univ Sch of Public Health, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Beth Israel Deaconess Hosp, Boston, MA; Brigham & Women’s Hosp, Boston, MA
| | - A. V. D’Amico
- MA Gen Hosp, Boston, MA; Boston Univ Sch of Public Health, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Beth Israel Deaconess Hosp, Boston, MA; Brigham & Women’s Hosp, Boston, MA
| | - J. Coen
- MA Gen Hosp, Boston, MA; Boston Univ Sch of Public Health, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Beth Israel Deaconess Hosp, Boston, MA; Brigham & Women’s Hosp, Boston, MA
| | - S. P. Mitchell
- MA Gen Hosp, Boston, MA; Boston Univ Sch of Public Health, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Beth Israel Deaconess Hosp, Boston, MA; Brigham & Women’s Hosp, Boston, MA
| | - C. E. Reilly
- MA Gen Hosp, Boston, MA; Boston Univ Sch of Public Health, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Beth Israel Deaconess Hosp, Boston, MA; Brigham & Women’s Hosp, Boston, MA
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Ross RW, Manola J, Hennessy K, Galsky M, Scher H, Small E, Kelly WK, Kantoff P. Reverse transcriptase polymerase chain reaction for prostate-specific antigen (RT-PCR PSA) responses may predict time to progression (TTP) in hormone refractory prostate cancer (HRPC) patients treated with chemotherapy. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. W. Ross
- Dana-Farber Cancer Ctr, Boston, MA; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Univ of CA, San Francisco, San Fransico, CA
| | - J. Manola
- Dana-Farber Cancer Ctr, Boston, MA; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Univ of CA, San Francisco, San Fransico, CA
| | - K. Hennessy
- Dana-Farber Cancer Ctr, Boston, MA; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Univ of CA, San Francisco, San Fransico, CA
| | - M. Galsky
- Dana-Farber Cancer Ctr, Boston, MA; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Univ of CA, San Francisco, San Fransico, CA
| | - H. Scher
- Dana-Farber Cancer Ctr, Boston, MA; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Univ of CA, San Francisco, San Fransico, CA
| | - E. Small
- Dana-Farber Cancer Ctr, Boston, MA; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Univ of CA, San Francisco, San Fransico, CA
| | - W. K. Kelly
- Dana-Farber Cancer Ctr, Boston, MA; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Univ of CA, San Francisco, San Fransico, CA
| | - P. Kantoff
- Dana-Farber Cancer Ctr, Boston, MA; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Univ of CA, San Francisco, San Fransico, CA
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Norden-Zfoni A, Manola J, Desai J, Morgan J, Bello CL, Deprimo SE, Shalinsky DR, Baum C, Demetri GD, Heymach J. Levels of circulating endothelial cells (CECs) and monocytes as pharmacodynamic markers of SU11248 activity in patients (pts) with metastatic imatinib-resistant GIST. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9036] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. Norden-Zfoni
- Children’s Hosp, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Pfizer Global Research and Development, La Jolla, CA
| | - J. Manola
- Children’s Hosp, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Pfizer Global Research and Development, La Jolla, CA
| | - J. Desai
- Children’s Hosp, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Pfizer Global Research and Development, La Jolla, CA
| | - J. Morgan
- Children’s Hosp, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Pfizer Global Research and Development, La Jolla, CA
| | - C. L. Bello
- Children’s Hosp, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Pfizer Global Research and Development, La Jolla, CA
| | - S. E. Deprimo
- Children’s Hosp, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Pfizer Global Research and Development, La Jolla, CA
| | - D. R. Shalinsky
- Children’s Hosp, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Pfizer Global Research and Development, La Jolla, CA
