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Araujo D, Greystoke A, Bates S, Bayle A, Calvo E, Castelo-Branco L, de Bono J, Drilon A, Garralda E, Ivy P, Kholmanskikh O, Melero I, Pentheroudakis G, Petrie J, Plummer R, Ponce S, Postel-Vinay S, Siu L, Spreafico A, Stathis A, Steeghs N, Yap C, Yap TA, Ratain M, Seymour L. Oncology phase I trial design and conduct: time for a change - MDICT Guidelines 2022. Ann Oncol 2023; 34:48-60. [PMID: 36182023 DOI: 10.1016/j.annonc.2022.09.158] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/18/2022] [Indexed: 02/03/2023] Open
Abstract
In 2021, the Food and Drug Administration Oncology Center of Excellence announced Project Optimus focusing on dose optimization for oncology drugs. The Methodology for the Development of Innovative Cancer Therapies (MDICT) Taskforce met to review and discuss the optimization of dosage for oncology trials and to develop a practical guide for oncology phase I trials. Defining a single recommended phase II dose based on toxicity may define doses that are neither the most effective nor the best tolerated. MDICT recommendations address the need for robust non-clinical data which are needed to inform trial design, as well as an expert team including statisticians and pharmacologists. The protocol must be flexible and adaptive, with clear definition of all endpoints. Health authorities should be consulted early and regularly. Strategies such as randomization, intrapatient dose escalation, and real-world eligibility criteria are encouraged whereas serial tumor sampling is discouraged in the absence of a strong rationale and appropriately validated assay. Endpoints should include consideration of all longitudinal toxicity. The phase I dose escalation trial should define the recommended dose range for later testing in randomized phase II trials, rather than a single recommended phase II dose, and consider scenarios where different populations may require different dosages. The adoption of these recommendations will improve dosage selection in early clinical trials of new anticancer treatments and ultimately, outcomes for patients.
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Affiliation(s)
- D Araujo
- Hospital de Base, Sao Jose do Rio Preto, Brazil
| | - A Greystoke
- Northern Centre for Cancer Care, Newcastle, UK
| | - S Bates
- Division of Hematology and Oncology, Department of Medicine, Columbia University, New York, USA
| | - A Bayle
- Institut Gustave Roussy, Paris, France
| | - E Calvo
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - L Castelo-Branco
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - J de Bono
- Institute of Cancer Research, University of London, London; The Royal Marsden Hospital, London, UK
| | - A Drilon
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - E Garralda
- Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - P Ivy
- National Cancer Institute, USA Cancer Therapy Evaluation Program Investigational Drug Branch (NCI/CTEP/IDB), Bethesda, USA
| | - O Kholmanskikh
- European Medicines Agency, Amsterdam, Netherlands; Federal Agency for Medicines and Health Products, Brussels, Belgium
| | - I Melero
- CUN and CIMA, University of Navarra, Pamplona, Spain
| | - G Pentheroudakis
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - J Petrie
- Canadian Cancer Trials Group, Queen's University, Kingston
| | - R Plummer
- Northern Centre for Cancer Care, Newcastle, UK
| | - S Ponce
- Institut Gustave Roussy, Paris, France
| | | | - L Siu
- Princess Margaret Cancer Centre, Toronto, Canada
| | - A Spreafico
- Princess Margaret Cancer Centre, Toronto, Canada
| | - A Stathis
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
| | - N Steeghs
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C Yap
- Institute of Cancer Research, University of London, London
| | - T A Yap
- Department of Investigational Cancer Therapeutics, University of Texas, MD Anderson Cancer Center, Houston
| | - M Ratain
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, USA
| | - L Seymour
- Canadian Cancer Trials Group, Queen's University, Kingston.
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Fletcher CE, Deng L, Orafidiya F, Yuan W, Lorentzen MPGS, Cyran OW, Varela-Carver A, Constantin TA, Leach DA, Dobbs FM, Figueiredo I, Gurel B, Parkes E, Bogdan D, Pereira RR, Zhao SG, Neeb A, Issa F, Hester J, Kudo H, Liu Y, Philippou Y, Bristow R, Knudsen K, Bryant RJ, Feng FY, Reed SH, Mills IG, de Bono J, Bevan CL. A non-coding RNA balancing act: miR-346-induced DNA damage is limited by the long non-coding RNA NORAD in prostate cancer. Mol Cancer 2022; 21:82. [PMID: 35317841 PMCID: PMC8939142 DOI: 10.1186/s12943-022-01540-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND miR-346 was identified as an activator of Androgen Receptor (AR) signalling that associates with DNA damage response (DDR)-linked transcripts in prostate cancer (PC). We sought to delineate the impact of miR-346 on DNA damage, and its potential as a therapeutic agent. METHODS RNA-IP, RNA-seq, RNA-ISH, DNA fibre assays, in vivo xenograft studies and bioinformatics approaches were used alongside a novel method for amplification-free, single nucleotide-resolution genome-wide mapping of DNA breaks (INDUCE-seq). RESULTS miR-346 induces rapid and extensive DNA damage in PC cells - the first report of microRNA-induced DNA damage. Mechanistically, this is achieved through transcriptional hyperactivation, R-loop formation and replication stress, leading to checkpoint activation and cell cycle arrest. miR-346 also interacts with genome-protective lncRNA NORAD to disrupt its interaction with PUM2, leading to PUM2 stabilisation and its increased turnover of DNA damage response (DDR) transcripts. Confirming clinical relevance, NORAD expression and activity strongly correlate with poor PC clinical outcomes and increased DDR in biopsy RNA-seq studies. In contrast, miR-346 is associated with improved PC survival. INDUCE-seq reveals that miR-346-induced DSBs occur preferentially at binding sites of the most highly-transcriptionally active transcription factors in PC cells, including c-Myc, FOXA1, HOXB13, NKX3.1, and importantly, AR, resulting in target transcript downregulation. Further, RNA-seq reveals widespread miR-346 and shNORAD dysregulation of DNA damage, replication and cell cycle processes. NORAD drives target-directed miR decay (TDMD) of miR-346 as a novel genome protection mechanism: NORAD silencing increases mature miR-346 levels by several thousand-fold, and WT but not TDMD-mutant NORAD rescues miR-346-induced DNA damage. Importantly, miR-346 sensitises PC cells to DNA-damaging drugs including PARP inhibitor and chemotherapy, and induces tumour regression as a monotherapy in vivo, indicating that targeting miR-346:NORAD balance is a valid therapeutic strategy. CONCLUSIONS A balancing act between miR-346 and NORAD regulates DNA damage and repair in PC. miR-346 may be particularly effective as a therapeutic in the context of decreased NORAD observed in advanced PC, and in transcriptionally-hyperactive cancer cells.
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Affiliation(s)
- C E Fletcher
- Imperial Centre for Translational and Experimental Medicine, Department of Surgery & Cancer, Imperial College London, London, UK.
