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Edmondson RJ, O'Connell RL, Banerjee S, Mileshkin L, Sykes P, Beale P, Fisher A, Bonaventura A, Millan D, Nottley S, Benson C, Hamilton A, Sjoquist K, Alexander L, Kelly C, Carty K, Divers L, Bradshaw N, Friedlander M. Phase 2 study of anastrozole in rare cohorts of patients with estrogen receptor/progesterone receptor positive leiomyosarcomas and carcinosarcomas of the uterine corpus: The PARAGON trial (ANZGOG 0903). Gynecol Oncol 2021; 163:524-530. [PMID: 34625284 DOI: 10.1016/j.ygyno.2021.09.010] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Aromatase inhibitors have been used empirically to treat a subset of patients with hormone receptor positive uterine leiomyosarcomas(LMS) and carcinosarcomas (UCS) mainly supported by retrospective data. We evaluated the activity of anastrozole in two rare cohorts; patients with recurrent/metastatic LMS and UCS enrolled in PARAGON, a basket trial of anastrozole in estrogen receptor (ER+)/progesterone receptor positive (PR+) gynecological cancers. METHOD An investigator-initiated, single-arm, prospective open-label trial of anastrozole 1 mg/day in patients with ER &/or PR + ve LMS or UCS with measurable disease, treated until progression or unacceptable toxicity. Primary endpoint was clinical benefit (complete/partial response + stable disease) rate (CBR) at 3 months. Secondary endpoints include progression-free survival (PFS), quality of life and toxicity. RESULTS 39 eligible patients were enrolled, 32 with LMS and 7 with UCS. For the LMS cohort CBR at 3 months was 35% (95% CI: 21-53%) with a median duration of clinical benefit of 5.8 months. Best response was a partial response in one patient. Two patients remained on treatment for more than one year. The median progression-free survival was 2.8 months (95% CI: 2.6-4.9). For the UCS cohort CBR at 3 months was 43% (95% CI: 16-75%) with a median duration of clinical benefit of 5.6 months. Stable disease was seen in 3 patients but no objective responses were seen. The median progression-free survival was 2.7 months (95% CI, 1.1-8.2). Safety was acceptable with 5/39 evaluable patients showing grade 3 toxicities. CONCLUSION Whilst objective response rates with anastrozole are low, the clinical benefit rate and good tolerance suggests that aromatase inhibitor therapy may have a role in a subset of patients with metastatic LMS and UCS.
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Affiliation(s)
- R J Edmondson
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK; Department of Obstetrics and Gynaecology, Manchester Academic Health Science Centre, St Mary's Hospital, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Level 5, Research, Oxford Road, Manchester, UK.
| | - R L O'Connell
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - S Banerjee
- The Royal Marsden NHS Foundation Trust, London, UK
| | - L Mileshkin
- Peter MacCallum Cancer Centre and The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - P Sykes
- Dept of Obstetrics and Gynaecology, University of Otago, New Zealand
| | - P Beale
- Chris O'Brien Lifehouse, Sydney, NSW, Australia
| | - A Fisher
- Queen Elizabeth Hospital, Gateshead, UK
| | - A Bonaventura
- School of Medicine & Public Health, University of Newcastle, Australia
| | - D Millan
- Queen Elizabeth University Hospital, Glasgow, UK
| | - S Nottley
- Royal Hospital for Women/Prince of Wales Hospital and Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - C Benson
- The Royal Marsden NHS Foundation Trust, London, UK
| | - A Hamilton
- Peter MacCallum Cancer Centre and The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - K Sjoquist
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - L Alexander
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, UK
| | - C Kelly
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, UK
| | - K Carty
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, UK
| | - L Divers
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, UK
| | - N Bradshaw
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
