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Karapetis CS, Liu H, Sorich MJ, Pederson LD, Van Cutsem E, Maughan T, Douillard JY, O'Callaghan CJ, Jonker D, Bokemeyer C, Sobrero A, Cremolini C, Chibaudel B, Zalcberg J, Adams R, Buyse M, Peeters M, Yoshino T, de Gramont A, Shi Q. Fluoropyrimidine type, patient age, tumour sidedness and mutation status as determinants of benefit in patients with metastatic colorectal cancer treated with EGFR monoclonal antibodies: individual patient data pooled analysis of randomised trials from the ARCAD database. Br J Cancer 2024; 130:1269-1278. [PMID: 38402342 PMCID: PMC11015038 DOI: 10.1038/s41416-024-02604-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND KRAS mutations in metastatic colorectal cancer (mCRC) are used as predictive biomarkers to select therapy with EGFR monoclonal antibodies (mAbs). Other factors may be significant determinants of benefit. METHODS Individual patient data from randomised trials with a head-to-head comparison between EGFR mAb versus no EGFR mAb (chemotherapy alone or best supportive care) in mCRC, across all lines of therapy, were pooled. Overall survival (OS) and progression-free survival (PFS) were compared between groups. Treatment effects within the predefined KRAS biomarker subsets were estimated by adjusted hazard ratio (HRadj) and 95% confidence interval (CI). EGFR mAb efficacy was measured within the KRAS wild-type subgroup according to BRAF and NRAS mutation status. In both KRAS wild-type and mutant subgroups, additional factors that could impact EGFR mAb efficacy were explored including the type of chemotherapy, line of therapy, age, sex, tumour sidedness and site of metastasis. RESULTS 5675 patients from 8 studies were included, all with known mCRC KRAS mutation status. OS (HRadj 0.90, 95% CI 0.84-0.98, p = 0.01) and PFS benefit (HRadj 0.73, 95% CI 0.68-0.79, p < 0.001) from EGFR mAbs was observed in the KRAS wild-type group. PFS benefit was seen in patients treated with fluorouracil (HRadj 0.75, 95% CI 0.68-0.82) but not with capecitabine-containing regimens (HRadj 1.04, 95% CI 0.86-1.26) (pinteraction = 0.002). Sidedness also interacted with EGFR mAb efficacy, with survival benefit restricted to left-sided disease (pinteraction = 0.038). PFS benefits differed according to age, with benefits greater in those under 70 (pinteraction = 0.001). The survival benefit was not demonstrated in those patients with mutations found in the KRAS, NRAS or BRAF genes. The presence of liver metastases interacted with EGFR mAb efficacy in patients with KRAS mutant mCRC (pinteraction = 0.004). CONCLUSION The benefit provided by EGFR mAbs in KRAS WT mCRC is associated with left-sided primary tumour location, younger patient age and absence of NRAS or BRAF mutations. Survival benefit is observed with fluorouracil but not capecitabine. Exploratory results support further research in KRAS mutant mCRC without liver metastases.
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Affiliation(s)
- C S Karapetis
- Flinders Medical Centre, Adelaide, SA, Australia.
- Flinders University, Adelaide, SA, Australia.
| | - H Liu
- Mayo Clinic, Rochester, NY, USA
| | - M J Sorich
- Flinders University, Adelaide, SA, Australia
| | | | - E Van Cutsem
- University Hospitals Gasthuisberg Leuven and University of Leuven, Leuven, Belgium
| | - T Maughan
- University of Liverpool, Liverpool, UK
| | - J Y Douillard
- University of Nantes and Integrated Centers of Oncology ICO Rene Gauducheau Cancer Nantes, Nantes, France
| | | | - D Jonker
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - C Bokemeyer
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - B Chibaudel
- Franco-British Institute Levallois-Perre, Levallois-Perre, France
| | - J Zalcberg
- Dept of Medical Oncology, Alfred Health and School of Public Health, Monash University, Melbourne, VIC, Australia
| | - R Adams
- Velindre Cancer Centre Cardiff University, Cardiff, UK
| | - M Buyse
- International Drug Development Institute, Louvain-la-Neuve, Belgium
| | - M Peeters
- Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - T Yoshino
- National Cancer Centre Hospital East, Kashiwa, Japan
| | - A de Gramont
- Franco-British Institute Levallois-Perre, Levallois-Perre, France
| | - Q Shi
- Mayo Clinic, Rochester, NY, USA
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Ramel S, Gueganton L, Nowak E, Bihan JL, Arnouat B, Belleguic C, Danner-Boucher I, Mankikian J, Payet A, Urban T, Buyse M, Hubeaux K. Sexual dysfunction in cystic fibrosis. J Cyst Fibros 2024:S1569-1993(24)00056-0. [PMID: 38688746 DOI: 10.1016/j.jcf.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/15/2024] [Accepted: 04/20/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Sexual dysfunction (erectile dysfunction in males, sexual dissatisfaction, sexual interest/arousal disorders, and dyspareunia in females) has not been the subject of indepth research in people with cystic fibrosis (CF). This study aimed to determine the prevalence of sexual dysfunction in adults with CF, factors associated with sexual dysfunction, and the impact of sexual dysfunction on quality of life. METHOD We conducted a multicentre study in adults with cystic fibrosis followed in specialist centres in Western France. We assessed erectile dysfunction and its severity using the IIEF5 self-questionnaire (International Index of Erectile Function); the FSFI (Female Sexual Function Index) was used to assess sexual function in females, and we evaluated quality of life in both sexes using the CFQ-R14+ questionnaire. RESULTS In total, 77 males and 74 females completed the sexual function questionnaire (mean age 32+/- 10 and 25+/- 8,5 years respectively). Among them, 21 % of males and 30 % of females reported sexual dysfunction. CFQ-R14+ score was significantly lower in males with erectile dysfunction than those without (p < 0.001). Faecal incontinence was associated with more frequent sexual dysfunction in females and higher severity of erectile dysfunction in males. CONCLUSION The prevalence of sexual disorders is relatively high in males and females with cystic fibrosis. Therefore, it seems important to train specialist teams to address the issue of sexuality without embarrassment, and to encourage them to seek out and treat faecal incontinence, which is associated with greater severity or frequency of these symptoms.
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Affiliation(s)
- Sophie Ramel
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France.
| | - Laetitia Gueganton
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Emmanuel Nowak
- Direction de la Recherche Clinique et de l'Innovation (DRCI), CHU de Brest, Brest, France & Centre d'Investigation Clinique, INSERM CIC 1412, CHU de Brest, Brest, France
| | - Jean Le Bihan
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Baptiste Arnouat
- Dept of Respiratory Medicine, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Chantal Belleguic
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, F-35033, Rennes, France
| | - Isabelle Danner-Boucher
- Service de Pneumologie, L'Institut Du Thorax, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Julie Mankikian
- Service de pneumologie et d'explorations fonctionnelles respiratoires, CHU, hôpital Bretonneau, Tours, France
| | - Annabelle Payet
- Service de Pneumologie, CHU La Réunion Site Sud Réunion, Saint Pierre, Réunion, France
| | - Thierry Urban
- Département de Pneumologie, CHU d'Angers, Angers, France
| | - Marion Buyse
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Katelyne Hubeaux
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France; Service d'explorations fonctionnelles, Fondation Ildys, Roscoff, France
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Xie W, Ravi P, Buyse M, Halabi S, Kantoff P, Sartor O, Soule H, Clarke N, Dignam J, James N, Fizazi K, Gillessen S, Mottet N, Murphy L, Parulekar W, Sandler H, Tombal B, Williams S, Sweeney CJ. Validation of metastasis-free survival as a surrogate endpoint for overall survival in localized prostate cancer in the era of docetaxel for castration-resistant prostate cancer. Ann Oncol 2024; 35:285-292. [PMID: 38061427 PMCID: PMC10922430 DOI: 10.1016/j.annonc.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/20/2023] [Accepted: 11/29/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Prior work from the Intermediate Clinical Endpoints in Cancer of the Prostate (ICECaP) consortium (ICECaP-1) demonstrated that metastasis-free survival (MFS) is a valid surrogate for overall survival (OS) in localized prostate cancer (PCa). This was based on data from patients treated predominantly before 2004, prior to docetaxel being available for the treatment of metastatic castrate-resistant prostate cancer (mCRPC). We sought to validate surrogacy in a more contemporary era (ICECaP-2) with greater availability of docetaxel and other systemic therapies for mCRPC. PATIENTS AND METHODS Eligible trials for ICECaP-2 were those providing individual patient data (IPD) after publication of ICECaP-1 and evaluating adjuvant/salvage therapy for localized PCa, and which collected MFS and OS data. MFS was defined as distant metastases or death from any cause, and OS was defined as death from any cause. Surrogacy was evaluated using a meta-analytic two-stage validation model, with an R2 ≥ 0.7 defined a priori as clinically relevant. RESULTS A total of 15 164 IPD from 14 trials were included in ICECaP-2, with 70% of patients treated after 2004. The median follow-up was 8.3 years and the median postmetastasis survival was 3.1 years in ICECaP-2, compared with 1.9 years in ICECaP-1. For surrogacy condition 1, Kendall's tau was 0.92 for MFS with OS at the patient level, and R2 from weighted linear regression (WLR) of 8-year OS on 5-year MFS was 0.73 (95% confidence interval 0.53-0.82) at the trial level. For condition 2, R2 was 0.83 (95% confidence interval 0.64-0.89) from WLR of log[hazard ratio (HR)]-OS on log(HR)-MFS. The surrogate threshold effect on OS was an HR(MFS) of 0.81. CONCLUSIONS MFS remained a valid surrogate for OS in a more contemporary era, where patients had greater access to docetaxel and other systemic therapies for mCRPC. This supports the use of MFS as the primary outcome measure for ongoing adjuvant trials in localized PCa.
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Affiliation(s)
- W Xie
- Dana-Farber Cancer Institute, Boston, USA
| | - P Ravi
- Dana-Farber Cancer Institute, Boston, USA
| | - M Buyse
- International Drug Development Institute, Louvain-la-Neuve; I-BioStat, Hasselt University, Hasselt, Belgium
| | | | | | | | - H Soule
- Prostate Cancer Foundation, Santa Monica, USA
| | - N Clarke
- The Christie NHS Foundation Trust, Manchester, UK
| | - J Dignam
- University of Chicago, Chicago, USA
| | - N James
- The Institute of Cancer Research & The Royal Marsden NHS Foundation Trust, London, UK
| | - K Fizazi
- Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - S Gillessen
- Oncology Institute of Southern Switzerland, EOC, Bellinzona; Università della Svizzera Italiana, Lugano, Switzerland
| | - N Mottet
- Mutualite Francoise Loire, St Etienne, France
| | - L Murphy
- Medical Research Council at UCL, London, UK
| | - W Parulekar
- Queens University, Kingston, Ontario, Canada
| | - H Sandler
- Cedars-Sinai Medical Center, Los Angeles, USA
| | - B Tombal
- Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - S Williams
- Peter MacCallum Cancer Centre, Melbourne
| | - C J Sweeney
- South Australian Immunogenomics Cancer Institute, University of Adelaide, Adelaide, Australia.
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Hubeaux K, Gueganton L, Nowak E, Arnouat B, Belleguic C, Danner-Boucher I, Mankikian J, Payet A, Urban T, Buyse M, Ramel S. Prevalence and severity of functional urinary and anorectal disorders and their impact on quality of life in cystic fibrosis. J Cyst Fibros 2023:S1569-1993(23)01659-4. [PMID: 37907384 DOI: 10.1016/j.jcf.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/08/2023] [Accepted: 10/14/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND In cystic fibrosis (CF), coughing is associated with a risk of pelvic floor dysfunction. However, data on the prevalence of symptoms (stress urinary incontinence, bladder overactivity, dysuria, and faecal incontinence) are lacking in males and females with CF. The impact of incontinence on adherence to respiratory care has not been studied. METHODS We conducted a multicentre study in adults with CF followed in the North-West French CF network. Urinary disorders and their severity were assessed using the Urinary Symptom Profile (USP) self-report questionnaire; the impact of urinary disorders on general quality of life was measured using the SF-Qualiveen questionnaire; faecal incontinence was assessed using the Wexner self-report questionnaire; and the CFQ-R14+ questionnaire was used to assess quality of life. A self-administered questionnaire developed for the study assessed the impact of symptoms on respiratory care. RESULTS Of the 178 people with CF included, 34 % reported stress urinary incontinence, with a large female predominance (63.5 % of females vs. 7.5 % of males), 65 % bladder overactivity (including 16 % urge incontinence) and 50 % faecal incontinence, also with a female predominance. Neither urinary nor faecal incontinence were related to the severity of the respiratory impairment (FEV1). Quality of life was particularly affected in women. Stress urinary Incontinence symptoms affected respiratory care in both sexes. CONCLUSION The prevalence of functional urinary and faecal disorders was high in adults with CF and impacted on quality of life and respiratory care. Therefore, multidisciplinary teams must have knowledge of symptoms, the diagnostic tools and management strategies to provide specific treatment.
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Affiliation(s)
- Katelyne Hubeaux
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Laetitia Gueganton
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Emmanuel Nowak
- Direction de la Recherche Clinique et de l'Innovation (DRCI), CHU de Brest, Brest, France & Centre d'Investigation Clinique, INSERM CIC 1412, CHU de Brest, Brest, France
| | - Baptiste Arnouat
- Dept of Respiratory Medicine, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Chantal Belleguic
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, Rennes F-35033, France
| | - Isabelle Danner-Boucher
- Service de Pneumologie, L'Institut Du Thorax, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Julie Mankikian
- Service de pneumologie et d'explorations fonctionnelles respiratoires, CHU, hôpital Bretonneau, Tours, France
| | - Annabelle Payet
- Service de Pneumologie, CHU La Réunion Site Sud Réunion, Saint Pierre, Réunion, France
| | - Thierry Urban
- Département de Pneumologie, CHU d'Angers, Angers, France
| | - Marion Buyse
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Sophie Ramel
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France.
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Martin M, Holmes F, Moy B, Mansi J, Gnant M, Buyse M, Barrios C, Bryce R, Wong A, Chan A. Continued efficacy of neratinib in patients with HER2-positive (HER2+) early-stage breast cancer: final overall survival (OS) analysis from the randomized phase 3 ExteNET trial. Breast 2021. [PMID: 33183970 DOI: 10.1016/s0960-9776(21)00093-x] [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: 12/17/2022] Open
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Malorni L, Curigliano G, Minisini AM, Cinieri S, Tondini CA, D'Hollander K, Arpino G, Bernardo A, Martignetti A, Criscitiello C, Puglisi F, Pestrin M, Sanna G, Moretti E, Risi E, Biagioni C, McCartney A, Boni L, Buyse M, Migliaccio I, Biganzoli L, Di Leo A. Palbociclib as single agent or in combination with the endocrine therapy received before disease progression for estrogen receptor-positive, HER2-negative metastatic breast cancer: TREnd trial. Ann Oncol 2019; 29:1748-1754. [PMID: 29893790 DOI: 10.1093/annonc/mdy214] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background The activity of palbociclib as a single agent in advanced breast cancer has not been extensively studied, with the only available clinical data limited to heavily pretreated patients. Preclinical data suggests palbociclib may partially reverse endocrine resistance, though this hypothesis has not been evaluated in previous clinical studies. This phase II, open-label, multicenter study examined the activity of palbociclib monotherapy, as well as palbociclib given in combination with the same endocrine therapy (ET) that was received prior to disease progression, in postmenopausal women with moderately pretreated, estrogen receptor-positive, HER2 negative advanced breast cancer. Patients and methods Eligible women with advanced disease which had progressed on one or two prior ETs were randomized 1 : 1 to receive either palbociclib alone, or palbociclib in combination with the ET as previously received. Primary end point was clinical benefit rate (CBR); secondary end points included progression-free survival (PFS). Results Between October 2012 and July 2016, a total of 115 patients were randomized. The CBR was 54% [95% confidence interval (CI): 41.5-63.7] for combination therapy, and 60% (95% CI: 47.8-72.9) for monotherapy. Median PFS was 10.8 months (95% CI: 5.6-12.7) for combination therapy, and 6.5 months (95% CI: 5.4-8.5) for monotherapy [hazard ratio (HR) 0.69; 95% CI: 0.4-1.1, exploratory P-value = 0.12]. Exploratory analyses revealed the PFS advantage for combination therapy was seen in the subgroup of patients who received prior ET for >6 months (HR 0.53; 95% CI: 0.3-0.9, exploratory P-value = 0.02), but not in those who received prior ET for ≤6 months. Conclusion Palbociclib has clinical activity as a single agent in women with moderately pretreated, oestrogen receptor-positive, HER2-negative advanced breast cancer. Palbociclib may have potential to reverse endocrine resistance in patients with a history of previous durable response to ET. Clinical trial information NCT02549430.