| | - L Deng
- Imperial Centre for Translational and Experimental Medicine, Department of Surgery & Cancer, Imperial College London, London, UK
| | - F Orafidiya
- Imperial Centre for Translational and Experimental Medicine, Department of Surgery & Cancer, Imperial College London, London, UK
| | - W Yuan
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - M P G S Lorentzen
- Imperial Centre for Translational and Experimental Medicine, Department of Surgery & Cancer, Imperial College London, London, UK
| | - O W Cyran
- Imperial Centre for Translational and Experimental Medicine, Department of Surgery & Cancer, Imperial College London, London, UK
| | - A Varela-Carver
- Imperial Centre for Translational and Experimental Medicine, Department of Surgery & Cancer, Imperial College London, London, UK
| | - T A Constantin
- Imperial Centre for Translational and Experimental Medicine, Department of Surgery & Cancer, Imperial College London, London, UK
| | - D A Leach
- Imperial Centre for Translational and Experimental Medicine, Department of Surgery & Cancer, Imperial College London, London, UK
| | - F M Dobbs
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, UK
- Broken String Biosciences, Unit AB303, Level 3, BioData Innovation Centre, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - I Figueiredo
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - B Gurel
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - E Parkes
- Institute for Radiation Oncology, Department of Oncology, University of Oxford, London, UK
| | - D Bogdan
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - R R Pereira
- Translational Oncogenomics, Manchester Cancer Research Centre and Cancer Research UK Manchester Institute, Manchester, UK
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - S G Zhao
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - A Neeb
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - F Issa
- Transplantation Research and Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - J Hester
- Transplantation Research and Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - H Kudo
- Section of Pathology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Y Liu
- Veracyte, Inc., San Diego, CA, USA
| | - Y Philippou
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - R Bristow
- Translational Oncogenomics, Manchester Cancer Research Centre and Cancer Research UK Manchester Institute, Manchester, UK
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
- Christie NHS Foundation Trust, Manchester, UK
| | - K Knudsen
- Department of Cancer Biology, Thomas Jefferson University, Philadelphia, PA, USA
- American Cancer Society and American Cancer Society Cancer Action Network, Washington DC, USA
| | - R J Bryant
- Institute for Radiation Oncology, Department of Oncology, University of Oxford, London, UK
| | - F Y Feng
- Departments of Urology and Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
| | - S H Reed
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, UK
| | - I G Mills
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
- Patrick G Johnston Centre for Cancer Research, Queen's University of Belfast, Belfast, UK
- Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - J de Bono
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - C L Bevan
- Imperial Centre for Translational and Experimental Medicine, Department of Surgery & Cancer, Imperial College London, London, UK
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Banerjee S, Grochot R, Shinde R, Lima J, Krebs M, Rahman R, Little M, Tunariu N, Curcean A, Badham H, Mahmud M, Turner A, Parmar M, Yap C, Minchom A, Lopez J, de Bono J, Banerji U. 725MO Phase I study of the combination of the dual RAF/MEK inhibitor VS-6766 and the FAK inhibitor defactinib: Results of efficacy in low grade serous ovarian cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Yu E, Piulats J, Gravis G, Fong P, Todenhöfer T, Laguerre B, Arranz J, Oudard S, Massard C, Stoeckle M, Nordquist L, Carles J, Huang M, Li Y, Qiu P, Poehlein C, Schloss C, de Bono J. 73P Association between homologous recombination repair mutations and response to pembrolizumab (pembro) plus olaparib (ola) in metastatic castration-resistant prostate cancer (mCRPC): KEYNOTE-365 Cohort A biomarker analysis. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Tagawa S, Sartor O, Saad F, Sakharova O, de Bono J, Feng F, Fizazi K, Morris M. 647TiP PSMAddition: A phase III trial to compare treatment with 177Lu-PSMA-617 plus standard of care (SOC) versus SOC alone in patients with metastatic hormone-sensitive prostate cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Fizazi K, Herrmann K, Krause B, Rahbar K, Chi K, Morris M, Sartor O, Tagawa S, Kendi A, Vogelzang N, Calais J, Nagarajah J, Wei X, Koshkin V, Beauregard JM, Chang B, DeSilvio M, Messmann R, de Bono J. 576MO Health-related quality of life (HRQoL), pain and safety outcomes in the phase III VISION study of 177Lu-PSMA-617 in patients with metastatic castration-resistant prostate cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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de Wit R, Wülfing C, Castellano D, Kramer G, Eymard JC, Sternberg CN, Fizazi K, Tombal B, Bamias A, Carles J, Iacovelli R, Melichar B, Sverrisdóttir Á, Theodore C, Feyerabend S, Helissey C, Foster MC, Ozatilgan A, Geffriaud-Ricouard C, de Bono J. Baseline neutrophil-to-lymphocyte ratio as a predictive and prognostic biomarker in patients with metastatic castration-resistant prostate cancer treated with cabazitaxel versus abiraterone or enzalutamide in the CARD study. ESMO Open 2021; 6:100241. [PMID: 34450475 PMCID: PMC8390550 DOI: 10.1016/j.esmoop.2021.100241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/05/2021] [Accepted: 07/21/2021] [Indexed: 01/04/2023] Open
Abstract
Background There is growing evidence that a high neutrophil-to-lymphocyte ratio (NLR) is associated with poor overall survival (OS) for patients with metastatic castration-resistant prostate cancer (mCRPC). In the CARD study (NCT02485691), cabazitaxel significantly improved radiographic progression-free survival (rPFS) and OS versus abiraterone or enzalutamide in patients with mCRPC previously treated with docetaxel and the alternative androgen-receptor-targeted agent (ARTA). Here, we investigated NLR as a biomarker. Patients and methods CARD was a multicenter, open-label study that randomized patients with mCRPC to receive cabazitaxel (25 mg/m2 every 3 weeks) versus abiraterone (1000 mg/day) or enzalutamide (160 mg/day). The relationships between baseline NLR [< versus ≥ median (3.38)] and rPFS, OS, time to prostate-specific antigen progression, and prostate-specific antigen response to cabazitaxel versus ARTA were evaluated using Kaplan–Meier estimates. Multivariable Cox regression with stepwise selection of covariates was used to investigate the prognostic association between baseline NLR and OS. Results The rPFS benefit with cabazitaxel versus ARTA was particularly marked in patients with high NLR {8.5 versus 2.8 months, respectively; hazard ratio (HR) 0.43 [95% confidence interval (CI) 0.27-0.67]; P < 0.0001}, compared with low NLR [7.5 versus 5.1 months, respectively; HR 0.69 (95% CI 0.45-1.06); P = 0.0860]. Higher NLR (continuous covariate, per 1 unit increase) independently associated with poor OS [HR 1.05 (95% CI 1.02-1.08); P = 0.0003]. For cabazitaxel, there was no OS difference between patients with high versus low NLR (15.3 versus 12.9 months, respectively; P = 0.7465). Patients receiving an ARTA with high NLR, however, had a worse OS versus those with low NLR (9.5 versus 13.3 months, respectively; P = 0.0608). Conclusions High baseline NLR predicts poor outcomes with an ARTA in patients with mCRPC previously treated with docetaxel and the alternative ARTA. Conversely, the activity of cabazitaxel is retained irrespective of NLR. Baseline NLR was evaluated as a biomarker in patients with mCRPC treated with cabazitaxel versus abiraterone or enzalutamide. High baseline NLR predicted poor outcomes with abiraterone or enzalutamide in patients with mCRPC. Clinical benefit from cabazitaxel was retained in higher baseline NLR patients.
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Affiliation(s)
- R de Wit
- Department of Medical Oncology, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - C Wülfing
- Department of Urology, Asklepios Tumorzentrum, Hamburg, Germany
| | - D Castellano
- Department of Medical Oncology, University Hospital 12 de Octubre, Madrid, Spain
| | - G Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - J-C Eymard
- Department of Medical Oncology, Institute Jean Godinot, Reims, France
| | - C N Sternberg
- Division of Hematology and Medical Oncology, Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, USA
| | - K Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, Villejuif, France; University of Paris Saclay, Saint-Aubin, France
| | - B Tombal
- Institut de Recherche Clinique, Université Catholique de Louvain, Louvain, Belgium
| | - A Bamias
- Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - J Carles
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - R Iacovelli
- Medical Oncology Unit, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy; Department of Medical Oncology, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - B Melichar
- Department of Oncology, Palacky University Medical School and Teaching Hospital, Olomouc, Czech Republic
| | - Á Sverrisdóttir
- Department of Oncology, Landspitali University Hospital, Reykjavik, Iceland
| | - C Theodore
- Department of Oncology, Foch Hospital, Suresnes, France
| | | | - C Helissey
- Hôpital d'Instruction des Armées Bégin, Saint Mandé, France
| | - M C Foster
- Global Medical Oncology, Sanofi, Cambridge, USA
| | - A Ozatilgan
- Global Medical Oncology, Sanofi, Cambridge, USA
| | | | - J de Bono
- Division of Clinical Studies, The Institute of Cancer Research, London, UK; Prostate Targeted Therapy Group, Royal Marsden Hospital, London, UK
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Thiery-Vuillemin A, Fizazi K, Sartor O, Oudard S, Bury D, Thangavelu K, Ozatilgan A, Poole EM, Eisenberger M, de Bono J. An analysis of health-related quality of life in the phase III PROSELICA and FIRSTANA studies assessing cabazitaxel in patients with metastatic castration-resistant prostate cancer. ESMO Open 2021; 6:100089. [PMID: 33740734 PMCID: PMC7980065 DOI: 10.1016/j.esmoop.2021.100089] [Citation(s) in RCA: 3] [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] [Received: 09/29/2020] [Revised: 01/28/2021] [Accepted: 02/21/2021] [Indexed: 12/29/2022] Open
Abstract
Background Men with metastatic castration-resistant prostate cancer (mCRPC) are living longer, therefore optimizing health-related quality of life (HRQL), as well as survival outcomes, is important for optimal patient care. The aim of this study was to assess the HRQL in patients with mCRPC receiving docetaxel or cabazitaxel. Patients and methods PROSELICA (NCT01308580) assessed the non-inferiority of cabazitaxel 20 mg/m2 (C20) versus 25 mg/m2 (C25) in patients with mCRPC after docetaxel. FIRSTANA (NCT01308567) assessed the superiority of C25 or C20 versus docetaxel 75 mg/m2 (D75) in patients with chemotherapy-naive mCRPC. HRQL and pain were analyzed using protocol-defined, prospectively collected, Functional Assessment of Cancer Therapy—Prostate (FACT-P) and McGill-Melzack questionnaires. Analyses included definitive improvements in HRQL, maintained or improved HRQL, and HRQL over time. Results In total, 2131 patients were evaluable for HRQL across the two studies. In PROSELICA, 38.8% and 40.5% of patients receiving C20 and C25, respectively, had definitive FACT-P total score (TS) improvements. In FIRSTANA, 43.4%, 49.7%, and 44.9% of patients receiving D75, C20, and C25, respectively, had definitive FACT-P TS improvements. In both trials, definitive improvements started after cycle 1 and were maintained for the majority of subsequent treatment cycles. More than two-thirds of patients maintained or improved their FACT-P TS. Conclusions In PROSELICA and FIRSTANA, >40% of the 2131 evaluable patients with mCRPC had definitive FACT-P TS improvements; improvements occurred early and were maintained. More than 75% of patients maintained or improved their FACT-P TS. Patients with metastatic castration-resistant prostate cancer (mCRPC) are living longer. Optimizing health-related quality of life (HRQL), as well as survival outcomes, is important for optimal patient care. This study analyzed the HRQL data from patients treated by cabazitaxel or docetaxel within the trials PROSELICA and FIRSTANA. HRQL is often maintained or improved in patients with mCRPC who receive docetaxel or cabazitaxel. This is the largest prospective clinical dataset assessing HRQL among patients with mCRPC treated with taxane chemotherapy.
