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Knetki-Wroblewska M, Wiśniewski P, Szatkowska-Tomczyk A, Owczarek J, Krzakowski M, Prochorec-Sobieszek M. 207P Does age affect PD-L1 expression? Results of a single-center analysis of a large cohort of patients. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00460-4] [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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Knetki-Wroblewska M, Tabor S, Płtużański A, Winiarczyk K, Sobczuk P, Lewandowska Z, Piórek A, Zajda K, Janowicz-Zebrowska A, Zaborowska-Szmit M, Badurak P, Borucka M, Kowalski D, Krzakowski M. 63P Inflammatory indexes and treatment response as correlates of pembrolizumab effectiveness in patients with PD-L1≥50%: Data from the real-life practice. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00317-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Fan Y, Drilon A, Chiu CH, Bowles D, Loong H, Siena S, Goto K, Krzakowski M, Ahn MJ, Murakami H, Dziadziuszko R, Zeuner H, Pitcher B, Cheick D, Krebs M. MA13.04 Entrectinib in Patients with ROS1 Fusion-Positive (ROS1-fp) NSCLC: Updated Efficacy and Safety Analysis. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Knetki-Wróblewska M, Kowalski D, Pluzanski A, Stanowska O, Wisniewski P, Winiarczyk K, Zaborowska-Szmit M, Zajda K, Prochorec-Sobieszek M, Krzakowski M. P78.08 Prediction of Pembrolizumab Efficacy in Non-Small-Cell Lung Cancer (NSCLC) Based on Experience From Expanded Access Program in Poland. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1171] [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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Reck M, Horn L, Mok T, Mansfield A, De Boer R, Losonczy G, Sugawara S, Dziadziuszko R, Krzakowski M, Smolin A, Hochmair M, Garassino M, Castro G, Bischoff H, Cardona A, Morris S, Liu S. OA11.06 IMpower133: Exploratory Analysis of Maintenance Therapy in Patients With Extensive-Stage Small-Cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.316] [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: 11/17/2022]
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6
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Knetki-Wróblewska M, Tysarowski A, Kowalski D, Krzakowski M. P78.10 Immunotherapy in Non-Small Cell Lung Cancer with High PD-L1 Expression and Coexistent RET- Fusion: The Description of Two Cases. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1173] [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: 11/26/2022]
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Tysarowski A, Seliga K, Gos A, Nowak A, Zub R, Jagielska B, Pluzanski A, Krzakowski M, Prochorec-Sobieszek M, Siedlecki J. P37.09 Comparison of 3 Different Methods for Determination of EGFR p.Thr790Met mutation in patients with NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tysarowski A, Seliga K, Nowak A, Wagrodzki M, Gos A, Zub R, Olszewska K, Jagielska B, Knetki-Wróblewska M, Pluzanski A, Krzakowski M, Siedlecki J, Prochorec-Sobieszek M. P37.02 Identification of Gene Fusions and Mutations in Patients with NSCLC using two Diagnostic Approaches: Rapid qPCR and NGS. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.749] [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: 10/21/2022]
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9
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Szczyrek M, Kuźnar-Kamińska B, Grenda A, Krawczyk P, Sawicki M, Głogowski M, Balicka G, Rolska-Kopińska A, Nicoś M, Jakimiec M, Batura-Gabryel H, Kowalski DM, Mlak R, Krzakowski M, Milanowski J. Diagnostic value of plasma expression of microRNAs complementary to Drosha and Dicer in lung cancer patients. Eur Rev Med Pharmacol Sci 2020; 23:3857-3866. [PMID: 31115013 DOI: 10.26355/eurrev_201905_17813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Lung cancer (LC) is diagnosed mostly in advanced, non-operable stage, with poor prognosis. The analysis of microRNAs may be a useful tool for early and non-invasive detection of cancer. Dicer and Drosha are enzymes with an essential role for microRNA biogenesis. The aim of our study was to analyze the expression of miRNA-27a-3p, miRNA-31, miRNA-182, miRNA-195 with the ability to reciprocal regulation of Dicer and Drosha expression in lung cancer patients. PATIENTS AND METHODS The relative expression of microRNAs was detected by qPCR in plasma of 160 LC patients. The U-Mann Whitney test was used to compare the relative expression between particular groups of lung cancer patients and healthy individuals. The diagnostic value of microRNAs examination was analyzed using a receiver operating curve. RESULTS We demonstrated that the plasma levels of miRNA-27, miRNA-31 and miRNA-182 were significantly higher and miRNA-195 significantly lower in the whole group of LC patients and in patients with early stages of NSCLC, in comparison with healthy donors. ROC analysis showed that four studied microRNAs have a potential diagnostic value for early stages of NSCLC with AUC=0.95 for miRNA-27a (94% sensitivity and 81% specificity, p=0.0001), 0.71 for miRNA-31 (73% sensitivity and 61% specificity, p=0.001) 0.77 for miRNA-182 (70% sensitivity and 79% specificity, p=0.0001) and 0.82 for miRNA-195 (74% sensitivity and 80% specificity, p=0.0001). CONCLUSIONS We have proved that the expression of miRNA-27a-3p, miRNA-31, miRNA-182, and miRNA-195 in patients with LC is different from the expression of these molecules in healthy people. The examination of these microRNAs in plasma could be used in non-invasive lung cancer diagnosis.
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Affiliation(s)
- M Szczyrek
- Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland.
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Liu S, Horn L, Mok T, Mansfield A, De Boer R, Losonczy G, Sugawara S, Dziadziuszko R, Krzakowski M, Smolin A, Hochmair M, Garassino M, Lam S, McCleland M, Cardona A, Morris S, Reck M. 1781MO IMpower133: Characterisation of long-term survivors treated first-line with chemotherapy ± atezolizumab in extensive-stage small cell lung cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1543] [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] [Indexed: 10/23/2022] Open
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11
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Conley A, Demetri G, Doebele R, Drilon A, Paz-Ares L, Cassier P, Siena S, Ahn MJ, Buchschacher G, Seto T, Chee C, Krzakowski M, Ou SH, Grohé C, Zagonel V, Spira A, Cheng A, Kapre A, Piault E, Rolfo C. 539P Patient-reported outcomes (PROs) from patients (Pts) with NTRK fusion-positive (NTRK-fp) solid tumours receiving entrectinib in the global phase II STARTRK-2 study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Grosso F, Aerts J, Ramlau R, Cedres S, Mencoboni M, Van Meerbeeck J, Dziadziuszko R, Planchard D, Chella A, Crino L, Krzakowski M, Ceresoli G, Weinberg U. P2.06-01 STELLAR Trial: Radiological Response Patterns of TTFields Plus Chemotherapy in First-Line Treatment of Malignant Pleural Mesothelioma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1619] [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: 10/25/2022]
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13
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Liu S, Mansfield A, Szczesna A, Havel L, Krzakowski M, Hochmair M, Huemer F, Losonczy G, Johnson M, Nishio M, Reck M, Mok T, Lam S, Shames D, Liu J, Ding B, Kabbinavar F, Lin W, Sandler A, Horn L. PL02.07 IMpower 133: Primary PFS, OS and Safety in a PH1/3 Study of 1L Atezolizumab + Carboplatin + Etoposide in Extensive-Stage SCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.013] [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: 11/26/2022]
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14
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Barlesi F, Vansteenkiste J, Spigel D, Ishii H, Garassino M, De Marinis F, Özgüroğlu M, Szczesna A, Polychronis A, Uslu R, Krzakowski M, Lee J, Calabro L, Frontera O, Ellers-Lenz B, Bajars M, Ruisi M, Park K. OA05.05 Avelumab vs Docetaxel for Previously Treated Advanced NSCLC: Primary Analysis of the Phase 3 JAVELIN Lung 200 Trial. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.260] [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: 10/28/2022]
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15
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Ceresoli G, Aerts J, Madrzak J, Dziadziuszko R, Ramlau R, Cedres S, Hiddinga B, Van Meerbeeck J, Mencoboni M, Planchard D, Chella A, Crinò L, Krzakowski M, Grosso F. MA12.06 STELLAR – Final Results of a Phase 2 Trial of TTFields with Chemotherapy for First-Line Treatment of Malignant Pleural Mesothelioma. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.416] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Leppert W, Zajaczkowska R, Wordliczek J, Dobrogowski J, Woron J, Krzakowski M. Pathophysiology and clinical characteristics of pain in most common locations in cancer patients. J Physiol Pharmacol 2016; 67:787-799. [PMID: 28195060] [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] [Received: 01/26/2016] [Accepted: 12/21/2016] [Indexed: 06/06/2023]
Abstract
Pain is one of the most common symptoms in cancer patients, especially in advanced disease. However, pain also accompanies a significant percentage of patients during diagnostic and therapeutic procedures. In some patients pain may be the first symptom of the disease. The causes of pain in cancer patients are often multifactorial including direct and indirect cancer effects, anticancer therapy and co-morbidities. Moreover, pain in cancer patients often has mixed pathophysiology including both nociceptive and neuropathic components, especially in patients with bone metastases. In this article, basic knowledge regarding epidemiology, pathophysiology and clinical features of pain in cancer patients with a primary tumour localised in lung, gastrointestinal tract (stomach, colon and pancreas), breast in women and prostate in men are presented. Pain is a common symptom in cancer patients and its appropriate assessment and treatment may significantly improve in patients' and families' quality of life.
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Affiliation(s)
- W Leppert
- Chair and Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland.