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Affiliation(s)
- L Malorni
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy.
| | - G Curigliano
- Division of Early Drug Development, Department of Haematology and Haemato-Oncology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - A M Minisini
- Department of Oncology, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - S Cinieri
- Medical Oncology Department, ASL Brindisi, Brindisi, Italy
| | - C A Tondini
- Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - K D'Hollander
- International Drug Development Institute, Louvain-La-Neuve, Belgium
| | - G Arpino
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples
| | - A Bernardo
- Medical Oncology Department, ICS Maugeri IRCCS, Pavia, Italy
| | - A Martignetti
- Oncology Department, Azienda USL Toscana Sud Est, Hospital Alta Val D'Elsa, Poggibonsi Siena, Italy
| | - C Criscitiello
- Division of Early Drug Development, Istituto Europeo di Oncologia, Milan, Italy
| | - F Puglisi
- Medical Oncology and Cancer Prevention Unit, IRCCS, CRO National Cancer Institute, Aviano; Department of Medicine, University of Udine, Udine, Italy
| | - M Pestrin
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - G Sanna
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - E Moretti
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - E Risi
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - C Biagioni
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - A McCartney
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - L Boni
- Clinical Trial Coordinating Center, AOU Careggi, Istituto Toscano Tumori, Florence, Italy
| | - M Buyse
- International Drug Development Institute, San Francisco, USA
| | - I Migliaccio
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - L Biganzoli
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - A Di Leo
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
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Vergote I, Bergfeldt K, Franquet A, Lisyanskaya AS, Bjermo H, Heldring N, Buyse M, Brize A. A randomized phase III trial in patients with recurrent platinum sensitive ovarian cancer comparing efficacy and safety of paclitaxel micellar and Cremophor EL-paclitaxel. Gynecol Oncol 2019; 156:293-300. [PMID: 31826802 DOI: 10.1016/j.ygyno.2019.11.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/21/2019] [Accepted: 11/24/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Paclitaxel micellar was developed to avoid Cremophor-EL (Cr-EL) associated dose limiting toxicity and to allow a shorter infusion time. The efficacy and safety of paclitaxel micellar (+carboplatin) was compared to Cr-EL paclitaxel (+carboplatin) in recurrent platinum-sensitive ovarian, fallopian tube or peritoneal carcinoma. METHODS This was a multicentre, open-label, randomized phase III trial. Adult patients with recurrent disease was assigned to six 3-week cycles of paclitaxel micellar (250 mg/m2) administered as 1-h infusion or Cr-EL paclitaxel (175 mg/m2) as 3-h infusion. Both arms received carboplatin (AUC 5-6). Primary objective was non-inferiority for progression free survival (PFS) using computed tomography scans. Overall survival (OS) was included as secondary endpoint. RESULTS Between 2009 and 2013, 789 patients were randomized to receive experimental (N = 397) or control (N = 392) treatment. PFS for paclitaxel micellar was non-inferior to Cr-EL paclitaxel with a hazard ratio of 0.86 (95% CI: 0.72;1.03) in the per protocol population (PP), favouring paclitaxel micellar (non-inferiority margin was 1.2). Non-inferiority of OS was shown in the PP population with a hazard ratio of 0.95 (95% CI: 0.78; 1.16), favouring paclitaxel micellar (non-inferiority margin was 1.185). The most common adverse event was neutropenia (grade ≥ 3); 245 patients (79%) for paclitaxel micellar vs 213 patients (66%) for Cr-EL paclitaxel. The frequency of peripheral sensory neuropathy (any grade) was similar between the arms; 16% for paclitaxel micellar and 20% for Cr-EL paclitaxel. CONCLUSION Paclitaxel micellar (+ carboplatin) is non-inferior to Cr-EL paclitaxel (+ carboplatin) in terms of PFS and OS in the studied population. It provides a treatment option of a higher paclitaxel dose with a shorter infusion time without mandatory premedication. TRIAL REGISTRATION NUMBER 2008-002668-32 (EudraCT), NCT00989131 (ClinicalTrials.gov).
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Affiliation(s)
- I Vergote
- Division of Gynecologic Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium.
| | - K Bergfeldt
- Joint Commission of County Councils for Advanced Radiotherapy, Uppsala, Sweden
| | - A Franquet
- International Drug Development Institute (IDDI), Louvain-la-Neuve, Belgium
| | | | - H Bjermo
- Oasmia Pharmaceutical AB, Vallongatan 1, SE-752 28 Uppsala, Sweden
| | - N Heldring
- Oasmia Pharmaceutical AB, Vallongatan 1, SE-752 28 Uppsala, Sweden
| | - M Buyse
- International Drug Development Institute (IDDI), Louvain-la-Neuve, Belgium
| | - A Brize
- Latvian Oncology Center, Riga Eastern Clinical University Hospital, Riga, Latvia
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Sobrero A, Grothey A, Iveson T, Labianca R, Yoshino T, Taieb J, Maughan T, Buyse M, André T, Meyerhardt J, Shields AF, Souglakos I, Douillard JY, Cervantes A. The hard road to data interpretation: 3 or 6 months of adjuvant chemotherapy for patients with stage III colon cancer? Ann Oncol 2019; 29:1099-1107. [PMID: 29438451 DOI: 10.1093/annonc/mdy064] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Six months of adjuvant oxaliplatin-based chemotherapy is standard for patients with stage III colon cancer following surgery. However, oxaliplatin is associated with peripheral neurotoxicity which worsens over treatment duration. Consequently, a shorter treatment duration, if equally effective, would be extremely beneficial. A pooled analysis of data for 12 834 stage III colon cancer patients, from six randomised phase III trials of adjuvant therapy, the International Duration Evaluation of Adjuvant chemotherapy study, was carried out and the results presented at the ASCO Annual Meeting 2017. To clarify the potential impact of these results on clinical practice, ESMO decided to sponsor a special session at their 2017 Annual Meeting dedicated to achieving a more meaningful interpretation of the results. Methods Medical oncologists from Europe, the United States and Asia selected for their involvement in the trials, together with an independent statistician and an independent clinician, were invited to provide their independent interpretations of the results and contribute to a moderated panel discussion. The pooled analysis evaluated the non-inferiority of 3 versus 6 months of adjuvant FOLFOX/CAPOX therapy but not the non-inferiority of 3 months CAPOX versus 6 months FOLFOX therapy. Results There was strong evidence of an interaction between the choice of regimen (CAPOX or FOLFOX) and duration of treatment. Patients were classified as either 'fighters' or 'fatalists', and 3-month CAPOX was considered standard for patients classified as fatalists even if they had high-risk disease. However, patients classified as 'fighters' would only receive 3 months of CAPOX if they had low-risk disease but would always receive 6 months of CAPOX/FOLFOX if they had T4 disease. The panel was split on whether they would advocate 3 or 6 months CAPOX therapy based on high-risk N2 disease. Conclusions The main drivers of the duration of treatment were choice of regimen and patient attitude, with risk, based mainly on T4 stage, having less influence.
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Affiliation(s)
- A Sobrero
- Department of Medical Oncology, IRCCS San Martino Hospital, Genoa, Italy
| | - A Grothey
- Division of Medical Oncology, Mayo Clinic Cancer Center, Rochester, USA
| | - T Iveson
- Department of Oncology, University Hospital, Southampton, Southampton, UK
| | - R Labianca
- Cancer Center, Ospedale Giovanni XXIII, Bergamo, Italy
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - J Taieb
- Digestive Oncology Department, European Hospital Georges Pompidou, Paris, France
| | - T Maughan
- CRUK/MRC Oxford Institute for Radiation Oncology, Gray Laboratories, University of Oxford, Oxford, UK
| | - M Buyse
- IDDI Inc., San Francisco, USA
| | - T André
- Department of Medical Oncology, Hospital St Antoine, Paris, France
| | - J Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston
| | - A F Shields
- Karmanos Cancer Institute, Wayne State University, Detroit, USA
| | - I Souglakos
- Department of Medical Oncology, University Hospital of Heraklion, University of Crete, Greece
| | | | - A Cervantes
- CIBERONC, Department of Medical Oncology, Institute of Health Research, INCLIVIA, University of Valencia, Valencia, Spain
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Delaloge S, Cella D, Ye Y, Buyse M, Chan A, Barrios CH, Holmes FA, Mansi J, Iwata H, Ejlertsen B, Moy B, Chia SKL, Gnant M, Smichkoska S, Ciceniene A, Martinez N, Filipović S, Ben-Baruch NE, Joy AA, Langkjer ST, Senecal F, de Boer RH, Moran S, Yao B, Bryce R, Auerbach A, Fallowfield L, Martin M. Effects of neratinib on health-related quality of life in women with HER2-positive early-stage breast cancer: longitudinal analyses from the randomized phase III ExteNET trial. Ann Oncol 2019; 30:567-574. [PMID: 30689703 DOI: 10.1093/annonc/mdz016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We report longitudinal health-related quality-of-life (HRQoL) data from the international, randomized, double-blind, placebo-controlled phase III ExteNET study, which demonstrated an invasive disease-free survival benefit of extended adjuvant therapy with neratinib over placebo in human epidermal growth factor receptor-2-positive early-stage breast cancer. PATIENTS AND METHODS Women (N = 2840) with early-stage HER2-positive breast cancer who had completed trastuzumab-based adjuvant therapy were randomly assigned to neratinib 240 mg/day or placebo for 12 months. HRQoL was an exploratory end point. Patients completed the Functional Assessment of Cancer Therapy-Breast (FACT-B) and EuroQol 5-Dimensions (EQ-5D) questionnaires at baseline and months 1, 3, 6, 9, and 12. Changes from baseline were compared using analysis of covariance with no imputation for missing values. Sensitivity analyses used alternative methods. Changes in HRQoL scores were regarded as clinically meaningful if they exceeded previously reported important differences (IDs). RESULTS Of the 2840 patients (intention-to-treat population), 2407 patients were evaluable for FACT-B (neratinib, N = 1171; placebo, N = 1236) and 2427 patients for EQ-5D (neratinib, N = 1186; placebo, N = 1241). Questionnaire completion rates exceeded 85%. Neratinib was associated with a decrease in global HRQoL scores at month 1 compared with placebo (adjusted mean differences: FACT-B total, -2.9 points; EQ-5D index, -0.02), after which between-group differences diminished at later time-points. Except for the FACT-B physical well-being (PWB) subscale at month 1; all between-group differences were less than reported IDs. The FACT-B breast cancer-specific subscale showed small improvements with neratinib at months 3-9, but all were less than IDs. Sensitivity analyses exploring missing data did not change the results. CONCLUSIONS Extended adjuvant neratinib was associated with a transient, reversible decrease in HRQoL during the first month of treatment, possibly linked to treatment-related diarrhea. With the exception of the PWB subscale at month 1, all neratinib-related HRQoL changes did not reach clinically meaningful thresholds. ClinicalTrials.gov: NCT00878709.
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Affiliation(s)
- S Delaloge
- Department of Medicine, Institut Gustave Roussy, Villejuif, France.
| | - D Cella
- Department of Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago
| | - Y Ye
- Puma Biotechnology Inc, Los Angeles, USA
| | - M Buyse
- International Drug Development Institute (IDDI), Louvain-la-Neuve, Belgium
| | - A Chan
- Breast Cancer Research Centre-WA & Curtin University, Perth, Australia
| | - C H Barrios
- Oncology Research Unit, Pontifical Catholic University of Rio Grande do Sul School of Medicine, Porto Alegre, Brazil
| | | | - J Mansi
- Department of Medical Oncology, Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, UK
| | - H Iwata
- Department of Breast Oncology, Aichi Cancer Center, Chikusa-ku, Nagoya, Japan
| | - B Ejlertsen
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - B Moy
- Department of Hematology/Oncology, Massachusetts General Hospital Cancer Center, Boston, USA
| | - S K L Chia
- Medical Oncology, British Columbia Cancer Agency, Vancouver, Canada
| | - M Gnant
- Department of Surgery and Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - S Smichkoska
- University Clinic for Radiotherapy and Oncology, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - A Ciceniene
- Oncology Institute of Vilnius University, Vilnius, Lithuania
| | - N Martinez
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - S Filipović
- Clinic of Oncology, Clinical Center Niš, Nis, Serbia
| | - N E Ben-Baruch
- Department of Oncology, Kaplan Medical Center, Rehovot, Israel
| | - A A Joy
- Cross Cancer Institute, Edmonton, Canada
| | - S T Langkjer
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - F Senecal
- Northwest Medical Specialties PLLC, Tacoma, USA
| | - R H de Boer
- Department of Medical Oncology, Royal Melbourne Hospital, Melbourne, Australia
| | - S Moran
- Puma Biotechnology Inc, Los Angeles, USA
| | - B Yao
- Puma Biotechnology Inc, Los Angeles, USA
| | - R Bryce
- Puma Biotechnology Inc, Los Angeles, USA
| | - A Auerbach
- Puma Biotechnology Inc, Los Angeles, USA
| | - L Fallowfield
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - M Martin
- Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain
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10
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Gnant M, Martin M, Holmes FA, Jackisch C, Chia SK, Iwata H, Moy B, Martinez N, Mansi J, Morales S, Ruiz-Borrego M, von Minckwitz G, Buyse M, Delaloge S, Bhandari M, Murias Rosales A, Galeano T, Fujita T, Luczak A, Barrios CH, Saura C, Rugo HS, Chien J, Johnston SR, Spencer M, Xu F, Barnett B, Chan A, Ejlertsen B. Abstract P2-13-01: Efficacy of neratinib in hormone receptor-positive patients who initiated treatment within 1 year of completing trastuzumab-based adjuvant therapy in HER2+ early-stage breast cancer: Subgroup analyses from the phase III ExteNET trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-13-01] [Citation(s) in RCA: 1] [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: 11/16/2022]
Abstract
Abstract
Background: The international, randomized, placebo-controlled phase III ExteNET trial showed that 1 year (yr) of neratinib 240 mg/day after trastuzumab-based adjuvant therapy significantly improved invasive disease-free survival (iDFS) in 2840 patients with early-stage HER2+ breast cancer at 2 yr (hazard ratio 0.67; 95% CI 0.50–0.91; p=0.009) [Chan 2016] and 5 yr (hazard ratio 0.73; 95% CI 0.57-0.92; p=0.008) [Martin 2017]. A prespecified subgroup analysis by hormone receptor (HR) status suggested enhanced efficacy with neratinib in patients with HR+ (2-yr hazard ratio 0.51; 95% CI 0.33–0.77) vs. HR– tumors (2-yr hazard ratio 0.93; 95% CI 0.60–1.43). The efficacy of neratinib was also greater in patients who initiated treatment within 1 yr of prior trastuzumab compared with those who started neratinib later. The European Medicines Agency's Committee for Medicinal Products for Human Use recently recommended neratinib for use in patients with HR+ tumors who initiate treatment within 1 yr of completing trastuzumab-based adjuvant therapy. Subgroup analyses from ExteNET examining iDFS benefits in this patient population are presented here.