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Affiliation(s)
| | - K Fizazi
- Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - O Sartor
- Tulane University School of Medicine, New Orleans, USA
| | - S Oudard
- George Pompidou European Hospital, René Descartes University, Paris, France
| | - D Bury
- Sanofi US, Cambridge, USA
| | | | | | | | - M Eisenberger
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, USA
| | - J de Bono
- Royal Marsden and The Institute of Cancer Research, Sutton, UK
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9
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de Wit R, Wülfing C, Castellano Gauna D, Kramer G, Eymard JC, Sternberg C, Fizazi K, Tombal B, Bamias A, Carles J, Iacovelli R, Melichar B, Sverrisdóttir Á, Theodore C, Feyerabend S, Helissey C, Poole E, Ozatilgan A, Geffriaud-Ricouard C, de Bono J. 629P Neutrophil-lymphocyte ratio (NLR) as a prognostic and predictive biomarker in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with cabazitaxel (CBZ) vs abiraterone or enzalutamide in the CARD study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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10
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Sandhu S, Hussain M, Mateo J, Fizazi K, Saad F, Shore N, Chi K, Sartor O, Agarwal N, Olmos D, Thiery-Vuillemin A, Twardowski P, Mehra N, Goessl C, Kang J, Burgents J, Wu W, Kohlmann A, Adelman C, de Bono J. PROfound: Phase III study of olaparib versus enzalutamide or abiraterone for metastatic castration-resistant prostate cancer (mCRPC) with homologous recombination repair (HRR) gene alterations. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz446.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hussain M, Mateo J, Fizazi K, Saad F, Shore N, Sandhu S, Chi K, Sartor O, Agarwal N, Olmos D, Thiery-Vuillemin A, Twardowski P, Mehra N, Goessl C, Kang J, Burgents J, Wu W, Kohlmann A, Adelman C, de Bono J. PROfound: Phase III study of olaparib versus enzalutamide or abiraterone for metastatic castration-resistant prostate cancer (mCRPC) with homologous recombination repair (HRR) gene alterations. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.039] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hong D, Arkenau H, de Bono J, Lassen U, Drew Y, Slomovitz B, Ghatta S, Windfeld K, Rangwala R, Concin N. Tisotumab vedotin (TV) in patients with previously treated recurrent or metastatic cervical cancer: Updated safety and efficacy results from the full cervical cohort of the phase II innova TV 201 study (NCT02001623). Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hollebecque A, de Bono J, Plummer R, Isambert N, Martin-Romano P, Baudin E, Mora S, Harding A, Nguyen A, Filvaroff E, Lamba M, Liu K, De Alvaro J, DiMartino J, Zuraek M, Nikolova Z. Phase I study of CC-90011 in patients with advanced solid tumors and relapsed/refractory non-Hodgkin lymphoma (R/R NHL). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.002] [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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Sundar R, Custodio A, Petruckevich A, Chénard-Poirier M, Ameratunga M, Collins D, Lim J, Kaye SB, Tunariu N, Banerji U, de Bono J, Lopez J. Clinical Outcome of Patients with Advanced Biliary Tract Cancer in a Dedicated Phase I Unit. Clin Oncol (R Coll Radiol) 2018; 30:185-191. [PMID: 29224898 DOI: 10.1016/j.clon.2017.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 10/19/2017] [Accepted: 11/22/2017] [Indexed: 11/25/2022]
Abstract
AIMS Advanced biliary tract carcinomas (ABC) are malignancies with limited effective therapies for advanced disease. There is little published evidence of outcomes of ABC patients participating in phase I clinical trials. MATERIALS AND METHODS Patient characteristics, treatment details and outcomes of ABC patients treated at a dedicated phase I unit were captured and analysed from case and trial records. RESULTS In total, 123 ABC patients were included in the study, of which 48 patients participated in 41 different phase I trials; 75 (61%) did not participate due to rapid disease progression or patient choice. Molecular characterisation of tumours using a targeted panel was conducted in 15 (31%), yielding several potentially actionable mutations, including BRCA, PIK3CA, FGFR, AKT and PTEN loss. Of the 39 evaluable patients there was one exceptional responder. Eighteen (46%) other patients achieved stable disease as their best response, with a clinical benefit rate at 4 months of 10%. Treatment was generally well tolerated with grade 3 or 4 adverse events only observed in eight patients (17 %), of which six were drug related and led to trial discontinuation in one (3%), with no toxicity-related deaths. CONCLUSION Carefully selected ABC patients have been found to tolerate experimental phase I clinical trials without excess toxicity. The aggressive nature of this disease warrants consideration of early referral to a phase I unit. Future work will require comprehensive molecular profiling in an attempt to understand the biology underlying the exceptional responders and to match patients in real-time to targeted therapies.
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Affiliation(s)
- R Sundar
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK; National University Health System, Singapore
| | - A Custodio
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| | - A Petruckevich
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| | - M Chénard-Poirier
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| | - M Ameratunga
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| | - D Collins
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| | - J Lim
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK; National University Health System, Singapore
| | - S B Kaye
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| | - N Tunariu
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| | - U Banerji
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| | - J de Bono
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| | - J Lopez
- Royal Marsden Hospital & The Institute of Cancer Research, London, UK.
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15
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Shenoy TR, Boysen G, Wang MY, Xu QZ, Guo W, Koh FM, Wang C, Zhang LZ, Wang Y, Gil V, Aziz S, Christova R, Rodrigues DN, Crespo M, Rescigno P, Tunariu N, Riisnaes R, Zafeiriou Z, Flohr P, Yuan W, Knight E, Swain A, Ramalho-Santos M, Xu DY, de Bono J, Wu H. CHD1 loss sensitizes prostate cancer to DNA damaging therapy by promoting error-prone double-strand break repair. Ann Oncol 2018; 28:1495-1507. [PMID: 28383660 DOI: 10.1093/annonc/mdx165] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Indexed: 01/08/2023] Open
Abstract
Background Deletion of the chromatin remodeler chromodomain helicase DNA-binding protein 1 (CHD1) is a common genomic alteration found in human prostate cancers (PCas). CHD1 loss represents a distinct PCa subtype characterized by SPOP mutation and higher genomic instability. However, the role of CHD1 in PCa development in vivo and its clinical utility remain unclear. Patients and methods To study the role of CHD1 in PCa development and its loss in clinical management, we generated a genetically engineered mouse model with prostate-specific deletion of murine Chd1 as well as isogenic CHD1 wild-type and homozygous deleted human benign and PCa lines. We also developed patient-derived organoid cultures and screened patients with metastatic PCa for CHD1 loss. Results We demonstrate that CHD1 loss sensitizes cells to DNA damage and causes a synthetic lethal response to DNA damaging therapy in vitro, in vivo, ex vivo, in patient-derived organoid cultures and in a patient with metastatic PCa. Mechanistically, CHD1 regulates 53BP1 stability and CHD1 loss leads to decreased error-free homologous recombination (HR) repair, which is compensated by increased error-prone non-homologous end joining (NHEJ) repair for DNA double-strand break (DSB) repair. Conclusions Our study provides the first in vivo and in patient evidence supporting the role of CHD1 in DSB repair and in response to DNA damaging therapy. We uncover mechanistic insights that CHD1 modulates the choice between HR and NHEJ DSB repair and suggest that CHD1 loss may contribute to the genomic instability seen in this subset of PCas.