- Department of Quality of Life Research, Gdansk Medical University, Gdansk, Poland
| | - R Zajaczkowska
- Department of Interdisciplinary Intensive Care, Jagiellonian University Medical College, Cracow, Poland
| | - J Wordliczek
- Department of Interdisciplinary Intensive Care, Jagiellonian University Medical College, Cracow, Poland
| | - J Dobrogowski
- Department of Pain Research and Treatment, Jagiellonian University Medical College, Cracow, Poland
| | - J Woron
- Department of Quality of Life Research, Gdansk Medical University, Gdansk, Poland
- Department of Clinical Pharmacology, Jagiellonian University Medical College, Cracow, Poland
| | - M Krzakowski
- Department of Lung and Thoracic Tumors, Maria Sklodowska-Curie Institute of Oncology, Warsaw, Poland
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Heigener D, Gottfried M, Bennouna J, Bondarenko I, Douillard JY, Krzakowski M, Mellemgaard A, Novello S, Orlov S, Summers Y, von Pawel J, Hocke J, Kaiser R, Reck M. Efficacy and safety of nintedanib (NIN)/docetaxel (DOC) in patients with lung adenocarcinoma: Further analyses from the LUME-Lung 1 study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.76] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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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Thongprasert S, Alexandru A, Schenker M, Abdelaziz A, Clement D, Boldeanu C, Jovanovic D, Reyes-Igama J, Petrović M, Geater S, Radosavljevic D, Perin B, Krzakowski M, Serwatowski P, Parra J, Sriuranpong V, Jones H, Cseh A, Gaafar R. 477TiP Phase IV study of afatinib as second-line therapy for patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) harboring common epidermal growth factor receptor (EGFR) mutations (Del19 and/or L858R). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv532.61] [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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19
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Vansteenkiste J, Barlesi F, Waller CF, Bennouna J, Gridelli C, Goekkurt E, Verhoeven D, Szczesna A, Feurer M, Milanowski J, Germonpre P, Lena H, Atanackovic D, Krzakowski M, Hicking C, Straub J, Picard M, Schuette W, O'Byrne K. Cilengitide combined with cetuximab and platinum-based chemotherapy as first-line treatment in advanced non-small-cell lung cancer (NSCLC) patients: results of an open-label, randomized, controlled phase II study (CERTO). Ann Oncol 2015; 26:1734-40. [PMID: 25939894 DOI: 10.1093/annonc/mdv219] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 04/28/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This multicentre, open-label, randomized, controlled phase II study evaluated cilengitide in combination with cetuximab and platinum-based chemotherapy, compared with cetuximab and chemotherapy alone, as first-line treatment of patients with advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Patients were randomized 1:1:1 to receive cetuximab plus platinum-based chemotherapy alone (control), or combined with cilengitide 2000 mg 1×/week i.v. (CIL-once) or 2×/week i.v. (CIL-twice). A protocol amendment limited enrolment to patients with epidermal growth factor receptor (EGFR) histoscore ≥200 and closed the CIL-twice arm for practical feasibility issues. Primary end point was progression-free survival (PFS; independent read); secondary end points included overall survival (OS), safety, and biomarker analyses. A comparison between the CIL-once and control arms is reported, both for the total cohorts, as well as for patients with EGFR histoscore ≥200. RESULTS There were 85 patients in the CIL-once group and 84 in the control group. The PFS (independent read) was 6.2 versus 5.0 months for CIL-once versus control [hazard ratio (HR) 0.72; P = 0.085]; for patients with EGFR histoscore ≥200, PFS was 6.8 versus 5.6 months, respectively (HR 0.57; P = 0.0446). Median OS was 13.6 for CIL-once versus 9.7 months for control (HR 0.81; P = 0.265). In patients with EGFR ≥200, OS was 13.2 versus 11.8 months, respectively (HR 0.95; P = 0.855). No major differences in adverse events between CIL-once and control were reported; nausea (59% versus 56%, respectively) and neutropenia (54% versus 46%, respectively) were the most frequent. There was no increased incidence of thromboembolic events or haemorrhage in cilengitide-treated patients. αvβ3 and αvβ5 expression was neither a predictive nor a prognostic indicator. CONCLUSIONS The addition of cilengitide to cetuximab/chemotherapy indicated potential clinical activity, with a trend for PFS difference in the independent-read analysis. However, the observed inconsistencies across end points suggest additional investigations are required to substantiate a potential role of other integrin inhibitors in NSCLC treatment. CLINICAL TRIAL REGISTRATION ID NUMBER NCT00842712.
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Affiliation(s)
- J Vansteenkiste
- Respiratory Oncology Unit, Department of Respiratory Medicine, University Hospitals KU Leuven, Leuven, Belgium
| | - F Barlesi
- Multidisciplinary Oncology and Therapeutic Innovations, Aix Marseille University-Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - C F Waller
- Haematology, Oncology and Stem Cell Transplantation, University Hospital of Freiburg, Freiburg, Germany
| | - J Bennouna
- Département d'Oncologie Médicale, Centre Rene Gauducheau, Saint-Herblain Cedex, France
| | - C Gridelli
- Division of Medical Oncology, Azienda Ospedaliera 'S.G. Moscati', Avellino, Italy
| | - E Goekkurt
- Department of Oncology, Hematology, Stem Cell Transplantation and Hemostaseology, University Hospital Aachen, Aachen, Germany
| | - D Verhoeven
- Iridium Cancer Network, Medical Oncology, AZ Klina, Antwerp, Belgium
| | - A Szczesna
- Mazowieckie Centrum Leczenia Chorób Pluc i Gruźlicy, Otwock, Poland
| | - M Feurer
- Lungenpraxis Munich, Munich, Germany
| | - J Milanowski
- Department of Pneumology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland
| | - P Germonpre
- Pulmonary Medicine, AZ Maria Middelares, Ghent, Belgium
| | - H Lena
- Pneumology, CHU Rennes, Rennes, France
| | - D Atanackovic
- Oncology/Hematology/Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Krzakowski
- The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Lung and Thoracic Tumours, Warsaw, Poland
| | | | | | | | - W Schuette
- Krankenhaus Martha-Maria Halle-Dölau, Klinik für Innere Medizin II, Halle, Germany
| | - K O'Byrne
- Cancer Services, Princess Alexandra Hospital, Brisbane, Australia
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Mellemgaard A, Orlov S, Krzakowski M, von Pawel J, Gottfried M, Bondarenko I, Barrueco J, Buchner H, Hocke J, Kaiser R, Novello S, Douillard J, Reck M. Effect of Nintedanib (Bibf 1120) Combined with Standard 2Nd-Line Docetaxel in Nsclc Patients Who Received Prior Pemetrexed in Lume-Lung 1: a Randomised, Placebo-Controlled Phase III Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu331.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Vansteenkiste J, Barlesi F, Waller C, Bennouna J, Gridelli C, Goekkurt E, Verhoeven D, Szczesna A, Feurer M, Milanowski J, Germonpre P, Lena H, Atanackovic D, Krzakowski M, Hicking C, Straub J, Picard M, Schuette W, Byrne KO. Cilengitide (Cil) Combined with Cetuximab and Platinum-Based Chemotherapy As First-Line Treatment in Advanced Non-Small Cell Lung Cancer (Nsclc) Patients (Pts): Phase Ii Randomised Certo Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.14] [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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22
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Krzakowski M, Mellemgaard A, Orlov S, von Pawel J, Gottfried M, Bondarenko I, Liao M, Barrueco J, Gaschler-Markefski B, Kaiser R, Novello S, Douillard J, Reck M. Prior Taxane Use in the Lume-Lung 1 Phase III Trial and the Effect on Outcome Following 2Nd-Line Treatment with Nintedanib (Bibf 1120) and Docetaxel in Patients with Advanced Nsclc. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu331.33] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Reck M, Mellemgaard A, Douillard JY, Orlov S, Krzakowski M, von Pawel J, Gottfried M, Bondarenko I, Liao M, Barrueco J, Gaschler-Markefski B, Kaiser R, Novello S. 30 Nintedanib (BIBF 1120) + docetaxel as second-line therapy in patients with stage IIIB/IV or recurrent NSCLC: results of the phase III, randomised, double-blind LUME-Lung 1 trial. Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70031-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Krzakowski M, Bennouna J, Dansin E, Kowalski D, Hiret S, Penel N, Favrel S, Tourani JM. Phase I dose-escalation study of oral vinflunine in combination with erlotinib in pre-treated and unselected EGFR patients with locally advanced or metastatic non-small-cell lung cancer. Cancer Chemother Pharmacol 2013; 73:231-6. [PMID: 24220936 PMCID: PMC3909260 DOI: 10.1007/s00280-013-2342-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 10/25/2013] [Indexed: 11/26/2022]
Abstract
Background Erlotinib, the epidermal growth factor receptor tyrosine kinase inhibitor, and the intra-venous vinflunine vinca alkaloid microtubule inhibitor have been shown to be effective in the setting of non-small-cell lung cancer (NSCLC) palliative patients with acceptable toxicities. This phase I study was conducted to determine the maximal tolerated dose (MTD) and the safety of an all-oral combination. A potential pharmacokinetic drug–drug interaction was also investigated.
Patients and methods Patients with unresectable stage IIIB or stage IV NSCLC who failed one or two previous chemotherapy regimens were treated with flat doses of oral vinflunine from day 1 to day 5 and from day 8 to day 12 every 3 weeks and erlotinib daily on a continuous basis. The dose levels of vinflunine/erlotinib were 95/100, 115/100, 115/150 and 135/100 mg. Results Thirty patients were enroled. The recommended dose was 115/150 mg and the MTD 135/100 mg. Dose-limiting toxicities included grade 3 febrile neutropenia (1 patient) and related death (1 patient). Non-haematologic grade 3/4 toxicities included fatigue, condition aggravated, hypokalaemia, tumour pain, acneiform dermatitis, diarrhoea, hyperbilirubinaemia and pulmonary haemorrhage, in one patient each. Of 25 patients evaluable for tumour response, 2 patients had partial response and 20 patients had stable disease. Conclusion The recommended doses for oral vinflunine and erlotinib combination were, respectively, 115 mg/day from day 1 to day 5 and from day 8 to day 12 every 3 weeks and 150 mg/day. There was no mutual impact on pharmacokinetics. The combination was safe but evaluation in phase II is needed to further refine the activity and toxicity that can be expected with prolonged administration of this dose schedule.
