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Casali PG, Le Cesne A, Poveda Velasco A, Kotasek D, Rutkowski P, Hohenberger P, Fumagalli E, Judson IR, Italiano A, Gelderblom H, Adenis A, Hartmann JT, Duffaud F, Goldstein D, Broto JM, Gronchi A, Dei Tos AP, Marréaud S, van der Graaf WTA, Zalcberg JR, Litière S, Blay JY. Time to Definitive Failure to the First Tyrosine Kinase Inhibitor in Localized GI Stromal Tumors Treated With Imatinib As an Adjuvant: A European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group Intergroup Randomized Trial in Collaboration With the Australasian Gastro-Intestinal Trials Group, UNICANCER, French Sarcoma Group, Italian Sarcoma Group, and Spanish Group for Research on Sarcomas. J Clin Oncol 2015; 33:4276-83. [PMID: 26573069 DOI: 10.1200/jco.2015.62.4304] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE In 2004, we started an intergroup randomized trial of adjuvant imatinib versus no further therapy after R0-R1 surgery patients with localized, high- or intermediate-risk GI stromal tumor (GIST). PATIENTS AND METHODS Patients were randomly assigned to 2 years of imatinib 400 mg daily or no further therapy after surgery. The primary end point was overall survival; relapse-free survival (RFS), relapse-free interval, and toxicity were secondary end points. In 2009, given the concurrent improvement in prognosis of patients with advanced GIST, we changed the primary end point to imatinib failure-free survival (IFFS), with agreement of the independent data monitoring committee. We report on a planned interim analysis. RESULTS A total of 908 patients were randomly assigned between December 2004 and October 2008: 454 to imatinib and 454 to observation. Of these, 835 patients were eligible. With a median follow-up of 4.7 years, 5-year IFFS was 87% in the imatinib arm versus 84% in the control arm (hazard ratio, 0.79; 98.5% CI, 0.50 to 1.25; P = .21); RFS was 84% versus 66% at 3 years and 69% versus 63% at 5 years (log-rank P < .001); and 5-year overall survival was 100% versus 99%, respectively. Among 528 patients with high-risk GIST by local pathologist, 5-year IFFS was 79% versus 73%; among 336 centrally reviewed high-risk patients, it was 77% versus 73%, respectively. CONCLUSION This study confirms that adjuvant imatinib has an overt impact on RFS. No significant difference in IFFS was observed, although in the high-risk subgroup there was a trend in favor of the adjuvant arm. IFFS was conceived as a potential end point in the adjuvant setting because it is sensitive to secondary resistance, which is the main adverse prognostic factor in patients with advanced GIST.
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Affiliation(s)
- Paolo G Casali
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium.
| | - Axel Le Cesne
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Andres Poveda Velasco
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Dusan Kotasek
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Piotr Rutkowski
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Peter Hohenberger
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Elena Fumagalli
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Ian R Judson
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Antoine Italiano
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Hans Gelderblom
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Antoine Adenis
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Jörg T Hartmann
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Florence Duffaud
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - David Goldstein
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Javier M Broto
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Alessandro Gronchi
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Angelo P Dei Tos
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Sandrine Marréaud
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Winette T A van der Graaf
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - John R Zalcberg
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Saskia Litière
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Jean-Yves Blay
- Paolo G. Casali, Elena Fumagalli, and Alessandro Gronchi, Fondazione Istituto di Recovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milano; Angelo P. Dei Tos, Azienda Unità Locale Socio Sanitaria 9 Treviso, Treviso, Italy; Axel Le Cesne, Gustave Roussy, Villejuif; Antoine Italiano, Institut Bergonie, Bordeaux; Antoine Adenis, Centre Oscar Lambret, Lille; Florence Duffaud, Hôpital de La Timone, Aix-Marseille Université, Marseille; Jean-Yves Blay, Centre Leon Berard, Lyon, France; Andres Poveda Velasco, Instituto Valenciano de Oncologia, Valencia; Javier M. Broto, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Dusan Kotasek, Adelaide Cancer Centre, Kurralta Park, and University of Adelaide, Adelaide, South Australia; David Goldstein, Prince of Wales Hospital, New South Wales, Sydney; John R. Zalcberg, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Piotr Rutkowski, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland; Peter Hohenberger, Mannheim University Medical Center, Mannheim; Jörg T. Hartmann, Christian-Albrechts University, Kiel, Germany; Ian R. Judson, Royal Marsden Hospital; Winette T.A. van der Graaf, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom; Hans Gelderblom, Leiden University Medical Center, Leiden; Winette T.A. van der Graaf, Radboud University Medical Center, Nijmegen, the Netherlands; Saskia Litière, and Sandrine Marréaud, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
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