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Falchook GS, Reeves J, Gandhi S, Spigel DR, Arrowsmith E, George DJ, Karlix J, Pouliot G, Hattersley MM, Gangl ET, James GD, Thompson J, Russell DL, Patel B, Kumar R, Lim E. A phase 2 study of AZD4635 in combination with durvalumab or oleclumab in patients with metastatic castration-resistant prostate cancer. Cancer Immunol Immunother 2024; 73:72. [PMID: 38430405 PMCID: PMC10908633 DOI: 10.1007/s00262-024-03640-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/22/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Inhibition of the adenosine 2A receptor (A2AR) diminishes the immunosuppressive effects of adenosine and may complement immune-targeting drugs. This phase 2 study evaluated the A2AR antagonist AZD4635 in combination with durvalumab or oleclumab in patients with metastatic castration-resistant prostate cancer. METHODS Patients with histologically/cytologically confirmed disease progressing within 6 months on ≥ 2 therapy lines were randomly assigned to either Module 1 (AZD4635 + durvalumab) or Module 2 (AZD4635 + oleclumab). Primary endpoints were objective response rate per RECIST v1.1 and prostate-specific antigen (PSA) response rate. Secondary endpoints included radiological progression-free survival (rPFS), overall survival, safety, and pharmacokinetics. RESULTS Fifty-nine patients were treated (Module 1, n = 29; Module 2, n = 30). Median number of prior therapies was 4. One confirmed complete response by RECIST (Module 1) and 2 confirmed PSA responses (1 per module) were observed. The most frequent adverse events (AEs) possibly related to AZD4635 were nausea (37.9%), fatigue (20.7%), and decreased appetite (17.2%) in Module 1; nausea (50%), fatigue (30%), and vomiting (23.3%) in Module 2. No dose-limiting toxicities or treatment-related serious AEs were observed. In Module 1, AZD4635 geometric mean trough concentration was 124.9 ng/mL (geometric CV% 69.84; n = 22); exposures were similar in Module 2. In Modules 1 and 2, median (95% CI) rPFS was 2.3 (1.6 -3.8) and 1.5 (1.3- 4.0) months, respectively. Median PFS was 1.7 versus 2.3 months for patients with high versus low blood-based adenosine signature. CONCLUSION In this heavily pretreated population, AZD4635 with durvalumab or oleclumab demonstrated minimal antitumor activity with a manageable safety profile. CLINICAL TRIAL gov identifier: NCT04089553.
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Affiliation(s)
- Gerald S Falchook
- Drug Development Unit, Sarah Cannon Research Institute at HealthONE, Denver, CO, USA.
| | - James Reeves
- Florida Cancer Specialists South, Sarah Cannon Research Institute, Fort Meyers, FL, USA
| | - Sunil Gandhi
- Florida Cancer Specialists South, Sarah Cannon Research Institute, St. Petersberg, FL, USA
| | - David R Spigel
- Tennessee Oncology, Sarah Cannon Research Institute, Nashville, TN, USA
| | - Edward Arrowsmith
- Tennessee Oncology, Sarah Cannon Research Institute, Nashville, TN, USA
| | | | - Janet Karlix
- Sarah Cannon Research Institute, Gainesville, FL, USA
| | | | | | | | | | | | | | | | - Rakesh Kumar
- Oncology R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Emerson Lim
- Medical Oncology & Hematology-LHCP, Corewell Health Medical Group, Grand Rapids, MI, USA
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Shiau C, Cao J, Gregory M, Kim Y, He S, Reeves J, Wang S, Lester NA, Su J, Wang PL, Beechem J, Hong TS, Wo JY, Ting D, Hemberg M, Hwang WL. Intercellular Mechanisms of Therapeutic Resistance at the Tumor-Stromal Interface Using Ultra High-Plex Single-Cell Spatial Transcriptomics and Genetically-Engineered Tumoroids. Int J Radiat Oncol Biol Phys 2023; 117:S101-S102. [PMID: 37784270 DOI: 10.1016/j.ijrobp.2023.06.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) There is a major gap in knowledge regarding how intercellular interactions in the tumor microenvironment (TME) mediate therapeutic resistance. Achievement of this goal has been limited by a lack of (1) spatial context in dissociated single-cell methods; (2) single-cell resolution in spatial profiling approaches; (3) high quality data and yield with FFPE patient specimens; and (4) computational methods for ligand-receptor analyses that consider both gene expression and spatial coordinates. MATERIALS/METHODS We developed an innovative spatial biology paradigm that combines cutting-edge experimental and computational methods to enable high-resolution, spatially-guided discovery of critical mediators of therapeutic resistance. We applied this approach to dissect the single-cell spatial transcriptomic landscape of untreated vs. chemoradiotherapy-treated primary human pancreatic ductal adenocarcinoma (PDAC; n = 21) using ultra-high plex spatial molecular imaging (SMI) optimized for high-sensitivity, subcellular detection of up to 6000 gene transcripts in FFPE sections-an order of magnitude greater than contemporary methods. RESULTS We recovered over 1,000,000 high-quality single cells in situ representing more than 20 distinct cell types, including epithelial, immune, endothelial, endocrine, and diverse stromal cells. We developed an optimal transport-based computational method to infer cell-cell communication at the cancer-stromal interface. Treatment with chemoradiotherapy was associated with the largest increase in fibroblast-malignant interactions. Comparing the SMI data with orthogonal single-nucleus RNA-sequencing and digital spatial profiling data, we identified CLCF1-CNTFR as the fibroblast-malignant interaction most associated with resistance to chemoradiotherapy in PDAC. CLCF1 is a gp130-family cytokine that activates Jak-STAT signaling and acts as a potent neurotrophic factor. Notably, the CLCF1-CNTRF (fibroblast-malignant) interaction has prominent pro-oncogenic effects in lung adenocarcinoma and an engineered CNTFR decoy receptor with therapeutic potential has been developed. To functionally validate the role of the CLCF1-CNTFR (fibroblast-malignant) interaction in mediating resistance to cytotoxic therapy, we created CRISPR-engineered cancer-fibroblast tumoroids and modulated expression of this ligand-receptor pair. Pancreatic cancer cell viability in the presence of 5-fluorouracil was better maintained with increased CLCF1-CNTFR signaling. CONCLUSION In this study, we integrated ultra high-plex single-cell spatial transcriptomics, optimal transport ligand-receptor predictions, and genetically-engineered stromal tumoroids to identify and validate CLCF1-CNTFR as an important intercellular mechanism of resistance to chemoradiotherapy in PDAC-pioneering a paradigm for translating single-cell spatial biology to clinical oncology.
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Affiliation(s)
- C Shiau
- Massachusetts General Hospital, Boston, MA
| | - J Cao
- Brigham and Women's Hospital, Boston, MA
| | - M Gregory
- Nanostring Technologies, Seattle, WA
| | - Y Kim
- Nanostring Technologies, Seattle, WA
| | - S He
- Nanostring Technologies, Seattle, WA
| | - J Reeves
- Nanostring Technologies, Seattle, WA
| | - S Wang
- Columbia University, New York, NY
| | - N A Lester
- Massaschusetts General Hospital, Boston, MA
| | - J Su
- Massachusetts General Hospital, BOSTON, MA
| | - P L Wang
- Massaschusetts General Hospital, Boston, MA
| | - J Beechem
- Nanostring Technologies, Seattle, WA
| | - T S Hong
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - J Y Wo
- Newton-Wellesley Hospital, Newton, MA
| | - D Ting
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - M Hemberg
- Brigham and Women's Hospital, Boston, MA
| | - W L Hwang
- Broad Institute of MIT and Harvard, Cambridge, MA
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Shahab S, Semerdzhiev DI, Reeves J, Daniel A, Martin DE, Sukpraprut-Braaten S. Waldenstrom Macroglobulinemia: Clinical Presentation, Diagnosis, and Management in an Elderly Male. Cureus 2023; 15:e44127. [PMID: 37750145 PMCID: PMC10518236 DOI: 10.7759/cureus.44127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/27/2023] Open
Abstract
Waldenstrom macroglobulinemia (WM) is a rare lymphoproliferative disease that can have an ambiguous clinical presentation. A key component of the pathophysiology of WM is bone marrow infiltration, which most commonly presents as anemia. Other symptoms of WM tend to be generalized and non-specific, which presents a diagnostic challenge. This was the case with our patient as well, when he presented to our outpatient clinic with non-specific symptoms. We present a 79-year-old male with longstanding pancytopenia, polyarthralgia, bilateral pedal edema, decreased appetite, and increased bleeding from wounds. The patient had a complete blood count (CBC) and complete metabolic panel (CMP) done, confirming present anemia, which prompted inpatient treatment and an oncology workup, confirming WM. The patient began a zanubrutinib monotherapy regimen, showing improvement in his pancytopenia, polyarthralgia, and overall symptoms.
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Affiliation(s)
- Shahman Shahab
- Medicine, Arkansas College of Osteopathic Medicine, Fort Smith, USA
| | - Dimitar I Semerdzhiev
- Medicine, Unity Health, Searcy, USA
- Medicine, Arkansas College of Osteopathic Medicine, Fort Smith, USA
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Rammal M, Li C, Reeves J, Moraes C, Harrington MJ. pH-Responsive Reversible Granular Hydrogels Based on Metal-Binding Mussel-Inspired Peptides. ACS Appl Mater Interfaces 2023. [PMID: 37289097 DOI: 10.1021/acsami.3c06013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Taking advantage of their thixotropic behavior, microporosity, and modular properties, granular hydrogels formed from jammed hydrogel microparticles have emerged as an exciting class of soft, injectable materials useful for numerous applications, ranging from the production of biomedical scaffolds for tissue repair to the therapeutic delivery of drugs and cells. Recently, the annealing of hydrogel microparticles in situ to yield a porous bulk scaffold has shown numerous benefits in regenerative medicine, including tissue-repair applications. Current annealing techniques, however, mainly rely either on covalent connections, which produce static scaffolds, or transient supramolecular interactions, which produce dynamic but mechanically weak hydrogels. To address these limitations, we developed microgels functionalized with peptides inspired by the histidine-rich cross-linking domains of marine mussel byssus proteins. Functionalized microgels can reversibly aggregate in situ via metal coordination cross-linking to form microporous, self-healing, and resilient scaffolds at physiological conditions by inclusion of minimal amounts of zinc ions at basic pH. Aggregated granular hydrogels can subsequently be dissociated in the presence of a metal chelator or under acidic conditions. Based on the demonstrated cytocompatibility of these annealed granular hydrogel scaffolds, we believe that these materials could be developed toward applications in regenerative medicine and tissue engineering.
