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Verschoor YL, van de Haar J, van den Berg JG, van Sandick JW, Kodach LL, van Dieren JM, Balduzzi S, Grootscholten C, IJsselsteijn ME, Veenhof AAFA, Hartemink KJ, Vollebergh MA, Jurdi A, Sharma S, Spickard E, Owers EC, Bartels-Rutten A, den Hartog P, de Miranda NFCC, van Leerdam ME, Haanen JBAG, Schumacher TN, Voest EE, Chalabi M. Author Correction: Neoadjuvant atezolizumab plus chemotherapy in gastric and gastroesophageal junction adenocarcinoma: the phase 2 PANDA trial. Nat Med 2024:10.1038/s41591-024-02898-8. [PMID: 38448792 DOI: 10.1038/s41591-024-02898-8] [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: 03/08/2024]
Affiliation(s)
- Yara L Verschoor
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Joris van de Haar
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Oncode Institute, Amsterdam, the Netherlands
| | - José G van den Berg
- Department of Pathology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Johanna W van Sandick
- Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Liudmila L Kodach
- Department of Pathology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Jolanda M van Dieren
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Sara Balduzzi
- Biometrics department, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Cecile Grootscholten
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | | | - Alexander A F A Veenhof
- Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Koen J Hartemink
- Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Marieke A Vollebergh
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | | | | | | | - Emilia C Owers
- Department of Nuclear Medicine, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Annemarieke Bartels-Rutten
- Department of Radiology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Peggy den Hartog
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | | | - Monique E van Leerdam
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - John B A G Haanen
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
- Oncology Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Ton N Schumacher
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Oncode Institute, Amsterdam, the Netherlands
- Department of Hematology, Leiden University Medical Center, Leiden, the Netherlands
| | - Emile E Voest
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Oncode Institute, Amsterdam, the Netherlands
| | - Myriam Chalabi
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
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Verschoor YL, van de Haar J, van den Berg JG, van Sandick JW, Kodach LL, van Dieren JM, Balduzzi S, Grootscholten C, IJsselsteijn ME, Veenhof AAFA, Hartemink KJ, Vollebergh MA, Jurdi A, Sharma S, Spickard E, Owers EC, Bartels-Rutten A, den Hartog P, de Miranda NFCC, van Leerdam ME, Haanen JBAG, Schumacher TN, Voest EE, Chalabi M. Neoadjuvant atezolizumab plus chemotherapy in gastric and gastroesophageal junction adenocarcinoma: the phase 2 PANDA trial. Nat Med 2024; 30:519-530. [PMID: 38191613 PMCID: PMC10878980 DOI: 10.1038/s41591-023-02758-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 12/07/2023] [Indexed: 01/10/2024]
Abstract
Gastric and gastroesophageal junction (G/GEJ) cancers carry a poor prognosis, and despite recent advancements, most patients die of their disease. Although immune checkpoint blockade became part of the standard-of-care for patients with metastatic G/GEJ cancers, its efficacy and impact on the tumor microenvironment (TME) in early disease remain largely unknown. We hypothesized higher efficacy of neoadjuvant immunotherapy plus chemotherapy in patients with nonmetastatic G/GEJ cancer. In the phase 2 PANDA trial, patients with previously untreated resectable G/GEJ tumors (n = 21) received neoadjuvant treatment with one cycle of atezolizumab monotherapy followed by four cycles of atezolizumab plus docetaxel, oxaliplatin and capecitabine. Treatment was well tolerated. There were grade 3 immune-related adverse events in two of 20 patients (10%) but no grade 4 or 5 immune-related adverse events, and all patients underwent resection without treatment-related delays, meeting the primary endpoint of safety and feasibility. Tissue was obtained at multiple time points, allowing analysis of the effects of single-agent anti-programmed cell death ligand 1 (PD-L1) and the subsequent combination with chemotherapy on the TME. Twenty of 21 patients underwent surgery and were evaluable for secondary pathologic response and survival endpoints, and 19 were evaluable for exploratory translational analyses. A major pathologic response (≤10% residual viable tumor) was observed in 14 of 20 (70%, 95% confidence interval 46-88%) patients, including 9 (45%, 95% confidence interval 23-68%) pathologic complete responses. At a median follow-up of 47 months, 13 of 14 responders were alive and disease-free, and five of six nonresponders had died as a result of recurrence. Notably, baseline anti-programmed cell death protein 1 (PD-1)+CD8+ T cell infiltration was significantly higher in responders versus nonresponders, and comparison of TME alterations following anti-PD-L1 monotherapy versus the subsequent combination with chemotherapy showed an increased immune activation on single-agent PD-1/L1 axis blockade. On the basis of these data, monotherapy anti-PD-L1 before its combination with chemotherapy warrants further exploration and validation in a larger cohort of patients with nonmetastatic G/GEJ cancer. ClinicalTrials.gov registration: NCT03448835 .
