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Speel EJ, Radonic T, Dafni U, Thunnissen E, Rüschoff J, Kowalski J, Kerr K, Bubendorf L, Valero IS, Joseph L, Navarro A, Monkhorst K, Madsen L, Losa JH, Biernat W, Dellaporta T, Kammler R, Peters S, Stahel R, Finn S. 191P ROS1 fusions in resected stage I-III adenocarcinoma (ADC): A Lungscape ETOP study. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00444-6] [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: 04/04/2023]
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Jebbink M, de Langen A, Monkhorst K, Boelens M, van den Broek D, van der Noort V, de Gooijer C, Mahn M, van der Wekken A, Hendriks L, Hashemi S, Paats M, Dingemans A, Smit E. Trastuzumab-emtansine and osimertinib (TRAEMOS) combination therapy to target HER2 bypass track resistance in EGFR mutation positive NSCLC. JTO Clin Res Rep 2023; 4:100481. [PMID: 37035409 PMCID: PMC10074240 DOI: 10.1016/j.jtocrr.2023.100481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/31/2023] [Accepted: 02/15/2023] [Indexed: 02/26/2023] Open
Abstract
Introduction EGFR tyrosine kinase inhibitor improved the survival of patients with metastatic EGFR mutation-positive (EGFRm+) NSCLC. Despite high response rates, resistance develops inevitably in every patient. In up to 13%, HER2 protein overexpression is found on progression. We hypothesized that dual blockade of EGFR and HER2 by osimertinib combined with trastuzumab-emtansine (T-DM1) could reinduce tumor responses. Methods In this multicenter, single-arm, phase 1-2 study (NCT03784599), patients with EGFRm+ NSCLC, progressing on osimertinib and HER2 overexpression were included. Patients were treated with T-DM1 3.6 mg/kg (intravenously) every 3 weeks and osimertinib 80 mg once a day. Primary end points were objective response rate (ORR) at 12 weeks and safety. Responses were assessed every 6 weeks (Response Evaluation Criteria in Solid Tumors 1.1). Sample size was calculated using Simon's two-stage minimax design (H0 = 41%, H1 > 55%, 80% power, one-sided type I error 10%: a ORR 16 of 36 was needed to proceed to 58 patients). Results From January 2019 to April 2021, 27 patients were enrolled. ORR after 12 weeks of treatment was 4% (1 of 27). Median progression-free survival was 2.8 months (95% confidence interval: 1.4-4.6 mo). Most frequent treatment-related adverse events of any grade were fatigue, diarrhea, and nausea, among these, grade 3 in four patients. There were no grade 4 or 5 therapy-related adverse events. Conclusions TRAEMOS (Trastuzumab-Emtansine and Osimertinib) is the first trial combining T-DM1 and osimertinib in patients with EGFRm+ NSCLC to target HER2 overexpression at osimertinib resistance. Safety profile was favorable compared with cytotoxic chemotherapy; but treatment revealed limited efficacy. Further clinical evaluation of this regimen is not warranted.