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Affiliation(s)
- T R Shenoy
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA
| | - G Boysen
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - M Y Wang
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Q Z Xu
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - W Guo
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - F M Koh
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research and Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA
| | - C Wang
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA
| | - L Z Zhang
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Y Wang
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA
| | - V Gil
- The Institute of Cancer Research, London, UK
| | - S Aziz
- The Institute of Cancer Research, London, UK
| | - R Christova
- The Institute of Cancer Research, London, UK
| | - D N Rodrigues
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - M Crespo
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - P Rescigno
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - N Tunariu
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - R Riisnaes
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Z Zafeiriou
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - P Flohr
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - W Yuan
- The Institute of Cancer Research, London, UK
| | - E Knight
- The Institute of Cancer Research, London, UK
| | - A Swain
- The Institute of Cancer Research, London, UK
| | - M Ramalho-Santos
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research and Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA
| | - D Y Xu
- The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - J de Bono
- The Institute of Cancer Research, London, UK.,Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - H Wu
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, USA.,The MOE Key Laboratory of Cell Proliferation and Differentiation, School of Life Sciences, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
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Demetriades P, Bell A, Gubran C, Marshall H, de Bono J, Hudsmith L. Suitability of cardiac resynchronisation therapy in patients with Fontan circulation and congenitally corrected transposition of the great arteries. Int J Cardiol 2017; 249:166-168. [DOI: 10.1016/j.ijcard.2017.08.066] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 08/18/2017] [Accepted: 08/29/2017] [Indexed: 11/30/2022]
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17
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Ingles Garces A, Ang J, Ameratunga M, Chenard-Poirier M, Dolling D, Diamantis N, Seeramreddi S, Sundar R, de Bono J, Lopez J, Banerji U. Drug-induced electrolyte abnormalities in oncology phase I trials: Analysis of 1088 cases treated at The Royal Marsden Hospital. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx367.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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18
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Chenard-Poirier M, Hong D, Coleman R, de Bono J, Mau-Sorensen M, Collins D, Lisby S, Basse L, Lassen U. A phase I/II safety study of tisotumab vedotin (HuMax®-TF-ADC) in patients with solid tumors. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx376.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rescigno P, de Bono J, Aparicio A, Chowdhury S, Twardowski P, Dawson N, Vaishampayan U, Pantuck A, Zhou Y, Fecteau D, Ganji G, Tolson J, Smith D, Medina J, Yan L. Phase I, open-label, dose-finding study of GSK2636771, a phosphoinositide 3-kinase (PI3K)β inhibitor, in combination with enzalutamide in male subjects with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.009] [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: 11/14/2022] Open
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20
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Chenard-Poirier M, Hong D, Coleman R, de Bono J, Mau-Sorensen M, Collins D, Lisby S, Basse L, Lassen U. A phase I/II safety study of tisotumab vedotin (HuMax®-TF-ADC) in patients with solid tumors. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx376.013] [Citation(s) in RCA: 5] [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: 11/14/2022] Open
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21
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Vergote I, Dean E, Lassen U, de Bono J, Drew Y, Machiels JP, Nielsen D, Arkenau HT, Forster M, Jones R, Slomovitz B, Spicer J, Johnson M, Cornez N, Gennigens C, Fulton B, Lisby S, Basse L, Coleman R, Hong D. A phase IIa study of tisotumab vedotin (HuMax®-TF-ADC) in patients with relapsed, recurrent and/or metastatic cervical cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.001] [Citation(s) in RCA: 4] [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: 11/14/2022] Open
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22
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Coleman N, Michalarea V, Alken S, Perez Lopez R, Tunariu N, Petruckevitch A, Banerji U, de Bono J, Welsh L, Saran F, Lopez J. Prognostic Impact of neutrophil to lymphocyte ratio (NLR) in patients (pts) with recurrent primary malignant brain tumours (PMBT) in phase I (Ph1) trials: The Royal Marsden (RMH) Experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx366.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Di Mitri D, Vasilevska J, Calcinotto A, Gil V, Boysen G, Revandkar A, Waugh D, Barry S, de Bono J, Alimonti A. Re-education of tumor-associated macrophages by CXCR2 blockade drives senescence enhancement and tumor inhibition in advanced prostate cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.008] [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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24
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James N, de Bono J, Spears M, Clarke N, Mason M, Dearnaley D, Ritchie A, Russell M, Gilson C, Jones R, Gillessen S, Matheson D, Aung S, Birtle A, Chowdhury S, Gale J, Malik Z, O'Sullivan J, Parmar M, Sydes M. Adding abiraterone for patients (pts) with high-risk prostate cancer (PCa) starting long-term androgen deprivation therapy (ADT): Outcomes in non-metastatic (M0) patients from STAMPEDE (NCT00268476). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.027] [Citation(s) in RCA: 5] [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: 11/15/2022] Open
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Nombela Blanco P, Lozano Mejorada R, Lorente Estelles D, Reid A, Romero Laorden N, Attard G, Cendón Flórez Y, Mateo J, Sandhu S, Massard C, Montesa A, Flohr P, Sáez M, Pacheco M, Castro Marcos E, de Bono J, Olmos Hidalgo D. Exploratory study of CK-M30 and pHH3 expression in Circulating Tumor Cells (CTCs) as biomarkers of docetaxel (DOC) efficacy in metastatic castration resistant prostate cancer (mCRPC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx390.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Sydes M, Mason M, Spears M, Clarke N, Dearnaley D, Ritchie A, Russell M, Gilson C, Jones R, de Bono J, Gillessen S, Millman R, Tolan S, Wagstaff J, Chowdhury S, Lester J, Sheehan D, Gale J, Parmar M, James N. Adding abiraterone acetate plus prednisolone (AAP) or docetaxel for patients (pts) with high-risk prostate cancer (PCa) starting long-term androgen deprivation therapy (ADT): Directly randomised data from STAMPEDE (NCT00268476). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Eisenberger M, Hardy-Bessard AC, Kim C, Géczi L, Ford D, Mourey L, Carles J, Parente P, Font A, Kacsó G, Barnes G, Wang H, Zhang W, Ozatilgan A, de Bono J. Assessment of health-related quality of life (HRQL) in PROSELICA: A Phase 3 trial assessing cabazitaxel 20 mg/m2 (C20) vs 25 mg/m2 (C25) in post-docetaxel (D) patients (pts) with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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Ingles Garces A, Ang J, Ameratunga M, Chenard-Poirier M, Dolling D, Sundar R, Kaye S, de Bono J, Banerji U, Lopez J. Impact of prior immune checkpoint inhibitors on haematological toxicity in phase I patients receiving chemotherapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx376.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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29
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de Bono J, Bracarda S, Chi K, Massard C, Olmos Hidalgo D, Sandhu S, Sternberg C, Gendreau S, Xu N, Baney T, Maslyar D, Sweeney C. Randomized phase III trial of ipatasertib vs. placebo, plus abiraterone and prednisone/prednisolone, in men with asymptomatic or mildly symptomatic previously untreated metastatic castrate-resistant prostate cancer (mCRPC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.051] [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: 11/13/2022] Open
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30
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Bryce AH, Alumkal JJ, Armstrong A, Higano CS, Iversen P, Sternberg CN, Rathkopf D, Loriot Y, de Bono J, Tombal B, Abhyankar S, Lin P, Krivoshik A, Phung D, Beer TM. Radiographic progression with nonrising PSA in metastatic castration-resistant prostate cancer: post hoc analysis of PREVAIL. Prostate Cancer Prostatic Dis 2017; 20:221-227. [PMID: 28117385 PMCID: PMC5435962 DOI: 10.1038/pcan.2016.71] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/08/2016] [Accepted: 11/29/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Advanced prostate cancer is a phenotypically diverse disease that evolves through multiple clinical courses. PSA level is the most widely used parameter for disease monitoring, but it has well-recognized limitations. Unlike in clinical trials, in practice, clinicians may rely on PSA monitoring alone to determine disease status on therapy. This approach has not been adequately tested. METHODS Chemotherapy-naive asymptomatic or mildly symptomatic men (n=872) with metastatic castration-resistant prostate cancer (mCRPC) who were treated with the androgen receptor inhibitor enzalutamide in the PREVAIL study were analyzed post hoc for rising versus nonrising PSA (empirically defined as >1.05 vs ⩽1.05 times the PSA level from 3 months earlier) at the time of radiographic progression. Clinical characteristics and disease outcomes were compared between the rising and nonrising PSA groups. RESULTS Of 265 PREVAIL patients with radiographic progression and evaluable PSA levels on the enzalutamide arm, nearly one-quarter had a nonrising PSA. Median progression-free survival in this cohort was 8.3 months versus 11.1 months in the rising PSA cohort (hazard ratio 1.68; 95% confidence interval 1.26-2.23); overall survival was similar between the two groups, although less than half of patients in either group were still at risk at 24 months. Baseline clinical characteristics of the two groups were similar. CONCLUSIONS Non-rising PSA at radiographic progression is a common phenomenon in mCRPC patients treated with enzalutamide. As restaging in advanced prostate cancer patients is often guided by increases in PSA levels, our results demonstrate that disease progression on enzalutamide can occur without rising PSA levels. Therefore, a disease monitoring strategy that includes imaging not entirely reliant on serial serum PSA measurement may more accurately identify disease progression.