Methods: Patients with early-stage HER2+ breast cancer who completed trastuzumab-based (neo)adjuvant therapy were assigned to oral neratinib 240 mg/day or placebo for 1 yr. Randomization was stratified by HR status (determined locally before trial entry), nodal status, and trastuzumab regimen. Endocrine therapy was allowed in patients with HR+ disease. The primary endpoint, iDFS, was tested by 2-sided log-rank test and hazard ratios (95% CI) were estimated using Cox proportional hazards models. Kaplan-Meier methods were used to estimate iDFS rates. Secondary endpoints were DFS-DCIS, time to distant recurrence, distant DFS, and CNS recurrences. The primary analysis was conducted at 2 yr, and a sensitivity analysis conducted at 5 yr. Clinicaltrials.gov:NCT00878709.
Results: Of the 2840 patients (neratinib, n=1420; placebo, n=1420), 1631 (57%) had HR+ disease (neratinib, n=816; placebo, n=815). Most (93%) HR+ patients were receiving endocrine therapy at baseline. 1334 of 1631 (82%) patients with HR+ tumors were randomized to start neratinib within 1 yr of last trastuzumab dose (neratinib, n=670; placebo, n=664). iDFS benefits from neratinib in this population are shown in the table. Secondary endpoints were also improved with neratinib vs. placebo in this population. Safety data in this subset will be presented at the meeting.
Table. iDFS in patients with an interval between last trastuzumab dose and randomization of ≤1 yr
HR+ population (N=1334)ITT population (N=2297) Hazard ratiob Hazard ratiob Δ, %a(95% CI)P-valueΔ, %a(95% CI)P-value2-yr analysisc+4.50.490.002+2.90.630.006 (0.30–0.78) (0.45–0.88) 5-yr analysisd+5.10.580.002+3.20.700.006 (0.41–0.82) (0.54–0.90) aDifference in iDFS rates between neratinib vs. placebo; bNeratinib vs. placebo; cData cut-off: July 2014; dData cut-off: March 2017
Conclusions: Neratinib may have enhanced and sustained efficacy in patients with HR+ disease who initiate treatment within 1 yr of trastuzumab-based adjuvant therapy.
Citation Format: Gnant M, Martin M, Holmes F-A, Jackisch C, Chia SK, Iwata H, Moy B, Martinez N, Mansi J, Morales S, Ruiz-Borrego M, von Minckwitz G, Buyse M, Delaloge S, Bhandari M, Murias Rosales A, Galeano T, Fujita T, Luczak A, Barrios CH, Saura C, Rugo HS, Chien J, Johnston SR, Spencer M, Xu F, Barnett B, Chan A, Ejlertsen B. Efficacy of neratinib in hormone receptor-positive patients who initiated treatment within 1 year of completing trastuzumab-based adjuvant therapy in HER2+ early-stage breast cancer: Subgroup analyses from the phase III ExteNET trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-13-01.
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Affiliation(s)
- M Gnant
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - M Martin
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - F-A Holmes
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - C Jackisch
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - SK Chia
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - H Iwata
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - B Moy
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - N Martinez
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - J Mansi
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - S Morales
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - M Ruiz-Borrego
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - G von Minckwitz
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - M Buyse
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - S Delaloge
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - M Bhandari
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - A Murias Rosales
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - T Galeano
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - T Fujita
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - A Luczak
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - CH Barrios
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - C Saura
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - HS Rugo
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - J Chien
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - SR Johnston
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - M Spencer
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - F Xu
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - B Barnett
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - A Chan
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - B Ejlertsen
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
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11
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Dalle H, Garcia M, Antoine B, Boehm V, Do TTH, Buyse M, Ledent T, Lamazière A, Magnan C, Postic C, Denis RG, Luquet S, Fève B, Moldes M. Adipocyte Glucocorticoid Receptor Deficiency Promotes Adipose Tissue Expandability and Improves the Metabolic Profile Under Corticosterone Exposure. Diabetes 2019; 68:305-317. [PMID: 30455377 DOI: 10.2337/db17-1577] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 11/07/2018] [Indexed: 01/20/2023]
Abstract
Widely used for their anti-inflammatory and immunosuppressive properties, glucocorticoids are nonetheless responsible for the development of diabetes and lipodystrophy. Despite an increasing number of studies focused on the adipocyte glucocorticoid receptor (GR), its precise role in the molecular mechanisms of these complications has not been elucidated. In keeping with this goal, we generated a conditional adipocyte-specific murine model of GR invalidation (AdipoGR knockout [KO] mice). Interestingly, when administered a corticosterone treatment to mimic hypercorticism conditions, AdipoGR-KO mice exhibited an improved glucose tolerance and insulin sensitivity. This was related to the adipose-specific activation of the insulin-signaling pathway, which contributed to fat mass expansion, as well as a shift toward an anti-inflammatory macrophage polarization in adipose tissue of AdipoGR-KO animals. Moreover, these mice were protected against ectopic lipid accumulation in the liver and displayed an improved lipid profile, contributing to their overall healthier phenotype. Altogether, our results indicate that adipocyte GR is a key factor of adipose tissue expansion and glucose and lipid metabolism control, which should be taken into account in the further design of adipocyte GR-selective modulators.
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Affiliation(s)
- Héloïse Dalle
- INSERM, Saint-Antoine Research Center, Sorbonne University, Paris, France
- Hospital-Universitary Institute, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Marie Garcia
- INSERM, Saint-Antoine Research Center, Sorbonne University, Paris, France
- Hospital-Universitary Institute, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Bénédicte Antoine
- INSERM, Saint-Antoine Research Center, Sorbonne University, Paris, France
- Hospital-Universitary Institute, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Vanessa Boehm
- INSERM, Saint-Antoine Research Center, Sorbonne University, Paris, France
- Hospital-Universitary Institute, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Thi Thu Huong Do
- INSERM, Saint-Antoine Research Center, Sorbonne University, Paris, France
- Hospital-Universitary Institute, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Marion Buyse
- INSERM, Saint-Antoine Research Center, Sorbonne University, Paris, France
- Hospital-Universitary Institute, Institute of Cardiometabolism and Nutrition, Paris, France
- Pharmacy Department, Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Paris, France
| | - Tatiana Ledent
- INSERM, Saint-Antoine Research Center, Sorbonne University, Paris, France
| | - Antonin Lamazière
- INSERM, CNRS UMR 70203, Laboratoire des Biomolécules, Assistance Publique-Hôpitaux de Paris, École Normale Supérieure, Sorbonne University, Paris, France
| | - Christophe Magnan
- Biologie Fonctionelle & Adaptative, CNRS UMR 8251, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Catherine Postic
- INSERM, U1016, Cochin Institute, Paris, France
- CNRS UMR 8104, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Raphaël George Denis
- Biologie Fonctionelle & Adaptative, CNRS UMR 8251, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Serge Luquet
- Biologie Fonctionelle & Adaptative, CNRS UMR 8251, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Bruno Fève
- INSERM, Saint-Antoine Research Center, Sorbonne University, Paris, France
- Hospital-Universitary Institute, Institute of Cardiometabolism and Nutrition, Paris, France
- Endocrinology Department, Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Paris, France
| | - Marthe Moldes
- INSERM, Saint-Antoine Research Center, Sorbonne University, Paris, France
- Hospital-Universitary Institute, Institute of Cardiometabolism and Nutrition, Paris, France
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12
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Courty E, Besseiche A, Do TTH, Liboz A, Aguid FM, Quilichini E, Buscato M, Gourdy P, Gautier JF, Riveline JP, Haumaitre C, Buyse M, Fève B, Guillemain G, Blondeau B. Adaptive β-Cell Neogenesis in the Adult Mouse in Response to Glucocorticoid-Induced Insulin Resistance. Diabetes 2019; 68:95-108. [PMID: 30327384 DOI: 10.2337/db17-1314] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 10/11/2018] [Indexed: 11/13/2022]
Abstract
Both type 1 and type 2 diabetes are characterized by deficient insulin secretion and decreased β-cell mass. Thus, regenerative strategies to increase β-cell mass need to be developed. To characterize mechanisms of β-cell plasticity, we studied a model of severe insulin resistance in the adult mouse and defined how β-cells adapt. Chronic corticosterone (CORT) treatment was given to adult mice and led to rapid insulin resistance and adaptive increased insulin secretion. Adaptive and massive increase of β-cell mass was observed during treatment up to 8 weeks. β-Cell mass increase was partially reversible upon treatment cessation and reinduced upon subsequent treatment. β-Cell neogenesis was suggested by an increased number of islets, mainly close to ducts, and increased Sox9 and Ngn3 mRNA levels in islets, but lineage-tracing experiments revealed that neoformed β-cells did not derive from Sox9- or Ngn3-expressing cells. CORT treatment after β-cell depletion partially restored β-cells. Finally, β-cell neogenesis was shown to be indirectly stimulated by CORT because serum from CORT-treated mice increased β-cell differentiation in in vitro cultures of pancreatic buds. Altogether, the results present a novel model of β-cell neogenesis in the adult mouse and identify the presence of neogenic factors in the serum of CORT-treated mice.
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Affiliation(s)
- Emilie Courty
- Sorbonne Université, INSERM, Saint-Antoine Research Center, Paris, France
- Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Adrien Besseiche
- Sorbonne Université, INSERM, Centre de Recherche des Cordeliers, Paris, France
| | - Thi Thu Huong Do
- Sorbonne Université, INSERM, Saint-Antoine Research Center, Paris, France
- Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Alexandrine Liboz
- Sorbonne Université, INSERM, Saint-Antoine Research Center, Paris, France
- Hospitalo-Universitary Institute, ICAN, Paris, France
| | | | - Evans Quilichini
- Sorbonne Université, CNRS, Institut de Biologie Paris-Seine, Paris, France
| | - Melissa Buscato
- Institute of Metabolic and Cardiovascular Diseases, UMR1048, INSERM, UPS, Université de Toulouse, Toulouse, France
| | - Pierre Gourdy
- Institute of Metabolic and Cardiovascular Diseases, UMR1048, INSERM, UPS, Université de Toulouse, Toulouse, France
- Service de Diabétologie, CHU de Toulouse, Toulouse, France
| | - Jean-François Gautier
- Sorbonne Université, INSERM, Centre de Recherche des Cordeliers, Paris, France
- Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, Department of Diabetes and Endocrinology, University Paris-Diderot 7, Sorbonne Paris Cité, Paris, France
| | - Jean-Pierre Riveline
- Sorbonne Université, INSERM, Centre de Recherche des Cordeliers, Paris, France
- Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, Department of Diabetes and Endocrinology, University Paris-Diderot 7, Sorbonne Paris Cité, Paris, France
| | - Cécile Haumaitre
- Sorbonne Université, CNRS, Institut de Biologie Paris-Seine, Paris, France
| | - Marion Buyse
- Sorbonne Université, INSERM, Saint-Antoine Research Center, Paris, France
- Hospitalo-Universitary Institute, ICAN, Paris, France
- Université Paris-Sud, EA 4123, Chatenay-Malabry, France
- Department of Pharmacy, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Bruno Fève
- Sorbonne Université, INSERM, Saint-Antoine Research Center, Paris, France
- Hospitalo-Universitary Institute, ICAN, Paris, France
- Department of Endocrinology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Ghislaine Guillemain
- Sorbonne Université, INSERM, Saint-Antoine Research Center, Paris, France
- Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Bertrand Blondeau
- Sorbonne Université, INSERM, Saint-Antoine Research Center, Paris, France
- Hospitalo-Universitary Institute, ICAN, Paris, France
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13
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Ejlertsen B, Chan A, Gnant M, von Minckwitz G, Delaloge S, Buyse M, O'Shaughnessy J, Mansi J, Moy B, Iwata H, Wong A, Ye Y, Means-Powell J, Hui R, Ruiz-Borrego M, Ruiz Simon A, Shen ZZ, Holmes FA, Lesniewski-Kmak K, Martin M. Abstract P1-13-05: Timing of initiation of neratinib after completion of trastuzumab-based adjuvant therapy in early-stage HER2+ breast cancer: Exploratory analyses from the phase III ExteNET trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-13-05] [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: 11/16/2022]
Abstract
Abstract
Background: The international, randomized, placebo-controlled phase III ExteNET trial showed that 1 year of neratinib after trastuzumab-based adjuvant therapy significantly improved 2-year invasive disease-free survival (iDFS) in early-stage HER2+ breast cancer (HR 0.67; 95% CI 0.50–0.91; p=0.009) [Chan et al. Lancet Oncol 2016]. The significant iDFS benefit with neratinib was maintained after a median of 5 years' follow-up (HR 0.73; 95% CI 0.57-0.92; p=0.008) [Martin et al. ESMO 2017]. We present exploratory analyses from the ExteNET trial examining the effects of the interval between completion of trastuzumab and randomization to commence neratinib on iDFS.
Methods: Women with early-stage HER2+ breast cancer were randomly assigned to oral neratinib 240 mg/day or placebo for 1 year after standard primary therapy and trastuzumab-based adjuvant therapy. Under the original study protocol, (neo)adjuvant trastuzumab was to be completed ≤24 months before randomization; this was revised to ≤12 months before randomization after the NCCTG-N9831/NSABP B-31 4-year analysis showed that the risk of relapse is greatest during the first 12 months after completing trastuzumab. Disease recurrences were collected prospectively during 1 and 2 years post-randomization, and from medical records during 3–5 years post-randomization. Patients randomized ≤12 months after completion of adjuvant trastuzumab were further separated to look at those who initiated neratinib ≤6 months of completing adjuvant trastuzumab. Primary endpoint: iDFS. HR (95% CI) estimated using Cox proportional-hazards models. Data cut-off: March 1, 2017. Clinicaltrials.gov: NCT00878709.
Results:The intention-to-treat population comprised 2840 patients (neratinib, n=1420; placebo, n=1420). Median time from last trastuzumab dose to randomization was 4.4 and 4.6 months in the neratinib and placebo groups, respectively. 81% of patients were randomized ≤12 months of completing trastuzumab. The effects of the interval between the last dose of trastuzumab and randomization/initiation of neratinib on iDFS after a median follow-up of 5.2 years are shown in the table.
Estimated 5-year iDFS rate, % P-valueInterval from last dose of trastuzumab to randomizationnNeratinibPlaceboHR (95% CI)a(2-sided)≤6 months164190.085.40.62 (0.46–0.84)0.002≤12 monthsb229789.786.50.70 (0.54–0.90)0.006>12 monthsb54392.392.61.00 (0.51–1.94)0.992a. Neratinib vs placebo; b. Protocol-defined subgroups
Conclusions: In ExteNET, patients who initiated neratinib within 12 months of completing trastuzumab-based adjuvant therapy appeared to derive greater benefit from treatment than those who started neratinib later. Further, exploratory analyses suggest that the magnitude of benefit with neratinib is greater if initiated sooner (i.e. within 6 months of completing trastuzumab). Given the benefits of neratinib overall in those initiating treatment ≤12 months from the end of adjuvant trastuzumab, extended adjuvant treatment with neratinib should be initiated early following completion of trastuzumab.
Citation Format: Ejlertsen B, Chan A, Gnant M, von Minckwitz G, Delaloge S, Buyse M, O'Shaughnessy J, Mansi J, Moy B, Iwata H, Wong A, Ye Y, Means-Powell J, Hui R, Ruiz-Borrego M, Ruiz Simon A, Shen Z-Z, Holmes FA, Lesniewski-Kmak K, Martin M. Timing of initiation of neratinib after completion of trastuzumab-based adjuvant therapy in early-stage HER2+ breast cancer: Exploratory analyses from the phase III ExteNET trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-13-05.