| | - C. Baum
- Children’s Hosp, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Pfizer Global Research and Development, La Jolla, CA
| | - G. D. Demetri
- Children’s Hosp, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Pfizer Global Research and Development, La Jolla, CA
| | - J. Heymach
- Children’s Hosp, Boston, MA; Dana-Farber Cancer Inst, Boston, MA; Pfizer Global Research and Development, La Jolla, CA
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Oh WK, Manola J, Babcic V, Harnam N, Kantoff PW. Response to second-line chemotherapy in patients with hormone refractory prostate cancer (HRPC) receiving two sequences of mitoxantrone (M) and taxanes (T). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4616] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- W. K. Oh
- Dana-Farber Cancer Inst, Boston, MA
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Affiliation(s)
- J. Yannucci
- Beth Israel Deaconess Medcl Ctr, Boston, MA; Dana-Farber Cancer Inst, Boston, MA
| | - J. Manola
- Beth Israel Deaconess Medcl Ctr, Boston, MA; Dana-Farber Cancer Inst, Boston, MA
| | - M. Garnick
- Beth Israel Deaconess Medcl Ctr, Boston, MA; Dana-Farber Cancer Inst, Boston, MA
| | - G. Bubley
- Beth Israel Deaconess Medcl Ctr, Boston, MA; Dana-Farber Cancer Inst, Boston, MA
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Tsai H, Manola J, Abner A, Talcott J, D’Amico A, Beard C. Patient-reported acute gastrointestinal and genitourinary toxicities during conventional dose 3-dimensional conformal radiation therapy for adenocarcinoma of the prostate planned following neoadjuvant hormonal therapy. Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.07.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dipaola RS, Manola J, Li S, Vaughn D, Roth B, Wilding G. A randomized phase II trial of mitoxantrone, estramustine and vinorelbine or 13-cis retinoic acid, interferon and paclitaxel in patients with metastatic hormone refractory prostate cancer: results of ECOG 3899. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. S. Dipaola
- Cancer Institute of New Jersey, New Brunswick, NJ; Dana Farber Cancer Institute-Statistical Center, Boston, MA; University of Pennsylvania, Philadelphia, PA; Vanderbilt University, Nashville, TN; University of Wisconson, Madison, WI
| | - J. Manola
- Cancer Institute of New Jersey, New Brunswick, NJ; Dana Farber Cancer Institute-Statistical Center, Boston, MA; University of Pennsylvania, Philadelphia, PA; Vanderbilt University, Nashville, TN; University of Wisconson, Madison, WI
| | - S. Li
- Cancer Institute of New Jersey, New Brunswick, NJ; Dana Farber Cancer Institute-Statistical Center, Boston, MA; University of Pennsylvania, Philadelphia, PA; Vanderbilt University, Nashville, TN; University of Wisconson, Madison, WI
| | - D. Vaughn
- Cancer Institute of New Jersey, New Brunswick, NJ; Dana Farber Cancer Institute-Statistical Center, Boston, MA; University of Pennsylvania, Philadelphia, PA; Vanderbilt University, Nashville, TN; University of Wisconson, Madison, WI
| | - B. Roth
- Cancer Institute of New Jersey, New Brunswick, NJ; Dana Farber Cancer Institute-Statistical Center, Boston, MA; University of Pennsylvania, Philadelphia, PA; Vanderbilt University, Nashville, TN; University of Wisconson, Madison, WI
| | - G. Wilding
- Cancer Institute of New Jersey, New Brunswick, NJ; Dana Farber Cancer Institute-Statistical Center, Boston, MA; University of Pennsylvania, Philadelphia, PA; Vanderbilt University, Nashville, TN; University of Wisconson, Madison, WI
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Van Den Abbeele AD, Badawi RD, Manola J, Morgan JA, Desai J, Kazanovicz A, Armand MS, Baum C, Demetri GD. Effects of cessation of imatinib mesylate (IM) therapy in patients (pts) with IM-refractory gastrointestinal stromal tumors (GIST) as visualized by FDG-PET scanning. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - R. D. Badawi
- Dana-Farber Cancer Institute, Boston, MA; Pfizer, San Diego, CA