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Affiliation(s)
- A H Bryce
- Division of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ, USA
| | - J J Alumkal
- OHSU Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - A Armstrong
- Division of Medical Oncology, Duke University Medical Center, Durham, NC, USA
| | - C S Higano
- Seattle Cancer Care Alliance, University of Washington, Seattle, WA, USA
| | - P Iversen
- Department of Clinical Medicine, Rigshospitalet, Copenhagen, Denmark
| | - C N Sternberg
- Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy
| | - D Rathkopf
- Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Y Loriot
- Department of Cancer Medicine, Institut Gustave-Roussy, Villejuif, France
| | - J de Bono
- Division of Clinical Studies, Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - B Tombal
- Division of Urology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - S Abhyankar
- Medical Affairs, Medivation, Inc., San Francisco, CA, USA
| | - P Lin
- Biostatistics, Medivation, Inc., San Francisco, CA, USA
| | - A Krivoshik
- Medical Oncology, Astellas Pharma, Inc., Northbrook, IL, USA
| | - D Phung
- Biostatistics, Astellas Pharma, Inc., Northbrook, IL, USA
| | - T M Beer
- OHSU Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
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Massard C, Mateo J, Loriot Y, Pezaro C, Albiges L, Mehra N, Varga A, Bianchini D, Ryan CJ, Petrylak DP, Attard G, Shen L, Fizazi K, de Bono J. Phase I/II trial of cabazitaxel plus abiraterone in patients with metastatic castration-resistant prostate cancer (mCRPC) progressing after docetaxel and abiraterone. Ann Oncol 2017; 28:90-95. [PMID: 28039155 PMCID: PMC5378222 DOI: 10.1093/annonc/mdw441] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background Abiraterone and cabazitaxel improve survival in patients with metastatic castration-resistant prostate cancer (mCRPC). We conducted an open-label phase I/II trial of cabazitaxel plus abiraterone to assess the antitumor activity and tolerability in patients with progressive mCRPC after docetaxel (phase I), and after docetaxel and abiraterone (phase II) (NCT01511536). Patients and methods The primary objectives were to determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs) of cabazitaxel plus abiraterone (phase I), and the prostate-specific antigen (PSA) response defined as a ≥ 50% decrease confirmed ≥3 weeks later with this combination (phase II). Results Ten patients were enrolled in the phase I component; nine were evaluable. No DLTs were identified. The MTD was established as the approved doses for both drugs (cabazitaxel 25 mg/m2 every 3 weeks and abiraterone 1000 mg once daily). Daily abiraterone treatment did not impact on cabazitaxel clearance. Twenty-seven patients received cabazitaxel plus abiraterone plus prednisone (5 mg twice daily) in phase II. The median number of cycles administered (cabazitaxel) was seven (range: 1-28). Grade 3-4 treatment-emergent adverse events included asthenia (in 5 patients; 14%), neutropenia (in 5 patients; 14%) and diarrhea (in 3 patients; 8%). Nine patients (24%) required dose reductions of cabazitaxel. Of 26 evaluable patients, 12 achieved a PSA response [46%; 95% confidence interval (CI): 26.6-66.6%]. Median PSA-progression-free survival was 6.9 months (95% CI: 4.1-10.3 months). Of 14 patients with measurable disease at baseline, 3 (21%) achieved a partial response per response evaluation criteria in solid tumors. Conclusions The combination of cabazitaxel and abiraterone has a manageable safety profile and shows antitumor activity in patients previously treated with docetaxel and abiraterone.
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Affiliation(s)
- C Massard
- Department of Drug Development, Gustave Roussy Cancer Campus, University of Paris Sud, Villejuif, France.,Department of Medical Oncology, Gustave Roussy Cancer Campus, University of Paris Sud, Villejuif, France
| | - J Mateo
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - Y Loriot
- Department of Medical Oncology, Gustave Roussy Cancer Campus, University of Paris Sud, Villejuif, France
| | - C Pezaro
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - L Albiges
- Department of Medical Oncology, Gustave Roussy Cancer Campus, University of Paris Sud, Villejuif, France
| | - N Mehra
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - A Varga
- Department of Drug Development, Gustave Roussy Cancer Campus, University of Paris Sud, Villejuif, France
| | - D Bianchini
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - C J Ryan
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, USA
| | - D P Petrylak
- Comprehensive Cancer Center Yale School of Medicine, New Haven
| | - G Attard
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - L Shen
- Sanofi Genzyme, Cambridge, USA
| | - K Fizazi
- Department of Medical Oncology, Gustave Roussy Cancer Campus, University of Paris Sud, Villejuif, France
| | - J de Bono
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
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de Wit R, Fizazi K, Efstathiou E, Dittamore R, Hitier S, Pantel K, Sternberg C, Tombal B, Wülfing C, de Bono J. CARD: A randomized phase 4 trial comparing cabazitaxel and an androgen receptor (AR)-targeted agent in men with metastatic castration-resistant prostate cancer (mCRPC) progressing after docetaxel and an alternative AR-targeted agent. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bryce A, Alumkal J, Armstrong A, Higano C, Iversen P, Sternberg C, Rathkopf D, Loriot Y, de Bono J, Tombal B, Abhyankar S, Lin P, Krivoshik A, Phung D, Beer T. A post hoc analysis of radiographic progression with nonrising prostate-specific antigen in patients with metastatic castration-resistant prostate cancer (mCRPC) in the PREVAIL study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Omlin A, Jones RJ, van der Noll R, Satoh T, Niwakawa M, Smith SA, Graham J, Ong M, Finkelman RD, Schellens JHM, Zivi A, Crespo M, Riisnaes R, Nava-Rodrigues D, Malone MD, Dive C, Sloane R, Moore D, Alumkal JJ, Dymond A, Dickinson PA, Ranson M, Clack G, de Bono J, Elliott T. AZD3514, an oral selective androgen receptor down-regulator in patients with castration-resistant prostate cancer - results of two parallel first-in-human phase I studies. Invest New Drugs 2015; 33:679-90. [PMID: 25920479 DOI: 10.1007/s10637-015-0235-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [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] [Received: 03/20/2015] [Accepted: 03/24/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND AZD3514 is a first-in-class, orally bio-available, androgen-dependent and -independent androgen receptor inhibitor and selective androgen-receptor down-regulator (SARD). METHODS In study 1 and 2, castration-resistant prostate cancer (CRPC) patients (pts) were initially recruited into a once daily (QD) oral schedule (A). In study 1, pharmacokinetic assessments led to twice daily (BID) dosing (schedule B) to increase exposure. Study 2 explored a once daily schedule. RESULTS In study 1, 49 pts were treated with escalating doses of AZD3514 (A 35 pts, B 14 pts). Starting doses were 100 mg (A) and 1000 mg (B). The AZD3514 formulation was switched from capsules to tablets at 1000 mg QD. 2000 mg BID was considered non-tolerable due to grade (G) 2 toxicities (nausea [N], vomiting [V]). No adverse events (AEs) met the dose-limiting toxicity (DLT) definition. Thirteen pts received AZD3514 in study 2, with starting doses of 250 mg QD. The most frequent drug-related AEs were N: G1/2 in 55/70 pts (79 %); G3 in 1 pt (1.4 %); & V: G1/2 in 34/70 pts (49 %) & G3 in 1 pt (1.4 %). PSA declines (≥50 %) were documented in 9/70 patients (13 %). Objective soft tissue responses per RECIST1.1 were observed in 4/24 (17 %) pts in study 1. CONCLUSION AZD3514 has moderate anti-tumour activity in pts with advanced CRPC but with significant levels of nausea and vomiting. However, anti-tumour activity as judged by significant PSA declines, objective responses and durable disease stabilisations, provides the rationale for future development of SARD compounds.