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Affiliation(s)
- B Ejlertsen
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - A Chan
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - M Gnant
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - G von Minckwitz
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - S Delaloge
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - M Buyse
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - J O'Shaughnessy
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - J Mansi
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - B Moy
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - H Iwata
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - A Wong
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - Y Ye
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - J Means-Powell
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - R Hui
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - M Ruiz-Borrego
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - A Ruiz Simon
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - Z-Z Shen
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - FA Holmes
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - K Lesniewski-Kmak
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
| | - M Martin
- Rigshospitalet, Copenhagen, Denmark; Breast Cancer Research Centre-Western Australia and Curtin University; Comprehensive Cancer Centre, Medical University of Vienna; German Breast Group; Institut Gustave Roussy; International Drug Development Institute; Texas Oncology-Baylor Charles A. Sammons Cancer Center; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; Puma Biotechnology Inc; Vanderbilt-Ingram Cancer Center; Westmead Hospital and the University of Sydney, Sydney, NSW, Australia; Hospital Universitario Virgen del Rocio; Instituto Valenciano de Oncología; Shanghai Cancer Center; Texas Oncology; Szpital Morski im. PCK Oddiział Onkologii Klinicznej, Gdyńskie Centrum Onkologii; Hospital General Universitario Gregorio Marañón
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Chia SKL, Martin M, Iwata H, Moy B, Lalani AS, Holmes FA, Mansi J, von Minckwitz G, Buyse M, Delaloge S, Ejlertsen B, Yao B, Murias Rosales A, Hellerstedt B, Cold S, Inoue K, Shen ZZ, Galeano T, Barrios CH, Chan A. Abstract P1-13-03: Effects of neratinib after trastuzumab-based adjuvant therapy in hormone receptor-positive HER2+ early-stage breast cancer: Exploratory analyses from the phase III ExteNET trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-13-03] [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: 11/16/2022]
Abstract
Abstract
Background: The international, randomized, placebo-controlled phase III ExteNET trial showed that a 1-year course of neratinib after trastuzumab-based adjuvant therapy significantly improved 2-year invasive disease-free survival (iDFS) in patients with early-stage HER2+ breast cancer (BC) (hazard ratio 0.67; 95% CI 0.50–0.91; p=0.009) [Chan et al. Lancet Oncol 2016]. The significant iDFS benefit with neratinib was maintained after a median 5 years' follow-up (hazard ratio 0.73; 95% CI 0.57-0.92; p=0.008) [Martin et al. ESMO 2017]. At both time-points, marked benefit with neratinib was evident in patients with hormone receptor (HR)+ tumors, whereas in patients with HR– disease, initial improvements with neratinib diminished after completing treatment. We report exploratory analyses from the ExteNET trial done to better characterize the effects of neratinib in the HR+ subgroup.
Methods: Patients with early-stage HER2+ BC were randomly assigned to oral neratinib 240 mg/day or placebo for 1 year after standard primary therapy and trastuzumab-based adjuvant therapy. Randomization was stratified by HR status (locally assessed), nodal status, and trastuzumab regimen. Adjuvant endocrine therapy was recommended for patients with HR+ disease. Data concerning disease recurrences were collected prospectively during year 1-2 post-randomization, and from medical records during year 3–5 post-randomization. Primary endpoint: iDFS. Secondary endpoints: DFS including ductal carcinoma in situ (DFS-DCIS); time to distant recurrence (TTDR); distant DFS (DDFS); cumulative incidence of central nervous system (CNS) recurrences; overall survival (OS). Hazard ratios (95% CI) were estimated using Cox proportional-hazards models. Data cut-off: March 2017. Clinicaltrials.gov: NCT00878709.
Results: 2840 patients were randomized (neratinib, n=1420; placebo, n=1420); 1631 (57%) patients had HR+ tumors (neratinib, n=816; placebo, n=815). 93% and 94% of HR+ patients in the neratinib and placebo groups, respectively, were receiving adjuvant endocrine therapy at baseline. Efficacy outcomes in the HR+ cohort after a median follow-up of 5.2 years are shown in the table. In subgroup analyses of the HR+ cohort, hazard ratios for iDFS were 0.49 in centrally confirmed HER2+ patients (n=951), and 0.58 in patients who had completed prior trastuzumab ≤12 months before randomization (n=1334). CNS recurrence and OS data are not yet mature.
Updated 2-year analysis5-year analysis Hazard ratiobP-value Hazard ratiobP-value Δ, %a(95% CI)(2 sided)Δ, %a(95% CI)(2 sided)iDFS4.10.49 (0.31–0.75)0.0014.40.60 (0.43–0.83)0.002DFS-DCIS4.80.45 (0.29–0.69)<0.0015.10.57 (0.42–0.79)<0.001DDFS3.10.52 (0.32–0.84)0.0084.00.60 (0.42–0.85)0.004TTDR2.90.52 (0.31–0.85)0.013.80.61 (0.42–0.86)0.006a. Difference in event rates between neratinib vs placebo; b. Neratinib vs placebo
Conclusions: Neratinib was associated with an absolute iDFS benefit of 4.4% in patients with HR+/HER2+ BC after 5 years' follow-up. HR/HER2 receptor cross-talk may underpin the notable effect of neratinib in patients with HR+ tumors when given in combination with endocrine therapy.
Citation Format: Chia SKL, Martin M, Iwata H, Moy B, Lalani AS, Holmes FA, Mansi J, von Minckwitz G, Buyse M, Delaloge S, Ejlertsen B, Yao B, Murias Rosales A, Hellerstedt B, Cold S, Inoue K, Shen Z-Z, Galeano T, Barrios CH, Chan A. Effects of neratinib after trastuzumab-based adjuvant therapy in hormone receptor-positive HER2+ early-stage breast cancer: Exploratory analyses from the phase III ExteNET trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-13-03.
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Affiliation(s)
- SKL Chia
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - M Martin
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - H Iwata
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - B Moy
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - AS Lalani
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - FA Holmes
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - J Mansi
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - G von Minckwitz
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - M Buyse
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - S Delaloge
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - B Ejlertsen
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - B Yao
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - A Murias Rosales
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - B Hellerstedt
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - S Cold
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - K Inoue
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - Z-Z Shen
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - T Galeano
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - CH Barrios
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
| | - A Chan
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Aichi Cancer Center Hospital; Massachusetts General Hospital Cancer Center; Puma Biotechnology Inc.; Texas Oncology; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; German Breast Group; International Drug Development Institute; Institut Gustave Roussy; Rigshospitalet; Compejo Hospitalario Materno Insular de Las Palmas; Texas Oncology, P.A; Odense University Hospital; Saitama Cancer Center; Shanghai Cancer Center; Magna Graecia University; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Breast Cancer Research Centre-Western Australia and Curtin University
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Chia SKL, Martin M, Holmes FA, Ejlertsen B, Delaloge S, Moy B, Iwata H, von Minckwitz G, Mansi J, Barrios CH, Gnant M, Tomašević Z, Denduluri N, Šeparović R, Kim SB, Hugger Jakobsen E, Harvey V, Robert N, Smith J, Harker G, Lalani AS, Zhang B, Eli LD, Buyse M, Chan A. Abstract PD3-12: PIK3CA alterations and benefit with neratinib after trastuzumab-based adjuvant therapy in early-stage HER2+ breast cancer: Correlative analyses of the phase III ExteNET trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd3-12] [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: 11/16/2022]
Abstract
Abstract
Background: Neratinib is a pan-HER tyrosine kinase inhibitor that blocks the PI3K/Akt and MAPK signaling pathways downstream from HER2. The international, randomized, placebo-controlled phase III ExteNET trial showed that a 1-year course of neratinib after trastuzumab-based adjuvant therapy significantly improved 2-year invasive disease-free survival (iDFS) in early-stage HER2+ breast cancer (HR 0.67; 95% CI 0.50–0.91; p=0.0091) [Chan et al. Lancet Oncol 2016]. Furthermore, the effects of neratinib on iDFS were shown to be durable at 5 years' follow-up (HR 0.73; 95% CI 0.57–0.92; p=0.008) [Martin et al. ESMO 2017]. PIK3CA alterations are common in HER2+ breast cancers, and in general are associated with a worse prognosis. We sought to assess the prognostic and predictive significance of PIK3CA alterations in an exploratory substudy of the ExteNET trial.
Methods: ExteNET is an international, multi-center, randomized, double-blind, placebo-controlled phase III trial (Clinicaltrials.gov: NCT00878709). Patients received oral neratinib 240 mg/day or placebo for 1 year. Of the intent-to-treat (ITT) population (n=2840), primary formalin-fixed paraffin-embedded (FFPE) tumor specimens were available from 991 patients for PIK3CA mutation testing by RT-PCR for two hot-spot mutations in exon 9 (E542K, E545K/D) and one hot-spot mutation in exon 20 (H1047R). 702 FFPE tumor slides underwent FISH analysis for PIK3CA amplification with a ratio of ≥2.2 considered as amplified. Primary endpoint: iDFS. iDFS events were tested by 2-sided log-rank tests, and HR (95% CI) were estimated using Cox proportional-hazards models. Data cut-off: March 2017.
Results: Baseline demographics and disease characteristics between treatment arms of the correlative cohort (n=1201) were balanced. Overall, 21.2% (n=210) of primary tumors harbored one of the specified PIK3CA mutations, and 8.7% (n=61) were PIK3CA FISH-amplified. Patients with PIK3CA-altered tumors (i.e. PIK3CA mutations or FISH-amplified) had fewer iDFS events with neratinib compared with placebo (HR 0.41; 95% CI 0.17-0.90, p=0.028). The interaction test was not significant (p=0.1842). Results of the various correlative analyses within treatment arms are shown in the table.
NeratinibPlacebo iDFS iDFS 2-sidedPopulationnevents, nnevents, nHR (95% CI)P valueaITT142011614201630.73 (0.57–0.92)b0.008bCorrelative cohort59345608700.67 (0.45–0.96)0.0317PIK3CA-mutation positive1047106170.43 (0.17–1.01)0.056PIK3CA-mutation negative38527396420.66 (0.40-1.06)0.089PIK3CA-amplified3312840.20 (0.01-1.33)0.106PIK3CA-non-amplified31629325360.85 (0.52-1.39)0.521PIK3CA-altered1308132200.41 (0.17-0.90)0.028a. Log-rank test; b. Stratified analysis
Conclusions: One year of neratinib treatment after trastuzumab-based adjuvant therapy significantly improves iDFS after 5 years in patients with early-stage HER2+ breast cancer. From this modest-sized exploratory cohort, it appears that PIK3CA may be a biomarker for differential sensitivity to neratinib after 1 year of trastuzumab in the adjuvant setting.These exploratory results should be validated in a larger subset.
Citation Format: Chia SKL, Martin M, Holmes FA, Ejlertsen B, Delaloge S, Moy B, Iwata H, von Minckwitz G, Mansi J, Barrios CH, Gnant M, Tomašević Z, Denduluri N, Šeparović R, Kim S-B, Hugger Jakobsen E, Harvey V, Robert N, Smith II J, Harker G, Lalani AS, Zhang B, Eli LD, Buyse M, Chan A. PIK3CA alterations and benefit with neratinib after trastuzumab-based adjuvant therapy in early-stage HER2+ breast cancer: Correlative analyses of the phase III ExteNET trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD3-12.
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Affiliation(s)
- SKL Chia
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - M Martin
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - FA Holmes
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - B Ejlertsen
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - S Delaloge
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - B Moy
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - H Iwata
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - G von Minckwitz
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - J Mansi
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - CH Barrios
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - M Gnant
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - Z Tomašević
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - N Denduluri
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - R Šeparović
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - S-B Kim
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - E Hugger Jakobsen
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - V Harvey
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - N Robert
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - J Smith
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - G Harker
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - AS Lalani
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - B Zhang
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - LD Eli
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - M Buyse
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
| | - A Chan
- British Columbia Cancer Agency, Vancouver, BC, Canada; Hospital General Universitario Gregorio Marañón; Texas Oncology; Rigshospitalet; Institut Gustave Roussy; Massachusetts General Hospital Cancer Center; Aichi Cancer Center Hospital; German Breast Group; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London; Pontifical Catholic University of Rio Grande do Sul School of Medicine; Comprehensive Cancer Centre, Medical University of Vienna; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; US Oncology Research; Sestre Milosrdnice University Hospital Center; University Hospital for Tumors; Asan Medical Centre; Sygehus Lillebaelt; Auckland Hospital; Virginia Cancer Specialists; Compass Oncology, US Oncology, Portland, OR; Utah Cancer Specialists; Puma Biotechnology Inc.; International Drug Development Institute; Breast Cancer Research Centre-Western Australia and Curtin University
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Affiliation(s)
| | - S Vansteelandt
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Gent, Belgium
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Saad ED, Buyse M. Exploratory analysis of the association of depth of response and survival in patients with metastatic non-small-cell lung cancer treated with a targeted therapy or immunotherapy. Ann Oncol 2017; 28:2629-2630. [PMID: 28945844 DOI: 10.1093/annonc/mdx456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Affiliation(s)
- E D Saad
- International Drug Development Institute, Louvain-la-Neuve, Belgium
| | - M Buyse
- International Drug Development Institute, San Francisco, USA; Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), Hasselt University, Hasselt, Belgium.
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Pandraud-Riguet I, Bonnet-Zamponi D, Bourcier E, Buyse M, Laribe-Caget S, Frémont P, Pautas E, Verny C, Hindlet P, Fernandez C. Monitoring of Potentially Inappropriate Prescriptions in Older Inpatients: A French Multicenter Study. J Am Geriatr Soc 2017; 65:2713-2719. [DOI: 10.1111/jgs.15081] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Irène Pandraud-Riguet
- Service de Pharmacie; Hôpital Saint-Antoine; Assistance Publique - Hôpitaux de Paris; Paris France
| | - Dominique Bonnet-Zamponi
- Observatoire du Médicament des Dispositifs Médicaux et de l'Innovation Thérapeutique Ile de France; Paris France
- Centre de Pharmaco-Epidémiologie; Assistance Publique - Hôpitaux de Paris; Paris France
| | - Elsa Bourcier
- Service de Pharmacie; Hôpital Saint-Antoine; Assistance Publique - Hôpitaux de Paris; Paris France
- Sorbonne Universités; UPMC Université Paris 06; INSERM; Institut Pierre Louis d'Epidémiologie et de Santé Publique; France
- Faculté de Pharmacie; Université Paris-Sud; Chatenay-Malabry France
| | - Marion Buyse
- Service de Pharmacie; Fondation Ildys; Roscoff France
| | - Sandra Laribe-Caget
- Service de Pharmacie; Hôpital Rothschild; Assistance Publique - Hôpitaux de Paris; Paris France
| | - Patrick Frémont
- Service de Psychiatrie; CH Lagny-Marne La Vallée; Lagny sur Marne France
| | - Eric Pautas
- Court Séjour Gériatrique; Hôpital Charles-Foix; Assistance Publique - Hôpitaux de Paris; Ivry-sur-Seine France
- Unité de Formation et de Recherche de Médecine Pierre-et-Marie-Curie; Université Paris 06; Paris France
| | - Christiane Verny
- Service de Gériatrie; Assistance Publique - Hôpitaux de Paris; Hôpital Bicêtre; Le Kremlin-Bicêtre France
| | - Patrick Hindlet
- Service de Pharmacie; Hôpital Saint-Antoine; Assistance Publique - Hôpitaux de Paris; Paris France
- Sorbonne Universités; UPMC Université Paris 06; INSERM; Institut Pierre Louis d'Epidémiologie et de Santé Publique; France
- Faculté de Pharmacie; Université Paris-Sud; Chatenay-Malabry France
| | - Christine Fernandez
- Service de Pharmacie; Hôpital Saint-Antoine; Assistance Publique - Hôpitaux de Paris; Paris France
- Sorbonne Universités; UPMC Université Paris 06; INSERM; Institut Pierre Louis d'Epidémiologie et de Santé Publique; France
- Faculté de Pharmacie; Université Paris-Sud; Chatenay-Malabry France
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Delaloge S, Ye Y, Cella D, Buyse M, Chan A, Barrios C, Holmes F, Mansi J, Iwata H, Ejlertsen B, Moy B, von Minckwitz G, Chia S, Gnant M, Smichkoska S, Ciceniene A, Moran S, Auerbach A, Fallowfield L, Martin Jimenez M. Effects of neratinib (N) on health-related quality of life (HRQoL) in early-stage HER2+ breast cancer (BC): longitudinal analyses from the phase III ExteNET trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.027] [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: 11/12/2022] Open
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Courty E, Gobalakichenane P, Garcia M, Muscat A, Kazakian C, Ledent T, Moldes M, Blondeau B, Mitanchez D, Buyse M, Fève B. Antenatal antipsychotic exposure induces multigenerational and gender-specific programming of adiposity and glucose tolerance in adult mouse offspring. Diabetes Metab 2017; 44:281-291. [PMID: 28729164 DOI: 10.1016/j.diabet.2017.06.005] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 05/17/2017] [Accepted: 06/14/2017] [Indexed: 12/22/2022]
Abstract
Second-generation antipsychotics (SGAs) are well known for their metabolic side effects in humans, including obesity and diabetes. These compounds are maintained during pregnancy to prevent the relapse of psychoses, but they readily diffuse across the placenta to the fetus, as documented with the widely-prescribed drug olanzapine (OLZ). However, observational studies have provided conflicting results on the potential impact of SGAs on fetal growth and body weight, and their effects on metabolic regulation in the offspring. For this reason, our study has tested whether antenatal exposure of CD1 mice to OLZ influenced metabolic outcomes in the offspring of the first (F1) and second (F2) generations. In F1 mice, OLZ antenatal treatment caused a decrease in neonatal body weight in both genders, an effect that persisted throughout life only in male animals. Interestingly, F1 female mice also displayed altered glucose homoeostasis. F2 mice, generated by mating normal males with F1 female mice exposed to OLZ during antenatal life, exhibited higher neonatal body weights which persisted only in F2 female animals. This was associated with expansion of fat mass and a concordant pattern of adipose tissue gene expression. Moreover, male and female F2 mice were glucose-intolerant. Thus, our study has demonstrated that antenatal OLZ exposure induces multigenerational and gender-specific programming of glucose tolerance in the offspring mice as adults, and points to the need for careful monitoring of children exposed to SGAs during pregnancy.