| | - J. Manola
- Dana-Farber Cancer Institute, Boston, MA; Pfizer, San Diego, CA
| | - J. A. Morgan
- Dana-Farber Cancer Institute, Boston, MA; Pfizer, San Diego, CA
| | - J. Desai
- Dana-Farber Cancer Institute, Boston, MA; Pfizer, San Diego, CA
| | - A. Kazanovicz
- Dana-Farber Cancer Institute, Boston, MA; Pfizer, San Diego, CA
| | - M. St. Armand
- Dana-Farber Cancer Institute, Boston, MA; Pfizer, San Diego, CA
| | - C. Baum
- Dana-Farber Cancer Institute, Boston, MA; Pfizer, San Diego, CA
| | - G. D. Demetri
- Dana-Farber Cancer Institute, Boston, MA; Pfizer, San Diego, CA
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Messing EM, Manola J, Sarosdy M, Wilding G, Crawford D, Kiernan M, Trump D. Immediate hormonal therapy versus observation after radical prostatectomy and pelvic lymphadenectomy for node positive prostate cancer: At 10 years results of EST3886. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4570] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- E. M. Messing
- University of Rochester, Rochester, NY; Dana Farber Cancer Institute, Boston, MA; South Texas Urology, San Antonio, NY; University of Wisconsin, Madison, NY; University of Colorado, Denver, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - J. Manola
- University of Rochester, Rochester, NY; Dana Farber Cancer Institute, Boston, MA; South Texas Urology, San Antonio, NY; University of Wisconsin, Madison, NY; University of Colorado, Denver, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - M. Sarosdy
- University of Rochester, Rochester, NY; Dana Farber Cancer Institute, Boston, MA; South Texas Urology, San Antonio, NY; University of Wisconsin, Madison, NY; University of Colorado, Denver, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - G. Wilding
- University of Rochester, Rochester, NY; Dana Farber Cancer Institute, Boston, MA; South Texas Urology, San Antonio, NY; University of Wisconsin, Madison, NY; University of Colorado, Denver, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - D. Crawford
- University of Rochester, Rochester, NY; Dana Farber Cancer Institute, Boston, MA; South Texas Urology, San Antonio, NY; University of Wisconsin, Madison, NY; University of Colorado, Denver, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - M. Kiernan
- University of Rochester, Rochester, NY; Dana Farber Cancer Institute, Boston, MA; South Texas Urology, San Antonio, NY; University of Wisconsin, Madison, NY; University of Colorado, Denver, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - D. Trump
- University of Rochester, Rochester, NY; Dana Farber Cancer Institute, Boston, MA; South Texas Urology, San Antonio, NY; University of Wisconsin, Madison, NY; University of Colorado, Denver, NY; Roswell Park Cancer Institute, Buffalo, NY
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Morgan JA, George S, Desai J, St. Amand M, Horton D, Wilkins E, Manola J, Demetri GD. Phase II study of gemcitabine/vinorelbine (GV) as first or second line chemotherapy in patients with metastatic soft tissue sarcoma (STS). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - S. George
- Dana Farber Cancer Institute, Boston, MA
| | - J. Desai
- Dana Farber Cancer Institute, Boston, MA
| | | | - D. Horton
- Dana Farber Cancer Institute, Boston, MA
| | - E. Wilkins
- Dana Farber Cancer Institute, Boston, MA
| | - J. Manola
- Dana Farber Cancer Institute, Boston, MA
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Holdsworth CH, Manola J, Badawi RD, Israel DA, Blanke C, Von Mehren M, Joensuu HT, Dimitrijevic S, Demetri GD, Van Den Abbeele AD. Use of computerized tomography (CT) as an early prognostic indicator of response to imatinib mesylate (IM) in patients with gastrointestinal stromal tumors (GIST). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C. H. Holdsworth
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR; Fox Chase Cancer Center, Philadelphia, PA; Helsinki University Central Hospital, Helsinki, Finland; Novartis Pharma AG, Basle, Switzerland