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Affiliation(s)
- Mostafa Rammal
- Department of Chemistry, McGill University, 801 Sherbrooke Street West, Montreal, Quebec H3A 0B8, Canada
| | - Chen Li
- Department of Chemical Engineering, McGill University, 3610 Rue University Montreal, Québec H3A 0C5, Canada
| | - James Reeves
- Department of Chemical Engineering, McGill University, 3610 Rue University Montreal, Québec H3A 0C5, Canada
| | - Christopher Moraes
- Department of Chemical Engineering, McGill University, 3610 Rue University Montreal, Québec H3A 0C5, Canada
| | - Matthew J Harrington
- Department of Chemistry, McGill University, 801 Sherbrooke Street West, Montreal, Quebec H3A 0B8, Canada
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Choueiri TK, Porta C, Suárez C, Hainsworth J, Voog E, Duran I, Reeves J, Czaykowski P, Castellano D, Chen J, Sedarati F, Powles T. Randomized Phase II Trial of Sapanisertib ± TAK-117 vs. Everolimus in Patients With Advanced Renal Cell Carcinoma After VEGF-Targeted Therapy. Oncologist 2022; 27:1048-1057. [PMID: 36146944 PMCID: PMC9732228 DOI: 10.1093/oncolo/oyac192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/03/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sapanisertib, a dual mTORC1/2 inhibitor, may offer more complete inhibition of the PI3K/AKT/mTOR pathway than mTORC1 inhibitors, such as everolimus. This phase II study evaluated the efficacy and safety of single-agent sapanisertib and sapanisertib plus the PI3Kα inhibitor TAK-117, vs. everolimus in patients with advanced clear cell renal cell carcinoma (ccRCC) that had progressed on or after VEGF-targeted therapy. MATERIALS AND METHODS Patients with histologically confirmed, advanced ccRCC were randomized 1:1:1 to receive single-agent everolimus 10 mg once daily, single-agent sapanisertib 30 mg once weekly, or sapanisertib 4 mg plus TAK-117 200 mg, both once daily for 3 days/week, in 28-day cycles. The primary endpoint was progression-free survival (PFS). RESULTS Ninety-five patients were treated with everolimus or sapanisertib (n = 32 each), or sapanisertib plus TAK-117 (n = 31). There were no significant differences in PFS among the 3 groups or across any subgroups. Median PFS was 3.8 months with everolimus vs. 3.6 months with sapanisertib (HR, 1.33; 95% CI, 0.75-2.36), and 3.1 months with sapanisertib plus TAK-117 (HR, 1.37; 95% CI, 0.75-2.52). No significant differences in overall survival were seen among groups. Overall response rate was 16.7%, 0%, and 7.1%, respectively. Discontinuations due to treatment-emergent adverse events were 15.6%, 28.1%, and 29.0%. CONCLUSION Sapanisertib with or without TAK-117 was less tolerable and did not improve efficacy vs. everolimus in patients with advanced ccRCC who had relapsed after or were refractory to VEGF-targeted therapies. Dual mTORC1/2 inhibition may not be an effective therapeutic approach for these patients.
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Affiliation(s)
- Toni K Choueiri
- Corresponding author: Toni K. Choueiri, MD, Jerome and Nancy Kohlberg Professor of Medicine, Department of Medicine and Harvard Medical School, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA. Tel: +1 617 632 3000;
| | - Camillo Porta
- Present address: University of Bari Aldo Moro, Bari, Italy
| | - Cristina Suárez
- Medical Oncology, Vall d’Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d´Hebron, Vall d´Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | | - Eric Voog
- Centre Jean Bernard/Clinique Victor Hugo, Institut Inter-régional de Cancérologie, Le Mans, France
| | - Ignacio Duran
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain
| | - James Reeves
- Florida Cancer Specialists/Sarah Cannon Research Institute, Fort Myers, FL, USA
| | | | - Daniel Castellano
- i+12 Research Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jingjing Chen
- Takeda Development Center Americas, Inc., Lexington, MA, USA
| | - Farhad Sedarati
- Takeda Development Center Americas, Inc., Lexington, MA, USA
| | - Thomas Powles
- Barts Cancer Institute, Royal Free NHS Trust, St. Bartholomew’s Hospital, London, UK
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Lim E, Reeves J, Gandhi S, Spigel D, Arrowsmith E, George D, Karlix J, Pouliot G, Hattersley M, Gangl E, James G, Thompson J, Russell D, Patel B, Kumar R, Falchook G. 1396P Phase II study of AZD4635 in combination with durvalumab or oleclumab in patients (pts) with metastatic castrate-resistant prostate cancer (mCRPC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Martin M, Hegg R, Kim SB, Schenker M, Grecea D, Garcia-Saenz JA, Papazisis K, Ouyang Q, Lacko A, Oksuzoglu B, Reeves J, Okera M, Testa L, Shimizu C, Denduluri N, Adamchuk H, Dakhil S, Wei R, Forrester T, Fernandez MM, Zimmermann A, Headley D, Johnston SRD. Treatment With Adjuvant Abemaciclib Plus Endocrine Therapy in Patients With High-risk Early Breast Cancer Who Received Neoadjuvant Chemotherapy: A Prespecified Analysis of the monarchE Randomized Clinical Trial. JAMA Oncol 2022; 8:1190-1194. [PMID: 35653145 PMCID: PMC9164117 DOI: 10.1001/jamaoncol.2022.1488] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Patients selected to receive neoadjuvant chemotherapy (NAC) are usually those at higher risk of relapse, and there is a need to find better therapeutic options for these patients. Objective To determine the efficacy and safety outcomes for patients with hormone receptor (HR)-positive, ERBB2 (formerly HER2)-, high-risk early breast cancer enrolled in the randomized clinical trial monarchE who received NAC. Design, Setting, and Participants The monarchE randomized clinical trial was a multicenter, phase 3, open-label study that evaluated adjuvant treatment with abemaciclib plus endocrine therapy (ET) compared with ET alone in patients with HR+, ERBB2-, and node-positive early breast cancer who were at high risk of recurrence. Patients were recruited between July 2017 and August 2019 from 603 sites in 38 countries. This subgroup analysis was performed with primary outcome data, with a cutoff date of July 8, 2020. Intervention Enrolled patients were randomized (1:1) to receive standard of care ET for at least 5 years with or without treatment with abemaciclib (150 mg, twice daily) for 2 years (treatment period) or until criteria were met for discontinuation. Main Outcomes and Measures Prior chemotherapy (NAC vs adjuvant vs none) was a stratification factor in monarchE, and and a prespecified exploratory analysis included outcomes in patients who received NAC. The data presented in this article are from the primary outcome analysis (395 invasive disease-free survival [IDFS] events; cutoff date, July 8, 2020; median follow-up 19 months [IQR, 15.6-23.9 months]). Invasive disease-free survival (the primary end point of monarchE) and distant relapse-free survival (DRFS) were evaluated using the Cox proportional hazard model and Kaplan-Meier method. Results Of the 5637 patients (mean [SD] age, 49.9 [10.6] years; 2046 women [99.5%]; 462 Asian [22.8%], 54 Black [2.7%], and 1473 White participants [70.8%]) enrolled in monarchE, 2056 (37%) received treatment with NAC. In this subgroup, treatment with abemaciclib and ET demonstrated clinically meaningful benefit in IDFS (hazard ratio, 0.61; 95% CI, 0.47-0.80) and DRFS (hazard ratio, 0.61; 95% CI, 0.46-0.81), which corresponded with an absolute improvement of 6.6% in 2-year IDFS rates and 6.7% in 2-year DRFS rates. A consistent treatment benefit was observed across subgroups of pathological breast tumor size or number of positive lymph nodes at surgery. Conclusions and Relevance In the randomized clinical trial monarchE, treatment with adjuvant abemaciclib combined with ET demonstrated a clinically meaningful improvement in IDFS and DRFS for patients with HR+, ERBB2-, node-positive, high-risk early breast cancer who received NAC before trial enrollment. Trial Registration ClinicalTrials.gov Identifier: NCT03155997.
