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Orbach D, Carton M, Khadir SK, Feuilly M, Kurtinecz M, Vokuhl C, Koscielniak E, Pierron G, Lemelle L, Sparber-Sauer M. Therapeutic benefit of larotrectinib over the historical standard of care in patients with locally advanced or metastatic infantile fibrosarcoma (EPI VITRAKVI study). ESMO Open 2024; 9:103006. [PMID: 38657345 PMCID: PMC11061226 DOI: 10.1016/j.esmoop.2024.103006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Patients with infantile fibrosarcoma (IFS) have shown strong and long-lasting responses to larotrectinib, a tropomyosin receptor kinase inhibitor (TRKi), in single-arm clinical trials. Conventional chemotherapy has also shown important efficacy. But, until now, no comparative data exist. This study aims to assess the therapeutic benefit of larotrectinib over the current standard of care (SOC) of chemotherapy in paediatric patients with locally advanced or metastatic IFS. PATIENTS AND METHODS EPI VITRAKVI is a retrospective, observational, externally controlled study (NCT05236257). Data of patients aged ≤21 years with locally advanced or metastatic IFS treated with larotrectinib in the phase I/II SCOUT trial (NCT02637687) were compared with those of an external historical control group (data of Institut Curie and Cooperative Weichteilsarkom Studiengruppe) treated with a chemotherapy-based regimen. Between-group differences were assessed after balancing groups using inverse probability of treatment weighting (IPTW). RESULTS In total, 93 patients were compared, 51 in the larotrectinib arm and 42 in the external control arm. After therapy, 4 patients (7.8%) in the larotrectinib group had a medical treatment failure event [start of new systemic treatment (2 cases), mutilating surgery (2 cases)] versus 15 (35.7%) in the external control group [start of new systemic treatment (6 cases), mutilating surgery (5 cases), radiation therapy (2 cases), and death (2 cases)]. Larotrectinib was associated with an 80% reduced likelihood of encountering a medical treatment failure event, when compared to the external control group (weighted and stratified hazard ratio 0.20, 95% confidence interval 0.06-0.63, P = 0.0060). These results were confirmed by sensitivity analyses, including exact matching, and subgroup analyses for number of lines of treatment. CONCLUSIONS Treatment with larotrectinib reduced the need of subsequent therapies compared to SOC with chemotherapy in children with locally advanced or metastatic IFS, regardless of the line of treatment.
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Affiliation(s)
- D Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris.
| | - M Carton
- Biometry Unit, Institut Curie, PSL Research University, Paris
| | | | - M Feuilly
- Bayer HealthCare SAS, La Garenne-Colombes, France
| | | | - C Vokuhl
- Section of Pediatric Pathology, Department of Pathology, University Hospital Bonn, Bonn
| | - E Koscielniak
- Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Stuttgart; Medizinische Fakultät der Universität Tübingen, Tübingen, Germany
| | - G Pierron
- Genetic Somatic Unit, PSL Research University, Institut Curie, Paris, France
| | - L Lemelle
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris
| | - M Sparber-Sauer
- Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Stuttgart; Medizinische Fakultät der Universität Tübingen, Tübingen, Germany
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Orbach D, Lemelle L, Carton M, Khadir S, Feuilly M, Kurtinecz M, Vokuhl C, Koscielniak E, Pierron G, Sparber-Sauer M. 44O Comparison of clinical outcomes of patients with infantile fibrosarcoma (IFS) treated with larotrectinib in the SCOUT study versus historical cohort: The EPI-VITRAKVI study. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101081] [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: 04/05/2023] Open
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Brownlee D, Tsou P, Aléon J, Alexander CMO, Araki T, Bajt S, Baratta GA, Bastien R, Bland P, Bleuet P, Borg J, Bradley JP, Brearley A, Brenker F, Brennan S, Bridges JC, Browning ND, Brucato JR, Bullock E, Burchell MJ, Busemann H, Butterworth A, Chaussidon M, Cheuvront A, Chi M, Cintala MJ, Clark BC, Clemett SJ, Cody G, Colangeli L, Cooper G, Cordier P, Daghlian C, Dai Z, D'Hendecourt L, Djouadi Z, Dominguez G, Duxbury T, Dworkin JP, Ebel DS, Economou TE, Fakra S, Fairey SAJ, Fallon S, Ferrini G, Ferroir T, Fleckenstein H, Floss C, Flynn G, Franchi IA, Fries M, Gainsforth Z, Gallien JP, Genge M, Gilles MK, Gillet P, Gilmour J, Glavin DP, Gounelle M, Grady MM, Graham GA, Grant PG, Green SF, Grossemy F, Grossman L, Grossman JN, Guan Y, Hagiya K, Harvey R, Heck P, Herzog GF, Hoppe P, Hörz F, Huth J, Hutcheon ID, Ignatyev K, Ishii H, Ito M, Jacob D, Jacobsen C, Jacobsen S, Jones S, Joswiak D, Jurewicz A, Kearsley AT, Keller LP, Khodja H, Kilcoyne ALD, Kissel J, Krot A, Langenhorst F, Lanzirotti A, Le L, Leshin LA, Leitner J, Lemelle L, Leroux H, Liu MC, Luening K, Lyon I, Macpherson G, Marcus MA, Marhas K, Marty B, Matrajt G, McKeegan K, Meibom A, Mennella V, Messenger K, Messenger S, Mikouchi T, Mostefaoui S, Nakamura T, Nakano T, Newville M, Nittler LR, Ohnishi I, Ohsumi K, Okudaira K, Papanastassiou DA, Palma R, Palumbo ME, Pepin RO, Perkins D, Perronnet M, Pianetta P, Rao W, Rietmeijer FJM, Robert F, Rost D, Rotundi A, Ryan R, Sandford SA, Schwandt CS, See TH, Schlutter D, Sheffield-Parker J, Simionovici A, Simon S, Sitnitsky I, Snead CJ, Spencer MK, Stadermann FJ, Steele A, Stephan T, Stroud R, Susini J, Sutton SR, Suzuki Y, Taheri M, Taylor S, Teslich N, Tomeoka K, Tomioka N, Toppani A, Trigo-Rodríguez JM, Troadec D, Tsuchiyama A, Tuzzolino AJ, Tyliszczak T, Uesugi K, Velbel M, Vellenga J, Vicenzi E, Vincze L, Warren J, Weber I, Weisberg M, Westphal AJ, Wirick S, Wooden D, Wopenka B, Wozniakiewicz P, Wright I, Yabuta H, Yano H, Young ED, Zare RN, Zega T, Ziegler K, Zimmerman L, Zinner E, Zolensky M. Comet 81P/Wild 2 Under a Microscope. Science 2006; 314:1711-6. [PMID: 17170289 DOI: 10.1126/science.1135840] [Citation(s) in RCA: 740] [Impact Index Per Article: 41.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The Stardust spacecraft collected thousands of particles from comet 81P/Wild 2 and returned them to Earth for laboratory study. The preliminary examination of these samples shows that the nonvolatile portion of the comet is an unequilibrated assortment of materials that have both presolar and solar system origin. The comet contains an abundance of silicate grains that are much larger than predictions of interstellar grain models, and many of these are high-temperature minerals that appear to have formed in the inner regions of the solar nebula. Their presence in a comet proves that the formation of the solar system included mixing on the grandest scales.
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Affiliation(s)
- Don Brownlee
- Department of Astronomy, University of Washington, Seattle, WA 98195, USA.
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