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Affiliation(s)
- Yara L Verschoor
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Joris van de Haar
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Oncode Institute, Amsterdam, the Netherlands
| | - José G van den Berg
- Department of Pathology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Johanna W van Sandick
- Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Liudmila L Kodach
- Department of Pathology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Jolanda M van Dieren
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Sara Balduzzi
- Biometrics department, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Cecile Grootscholten
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | | | - Alexander A F A Veenhof
- Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Koen J Hartemink
- Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Marieke A Vollebergh
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | | | | | | | - Emilia C Owers
- Department of Nuclear Medicine, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Annemarieke Bartels-Rutten
- Department of Radiology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Peggy den Hartog
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | | | - Monique E van Leerdam
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - John B A G Haanen
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
- Oncology Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Ton N Schumacher
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Oncode Institute, Amsterdam, the Netherlands
- Department of Hematology, Leiden University Medical Center, Leiden, the Netherlands
| | - Emile E Voest
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Oncode Institute, Amsterdam, the Netherlands
| | - Myriam Chalabi
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
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El Sissy C, Kirilovsky A, Lagorce Pagès C, Marliot F, Custers PA, Dizdarevic E, Sroussi M, Castillo-Martin M, Haicheur N, Dermani M, Loche N, Buttard B, Musina AM, Anitei MG, van den Berg JG, Broeks A, Iseas S, Coraglio M, Loria FS, Romero A, Laurent-Puig P, de Reyniès A, Fernandez LM, Karoui M, Tougeron D, Vaccaro CA, Santino JP, Poulsen LØ, Lindebjerg J, O'Connor JM, Scripcariu V, Dimofte MG, Gérard JP, Chalabi M, Figueiredo N, Perez RO, Habr-Gama A, Galon J, Hansen TF, Jensen LH, Beets G, Zeitoun G, Pagès F. International Validation of the Immunoscore Biopsy in Patients With Rectal Cancer Managed by a Watch-and-Wait Strategy. J Clin Oncol 2024; 42:70-80. [PMID: 37788410 PMCID: PMC10730081 DOI: 10.1200/jco.23.00586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/06/2023] [Accepted: 07/24/2023] [Indexed: 10/05/2023] Open
Abstract
PURPOSE No biomarker capable of improving selection and monitoring of patients with rectal cancer managed by watch-and-wait (W&W) strategy is currently available. Prognostic performance of the Immunoscore biopsy (ISB) was recently suggested in a preliminary study. METHODS This international validation study included 249 patients with clinical complete response (cCR) managed by W&W strategy. Intratumoral CD3+ and CD8+ T cells were quantified on pretreatment rectal biopsies by digital pathology and converted to ISB. The primary end point was time to recurrence (TTR; the time from the end of neoadjuvant treatment to the date of local regrowth or distant metastasis). Associations between ISB and outcomes were analyzed by stratified Cox regression adjusted for confounders. Immune status of tumor-draining lymph nodes (n = 161) of 17 additional patients treated by neoadjuvant chemoradiotherapy and surgery was investigated by 3'RNA-Seq and immunofluorescence. RESULTS Recurrence-free rates at 5 years were 91.3% (82.4%-100.0%), 62.5% (53.2%-73.3%), and 53.1% (42.4%-66.5%) with ISB High, ISB Intermediate, and ISB Low, respectively (hazard ratio [HR; Low v High], 6.51; 95% CI, 1.99 to 21.28; log-rank P = .0004). ISB was also significantly associated with disease-free survival (log-rank P = .0002), and predicted both local regrowth and distant metastasis. In multivariate analysis, ISB was independent of patient age, sex, tumor location, cT stage (T, primary tumor; c, clinical), cN stage (N, regional lymph node; c, clinical), and was the strongest predictor for TTR (HR [ISB High v Low], 6.93; 95% CI, 2.08 to 23.15; P = .0017). The addition of ISB to a clinical-based model significantly improved the prediction of recurrence. Finally, B-cell proliferation and memory in draining lymph nodes was evidenced in the draining lymph nodes of patients with cCR. CONCLUSION The ISB is validated as a biomarker to predict both local regrowth and distant metastasis, with a gradual scaling of the risk of pejorative outcome.