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Affiliation(s)
- Miguel Martin
- Medical Oncology Service, Hospital General Universitario Gregorio Marañon, Universidad Complutense, Centro de Investigación Biomédica en Red-Cáncer, Grupo Español de Investigación en Cáncer de Mama, Madrid, Spain
| | - Roberto Hegg
- Clinica de Pesquisa e Centro São Paulo, São Paulo, Brazil
| | - Sung-Bae Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Michael Schenker
- Centrul de Oncologie Sf Nectarie SRL, University of Medicine and Pharmacy Craiova, Craiova, Romania
| | - Daniela Grecea
- Institutul Oncologic “Prof.Dr. Ion Chiricuta” Cluj-Napoca, Cluj-Napoca, Romania
| | | | | | | | - Aleksandra Lacko
- Dolnoslaskie Centrum Onkologii, Uniwersytet Medyczny we Wroclawiu, Wroclaw, Poland
| | - Berna Oksuzoglu
- Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - James Reeves
- Florida Cancer Specialists/Sarah Cannon Research Institute, Fort Myers
| | - Meena Okera
- Adelaide Cancer Centre, Kurralta Park, Australia
| | - Laura Testa
- Instituto D’Or de Pesquisa e Ensino, São Paulo, Brazil
| | - Chikako Shimizu
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Neelima Denduluri
- Virginia Cancer Specialists, US Oncology Network, Arlington, Virginia
| | - Hryhoriy Adamchuk
- Communal Enterprise “Kryvyi Rih oncology dispensary” Dnipr region, Kryvyi Rih, Ukraine
| | | | - Ran Wei
- Eli Lilly and Company, Indianapolis, Indiana
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Schlauch D, Fu X, Jones SF, Burris HA, Spigel DR, Reeves J, McKenzie AJ. Tumor-Specific and Tumor-Agnostic Molecular Signatures Associated With Response to Immune Checkpoint Inhibitors. JCO Precis Oncol 2022; 5:1625-1638. [PMID: 34994650 DOI: 10.1200/po.21.00008] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Next-generation sequencing (NGS) testing is being incorporated into routine standard of care for patients with cancer. Immune checkpoint inhibitors (CPIs) are approved for use in both tumor-specific and tumor-agnostic indications. We sought to determine tumor type-specific or tumor-agnostic correlations between mutations detected by NGS and response to CPIs. MATERIALS AND METHODS A retrospective analysis of 26,004 patient records with NGS data available was conducted. Time to treatment failure and overall survival analyses were performed. Hazard ratios and associated statistics were computed in the R programming language. The study was considered exempt from internal review board review and data were considered nonhuman subjects. RESULTS Response to CPIs varied between tumor types with melanoma and lung cancer performing relatively better on CPIs than other tumor types. Within tumor types, response to CPIs was stratified by mutations in specific genes. Tumor-agnostic markers including high tumor mutation burden and microsatellite instability-high were also associated with longer time to treatment failure on CPIs. Importantly, within the high tumor mutation burden and microsatellite instability-high groups, mutations in individual genes correlate with response to CPIs. CONCLUSION The results from commercial NGS panels may be used to stratify patients for response to CPIs. In tumors where CPIs show relatively low efficacy, there may be distinct patient populations-based on gene mutation status-that are predicted to have better response to CPIs. Likewise, there may be distinct patient populations who do relatively worse on CPIs within tumor types known to respond well to CPIs.
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Affiliation(s)
- Daniel Schlauch
- Sarah Cannon Research Institute, Nashville, TN.,Genospace, Boston, MA
| | - Xiaotong Fu
- Sarah Cannon Research Institute, Nashville, TN.,Genospace, Boston, MA
| | | | - Howard A Burris
- Sarah Cannon Research Institute, Nashville, TN.,Tennessee Oncology, PLLC, Nashville, TN
| | - David R Spigel
- Sarah Cannon Research Institute, Nashville, TN.,Tennessee Oncology, PLLC, Nashville, TN
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Spring L, Han H, Hamilton E, Irie H, Santa-Maria C, Reeves J, Pan P, Shan M, Tang Y, Graham J, Hazard S, Ellisen L, Isakoff S. Neoadjuvant niraparib in patients with HER2-negative, BRCA-mutated resectable breast cancer. Breast 2021. [DOI: 10.1016/s0960-9776(21)00183-1] [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: 12/01/2022] Open
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Powles T, Atkins MB, Escudier B, Motzer RJ, Rini BI, Fong L, Joseph RW, Pal SK, Sznol M, Hainsworth J, Stadler WM, Hutson TE, Ravaud A, Bracarda S, Suarez C, Choueiri TK, Reeves J, Cohn A, Ding B, Leng N, Hashimoto K, Huseni M, Schiff C, McDermott DF. Efficacy and Safety of Atezolizumab Plus Bevacizumab Following Disease Progression on Atezolizumab or Sunitinib Monotherapy in Patients with Metastatic Renal Cell Carcinoma in IMmotion150: A Randomized Phase 2 Clinical Trial. Eur Urol 2021; 79:665-673. [PMID: 33678522 DOI: 10.1016/j.eururo.2021.01.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 01/05/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND The use of immune checkpoint inhibitors combined with vascular endothelial growth factor (VEGF)-targeted therapy as second-line treatment for metastatic clear cell renal cancer (mRCC) has not been evaluated prospectively. OBJECTIVE To evaluate the efficacy and safety of atezolizumab + bevacizumab following disease progression on atezolizumab or sunitinib monotherapy in patients with mRCC. DESIGN, SETTING, AND PARTICIPANTS IMmotion150 was a multicenter, randomized, open-label, phase 2 study of patients with untreated mRCC. Patients randomized to the atezolizumab or sunitinib arm who had investigator-assessed progression as per RECIST 1.1 could be treated with second-line atezolizumab + bevacizumab. INTERVENTION Patients received atezolizumab 1200 mg intravenously (IV) plus bevacizumab 15 mg/kg IV every 3 wk following disease progression on either atezolizumab or sunitinib monotherapy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The secondary endpoints analyzed during the second-line part of IMmotion150 included objective response rate (ORR), progression-free survival (PFS), and safety. PFS was examined using Kaplan-Meier methods. RESULTS AND LIMITATIONS Fifty-nine patients in the atezolizumab arm and 78 in the sunitinib arm were eligible, and 103 initiated second-line atezolizumab + bevacizumab (atezolizumab arm, n = 44; sunitinib arm, n = 59). ORR (95% confidence interval [CI]) was 27% (19-37%). The median PFS (95% CI) from the start of second line was 8.7 (5.6-13.7) mo. The median event follow-up duration was 19.4 (12.9-21.9) mo among the 25 patients without a PFS event. Eighty-six (83%) patients had treatment-related adverse events; 31 of 103 (30%) had grade 3/4 events. Limitations were the small sample size and selection for progressors. CONCLUSIONS The atezolizumab + bevacizumab combination had activity and was tolerable in patients with progression on atezolizumab or sunitinib. Further studies are needed to investigate sequencing strategies in mRCC. PATIENT SUMMARY Patients with advanced kidney cancer whose disease had worsened during treatment with atezolizumab or sunitinib began second-line treatment with atezolizumab + bevacizumab. Tumors shrank in more than one-quarter of patients treated with this combination, and side effects were manageable.
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Affiliation(s)
- Thomas Powles
- Barts Cancer Institute, Queen Mary University of London, London, UK.
| | - Michael B Atkins
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | | | | | - Brian I Rini
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lawrence Fong
- University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | | | - Sumanta K Pal
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | | | | | | | - Thomas E Hutson
- Texas Oncology-Baylor Charles A. Sammons Cancer Center, Dallas, TX, USA
| | - Alain Ravaud
- CHU Hopitaux de Bordeaux, Hôpital Saint-André, Bordeaux, France
| | | | - Cristina Suarez
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - James Reeves
- Florida Cancer Specialists & Research Institute, Fort Myers, FL, USA
| | - Allen Cohn
- Rocky Mountain Cancer Center, Denver, CO, USA
| | | | - Ning Leng
- Genentech, Inc., South San Francisco, CA, USA
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Tan D, Farago A, Kummar S, Moreno V, Patel J, Lassen U, Solomon B, Rosen L, Leyvraz S, Reeves J, Brega N, Dima L, Childs B, Drilon A. MA11.09 Efficacy and Safety of Larotrectinib in Patients with Tropomyosin Receptor Kinase (TRK) Fusion Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.253] [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: 10/21/2022]
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Reeves J, Goedken P, Hall K, Lee S, Cwiak C. P26 Anesthesia providers perspectives on abortion provision: A qualitative study. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Han H, Liu MC, Hamilton E, Irie H, Santa-Maria CA, Reeves J, Liem A, Naraine AM, Nangia J, Page D, Duncan M, Shan M, Tang Y, Graham JR, Ellisen LW, Isakoff S, Spring L. Abstract P3-11-03: Pilot neoadjuvant study of niraparib in HER2-negative, BRCA-mutated resectable breast cancer. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p3-11-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Niraparib is a selective poly(ADP-ribose) polymerase 1/2 inhibitor that has demonstrated antitumor activity in advanced triple-negative breast cancer (TNBC) in combination with a programmed cell death 1 inhibitor, with the greatest clinical activity seen in tumors with breast cancer susceptibility gene (BRCA) mutations. Pharmacologically, niraparib has demonstrated a wide volume of distribution and high cell membrane permeability. In breast and ovarian cancer xenograft mouse models, niraparib achieved tumor exposures that were 3.3 times greater than plasma exposure. The objective of this study is to evaluate the antitumor activity of single-agent niraparib in the neoadjuvant treatment of patients with localized, human epidermal growth factor receptor 2 (HER2)-negative, BRCA-mutated breast cancer. The relative concentration of niraparib in tumor versus plasma was also assessed. Methods: Eligible patients were ≥18 years old, with HER2-negative, BRCA-mutated (germline or somatic) resectable breast cancer with a tumor size of ≥1 cm who had not received prior treatment for the current malignancy. Patients received niraparib 200 mg once daily for 2 months. At the end of 2 months, at their treating physician’s discretion, patients proceeded directly to surgery, received additional cycles of niraparib (maximum of 6 months), or received neoadjuvant chemotherapy. The primary endpoint was tumor response rate measured by magnetic resonance imaging (MRI) after 2 months of treatment. Response was defined as a ≥30% reduction in tumor volume from baseline. Secondary endpoints included tumor response rate measured by ultrasound, quantified percent change in tumor volume measured by MRI or ultrasound, pathological complete response, and safety and tolerability. Additionally, niraparib concentrations were measured in tumor and plasma samples using qualified liquid chromatography-tandem mass spectrometry. Results: Twenty-one patients were enrolled. As of June 2019, 18 patients had both an MRI and ultrasound scan at the end of month 2 and were evaluable for response. Ten patients are currently on treatment. The median age of patients was 43 years (range, 21-73). Fourteen patients had a BRCA1 mutation, 6 patients had a BRCA2 mutation, and 1 patient had both. Fifteen patients had TNBC, and 6 patients had hormone receptor-positive disease. All 18 response-evaluable patients had a clinical response after 2 months of treatment by at least one imaging modality; no patient experienced disease progression. Tumor response rate measured by MRI after 2 months of treatment was 89% (n/N = 16/18). Results measured by ultrasound were similar, with a 94% response rate at cycle 2 (n/N = 17/18). The median percent decrease in tumor volume after 2 months of treatment was 88% (range, 26-100%) and 89% (range, 23-100%) as measured by MRI and ultrasound, respectively. In the 5 samples measured thus far, niraparib concentrations in tumor biopsies after 2 months of treatment ranged from approximately 4-131-fold higher than those in corresponding plasma samples. Efficacy and tumor concentration data for all patients will be presented at the meeting. The most common (≥10%) drug-related treatment-emergent adverse events (TEAEs) of any grade were nausea, fatigue, anemia, insomnia, and decreased appetite. The only drug-related grade ≥3 toxicity in ≥10% of patients was anemia (3 patients). Three patients had a dose reduction due to a TEAE; no patient discontinued treatment due to a TEAE. Conclusion: Niraparib was well tolerated and showed promising antitumor activity in the neoadjuvant treatment of patients with localized HER2-negative, BRCA-mutated breast cancer. Niraparib achieved 4-131-fold higher concentrations in tumor than in plasma. Clinical trial information: NCT03329937. Funding: TESARO: A GSK Company (Waltham, MA, USA) sponsored the study.