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Affiliation(s)
- M. Jebbink
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A.J. de Langen
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - K. Monkhorst
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M.C. Boelens
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D. van den Broek
- Department of Laboratory Medicine, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - V. van der Noort
- Department of Statistics, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C.J. de Gooijer
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M. Mahn
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A.J. van der Wekken
- Department of Pulmonology, University of Groningen and University of Medical Centre Groningen, Groningen, The Netherlands
| | - L. Hendriks
- Department of Pulmonology, MUMC, Maastricht, The Netherlands
- GROW—School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - S.M.S. Hashemi
- Department of Pulmonary Medicine, Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - M.S. Paats
- Department of Pulmonary Diseases, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - A.C. Dingemans
- Department of Pulmonary Diseases, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - E.F. Smit
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Pulmonary Diseases, Leiden University Medical Center, Leiden, The Netherlands
- Corresponding author. Address for correspondence: E. F. Smit, MD, PhD, Department of Pulmonary Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
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Schipper L, Samsom K, Snaebjornsson P, Battaglia T, Bosch L, Lalezari F, Priestley P, Shale C, van den Broek A, Jacobs N, Roepman P, van der Hoeven J, Steeghs N, Vollebergh M, Marchetti S, Cuppen E, Meijer G, Voest E, Monkhorst K. Complete genomic characterization in patients with cancer of unknown primary origin in routine diagnostics. ESMO Open 2022; 7:100611. [PMID: 36463731 PMCID: PMC9808446 DOI: 10.1016/j.esmoop.2022.100611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND In ∼3%-5% of patients with metastatic disease, tumor origin remains unknown despite modern imaging techniques and extensive pathology work-up. With long diagnostic delays and limited and ineffective therapy options, the clinical outcome of patients with cancer of unknown primary (CUP) remains poor. Large-scale genome sequencing studies have revealed that tumor types can be predicted based on distinct patterns of somatic variants and other genomic characteristics. Moreover, actionable genomic events are present in almost half of CUP patients. This study investigated the clinical value of whole genome sequencing (WGS) in terms of primary tumor identification and detection of actionable events, in the routine diagnostic work-up of CUP patients. PATIENTS AND METHODS A WGS-based tumor type 'cancer of unknown primary prediction algorithm' (CUPPA) was developed based on previously described principles and validated on a large pan-cancer WGS database of metastatic cancer patients (>4000 samples) and 254 independent patients, respectively. We assessed the clinical value of this prediction algorithm as part of routine WGS-based diagnostic work-up for 72 CUP patients. RESULTS CUPPA correctly predicted the primary tumor type in 78% of samples in the independent validation cohort (194/254 patients). High-confidence predictions (>95% precision) were obtained for 162/254 patients (64%). When integrated in the diagnostic work-up of CUP patients, CUPPA could identify a primary tumor type for 49/72 patients (68%). Most common diagnoses included non-small-cell lung (n = 7), gastroesophageal (n = 4), pancreatic (n = 4), and colorectal cancer (n = 3). Actionable events with matched therapy options in clinical trials were identified in 47% of patients. CONCLUSIONS Genome-based tumor type prediction can predict cancer diagnoses with high accuracy when integrated in the routine diagnostic work-up of patients with metastatic cancer. With identification of the primary tumor type in the majority of patients and detection of actionable events, WGS is a valuable diagnostic tool for patients with CUP.
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Affiliation(s)
- L.J. Schipper
- Department of Molecular Oncology, Netherlands Cancer Institute, Amsterdam,Oncode Institute, Utrecht, The Netherlands
| | - K.G. Samsom
- Department of Pathology, Netherlands Cancer Institute, Amsterdam
| | - P. Snaebjornsson
- Department of Pathology, Netherlands Cancer Institute, Amsterdam
| | - T. Battaglia
- Department of Molecular Oncology, Netherlands Cancer Institute, Amsterdam
| | - L.J.W. Bosch
- Department of Pathology, Netherlands Cancer Institute, Amsterdam
| | - F. Lalezari
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - P. Priestley
- Hartwig Medical Foundation Australia, Sydney, Australia
| | - C. Shale
- Hartwig Medical Foundation Australia, Sydney, Australia
| | | | - N. Jacobs
- Hartwig Medical Foundation, Amsterdam
| | | | | | - N. Steeghs
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam
| | - M.A. Vollebergh
- Department of Gastroenterology, Netherlands Cancer Institute, Amsterdam
| | - S. Marchetti
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam
| | - E. Cuppen
- Oncode Institute, Utrecht, The Netherlands,Hartwig Medical Foundation, Amsterdam,Center for Molecular Medicine, UMC Utrecht, Utrecht
| | - G.A. Meijer
- Department of Pathology, Netherlands Cancer Institute, Amsterdam