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Knox J, McNamara M, Goyal L, Cosgrove D, Springfeld C, Sjoquist K, Park J, Verdaguer H, Braconi C, Ross P, Oh DY, De Gramont A, Shroff R, Zalcberg J, Palmer D, Valle J. 59TiP Phase III study of NUC-1031 + cisplatin vs gemcitabine + cisplatin for first-line treatment of patients with advanced biliary tract cancer (NuTide:121). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Pavlakis N, Shitara K, Sjoquist K, Martin A, Jaworski A, Yip S, Oh DY, Moehler M, Chen LT, Bekaii-Saab T, Simes J, Goldstein D. 1438TiP INTEGRATE IIb: A randomised phase III open label study of regorafenib + nivolumab vs standard chemotherapy in refractory advanced gastro-oesophageal cancer (AGOC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1547] [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: 11/17/2022] Open
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Jain A, Sjoquist K, Yip D. ESMO localised colon cancer guidelines: ‘can we improve on our surveillance protocols?’. Ann Oncol 2020; 31:1778-1779. [DOI: 10.1016/j.annonc.2020.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 09/15/2020] [Indexed: 10/23/2022] Open
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Knox J, McNamara M, Goyal L, Doherty M, Cosgrove D, Springfeld C, Sjoquist K, Park J, Verdaguer H, Braconi C, Ross P, De Gramont A, Zalcberg J, Palmer D, Valle J. 80TiP Global phase III study of NUC-1031 plus cisplatin vs gemcitabine plus cisplatin for first-line treatment of patients with advanced biliary tract cancer (NuTide:121). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.058] [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: 10/23/2022] Open
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Mileshkin L, Barnes E, Moore K, Gebski V, King M, Narayan K, Kolodziej I, Sjoquist K, Fyles A, Small W, Gaffney D, Quinn M, Andrews J, Thompson S, Huh W, Carlson M, Disilvestro P, Rischin D, Stockler M, Monk B. Disparities starting adjuvant chemotherapy for locally advanced cervix cancer in the international, academic, randomised, phase III OUTBACK trial (ANZGOG 0902, RTOG 1174, NRG 0274). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Thavaneswaran S, Sebastian L, Ballinger M, Cowley M, Grady J, Joshua A, Lee C, Sjoquist K, Hague W, Simes J, Thomas D. The cancer molecular screening and therapeutics program (MoST): A molecular screening platform with multiple, parallel, signal-seeking therapeutic substudies. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy279.434] [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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Vasista A, Martin A, Pavlakis N, Sjoquist K, Snow S, Jonker D, Chua Y, Epstein R, Bonaventura A, Khasraw M, Varma S, Singhal N, Ransom D, Aubin F, Burkes R, Lim H, Lemay F, Begbie S, Stockler M, Kiely B. Accuracy and prognostic significance of oncologists’ estimates and scenarios for survival time in a randomised Phase 2 trial of regorafenib in advanced gastric cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.050] [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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Chantrill L, Johns A, Watson C, Mead S, Gill A, Pavlakis N, Grimison P, Asghari G, Li B, Chou A, Simpson S, Martyn-Smith M, Nagrial A, Chin V, Sebastian L, Yip S, Sjoquist K, Grimmond S, Simes R, Biankin A. Precision Medicine for Advanced Pancreas Cancer: Early Lessons Learned from Negotiating the Pitfalls of a Molecular Therapeutics Trial in a Poor Prognosis Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu358.59] [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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Shannon J, Goldstein D, Wong N, Chinchen S, Sjoquist K, O'Connell R, Grimison P, McLachlan S, Tebbutt N, Lipton L, Vasey P, Cronk M, Varma S, Jefford M, Segelov E, Abdi E, Ng S, Karapetis C, Gebski V, Zalcberg J. A Multi-Centre, Phase Ii, Open-Label, Single Arm Study of Panitumumab, Cisplatin and Gemcitabine in Biliary Tract Cancer: Primary Results of the Agitg Tactic Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sjoquist K. Improving productivity by design. Dent Econ 1987; 77:49-50, 52. [PMID: 3482602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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