Citation Format: Hyo Han, Minetta C Liu, Erika Hamilton, Hanna Irie, Cesar A Santa-Maria, James Reeves, Andre Liem, Adrianna Milillo Naraine, Julie Nangia, David Page, Meghan Duncan, Ming Shan, Yongqiang Tang, Julie R Graham, Leif W Ellisen, Steven Isakoff, Laura Spring. Pilot neoadjuvant study of niraparib in HER2-negative, BRCA-mutated resectable breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-11-03.
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Affiliation(s)
- Hyo Han
- 1Moffitt Cancer Center, McKinley Outpatient Clinic, Tampa, FL
| | | | - Erika Hamilton
- 3Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN
| | - Hanna Irie
- 4Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - James Reeves
- 6Florida Cancer Specialists-South, Fort Myers, FL
| | - Andre Liem
- 7Pacific Shores Medical Group, Long Beach, CA
| | | | | | - David Page
- 10Providence Portland Medical Center, Portland, OR
| | | | - Ming Shan
- 11TESARO: A GSK Company, Waltham, MA
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Radosevic-Robin N, Reeves J, Leroy K, Duruisseaux M, Morel P, Bhagat M, Penault-Llorca F, Damotte D, Goldwasser F, Brindel A, Cumberbatch M, Ong S, Lopez J, Warren S. Immunological signature meta-analysis across lung cancer cohorts within the NanoString Clinical Transcriptional Atlas Group (CTAG) associated with patient outcome and history. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz447.021] [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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Spring L, Shan M, Liu M, Hamilton E, Santa-Maria C, Irie H, Isakoff S, Reeves J, Ellisen L, Liem A, Naraine AM, Nangia J, Page D, Pan P, Sun K, Graham J, Han H. Clinical confirmation of higher exposure to niraparib in tumour vs plasma in patients with breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.036] [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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Ballesteros-Merino C, Herz T, Church S, Widmaier M, Budco A, Medrikova D, Kanchev I, Spitzmueller A, Shaepe A, White A, Reeves J, Sullivan A, Bailey M, Jensen S, Handy J, Sanborn R, Bifulco C, Warren S, Beechem J, Fox B. Integrative combination of high-plex digital profiling techniques and cluster analysis to reveal complex immune biology in the tumour microenvironment of mesothelioma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.042] [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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Zinzani P, Samaniego F, Jurczak W, Lech-Maranda E, Ghosh N, Anz B, Patten P, Reeves J, Leslie L, Smolewski P, Chavez J, Scarfo L, Derenzini E, Burke J, Sharman J, Kolibaba K, O'Connor O, Cheah C, Miskin H, Sportelli P, Weiss M, Fowler N. UMBRALISIB MONOTHERAPY DEMONSTRATES EFFICACY AND SAFETY IN PATIENTS WITH RELAPSED/REFRACTORY MARGINAL ZONE LYMPHOMA: A MULTICENTER, OPEN-LABEL, REGISTRATION DIRECTED PHASE 2 STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.139_2629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- P. Zinzani
- Institute of Hematology; "L. e A. Seragnoli" University of Bologna; Bologna Italy
| | - F. Samaniego
- Department of Lymphoma/ Myeloma; MD Anderson Cancer Center; Houston United States
| | - W. Jurczak
- Department of Hematology; Jagiellonian University; Krakow Poland
| | - E. Lech-Maranda
- Department of Hematology; Institute of Hematology and Transfusion Medicine; Warsaw Poland
| | - N. Ghosh
- Department of Hematologic Oncology and Blood Disorders; Levine Cancer Center; Charlotte United States
| | - B. Anz
- Tennessee Oncology; Sarah Cannon Research Institute; Chattanooga United States
| | - P. Patten
- Department of Hematology; Kings Hospital NHS Foundation Trust; London United Kingdom
| | - J. Reeves
- Florida Cancer Specialists; Sarah Cannon Research Institute; Fort Myers United States
| | - L.A. Leslie
- John Theurer Cancer Center; Hackensack University Medical Center; Hackensack United States
| | - P. Smolewski
- Department of Hematology; Copernicus Memorial Hospital; Lodz Poland
| | - J.C. Chavez
- Department of Hematology; H. Lee Moffitt Cancer Center and Research Institute; Tampa United States
| | - L. Scarfo
- IRCCS Ospedale San Raffaele; Università Vita-Salute San Raffaele; Milan Italy
| | - E. Derenzini
- Department of Hematology; European Institute of Oncology; Milan Italy
| | - J.M. Burke
- Rocky Mountain Cancer Centers; US Oncology; Aurora United States
| | - J. Sharman
- Willamette Valley Cancer Institute; US Oncology; Eugene United States
| | - K. Kolibaba
- Compass Oncology; US Oncology; Vancouver United States
| | - O.A. O'Connor
- Center for Lymphoid Malignancies; Columbia University Medical Center; New York United States
| | - C.Y. Cheah
- Department of Hematology; Sir Charles Gairdner Hospital; Perth Australia
| | - H.P. Miskin
- Drug Development; TG Therapeutics; New York United States
| | - P. Sportelli
- Drug Development; TG Therapeutics; New York United States
| | - M.S. Weiss
- Drug Development; TG Therapeutics; New York United States
| | - N.H. Fowler
- Department of Lymphoma/ Myeloma; MD Anderson Cancer Center; Houston United States
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Hinerfeld D, Fuhrman K, Church S, Zollinger D, Reeves J, Bailey C, Warren S. Differential analysis of complex immune biology in MSI and MSS colorectal tumor microenvironments using high-plex spatial resolution. Eur J Cancer 2019. [DOI: 10.1016/j.ejca.2019.01.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Han H, Hamilton E, Irie H, Isakoff S, Jelovac D, Liem A, Liu MC, Milillo A, Nangia J, Page D, Reeves J, Santa-Maria C, Duncan M, Graham JR, Chen J, Dezube BJ, Spring L. Abstract OT3-03-01: Open-label, single-arm study evaluating the antitumor activity and safety of niraparib as neoadjuvant treatment in patients with localized, HER2-negative, BRCA-mutant breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot3-03-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Neoadjuvant chemotherapy is administered to patients with operable breast cancer to downstage the tumor to allow for less extensive surgery and to provide prognostic information about drug efficacy and risk of disease recurrence. Patients who achieve a pathological complete response (pCR) following neoadjuvant treatment have a more favorable outcome than patients with residual invasive disease. Single-agent poly(ADP-ribose) polymerase (PARP) inhibitors have clinical efficacy in BRCA-mutated breast cancer. Niraparib, a potent and selective PARP1/2 inhibitor, is approved for maintenance treatment of patients with recurrent ovarian cancer and has demonstrated strong antitumor activity in in vivo studies with BRCA1-mutant breast cancer. The objective of this study is to evaluate the antitumor activity of single-agent niraparib in the neoadjuvant treatment of patients with localized, human epidermal growth factor receptor 2 (HER2)-negative, BRCAmut breast cancer.
Trial Design: This is an open-label, single-arm pilot study with a target enrollment of 20 evaluable patients. Eligible patients are those ≥18 years old with histologically-confirmed HER2-negative localized breast cancer and either a BRCA1 or BRCA2 mutation (germline or somatic) and no prior anti-cancer therapies for the current malignancy. Patients will receive 200 mg of oral niraparib once daily for 2 months, after which they may either proceed directly to surgery or receive chemotherapy at the discretion of the physician. The primary endpoint is tumor response rate based on the change in tumor volume as measured by breast MRI after 2 months of treatment with niraparib; a response is defined as ≥30% reduction of tumor volume from baseline. Secondary endpoints include pCR rate, tumor response rate based on the change in tumor volume as measured by breast ultrasound, and safety and tolerability. Data will be summarized in a descriptive nature by frequency distributions (number and percentage of patients) for categorical variables and by the mean, median, and standard deviation for continuous variables. Tumor response rate will be tabulated together with its 95% binomial exact confidence interval.
Funding: TESARO, Inc., Waltham, MA, USA sponsored the study.
Citation Format: Han H, Hamilton E, Irie H, Isakoff S, Jelovac D, Liem A, Liu MC, Milillo A, Nangia J, Page D, Reeves J, Santa-Maria C, Duncan M, Graham JR, Chen J, Dezube BJ, Spring L. Open-label, single-arm study evaluating the antitumor activity and safety of niraparib as neoadjuvant treatment in patients with localized, HER2-negative, BRCA-mutant breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-03-01.