| | - E.E. Voest
- Department of Molecular Oncology, Netherlands Cancer Institute, Amsterdam,Oncode Institute, Utrecht, The Netherlands,Department of Gastroenterology, Netherlands Cancer Institute, Amsterdam
| | - K. Monkhorst
- Department of Pathology, Netherlands Cancer Institute, Amsterdam,Correspondence to: Dr Kim Monkhorst, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. Tel: +0205122948
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Castenmiller S, de Groot R, Guislain A, Monkhorst K, Hartemink K, Veenhof A, Smit E, Haanen J, Wolkers M. Effective generation of tumor-infiltrating lymphocyte products from metastatic non-small-cell lung cancer (NSCLC) lesions irrespective of location and previous treatments. Immuno-Oncology and Technology 2022; 15:100090. [PMID: 35965844 PMCID: PMC9372740 DOI: 10.1016/j.iotech.2022.100090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Non-small-cell lung cancer (NSCLC) is the leading cause of cancer-related mortality worldwide. Because current treatment regimens show limited success rates, alternative therapeutic approaches are needed. We recently showed that treatment-naïve, stage I/II primary NSCLC tumors contain a high percentage of tumor-reactive T cells, and that these tumor-reactive T cells can be effectively expanded and used for the generation of autologous tumor-infiltrating T cell (TIL) therapy. Whether these promising findings also hold true for metastatic lesions is unknown yet critical for translation into the clinic. Materials and methods We studied the lymphocyte composition using flow cytometry from 27 metastatic NSCLC lesions obtained from different locations and from patients with different histories of treatment regimens. We determined the expansion capacity of TILs with the clinically approved protocol, and measured their capacity to produce the key pro-inflammatory cytokines interferon-γ, tumor necrosis factor and interleukin 2 and to express CD137 upon co-culture of expanded TILs with the autologous tumor digest. Results The overall number and composition of lymphocyte infiltrates from the various metastatic lesions was by and large comparable to that of early-stage primary NSCLC tumors. We effectively expanded TILs from all metastatic NSCLC lesions to numbers that were compatible with TIL transfusion, irrespective of the location of the metastasis and of the previous treatment. Importantly, 16 of 21 (76%) tested TIL products displayed antitumoral activity, and several contained polyfunctional T cells. Conclusions Metastatic NSCLC lesions constitute a viable source for the generation of tumor-reactive TIL products for therapeutic purposes irrespective of their location and the pre-treatment regimens. T cells can be efficiently isolated and expanded from late-stage NSCLC lesions. TIL products from metastatic NSCLC lesions are polyfunctional. Metastatic location or pre-treatment regimen does not affect T cells. Adoptive TIL therapy is a therapeutic option for late-stage NSCLC patients.
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Jebbink M, Langen AD, Monkhorst K, Boelens M, Van Den Broek D, Van Der Noort V, Gooijer CD, Wekken AVD, Hendriks L, Hashemi S, Paats M, Dingemans A, Smit E. MA02.07 T-DM1 and Osimertinib (TRAEMOS) To Target HER2 Bypass Track Resistance in EGFRm+ NSCLC: Interim Analysis of a Phase II Trial. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jebbink M, van der Wel J, van den Broek D, Boelens M, Monkhorst K, Ruiter G, Burgers S, Steinbusch L, Baas P, Kastelijn L, van der Wall E, Stellingwerf M, Smit E, de Langen A. 1740P Track and treat in NSCLC (TATIN) - ctDNA guided treatment of early resistance to second-line osimertinib treatment in patients with EGFR mutation positive (EGFRm) NSCLC. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1984] [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: 12/01/2022] Open
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Hondelink L, Cohen D, von der Thüsen J, Dubbink E, Van Wezel T, Monkhorst K. 136P Best practice recommendations for molecular analysis of acquired EGFR TKI resistance mechanisms. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01978-x] [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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Hopstaken JS, de Ruiter JC, van Diessen JNA, Theelen WSME, Monkhorst K, Hartemink KJ. [Treatment of non-small cell lung cancer]. Ned Tijdschr Geneeskd 2021; 165:D5486. [PMID: 33651512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this review article we discuss the diagnostic workup and current treatment strategies for non-small cell lung cancer (NSCLC). Anatomical resection and systematic lymph node dissection is the recommended treatment for early-stage NSCLC. Stereotactic body radiotherapy (SBRT) is an alternative for non-operable patients. Locally advanced NSCLC could be treated with a combination of chemotherapy, radiotherapy and immunotherapy, and in select cases followed by surgical resection. Treatment for patients with metastasized NSCLC depends on molecular tumor characteristics, PD-L1 expression and could consist of chemotherapy, immunotherapy, targeted therapy or a combination of these modalities. In all stages, best supportive care is an option to consider. Because of the success of immunotherapy and targeted therapy for stage IV NSCLC, numerous trials have started to investigate the efficacy of these modalities in early-stage NSCLC as well, further optimizing treatment strategies for this patient group.