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Ramalingam S, Crawford J, Chang A, Manegold C, Perez-Soler R, Douillard JY, Thatcher N, Barlesi F, Owonikoko T, Wang Y, Pultar P, Zhu J, Malik R, Giaccone G, Della-Fiorentina S, Begbie S, Jennens R, Dass J, Pittman K, Ivanova N, Koynova T, Petrov P, Tomova A, Tzekova V, Couture F, Hirsh V, Burkes R, Sangha R, Ambrus M, Janaskova T, Musil J, Novotny J, Zatloukal P, Jakesova J, Klenha K, Roubec J, Vanasek J, Fayette J, Barlesi F, Bennouna-Louridi J, Chouaid C, Mazières J, Vallerand H, Robinet G, Souquet PJ, Spaeth D, Schott R, Lena H, Martinet Y, El Kouri C, Baize N, Scherpereel A, Molinier O, Fuchs F, Josten K, Manegold C, Marschner N, Schneller F, Overbeck T, Thomas M, von Pawel J, Reck M, Schuette W, Hagen V, Schneider CP, Georgoulias V, Varthalitis I, Zarogoulidis K, Syrigos K, Papandreou C, Bocskei C, Csanky E, Juhasz E, Losonczy G, Mark Z, Molnar I, Papai-Szekely Z, Tehenes S, Vinkler I, Almel S, Bakshi A, Bondarde S, Maru A, Pathak A, Pedapenki R, Prasad K, Prasad S, Kilara N, Gorijavolu D, Deshmukh C, John S, Sharma L, Amoroso D, Bajetta E, Bidoli P, Bonetti A, De Marinis F, Maio M, Passalacqua R, Cascinu S, Bearz A, Bitina M, Brize A, Purkalne G, Skrodele M, Baba A, Ratnavelu K, Saw M, Samson-Fernando M, Ladrera G, Jassem J, Koralewski P, Serwatowski P, Krzakowski M, Cebotaru C, Filip D, Ganea-Motan D, Ianuli C, Manolescu I, Udrea A, Burdaeva O, Byakhov M, Filippov A, Lazarev S, Mosin I, Orlov S, Udovitsa D, Khorinko A, Protsenko S, Chang A, Lim H, Tan Y, Tan E, Bastus Piulats R, Garcia-Foncillas J, Valdivia J, de Castro J, Domine Gomez M, Kim S, Lee JS, Kim H, Lee J, Shin S, Kim DW, Kim YC, Park K, Chang CS, Chang GC, Goan YG, Su WC, Tsai CM, Kuo HP, Benekli M, Demir G, Gokmen E, Sevinc A, Crawford J, Giaccone G, Haigentz M, Owonikoko T, Agarwal M, Pandit S, Araujo R, Vrindavanam N, Bonomi P, Berg A, Wade J, Bloom R, Amin B, Camidge R, Hill D, Rarick M, Flynn P, Klein L, Lo Russo K, Neubauer M, Richards P, Ruxer R, Savin M, Weckstein D, Rosenberg R, Whittaker T, Richards D, Berry W, Ottensmeier C, Dangoor A, Steele N, Summers Y, Rankin E, Rowley K, Giridharan S, Kristeleit H, Humber C, Taylor P. Talactoferrin alfa versus placebo in patients with refractory advanced non-small-cell lung cancer (FORTIS-M trial). Ann Oncol 2013; 24:2875-80. [DOI: 10.1093/annonc/mdt371] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [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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Madej G, Krzakowski M, Pawiriski A, Lasota W, Rogowski W, Skoneczna I. A Comparative Study of the Use of Navoban (ICS 205-930), a 5-HT3 Antagonist, versus a Standard Antiemetic Regimen of Dexamethasone and Metoclopramide in the Treatment of Cisplatin-Containing Chemotherapy. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/bf03259737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kozloff MF, Martin LP, Krzakowski M, Samuel TA, Rado TA, Arriola E, De Castro Carpeño J, Herbst RS, Tarazi J, Kim S, Rosbrook B, Tortorici M, Olszanski AJ, Cohen RB. Phase I trial of axitinib combined with platinum doublets in patients with advanced non-small cell lung cancer and other solid tumours. Br J Cancer 2012; 107:1277-85. [PMID: 22990652 PMCID: PMC3494447 DOI: 10.1038/bjc.2012.406] [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] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: This phase I dose-finding trial evaluated safety, efficacy and pharmacokinetics of axitinib, a potent and selective second-generation inhibitor of vascular endothelial growth factor receptors, combined with platinum doublets in patients with advanced non-small cell lung cancer (NSCLC) and other solid tumours. Methods: In all, 49 patients received axitinib 5 mg twice daily (b.i.d.) with paclitaxel/carboplatin or gemcitabine/cisplatin in 3-week cycles. Following determination of the maximum tolerated dose, a squamous cell NSCLC expansion cohort was enroled and received axitinib 5 mg b.i.d. with paclitaxel/carboplatin. Results: Two patients experienced dose-limiting toxicities: febrile neutropenia (n=1) in the paclitaxel/carboplatin cohort and fatigue (n=1) in the gemcitabine/cisplatin cohort. Common nonhaematologic treatment-related adverse events were hypertension (36.7%), diarrhoea (34.7%) and fatigue (28.6%). No grade⩾3 haemoptysis occurred among 12 patients with squamous cell NSCLC. The objective response rate was 37.0% for patients receiving axitinib/paclitaxel/carboplatin (n=27) and 23.8% for patients receiving axitinib/gemcitabine/cisplatin (n=21). Pharmacokinetics of axitinib and chemotherapeutic agents were similar when administered alone or in combination. Conclusion: Axitinib 5 mg b.i.d. may be combined with standard paclitaxel/carboplatin or gemcitabine/cisplatin regimens without evidence of overt drug–drug interactions. Both combinations demonstrated clinical efficacy and were well tolerated.
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Affiliation(s)
- M F Kozloff
- Section of Oncology/Hematology, Ingalls Hospital, Harvey, IL, USA.
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Brodowicz T, Ciuleanu T, Crawford J, Filipits M, Fischer JR, Georgoulias V, Gridelli C, Hirsch FR, Jassem J, Kosmidis P, Krzakowski M, Manegold C, Pujol JL, Stahel R, Thatcher N, Vansteenkiste J, Minichsdorfer C, Zöchbauer-Müller S, Pirker R, Zielinski CC. Third CECOG consensus on the systemic treatment of non-small-cell lung cancer. Ann Oncol 2012; 23:1223-1229. [PMID: 21940784 DOI: 10.1093/annonc/mdr381] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The current third consensus on the systemic treatment of non-small-cell lung cancer (NSCLC) builds upon and updates similar publications on the subject by the Central European Cooperative Oncology Group (CECOG), which has published such consensus statements in the years 2002 and 2005 (Zielinski CC, Beinert T, Crawford J et al. Consensus on medical treatment of non-small-cell lung cancer--update 2004. Lung Cancer 2005; 50: 129-137). The principle of all CECOG consensus is such that evidence-based recommendations for state-of-the-art treatment are given upon which all participants and authors of the manuscript have to agree (Beslija S, Bonneterre J, Burstein HJ et al. Third consensus on medical treatment of metastatic breast cancer. Ann Oncol 2009; 20 (11): 1771-1785). This is of particular importance in diseases in which treatment options depend on very particular clinical and biologic variables (Zielinski CC, Beinert T, Crawford J et al. Consensus on medical treatment of non-small-cell lung cancer--update 2004. Lung Cancer 2005; 50: 129-137; Beslija S, Bonneterre J, Burstein HJ et al. Third consensus on medical treatment of metastatic breast cancer. Ann Oncol 2009; 20 (11): 1771-1785). Since the publication of the last CECOG consensus on the medical treatment of NSCLC, a series of diagnostic tools for the characterization of biomarkers for personalized therapy for NSCLC as well as therapeutic options including adjuvant treatment, targeted therapy, and maintenance treatment have emerged and strongly influenced the field. Thus, the present third consensus was generated that not only readdresses previous disease-related issues but also expands toward recent developments in the management of NSCLC. It is the aim of the present consensus to summarize minimal quality-oriented requirements for individual patients with NSCLC in its various stages based upon levels of evidence in the light of a rapidly expanding array of individual therapeutic options.
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Affiliation(s)
- T Brodowicz
- Clinical Division of Oncology, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria; Central European Cooperative Oncology Group
| | - T Ciuleanu
- Medical Oncology Department, Institute of Oncology, Cluj-Napoca, Romania
| | - J Crawford
- Department of Medicine, Duke Medical Center, Durham, USA
| | - M Filipits
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria
| | - J R Fischer
- Department of Medicine II, Onkology, Klinik Löwenstein, Löwenstein, Germany
| | - V Georgoulias
- Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Crete, Greece
| | - C Gridelli
- Division of Medical Oncology, S.G. Moscati Hospital, Contrada Amoretta, Italy
| | - F R Hirsch
- Department of Pathology, University of Colorado, Aurora, USA
| | - J Jassem
- Central European Cooperative Oncology Group; Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - P Kosmidis
- Department of Medical Oncology, Hygeia Hospital, Athens, Greece
| | - M Krzakowski
- Central European Cooperative Oncology Group; Department of Lung and Thoracic Tumours, Maria Sklodowska Curie Memorial Cancer Center, Warsaw, Poland
| | - Ch Manegold
- Department of Surgery, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - J L Pujol
- Department of Oncology Lung, Hopital Arnaud de Villeneuve, Montpellier, France
| | - R Stahel
- Laboratory for Molecular Oncology, Department of Thoracic Oncology, Clinic and Policlinic for Oncology, University Hospital Zurich, Zurich, Switzerland
| | - N Thatcher
- Department of Medical Oncology, Christie Hospital NHS Trust, Manchester, UK
| | - J Vansteenkiste
- Respiratory Oncology Unit (Pulmonology), University Hospital Gasthuisberg, Leuven, Belgium
| | - C Minichsdorfer
- Clinical Division of Oncology, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria
| | - S Zöchbauer-Müller
- Clinical Division of Oncology, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria
| | - R Pirker
- Clinical Division of Oncology, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria
| | - C C Zielinski
- Clinical Division of Oncology, Comprehensive Cancer Center, Medical University Vienna-General Hospital, Vienna, Austria; Central European Cooperative Oncology Group.
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Pirker R, Pereira JR, Szczesna A, von Pawel J, Krzakowski M, Ramlau R, Vynnychenko I, Park K, Eberhardt WEE, de Marinis F, Heeger S, Goddemeier T, O'Byrne KJ, Gatzemeier U. Prognostic factors in patients with advanced non-small cell lung cancer: data from the phase III FLEX study. Lung Cancer 2012; 77:376-82. [PMID: 22498112 DOI: 10.1016/j.lungcan.2012.03.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 03/13/2012] [Accepted: 03/15/2012] [Indexed: 02/07/2023]
Abstract
The FLEX study demonstrated that the addition of cetuximab to chemotherapy significantly improved overall survival in the first-line treatment of patients with advanced non-small cell lung cancer (NSCLC). In the FLEX intention to treat (ITT) population, we investigated the prognostic significance of particular baseline characteristics. Individual patient data from the treatment arms of the ITT population of the FLEX study were combined. Univariable and multivariable Cox regression models were used to investigate variables with potential prognostic value. The ITT population comprised 1125 patients. In the univariable analysis, longer median survival times were apparent for females compared with males (12.7 vs 9.3 months); patients with an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 compared with 1 compared with 2 (13.5 vs 10.6 vs 5.9 months); never smokers compared with former smokers compared with current smokers (14.6 vs 11.1 vs 9.0); Asians compared with Caucasians (19.5 vs 9.6 months); patients with adenocarcinoma compared with squamous cell carcinoma (12.4 vs 9.3 months) and those with metastases to one site compared with two sites compared with three or more sites (12.4 months vs 9.8 months vs 6.4 months). Age (<65 vs ≥65 years), tumor stage (IIIB with pleural effusion vs IV) and percentage of tumor cells expressing EGFR (<40% vs ≥40%) were not identified as possible prognostic factors in relation to survival time. In multivariable analysis, a stepwise selection procedure identified age (<65 vs ≥65 years), gender, ECOG PS, smoking status, region, tumor histology, and number of organs involved as independent factors of prognostic value. In summary, in patients with advanced NSCLC enrolled in the FLEX study, and consistent with previous analyses, particular patient and disease characteristics at baseline were shown to be independent factors of prognostic value. The FLEX study is registered with ClinicalTrials.gov, number NCT00148798.
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Affiliation(s)
- R Pirker
- Department of Medicine I, Medical University Vienna, Vienna, Austria.