| | - J. Manola
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR; Fox Chase Cancer Center, Philadelphia, PA; Helsinki University Central Hospital, Helsinki, Finland; Novartis Pharma AG, Basle, Switzerland
| | - R. D. Badawi
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR; Fox Chase Cancer Center, Philadelphia, PA; Helsinki University Central Hospital, Helsinki, Finland; Novartis Pharma AG, Basle, Switzerland
| | - D. A. Israel
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR; Fox Chase Cancer Center, Philadelphia, PA; Helsinki University Central Hospital, Helsinki, Finland; Novartis Pharma AG, Basle, Switzerland
| | - C. Blanke
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR; Fox Chase Cancer Center, Philadelphia, PA; Helsinki University Central Hospital, Helsinki, Finland; Novartis Pharma AG, Basle, Switzerland
| | - M. Von Mehren
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR; Fox Chase Cancer Center, Philadelphia, PA; Helsinki University Central Hospital, Helsinki, Finland; Novartis Pharma AG, Basle, Switzerland
| | - H. T. Joensuu
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR; Fox Chase Cancer Center, Philadelphia, PA; Helsinki University Central Hospital, Helsinki, Finland; Novartis Pharma AG, Basle, Switzerland
| | - S. Dimitrijevic
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR; Fox Chase Cancer Center, Philadelphia, PA; Helsinki University Central Hospital, Helsinki, Finland; Novartis Pharma AG, Basle, Switzerland
| | - G. D. Demetri
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR; Fox Chase Cancer Center, Philadelphia, PA; Helsinki University Central Hospital, Helsinki, Finland; Novartis Pharma AG, Basle, Switzerland
| | - A. D. Van Den Abbeele
- Dana-Farber Cancer Institute, Boston, MA; Oregon Health and Science University, Portland, OR; Fox Chase Cancer Center, Philadelphia, PA; Helsinki University Central Hospital, Helsinki, Finland; Novartis Pharma AG, Basle, Switzerland
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Gordon MS, Manola J, Fairclough D, Cella D, Richardson R, Sosman J, Kasimis B, Dutcher JP, Wilding G. Low dose interferon-α2b (IFN) + thalidomide (T) in patients (pts) with previously untreated renal cell cancer (RCC). Improvement in progression-free survival (PFS) but not quality of life (QoL) or overall survival (OS). A phase III study of the Eastern Cooperative Oncology Group (E2898). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4516] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. S. Gordon
- Arizona Cancer Center, Scottsdale, AZ; Dana-Farber Cancer Institute, Boston, MA; AMC Cancer Research Center, Denver, CO; Evanston Northwestern Healthcare, Evanston, IL; Mayo Clinic, Rochester, MN; Vanderbilt University Medical Center, Nashville, TN; VA New Jersey Health Care System, East Orange, NJ; Our Lady of Mercy Medical Center, Bronx, NY; University of Wisconsin Hospital and Clinics, Madison, WI
| | - J. Manola
- Arizona Cancer Center, Scottsdale, AZ; Dana-Farber Cancer Institute, Boston, MA; AMC Cancer Research Center, Denver, CO; Evanston Northwestern Healthcare, Evanston, IL; Mayo Clinic, Rochester, MN; Vanderbilt University Medical Center, Nashville, TN; VA New Jersey Health Care System, East Orange, NJ; Our Lady of Mercy Medical Center, Bronx, NY; University of Wisconsin Hospital and Clinics, Madison, WI
| | - D. Fairclough
- Arizona Cancer Center, Scottsdale, AZ; Dana-Farber Cancer Institute, Boston, MA; AMC Cancer Research Center, Denver, CO; Evanston Northwestern Healthcare, Evanston, IL; Mayo Clinic, Rochester, MN; Vanderbilt University Medical Center, Nashville, TN; VA New Jersey Health Care System, East Orange, NJ; Our Lady of Mercy Medical Center, Bronx, NY; University of Wisconsin Hospital and Clinics, Madison, WI
| | - D. Cella