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Affiliation(s)
- E Courty
- Inserm, Saint-Antoine Research Center, Saint-Antoine Hospital, Sorbonne University, Pierre-and-Marie-Curie University Paris 06, 75012 Paris, France; Hospitalo-Universitary Institute, ICAN, 75013 Paris, France
| | - P Gobalakichenane
- Inserm, Saint-Antoine Research Center, Saint-Antoine Hospital, Sorbonne University, Pierre-and-Marie-Curie University Paris 06, 75012 Paris, France; Hospitalo-Universitary Institute, ICAN, 75013 Paris, France; Department of Neonatology, Armand-Trousseau Hospital, 75012 Paris, France
| | - M Garcia
- Inserm, Saint-Antoine Research Center, Saint-Antoine Hospital, Sorbonne University, Pierre-and-Marie-Curie University Paris 06, 75012 Paris, France; Hospitalo-Universitary Institute, ICAN, 75013 Paris, France
| | - A Muscat
- Inserm, Saint-Antoine Research Center, Saint-Antoine Hospital, Sorbonne University, Pierre-and-Marie-Curie University Paris 06, 75012 Paris, France; Hospitalo-Universitary Institute, ICAN, 75013 Paris, France
| | - C Kazakian
- Inserm, Saint-Antoine Research Center, Saint-Antoine Hospital, Sorbonne University, Pierre-and-Marie-Curie University Paris 06, 75012 Paris, France; Hospitalo-Universitary Institute, ICAN, 75013 Paris, France
| | - T Ledent
- Inserm, Saint-Antoine Research Center, Saint-Antoine Hospital, Sorbonne University, Pierre-and-Marie-Curie University Paris 06, 75012 Paris, France
| | - M Moldes
- Inserm, Saint-Antoine Research Center, Saint-Antoine Hospital, Sorbonne University, Pierre-and-Marie-Curie University Paris 06, 75012 Paris, France; Hospitalo-Universitary Institute, ICAN, 75013 Paris, France
| | - B Blondeau
- Inserm, Saint-Antoine Research Center, Saint-Antoine Hospital, Sorbonne University, Pierre-and-Marie-Curie University Paris 06, 75012 Paris, France; Hospitalo-Universitary Institute, ICAN, 75013 Paris, France
| | - D Mitanchez
- Inserm, Saint-Antoine Research Center, Saint-Antoine Hospital, Sorbonne University, Pierre-and-Marie-Curie University Paris 06, 75012 Paris, France; Hospitalo-Universitary Institute, ICAN, 75013 Paris, France; Department of Neonatology, Armand-Trousseau Hospital, 75012 Paris, France
| | - M Buyse
- Inserm, Saint-Antoine Research Center, Saint-Antoine Hospital, Sorbonne University, Pierre-and-Marie-Curie University Paris 06, 75012 Paris, France; Hospitalo-Universitary Institute, ICAN, 75013 Paris, France; Paris-Sud University, EA 4123, 92296 Châtenay-Malabry, France; Department of Pharmacy, Saint-Antoine Hospital, AP-HP, 75012 Paris, France
| | - B Fève
- Inserm, Saint-Antoine Research Center, Saint-Antoine Hospital, Sorbonne University, Pierre-and-Marie-Curie University Paris 06, 75012 Paris, France; Hospitalo-Universitary Institute, ICAN, 75013 Paris, France; Department of Endocrinology, Saint-Antoine Hospital, AP-HP, 75012 Paris, France.
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Yardley D, Hurvitz S, Jiang ZF, Toi M, Burris H, Buyse M, Slamon D, Makhson A, Elsaid A, Lerzo G, Hellerstedt B, Nuzzo F, Sohn J, Manzyuk L, Cabaribere D, Lincy J, Weimann A, Noel-Baron F, Pacaud L, Andre F. Abstract P4-22-13: Everolimus plus trastuzumab and paclitaxel as first-line therapy in women with HER2+ advanced breast cancer: Overall survival results from BOLERO-1. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-22-13] [Citation(s) in RCA: 2] [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: 11/16/2022]
Abstract
Abstract
Background
Everolimus (EVE), an mTOR inhibitor has shown activity in HER2+ advanced breast cancer (ABC) in both preclinical and clinical studies. In the pivotal BOLERO-1 trial (NCT00876395), the progression-free survival (PFS) was not significantly different between the EVE + trastuzumab (TRAS) + paclitaxel (PAC) combination and placebo (PBO) + TRAS + PAC in the full HER2+ population (EVE, 15.0 mo vs PBO, 14.5 mo; HR=0.89; 95% CI: 0.73-1.08; p=0.1166). Although not reaching protocol defined level for statistical significance, the hormone receptor negative (HR-) subpopulation appeared to benefit from EVE, with a 7.2 mo PFS benefit vs PBO arm (EVE, 20.3 mo vs PBO, 13.1 mo; HR=0.66; 95% CI: 0.48-0.91; p=0.0049). The final exploratory overall survival (OS) analysis from the study is presented here.
Methods
In this phase 3 randomized trial, 719 women with HER2+ ABC without prior TRAS or chemotherapy in the metastatic setting were randomized 2:1 to receive either EVE (10 mg/d) or placebo (PBO) and weekly PAC+TRAS, stratified by visceral metastasis (lung, liver, peritoneal or pleural: yes vs no) and prior adjuvant or neo-adjuvant treatment with TRAS (yes vs no). As the primary objectives (PFS on full population and on HR- subpopulation) of BOLERO-1 were not met, the key secondary endpoint of OS was not formally statistically tested. However, given the results of PFS, in particular in the HR- subpopulation, a change to the OS analysis plan was made by introducing one final exploratory OS analysis at the time of study termination.
Results
At data cutoff (Dec 31, 2015), the median duration of exposure was 40.8 weeks (range: 0.6-320.4) in the EVE arm and 48.1 weeks (range: 1.1-308.0) in the PBO arm. After a median follow-up of 60.3 mo, 350 deaths were recorded in the full population, 238 (49.6%) in the EVE arm and 112 (46.9%) pts in the PBO arm. In the full population, the median OS was comparable in the EVE vs PBO arms (48.6 mo vs 50.0 mo respectively; HR = 1.13; 95% CI: 0.90-1.42). In the HR- subpopulation, 138 deaths were recorded; 88 (42.3%) pts in the EVE arm and 50 (48.5%) pts in the PBO arm. In the HR- subpopulation, the median OS in the EVE arm was longer compared to PBO arm (57.0 mo vs 41.6 mo respectively; HR = 0.83; 95% CI: 0.59-1.18). Stomatitis, diarrhea, alopecia, cough, rash, pyrexia, neutropenia, and fatigue were the most frequent adverse events (AEs) reported in EVE arm (≥35%). AEs leading to dose interruption and/or change were reported in 441 (93.4%) pts in EVE arm and 165 (69.3%) pts in the PBO arm respectively. Overall, AEs leading to treatment discontinuation were reported in 262 (55.5%) pts in EVE arm and 98 (41.2%) pts in PBO arm. Serious AEs were reported in 171 (36.2%) pts in the EVE arm and 40 (16.8%) pts in the PBO arm respectively. On treatment AE related deaths were reported for 3.6% pts in the EVE arm and 0% pts in the PBO arm.
Conclusions
The median OS was similar in the EVE vs PBO arms for overall population. However, a prolongation of 15.4 mo in median OS of HR- subpopulation was observed in the EVE arm vs PBO arm in this exploratory analysis. Pts in the EVE arm had a manageable safety, consistent with the safety profile of EVE and no new safety signals were identified.
Citation Format: Yardley D, Hurvitz S, Jiang Z-f, Toi M, Burris H, Buyse M, Slamon D, Makhson A, Elsaid A, Lerzo G, Hellerstedt B, Nuzzo F, Sohn J, Manzyuk L, Cabaribere D, Lincy J, Weimann A, Noel-Baron F, Pacaud L, Andre F. Everolimus plus trastuzumab and paclitaxel as first-line therapy in women with HER2+ advanced breast cancer: Overall survival results from BOLERO-1 [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-22-13.
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Affiliation(s)
- D Yardley
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - S Hurvitz
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - Z-f Jiang
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - M Toi
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - H Burris
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - M Buyse
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - D Slamon
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - A Makhson
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - A Elsaid
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - G Lerzo
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - B Hellerstedt
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - F Nuzzo
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - J Sohn
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - L Manzyuk
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - D Cabaribere
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - J Lincy
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - A Weimann
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - F Noel-Baron
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - L Pacaud
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - F Andre
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
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Xie W, Sweeney C, Regan M, Nakabayashi M, Buyse M, Clarke N, Collette L, Dignam J, Fizazi K, Habibian M, Halabi S, Kantoff P, Parulekar W, Sandler H, Sartor O, Soule H, Sydes M, Tombal B, Williams S. Metastasis free survival (MFS) is a surrogate for overall survival (OS) in localized prostate cancer (CaP). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Martinerie C, Garcia M, Do TTH, Antoine B, Moldes M, Dorothee G, Kazazian C, Auclair M, Buyse M, Ledent T, Marchal PO, Fesatidou M, Beisseiche A, Koseki H, Hiraoka S, Chadjichristos CE, Blondeau B, Denis RG, Luquet S, Fève B. NOV/CCN3: A New Adipocytokine Involved in Obesity-Associated Insulin Resistance. Diabetes 2016; 65:2502-15. [PMID: 27284105 DOI: 10.2337/db15-0617] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 05/23/2016] [Indexed: 11/13/2022]
Abstract
Identification of new adipokines that potentially link obesity to insulin resistance represents a major challenge. We recently showed that NOV/CCN3, a multifunctional matricellular protein, is synthesized and secreted by adipose tissue, with plasma levels highly correlated with BMI. NOV involvement in tissue repair, fibrotic and inflammatory diseases, and cancer has been previously reported. However, its role in energy homeostasis remains unknown. We investigated the metabolic phenotype of NOV(-/-) mice fed a standard or high-fat diet (HFD). Strikingly, the weight of NOV(-/-) mice was markedly lower than that of wild-type mice but only on an HFD. This was related to a significant decrease in fat mass associated with an increased proportion of smaller adipocytes and to a higher expression of genes involved in energy expenditure. NOV(-/-) mice fed an HFD displayed improved glucose tolerance and insulin sensitivity. Interestingly, the absence of NOV was associated with a change in macrophages profile (M1-like to M2-like), in a marked decrease in adipose tissue expression of several proinflammatory cytokines and chemokines, and in enhanced insulin signaling. Conversely, NOV treatment of adipocytes increased chemokine expression. Altogether, these results show that NOV is a new adipocytokine that could be involved in obesity-associated insulin-resistance.
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Affiliation(s)
- Cécile Martinerie
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Marie Garcia
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Thi Thu Huong Do
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Bénédicte Antoine
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Marthe Moldes
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Guillaume Dorothee
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France
| | - Chantal Kazazian
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Martine Auclair
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Marion Buyse
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France Hospitalo-Universitary Institute, ICAN, Paris, France Department of Pharmacy, Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Paris, France Paris-Sud University, EA 4123, Châtenay-Malabry, France
| | - Tatiana Ledent
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France
| | - Pierre-Olivier Marchal
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Maria Fesatidou
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France Hospitalo-Universitary Institute, ICAN, Paris, France
| | - Adrien Beisseiche
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Cordeliers Research Center, Paris, France
| | - Haruhiko Koseki
- RIKEN Research Center for Allergy and Immunology (RCAI), RIKEN Yokohama Institute, Yokohama, Japan
| | - Shuichi Hiraoka
- Department of Biochemistry, Kobe Pharmaceutical University, Kobe, Japan
| | | | - Bertrand Blondeau
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Cordeliers Research Center, Paris, France
| | | | - Serge Luquet
- Sorbonne Paris City University, Paris Diderot University, BFA, CNRS, Paris, France
| | - Bruno Fève
- Sorbonne Universities, Pierre and Marie Curie University Paris 06, INSERM, Saint-Antoine Research Center, Saint-Antoine Hospital, Paris, France Hospitalo-Universitary Institute, ICAN, Paris, France Department of Endocrinology, Paris, Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Paris, France
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Liénard JL, Quinaux E, Fabre-Guillevin E, Piedbois P, Jouhaud A, Decoster G, Buyse M. Impact of on-site initiation visits on patient recruitment and data quality in a randomized trial of adjuvant chemotherapy for breast cancer. Clin Trials 2016; 3:486-92. [PMID: 17060222 DOI: 10.1177/1740774506070807] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [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: 11/15/2022]
Abstract
Purpose To provide empirical evidence on the impact of on-site initiation visits on the following outcomes: patient recruitment, quantity and quality of data submitted to the trial coordinating office, and patients' follow-up time. Patients and methods This methodological study was performed as part of a randomized trial comparing two combination chemotherapies for adjuvant treatment of breast cancer. Centers participating to the trial were randomized to either receive systematic on-site visits (Visited group), or not (Non-visited group). Results The study was terminated after two years, while the main randomized trial continued. Of the 135 centers that had expressed an interest in the trial, only 69 randomized at least one patient (35/68 in the Visited group, 34/67 in the Nonvisited group). Almost two-thirds of the patients were entered by 17 centers (10 in the Visited group, seven in the Non-visited group) that accrued more than 10 patients each. None of the prespecified outcomes favored the group of centers submitted to on-site initiation visits (ie, mean number of queries par patient: 6.1 ± 9.7 versus 5.4 ± 6.4, respectively for the Visited and Non-visited groups). Spontaneous transmittal of case report forms, although required by protocol, was low in both randomized groups (mean number of pages per patient: 1.5 ± 2.0 versus 2.1 ± 2.3, respectively), with investigators submitting about one-third of the expected forms on time (29% and 39%, respectively). Limitations This study could not evaluate the impact of repeated on-site visits on clinical outcomes. Conclusion Systematic on-site initiation visits did not contribute significantly to this clinical trial.
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Affiliation(s)
- J-L Liénard
- International Drug Development Institute (IDDI), Brussels, Belgium.