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Affiliation(s)
- A Omlin
- Prostate Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
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Lorente D, Omlin A, Ferraldeschi R, Pezaro C, Perez R, Mateo J, Altavilla A, Zafeirou Z, Tunariu N, Parker C, Dearnaley D, Gillessen S, de Bono J, Attard G. Tumour responses following a steroid switch from prednisone to dexamethasone in castration-resistant prostate cancer patients progressing on abiraterone. Br J Cancer 2014; 111:2248-53. [PMID: 25314055 PMCID: PMC4264443 DOI: 10.1038/bjc.2014.531] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 09/02/2014] [Accepted: 09/10/2014] [Indexed: 12/16/2022] Open
Abstract
Background: Abiraterone is a CYP17A1 inhibitor that improves survival in castration-resistant prostate cancer (CRPC). Abiraterone is licensed in combination with prednisone 5 mg twice daily to prevent a syndrome of secondary mineralocorticoid excess. We hypothesised that a ‘steroid switch' from prednisone to dexamethasone would induce secondary responses in patients progressing on abiraterone and prednisone 5 mg b.i.d. Methods: We performed a ‘steroid switch' in patients with CRPC at PSA progression on abiraterone and prednisolone. Patients were monitored for secondary declines in PSA, radiological tumour regression and toxicity. Results: A retrospective analysis of 30 CRPC patients who underwent a steroid switch from prednisolone to dexamethasone while on abiraterone was performed. A total of six patients (20%) had a ⩾50% PSA decline that was confirmed by a second PSA level at least 3 weeks later. In all, 11 patients (39.2%) had a confirmed ⩾30% PSA decline. Median time to PSA progression on abiraterone and dexamethasone was 11.7 weeks (95% CI: 8.6–14.8 weeks) in the whole cohort and 27.6 weeks (95% CI: 14.5–40.7 weeks) in patients who achieved a confirmed 50% PSA decline. Nine patients had RECIST evaluable disease: two of these patients had RECIST partial response, six patients had stable disease and one patient had progressive disease at the first imaging assessment. Treatment was well tolerated, with no grade 3 and grade 4 adverse events. One patient had to be reverted to prednisolone because of grade 2 hypotension. Conclusions: Durable PSA responses occur in up to 40% of patients following a ‘steroid switch' for PSA progression on abiraterone and prednisone. Studies are ongoing to elucidate the mechanisms underlying this response.
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Affiliation(s)
- D Lorente
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton SM2 5PT, Surrey, UK
| | - A Omlin
- 1] Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton SM2 5PT, Surrey, UK [2] Kantonsspital St. Gallen, Department of Oncology and Haematology, Rorschacherstrasse 95, CH-9007 St. Gallen, Switzerland
| | - R Ferraldeschi
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton SM2 5PT, Surrey, UK
| | - C Pezaro
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton SM2 5PT, Surrey, UK
| | - R Perez
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton SM2 5PT, Surrey, UK
| | - J Mateo
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton SM2 5PT, Surrey, UK
| | - A Altavilla
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton SM2 5PT, Surrey, UK
| | - Z Zafeirou
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton SM2 5PT, Surrey, UK
| | - N Tunariu
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton SM2 5PT, Surrey, UK
| | - C Parker
- Academic Urology Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, Surrey, UK
| | - D Dearnaley
- Academic Urology Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, Surrey, UK
| | - S Gillessen
- Kantonsspital St. Gallen, Department of Oncology and Haematology, Rorschacherstrasse 95, CH-9007 St. Gallen, Switzerland
| | - J de Bono
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton SM2 5PT, Surrey, UK
| | - G Attard
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton SM2 5PT, Surrey, UK
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Ferraldeschi R, Slovin S, Hussain S, Saad F, Garcia J, Kabbinavar F, Uppal N, Vogelzang N, Poiesz B, Gelmann E, Picus J, Mahadevan D, Sundar S, Nikapota A, Pacey S, Oganesian A, Manlapaz-Espiritu L, Hao Y, Keer H, de Bono J. A Phase 1/2 Study of At13387, a Heat Shock Protein 90 (Hsp90) Inhibitor in Combination with Abiraterone Acetate (Aa) and Prednisone (P) in Patients (Pts) with Castration-Resistant Prostate Cancer (Mcrpc) No Longer Responding to Aa. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu336.24] [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: 11/13/2022] Open
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Lorente D, Templeton A, Sartor O, Bahl A, Su Z, Devin J, de Bono J. Association of Neutrophil-To-Lymphocyte Ratio (Nlr) with Survival (Os) in Metastatic Castration-Resistant Prostate Cancer (Mcrpc) Patients Receiving Prednisone (P) Plus Cabazitaxel (Cbz) or Mitoxantrone (Mtx) in the Tropic Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu336.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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McCready J, Chow AW, Lowe MD, Segal OR, Ahsan S, de Bono J, Dhaliwal M, Mfuko C, Ng A, Rowland ER, Bradley RJW, Paisey J, Roberts P, Morgan JM, Sandilands A, Yue A, Lambiase PD. Safety and efficacy of multipolar pulmonary vein ablation catheter vs. irrigated radiofrequency ablation for paroxysmal atrial fibrillation: a randomized multicentre trial. Europace 2014; 16:1145-53. [PMID: 24843051 PMCID: PMC4114331 DOI: 10.1093/europace/euu064] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [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: 12/04/2022] Open
Abstract
Aims The current challenge in atrial fibrillation (AF) treatment is to develop effective, efficient, and safe ablation strategies. This randomized controlled trial assesses the medium-term efficacy of duty-cycled radiofrequency ablation via the circular pulmonary vein ablation catheter (PVAC) vs. conventional electro-anatomically guided wide-area circumferential ablation (WACA). Methods and results One hundred and eighty-eight patients (mean age 62 ± 12 years, 116 M : 72 F) with paroxysmal AF were prospectively randomized to PVAC or WACA strategies and sequentially followed for 12 months. The primary endpoint was freedom from symptomatic or documented >30 s AF off medications for 7 days at 12 months post-procedure. One hundred and eighty-three patients completed 12 m follow-up. Ninety-four patients underwent PVAC PV isolation with 372 of 376 pulmonary veins (PVs) successfully isolated and all PVs isolated in 92 WACA patients. Three WACA and no PVAC patients developed tamponade. Fifty-six percent of WACA and 60% of PVAC patients were free of AF at 12 months post-procedure (P = ns) with a significant attrition rate from 77 to 78%, respectively, at 6 months. The mean procedure (140 ± 43 vs. 167 ± 42 min, P<0.0001), fluoroscopy (35 ± 16 vs. 42 ± 20 min, P<0.05) times were significantly shorter for PVAC than for WACA. Two patients developed strokes within 72 h of the procedure in the PVAC group, one possibly related directly to PVAC ablation in a high-risk patient and none in the WACA group (P = ns). Two of the 47 patients in the PVAC group who underwent repeat ablation had sub-clinical mild PV stenoses of 25–50% and 1 WACA patient developed delayed severe PV stenosis requiring venoplasty. Conclusion The pulmonary vein ablation catheter is equivalent in efficacy to WACA with reduced procedural and fluoroscopy times. However, there is a risk of thrombo-embolic and pulmonary stenosis complications which needs to be addressed and prospectively monitored. ClinicalTrials.gov Identifier NCT00678340.