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Manegold C, van Zandwijk N, Szczesna A, Zatloukal P, Au JSK, Blasinska-Morawiec M, Serwatowski P, Krzakowski M, Jassem J, Tan EH, Benner RJ, Ingrosso A, Meech SJ, Readett D, Thatcher N. A phase III randomized study of gemcitabine and cisplatin with or without PF-3512676 (TLR9 agonist) as first-line treatment of advanced non-small-cell lung cancer. Ann Oncol 2012; 23:72-77. [PMID: 21464154 DOI: 10.1093/annonc/mdr030] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND This open-label phase III study assessed the addition of Toll-like receptor 9-activating oligodeoxynucleotide PF-3512676 to gemcitabine/cisplatin chemotherapy in patients with non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Chemotherapy-naive patients with stage IIIB or IV NSCLC were randomized (1:1) to receive six or fewer 3-week cycles of i.v. gemcitabine (1250 mg/m2 on days 1 and 8) and cisplatin alone (75 mg/m2 on day 1, control arm) or combined with s.c. PF-3512676 0.2 mg/kg on days 8 and 15 of each chemotherapy cycle and weekly thereafter until progression or unacceptable toxicity (experimental arm). No crossover was planned. The primary end point was overall survival (OS). RESULTS A total of 839 patients were randomized. Baseline demographics were well balanced. Median OS (11.0 versus 10.7 months; P=0.98) and median progression-free survival (PFS) (both 5.1 months) were similar between groups. Grade≥3 hematologic adverse events (AEs), injection-site reactions, and influenza-like symptoms were more frequently reported among patients receiving PF-3512676. At the first-interim analysis, the Data Safety Monitoring Committee recommended study discontinuation. Administration of PF-3512676 was halted based on efficacy futility and increased grade≥3 AEs (experimental arm). CONCLUSIONS Addition of PF-3512676 to gemcitabine/cisplatin chemotherapy did not improve OS or PFS but did increase toxicity.
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Affiliation(s)
- C Manegold
- Interdisciplinary Thoracic Oncology, Department of Surgery, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
| | - N van Zandwijk
- Bernie Banton Centre, University of Sydney, Sydney, Australia
| | - A Szczesna
- 3rd Department, Regional Lung Diseases Hospital, Otwock, Poland
| | - P Zatloukal
- 3rd Faculty of Medicine, Charles University, Faculty Hospital Bulovka and Postgraduate Medical Institute, Prague, Czech Republic
| | - J S K Au
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | | | - P Serwatowski
- Chemotherapy Department, Specialistic Hospital Named After Professor A. Sokolowski, Szczecin-Zdunowo
| | - M Krzakowski
- Lung and Thoracic Tumours Department, Maria Sklodowska-Curie Memorial Cancer Centre, Warsaw
| | - J Jassem
- Department of Oncology and Radiology, Medical University of Gdansk, Gdansk, Poland
| | - E H Tan
- Department of Medical Oncology, National Cancer Centre, Singapore
| | - R J Benner
- Pfizer Global Research and Development, New London, USA
| | - A Ingrosso
- Pfizer Global Research and Development, Milan, Italy
| | - S J Meech
- Pfizer Global Research and Development, New London, USA
| | - D Readett
- Pfizer Global Research and Development, New London, USA
| | - N Thatcher
- Department of Medical Oncology, Christie Hospital, Manchester, UK
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von Pawel J, Pirker R, Pereira J, Krzakowski M, Park K, Eberhardt W, Schnaars Y, Heeger S, Goddemeier T, Paz-Ares L. 9019 POSTER DISCUSSION Safety Analysis of Patient Subgroups Defined by Low and High Tumour Epidermal Growth Factor Receptor (EGFR) Expression in FLEX Study Patients With Advanced Non-Small Cell Lung Cancer (NSCLC) Receiving Chemotherapy With or Without Cetuximab as First-Line Therapy. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72331-0] [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: 10/17/2022]
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Vashishtha A, Patel PH, Yu W, Bothos JG, Simpson J, Maneatis T, Doessegger L, Peterson AC, Clement-Duchene C, Robinet G, Krzakowski M, Blumenschein GR, Goldschmidt JH, Daniel DB, Spigel DR. Safety data and patterns of progression in met diagnostic subgroups in OAM4558g; A phase II trial evaluating MetMAb in combination with erlotinib in advanced NSCLC. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Richardson GE, Ciuleanu TE, Costa L, Gans SJM, Garcia Saenz JÁ, Hirsh V, Hungria V, Krzakowski M, Manegold C, Nahi H, Novello S, Petzer AL, Rader ME, Solal-Celigny P, Vadhan-Raj S, Vansteenkiste JF, Woll PJ, Ke C, Chung K, Yeh H. Denosumab versus zoledronic acid in patients with bone metastases from solid tumors other than breast and prostate cancers or multiple myeloma: A number needed to treat (NNT) analysis. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Reck M, Krzakowski M, Jassem J, Eschbach C, Kozielski J, Costanzi J, Gatzemeier U, Shogen K, Pawel JV. Ranpirnase + Doxorubicin versus Doxorubicin bei Patienten mit nicht operablem Mesotheliom – eine randomisierte Phase III Studie. Pneumologie 2010. [DOI: 10.1055/s-0030-1251120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schuette W, Krzakowski M, Massuti B, Otterson G, Lizambri R, Wei H, Berger D, Chen Y. Palifermin Reduces Dysphagia in Patients with Locally-advanced Unresected Non–small-cell Lung Cancer Undergoing Concurrent Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.275] [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]
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36
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Kozloff M, Martin L, Krzakowski M, Samuel T, Tarazi J, Rosbrook B, Tortorici M, Olszanski A, Cohen R. 1231 A phase I study of axitinib (AG-013736) combined with paclitaxel/carboplatin (P/C), gemcitabine/cisplatin (Gem/Cis) or pemetrexed/cisplatin (Pem/Cis) in patients (pts) with solid tumours, including advanced non-small cell lung cancer (NSCLC). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70443-4] [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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Krzakowski M. 30 Facing increasing costs of cancer care: Polish experience. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70037-0] [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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Belani CP, Brodowicz T, Ciuleanu T, Kim JH, Krzakowski M, Laack E, Wu YL, Peterson P, Krejcy K, Zielinski C. Maintenance pemetrexed (Pem) plus best supportive care (BSC) versus placebo (Plac) plus BSC: A randomized phase III study in advanced non-small cell lung cancer (NSCLC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.18_suppl.cra8000] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
CRA8000 Background: Pemetrexed's efficacy, favorable tolerability profile, and ease of administration provided a strong rationale for evaluation as maintenance therapy in patients (pts) with advanced NSCLC. We present the final analyses for all outcomes, including overall survival (OS), from a phase III study of Pem vs. Plac (Ciuleanu, J Clin Oncol 26, 2008, A 8011) in pts with stage IIIB/IV NSCLC who had not progressed on four cycles of platinum-based chemotherapy. Methods: In this double-blind trial, pts were randomized 2:1 to receive Pem (500 mg/m2, day 1) plus BSC or Plac plus BSC in 21-day cycles until disease progression. All pts received vitamin B12, folic acid, and dexamethasone. The final OS analysis was performed using an unadjusted Cox model. Overall α = 0.05 for PFS and OS. Results: In the 663 randomized pts (Pem 441: Plac 222), Pem resulted in significantly better OS (13.4 vs. 10.6 mos [HR 0.79, 95% CI: 0.65–0.95, P = 0.012]). As reported earlier, Pem also had better PFS (P <0.00001) and response (P <0.001) ( Table ). The improvements in PFS and OS were observed primarily in patients with non-squamous histology (PFS HR = 0.47 and OS HR = 0.70). Treatment by histology interaction for OS was significant (P = 0.038). Drug-related grade 3/4 toxicities were higher for Pem (16% vs 4%; P <0.001); specifically, fatigue (5% vs 0.5%) and neutropenia (2.9% vs. 0%). Grade 3/4 toxicities did not increase significantly in pts who received ≥6 and ≥10 cycles of Pem. There were no Pem-related deaths. Fewer pts in the Pem arm (51.5% vs 67.1%; P <0.001) received systemic post-discontinuation therapy. Conclusions: Pem maintenance therapy is well tolerated and offers superior OS and PFS compared with Plac, making it a new treatment paradigm for patients with advanced NSCLC who respond to initial therapy. This trial further validates that Pem has greater efficacy in patients with non-squamous histology. [Table: see text] [Table: see text]
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Affiliation(s)
- C. P. Belani
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University of Vienna, General Hospital of Vienna, and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria
| | - T. Brodowicz
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University of Vienna, General Hospital of Vienna, and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria
| | - T. Ciuleanu
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University of Vienna, General Hospital of Vienna, and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria
| | - J. H. Kim
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University of Vienna, General Hospital of Vienna, and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria
| | - M. Krzakowski
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University of Vienna, General Hospital of Vienna, and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria
| | - E. Laack
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University of Vienna, General Hospital of Vienna, and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria
| | - Y. L. Wu
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University of Vienna, General Hospital of Vienna, and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria
| | - P. Peterson
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University of Vienna, General Hospital of Vienna, and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria
| | - K. Krejcy
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University of Vienna, General Hospital of Vienna, and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria
| | - C. Zielinski
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University of Vienna, General Hospital of Vienna, and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria
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Pirker R, Rodrigues-Pereira J, Szczesna A, Von Pawel J, Krzakowski M, Ramlau R, Vynnychenko I, Park K, Emig M, Gatzemeier U. Prognostic factors in advanced NSCLC: Experience from the FLEX trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8083 Background: The FLEX trial demonstrated superior survival for cisplatin/vinorelbine plus cetuximab versus cisplatin/vinorelbine alone in patients with advanced EGFR-positive NSCLC. Here we report on the prognostic factors observed in the trial independent of cetuximab treatmentMethods: 1125 patients were randomized to cisplatin/vinorelbine plus cetuximab or cisplatin/vinorelbine alone. Prognostic factors were determined by both univariate and multivariate analyses. Results: Patient baseline characteristics were: 70% male, median age 59 (18–83) years, 31% older than 65 years, 94% stage IV, 47% adenocarcinoma, 34% squamous cell carcinoma, 83% ECOG 0/1. The trial confirmed the following prognostic factors in the univariate analysis: gender, performance status, histology, smoking status, and ethnicity. Females had longer survival than males (12.7 versus 9.3 months). Patients with ECOG performance status 0, 1, and 2 had median survival times of 13.5, 10.6 and 5.9 months, respectively. Patients with adenocarcinomas had a median survival of 12.4 months and those with squamous cell carcinomas had a median survival of 9.3 months. Smokers, former smokers, and never-smokers had median survival times of 9.0, 11.1 and 14.6 months, respectively. Outcome was better for Asians (n=121) compared to Caucasians (n=946) (median 19.5 versus 9.6 months). Age <65 and age ≥65 did not indicate prognosis. Multivariate analysis confirmed the prognostic significance of performance status, gender, smoking status, region (Europe versus Australasia), and histology. Conclusions: The FLEX trial confirmed several prognostic factors, including gender, performance status, histological subtype, ethnicity, and smoking status for patients with advanced NSCLC. [Table: see text]
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Affiliation(s)
- R. Pirker
- Medical University of Vienna, Vienna, Austria; Arnaldo Vieira de Carvalho Cancer Institute, Sao Paulo, Brazil; Mazowieckie Centrum Leczenia Chorob Pluc Gruzlicy, Otwock, Poland; Asklepios Fachkliniken Muenchen-Gauting, Gauting, Germany; Maria Sklodowska-Curie, Memorial Cancer Center, Warsaw, Poland; Oncology Department, Regional Center Lung Diseases, Poznan, Poland; Sumy Regional Oncology Centre, Sumy, Ukraine; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J. Rodrigues-Pereira
- Medical University of Vienna, Vienna, Austria; Arnaldo Vieira de Carvalho Cancer Institute, Sao Paulo, Brazil; Mazowieckie Centrum Leczenia Chorob Pluc Gruzlicy, Otwock, Poland; Asklepios Fachkliniken Muenchen-Gauting, Gauting, Germany; Maria Sklodowska-Curie, Memorial Cancer Center, Warsaw, Poland; Oncology Department, Regional Center Lung Diseases, Poznan, Poland; Sumy Regional Oncology Centre, Sumy, Ukraine; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - A. Szczesna
- Medical University of Vienna, Vienna, Austria; Arnaldo Vieira de Carvalho Cancer Institute, Sao Paulo, Brazil; Mazowieckie Centrum Leczenia Chorob Pluc Gruzlicy, Otwock, Poland; Asklepios Fachkliniken Muenchen-Gauting, Gauting, Germany; Maria Sklodowska-Curie, Memorial Cancer Center, Warsaw, Poland; Oncology Department, Regional Center Lung Diseases, Poznan, Poland; Sumy Regional Oncology Centre, Sumy, Ukraine; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J. Von Pawel
- Medical University of Vienna, Vienna, Austria; Arnaldo Vieira de Carvalho Cancer Institute, Sao Paulo, Brazil; Mazowieckie Centrum Leczenia Chorob Pluc Gruzlicy, Otwock, Poland; Asklepios Fachkliniken Muenchen-Gauting, Gauting, Germany; Maria Sklodowska-Curie, Memorial Cancer Center, Warsaw, Poland; Oncology Department, Regional Center Lung Diseases, Poznan, Poland; Sumy Regional Oncology Centre, Sumy, Ukraine; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - M. Krzakowski
- Medical University of Vienna, Vienna, Austria; Arnaldo Vieira de Carvalho Cancer Institute, Sao Paulo, Brazil; Mazowieckie Centrum Leczenia Chorob Pluc Gruzlicy, Otwock, Poland; Asklepios Fachkliniken Muenchen-Gauting, Gauting, Germany; Maria Sklodowska-Curie, Memorial Cancer Center, Warsaw, Poland; Oncology Department, Regional Center Lung Diseases, Poznan, Poland; Sumy Regional Oncology Centre, Sumy, Ukraine; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - R. Ramlau
- Medical University of Vienna, Vienna, Austria; Arnaldo Vieira de Carvalho Cancer Institute, Sao Paulo, Brazil; Mazowieckie Centrum Leczenia Chorob Pluc Gruzlicy, Otwock, Poland; Asklepios Fachkliniken Muenchen-Gauting, Gauting, Germany; Maria Sklodowska-Curie, Memorial Cancer Center, Warsaw, Poland; Oncology Department, Regional Center Lung Diseases, Poznan, Poland; Sumy Regional Oncology Centre, Sumy, Ukraine; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - I. Vynnychenko
- Medical University of Vienna, Vienna, Austria; Arnaldo Vieira de Carvalho Cancer Institute, Sao Paulo, Brazil; Mazowieckie Centrum Leczenia Chorob Pluc Gruzlicy, Otwock, Poland; Asklepios Fachkliniken Muenchen-Gauting, Gauting, Germany; Maria Sklodowska-Curie, Memorial Cancer Center, Warsaw, Poland; Oncology Department, Regional Center Lung Diseases, Poznan, Poland; Sumy Regional Oncology Centre, Sumy, Ukraine; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - K. Park
- Medical University of Vienna, Vienna, Austria; Arnaldo Vieira de Carvalho Cancer Institute, Sao Paulo, Brazil; Mazowieckie Centrum Leczenia Chorob Pluc Gruzlicy, Otwock, Poland; Asklepios Fachkliniken Muenchen-Gauting, Gauting, Germany; Maria Sklodowska-Curie, Memorial Cancer Center, Warsaw, Poland; Oncology Department, Regional Center Lung Diseases, Poznan, Poland; Sumy Regional Oncology Centre, Sumy, Ukraine; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - M. Emig
- Medical University of Vienna, Vienna, Austria; Arnaldo Vieira de Carvalho Cancer Institute, Sao Paulo, Brazil; Mazowieckie Centrum Leczenia Chorob Pluc Gruzlicy, Otwock, Poland; Asklepios Fachkliniken Muenchen-Gauting, Gauting, Germany; Maria Sklodowska-Curie, Memorial Cancer Center, Warsaw, Poland; Oncology Department, Regional Center Lung Diseases, Poznan, Poland; Sumy Regional Oncology Centre, Sumy, Ukraine; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - U. Gatzemeier
- Medical University of Vienna, Vienna, Austria; Arnaldo Vieira de Carvalho Cancer Institute, Sao Paulo, Brazil; Mazowieckie Centrum Leczenia Chorob Pluc Gruzlicy, Otwock, Poland; Asklepios Fachkliniken Muenchen-Gauting, Gauting, Germany; Maria Sklodowska-Curie, Memorial Cancer Center, Warsaw, Poland; Oncology Department, Regional Center Lung Diseases, Poznan, Poland; Sumy Regional Oncology Centre, Sumy, Ukraine; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Martin LP, Kozloff MF, Krzakowski M, Samuel TA, Rado TA, Tarazi J, Rosbrook B, Tortorici M, Olszanski AJ, Cohen RB. Axitinib (AG-013736; AG) combined with chemotherapy in patients (pts) with advanced non-small cell lung cancer (NSCLC) and other solid tumors. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.3559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3559 Background: AG is an oral, potent and selective inhibitor of VEGFRs 1, 2, 3. Anti-VEGF therapies combined with chemotherapy improve survival vs chemotherapy alone in pts with advanced solid tumors, including NSCLC. This phase I trial assessed AG combined with chemotherapy. Methods: Pts with advanced solid tumors without prior treatment with platins or taxanes received paclitaxel/carboplatin (P: 200 mg/m2 / C: AUC 6 mg*min/mL) every 3 weeks + AG at lead-in doses of 1, 3 or 5 mg BID. AG was increased to 5 mg BID post lead-in. Another cohort of pts with any prior chemotherapy for metastatic disease received AG 5 mg BID + gemcitabine/cisplatin (G: 1250 mg/m2 on days 1 and 8 / Cis: 80 mg/m2 on day 1) in 3-week cycles. For all cohorts, cycle 1 consisted of a 3–5-day lead-in period followed by AG for 18 days. On day 19, AG was held and then continued without interruption on day 3, cycle 2. Following determination of the maximum tolerated doses (MTDs) of AG + P/C or G/Cis, pts with squamous NSCLC were enrolled into an expansion cohort (prior anti-VEGF therapy not permitted) and received AG 5 mg BID + P/C. Dose-limiting toxicities (DLTs), adverse events (AEs), objective response rate (ORR), and pharmacokinetics (PK) were evaluated. Results: A total of 47 pts were enrolled; 26 pts were evaluable in the P/C cohort (including 12 pts with squamous NSCLC) and 21 pts in the G/Cis cohort. The MTD for AG in combination with standard doses of P/C and G/Cis was 5 mg BID. DLTs included fatigue, proteinuria and rash (1 each). Treatment-related AEs included hypertension (42%), diarrhea (35%) and fatigue (35%) in the P/C cohort, and headache (29%), hypertension (29%) and fatigue (24%) in the G/Cis cohort. There was no grade ≥3 hemoptysis among 12 pts with squamous NSCLC. The ORR was 29% and 26% for P/C (n = 24) and G/Cis (n = 19) cohorts, respectively. AG, P, C, G and Cis PK parameters and profiles were similar when administered alone and in combination (eg P: mean (%CV) AUCinf 20,822 (21) and 20,596 (21) ng.h/mL, respectively). Conclusions: AG 5 mg BID can be combined with standard P/C and G/Cis regimens with no apparent overlapping toxicities and unaltered PK. Both combinations have antitumor activity. In pts with squamous NSCLC, AG + P/C was well tolerated with no evidence of grade ≥3 hemoptysis. [Table: see text]
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Affiliation(s)
- L. P. Martin
- Fox Chase Cancer Center, Philadelphia, PA; Ingalls Hospital, Harvey, IL; Institute of Oncology, Warsaw, Poland; Medical College of Georgia Cancer Center, Augusta, GA; Columbia Basin Hematology & Oncology, Kennewick, WA; Pfizer Oncology, San Diego, CA; Pfizer Oncology, New London, CT
| | - M. F. Kozloff
- Fox Chase Cancer Center, Philadelphia, PA; Ingalls Hospital, Harvey, IL; Institute of Oncology, Warsaw, Poland; Medical College of Georgia Cancer Center, Augusta, GA; Columbia Basin Hematology & Oncology, Kennewick, WA; Pfizer Oncology, San Diego, CA; Pfizer Oncology, New London, CT
| | - M. Krzakowski
- Fox Chase Cancer Center, Philadelphia, PA; Ingalls Hospital, Harvey, IL; Institute of Oncology, Warsaw, Poland; Medical College of Georgia Cancer Center, Augusta, GA; Columbia Basin Hematology & Oncology, Kennewick, WA; Pfizer Oncology, San Diego, CA; Pfizer Oncology, New London, CT
| | - T. A. Samuel
- Fox Chase Cancer Center, Philadelphia, PA; Ingalls Hospital, Harvey, IL; Institute of Oncology, Warsaw, Poland; Medical College of Georgia Cancer Center, Augusta, GA; Columbia Basin Hematology & Oncology, Kennewick, WA; Pfizer Oncology, San Diego, CA; Pfizer Oncology, New London, CT
| | - T. A. Rado
- Fox Chase Cancer Center, Philadelphia, PA; Ingalls Hospital, Harvey, IL; Institute of Oncology, Warsaw, Poland; Medical College of Georgia Cancer Center, Augusta, GA; Columbia Basin Hematology & Oncology, Kennewick, WA; Pfizer Oncology, San Diego, CA; Pfizer Oncology, New London, CT
| | - J. Tarazi
- Fox Chase Cancer Center, Philadelphia, PA; Ingalls Hospital, Harvey, IL; Institute of Oncology, Warsaw, Poland; Medical College of Georgia Cancer Center, Augusta, GA; Columbia Basin Hematology & Oncology, Kennewick, WA; Pfizer Oncology, San Diego, CA; Pfizer Oncology, New London, CT
| | - B. Rosbrook
- Fox Chase Cancer Center, Philadelphia, PA; Ingalls Hospital, Harvey, IL; Institute of Oncology, Warsaw, Poland; Medical College of Georgia Cancer Center, Augusta, GA; Columbia Basin Hematology & Oncology, Kennewick, WA; Pfizer Oncology, San Diego, CA; Pfizer Oncology, New London, CT
| | - M. Tortorici