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Affiliation(s)
- J S Hopstaken
- Nederlands Kankerinstituut-Antoni van Leeuwenhoek, afd. Chirurgie, Amsterdam (thans: Radboudumc, afd. Chirurgie, Nijmegen)
| | - J C de Ruiter
- Nederlands Kankerinstituut-Antoni van Leeuwenhoek, afd. Chirurgie, Amsterdam
| | - J N A van Diessen
- Nederlands Kankerinstituut-Antoni van Leeuwenhoek, afd. Radiotherapie, Amsterdam
| | - W S M E Theelen
- Nederlands Kankerinstituut-Antoni van Leeuwenhoek, afd. Thoracale Oncologie, Amsterdam
| | - K Monkhorst
- Nederlands Kankerinstituut-Antoni van Leeuwenhoek, afd. Pathologie, Amsterdam
| | - K J Hartemink
- Nederlands Kankerinstituut-Antoni van Leeuwenhoek, afd. Chirurgie, Amsterdam
- Contact: K.J. Hartemink
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9
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Monkhorst K, Samsom K, Schipper L, Roepman P, Bosch L, de Bruijn E, Hoes L, Riethorst I, Schoenmaker L, van der Kolk L, Buffart T, van der Hoeven K, Voest E, Cuppen E, Meijer G. 1189O Validation of whole genome sequencing in routine clinical practice. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.083] [Citation(s) in RCA: 5] [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: 11/25/2022] Open
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Theelen WSME, Krijgsman O, Monkhorst K, Kuilman T, Peters DDGC, Cornelissen S, Ligtenberg MA, Willems SM, Blaauwgeers JLG, van Noesel CJM, Peeper DS, van den Heuvel MM, Schulze K. Presence of a 34-gene signature is a favorable prognostic marker in squamous non-small cell lung carcinoma. J Transl Med 2020; 18:271. [PMID: 32620126 PMCID: PMC7333331 DOI: 10.1186/s12967-020-02436-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/24/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The tumor immune microenvironment is a heterogeneous entity. Gene expression analysis allows us to perform comprehensive immunoprofiling and may assist in dissecting the different components of the immune infiltrate. As gene expression analysis also provides information regarding tumor cells, differences in interactions between the immune system and specific tumor characteristics can also be explored. This study aims to gain further insights in the composition of the tumor immune infiltrate and to correlate these components to histology and overall survival in non-small cell lung cancer (NSCLC). METHODS Archival tissues from 530 early stage, resected NSCLC patients with annotated tumor and patient characteristics were analyzed using the NanoString nCounter Analysis system. RESULTS Unsupervised clustering of the samples was mainly driven by the overall level of inflammation, which was not correlated with survival in this patient set. Adenocarcinoma (AD) showed a significantly higher degree of immune infiltration compared to squamous cell carcinoma (SCC). A 34-gene signature, which did not correlate with the overall level of immune infiltration, was identified and showed an OS benefit in SCC. Strikingly, this benefit was not observed in AD. This difference in OS in SCC specifically was confirmed in two independent NSCLC cohorts. The highest correlation between expression of the 34-gene signature and specific immune cell populations was observed for NK cells, but although a plausible mechanism for NK cell intervention in tumor growth could be established in SCC over AD, this could not be translated back to immunohistochemistry, which showed that NK cell infiltration is scarce irrespective of histology. CONCLUSIONS These findings suggest that the ability of immune cell infiltration and the interaction between tumor and immune cells may be different between AD and SCC histology and that a subgroup of SCC tumors seems more susceptible to Natural Killer cell recognition and killing, whereas this may not occur in AD tumors. A highly sensitive technique like NanoString was able to detect this subgroup based on a 34-gene signature, but further research will be needed to assist in explaining the biological rationale of such low-level expression signatures.