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Affiliation(s)
- H Han
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - E Hamilton
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - H Irie
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - S Isakoff
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - D Jelovac
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - A Liem
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - MC Liu
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - A Milillo
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - J Nangia
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - D Page
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - J Reeves
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - C Santa-Maria
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - M Duncan
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - JR Graham
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - J Chen
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - BJ Dezube
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
| | - L Spring
- Moffitt Cancer Center-McKinley Outpatient Clinic, Tampa, FL; Tennessee Oncology, Nashville, TN; Icahn School of Medicine at Mount Sinai, New York, NY; Massachusetts General Hospital, Boston, MA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Pacific Shores Medical Group, Long Beach, CA; Mayo Clinic Rochester, Rochester, MN; Memorial Health Care System, Hollywood, FL; Baylor College of Medicine, Houston, TX; Providence Portland Medical Center, Portland, OR; Florida Cancer Specialists-South, Fort Myers, FL; TESARO, Inc., Waltham, MA
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Bregar A, Deshpande A, Hirsch H, Zi T, Reeves J, Sathyanarayanan S, Rueda B, Growdon W. Characterization of immune regulatory molecules B7-H4 and PD-L1 in low- and high-grade endometrial tumors. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Jochems A, El-Naqa I, Kessler M, Mayo C, Reeves J, Shruti J, Matuszak M, Ten Haken R, Faive-Fin C, Price G, Holloway L, Vinod S, Field M, Samir Barakat M, Thwaites D, Dekker A, Lambin P. PV-0240: A logistic regression model to predict 30-day mortality: difference between routine and trial data. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30683-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jochems A, Deist T, El-Naqa I, Kessler M, Mayo C, Reeves J, Jolly S, Matuszak M, Ten Haken R, Van Soes J, Oberije C, Faivre-Finn C, Price G, Lambin P, Dekker A. EP-1596: Developing and validating a survival prediction model for NSCLC patients using distributed learning. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32031-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chi KN, Higano CS, Blumenstein B, Ferrero JM, Reeves J, Feyerabend S, Gravis G, Merseburger AS, Stenzl A, Bergman AM, Mukherjee SD, Zalewski P, Saad F, Jacobs C, Gleave M, de Bono JS. Custirsen in combination with docetaxel and prednisone for patients with metastatic castration-resistant prostate cancer (SYNERGY trial): a phase 3, multicentre, open-label, randomised trial. Lancet Oncol 2017; 18:473-485. [PMID: 28283282 DOI: 10.1016/s1470-2045(17)30168-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/17/2017] [Accepted: 01/20/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Clusterin is a chaperone protein associated with treatment resistance and upregulated by apoptotic stressors such as chemotherapy. Custirsen is a second-generation antisense oligonucleotide that inhibits clusterin production. The aim of the SYNERGY trial was to investigate the effect of custirsen in combination with docetaxel and prednisone on overall survival in patients with metastatic castration-resistant prostate cancer. METHODS SYNERGY was a phase 3, multicentre, open-label, randomised trial set at 134 study centres in 12 countries. Patients were eligible for participation if they had: metastatic castration-resistant prostate cancer and had received no previous chemotherapy; prostate-specific antigen greater than 5 ng/mL; and a Karnofsky performance score of 70% or higher. Patients were randomly assigned 1:1 centrally to either the docetaxel, prednisone, and custirsen combination or docetaxel and prednisone alone. Patients were not masked to treatment allocation. Randomisation was stratified by opioid use for cancer-related pain and radiographic evidence of progression. All patients received docetaxel 75 mg/m2 intravenously with 5 mg of prednisone orally twice daily. Patients assigned docetaxel, prednisone, and custirsen received weekly doses of custirsen 640 mg intravenously after three loading doses of 640 mg. The primary endpoint was overall survival analysed in the intention-to-treat population. Patients who received at least one study dose were included in the safety analysis set. This trial is registered with ClinicalTrials.gov, number NCT01188187. The trial is completed and final analyses are reported here. FINDINGS Between Dec 10, 2010, and Nov 7, 2012, 1022 patients were enrolled to the trial, of whom 510 were assigned docetaxel, prednisone, and custirsen and 512 were allocated docetaxel and prednisone. No difference in overall survival was recorded between the two groups (median survival 23·4 months [95% CI 20·9-24·8] with docetaxel, prednisone, and custirsen vs 22·0 months [19·5-24·0] with docetaxel and prednisone; hazard ratio [HR] 0·93, 95% CI 0·79-1·10; p=0·415). The most common adverse events of grade 3 or worse in the docetaxel, prednisone and custirsen group (n=501) compared with the docetaxel and prednisone alone group (n=499) were neutropenia (grade 3, 63 [13%] vs 28 [6%]; grade 4, 98 [20%] vs 77 [15%]), febrile neutropenia (grade 3, 52 [10%] vs 31 [6%]; grade 4, four [1%] vs two [<1%]), and fatigue (grade 3, 53 [11%] vs 41 [8%]; grade 4, three [1%] vs one [<1%]). One or more serious adverse events were reported for 214 (43%) of 501 patients treated with docetaxel, prednisone, and custirsen and 181 (36%) of 499 receiving docetaxel and prednisone alone. Adverse events were attributable to 23 (5%) deaths in the docetaxel, prednisone, and custirsen group and 24 (5%) deaths in the docetaxel and prednisone alone group. INTERPRETATION Addition of custirsen to first-line docetaxel and prednisone was reasonably well tolerated, but overall survival was not significantly longer for patients with metastatic castration-resistant prostate cancer treated with this combination, compared with patients treated with docetaxel and prednisone alone. FUNDING OncoGenex Technologies.
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Affiliation(s)
- Kim N Chi
- Department of Medicine, Division of Medical Oncology, University of British Columbia, BC Cancer Agency, Vancouver Prostate Centre, Vancouver, BC, Canada.
| | - Celestia S Higano
- Department of Medicine, Division of Medical Oncology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | | | | | - Gwenaelle Gravis
- Institut Paoli Calmette, Department of Cancer Medicine, Marseille, France
| | - Axel S Merseburger
- Department of Urology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | | | - Andries M Bergman
- Netherlands Cancer Institute and Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Som D Mukherjee
- Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton, ON, Canada
| | | | - Fred Saad
- Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | | | - Martin Gleave
- Department of Medicine, Division of Medical Oncology, University of British Columbia, BC Cancer Agency, Vancouver Prostate Centre, Vancouver, BC, Canada
| | - Johann S de Bono
- Drug Development Unit, Royal Marsden Hospital and Institute of Cancer Research, London, UK
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24
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Garcia-Manero G, Montalban-Bravo G, Berdeja JG, Abaza Y, Jabbour E, Essell J, Lyons RM, Ravandi F, Maris M, Heller B, DeZern AE, Babu S, Wright D, Anz B, Boccia R, Komrokji RS, Kuriakose P, Reeves J, Sekeres MA, Kantarjian HM, Ghalie R, Roboz GJ. Phase 2, randomized, double-blind study of pracinostat in combination with azacitidine in patients with untreated, higher-risk myelodysplastic syndromes. Cancer 2017; 123:994-1002. [PMID: 28094841 DOI: 10.1002/cncr.30533] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [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: 08/31/2016] [Revised: 11/08/2016] [Accepted: 11/09/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND The prognosis of patients with higher-risk myelodysplastic syndromes (MDS) remains poor despite available therapies. Histone deacetylase inhibitors have demonstrated activity in patients with MDS and in vitro synergy with azacitidine. METHODS A phase 2 randomized, placebo-controlled clinical trial of azacitidine and pracinostat was conducted in patients who had International Prognostic Scoring System intermediate-2-risk or high-risk MDS. The primary endpoint was the complete response (CR) rate by cycle 6 of therapy. RESULTS Of 102 randomized patients, there were 51 in the pracinostat group and 51 in the placebo group. The median age was 69 years. The CR rate by cycle 6 of therapy was 18% and 33% (P = .07) in the pracinostat and placebo groups, respectively. No significant differences in overall survival (median, 16 vs 19 months, respectively; hazard ratio, 1.21; 95% confidence interval, 0.66-2.23) or progression-free survival (11 vs 9 months, respectively; hazard ratio, 0.82; 95% confidence interval, 0.546-1.46) were observed between groups. Grade ≥3 adverse events occurred more frequently in the pracinostat group (98% vs 74%), leading to more treatment discontinuations (20% vs 10%). CONCLUSIONS The combination of azacitidine with pracinostat did not improve outcomes in patients with higher-risk MDS. Higher rates of treatment discontinuation may partially explain these results, suggesting alternative dosing and schedules to improve tolerability may be required to determine the potential of the combination. Cancer 2017;123:994-1002. © 2016 American Cancer Society.