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Affiliation(s)
- Carine El Sissy
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Immunomonitoring Platform, Laboratory of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Georges Pompidou European Hospital, Paris, France
| | - Amos Kirilovsky
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Immunomonitoring Platform, Laboratory of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Georges Pompidou European Hospital, Paris, France
| | - Christine Lagorce Pagès
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Immunomonitoring Platform, Laboratory of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Georges Pompidou European Hospital, Paris, France
- Department of Pathology, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Florence Marliot
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Immunomonitoring Platform, Laboratory of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Georges Pompidou European Hospital, Paris, France
| | - Petra A. Custers
- Department of Surgery, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands
| | - Edina Dizdarevic
- Department of Oncology, Danish Colorectal Cancer Center South, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Marine Sroussi
- Cordeliers Research Center, Sorbonne University, INSERM, University Paris Cité, SIRIC CARPEM, Paris, France
- Chemistry Biology Innovation Institute, BioChimie Laboratory, ESPCI, UMR8231 CNRS, University PSL, Paris, France
| | | | - Nacilla Haicheur
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Immunomonitoring Platform, Laboratory of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Georges Pompidou European Hospital, Paris, France
| | - Mohamed Dermani
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Immunomonitoring Platform, Laboratory of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Georges Pompidou European Hospital, Paris, France
| | - Nicolas Loche
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Immunomonitoring Platform, Laboratory of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Georges Pompidou European Hospital, Paris, France
| | - Bénedicte Buttard
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
| | - Ana Maria Musina
- Department of Surgical Oncology, Regional Institute of Oncology (IRO), Iasi, Romania
- “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Maria Gabriela Anitei
- “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- Surgical Oncology Unit, Regional Institute of Oncology, Iasi, Romania
| | - José G. van den Berg
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Annegien Broeks
- Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Soledad Iseas
- Oncology Unit, Gastroenterology Hospital Carlos Bonorino Udaondo, Buenos Aires, Argentina
| | - Mariana Coraglio
- Oncology Unit, Gastroenterology Hospital Carlos Bonorino Udaondo, Buenos Aires, Argentina
| | - Fernando Sanchez Loria
- GI Clinical Oncology and GI Surgical Oncology, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - Alfredo Romero
- Department of Clinical Oncology, British Hospital of Buenos Aires, Buenos Aires, Argentina
| | - Pierre Laurent-Puig
- Cordeliers Research Center, Sorbonne University, University Paris Cité, INSERM UMR1138, Paris, France
- Department of Biology, Cancer Institute Paris CARPEM, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Aurélien de Reyniès
- Cordeliers Research Center, University Paris Cité, INSERM UMRS1138, Paris, France
- AP-HP, SeqOIA Genomic Medicine Laboratory—IT Platform, Paris, France
| | - Laura M. Fernandez
- Colorectal Surgery, Digestive Department, Champalimaud Foundation, Lisbon, Portugal
| | - Mehdi Karoui
- Department of Digestive and Oncologic Surgery, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - David Tougeron
- Department of Hepato-Gastro-Enterology and Nutritional Assistance, University Hospital of Poitiers, Poitiers, France
| | - Carlos A. Vaccaro
- Department of General Surgery, Hospital Italiano, Buenos Aires, Argentina
| | - Juan P. Santino
- Department of General Surgery, Hospital Italiano, Buenos Aires, Argentina
| | - Laurids Østergaard Poulsen
- Department of Oncology, Danish Colorectal Cancer Center South, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Jan Lindebjerg
- Department of Oncology, Danish Colorectal Cancer Center South, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Juan Manuel O'Connor
- GI Clinical Oncology and GI Surgical Oncology, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - Viorel Scripcariu
- “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- Surgical Oncology Unit, Regional Institute of Oncology, Iasi, Romania
| | - Mihail-Gabriel Dimofte
- Department of Surgical Oncology, Regional Institute of Oncology (IRO), Iasi, Romania
- “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | | | - Myriam Chalabi
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Nuno Figueiredo
- Colorectal Surgery, Digestive Department, Champalimaud Foundation, Lisbon, Portugal
| | - Rodrigo O. Perez
- Division of Colorectal Surgery, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
- Department of Surgical Oncology, Beneficencia Portuguesa Hospital, São Paulo, Brazil
- Angelita and Joaquim Gama Institute, São Paulo, Brazil
| | - Angelita Habr-Gama
- Division of Colorectal Surgery, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
- Department of Surgical Oncology, Beneficencia Portuguesa Hospital, São Paulo, Brazil
- Angelita and Joaquim Gama Institute, São Paulo, Brazil
| | - Jérôme Galon
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
| | - Torben Frøstrup Hansen
- Department of Oncology, Danish Colorectal Cancer Center South, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lars Henrik Jensen
- Department of Oncology, Danish Colorectal Cancer Center South, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Geerard Beets
- Department of Surgery, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands
| | - Guy Zeitoun
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Immunomonitoring Platform, Laboratory of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Georges Pompidou European Hospital, Paris, France