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25
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Saad ED, Buyse M. Response to the letter to the editor 'Reply to "Statistical controversies in clinical research: end points other than survival are vital for regulatory approval of anticancer agents" by H. K. van Halteren'. Ann Oncol 2016; 27:1653. [PMID: 27154422 DOI: 10.1093/annonc/mdw196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E D Saad
- International Drug Development Institute, Louvain-la-Neuve, Belgium Dendrix Research, Sao Paulo, Brazil
| | - M Buyse
- International Drug Development Institute, Louvain-la-Neuve, Belgium Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), Hasselt University, Diepenbeek, Belgium
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Michiels S, Pugliano L, Marguet S, Grun D, Barinoff J, Cameron D, Cobleigh M, Di Leo A, Johnston S, Gasparini G, Kaufman B, Marty M, Nekljudova V, Paluch-Shimon S, Penault-Llorca F, Slamon D, Vogel C, von Minckwitz G, Buyse M, Piccart M. Progression-free survival as surrogate end point for overall survival in clinical trials of HER2-targeted agents in HER2-positive metastatic breast cancer. Ann Oncol 2016; 27:1029-1034. [PMID: 26961151 DOI: 10.1093/annonc/mdw132] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [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: 12/10/2015] [Accepted: 03/03/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The gold standard end point in randomized clinical trials in metastatic breast cancer (MBC) is overall survival (OS). Although therapeutics have been approved based on progression-free survival (PFS), its use as a primary end point is controversial. We aimed to assess to what extent PFS may be used as a surrogate for OS in randomized trials of anti-HER2 agents in HER2+ MBC. METHODS Eligible trials accrued HER2+ MBC patients in 1992-2008. A correlation approach was used: at the individual level, to estimate the association between investigator-assessed PFS and OS using a bivariate model and at the trial level, to estimate the association between treatment effects on PFS and OS. Correlation values close to 1.0 would indicate strong surrogacy. RESULTS We identified 2545 eligible patients in 13 randomized trials testing trastuzumab or lapatinib. We collected individual patient data from 1963 patients and retained 1839 patients from 9 trials for analysis (7 first-line trials). During follow-up, 1072 deaths and 1462 progression or deaths occurred. The median survival time was 22 months [95% confidence interval (CI) 21-23 months] and the median PFS was 5.7 months (95% CI 5.5-6.1 months). At the individual level, the Spearman correlation was equal to ρ = 0.67 (95% CI 0.66-0.67) corresponding to a squared correlation value of 0.45. At the trial level, the squared correlation between treatment effects (log hazard ratios) on PFS and OS was provided by R(2) = 0.51 (95% CI 0.22-0.81). CONCLUSIONS In trials of HER2-targeted agents in HER2+ MBC, PFS moderately correlates with OS at the individual level and treatment effects on PFS correlate moderately with those on overall mortality, providing only modest support for considering PFS as a surrogate. PFS does not completely substitute for OS in this setting.
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Affiliation(s)
- S Michiels
- Unit of Biostatistics and Epidemiology, Gustave Roussy, Villejuif; University Paris-Sud, University Paris-Saclay, UVSQ, CESP, INSERM, Villejuif; Plateform Ligue nationale contre le cancer for meta-analyses in oncology, Gustave Roussy, Villejuif, France; Institut Jules Bordet, Université Libre de Bruxelles, Brussels.
| | - L Pugliano
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels; Breast International Group (BIG), Brussels, Belgium
| | - S Marguet
- Unit of Biostatistics and Epidemiology, Gustave Roussy, Villejuif
| | - D Grun
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels
| | - J Barinoff
- Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany
| | - D Cameron
- Department of Oncology, University of Edinburgh, Edinburgh, UK
| | - M Cobleigh
- Rush University Medical Center, Chicago, USA
| | - A Di Leo
- Medical Oncology Unit, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy
| | - S Johnston
- Breast Unit, Royal Marsden Hospital, London, UK
| | - G Gasparini
- Scientific Direction, IRCCS National Cancer Research Centre "Giovanni Paolo II,"Bari, Italy
| | - B Kaufman
- The Institute of Breast Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - M Marty
- Breast Cancer Diseases Unit and Department of Medical Oncology, Saint Louis Hospital, APHP, Paris, France
| | - V Nekljudova
- German Breast Group, GBG ForschungsGmbH, Neu-Isenburg, Germany
| | - S Paluch-Shimon
- The Institute of Breast Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - F Penault-Llorca
- Department of Pathology, Centre Jean Perrin, EA 4233, University of Auvergne, Clermont-Ferrand, France
| | - D Slamon
- Jonsson Comprehensive Cancer Center, University of California-Los Angeles, Los Angeles
| | - C Vogel
- University of Miami School of Medicine, Comprehensive Cancer Research Group Inc, Columbia Cancer Research Network of Florida, Miami, USA
| | - G von Minckwitz
- German Breast Group, GBG ForschungsGmbH, Neu-Isenburg, Germany
| | - M Buyse
- IDDI, Louvain-la-Neuve, Hasselt University, Hasselt, Belgium
| | - M Piccart
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels; Breast International Group (BIG), Brussels, Belgium
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Mackey JR, Pieńkowski T, Crown J, Sadeghi S, Martin M, Chan A, Saleh M, Sehdev S, Provencher L, Semiglazov V, Press MF, Sauter G, Lindsay M, Houé V, Buyse M, Drevot P, Hitier S, Bensfia S, Eiermann W. Long-term outcomes after adjuvant treatment of sequential versus combination docetaxel with doxorubicin and cyclophosphamide in node-positive breast cancer: BCIRG-005 randomized trial. Ann Oncol 2016; 27:1041-1047. [PMID: 26940688 DOI: 10.1093/annonc/mdw098] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/16/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The optimal regimen for adjuvant breast cancer chemotherapy is undefined. We compared sequential to concurrent combination of doxorubicin and cyclophosphamide with docetaxel chemotherapy in women with node-positive non-metastatic breast cancer. We report the final, 10-year analysis of disease-free survival (DFS), overall survival (OS), and long-term safety. PATIENTS AND METHODS A total of 3298 women with HER2 nonamplified breast cancer were randomized to doxorubicin and cyclophosphamide every 3 weeks for four cycles followed by docetaxel (AC → T) every 3 weeks for four cycles or docetaxel, doxorubicin, and cyclophosphamide (TAC) every 3 weeks for six cycles. The patients received standard radiotherapy and endocrine therapy and were followed up for 10 years with annual clinical evaluation and mammography. RESULTS The 10-year DFS rates were 66.5% in the AC → T arm and 66.3% in the TAC arm (P = 0.749). OS was 79.9% in the AC → T arm and 78.9% in the TAC arm (P = 0.506). TAC was associated with higher rates of febrile neutropenia, although G-CSF primary prophylaxis greatly reduced this risk. AC → T was associated with a higher rate of myalgia, hand-foot syndrome, fluid retention, and sensory neuropathy. CONCLUSION This 10-year analysis of the BCIRG-005 trial confirmed that the efficacy of TAC was not superior to AC → T in women with node-positive early breast cancer. The toxicity profiles differ between arms and were consistent with previous reports. The TAC regimen with G-CSF support provides shorter adjuvant treatment duration with less toxicity. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT00312208.
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Affiliation(s)
- J R Mackey
- Department of Oncology, Cross Cancer Institute, Edmonton, Canada.
| | - T Pieńkowski
- Department of Oncology, Postgraduate Medical Education Centre, Warsaw, Poland
| | - J Crown
- All-Ireland Co-Operative Oncology Research Group, Dublin City University, Dublin, Ireland
| | - S Sadeghi
- Department of Oncology, University of California, Los Angeles, USA
| | - M Martin
- Department of Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - A Chan
- Breast Cancer Research Centre, WA & Curtin University, Perth, Australia
| | - M Saleh
- Department of Oncology, University of Alabama Comprehensive Cancer Center, Birmingham, USA
| | - S Sehdev
- Department of Oncology, William Osler Health Center, Brampton Civic Hospital, Brampton
| | - L Provencher
- Department of Oncology, CHU de Québec/Université Laval, Québec, Canada
| | - V Semiglazov
- Department of Oncology, Research Institute of Oncology N.N. Petrov Rosmedtechnologiy, St Petersburg, Russian Federation
| | - M F Press
- Department of Pathology, University of Southern California, Los Angeles, USA
| | - G Sauter
- Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Lindsay
- Translational Research in Oncology, Edmonton, Canada
| | - V Houé
- Translational Research in Oncology, Paris, France
| | - M Buyse
- Biostatistics, International Drug Development Institute Statistics, Leuven, Belgium
| | - P Drevot
- Translational Research in Oncology, Paris, France
| | - S Hitier
- Clinical Studies, Sanofi, Paris, France
| | - S Bensfia
- Clinical Studies, Sanofi, Paris, France
| | - W Eiermann
- Gynecology and Obstetrics, Isarklinikum & IOZ, Munich, Germany
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Buyse M, Hurvitz SA, Andre F, Jiang Z, Burris HA, Toi M, Eiermann W, Lindsay MA, Slamon D. Statistical controversies in clinical research: statistical significance-too much of a good thing …. Ann Oncol 2016; 27:760-2. [PMID: 26861602 DOI: 10.1093/annonc/mdw047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 01/26/2016] [Indexed: 11/14/2022] Open
Abstract
The use and interpretation of P values is a matter of debate in applied research. We argue that P values are useful as a pragmatic guide to interpret the results of a clinical trial, not as a strict binary boundary that separates real treatment effects from lack thereof. We illustrate our point using the result of BOLERO-1, a randomized, double-blind trial evaluating the efficacy and safety of adding everolimus to trastuzumab and paclitaxel as first-line therapy for HER2+ advanced breast cancer. In this trial, the benefit of everolimus was seen only in the predefined subset of patients with hormone receptor-negative breast cancer at baseline (progression-free survival hazard ratio = 0.66, P = 0.0049). A strict interpretation of this finding, based on complex 'alpha splitting' rules to assess statistical significance, led to the conclusion that the benefit of everolimus was not statistically significant either overall or in the subset. We contend that this interpretation does not do justice to the data, and we argue that the benefit of everolimus in hormone receptor-negative breast cancer is both statistically compelling and clinically relevant.
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Affiliation(s)
- M Buyse
- Department of Biostatistics, International Drug Development Institute (IDDI), Louvain La Neuve, Belgium
| | - S A Hurvitz
- Division of Hematology-Oncology, University of California, Los Angeles (UCLA), Los Angeles, USA
| | - F Andre
- Department of Medical Oncology, Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - Z Jiang
- Department of Breast Oncology, Beijing 307 Hospital of PLA, Beijing, China
| | - H A Burris
- Department of Drug Development, Sarah Cannon Research Institute, Nashville, USA
| | - M Toi
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - W Eiermann
- Breast Surgery Clinic, Isarklinikum München, Munich, Germany
| | - M-A Lindsay
- Department of Scientific Development, Translational Research in Oncology (TRIO), Edmonton, Canada
| | - D Slamon
- Division of Hematology-Oncology, University of California, Los Angeles (UCLA), Los Angeles, USA
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Saad ED, Buyse M. Statistical controversies in clinical research: end points other than overall survival are vital for regulatory approval of anticancer agents. Ann Oncol 2015; 27:373-8. [PMID: 26578738 DOI: 10.1093/annonc/mdv562] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/02/2015] [Indexed: 11/14/2022] Open
Abstract
There is an ongoing debate about the relative merits of overall survival (OS) and other metrics that can be used as primary end points in cancer clinical trials. Although survival time is arguably the most objective metric for assessing the efficacy of anticancer treatment, OS as a clinical-trial end point needs to be conceptually distinguished from increased survival time as a goal desired by patients, clinicians and public-health policy makers. OS presents several drawbacks as a primary end point that threatens to hamper further drug development, including the increase in the number of patients and the much longer follow-up required in a clinical trial. In many settings of first-line therapy for metastatic disease, median OS is currently two to four times longer than median progression-free survival. As a result, the analysis of OS may be increasingly confounded by the effect of salvage therapies used after disease progression. In this review, we use straightforward statistical reasoning and examples from the oncology literature to argue that OS should no longer be the primary end point of most future phase III cancer clinical trials that aim at assessing the efficacy of novel therapies in the setting of metastatic disease.
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Affiliation(s)
- E D Saad
- International Drug Development Institute, Louvain-la-Neuve, Belgium Department of Medical Oncology, Dendrix Research, Sao Paulo, Brazil
| | - M Buyse
- International Drug Development Institute, Louvain-la-Neuve, Belgium Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), Hasselt University, Diepenbeek, Belgium
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Ignatiadis M, Buyse M, Sotiriou C. St Gallen International Expert Consensus on the primary therapy of early breast cancer: an invaluable tool for physicians and scientists. Ann Oncol 2015; 26:1519-20. [PMID: 26063634 DOI: 10.1093/annonc/mdv259] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Ignatiadis
- Department of Medical Oncology and Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels
| | - M Buyse
- International Drug Development Institute, Louvain-la-Neuve, Belgium
| | - C Sotiriou
- Department of Medical Oncology and Breast Cancer Translational Research Laboratory, J. C. Heuson, Institut Jules Bordet, Université Libre de Bruxelles, Brussels
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Delbaldo C, Ychou M, Zawadi A, Douillard JY, André T, Guerin-Meyer V, Rougier P, Dupuis O, Faroux R, Jouhaud A, Quinaux E, Buyse M, Piedbois P. Postoperative irinotecan in resected stage II-III rectal cancer: final analysis of the French R98 Intergroup trial†. Ann Oncol 2015; 26:1208-1215. [PMID: 25739671 DOI: 10.1093/annonc/mdv135] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/20/2015] [Indexed: 08/08/2023] Open
Abstract
BACKGROUD The R98 trial explores the addition of irinotecan to a 5-fluorouracil (5-FU) plus leucovorin (5-FU/LV) adjuvant regimen in optimally resected stages II-III rectal cancers. We report the updated long-term results. Disease-free survival (DFS) was the primary end point. PATIENST AND METHODS Between March 1999 and December 2005, 357 patients were randomized: 178 in 5-FU/LV and 179 in LV5-FU2 + irinotecan arm. The trial was stratified by control arm: Mayo Clinic regimen or LV5-FU2 regimen. RESULTS Three hundred and fifty-seven randomized patients were evaluable for efficacy. With a follow-up of 156 months, the DFS was in favour of experimental arm but did not reach statistical significance [hazard ratio (HR) = 0.80, P = 0.154]. The same was observed for overall survival (OS) (HR = 0.87, P = 0.433). The 5-year DFS was 58% in the control arm and 63% in the experimental arm. The 5-year OS was 74% in the control arm and 75% in the experimental arm. Patients allocated to the experimental arm had more grade 3-4 neutropenia when compared with the LV5-FU2 arm (33% versus 6%, P = 0.03), but not when compared with the Mayo Clinic arm (33% versus 36%, P = 0.84). Grade 3-4 diarrhoea tended to be higher in the experimental arm, but analyses stratified by control arm or by radiotherapy failed to show significant differences across strata (test for interaction P = 0.44). CONCLUSION Even though a benefit of irinotecan in subgroups of patients cannot be excluded, due to early termination and lack of power, the study does not support the addition of irinotecan to 5-FU/LV in routine in patients with resected stage II-III rectal cancer.