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Affiliation(s)
- W S M E Theelen
- Department of Thoracic Oncology, The Netherlands Cancer Institute, Postbus 90203, 1006 BE, Amsterdam, The Netherlands.
| | - O Krijgsman
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - K Monkhorst
- Division of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - T Kuilman
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Neogene Therapeutics, Amsterdam, The Netherlands
| | - D D G C Peters
- Core Facility Molecular Pathology & Biobanking, Department of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S Cornelissen
- Core Facility Molecular Pathology & Biobanking, Department of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M A Ligtenberg
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S M Willems
- Department of Pathology, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - C J M van Noesel
- Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands
| | - D S Peeper
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M M van den Heuvel
- Department of Pulmonology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - K Schulze
- Oncology Biomarker Development, Genentech Inc, South San Francisco, USA
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van Veggel B, Madeira R Santos JFV, Hashemi SMS, Paats MS, Monkhorst K, Heideman DAM, Groves M, Radonic T, Smit EF, Schuuring E, van der Wekken AJ, de Langen AJ. Osimertinib treatment for patients with EGFR exon 20 mutation positive non-small cell lung cancer. Lung Cancer 2019; 141:9-13. [PMID: 31926441 DOI: 10.1016/j.lungcan.2019.12.013] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [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: 09/11/2019] [Revised: 12/10/2019] [Accepted: 12/19/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Epidermal growth factor receptor (EGFR) exon 20 insertions comprise 4-10 % of EGFR mutations in non-small cell lung cancer (NSCLC) and are associated with primary resistance to first and second generation EGFR tyrosine kinase inhibitors (TKIs). In vitro and preclinical animal studies have shown that osimertinib exerts antitumor activity against EGFR exon 20 mutation positive NSCLC. We report on a cohort of advanced stage NSCLC patients who harbor an EGFR exon 20 mutation and received osimertinib treatment. MATERIAL AND METHODS Twenty-one patients were treated with osimertinib 80 or 160 mg once daily from April 2016 to June 2018, in four institutions in the Netherlands. Data were obtained retrospectively. Progression free survival (PFS), disease control rate (DCR), overall survival (OS) and objective response rate (ORR) were assessed using RECIST v1.1. RESULTS Thirteen patients received prior platinum-based chemotherapy, and three patients a first - or second generation EGFR TKI. We observed 1 partial response, 17 patients with stable disease and 3 with progressive disease as best response to osimertinib (ORR 5 %). Median PFS was 3.6 (95 % CI, 2.6-4.5) months. PFS did not differ for patients with co-occurring TP53 mutations (p = 0.937). The DCR at three months was 71 %. Median OS was 8.7 (95 % CI, 1.1-16.4) months. CONCLUSION Osimertinib has limited antitumor activity in patients with EGFR exon 20 mutated NSCLC, with an ORR of 5 %.