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Affiliation(s)
- J McCready
- Cardiology Department, The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London W1G 8PH, UK
| | - A W Chow
- Cardiology Department, The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London W1G 8PH, UK
| | - M D Lowe
- Cardiology Department, The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London W1G 8PH, UK
| | - O R Segal
- Cardiology Department, The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London W1G 8PH, UK
| | - S Ahsan
- Cardiology Department, The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London W1G 8PH, UK
| | - J de Bono
- Cardiology Department, The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London W1G 8PH, UK
| | - M Dhaliwal
- Cardiology Department, The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London W1G 8PH, UK
| | - C Mfuko
- Cardiology Department, The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London W1G 8PH, UK
| | - A Ng
- Cardiology Department, Glenfield Heart Centre, Leicester, Leicestershire LE39QP, UK
| | - E R Rowland
- Cardiology Department, The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London W1G 8PH, UK
| | - R J W Bradley
- Cardiology Department, The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London W1G 8PH, UK
| | - J Paisey
- Cardiology Department, Royal Bournemouth Hospital Castle Lane East Bournemouth, Bournemouth BH7 7DW, UK
| | - P Roberts
- Cardiology Department, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK
| | - J M Morgan
- Cardiology Department, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK
| | - A Sandilands
- Cardiology Department, Glenfield Heart Centre, Leicester, Leicestershire LE39QP, UK
| | - A Yue
- Cardiology Department, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK
| | - P D Lambiase
- Cardiology Department, The Heart Hospital, University College Hospital and Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London W1G 8PH, UK
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Pezaro C, Omlin A, Lorente D, Rodrigues DN, Ferraldeschi R, Bianchini D, Mukherji D, Riisnaes R, Altavilla A, Crespo M, Tunariu N, de Bono J, Attard G. Visceral disease in castration-resistant prostate cancer. Eur Urol 2014; 65:270-273. [PMID: 24295792 PMCID: PMC4881819 DOI: 10.1016/j.eururo.2013.10.055] [Citation(s) in RCA: 150] [Impact Index Per Article: 15.0] [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] [Received: 09/23/2013] [Accepted: 10/31/2013] [Indexed: 11/29/2022]
Abstract
Metastatic involvement of the viscera in men with advanced castration-resistant prostate cancer (CRPC) has been poorly characterised to date. In 359 CRPC patients treated between June 2003 and December 2011, the frequency of radiologically detected visceral metastases before death was 32%. Of the 92 patients with computed tomography performed within 3 mo of death, 49% had visceral metastases. Visceral metastases most commonly involved the liver (20%) and lung (13%). Median survival from diagnosis of visceral disease was 7.1 mo (95% confidence interval, 5.9-8.3). Survival was affected by the degree of bone involvement at detection of visceral disease, varying from 6.1 mo in men with more than six bone metastases to 18.2 mo in men with no bone metastases (p=0.001). Heterogeneity was noted in clinical phenotypes and prostate-specific antigen trends at development of visceral metastases. Visceral metastases are now more commonly detected in men with CRPC, likely due to the introduction of novel survival-prolonging treatments.
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Affiliation(s)
- C Pezaro
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - A Omlin
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - D Lorente
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - D Nava Rodrigues
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - R Ferraldeschi
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - D Bianchini
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - D Mukherji
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - R Riisnaes
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - A Altavilla
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - M Crespo
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - N Tunariu
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - J de Bono
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
| | - G Attard
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Downs Road, Sutton, Surrey, UK
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Tagney J, Palmer S, Morris M, Albarran JW, Lockyer L, Burchardt C, Hall G, Parslow J, Ernst S, Osman J, Kavanagh H, Dayer MJ, Quinton E, Clift P, Hudsmith L, Thorne S, de Bono J, Pounds G, Mumford SL, Jarman J, Brough CEP, McGee C, Rao A, Wright DJ, Brough CEP, McGee C, Rao A, Wright DJ, Ahmed FZ, Allen S, Mamas M, Zaidi AM, Cantor EJ, Carroz P, Schilling RJ, Barker D, Cullen D, Hall R, Ng Kam Chuen MJ, Hughes S, Sharpe A, Wright DJ, Rao A, Ng Kam Chuen MJ, Wright DJ, Hughes S, Belchambers S, Sendegaya M, Rao A. ABSTRACTS FOR ORAL PRESENTATION, SESSION 1, HRC 2013. Europace 2013. [DOI: 10.1093/europace/eut314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fabritz L, Fortmuller L, Vloumidi E, Yue TY, Syeda F, Kirchhof P, Leube R, Krusche C, Chin SH, Winter J, Brack KE, Ng GA, Ng FS, Holzem KM, Koppel AC, Janks D, Wit AL, Peters NS, Efimov IR, Chowdhury RA, El-Harasis MA, Dupont E, Terracciano CMN, Peters NS, Mellor GJ, Raju H, de Noronha SV, Papadakis M, Sharma S, Behr ER, Sheppard MN, Jamil-Copley S, Bai W, Ariff B, Lim PB, Koa-Wing M, Kyriacou A, Hayat S, Sohaib A, Qureshi N, Sandler B, O'Regan D, Whinnett Z, Davies W, Rueckert D, Kanagaratnam P, Peters N, Lambiase PD, Chow AW, Lowe MD, Segal OR, Ahsan S, de Bono J, Dhaliwal M, Mfuko C, Ng A, Sandilands A, Paisey J, Roberts P, Morgan JM, McCready J, Yue A, Ullah W, Hunter R, Lovell M, Dhinoja M, Sporton S, Earley M, Schilling R, Ghosh J, Martin A, Keech A, Chan KH, Gomes S, Singarayar S, McGuire M, Lee G, Hunter R, Berriman T, Diab I, Kamdar R, Richmond L, Baker V, Goromonzi F, Sawhney V, Duncan E, Unsworth B, Mayet J, Abrams D, Dhinoja M, Sporton S, Earley M, Schilling RJ, Bowers RW, Mulholland V, Balasubramaniam RN, Paisey JR, Sopher SM, Chu GS, Chin SH, Winter J, Armstrong S, Masca N, Almeida TP, Brown PD, Sandilands AJ, Schlindwein FS, Ng GA. ABSTRACTS FOR ORAL PRESENTATION, SESSION 2, HRC 2013. Europace 2013. [DOI: 10.1093/europace/eut315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sandhu SK, Omlin A, Hylands L, Miranda S, Barber LJ, Riisnaes R, Reid AH, Attard G, Chen L, Kozarewa I, Gevensleben H, Campbell J, Fenwick K, Assiotis I, Olmos D, Yap TA, Fong P, Tunariu N, Koh D, Molife LR, Kaye S, Lord CJ, Ashworth A, de Bono J. Poly (ADP-ribose) polymerase (PARP) inhibitors for the treatment of advanced germline BRCA2 mutant prostate cancer. Ann Oncol 2013; 24:1416-8. [PMID: 23524863 DOI: 10.1093/annonc/mdt074] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Affiliation(s)
- R. Ferraldeschi
- Division of Cancer Therapeutics, Signal Transduction & Molecular Pharmacology and Clinical Pharmacology & Trials Team, Institute of Cancer Research, Sutton, SM25NG, United Kingdom;
| | - C. Pezaro
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, SM25PT, United Kingdom; ,
| | - V. Karavasilis
- Medical Oncology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece;
| | - J. de Bono
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, SM25PT, United Kingdom; ,
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Mezynski J, Pezaro C, Bianchini D, Zivi A, Sandhu S, Thompson E, Hunt J, Sheridan E, Baikady B, Sarvadikar A, Maier G, Reid AHM, Mulick Cassidy A, Olmos D, Attard G, de Bono J. Antitumour activity of docetaxel following treatment with the CYP17A1 inhibitor abiraterone: clinical evidence for cross-resistance? Ann Oncol 2012; 23:2943-2947. [PMID: 22771826 DOI: 10.1093/annonc/mds119] [Citation(s) in RCA: 210] [Impact Index Per Article: 17.5] [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: 12/14/2022] Open
Abstract
BACKGROUND Abiraterone and docetaxel are both approved treatments for men with metastatic castration-resistant prostate cancer (mCRPC). Abiraterone pre-docetaxel is currently undergoing evaluation in a phase III study. In vitro studies indicate that taxanes may act by disrupting androgen receptor signalling. We hypothesised that prior abiraterone exposure would adversely impact docetaxel efficacy. PATIENTS AND METHODS We retrospectively evaluated activity of docetaxel in mCRPC patients previously treated with abiraterone, using Prostate Cancer Working Group and radiological criteria. RESULTS Of the 54 patients treated with abiraterone, 35 subsequently received docetaxel. Docetaxel resulted in a prostate-specific antigen (PSA) decline of ≥50% in nine patients [26%, 95% confidence interval (CI) 13% to 43%], with a median time to PSA progression of 4.6 months (95% CI 4.2% to 5.9%). PSA declines ≥30% were achieved by 13 patients (37%, 95% CI 22% to 55%). The median overall survival was 12.5 months (95% CI 10.6-19.4). All patients who failed to achieve a PSA fall on abiraterone and were deemed abiraterone-refractory were also docetaxel-refractory (N = 8). In the 24 patients with radiologically evaluable disease, partial responses were reported in four patients (11%), none of whom were abiraterone-refractory. CONCLUSION The activity of docetaxel post-abiraterone appears lower than anticipated and no responses to docetaxel were observed in abiraterone-refractory patients.