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Affiliation(s)
| | | | | | - Yasmin Abaza
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elias Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Roger M Lyons
- Cancer Care Center of South Texas, San Antonio, Texas
| | - Farhad Ravandi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | | | - Amy E DeZern
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Sunil Babu
- Fort Wayne Medical Oncology and Hematology, Fort Wain, Indiana
| | - David Wright
- Florida Cancer Specialists-North, Jacksonville, Florida
| | | | - Ralph Boccia
- Center for Cancer and Blood Disorders, Bethesda, Maryland
| | | | - Philip Kuriakose
- Department of Internal Medicine, Division of Hematology Oncology, Henry Ford Hospital, Detroit, Michigan
| | - James Reeves
- Florida Cancer Specialists-South, Cape Coral, Florida
| | | | - Hagop M Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Gail J Roboz
- Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical
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25
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Yardley DA, Reeves J, Dees EC, Osborne C, Paul D, Ademuyiwa F, Soliman H, Guthrie T, Andersen J, Krekow L, Choksi J, Daniel B, Danso M, Favret A, Oommen S, Brufsky A, Bromund JL, Lin Y, Ibrahim AB, Richards PD. Ramucirumab With Eribulin Versus Eribulin in Locally Recurrent or Metastatic Breast Cancer Previously Treated With Anthracycline and Taxane Therapy: A Multicenter, Randomized, Phase II Study. Clin Breast Cancer 2016; 16:471-479.e1. [PMID: 27569274 DOI: 10.1016/j.clbc.2016.07.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 07/18/2016] [Accepted: 07/21/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Use of antiangiogenic agents in treatment of metastatic breast cancer (MBC) remains controversial. We evaluated the efficacy and safety of ramucirumab and eribulin versus eribulin alone as third- to fifth-line therapy in women with advanced breast cancer. PATIENTS AND METHODS In this randomized (1:1), open-label, phase II study, US women aged 18 years or older with 2 to 4 previous chemotherapy regimens for locally recurrent or MBC, previous anthracycline and taxane treatment, and Eastern Cooperative Oncology Group performance status of 0 or 1 received ramucirumab with eribulin or eribulin alone in 21-day cycles (eribulin 1.4 mg/m2 intravenously on days 1 and 8; ramucirumab 10 mg/kg intravenously on day 1). Randomization was stratified according to previous antiangiogenic therapy and triple-negative status. The primary end point was progression-free survival (PFS) in the intention to treat population. RESULTS One hundred forty-one women were randomized to ramucirumab with eribulin (n = 71) or eribulin alone (n = 70). Median PFS for ramucirumab with eribulin was 4.4 months (95% confidence interval [CI], 3.1-6.7) compared with 4.1 months (95% CI, 3.2-5.6) for eribulin (hazard ratio [HR], 0.83; 95% CI, 0.56-1.23; P = .35). Median overall survival in patients who received ramucirumab with eribulin was 13.5 months (95% CI, 10.4-17.9) compared with 11.5 months (95% CI, 9.0-17.3) in patients who received eribulin alone (HR, 0.91; 95% CI, 0.59-1.41; P = .68); objective response rate was 21% (13 of 62 patients) for the combination and 28% (17 of 60 patients) for eribulin alone. No unexpected toxicity was identified for the combination. CONCLUSION Ramucirumab combined with eribulin did not significantly improve PFS in advanced MBC.
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Affiliation(s)
- Denise A Yardley
- Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN.
| | - James Reeves
- Florida Cancer Specialists and Research Institute, Fort Myers, FL
| | - E Claire Dees
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Cynthia Osborne
- Baylor Charles A. Sammons Cancer Center, US Oncology Research, Dallas, TX
| | - Devchand Paul
- Rocky Mountain Cancer Centers, US Oncology Research, Denver, CO
| | - Foluso Ademuyiwa
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Hatem Soliman
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | - Jay Andersen
- Northwest Cancer Specialists, PC, US Oncology Research, Portland, OR
| | - Lea Krekow
- Texas Oncology-Bedford, US Oncology Research, Bedford, TX
| | - Janak Choksi
- Medical Oncologist, Alamance Regional Medical Center, Burlington, NC
| | | | - Michael Danso
- Virginia Oncology Associates, US Oncology Research, Norfolk, VA
| | - Anne Favret
- Virginia Cancer Specialists, PC, US Oncology Research, Fairfax, VA
| | - Sanjay Oommen
- Texas Oncology-Fort Worth, US Oncology Research, Fort Worth, TX
| | - Adam Brufsky
- Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Magee-Women's Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Jane L Bromund
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN
| | - Yong Lin
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN
| | | | - Paul D Richards
- Oncology and Hematology Associates of Southwest Virginia, US Oncology Research, Salem, VA
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26
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Kelly D, Hawdon G, Reeves J, Morris A, Cunningham M, Barrett J. Safety of intravenous metoprolol use in unmonitored wards: a single-centre observational study. Intern Med J 2016; 45:934-8. [PMID: 26109478 DOI: 10.1111/imj.12842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 06/10/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM This study aims to examine and quantify the risks associated with the use of intravenous metoprolol on unmonitored wards. METHOD This study was a retrospective single-centre observational study from 1 January 2009 to 31 December 2013. The study hospital was a 415-bed, private hospital in Melbourne, Victoria. The study population was all patients who received intravenous metoprolol on an unmonitored ward. The primary outcome measure was the rate of serious adverse events (SAE), defined as a complication of intravenous metoprolol resulting in transfer to a critical-care environment, a medical emergency team call or death. RESULTS Six hundred and nine patients received a total of 8260 doses of intravenous metoprolol. Seven cases were identified with a SAE deemed possibly related to beta-blocker use and there was one death. All SAE were hypotension, giving an overall rate of hypotension of 7/609 or 1.1% (95% confidence interval (CI), 0.5 to 2.4%) with a rate per dose delivered of 0.8/1000 doses (95% CI 0.3 to 1.7). The death occurred in a 94-year-old woman with abdominal sepsis. After case file review, consensus opinion deemed this to be unrelated to intravenous metoprolol. CONCLUSION The use of intravenous metoprolol on unmonitored wards appears to be safe. The complication rate was low, suggesting that this may be a sensible approach to the management of in-hospital populations at risk of beta-blocker withdrawal.
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Affiliation(s)
- D Kelly
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - G Hawdon
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - J Reeves
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - A Morris
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - M Cunningham
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - J Barrett
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
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27
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Niesvizky R, Flinn IW, Rifkin R, Gabrail N, Charu V, Clowney B, Essell J, Gaffar Y, Warr T, Neuwirth R, Zhu Y, Elliott J, Esseltine DL, Niculescu L, Reeves J. Community-Based Phase IIIB Trial of Three UPFRONT Bortezomib-Based Myeloma Regimens. J Clin Oncol 2015; 33:3921-9. [PMID: 26056177 DOI: 10.1200/jco.2014.58.7618] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The US community-based, phase IIIB UPFRONT trial was designed to compare three frontline bortezomib-based regimens in transplantation-ineligible patients with myeloma. PATIENTS AND METHODS Patients (N = 502) were randomly assigned 1:1:1 to 24 weeks (eight 21-day cycles) of induction with bortezomib-dexamethasone (VD; n = 168; intravenous bortezomib 1.3 mg/m(2), days 1, 4, 8, and 11 plus oral dexamethasone 20 mg, days 1, 2, 4, 5, 8, 9, 11, and 12 [cycles 1 to 4], or 1, 2, 4, and 5 [cycles 5 to 8]), bortezomib-thalidomide-dexamethasone (VTD; n = 167; bortezomib and dexamethasone as before plus oral thalidomide 100 mg, days 1 to 21), or bortezomib-melphalan-prednisone (VMP; n = 167; bortezomib as before plus oral melphalan 9 mg/m(2) and oral prednisone 60 mg/m(2), days 1 to 4, every other cycle), followed by 25 weeks (five 35-day cycles) of bortezomib maintenance (1.6 mg/m(2), days 1, 8, 15, and 22). The primary end point was progression-free survival. RESULTS After 42.7 months' median follow-up, median progression-free survival with VD, VTD, and VMP was 14.7, 15.4, and 17.3 months, respectively; median overall survival was 49.8, 51.5, and 53.1 months, with no significant differences among treatments for either end point (global P = .46 and P = .79, respectively, Wald test). Overall response rates were 73% (VD), 80% (VTD), and 70% (VMP). Adverse events were more common with VTD than VD or VMP. Bortezomib maintenance was feasible without producing cumulative toxicity. CONCLUSION Although all bortezomib-containing regimens produced good outcomes, VTD and VMP did not appear to offer an advantage over VD in transplantation-ineligible patients with myeloma treated in US community practice.
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Affiliation(s)
- Ruben Niesvizky
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL.
| | - Ian W Flinn
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - Robert Rifkin
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - Nashat Gabrail
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - Veena Charu
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - Billy Clowney
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - James Essell
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - Yousuf Gaffar
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - Thomas Warr
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - Rachel Neuwirth
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - Yanyan Zhu
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - Jennifer Elliott
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - Dixie-Lee Esseltine
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - Liviu Niculescu
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
| | - James Reeves
- Ruben Niesvizky, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; Ian W. Flinn, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Robert Rifkin, US Oncology Research/McKesson Specialty Health, The Woodlands, TX; Nashat Gabrail, Gabrail Cancer Center, Canton, OH; Veena Charu, Pacific Cancer Medical Center, Anaheim, CA; Billy Clowney, Santee Hematology/Oncology, Sumter, SC; James Essell, Sarah Cannon Research Institute and Oncology Hematology Care, Cincinnati, OH; Yousuf Gaffar, University of Maryland-St Joseph Medical Center, Towson, MD; Thomas Warr, Clinic Cancer Care, Great Falls, MT; Rachel Neuwirth, Yanyan Zhu, Jennifer Elliott, Dixie-Lee Esseltine, and Liviu Niculescu, Millennium Pharmaceuticals, Cambridge, MA; and James Reeves, Sarah Cannon Research Institute and Florida Cancer Specialists, Fort Myers, FL
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Hurwitz H, Tan B, Reeves J, Xiong H, Lenz H, Hochster H, Laeufle R, Sommer N, Young J, Byrtek M, Bendell J. Interim Safety Results from Steam: a Randomized Phase 2 Trial of Sequential and Concurrent Folfoxiri–Bevacizumab (Bev) Vs Folfox–Bev for the First-Line (1L) Treatment (Tx) of Patients (Pts) with Metastatic Colorectal Cancer (Mcrc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.24] [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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29
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Chi K, Higano C, Reeves J, Feyerabend S, Gravis G, Ferrero J, Jacobs C, Barnett-Griness O, Pande A, de Bono J. A Randomized Phase 3 Study Comparing First-Line Docetaxel/Prednisone (Dp) to Dp Plus Custirsen in Men with Metastatic Castration-Resistant Prostate Cancer (Mcrpc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu336.3] [Citation(s) in RCA: 4] [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: 11/14/2022] Open
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Abstract
As the population ages and life expectancy increases, clinicians today find themselves in the wake of an ever-growing demand for high-quality aesthetic dental treatment, by increasingly informed patients. The long-term success of both cosmetic and restorative dentistry is dependent on well designed restorations and the health of the periodontal tissues. Overhanging restorations, full crown restorations with poor marginal fit, and implant-supported prosthetics with inadequate hygiene access all increase the risk for periodontal sequelae and interproximal caries. When planning restorative treatment, consideration should be given to the restorative design, the need for hygiene access and the location of intended implants. In addition, the patient's manual dexterity and ability to manipulate oral hygiene aids is a crucial consideration, as is adequate access for the hygienist to manually debride and maintain the restorations.