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Affiliation(s)
- B van Veggel
- Dept of Thoracic Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands
| | | | - S M S Hashemi
- Dept of Pulmonary Diseases, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - M S Paats
- Dept of Pulmonary Diseases, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - K Monkhorst
- Dept of Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, the Netherlands
| | - D A M Heideman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - M Groves
- University of Groningen, Faculty of Science and Engineering, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - T Radonic
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - E F Smit
- Dept of Thoracic Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands
| | - E Schuuring
- Dep of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - A J van der Wekken
- Dept of Pulmonary Diseases, University of Groningen and University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - A J de Langen
- Dept of Thoracic Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
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de Vries R, Muller M, van der Noort V, Theelen WSME, Schouten RD, Hummelink K, Muller SH, Wolf-Lansdorf M, Dagelet JWF, Monkhorst K, Maitland-van der Zee AH, Baas P, Sterk PJ, van den Heuvel MM. Prediction of response to anti-PD-1 therapy in patients with non-small-cell lung cancer by electronic nose analysis of exhaled breath. Ann Oncol 2019; 30:1660-1666. [PMID: 31529107 DOI: 10.1093/annonc/mdz279] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [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] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors have improved survival outcome of advanced non-small-cell lung cancer (NSCLC). However, most patients do not benefit. Therefore, biomarkers are needed that accurately predict response. We hypothesized that molecular profiling of exhaled air may capture the inflammatory milieu related to the individual responsiveness to anti-programmed death ligand 1 (PD-1) therapy. This study aimed to determine the accuracy of exhaled breath analysis at baseline for assessing nonresponders versus responders to anti-PD-1 therapy in NSCLC patients. METHODS This was a prospective observational study in patients receiving checkpoint inhibitor therapy using both a training and validation set of NSCLC patients. At baseline, breath profiles were collected in duplicate by a metal oxide semiconductor electronic nose (eNose) positioned at the rear end of a pneumotachograph. Patients received nivolumab or pembrolizumab of which the efficacy was assessed by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 at 3-month follow-up. Data analysis involved advanced signal-processing and statistics based on independent t-tests followed by linear discriminant and receiver operating characteristic (ROC) analysis. RESULTS Exhaled breath data of 143 NSCLC patients (training: 92, validation: 51) were available at baseline. ENose sensors contributed significantly (P < 0.05) at baseline in differentiating between patients with different responses at 3 months of anti-PD-1 treatment. The eNose sensors were combined into a single biomarker with an ROC-area under the curve (AUC) of 0.89 [confidence interval (CI) 0.82-0.96]. This AUC was confirmed in the validation set: 0.85 (CI 0.75-0.96). CONCLUSION ENose assessment was effective in the noninvasive prediction of individual patient responses to immunotherapy. The predictive accuracy and efficacy of the eNose for discrimination of immunotherapy responder types were replicated in an independent validation set op patients. This finding can potentially avoid application of ineffective treatment in identified probable nonresponders.
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Affiliation(s)
- R de Vries
- Department of Respiratory Medicine, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands; Breathomix B.V., Reeuwijk, The Netherlands.
| | - M Muller
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - V van der Noort
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - W S M E Theelen
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - R D Schouten
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - K Hummelink
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S H Muller
- Department of Clinical Physics and Instrumentation, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M Wolf-Lansdorf
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J W F Dagelet
- Department of Respiratory Medicine, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands
| | - K Monkhorst
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A H Maitland-van der Zee
- Department of Respiratory Medicine, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands
| | - P Baas
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - P J Sterk
- Department of Respiratory Medicine, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands
| | - M M van den Heuvel
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Respiratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
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Roepman P, Bosch L, Samsom K, Schipper L, de Bruijn E, Hoes L, Riethorst I, Schoenmaker L, van der Kolk L, van Snellenberg H, Voest E, Cuppen E, Monkhorst K, Meijer G. WGS implementation in standard cancer diagnostics for every cancer patient (WIDE). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz257.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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14