- Fox Chase Cancer Center, Philadelphia, PA; Ingalls Hospital, Harvey, IL; Institute of Oncology, Warsaw, Poland; Medical College of Georgia Cancer Center, Augusta, GA; Columbia Basin Hematology & Oncology, Kennewick, WA; Pfizer Oncology, San Diego, CA; Pfizer Oncology, New London, CT
| | - A. J. Olszanski
- Fox Chase Cancer Center, Philadelphia, PA; Ingalls Hospital, Harvey, IL; Institute of Oncology, Warsaw, Poland; Medical College of Georgia Cancer Center, Augusta, GA; Columbia Basin Hematology & Oncology, Kennewick, WA; Pfizer Oncology, San Diego, CA; Pfizer Oncology, New London, CT
| | - R. B. Cohen
- Fox Chase Cancer Center, Philadelphia, PA; Ingalls Hospital, Harvey, IL; Institute of Oncology, Warsaw, Poland; Medical College of Georgia Cancer Center, Augusta, GA; Columbia Basin Hematology & Oncology, Kennewick, WA; Pfizer Oncology, San Diego, CA; Pfizer Oncology, New London, CT
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Brodowicz T, Steiner I, Beslija S, Ciuleanu TE, Inbar M, Krzakowski M, Kahan Z, Tzekova V, Vrbanec D, Zielinski CC. Time interval between final protocol approval (FPA) and inclusion of the first patient into randomized clinical trials (RCTs) performed by the Central European Cooperative Oncology Group (CECOG): A 10-year experience. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6546 Background: CECOG has been formed in 1999 to unite centers of clinical oncology from Central and Southeastern Europe and Israel in order to conduct and coordinate multicenter oncology RCTs. Based on the European legislation passed in 2001 (Directive 2001/20/EC), clinical trials must get ethical approval and approval from the competent authorities (CA). However, the duration of these regulatory procedures to initiate a clinical trial is a factor determining the competitive position in clinical research. Methods: Within the last 10 years, CECOG conducted trials in breast, colorectal, esophago-gastric, NSCLC, pancreatic, prostate cancer and GIST. We analyzed the dates of FPA, the approvals by Ethics Review Boards (ERB) and CAs, the letters of agreement between sponsor and site (LoA), the site initiation and the inclusion of the first patient in a total of 6 multicenter trials in 25 CECOG study centers in Austria, Bosnia, Bulgaria, Croatia, the Czech Republic, Hungary, Israel, Poland, Romania, Serbia, and Slovakia. Results: The average time interval from FPA to the inclusion of the first patient was 18.4 ± 9.4 months. Most of this time has been spent for regulatory procedures, i.e. the approval by ERBs (9.6 ± 7.2 months) and CAs (10.0 ± 6.6 months). The LoA were signed 11.5 ± 9.4 months after FPA. The time interval from approval by the CAs to site initiation was 3.3 ± 3.7 months and the interval between site initiation and the inclusion of the first patient was 4.2 ± 4.5 months. Conclusions: The ‘paper to patient process‘ - the time interval between the approval of the final study protocol and the inclusion of the first patient - required 18.4 months on average in 6 multicenter trials conducted by CECOG. As the regulatory procedures used up more than 50% of duration of the whole process, optimization is necessary and realistic in order to make novel therapies available to patients more quickly. No significant financial relationships to disclose.
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Affiliation(s)
- T. Brodowicz
- Medical University of Vienna, Vienna, Austria; Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; Universitatea de Medicina, Cluj-Napoca, Romania; Tel Aviv Medical Center, Tel Aviv, Israel; Maria Skolodowska-Curie Memorial Cancer Center, Warsaw, Poland; Onkotherapias Klinika, Szeged, Hungary; University Hospital Queen Joanna, Sofia, Bulgaria; University Hospital Rebro, Zagreb, Croatia
| | - I. Steiner
- Medical University of Vienna, Vienna, Austria; Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; Universitatea de Medicina, Cluj-Napoca, Romania; Tel Aviv Medical Center, Tel Aviv, Israel; Maria Skolodowska-Curie Memorial Cancer Center, Warsaw, Poland; Onkotherapias Klinika, Szeged, Hungary; University Hospital Queen Joanna, Sofia, Bulgaria; University Hospital Rebro, Zagreb, Croatia
| | - S. Beslija
- Medical University of Vienna, Vienna, Austria; Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; Universitatea de Medicina, Cluj-Napoca, Romania; Tel Aviv Medical Center, Tel Aviv, Israel; Maria Skolodowska-Curie Memorial Cancer Center, Warsaw, Poland; Onkotherapias Klinika, Szeged, Hungary; University Hospital Queen Joanna, Sofia, Bulgaria; University Hospital Rebro, Zagreb, Croatia
| | - T. E. Ciuleanu
- Medical University of Vienna, Vienna, Austria; Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; Universitatea de Medicina, Cluj-Napoca, Romania; Tel Aviv Medical Center, Tel Aviv, Israel; Maria Skolodowska-Curie Memorial Cancer Center, Warsaw, Poland; Onkotherapias Klinika, Szeged, Hungary; University Hospital Queen Joanna, Sofia, Bulgaria; University Hospital Rebro, Zagreb, Croatia
| | - M. Inbar
- Medical University of Vienna, Vienna, Austria; Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; Universitatea de Medicina, Cluj-Napoca, Romania; Tel Aviv Medical Center, Tel Aviv, Israel; Maria Skolodowska-Curie Memorial Cancer Center, Warsaw, Poland; Onkotherapias Klinika, Szeged, Hungary; University Hospital Queen Joanna, Sofia, Bulgaria; University Hospital Rebro, Zagreb, Croatia
| | - M. Krzakowski
- Medical University of Vienna, Vienna, Austria; Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; Universitatea de Medicina, Cluj-Napoca, Romania; Tel Aviv Medical Center, Tel Aviv, Israel; Maria Skolodowska-Curie Memorial Cancer Center, Warsaw, Poland; Onkotherapias Klinika, Szeged, Hungary; University Hospital Queen Joanna, Sofia, Bulgaria; University Hospital Rebro, Zagreb, Croatia
| | - Z. Kahan
- Medical University of Vienna, Vienna, Austria; Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; Universitatea de Medicina, Cluj-Napoca, Romania; Tel Aviv Medical Center, Tel Aviv, Israel; Maria Skolodowska-Curie Memorial Cancer Center, Warsaw, Poland; Onkotherapias Klinika, Szeged, Hungary; University Hospital Queen Joanna, Sofia, Bulgaria; University Hospital Rebro, Zagreb, Croatia
| | - V. Tzekova
- Medical University of Vienna, Vienna, Austria; Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; Universitatea de Medicina, Cluj-Napoca, Romania; Tel Aviv Medical Center, Tel Aviv, Israel; Maria Skolodowska-Curie Memorial Cancer Center, Warsaw, Poland; Onkotherapias Klinika, Szeged, Hungary; University Hospital Queen Joanna, Sofia, Bulgaria; University Hospital Rebro, Zagreb, Croatia
| | - D. Vrbanec
- Medical University of Vienna, Vienna, Austria; Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; Universitatea de Medicina, Cluj-Napoca, Romania; Tel Aviv Medical Center, Tel Aviv, Israel; Maria Skolodowska-Curie Memorial Cancer Center, Warsaw, Poland; Onkotherapias Klinika, Szeged, Hungary; University Hospital Queen Joanna, Sofia, Bulgaria; University Hospital Rebro, Zagreb, Croatia
| | - C. C. Zielinski
- Medical University of Vienna, Vienna, Austria; Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina; Universitatea de Medicina, Cluj-Napoca, Romania; Tel Aviv Medical Center, Tel Aviv, Israel; Maria Skolodowska-Curie Memorial Cancer Center, Warsaw, Poland; Onkotherapias Klinika, Szeged, Hungary; University Hospital Queen Joanna, Sofia, Bulgaria; University Hospital Rebro, Zagreb, Croatia
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Belani CP, Brodowicz T, Ciuleanu T, Kim JH, Krzakowski M, Laack E, Wu YL, Peterson P, Krejcy K, Zielinski C. Maintenance pemetrexed (Pem) plus best supportive care (BSC) versus placebo (Plac) plus BSC: A randomized phase III study in advanced non-small cell lung cancer (NSCLC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.cra8000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
CRA8000 The full, final text of this abstract will be available in Part II of the 2009 ASCO Annual Meeting Proceedings, distributed onsite at the Meeting on May 30, 2009, and as a supplement to the June 20, 2009, issue of the Journal of Clinical Oncology. [Table: see text]
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Affiliation(s)
- C. P. Belani
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University Vienna General Hospital and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria; Medical University of
| | - T. Brodowicz
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University Vienna General Hospital and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria; Medical University of
| | - T. Ciuleanu
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University Vienna General Hospital and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria; Medical University of
| | - J. H. Kim
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University Vienna General Hospital and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria; Medical University of
| | - M. Krzakowski
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University Vienna General Hospital and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria; Medical University of
| | - E. Laack
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University Vienna General Hospital and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria; Medical University of
| | - Y. L. Wu
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University Vienna General Hospital and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria; Medical University of
| | - P. Peterson
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University Vienna General Hospital and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria; Medical University of
| | - K. Krejcy
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University Vienna General Hospital and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria; Medical University of
| | - C. Zielinski
- Penn State Hershey Cancer Institute, Hershey, PA; Medical University Vienna General Hospital and CECOG, Vienna, Austria; Oncology Institute Ion Chiricuta and CECOG, Cluj, Romania; Yonsei Cancer Center, Seoul, Republic of Korea; Centre of Oncology-Institute and CECOG, Warsaw, Poland; University Cancer Center Hamburg, Eppendorf, Germany; Guangdong Province People's Hospital, Guangzhou, China; Eli Lilly and Company, Indianapolis, IN; Eli Lilly Regional Operations, Vienna, Austria; Medical University of