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Affiliation(s)
- C Delbaldo
- Oncology Unit, Diaconesses Croix Saint Simon Hospital, Paris.
| | - M Ychou
- Digestive Oncology Unit, ICM Val D'Aurelle, Montpellier
| | - A Zawadi
- Radiotherapy Unit, Departemental Hospital Center, La Roche Sur Yon
| | | | - T André
- Oncology Unit, Saint-Antoine Hospital, GERCOR, and UMPC University Paris VI, Paris
| | | | - P Rougier
- Hepatogastroenterology and Digestive Oncology Unit, Université Paris V, Europeen Georges Pompidou Hospital, Paris
| | - O Dupuis
- Radiotherapy Unit, Jean-Bernard Center, Le Mans
| | - R Faroux
- Digestive Unit, Departemental Hospital Center, La Roche sur Yon
| | - A Jouhaud
- Radiotherapy Unit, Henri Mondor Hospital, Créteil, France
| | - E Quinaux
- International Development Drug Institute (IDDI), Louvain-la-Neuve, Belgium
| | - M Buyse
- International Development Drug Institute (IDDI), Louvain-la-Neuve, Belgium
| | - P Piedbois
- Oncology Unit, Paul Strauss Center, Strasbourg, France
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Péron J, Buyse M, Roy P. Évaluation de la balance bénéfice-risque des nouveaux traitements en utilisant les comparaisons par paire généralisées : le cas de l’erlotinib dans le cancer du pancréas. Rev Epidemiol Sante Publique 2015. [DOI: 10.1016/j.respe.2015.03.006] [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: 11/29/2022] Open
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Affiliation(s)
- J-C Soria
- Department of Drug Development, Institut Gustave Roussy, Villejuif, France
| | - M Buyse
- International Drug Development Institute (IDDI), Louvain-la-Neuve, Belgium
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Péron J, Roy P, Ding K, Parulekar WR, Roche L, Buyse M. Assessing the benefit-risk of new treatments using generalised pairwise comparisons: the case of erlotinib in pancreatic cancer. Br J Cancer 2015; 112:971-6. [PMID: 25688740 PMCID: PMC4366896 DOI: 10.1038/bjc.2015.55] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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] [Received: 11/07/2014] [Revised: 12/31/2014] [Accepted: 01/12/2015] [Indexed: 12/18/2022] Open
Abstract
Background: Efficacy and safety are the two considerations when characterising the effects of a new therapy. We sought to apply an innovative method of assessing the benefit–risk balance using data from a completed randomised controlled trial that compared erlotinib vs placebo added to gemcitabine in patients with advanced pancreatic cancer (NCIC CTG PA.3). Methods: We applied generalised pairwise comparisons with several prioritised outcome measures (e.g., one or more benefit outcomes and one or more risk outcomes). Here, the first priority outcome was overall survival (OS) time. Differences in OS that exceeded 2 months were considered clinically meaningful. The second priority outcome was toxicity. The overall treatment effect was quantified using the proportion in favour of erlotinib, which can be interpreted as the net proportion of patients who have a better overall outcome with erlotinib as compared with placebo. Sensitivity analyses were performed. Results: In this trial 569 patients were randomly assigned in a 1 : 1 ratio to receive gemcitabine plus either erlotinib or a matched placebo. Overall, the method indicated no statistically significant overall treatment effect in favour of erlotinib; if anything, the point estimate of the net proportion leaned in favour of the placebo group (overall proportion in favour of erlotinib=−3.6%, 95% CI, −14.2– 7.1% P=0.51). The net proportion was never in favour of the erlotinib group throughout all sensitivity analyses. Conclusions: Generalised pairwise comparisons make it possible to assess the benefit–risk balance of new treatments using a single statistical test for any number of prioritised outcomes. The benefit–risk assessment was not in favour of adding erlotinib to gemcitabine for the treatment of patients with advanced pancreatic cancer.
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Affiliation(s)
- J Péron
- 1] Service de biostatistiques, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite F-69310, France [2] CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Université Lyon 1, Villeurbanne, France
| | - P Roy
- 1] Service de biostatistiques, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite F-69310, France [2] CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Université Lyon 1, Villeurbanne, France
| | - K Ding
- NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada
| | - W R Parulekar
- NCIC Clinical Trials Group, Queen's University, Kingston, Ontario, Canada
| | - L Roche
- 1] Service de biostatistiques, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite F-69310, France [2] CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Université Lyon 1, Villeurbanne, France
| | - M Buyse
- International Drug Development Institute (IDDI), Louvain-la-Neuve, Belgium
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Desmet L, Venet D, Doffagne E, Timmermans C, Burzykowski T, Legrand C, Buyse M. Linear mixed-effects models for central statistical monitoring of multicenter clinical trials. Stat Med 2014; 33:5265-79. [DOI: 10.1002/sim.6294] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 08/15/2014] [Indexed: 11/06/2022]
Affiliation(s)
- L. Desmet
- Institut de Statistique, Biostatistique et Sciences Actuarielles (ISBA); Université catholique de Louvain; Louvain-la-Neuve Belgium
| | - D. Venet
- Institut de Recherches Interdisciplinaires et de Développements en Intelligence Artificielle (IRIDIA); Université Libre de Bruxelles; Brussels Belgium
| | - E. Doffagne
- International Drug Development Institute (IDDI) S.A.; Louvain-la-Neuve Belgium
| | - C. Timmermans
- International Drug Development Institute (IDDI) S.A.; Louvain-la-Neuve Belgium
| | - T. Burzykowski
- International Drug Development Institute (IDDI) S.A.; Louvain-la-Neuve Belgium
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat); Hasselt University; Diepenbeek Belgium
| | - C. Legrand
- Institut de Statistique, Biostatistique et Sciences Actuarielles (ISBA); Université catholique de Louvain; Louvain-la-Neuve Belgium
| | - M. Buyse
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat); Hasselt University; Diepenbeek Belgium
- International Drug Development Institute (IDDI) Inc.; San Francisco CA U.S.A
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Suciu S, Eggermont A, Lorigan P, Kirkwood J, Markovic S, Garbe C, Cameron D, Kotapati S, Konto C, Chen T, Wheatley K, Ives N, De Schaetzen G, Efendi A, Buyse M. Relapse-Free Survival (Rfs) As a Surrogate Endpoint for Overall Survival (Os) in Adjuvant Interferon Trials in Patients (Pts) with Resectable Cutaneous Melanoma: an Individual Patient Data (Ipd) Meta-Analysis. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu344.5] [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: 11/14/2022] Open
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Do TTH, Hindlet P, Waligora-Dupriet AJ, Kapel N, Neveux N, Mignon V, Deloménie C, Farinotti R, Fève B, Buyse M. Disturbed intestinal nitrogen homeostasis in a mouse model of high-fat diet-induced obesity and glucose intolerance. Am J Physiol Endocrinol Metab 2014; 306:E668-80. [PMID: 24425764 DOI: 10.1152/ajpendo.00437.2013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The oligopeptide transporter peptide cotransporter-1 Slc15a1 (PEPT1) plays a major role in the regulation of nitrogen supply, since it is responsible for 70% of the dietary nitrogen absorption. Previous studies demonstrated that PEPT1 expression and function in jejunum are reduced in diabetes and obesity, suggesting a nitrogen malabsorption from the diet. Surprisingly, we reported here a decrease in gut nitrogen excretion in high-fat diet (HFD)-fed mice and further investigated the mechanisms that could explain this apparent contradiction. Upon HFD, mice exhibited an increased concentration of free amino acids (AAs) in the portal vein (60%) along with a selective increase in the expression of two AA transporters (Slc6a20a, Slc36a1), pointing to a specific and adaptive absorption of some AAs. A delayed transit time (+40%) and an increased intestinal permeability (+80%) also contribute to the increase in nitrogen absorption. Besides, HFD mice exhibited a 2.2-fold decrease in fecal DNA resulting from a reduction in nitrogen catabolism from cell desquamation and/or in the intestinal microbiota. Indeed, major quantitative (2.5-fold reduction) and qualitative alterations of intestinal microbiota were observed in feces of HFD mice. Collectively, our results strongly suggest that both increased AA transporters, intestinal permeability and transit time, and changes in gut microbiota are involved in the increased circulating AA levels. Modifications in nitrogen homeostasis provide a new insight in HFD-induced obesity and glucose intolerance; however, whether these modifications are beneficial or detrimental for the HFD-associated metabolic complications remains an open issue.
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Affiliation(s)
- Thi Thu Huong Do
- Université Pierre et Marie Curie, Paris, Unité Mixte de Recherche S938, Paris, France
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Cavin JB, Tavernier A, Ducroc R, Denis R, Cluzeaud F, Guilmeau S, Barbot L, Kapel N, Buyse M, Le Beyec J, Joly F, Luquet S, Le Gall M, Bado A. O33 L’invalidation spécifique du récepteur intestinal LEPR-B modifie l’activité des transporteurs entérocytaires et confère aux souris une moindre susceptibilité à l’obésité nutritionnelle. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70305-4] [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: 12/01/2022]
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Delbaldo C, Serin D, Mousseau M, Greget S, Audhuy B, Priou F, Berdah JF, Teissier E, Laplaige P, Zelek L, Quinaux E, Buyse M, Piedbois P. A phase III adjuvant randomised trial of 6 cycles of 5-fluorouracil-epirubicine-cyclophosphamide (FEC100) versus 4 FEC 100 followed by 4 Taxol (FEC-T) in node positive breast cancer patients (Trial B2000). Eur J Cancer 2013; 50:23-30. [PMID: 24183460 DOI: 10.1016/j.ejca.2013.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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: 01/22/2013] [Revised: 08/16/2013] [Accepted: 09/26/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Standard adjuvant chemotherapy regimens for patients with node positive (N+) breast cancer consisted of anthracycline followed by taxane. The European Association for Research in Oncology embarked in 2000 on a phase III trial comparing 6 cycles of FEC100 versus 4 FEC100 followed by 4 Taxol. Primary end-point was disease free survival. Secondary end-points were overall survival, local recurrence free interval, metastases free interval and safety. PATIENTS AND METHODS Between March 2000 and December 2002, 837 patients were randomised between 6FEC100 for 6 cycles (417patients) or FEC100 for 4 cycles then Taxol 175mg/m(2)/3 weeks for 4 cycles (4FEC100-4T) (420 patients). One thousand patients had been planned initially but the trial was closed earlier due to slow accrual. RESULTS Hazard ratios (HRs) were 0.99 for disease-free survival (DFS) (95%CI: 0.77-1.26; p=0.91), and 0.85 for overall survival (OS) (95%CI: 0.62-1.15; p=0.29). Nine-year DFS were 62.9% versus 62.5% for 6FEC100 and 4FEC100-4T, respectively. Nine-year OS were 73.9% versus 77% for 6FEC100 and 4FEC100-4T, respectively. Toxicity analyses based on 803 evaluable patients showed that overall grade 3-4 toxicities were similar in both arms (63% versus 58% for 6FEC100 arm and 4FEC100-4T arm, respectively; p=0.16). CONCLUSION In this trial replacing the last 2 FEC100 cycles of 6FEC100 regimen by 4 Taxol does not lead to a discernable DFS or OS advantage. The lack of a significant difference between the randomised treatment arms may however be due to a lack of power of this trial to detect small, yet clinically worthwhile, treatment benefits.
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Affiliation(s)
- C Delbaldo
- Service de Cancérologie, Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, France.
| | - D Serin
- Clinique St Catherine, Avignon, France
| | | | - S Greget
- Clinique St Clotilde, La Réunion, France
| | | | - F Priou
- Service Onco-Hématologie, Centre Hospitalier Départemental, La Roche Sur Yon, France
| | | | - E Teissier
- Centre Azuréen de Cancérologie, Mougins, France
| | - P Laplaige
- Polyclinique de Blois, La Chaussée St Victor, France
| | - L Zelek
- Service de Cancérologie, Hôpital Avicennes, Hôpitaux Universitaires Paris-Seine-Saint Denis, France
| | - E Quinaux
- International Development Drug Institute (IDDI), Louvain-la-Neuve, Belgium
| | - M Buyse
- International Development Drug Institute (IDDI), Louvain-la-Neuve, Belgium
| | - P Piedbois
- Service d'Oncologie Médicale, Hôpital Henri Mondor, Créteil, France
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Haibe-Kains B, Desmedt C, Di Leo A, Azambuja E, Larsimont D, Selleslags J, Delaloge S, Duhem C, Kains J, Carly B, Maerevoet M, Vindevoghel A, Rouas G, Lallemand F, Durbecq V, Cardoso F, Salgado R, Rovere R, Bontempi G, Michiels S, Buyse M, Nogaret J, Qi Y, Symmans F, Pusztai L, D'Hondt V, Piccart-Gebhart M, Sotiriou C. Genome-wide gene expression profiling to predict resistance to anthracyclines in breast cancer patients. Genom Data 2013; 1:7-10. [PMID: 26484051 PMCID: PMC4608867 DOI: 10.1016/j.gdata.2013.09.001] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 09/12/2013] [Indexed: 11/19/2022]
Abstract
Validated biomarkers predictive of response/resistance to anthracyclines in breast cancer are currently lacking. The neoadjuvant Trial of Principle (TOP) study, in which patients with estrogen receptor (ER)–negative tumors were treated with anthracycline (epirubicin) monotherapy, was specifically designed to evaluate the predictive value of topoisomerase II-alpha (TOP2A) and develop a gene expression signature to identify those patients who do not benefit from anthracyclines. Here we describe in details the contents and quality controls for the gene expression and clinical data associated with the study published by Desmedt and colleagues in the Journal of Clinical Oncology in 2011 (Desmedt et al., 2011). We also provide R code to easily access the data and perform the quality controls and basic analyses relevant to this dataset.
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Affiliation(s)
- B. Haibe-Kains
- Institut Jules Bordet, Brussels, Belgium
- Machine Learning Group, Université Libre de Bruxelles, Brussels, Belgium
- Ontario Cancer Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - C. Desmedt
- Institut Jules Bordet, Brussels, Belgium
| | | | | | | | | | | | - C. Duhem
- Centre Hospitalier du Luxembourg, Luxembourg
| | - J.P. Kains
- HIS—Site Etterbeek-Ixelles, Brussels, Belgium
| | - B. Carly
- Hopital Saint-Pierre, Brussels, Belgium
| | | | | | - G. Rouas
- Institut Jules Bordet, Brussels, Belgium
| | | | - V. Durbecq
- Institut Jules Bordet, Brussels, Belgium
| | - F. Cardoso
- Institut Jules Bordet, Brussels, Belgium
| | - R. Salgado
- Institut Jules Bordet, Brussels, Belgium
| | - R. Rovere
- Institut Jules Bordet, Brussels, Belgium
| | - G. Bontempi
- Machine Learning Group, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | | | - Y. Qi
- Institut Jules Bordet, Brussels, Belgium
| | - F. Symmans
- The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - L. Pusztai
- Yale Cancer Center, Yale University, New Haven, CT, USA
| | - V. D'Hondt
- Institut Jules Bordet, Brussels, Belgium
| | | | - C. Sotiriou
- Institut Jules Bordet, Brussels, Belgium
- Corresponding author at: Institut Jules Bordet, 121 Boulevard de Waterloo, 1000 Bruxelles, Belgium. Tel.: +32 2 541 34 28; fax: +32 2 538 08 58.
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Ajani JA, Buyse M, Lichinitser M, Gorbunova V, Bodoky G, Douillard JY, Cascinu S, Heinemann V, Zaucha R, Carrato A, Ferry D, Moiseyenko V. Combination of cisplatin/S-1 in the treatment of patients with advanced gastric or gastroesophageal adenocarcinoma: Results of noninferiority and safety analyses compared with cisplatin/5-fluorouracil in the First-Line Advanced Gastric Cancer Study. Eur J Cancer 2013; 49:3616-24. [PMID: 23899532 DOI: 10.1016/j.ejca.2013.07.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [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: 03/08/2013] [Accepted: 07/01/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND The aim of developing oral fluorouracil (5-FU) is to provide a more convenient administration route with similar efficacy and the best achievable tolerance. S-1, a novel oral fluoropyrimidine, was specifically designed to overcome the limitations of intravenous fluoropyrimidine therapies. PATIENTS AND METHODS A multicentre, randomised phase 3 trial was undertaken to compare S-1/cisplatin (CS) with infusional 5-FU/cisplatin (CF) in 1053 patients with untreated, advanced gastric/gastroesophageal adenocarcinoma. This report discusses a post-hoc noninferiority overall survival (OS) and safety analyses. RESULTS Results (1029 treated; CS = 521/CF = 508) revealed OS in CS (8.6 months) was statistically noninferior to CF (7.9 months) [hazard ratio (HR) = 0.92 (two-sided 95% confidence interval (CI), 0.80-1.05)] for any margin equal to or greater than 1.05. Statistically significant safety advantages for the CS arm were observed [G3/4 neutropenia (CS, 18.6%; CF, 40.0%), febrile neutropenia (CS, 1.7%; CF, 6.9%), G3/4 stomatitis (CS, 1.3%; CF, 13.6%), diarrhoea (all grades: CS, 29.2%; CF, 38.4%) and renal adverse events (all grades: CS, 18.8%; CF, 33.5%)]. Hand-foot syndrome, infrequently reported, was mainly grade 1/2 in both arms. Treatment-related deaths were significantly lower in the CS arm than the CF arm (2.5% and 4.9%, respectively; P<0.047). CONCLUSION CS is noninferior to CF with a better safety profile and provides a new treatment option for patients with advanced gastric carcinoma.