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Huijberts SCFA, van Brummelen E, van Geel R, Opdam F, Marchetti S, Steeghs N, Pulleman S, Thijssen B, Rosing H, Monkhorst K, Huitema A, Beijnen J, Bernards R, Schellens J. Phase I study of lapatinib and trametinib in patients with KRAS mutant colorectal, non-small cell lung and pancreatic cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.035] [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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15
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van Veggel B, van der Wekken A, Hashemi S, Cornelissen R, Monkhorst K, Heideman D, Radonic T, Smit E, Schuuring E, De Langen J. Osimertinib treatment for patients with EGFR exon 20 insertion positive non-small cell lung cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Van Veggel B, Van Der Wekken A, Hashemi S, Cornelissen R, Monkhorst K, Heideman D, Radonic T, Schuuring E, Smit E, De Langen J. P2.13-42 Osimertinib Treatment for Patients with EGFR exon 20 Insertion Positive Non-Small-Cell Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1437] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ferone G, Song J, Sutherland K, Bhaskaran R, Van Der Vliet J, Cozijnsen M, Monkhorst K, Berns A. PO-221 Mouse models of lung squamous cell carcinoma for preclinical intervention studies. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.739] [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: 11/04/2022] Open
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Kerr K, Dafni U, Schulze K, Thunnissen E, Bubendorf L, Hager H, Finn S, Biernat W, Vliegen L, Losa J, Marchetti A, Cheney R, Warth A, Speel EJ, Blackhall F, Monkhorst K, Jantus Lewintre E, Tischler V, Clark C, Bertran-Alamillo J, Meldgaard P, Gately K, Wrona A, Vandenberghe P, Felip E, De Luca G, Savic S, Muley T, Smit E, Dingemans AM, Priest L, Baas P, Camps C, Weder W, Polydoropoulou V, Geiger T, Kammler R, Sumiyoshi T, Molina M, Shames D, Stahel R, Peters S. Prevalence and clinical association of gene mutations through multiplex mutation testing in patients with NSCLC: results from the ETOP Lungscape Project. Ann Oncol 2018; 29:200-208. [DOI: 10.1093/annonc/mdx629] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Kerr K, Thunnissen E, Dafni U, Soltermann A, Finn S, Bubendorf L, Verbeken E, Biernat W, Warth A, Marchetti A, Speel EJ, Pokharel S, Quinn A, Monkhorst K, Navarro A, Polydoropoulou V, Kammler R, Peters S, Stahel R, Lungscape Consortium O. Association of programmed cell death 1 ligand (PD-L1) expression with molecular alterations in non-small cell lung cancer (NSCLC) patients (pts): Results from the European Thoracic Oncology Platform (ETOP) Lungscape cohort. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx390.002] [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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Ditzel M, Deerenberg EB, Grotenhuis N, Harlaar JJ, Monkhorst K, Bastiaansen-Jenniskens YM, Jeekel J, Lange JF. Biologic meshes are not superior to synthetic meshes in ventral hernia repair: an experimental study with long-term follow-up evaluation. Surg Endosc 2013; 27:3654-62. [DOI: 10.1007/s00464-013-2939-y] [Citation(s) in RCA: 29] [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] [Received: 01/22/2013] [Accepted: 03/14/2013] [Indexed: 01/31/2023]
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Daams F, Monkhorst K, van den Broek J, Slieker JC, Jeekel J, Lange JF. Local ischaemia does not influence anastomotic healing: an experimental study. ACTA ACUST UNITED AC 2013; 50:24-31. [PMID: 23548268 DOI: 10.1159/000348411] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 01/28/2013] [Indexed: 12/19/2022]
Abstract
The role of local ischaemia in the pathogenesis of colorectal anastomotic leakage (AL) is not known. This study investigates the role of local ischaemia caused by sutures in an experimental colonic anastomosis model. 36 mice were assigned to three types of anastomosis, all using running sutures; in the first group 5 stitches were used, in the second group 12 stitches were used, and in the third group at least 30 stitches were used. After 7 days the mice were re-operated, signs of AL were scored, and coronal sections of the anastomosis were histologically analyzed. The distribution of weight was not significantly different between the three groups. Mortality was 44% and not significantly different between the groups (group 1: 5/12, group 2: 4/12, and group 3: 7/12, p = 0.72). Faecal and purulent AL were observed in 6 animals in group 1, 2 in group 2, and 3 in group 3 (group 1: 50%, group 2: 17%, and group 3: 25%, p = 0.19). The distance between the two colonic edges (group 1: 0.51 μm, group 2: 1.34 μm, and group 3: 0.53 μm, p = 0.18), the diameter of the lumen at the site of the anastomosis (group 1: 2.92 μm, group 2: 4.06 μm, and group 3: 3.2 μm, p = 0.9), and the largest diameter of the lumen proximally to the anastomosis (group 1: 2.05 μm, group 2: 3.1 μm, and group 3: 2.6 μm, p = 0.25) were not different between the groups. Histological parameters of wound healing were not significantly different for the three groups. In this study no macroscopic and microscopic differences were observed between colon anastomosis with 5 stitches versus 12 and >30 stitches. This might indicate that local ischaemia does not negatively influence colonic wound healing.