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Reck M, Krzakowski M, Jassem J, Eschbach C, Kozielski J, Costanzi JJ, Gatzemeier U, Shogen K, von Pawel J. Randomized, multicenter phase III study of ranpirnase plus doxorubicin (DOX) versus DOX in patients with unresectable malignant mesothelioma (MM). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.7507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7507 Background: Ranpirnase (Onconase), a novel ribonuclease with preclinical activity against various tumors, has led to a median survival of 8.3 ms (one year survival: 42%) in a multicentre phase II trial in chemonaive and pretreated pts whom met the Cancer and Leukemia Group B (CALGB) prognostic criteria for group 1–4 (Mikulski, J Clin Oncol 20, 2001). Methods: This multicenter controlled phase III trial compared efficacy and safety of Dox (one of the most active single agents when the study was planned) with or without ranpirnase. Primary endpoint was overall survival (OS), secondary endpoints included progression-free survival, response rate, safety and disease related symptoms. Eligibility criteria: histologically proven unresectable MM; CALGB group 1–4, ECOG PS 0–1, adequate organ function. Stratification was performed according to CALGB group and histology (epitheloid vs. non-epitheloid). One line of prior therapy was permitted. Between 08/01 and 09/07 413 eligible pts were randomized to DOX 60 mg/m2 every 3 wks with or without ranpirnase 240 μg/m2 weekly (cycle 1) and 480 μg/m2 in subsequent cycles (maximum 6) if no severe toxicity had occurred. The study was designed to detect an increase of 4 ms (9 vs. 13) in median OS (MST) using a two-sided logrank test (α = 5%) with 90% power. Results: Both arms were well balanced (DOX + ranpirnase / DOX: 203/210 pts): Mean age 62.2/61.8 yrs; males 157/156; PS 0 52/60; PS 1 151/150; prior chemo 65/65 pts (pemetrexed 35/35; other chemo 30/30). CALGB groups 14/14 (1), 45/51 (2), 117/115 (3), 27/30 (4). In the intent to treat population (ITT) there was no significant difference in OS (MST: 11.1 vs 10.7 ms; HR 1.02, 95% CI 0.82–1.26) whilst in a preplanned analysis including 130 pretreated patients a significant advantage in survival in favor of DOX + ranpirnase was found (MST: 10.5 vs 9 ms; HR 1.49, 95% CI 1.02–2.17). The safety profile for both treatment arms was similar. Most frequent side effects reported for both treatment groups included nausea, fatigue and alopecia. Conclusions: Combination of ranpirnase and DOX is a safe and feasible treatment in unresectable MM and showed a significant impact on survival of pretreated patients compared to DOX alone. [Table: see text]
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Affiliation(s)
- M. Reck
- Hospital Grosshansdorf, Grosshansdorf, Germany; Institute of Oncology, Warsaw, Poland; Medical University, Gdansk, Poland; Asklepios Klinikum Harburg, Hamburg, Germany; Medical University, Zabrze, Poland; Lone Star Oncology Consultants, Austin, TX; Alfacell, Somerset, NY; Asklepios Klinikum Gauting, Gauting, Germany
| | - M. Krzakowski
- Hospital Grosshansdorf, Grosshansdorf, Germany; Institute of Oncology, Warsaw, Poland; Medical University, Gdansk, Poland; Asklepios Klinikum Harburg, Hamburg, Germany; Medical University, Zabrze, Poland; Lone Star Oncology Consultants, Austin, TX; Alfacell, Somerset, NY; Asklepios Klinikum Gauting, Gauting, Germany
| | - J. Jassem
- Hospital Grosshansdorf, Grosshansdorf, Germany; Institute of Oncology, Warsaw, Poland; Medical University, Gdansk, Poland; Asklepios Klinikum Harburg, Hamburg, Germany; Medical University, Zabrze, Poland; Lone Star Oncology Consultants, Austin, TX; Alfacell, Somerset, NY; Asklepios Klinikum Gauting, Gauting, Germany
| | - C. Eschbach
- Hospital Grosshansdorf, Grosshansdorf, Germany; Institute of Oncology, Warsaw, Poland; Medical University, Gdansk, Poland; Asklepios Klinikum Harburg, Hamburg, Germany; Medical University, Zabrze, Poland; Lone Star Oncology Consultants, Austin, TX; Alfacell, Somerset, NY; Asklepios Klinikum Gauting, Gauting, Germany
| | - J. Kozielski
- Hospital Grosshansdorf, Grosshansdorf, Germany; Institute of Oncology, Warsaw, Poland; Medical University, Gdansk, Poland; Asklepios Klinikum Harburg, Hamburg, Germany; Medical University, Zabrze, Poland; Lone Star Oncology Consultants, Austin, TX; Alfacell, Somerset, NY; Asklepios Klinikum Gauting, Gauting, Germany
| | - J. J. Costanzi
- Hospital Grosshansdorf, Grosshansdorf, Germany; Institute of Oncology, Warsaw, Poland; Medical University, Gdansk, Poland; Asklepios Klinikum Harburg, Hamburg, Germany; Medical University, Zabrze, Poland; Lone Star Oncology Consultants, Austin, TX; Alfacell, Somerset, NY; Asklepios Klinikum Gauting, Gauting, Germany
| | - U. Gatzemeier
- Hospital Grosshansdorf, Grosshansdorf, Germany; Institute of Oncology, Warsaw, Poland; Medical University, Gdansk, Poland; Asklepios Klinikum Harburg, Hamburg, Germany; Medical University, Zabrze, Poland; Lone Star Oncology Consultants, Austin, TX; Alfacell, Somerset, NY; Asklepios Klinikum Gauting, Gauting, Germany
| | - K. Shogen
- Hospital Grosshansdorf, Grosshansdorf, Germany; Institute of Oncology, Warsaw, Poland; Medical University, Gdansk, Poland; Asklepios Klinikum Harburg, Hamburg, Germany; Medical University, Zabrze, Poland; Lone Star Oncology Consultants, Austin, TX; Alfacell, Somerset, NY; Asklepios Klinikum Gauting, Gauting, Germany
| | - J. von Pawel
- Hospital Grosshansdorf, Grosshansdorf, Germany; Institute of Oncology, Warsaw, Poland; Medical University, Gdansk, Poland; Asklepios Klinikum Harburg, Hamburg, Germany; Medical University, Zabrze, Poland; Lone Star Oncology Consultants, Austin, TX; Alfacell, Somerset, NY; Asklepios Klinikum Gauting, Gauting, Germany
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Krzakowski M. Epoetin delta: efficacy in the treatment of anaemia in cancer patients receiving chemotherapy. Clin Oncol (R Coll Radiol) 2008; 20:705-13. [PMID: 18691854 DOI: 10.1016/j.clon.2008.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Revised: 05/08/2008] [Accepted: 06/02/2008] [Indexed: 11/20/2022]
Abstract
AIMS To assess the effect of epoetin delta on anaemia in patients with cancer who were receiving chemotherapy. MATERIALS AND METHODS This report includes data from two 12-week studies of epoetin delta: a randomised, double-blind, placebo-controlled study of three times weekly epoetin delta (150 or 300IU/kg) and an open-label extension collecting further efficacy and safety information, in which patients initially received epoetin delta 150IU/kg. Co-primary end points for the double-blind study were an increase in haemoglobin levels and a reduction in the requirement for red blood cell transfusions compared with placebo. RESULTS Double-blind study: 313 cancer patients were randomised to epoetin delta or placebo. Epoetin delta was associated with a significantly greater increase in haemoglobin levels from baseline compared with placebo (epoetin delta 150 and 300IU/kg vs placebo: 2.5 and 2.5g/dl vs 0.6g/dl; P<0.0001 for both comparisons), meeting one co-primary end point. However, there were no significant differences between groups in the proportion of patients requiring red blood cell transfusions (epoetin delta 150 and 300IU/kg vs placebo: 26.0 and 21.9% vs 26.9%), the second co-primary end point. Open-label study: 149 patients entered the extension study. During the extension, haemoglobin levels were maintained and a higher proportion of patients who previously received placebo required transfusions than those who had previously received epoetin delta (previous epoetin delta 150 and 300IU/kg: 7.1 and 11.4% vs previous placebo: 15.9%). Adverse events were as expected for this population in both studies. CONCLUSION Epoetin delta shows potential as a treatment for anaemia in cancer patients receiving chemotherapy.
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Affiliation(s)
- M Krzakowski
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warszawa, Poland.
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Pirker R, Szczesna A, von Pawel J, Krzakowski M, Ramlau R, Park K, Gatzemeier U, Bajeta E, Emig M, Pereira JR. FLEX: A randomized, multicenter, phase III study of cetuximab in combination with cisplatin/vinorelbine (CV) versus CV alone in the first-line treatment of patients with advanced non-small cell lung cancer (NSCLC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.3] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ciuleanu TE, Brodowicz T, Belani CP, Kim J, Krzakowski M, Laack E, Wu Y, Peterson P, Adachi S, Zielinski CC. Maintenance pemetrexed plus best supportive care (BSC) versus placebo plus BSC: A phase III study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8011] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kowalski DM, Krzakowski M, Jaskiewicz P, Janowicz-Zebrowska A, Glogowski M. EGFR tyrosine kinase inhibitors in the treatment of advanced non-small cell lung cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.19117] [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: 11/20/2022] Open
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Smit E, Reck M, Krzakowski M, Gridelli C, Curescu S, Berzinec P, Barata F, McDermott R, Jovanovic D, Magyar P. 6510 ORAL Erlotinib in patients with advanced non-small-cell lung cancer (NSCLC): interim results from the European subpopulation of the open-label TRUST study. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71338-1] [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: 11/30/2022] Open
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Nawrocki S, Krzakowski M, Wasilewska-Teńluk E, Kowalski D. Palliative radiotherapy versus palliative chemoradiotherapy in treatment of NSCLC stage IIIA and IIIB: Phase II randomized trial. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18128 Background: The optimal treatment for stage IIIA/IIIB NSCLC patients who do not qualify for radical treatment has not been identified. Different palliative radiotherapy regimens and chemotherapy are used but have not been compared. We decided to combine short chemotherapy and radiotherapy (CT-RT) in order to improve therapeutic index of radiotherapy (RT). Methods: Eligibility criteria: Locally advanced, inoperable patients (pts) in IIIA (N2 positive) -IIIB clinical stage with tumor larger than 8 cm in longest diameter or/and FEV1 smaller than 40%, PS: 0–2 (ECOG), non-eligible for radical CT-RT. Treatment: RT arm - 3-D radiotherapy, 30 Gy/3 Gy, 2 weeks. CT-RT arm - two cycles of CT (cisplatin: 80 mg/m2; d 1, 22; vinorelbine: 25 mg/m2 iv; d 1,8,22,29) followed by RT as in Arm 1 with concurrent third cycle of CT (cisplatin 80 mg/m2, d 43; vinorelbine 25 mg/m2 iv., d 43, 50). Study design: Phase II, two-center, randomized study, stratification IIIA vs. IIIB, PS 0–1 vs. 2, treating center (Warsaw vs. Olsztyn). Two-stage design, a and β errors = 0,1; p1 minus p0 = 0,20. Planned sample size - 46 pts/arm. Primary endpoint: response rate (RECIST). Secondary end-points: overall survival (OS), toxicity, progression free survival (PFS). Results: During 2 years 104 pts randomized, 98 eligible for toxicity and survival/progression analysis, 82 for response assessment. Demographics: median age - 65 (45–78), IIIA/IIIB: 27/71 pts. PS 0–1/2: 72/26. Well balanced between arms. Response rate: RT arm- 26%, CT-RT arm- 46%, median OS for RT arm - 195 days, CT-RT arm 2 - 385 days, log-rank test p=0,047, median PFS for RT arm - 140 days, CT-RT arm - 172 days, log-rank test p=0,16. Toxicity: deaths - 2 in RT arm, 2 in CT-RT arm; hematological G3–4 - 0 in RT arm, Arm CT- RT: anemia - 2, thrombocytopenia - 6, neutropenia - 11, esophagitis - 2. Other G3–4: RT arm -3, CT-RT arm -1. Conclusions: Palliative radiotherapy (30Gy) with chemotherapy postponed to progression is a suboptimal treatment for patients with locally advanced NSCLC. 2 cycles of cisplatin/vinorelbine plus RT concomitantly with 3 cycle increases clinical response rate and significantly prolongs survival at the cost of acceptable toxicity in palliative setting. No significant financial relationships to disclose.