- Arizona Cancer Center, Scottsdale, AZ; Dana-Farber Cancer Institute, Boston, MA; AMC Cancer Research Center, Denver, CO; Evanston Northwestern Healthcare, Evanston, IL; Mayo Clinic, Rochester, MN; Vanderbilt University Medical Center, Nashville, TN; VA New Jersey Health Care System, East Orange, NJ; Our Lady of Mercy Medical Center, Bronx, NY; University of Wisconsin Hospital and Clinics, Madison, WI
| | - R. Richardson
- Arizona Cancer Center, Scottsdale, AZ; Dana-Farber Cancer Institute, Boston, MA; AMC Cancer Research Center, Denver, CO; Evanston Northwestern Healthcare, Evanston, IL; Mayo Clinic, Rochester, MN; Vanderbilt University Medical Center, Nashville, TN; VA New Jersey Health Care System, East Orange, NJ; Our Lady of Mercy Medical Center, Bronx, NY; University of Wisconsin Hospital and Clinics, Madison, WI
| | - J. Sosman
- Arizona Cancer Center, Scottsdale, AZ; Dana-Farber Cancer Institute, Boston, MA; AMC Cancer Research Center, Denver, CO; Evanston Northwestern Healthcare, Evanston, IL; Mayo Clinic, Rochester, MN; Vanderbilt University Medical Center, Nashville, TN; VA New Jersey Health Care System, East Orange, NJ; Our Lady of Mercy Medical Center, Bronx, NY; University of Wisconsin Hospital and Clinics, Madison, WI
| | - B. Kasimis
- Arizona Cancer Center, Scottsdale, AZ; Dana-Farber Cancer Institute, Boston, MA; AMC Cancer Research Center, Denver, CO; Evanston Northwestern Healthcare, Evanston, IL; Mayo Clinic, Rochester, MN; Vanderbilt University Medical Center, Nashville, TN; VA New Jersey Health Care System, East Orange, NJ; Our Lady of Mercy Medical Center, Bronx, NY; University of Wisconsin Hospital and Clinics, Madison, WI
| | - J. P. Dutcher
- Arizona Cancer Center, Scottsdale, AZ; Dana-Farber Cancer Institute, Boston, MA; AMC Cancer Research Center, Denver, CO; Evanston Northwestern Healthcare, Evanston, IL; Mayo Clinic, Rochester, MN; Vanderbilt University Medical Center, Nashville, TN; VA New Jersey Health Care System, East Orange, NJ; Our Lady of Mercy Medical Center, Bronx, NY; University of Wisconsin Hospital and Clinics, Madison, WI
| | - G. Wilding
- Arizona Cancer Center, Scottsdale, AZ; Dana-Farber Cancer Institute, Boston, MA; AMC Cancer Research Center, Denver, CO; Evanston Northwestern Healthcare, Evanston, IL; Mayo Clinic, Rochester, MN; Vanderbilt University Medical Center, Nashville, TN; VA New Jersey Health Care System, East Orange, NJ; Our Lady of Mercy Medical Center, Bronx, NY; University of Wisconsin Hospital and Clinics, Madison, WI
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Oh WK, Hagmann E, Manola J, George DJ, Gilligan TD, Smith MR, Kaufman DS, Kantoff PW. A phase I study of estramustine, weekly docetaxel and carboplatin (EDC) chemotherapy in patients with hormone refractory prostate cancer (HRPC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- W. K. Oh
- Dana-Farber Cancer Institute, Boston, MA; Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - E. Hagmann
- Dana-Farber Cancer Institute, Boston, MA; Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - J. Manola
- Dana-Farber Cancer Institute, Boston, MA; Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - D. J. George
- Dana-Farber Cancer Institute, Boston, MA; Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - T. D. Gilligan
- Dana-Farber Cancer Institute, Boston, MA; Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - M. R. Smith
- Dana-Farber Cancer Institute, Boston, MA; Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - D. S. Kaufman
- Dana-Farber Cancer Institute, Boston, MA; Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
| | - P. W. Kantoff
- Dana-Farber Cancer Institute, Boston, MA; Duke University Medical Center, Durham, NC; Massachusetts General Hospital, Boston, MA