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Hainsworth JD, Greco FA, Raefsky EL, Thompson DS, Lunin S, Reeves J, White L, Quinn R, DeBusk LM, Flinn IW. Rituximab with or without bevacizumab for the treatment of patients with relapsed follicular lymphoma. Clin Lymphoma Myeloma Leuk 2014; 14:277-83. [PMID: 24679633 DOI: 10.1016/j.clml.2014.02.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 02/17/2014] [Accepted: 02/24/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION/BACKGROUND Inhibition of tumor angiogenesis by the interruption of VEGF pathway signaling is of therapeutic value in several solid tumors. Preclinical evidence supports similar importance of the pathway in non-Hodgkin lymphoma. In this randomized phase II trial, we compared the efficacy and toxicity of rituximab with bevacizumab versus single-agent rituximab, in patients with previously-treated follicular lymphoma. PATIENTS AND METHODS Patients (n = 60) were randomized (1:1) to receive rituximab (375 mg/m(2) intravenously [I.V.] weekly for 4 weeks) either as a single agent or with bevacizumab (10 mg/kg I.V. on days 3 and 15). Patients with an objective response or stable disease at week 12 received 4 additional doses of rituximab (at months 3, 5, 7, and 9); patients who received rituximab/bevacizumab also received bevacizumab 10 mg/kg I.V. every 2 weeks for 16 doses. RESULTS After a median follow-up of 34 months, PFS was improved in patients who received rituximab/bevacizumab compared with patients who received rituximab alone (median 20.7 vs. 10.4 months respectively; HR, 0.40 (95% confidence interval [CI], 0.20-0.80); P = .007). Overall survival was also improved numerically (73% vs. 53% at 4 years), but did not reach statistical significance (HR, 0.40 (95% CI, 0.15-1.05); P = .055). The addition of bevacizumab increased the toxicity of therapy, but both regimens were well tolerated (no grade 4 toxicity). CONCLUSION The addition of bevacizumab to rituximab significantly improved PFS. The role of angiogenesis inhibition in the treatment of follicular lymphoma requires further definition in larger clinical trials.
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Affiliation(s)
- John D Hainsworth
- Sarah Cannon Research Institute (SCRI), Nashville, TN; Tennessee Oncology PLLC, Nashville, TN.
| | - F Anthony Greco
- Sarah Cannon Research Institute (SCRI), Nashville, TN; Tennessee Oncology PLLC, Nashville, TN
| | | | | | | | | | - Lynn White
- Sarah Cannon Research Institute (SCRI), Nashville, TN
| | - Raven Quinn
- Sarah Cannon Research Institute (SCRI), Nashville, TN
| | | | - Ian W Flinn
- Sarah Cannon Research Institute (SCRI), Nashville, TN; Tennessee Oncology PLLC, Nashville, TN
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Knight J, Wakeman M, Reeves J. ABEL-SPORT™ TEST FOR ASSESSING OVER TRAINING SYNDROME AND DETECTING INFECTION. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-093073.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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33
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Boivin GP, Platt KM, Corbett J, Reeves J, Hardy AL, Elenes EY, Charnigo RJ, Hunter SA, Pearson KJ. The effects of high-fat diet, branched-chainamino acids and exercise on female C57BL/6 mouse Achilles tendon biomechanical properties. Bone Joint Res 2013; 2:186-92. [PMID: 24021530 PMCID: PMC3774102 DOI: 10.1302/2046-3758.29.2000196] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives The goals of this study were: 1) to determine if high-fat diet
(HFD) feeding in female mice would negatively impact biomechanical
and histologic consequences on the Achilles tendon and quadriceps
muscle; and 2) to investigate whether exercise and branched-chain
amino acid (BCAA) supplementation would affect these parameters
or attenuate any negative consequences resulting from HFD consumption. Methods We examined the effects of 16 weeks of 60% HFD feeding, voluntary
exercise (free choice wheel running) and BCAA administration in
female C57BL/6 mice. The Achilles tendons and quadriceps muscles
were removed at the end of the experiment and assessed histologically
and biomechanically. Results HFD feeding significantly decreased the Achilles tendon modulus
without histological alterations. BCAA administration significantly
decreased the stiffness of Achilles tendons in the exercised normal
diet mice. Exercise partially ameliorated both the weight gain and
glucose levels in the HFD-fed mice, led to a significant decrease
in the maximum load of the Achilles tendon, and an increase in the
average fibril diameter of the quadriceps femoris muscle. There
were significant correlations between body weight and several biomechanical
properties, demonstrating the importance of controlling obesity
for maintaining healthy tendon properties. Conclusions In summary, this study showed a significant impact of obesity
and body weight on tendon biomechanical properties with limited
effects of exercise and BCAAs. Cite this article: Bone Joint Res 2013;2:186–92.
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Affiliation(s)
- G P Boivin
- Wright State University Boonshoft Schoolof Medicine, 3640 Col. Glenn Highway, Dayton, Ohio45435, USA
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Motzer RJ, Hutson TE, Cella D, Reeves J, Hawkins R, Guo J, Nathan P, Staehler M, de Souza P, Merchan JR, Boleti E, Fife K, Jin J, Jones R, Uemura H, De Giorgi U, Harmenberg U, Wang J, Sternberg CN, Deen K, McCann L, Hackshaw MD, Crescenzo R, Pandite LN, Choueiri TK. Pazopanib versus sunitinib in metastatic renal-cell carcinoma. N Engl J Med 2013; 369:722-31. [PMID: 23964934 DOI: 10.1056/nejmoa1303989] [Citation(s) in RCA: 1373] [Impact Index Per Article: 124.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pazopanib and sunitinib provided a progression-free survival benefit, as compared with placebo or interferon, in previous phase 3 studies involving patients with metastatic renal-cell carcinoma. This phase 3, randomized trial compared the efficacy and safety of pazopanib and sunitinib as first-line therapy. METHODS We randomly assigned 1110 patients with clear-cell, metastatic renal-cell carcinoma, in a 1:1 ratio, to receive a continuous dose of pazopanib (800 mg once daily; 557 patients) or sunitinib in 6-week cycles (50 mg once daily for 4 weeks, followed by 2 weeks without treatment; 553 patients). The primary end point was progression-free survival as assessed by independent review, and the study was powered to show the noninferiority of pazopanib versus sunitinib. Secondary end points included overall survival, safety, and quality of life. RESULTS Pazopanib was noninferior to sunitinib with respect to progression-free survival (hazard ratio for progression of disease or death from any cause, 1.05; 95% confidence interval [CI], 0.90 to 1.22), meeting the predefined noninferiority margin (upper bound of the 95% confidence interval, <1.25). Overall survival was similar (hazard ratio for death with pazopanib, 0.91; 95% CI, 0.76 to 1.08). Patients treated with sunitinib, as compared with those treated with pazopanib, had a higher incidence of fatigue (63% vs. 55%), the hand-foot syndrome (50% vs. 29%), and thrombocytopenia (78% vs. 41%); patients treated with pazopanib had a higher incidence of increased levels of alanine aminotransferase (60%, vs. 43% with sunitinib). The mean change from baseline in 11 of 14 health-related quality-of-life domains, particularly those related to fatigue or soreness in the mouth, throat, hands, or feet, during the first 6 months of treatment favored pazopanib (P<0.05 for all 11 comparisons). CONCLUSIONS Pazopanib and sunitinib have similar efficacy, but the safety and quality-of-life profiles favor pazopanib. (Funded by GlaxoSmithKline Pharmaceuticals; COMPARZ ClinicalTrials.gov number, NCT00720941.).
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Affiliation(s)
- Robert J Motzer
- Department of Medicine, Genitourinary Oncology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021, USA.
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Hainsworth JD, Shipley DL, Reeves J, Arrowsmith ER, Barnes EK, Waterhouse DM. High-dose bevacizumab in the treatment of patients with advanced clear cell renal carcinoma: a phase II trial of the Sarah Cannon Oncology Research Consortium. Clin Genitourin Cancer 2013; 11:283-289.e1. [PMID: 23684421 DOI: 10.1016/j.clgc.2013.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 02/28/2013] [Accepted: 04/02/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND The dose of bevacizumab necessary to optimally inhibit tumor angiogenesis in advanced renal cell carcinoma is unknown. In this phase II trial, we evaluated the efficacy and safety of 2 escalated doses of bevacizumab in patients with advanced clear cell renal carcinoma. PATIENTS AND METHODS Eligible patients had metastatic or locally advanced unresectable clear cell renal carcinoma. Patients who were previously untreated or who had previously received vascular endothelial growth factor receptor (VEGFR)-targeted therapy were eligible and were considered separately in the efficacy evaluation. Two doses of bevacizumab were evaluated in sequential cohorts: 15 mg/kg every 2 weeks and 15 mg/kg weekly. The initial reevaluation was at 8 weeks; responding and stable patients continued treatment, with reevaluations every 8 weeks until tumor progression or unacceptable toxicity occurred. RESULTS One hundred nineteen eligible patients were enrolled and received bevacizumab 15 mg/kg every 2 weeks (n = 61) or bevacizumab 15 mg/kg weekly (n = 58). Seventy patients were previously untreated with VEGFR-targeted therapy. In previously untreated patients, the overall response rate was 19%, with a median progression-free survival (PFS) of 7.8 months. Less activity was seen in patients previously treated with VEGFR-targeted agents (overall response rate, 4%; median PFS, 3.7 months). There was no suggestion of any difference in efficacy between the 2 dose levels tested. Both dose levels were tolerated well by most patients, with a spectrum of toxicity typical for bevacizumab. Grade 3/4 proteinuria was more frequent with both of these escalated doses, particularly with 15 mg/kg weekly. CONCLUSION Although administration of escalated doses of bevacizumab was feasible in patients with advanced clear cell renal carcinoma, there was no suggestion that these doses were more efficacious than bevacizumab administered at the standard dose of 10 mg/kg every 2 weeks.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Angiogenesis Inhibitors/adverse effects
- Angiogenesis Inhibitors/therapeutic use
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/therapeutic use
- Bevacizumab
- Carcinoma, Renal Cell/drug therapy
- Carcinoma, Renal Cell/mortality
- Disease-Free Survival
- Female
- Humans
- Kidney Neoplasms/drug therapy
- Kidney Neoplasms/mortality
- Male
- Middle Aged
- Neoplasm Metastasis/drug therapy
- Neovascularization, Pathologic/drug therapy
- Treatment Outcome
- Vascular Endothelial Growth Factor A/antagonists & inhibitors
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Affiliation(s)
- John D Hainsworth
- Sarah Cannon Research Institute, 3322 West End Ave., Nashville, TN 37203, USA.