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Affiliation(s)
- S. Nawrocki
- ZOZ MSWiA z Warmiśsko-Mazurskim Centrum Onkol, Olsztyn, Poland; CO-I im. M. Sklodowskiej-Curie, Warszawa, Poland
| | - M. Krzakowski
- ZOZ MSWiA z Warmiśsko-Mazurskim Centrum Onkol, Olsztyn, Poland; CO-I im. M. Sklodowskiej-Curie, Warszawa, Poland
| | - E. Wasilewska-Teńluk
- ZOZ MSWiA z Warmiśsko-Mazurskim Centrum Onkol, Olsztyn, Poland; CO-I im. M. Sklodowskiej-Curie, Warszawa, Poland
| | - D. Kowalski
- ZOZ MSWiA z Warmiśsko-Mazurskim Centrum Onkol, Olsztyn, Poland; CO-I im. M. Sklodowskiej-Curie, Warszawa, Poland
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Gatzemeier U, Ardizzoni A, Horwood K, van Meerbeeck J, Magyar P, Gottfried M, Arrieta O, Krzakowski M, Franke F, van Zandwijk N. Erlotinib in non-small cell lung cancer (NSCLC): Interim safety analysis of the TRUST study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7645] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7645 Background: In patients (pts) with relapsed NSCLC, erlotinib 150 mg/d significantly prolonged survival, delayed symptom progression, and improved quality of life versus placebo (Shepherd et al, N Engl J Med 2005;353:123–32). TRUST is an open label, non- randomized trial initiated to provide erlotinib access to pts with advanced NSCLC. Methods: Eligible pts had stage IIIb/IV NSCLC, and had failed or were unsuitable for chemotherapy. Erlotinib (150 mg/d p.o.) was given until disease progression or unacceptable toxicity. Pts were monitored monthly. Results: In November 2006, data were available for 5,015 pts (ITT population) from 51 countries. Median age was 63y (range 19–95). Pt characteristics (%) were: male/female 62/38; Caucasian/Oriental/other 76/19/5; non-smoker/ex- or current-smoker 28/71 (no data 1); ECOG PS 0/1/2/3 21/53/20/6; adenocarcinoma/squamous cell/other 53/25/21; stage IIIb/IV 22/78; erlotinib 1st/2nd/3rd-line/other 14/48/37/1. Safety data were available for 4,423 pts, 55% of whom had at least one adverse event (AE). Only 5% had one or more erlotinib- related serious AEs, the most common being gastrointestinal (GI) disorders (86 pts; 63 grade [gr] 3/4). 6% of pts discontinued treatment due to erlotinib-related AEs: GI disorders in 96 pts (54 gr 3/4), skin disorders in 92 (50 gr 3/4). Unexpected erlotinib-related AEs occurred in 10% of pts (4% gr 1, 3% gr 2, 3% gr 3/4). As expected, rash was observed in 70% of pts, with the majority (84%) being of gr 1/2. 80% pts received >4 weeks of erlotinib. Among 4,405 pts, only 14% had dose reductions, mainly due to rash (83%) and diarrhea (21%). Similar safety results were seen for 2nd-line pts only. Efficacy for all and 2nd-line pts will be presented. Conclusions: These results, achieved through routine clinical use of erlotinib in unselected pts with advanced NSCLC, confirm the favorable tolerability profile seen with erlotinib in selected patients in the clinical trial setting. [Table: see text]
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Affiliation(s)
- U. Gatzemeier
- Hospital Grosshansdorf, Grosshansdorf, Germany; University Hospital, Parma, Italy; John Flynn-Gold Coast Private Hospital, Tugun, Queensland, Australia; University Hospital, Ghent, Belgium; Semmelweis University of Medicine, Budapest, Hungary; Meir-Sapir Medical Center, Kfar Saba, Israel; Instituto Nacional de Cancerología, Mexico City, Mexico; Centrum Onkologii Instytut, Warsaw, Poland; Hospital de Caridade de Ijui, Ijui, Brazil; Netherlands Cancer Inst/Antoni van Leeuwenhoe Hosp, Amsterdam, The
| | - A. Ardizzoni
- Hospital Grosshansdorf, Grosshansdorf, Germany; University Hospital, Parma, Italy; John Flynn-Gold Coast Private Hospital, Tugun, Queensland, Australia; University Hospital, Ghent, Belgium; Semmelweis University of Medicine, Budapest, Hungary; Meir-Sapir Medical Center, Kfar Saba, Israel; Instituto Nacional de Cancerología, Mexico City, Mexico; Centrum Onkologii Instytut, Warsaw, Poland; Hospital de Caridade de Ijui, Ijui, Brazil; Netherlands Cancer Inst/Antoni van Leeuwenhoe Hosp, Amsterdam, The
| | - K. Horwood
- Hospital Grosshansdorf, Grosshansdorf, Germany; University Hospital, Parma, Italy; John Flynn-Gold Coast Private Hospital, Tugun, Queensland, Australia; University Hospital, Ghent, Belgium; Semmelweis University of Medicine, Budapest, Hungary; Meir-Sapir Medical Center, Kfar Saba, Israel; Instituto Nacional de Cancerología, Mexico City, Mexico; Centrum Onkologii Instytut, Warsaw, Poland; Hospital de Caridade de Ijui, Ijui, Brazil; Netherlands Cancer Inst/Antoni van Leeuwenhoe Hosp, Amsterdam, The
| | - J. van Meerbeeck
- Hospital Grosshansdorf, Grosshansdorf, Germany; University Hospital, Parma, Italy; John Flynn-Gold Coast Private Hospital, Tugun, Queensland, Australia; University Hospital, Ghent, Belgium; Semmelweis University of Medicine, Budapest, Hungary; Meir-Sapir Medical Center, Kfar Saba, Israel; Instituto Nacional de Cancerología, Mexico City, Mexico; Centrum Onkologii Instytut, Warsaw, Poland; Hospital de Caridade de Ijui, Ijui, Brazil; Netherlands Cancer Inst/Antoni van Leeuwenhoe Hosp, Amsterdam, The
| | - P. Magyar
- Hospital Grosshansdorf, Grosshansdorf, Germany; University Hospital, Parma, Italy; John Flynn-Gold Coast Private Hospital, Tugun, Queensland, Australia; University Hospital, Ghent, Belgium; Semmelweis University of Medicine, Budapest, Hungary; Meir-Sapir Medical Center, Kfar Saba, Israel; Instituto Nacional de Cancerología, Mexico City, Mexico; Centrum Onkologii Instytut, Warsaw, Poland; Hospital de Caridade de Ijui, Ijui, Brazil; Netherlands Cancer Inst/Antoni van Leeuwenhoe Hosp, Amsterdam, The
| | - M. Gottfried
- Hospital Grosshansdorf, Grosshansdorf, Germany; University Hospital, Parma, Italy; John Flynn-Gold Coast Private Hospital, Tugun, Queensland, Australia; University Hospital, Ghent, Belgium; Semmelweis University of Medicine, Budapest, Hungary; Meir-Sapir Medical Center, Kfar Saba, Israel; Instituto Nacional de Cancerología, Mexico City, Mexico; Centrum Onkologii Instytut, Warsaw, Poland; Hospital de Caridade de Ijui, Ijui, Brazil; Netherlands Cancer Inst/Antoni van Leeuwenhoe Hosp, Amsterdam, The
| | - O. Arrieta
- Hospital Grosshansdorf, Grosshansdorf, Germany; University Hospital, Parma, Italy; John Flynn-Gold Coast Private Hospital, Tugun, Queensland, Australia; University Hospital, Ghent, Belgium; Semmelweis University of Medicine, Budapest, Hungary; Meir-Sapir Medical Center, Kfar Saba, Israel; Instituto Nacional de Cancerología, Mexico City, Mexico; Centrum Onkologii Instytut, Warsaw, Poland; Hospital de Caridade de Ijui, Ijui, Brazil; Netherlands Cancer Inst/Antoni van Leeuwenhoe Hosp, Amsterdam, The
| | - M. Krzakowski
- Hospital Grosshansdorf, Grosshansdorf, Germany; University Hospital, Parma, Italy; John Flynn-Gold Coast Private Hospital, Tugun, Queensland, Australia; University Hospital, Ghent, Belgium; Semmelweis University of Medicine, Budapest, Hungary; Meir-Sapir Medical Center, Kfar Saba, Israel; Instituto Nacional de Cancerología, Mexico City, Mexico; Centrum Onkologii Instytut, Warsaw, Poland; Hospital de Caridade de Ijui, Ijui, Brazil; Netherlands Cancer Inst/Antoni van Leeuwenhoe Hosp, Amsterdam, The
| | - F. Franke
- Hospital Grosshansdorf, Grosshansdorf, Germany; University Hospital, Parma, Italy; John Flynn-Gold Coast Private Hospital, Tugun, Queensland, Australia; University Hospital, Ghent, Belgium; Semmelweis University of Medicine, Budapest, Hungary; Meir-Sapir Medical Center, Kfar Saba, Israel; Instituto Nacional de Cancerología, Mexico City, Mexico; Centrum Onkologii Instytut, Warsaw, Poland; Hospital de Caridade de Ijui, Ijui, Brazil; Netherlands Cancer Inst/Antoni van Leeuwenhoe Hosp, Amsterdam, The
| | - N. van Zandwijk
- Hospital Grosshansdorf, Grosshansdorf, Germany; University Hospital, Parma, Italy; John Flynn-Gold Coast Private Hospital, Tugun, Queensland, Australia; University Hospital, Ghent, Belgium; Semmelweis University of Medicine, Budapest, Hungary; Meir-Sapir Medical Center, Kfar Saba, Israel; Instituto Nacional de Cancerología, Mexico City, Mexico; Centrum Onkologii Instytut, Warsaw, Poland; Hospital de Caridade de Ijui, Ijui, Brazil; Netherlands Cancer Inst/Antoni van Leeuwenhoe Hosp, Amsterdam, The
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