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Tay MH, Kaufman DS, Regan MM, Leibowitz SB, George DJ, Febbo PG, Manola J, Smith MR, Kaplan ID, Kantoff PW, Oh WK. Finasteride and bicalutamide as primary hormonal therapy in patients with advanced adenocarcinoma of the prostate. Ann Oncol 2004; 15:974-8. [PMID: 15151957 DOI: 10.1093/annonc/mdh221] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Medical or surgical castration is effective in advanced prostate cancer but with profound side-effects, particularly on sexual function. Effective, less toxic therapies are needed. This study examined whether the addition of finasteride to high-dose bicalutamide enhanced disease control, as measured by additional decreases in serum prostate-specific antigen (PSA). PATIENTS AND METHODS Forty-one patients with advanced prostate cancer received bicalutamide (150 mg/day). Finasteride (5 mg/day) was added at first PSA nadir. Serum PSA was measured every 2 weeks until disease progression. Questionnaires were administered to assess sexual function. RESULTS Median follow-up is 3.9 years. At the first PSA nadir, median decrease in PSA from baseline was 96.5%. Thirty of 41 patients (73%) achieved a second PSA nadir and median decrease of 98.5% from baseline. Median time to each nadir was 3.7 and 5.8 weeks, respectively. Median time to treatment failure was 21.3 months. Toxicities were minor, including gynecomastia. Seventeen of 29 (59%) and 12 of 24 (50%) men had normal sex drive at baseline and at second PSA nadir, respectively. One-third of men had spontaneous erection at both time points. CONCLUSION Finasteride provides additional intracellular androgen blockade when added to bicalutamide. Duration of control is comparable to castration, with preserved sexual function in some patients.
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Affiliation(s)
- M-H Tay
- Lank Center for Genitourinary Oncology, Division of Solid Tumor Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA
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Garcia-Carbonero R, Supko JG, Manola J, Seiden MV, Harmon D, Ryan DP, Quigley MT, Merriam P, Canniff J, Goss G, Matulonis U, Maki RG, Lopez T, Puchalski TA, Sancho MA, Gomez J, Guzman C, Jimeno J, Demetri GD. Phase II and pharmacokinetic study of ecteinascidin 743 in patients with progressive sarcomas of soft tissues refractory to chemotherapy. J Clin Oncol 2004; 22:1480-90. [PMID: 15084621 DOI: 10.1200/jco.2004.02.098] [Citation(s) in RCA: 243] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To assess the efficacy of the marine-derived alkaloid ecteinascidin 743 (ET-743) in patients with soft tissue sarcomas that progressed despite prior conventional chemotherapy and to characterize the pharmacokinetic profiles of ET-743 in this patient population. PATIENTS AND METHODS Thirty-six previously treated soft tissue sarcoma patients from three institutions received ET-743 as a 24-hour continuous intravenous (IV) infusion at a dose of 1,500 microg/m(2) every 3 weeks. Pharmacokinetic studies were also performed. Patients were restaged every two cycles for response by objective criteria. RESULTS Objective responses were observed in three patients, with one complete response and two partial responses, for an overall response rate of 8% (95% CI, 2% to 23%). Responses were durable for up to 20 months. Two minor responses (43% and 47% tumor reduction) were observed, for an overall clinical benefit rate of 14%. The predominant toxicities were neutropenia and self-limited transaminitis of grade 3 to 4 severity in 34% and 26% of patients, respectively. The estimated 1-year time to progression and overall survival rates were 9% (95% CI, 3% to 27%) and 53% (95% CI, 39% to 73%), respectively. The maximum observed plasma concentration and total plasma clearance of ET-743 (mean +/- standard deviation), 1.04 +/- 0.48 ng/mL and 35.6 +/- 16.2 L/h/m(2), respectively, were consistent with previously reported values from phase I studies of the drug given as a 24-hour IV infusion. CONCLUSION ET-743 is a promising new option for the management of several histologic subtypes of sarcoma. Durable objective responses were obtained in a subset of sarcoma patients with disease progression despite prior chemotherapy. Additionally, the relatively high survival rate noted in this series of previously treated patients further justifies development of this agent.