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Affiliation(s)
- J A Ajani
- Department of Gastrointestinal Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, USA.
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Aron-Wisnewsky J, Lemaitre F, Clément K, Bouillot JL, Fernandez C, Basdevant A, Oppert JM, Buyse M. Pharmacokinetics of Immunomodulator Treatments After Roux-En-Y Bypass in Obese Patient. J Clin Pharmacol 2013; 53:779-84. [DOI: 10.1002/jcph.99] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 04/15/2013] [Indexed: 01/08/2023]
Affiliation(s)
| | - Florian Lemaitre
- Clinical Pharmacy Laboratory; Faculty of Pharmacy, University Paris XI; 5, rue Jean Baptiste Clément; 92296; Chatenay-Malabry; France
| | | | - Jean-Luc Bouillot
- Surgery Department; Ambroise Paré Hospital Assistance Publique-Hôpitaux de Paris; 9, avenue Charles de Gaulle; 92104; Boulogne-Billancourt cedex; France
| | | | | | - Jean-Michel Oppert
- Nutrition Department, Part of the Institute of Cardio-metabolism and Nutrition (ICAN); Pitié-Salpétrière Hospital (AP-HP) and Center for Human Nutrition Research-Ile-de-France (CRNH-IdF), University Pierre et Marie Curie-Paris 6; 83 boulevard de l'Hôpital; 75013; Paris; France
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Oakman C, Francis PA, Crown J, Quinaux E, Buyse M, De Azambuja E, Margeli Vila M, Andersson M, Nordenskjöld B, Jakesz R, Thürlimann B, Gutiérrez J, Harvey V, Punzalan L, Dell'orto P, Larsimont D, Steinberg I, Gelber RD, Piccart-Gebhart M, Viale G, Di Leo A. Overall survival benefit for sequential doxorubicin-docetaxel compared with concurrent doxorubicin and docetaxel in node-positive breast cancer--8-year results of the Breast International Group 02-98 phase III trial. Ann Oncol 2013; 24:1203-11. [PMID: 23293111 DOI: 10.1093/annonc/mds627] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background In women with node-positive breast cancer, the Breast International Group (BIG) 02-98 tested the incorporation of docetaxel (Taxotere) into doxorubicin (Adriamycin)-based chemotherapy, and compared sequential and concurrent docetaxel. At 5 years, there was a trend for improved disease-free survival (DFS) with docetaxel. We present results at 8-year median follow-up and exploratory analyses within biologically defined subtypes. Methods Patients were randomly assigned to one of four treatments: (i) sequential control: doxorubicin (A) (75 mg/m(2)) × 4 →classical cyclophosphamide, methotrexate, 5-fluorouracil (CMF); (ii) concurrent control: doxorubicin, cyclophosphamide (AC)(60/600 mg/m(2)) × 4 →CMF; (iii) sequential docetaxel: A (75 mg/m(2)) × 3 → docetaxel (T) (100 mg/m(2)) × 3 → CMF and (iv) concurrent docetaxel: AT(50/75 mg/m(2)) × 4 →CMF. The primary comparison evaluated docetaxel efficacy regardless of the schedule. Exploratory analyses were undertaken within biologically defined subtypes. Results Two thousand eight hundred and eighty-seven patients were enrolled. After 93.4 months of median follow-up, there were 916 DFS events. For the primary comparison, there was no significant improvement in DFS from docetaxel [hazard ratio (HR) = 0.91, 95% confidence interval (CI) = 0.80-1.05, P = 0.187]. In secondary comparisons, sequential docetaxel significantly improved DFS compared with sequential control (HR = 0.81, 95% CI = 0.67-0.99, P = 0.036), and significantly improved DFS (HR = 0.84, 95% CI = 0.72-0.99, P = 0.035) and overall survival (OS) (HR = 0.79, 95% CI = 0.65-0.98, P = 0.028) compared with concurrent doxorubicin-docetaxel. Luminal-A disease had the best prognosis. HRs favored addition of sequential docetaxel in all subtypes, except luminal-A; but this observation was not statistically supported because of limited numbers. Conclusion With further follow-up, the sequential docetaxel schedule resulted in significantly better OS than concurrent doxorubicin-docetaxel, and continued to show better DFS than sequential doxorubicin-based control.
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Affiliation(s)
- C Oakman
- Sandro Pitigliani Medical Oncology Unit, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy
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Durand J, Blanchet B, Buyse M, Neveux N, Boudou-Rouquette P, Mir O, Vidal M, Cynober L, Goldwasser F. Relationship Between Intestinal Function and Exposure to Sorafenib and Sunitinib in Cancer Patients. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32797-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
BACKGROUND In age-related macular degeneration (ARMD) trials, the FDA-approved endpoint is the loss (or gain) of at least three lines of vision as compared to baseline. The use of such a response endpoint entails a potentially severe loss of information. A more efficient strategy could be obtained by using longitudinal measures of the change in visual acuity. In this paper we investigate, by using data from two randomized clinical trials, the mean and variance-covariance structures of the longitudinal measurements of the change in visual acuity. METHODS Individual patient data were collected in 234 patients in a randomized trial comparing interferon-α with placebo and in 1181 patients in a randomized trial comparing three active doses of pegaptanib with sham. A linear model for longitudinal data was used to analyze the repeated measurements of the change in visual acuity. RESULTS For both trials, the data were adequately summarized by a model that assumed a quadratic trend for the mean change in visual acuity over time, a power variance function, and an antedependence correlation structure. The power variance function was remarkably similar for the two datasets and involved the square root of the measurement time. CONCLUSIONS The similarity of the estimated variance functions and correlation structures for both datasets indicates that these aspects may be a genuine feature of the measurements of changes in visual acuity in patients with ARMD. The feature can be used in the planning and analysis of trials that use visual acuity as the clinical endpoint of interest.
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Affiliation(s)
- Tomasz Burzykowski
- International Drug Development Institute (IDDI), Louvain-la-Neuve, Belgium; Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), Hasselt University, Diepenbeek, Belgium.
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Do TM, Noel-Hudson MS, Ribes S, Besengez C, Smirnova M, Cisternino S, Buyse M, Calon F, Chimini G, Chacun H, Scherrmann JM, Farinotti R, Bourasset F. ABCG2- and ABCG4-Mediated Efflux of Amyloid-β Peptide 1-40 at the Mouse Blood-Brain Barrier. ACTA ACUST UNITED AC 2012; 30:155-66. [DOI: 10.3233/jad-2012-112189] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Tuan Minh Do
- Department of Clinical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, University of Paris-Sud, Châtenay-Malabry, France
| | - Marie-Sophie Noel-Hudson
- Department of Clinical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, University of Paris-Sud, Châtenay-Malabry, France
| | - Sandy Ribes
- Department of Clinical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, University of Paris-Sud, Châtenay-Malabry, France
| | - Capucine Besengez
- Department of Pharmacokinetics, INSERM U705, CNRS UMR 8206, Faculty of Pharmacy, Université Paris Descartes, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Maria Smirnova
- Department of Pharmacokinetics, INSERM U705, CNRS UMR 8206, Faculty of Pharmacy, Université Paris Descartes, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Salvatore Cisternino
- Department of Pharmacokinetics, INSERM U705, CNRS UMR 8206, Faculty of Pharmacy, Université Paris Descartes, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Marion Buyse
- Department of Clinical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, University of Paris-Sud, Châtenay-Malabry, France
| | | | - Giovanna Chimini
- Centre d'Immunologie de Marseille-Luminy, INSERM-CNRS-Université de La Méditerranée, Marseille, France
| | - Hélène Chacun
- Laboratory of Biopharmacy and Pharmaceutical Technology, CNRS UMR 8612, Faculty of Pharmacy, University of Paris-Sud, Châtenay-Malabry, France
| | - Jean-Michel Scherrmann
- Department of Pharmacokinetics, INSERM U705, CNRS UMR 8206, Faculty of Pharmacy, Université Paris Descartes, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Robert Farinotti
- Department of Clinical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, University of Paris-Sud, Châtenay-Malabry, France
| | - Fanchon Bourasset
- Department of Pharmacokinetics, INSERM U705, CNRS UMR 8206, Faculty of Pharmacy, Université Paris Descartes, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
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Affiliation(s)
- M Buyse
- International Drug Development Institute, Louvain-la-Neuve, Belgium
| | - D J Sargent
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester
| | - R M Goldberg
- Ohio State University Comprehensive Cancer Center, The James Cancer Hospital and Solove Research Institute, Columbus, USA
| | - A de Gramont
- Department of Oncology, Hôpital Saint-Antoine, Paris, France.
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Duchnowska R, Biernat W, Szostakiewicz B, Sperinde J, Piette F, Haddad M, Paquet A, Lie Y, Czartoryska-Arlukowicz B, Wysocki P, Jankowski T, Radecka B, Foszczynska-Kloda M, Litwiniuk M, Debska S, Weidler J, Huang W, Buyse M, Bates M, Jassem J. P2-12-05: Correlation between Quantitative HER2 Protein Expression and Risk of Brain Metastases in HER2−Positive Advanced Breast Cancer Patients Receiving Trastuzumab-Containing Therapy. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p2-12-05] [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: 11/16/2022]
Abstract
Abstract
Background. Patients with HER2−positive breast cancer are at particularly high risk for brain metastases; however, the biological basis is not fully understood. Within HER2−positive breast cancer tumors, it is possible to resolve a ∼1.5-log range of HER2 protein expression using a novel quantitative HER2 assay (HERmark®). We investigated the correlation between quantitative HER2 protein expression in primary breast cancers and the time to brain metastases (TTBM) in HER2−positive advanced breast cancer patients treated with trastuzumab.
Methods. The study group included 142 consecutive patients who were administered trastuzumab-based therapy for HER2−positive metastatic breast cancer, defined as 3+ categorical staining by immunohistochemistry (IHC). HER-2/neu gene copy number was subsequently quantified as HER2/CEP17 ratio by central laboratory fluorescence in situ hybridization (FISH). HER2 protein was quantified as total HER2 protein expression (H2T) by the HERmark assay in formalin-fixed, paraffin-embedded primary tumor samples. HER2 variables were correlated with clinical features and TTBM measured from the initiation of trastuzumab-containing therapy.
Results. H2T level (continuous variable) was correlated with shorter TTBM (HR=2.3; p=0.013), whereas HER2 gene amplification by FISH (p=0.28) and continuous HER2/CEP17 ratio (p=0.25) had no significant prognostic impact. The correlation between continuous H2T level and TTBM was confirmed in a multivariate analysis (HR=3.2; p=0.021). Controlling for the competing risk of death from causes other than brain metastases, continuous H2T remained a strong correlate of TTBM (HR=2.7; p=0.0009). In the subset of patients that was centrally-determined HER2 positive by FISH (117 patients), above-median H2T level was significantly associated with shorter TTBM (HR=2.4; p=0.005), whereas this was not true for median FISH/CEP17 ratio (p=0.4). In a multivariate analysis of this subset, continuous H2T (p=0.021) and a time dependent covariate capturing time to non-brain metastases (p=0.0044) were prognostic for TTBM, whereas FISH/CEP17, ER, PgR and grade were not.
Conclusions. These data reveal a strong relationship between quantitative HER2 protein expression levels and the risk of brain relapse in HER2−positive advanced breast cancer patients. Consequently, quantitative assessment of HER2 protein expression may inform and facilitate refinements in therapeutic treatment strategies for selected subpopulations of patients in this group.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-12-05.
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Affiliation(s)
- R Duchnowska
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - W Biernat
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - B Szostakiewicz
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - J Sperinde
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - F Piette
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - M Haddad
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - A Paquet
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - Y Lie
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - B Czartoryska-Arlukowicz
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - P Wysocki
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - T Jankowski
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - B Radecka
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - M Foszczynska-Kloda
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - M Litwiniuk
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - S Debska
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - J Weidler
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - W Huang
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - M Buyse
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - M Bates
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
| | - J Jassem
- 1Military Institute of Medicine, Warsaw, Poland; Medical University of Gdansk, Gdansk, Poland; Monogram Biosciences, South San Francisco, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; Bialystok Oncology Center, Bialystok, Poland; Great Poland Cancer Center, Poznan, Poland; Lublin Oncology Center, Lublin, Poland; Opole Oncology Center, Opole, Poland; West Pomeranian Oncology Center, Szczecin, Poland; Poznan University of Medical Sciences, Poznan, Poland; Regional Cancer Center, Lódz, Poland; Cepheid, Sunnyvale, CA
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Oza A, Castonguay V, Tsoref D, Diaz–Padilla I, Karakasis K, Mackay H, Welch S, Weberpals J, Hoskins P, Plante M, Provencher D, Tonkin K, Covens A, Ghatage P, Gregoire J, Hirte H, Miller D, Rosen B, Bentley J, Maroun J, Buyse M, Coens C, Brady M, Stuart G. Corrigendum: Progression-Free Survival in Advanced Ovarian Cancer: A Canadian Review and Expert Panel Perspective. Curr Oncol 2011. [DOI: 10.3747/co.v18is2.939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In recent years, significant advances have been made in the management of metastatic colorectal cancer. Traditionally, an improvement in overall survival has been considered the “gold standard”—the most convincing measure of efficacy. However, overall survival requires larger patient numbers and longer follow-up and may often be confounded by other factors, including subsequent therapies and crossover. Given the number of active therapies for potential investigation, demand for rapid evaluation and early availability of new therapies is growing. Progression-free survival is regarded as an important measure of treatment benefit and, compared with overall survival, can be evaluated earlier, with fewer patients and no confounding by subsequent lines of therapy. The present paper reviews the advantages, limitations, and relevance of progression-free survival as a primary endpoint in randomized trials of metastatic colorectal cancer.
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Hindlet P, Barraud C, Boschat L, Farinotti R, Bado A, Buyse M. Rosiglitazone and metformin have opposite effects on intestinal absorption of oligopeptides via the proton-dependent PepT1 transporter. Mol Pharmacol 2011; 81:319-27. [PMID: 22108913 DOI: 10.1124/mol.111.073874] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The intestinal H(+)/peptide cotransporter 1 (PepT1) plays a major role in nitrogen supply to the body by mediating intestinal absorption of di- and tripeptides. Previous studies have reported that in animal models of type 2 diabetes/obesity, PepT1 activity and expression were markedly reduced. This prompted us to investigate the effects of two antidiabetic drugs, rosiglitazone and metformin, on PepT1 activity/expression in a murine diet-induced obesity model. C57BL/6J male mice were fed a high-fat diet (HFD) or a standard chow for 6 weeks and then were treated for 7 days with metformin (250 mg/kg/day) and/or rosiglitazone (8 mg/kg/day). For in vitro studies, Caco-2 enterocyte-like cells were treated for 7 days with metformin (10 mM) and/or rosiglitazone (10 μM). A 7-day rosiglitazone treatment increased PepT1 activity and prevented the 2-fold HFD-induced reduction in PepT1 transport. Metformin alone did not modify PepT1 activity but counteracted rosiglitazone-induced PepT1-mediated transport. As with the in vivo studies, rosiglitazone treatment up-regulated PepT1 transport activity with concomitant induction of S6 ribosomal protein activation in vitro. Furthermore, metformin decreased PepT1 expression (mRNA and protein) and its transport activity. The effect of metformin was linked to a reduction of phosphorylated S6 ribosomal protein (active form) and of phosphorylated 4E-BP1 (inactive form), a translation repressor. These data demonstrate that two antidiabetic drugs exert opposite effects on the PepT1 transport function probably through direct action on enterocytes. In our type 2 diabetes/obesity model, rosiglitazone, a peroxisome proliferator-activated receptor-γ agonist compensated for the HFD-induced PepT1 down-regulation, whereas metformin reversed rosiglitazone activity at the translational level.
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Affiliation(s)
- Patrick Hindlet
- Clinical Pharmacy Department (EA4123), Paris-Sud 11 University, Châtenay-Malabry, France.
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