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Affiliation(s)
- J Mezynski
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - C Pezaro
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - D Bianchini
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - A Zivi
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - S Sandhu
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - E Thompson
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - J Hunt
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - E Sheridan
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - B Baikady
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - A Sarvadikar
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - G Maier
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - A H M Reid
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - A Mulick Cassidy
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - D Olmos
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - G Attard
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK.
| | - J de Bono
- Section of Medicine, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
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Sternberg C, Scher H, Molina A, North S, Mainwaring P, Hao Y, Gagnon D, Kheoh T, Haqq C, de Bono J. 7015 POSTER DISCUSSION Fatigue Improvement/Reduction With Abiraterone Acetate in Patients With Metastatic Castration-Resistant Prostate Cancer (mCRPC) Post-docetaxel – Results From the COU-AA-301 Phase 3 Study. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71966-9] [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: 10/17/2022]
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Omlin A, Venugopal B, Kristeleit R, Shah K, Fourneau N, Hellemans P, de Bono J, Plummer R, Banerji U, Evans J. 1234 POSTER A First in Man Phase 1 Study of JNJ-26481585, a Novel Oral Histone Deacetylase Inhibitor (HDACi) in Advanced Cancer Patients -Evidence of Target Modulation, Antitumour Activity and Additional Safety Data in an Expanded Patient Cohort. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70846-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Makosch GA, Griffiths A, Meredith T, Qureshi N, Wong K, de Bono J, Bashir Y, Betts TR, Rajappan K. 138 Catheter ablation of atrial fibrillation whilst taking therapeutic warfarin: a british experience: Abstract 138 Table 1. Heart 2010. [DOI: 10.1136/hrt.2010.196113.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wong KCK, Lim CS, Sadarmin PP, de Bono J, Qureshi N, Jones M, Bashir Y, Rajappan K, Betts TR. 134 High incidence of acute circumflex artery injury following mitral isthmus ablation. Heart 2010. [DOI: 10.1136/hrt.2010.196113.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Arkenau H, Evans J, Lokelma M, Roxburgh P, Morisson R, Coffey M, Gill G, Mettinger K, Thompson B, de Bono J. A phase I study of the combination of intravenous Reolysin (REO) and gemcitabine (GEM) in patients (pts) with advanced cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.3584] [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
3584 Background: REO (reovirus serotype 3) is a Dearing strain, naturally occurring, non-enveloped virus with limited pathogenecity in humans. REO replicates specifically in transformed Ras-activated cells due to inhibition of the dsRNA-activated protein kinase, resulting in cell-lysis. GEM has shown efficacy in a wide range of tumors commonly driven by activated Ras, and causes cell cycle arrest in S phase. Results from isobologram analysis suggest potential synergies of REO and GEM. Methods: This open-label, dose-escalating, two-centre phase-I trial studied the combination of iv REO, d1–5 and iv GEM, d1 and 8, qw3. The REO starting dose was 3x109 TCID50 over 1-hour, increasing in successive cohorts and GEM was given at a fixed dose of 1,000 mg/m2 over 30-min. Endpoints were the maximum tolerated dose (MTD), dose limiting toxicity (DLT), and safety profile of REOGEM and to establish a RP2D. Secondary endpoints were to evaluate the immune response, to evaluate pharmacokinetics of REOGEM and to describe any antitumor activity. Results: Since July 2007, 15 heavily pre-treated pts with disease progression prior to trial entry (9M/6F, median age 56 years, ECOG 0/1: 3/12) were entered into this trial. After 2 pts had Grade >3 toxicities during the first cycle (1 pt: GGT and Trop-I increase and PD; 1 pt: Trop-I increase and unspecific ST-changes) considered probably related to both agents the protocol was amended and the dose of REO was adjusted to 1x109 TCID50, d1 of each cycle (C-1) and increased in subsequent cohorts to 3x109, 1x1010, and 3x1010 TCID50. In total 45 cycles were administered (median 3) resulting in mild and expected toxicities including fever, headaches, rhinorrhea, fatigue and myelosupression. The MTD was not reached. Of the 10 pts evaluable for response, 2 pts (breast and nasopharyngeal) had PR and/or clinical response and 5 pts had SD for 4–8 cycles, amounting for a total disease control rate (CR+PR+SD) of 70%. Conclusions: The combination of REOGEM was well tolerated and resulted in disease control for a majority of pts. A RP2D, of REO 3x1010, d1 and GEM 1000mg/m2, d1 and 8, qw3, was recommended and phase-2 trials are underway. [Table: see text]
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Affiliation(s)
- H. Arkenau
- University of New South Wales, Sydney, Australia; Beatson Cancer Centre, Glasgow, United Kingdom; The Royal Marsden Hospital, Sutton, United Kingdom; The Beatson Cancer Centre, Glasgow, United Kingdom; Oncolytics Biotech Inc., Calgary, AB, Canada
| | - J. Evans
- University of New South Wales, Sydney, Australia; Beatson Cancer Centre, Glasgow, United Kingdom; The Royal Marsden Hospital, Sutton, United Kingdom; The Beatson Cancer Centre, Glasgow, United Kingdom; Oncolytics Biotech Inc., Calgary, AB, Canada
| | - M. Lokelma
- University of New South Wales, Sydney, Australia; Beatson Cancer Centre, Glasgow, United Kingdom; The Royal Marsden Hospital, Sutton, United Kingdom; The Beatson Cancer Centre, Glasgow, United Kingdom; Oncolytics Biotech Inc., Calgary, AB, Canada
| | - P. Roxburgh
- University of New South Wales, Sydney, Australia; Beatson Cancer Centre, Glasgow, United Kingdom; The Royal Marsden Hospital, Sutton, United Kingdom; The Beatson Cancer Centre, Glasgow, United Kingdom; Oncolytics Biotech Inc., Calgary, AB, Canada
| | - R. Morisson
- University of New South Wales, Sydney, Australia; Beatson Cancer Centre, Glasgow, United Kingdom; The Royal Marsden Hospital, Sutton, United Kingdom; The Beatson Cancer Centre, Glasgow, United Kingdom; Oncolytics Biotech Inc., Calgary, AB, Canada
| | - M. Coffey
- University of New South Wales, Sydney, Australia; Beatson Cancer Centre, Glasgow, United Kingdom; The Royal Marsden Hospital, Sutton, United Kingdom; The Beatson Cancer Centre, Glasgow, United Kingdom; Oncolytics Biotech Inc., Calgary, AB, Canada
| | - G. Gill
- University of New South Wales, Sydney, Australia; Beatson Cancer Centre, Glasgow, United Kingdom; The Royal Marsden Hospital, Sutton, United Kingdom; The Beatson Cancer Centre, Glasgow, United Kingdom; Oncolytics Biotech Inc., Calgary, AB, Canada
| | - K. Mettinger
- University of New South Wales, Sydney, Australia; Beatson Cancer Centre, Glasgow, United Kingdom; The Royal Marsden Hospital, Sutton, United Kingdom; The Beatson Cancer Centre, Glasgow, United Kingdom; Oncolytics Biotech Inc., Calgary, AB, Canada
| | - B. Thompson
- University of New South Wales, Sydney, Australia; Beatson Cancer Centre, Glasgow, United Kingdom; The Royal Marsden Hospital, Sutton, United Kingdom; The Beatson Cancer Centre, Glasgow, United Kingdom; Oncolytics Biotech Inc., Calgary, AB, Canada
| | - J. de Bono
- University of New South Wales, Sydney, Australia; Beatson Cancer Centre, Glasgow, United Kingdom; The Royal Marsden Hospital, Sutton, United Kingdom; The Beatson Cancer Centre, Glasgow, United Kingdom; Oncolytics Biotech Inc., Calgary, AB, Canada
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