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Affiliation(s)
- R Garcia-Carbonero
- Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Shields Warren Bldg, Room G530, 44 Binney St, Boston, MA 02115, USA.
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D'Amico AV, Manola J, Loffredo M, Lopes L, Nissen K, O'Farrell DA, Gordon L, Tempany CM, Cormack RA. A practical method to achieve prostate gland immobilization and target verification for daily treatment. Int J Radiat Oncol Biol Phys 2001; 51:1431-6. [PMID: 11728704 DOI: 10.1016/s0360-3016(01)02663-3] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE A practical method to achieve prostate immobilization and daily target localization for external beam radiation treatment is described. METHODS AND MATERIALS Ten patients who underwent prostate brachytherapy using permanent radioactive source placement were selected for study. To quantify prostate motion both with and without the presence of a specially designed inflatable intrarectal balloon, the computerized tomography-based coordinates of all intraprostatic radioactive sources were compared over 3 consecutive measurements at 1-min intervals. RESULTS The placement and inflation of the intrarectal balloon were well tolerated by all patients. The mean (range) displacement of the prostate gland when the intrarectal balloon was present vs. absent was 1.3 (0-2.2) mm vs. 1.8 (0-9.1) mm (p = 0.03) at 2 min respectively. The maximum displacement in any direction (anterior-posterior, superior-inferior, or right-left) when the intrarectal balloon was inflated vs. absent was reduced to < or =1 mm from 4 mm. CONCLUSIONS Both prostate gland immobilization and target verification are possible using a specially designed inflatable intrarectal balloon. Using this device, the posterior margin necessary on the lateral fields to ensure dosimetric coverage of the entire prostate gland could be safely reduced to 5 mm and treatment could be set up and verified using a lateral portal image.
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Affiliation(s)
- A V D'Amico
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, MA 02115, USA.
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Shapiro CL, Manola J, Leboff M. Ovarian failure after adjuvant chemotherapy is associated with rapid bone loss in women with early-stage breast cancer. J Clin Oncol 2001; 19:3306-11. [PMID: 11454877 DOI: 10.1200/jco.2001.19.14.3306] [Citation(s) in RCA: 317] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We sought to evaluate the effects of chemotherapy-induced ovarian failure on bone loss and markers of skeletal turnover in a prospective longitudinal study of young women with breast cancer receiving adjuvant chemotherapy. PATIENTS AND METHODS Forty-nine premenopausal women with stage I/II breast cancers receiving adjuvant chemotherapy were evaluated within 4 weeks of starting chemotherapy (baseline), and 6 and 12 months after starting chemotherapy with dual-energy absorptiometry and markers of skeletal turnover osteocalcin and bone-specific alkaline phosphatase. Chemotherapy-induced ovarian failure was defined as a negative pregnancy test, greater than 3 months of amenorrhea, and a follicle-stimulating hormone > or = 30 MIU/mL at the 12-month evaluation. RESULTS Among the 35 women who were defined as having ovarian failure, highly significant bone loss was observed in the lumbar spine by 6 months and increased further at 12 months. The median percentage decrease of bone mineral density in the spine from 0 to 6 months and 6 to 12 months was -4.0 (range, -10.4 to +1.0; P =.0001) and -3.7 (range, -10.1 to 9.2; P =.0001), respectively. In contrast, there were no significant decreases in bone mineral density in the 14 patients who retained ovarian function. Serum osteocalcin and bone specific alkaline phosphatase, markers of skeletal turnover, increased significantly in the women who developed ovarian failure. CONCLUSION Chemotherapy-induced ovarian failure causes rapid and highly significant bone loss in the spine. This may have implications for long-term breast cancer survivors who may be at higher risk for osteopenia, and subsequently osteoporosis. Women with breast cancer who develop chemotherapy-induced ovarian failure should have their bone density monitored and treatments to attenuate bone loss should be evaluated.
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Affiliation(s)
- C L Shapiro
- The Authur G. James Cancer Hospital and Richard J. Solove Research Institute, Ohio State University, Columbus 43210, USA.
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