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Affiliation(s)
- F Daams
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Mitalas LE, van Onkelen RS, Monkhorst K, Zimmerman DD, Gosselink MP, Schouten WR. Identification of epithelialization in high transsphincteric fistulas. Tech Coloproctol 2012; 16:113-7. [PMID: 22231563 PMCID: PMC3310980 DOI: 10.1007/s10151-011-0803-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 12/10/2011] [Indexed: 12/15/2022]
Abstract
Background At present, transanal advancement flap repair (TAFR) is the treatment of choice for transsphincteric fistulas passing through the upper and middle third of the external anal sphincter. It has been suggested that epithelialization of the fistula tract contributes to the failure of the treatment. The aim of this study was to assess the prevalence of epithelialization of the fistula tract and to study its effect on the outcome of TAFR and TAFR combined with ligation of the intersphincteric fistula tract (LIFT). Methods Forty-four patients with a high transsphincteric fistula of cryptoglandular origin underwent TAFR. Nine of these patients underwent a combined procedure of TAFR with LIFT. In all patients the fistula tract was excised from the external opening up to the outer border of the external anal sphincter. In patients undergoing TAFR combined with LIFT an additional central part of the intersphincteric fistula tract was excised. A total of 53 specimens were submitted. Histopathological examination of the specimens was carried out by a pathologist, blinded for clinical data. Results Epithelialization of the distal and intersphincteric fistula tract was observed in only 25 and 22% of fistulas, respectively. There was no difference in outcome between fistulas with or without epithelialization. Conclusions Epithelialization of high transsphincteric fistulas is rare and does not affect the outcome of TAFR and TAFR combined with LIFT.
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Affiliation(s)
- L E Mitalas
- Division of Colon and Rectal Surgery, Department of Surgery, Erasmus MC, University Medical Center, H 181,'s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
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McMorrow T, van den Wijngaard A, Wollenschlaeger A, van de Corput M, Monkhorst K, Trimborn T, Fraser P, van Lohuizen M, Jenuwein T, Djabali M, Philipsen S, Grosveld F, Milot E. Activation of the beta globin locus by transcription factors and chromatin modifiers. EMBO J 2000; 19:4986-96. [PMID: 10990462 PMCID: PMC314215 DOI: 10.1093/emboj/19.18.4986] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [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] [Indexed: 11/13/2022] Open
Abstract
Locus control regions (LCRs) alleviate chromatin-mediated transcriptional repression. Incomplete LCRs partially lose this property when integrated in transcriptionally restrictive genomic regions such as centromeres. This frequently results in position effect variegation (PEV), i.e. the suppression of expression in a proportion of the cells. Here we show that this PEV is influenced by the heterochromatic protein SUV39H1 and by the Polycomb group proteins M33 and BMI-1. A concentration variation of these proteins modulates the proportion of cells expressing human globins in a locus-dependent manner. Similarly, the transcription factors Sp1 or erythroid Krüppel-like factor (EKLF) also influence PEV, characterized by a change in the number of expressing cells and the chromatin structure of the locus. However, in contrast to results obtained in a euchromatic locus, EKLF influences the expression of the gamma- more than the beta-globin genes, suggesting that the relief of silencing is caused by the binding of EKLF to the LCR and that genes at an LCR proximal position are more likely to be in an open chromatin state than genes at a distal position.
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Affiliation(s)
- T McMorrow
- Department of Cell Biology and Genetics, Medical Genetics Centre, Faculty of Medicine, Erasmus University Rotterdam
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