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Reeves J, Cheng Z, Kovach J, Kleinhenz MD, Grewal PS. Quantifying soil health and tomato crop productivity in urban community and market gardens. Urban Ecosyst 2013. [DOI: 10.1007/s11252-013-0308-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Greenwald S, Banks H, Birch M, Brewin M, Hu S, Kenz Z, Kruse C, Mehta D, Reeves J, Shaw S, Whiteman J. P2.20 ACOUSTIC LOCALISATION OF CORONARY ARTERY STENOSIS: WAVE PROPAGATION IN SOFT TISSUE MIMICKING GELS. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.081] [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: 10/26/2022] Open
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Shaw S, Whiteman J, Greenwald S, Kruse C, Banks H, Birch M, Kenz Z, Reeves J, Hu S, Brewin M. P2.18 TOWARDS COMPUTATIONAL DIAGNOSIS OF CORONARY ARTERY DISEASE. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.079] [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: 10/26/2022] Open
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39
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Patel S, Gilmore R, Duwayri Y, Rajani R, Reeves J, Brewster L, Dodson T, Veeraswamy R. Stress Tests Are Overutilized in the Preoperative Evaluation of Endovascular Aneurysm Repair. J Vasc Surg 2012. [DOI: 10.1016/j.jvs.2012.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Borson R, Harker G, Reeves J, Beck T, Hager S, Horvath W, Jones M, Tillinghast G, Arrowsmith E, Harrer G, Kudrik FJ, Malamud SC, Bromund J, Zeigler H, Tai DF, Kornberg LJ, Obasaju C, Orlando M, Yardley DA. Phase II Study of Gemcitabine and Bevacizumab As First-Line Treatment in Taxane-Pretreated, HER2-Negative, Locally Recurrent or Metastatic Breast Cancer. Clin Breast Cancer 2012; 12:322-30. [DOI: 10.1016/j.clbc.2012.07.004] [Citation(s) in RCA: 3] [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] [Received: 12/13/2011] [Revised: 06/26/2012] [Accepted: 07/09/2012] [Indexed: 10/27/2022]
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Motzer R, Hutson T, Reeves J, Hawkins R, Guo J, Nathan P, Staehler M, de Souza P, Merchan J, Fife K, Jin J, Jones R, Uemura H, De Giorgi U, Harmenberg U, Wang J, Cella D, McCann L, Deen K, Choueiri T. Randomized, Open-Label, Phase III Trial Of Pazopanib Versus Sunitinib In First-Line Treatment Of Patients With Metastatic Renal Cell Carcinoma (MRCC): Results of the Comparz Trial. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34325-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [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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Leonard J, Reeves J, Ferhanoglu B, Doner KT, Eom H, Flinn IW, Raposo J, Chowhan NM, Suh C, Noga S, Tumyan G, Aung S, Hajdenberg J, Ulrich BK, Pendergrass KB, Mulligan G, Rizo A, Kussick S, Offner F. PYRAMID and LYM2034: Targeted randomized phase II studies of bortezomib with or without immunochemotherapy in newly diagnosed nongerminal center B-cell-like (GCB) diffuse large B-cell lymphoma (DLBCL), including rapid prospective non-GCB subtype identification. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Niesvizky R, Flinn IW, Rifkin RM, Gabrail N, Charu V, Gaffar Y, Neuwirth R, Corzo D, Reeves J. Impact of baseline characteristics on efficacy and safety after bortezomib-based induction and maintenance in newly diagnosed multiple myeloma (MM) patients ineligible for transplant in the phase IIIb UPFRONT study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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44
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Reeves J, Velazquez-Ramirez G, Dodson TF, McClusky D, Kasirajan K, Veeraswamy R, Salam A, Chaikof E, Corriere MA. Characterization of Resident Surgeon Participation During Carotid Endarterectomy and Impact on Perioperative Outcomes. J Vasc Surg 2011. [DOI: 10.1016/j.jvs.2010.11.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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45
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Oldroyd J, Levinson M, Stephenson G, Rouse A, Leeuwrik T, Reeves J, Shardey G, Hawdon G, Lefkovits J, Barrett J. A Focus Group Study Investigating Quality of Life in Octogenarians Following Cardiac Surgery. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.545] [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: 10/18/2022]
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46
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Spigel DR, Greco FA, Thompson DS, Webb C, Rubinsak J, Inhorn RC, Reeves J, Vazquez ER, Lane CM, Burris HA, Hainsworth JD. Phase II Study of Cetuximab, Docetaxel, and Gemcitabine in Patients With Previously Untreated Advanced Non–Small-Cell Lung Cancer. Clin Lung Cancer 2010; 11:198-203. [DOI: 10.3816/clc.2010.n.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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47
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Lester P, Peterson K, Reeves J, Knauss L, Glover D, Mogil C, Duan N, Saltzman W, Pynoos R, Wilt K, Beardslee W. The long war and parental combat deployment: effects on military children and at-home spouses. J Am Acad Child Adolesc Psychiatry 2010. [PMID: 20410724 DOI: 10.1016/j.jaac.2010.01.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Given the growing number of military service members with families and the multiple combat deployments characterizing current war time duties, the impact of deployments on military children requires clarification. Behavioral and emotional adjustment problems were examined in children (aged 6 through 12) of an active duty Army or Marine Corps parent currently deployed (CD) or recently returned (RR) from Afghanistan or Iraq. METHOD Children (N = 272) and their at-home civilian (AHC) (N = 163) and/or recently returned active duty (AD) parent (N = 65) were interviewed. Child adjustment outcomes were examined in relation to parental psychological distress and months of combat deployment (of the AD) using mixed effects linear models. RESULTS Parental distress (AHC and AD) and cumulative length of parental combat-related deployments during the child's lifetime independently predicted increased child depression and externalizing symptoms. Although behavioral adjustment and depression levels were comparable to community norms, anxiety was significantly elevated in children in both deployment groups. In contrast, AHC parental distress was greater in those with a CD (vs. RR) spouse. CONCLUSIONS Findings indicate that parental combat deployment has a cumulative effect on children that remains even after the deployed parent returns home, and that is predicted by psychological distress of both the AD and AHC parent. Such data may be informative for screening, prevention, and intervention strategies.
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Affiliation(s)
- Patricia Lester
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90024, USA.
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48
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49
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Roman S, Cusdin FS, Fonfria E, Goodwin JA, Reeves J, Lappin SC, Chambers L, Walter DS, Clay WC, Michel AD. Cloning and pharmacological characterization of the dog P2X7 receptor. Br J Pharmacol 2009; 158:1513-26. [PMID: 19814727 DOI: 10.1111/j.1476-5381.2009.00425.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND PURPOSE Human and rodent P2X7 receptors exhibit differences in their sensitivity to antagonists. In this study we have cloned and characterized the dog P2X7 receptor to determine if its antagonist sensitivity more closely resembles the human or rodent orthologues. EXPERIMENTAL APPROACH A cDNA encoding the dog P2X7 receptor was isolated from a dog heart cDNA library, expressed in U-2 OS cells using the BacMam viral expression system and characterized in electrophysiological, ethidium accumulation and radioligand binding studies. Native P2X7 receptors were examined by measuring ATP-stimulated interleukin-1beta release in dog and human whole blood. KEY RESULTS The dog P2X7 receptor was 595 amino acids long and exhibited high homology (>70%) to the human and rodent orthologues although it contained an additional threonine at position 284 and an amino acid deletion at position 538. ATP possessed low millimolar potency at dog P2X7 receptors. 2'-&3'-O-(4benzoylbenzoyl) ATP had slightly higher potency but was a partial agonist. Dog P2X7 receptors possessed relatively high affinity for a number of selective antagonists of the human P2X7 receptor although there were some differences in potency between the species. Compound affinities in human and dog blood exhibited a similar rank order of potency as observed in studies on the recombinant receptor although absolute potency was considerably lower. CONCLUSIONS AND IMPLICATIONS Dog recombinant and native P2X7 receptors display a number of pharmacological similarities to the human P2X7 receptor. Thus, dog may be a suitable species for assessing target-related toxicity of antagonists intended for evaluation in the clinic.
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Affiliation(s)
- S Roman
- Neurology Centre of Excellence for Drug Discovery, GlaxoSmithKline Research & Development Limited, New Frontiers Science Park, Harlow, Essex, UK.
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McLay R, McBrien C, Kleyensteuber B, Reeves J. Intoxication With Mouthwash Presenting as Psychosis and Delirium in a Combat Theater. Mil Med 2009; 174:828-31. [DOI: 10.7205/milmed-d-03-5208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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