| | - Franck Pagès
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Immunomonitoring Platform, Laboratory of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Georges Pompidou European Hospital, Paris, France
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4
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Verweij ME, Tanaka MD, Kensen CM, van der Heide UA, Marijnen CAM, Janssen T, Vijlbrief T, van Grevenstein WMU, Moons LMG, Koopman M, Lacle MM, Braat MNGJA, Chalabi M, Maas M, Huibregtse IL, Snaebjornsson P, Grotenhuis BA, Fijneman R, Consten E, Pronk A, Smits AB, Heikens JT, Eijkelenkamp H, Elias SG, Verkooijen HM, Schoenmakers MMC, Meijer GJ, Intven M, Peters FP. Towards Response ADAptive Radiotherapy for organ preservation for intermediate-risk rectal cancer (preRADAR): protocol of a phase I dose-escalation trial. BMJ Open 2023; 13:e065010. [PMID: 37321815 PMCID: PMC10277084 DOI: 10.1136/bmjopen-2022-065010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 05/23/2022] [Accepted: 05/07/2023] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION Organ preservation is associated with superior functional outcome and quality of life (QoL) compared with total mesorectal excision (TME) for rectal cancer. Only 10% of patients are eligible for organ preservation following short-course radiotherapy (SCRT, 25 Gy in five fractions) and a prolonged interval (4-8 weeks) to response evaluation. The organ preservation rate could potentially be increased by dose-escalated radiotherapy. Online adaptive magnetic resonance-guided radiotherapy (MRgRT) is anticipated to reduce radiation-induced toxicity and enable radiotherapy dose escalation. This trial aims to establish the maximum tolerated dose (MTD) of dose-escalated SCRT using online adaptive MRgRT. METHODS AND ANALYSIS The preRADAR is a multicentre phase I trial with a 6+3 dose-escalation design. Patients with intermediate-risk rectal cancer (cT3c-d(MRF-)N1M0 or cT1-3(MRF-)N1M0) interested in organ preservation are eligible. Patients are treated with a radiotherapy boost of 2×5 Gy (level 0), 3×5 Gy (level 1), 4×5 Gy (level 2) or 5×5 Gy (level 3) on the gross tumour volume in the week following standard SCRT using online adaptive MRgRT. The trial starts on dose level 1. The primary endpoint is the MTD based on the incidence of dose-limiting toxicity (DLT) per dose level. DLT is a composite of maximum one in nine severe radiation-induced toxicities and maximum one in three severe postoperative complications, in patients treated with TME or local excision within 26 weeks following start of treatment. Secondary endpoints include the organ preservation rate, non-DLT, oncological outcomes, patient-reported QoL and functional outcomes up to 2 years following start of treatment. Imaging and laboratory biomarkers are explored for early response prediction. ETHICS AND DISSEMINATION The trial protocol has been approved by the Medical Ethics Committee of the University Medical Centre Utrecht. The primary and secondary trial results will be published in international peer-reviewed journals. TRIAL REGISTRATION NUMBER WHO International Clinical Trials Registry (NL8997; https://trialsearch.who.int).
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Affiliation(s)
- Maaike E Verweij
- Department of Radiation-Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Max D Tanaka
- Department of Radiation-Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Chavelli M Kensen
- Department of Radiation-Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Uulke A van der Heide
- Department of Radiation-Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Corrie A M Marijnen
- Department of Radiation-Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Tomas Janssen
- Department of Radiation-Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Tineke Vijlbrief
- Department of Radiation-Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Leon M G Moons
- Department of Gastroenterology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Miriam Koopman
- Department of Medical Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Miangela M Lacle
- Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Manon N G J A Braat
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Myriam Chalabi
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Monique Maas
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Inge L Huibregtse
- Department of Gastroenterology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Petur Snaebjornsson
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Remond Fijneman
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Esther Consten
- Department of Surgery, Meander Medical Centre, Amersfoort, The Netherlands
- Department of Surgery, University Medical Centre Groningen, Groningen, The Netherlands
| | - Apollo Pronk
- Department of Surgery, Diakonessenhuis Utrecht Zeist Doorn, Utrecht, The Netherlands
| | - Anke B Smits
- Department of Surgery, Sint Antonius Hospital, Nieuwegein, The Netherlands
| | - Joost T Heikens
- Department of Surgery, Hospital Rivierenland, Tiel, The Netherlands
| | - Hidde Eijkelenkamp
- Department of Radiation-Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Sjoerd G Elias
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
| | - Helena M Verkooijen
- Department of Radiation-Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Gert J Meijer
- Department of Radiation-Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Martijn Intven
- Department of Radiation-Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Femke P Peters
- Department of Radiation-Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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5
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Salem ME, Kopetz S, Tabernero J, Sinicrope FA, Chalabi M, Tie J, Kadakia KC, George TJ, Mauer E, Macera L, Chao CY, Lonardi S, Van Cutsem E, Andre T, Overman MJ. Comprehensive characterization of KRAS mutations and inter-relation with primary tumor location in colorectal cancers. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.231] [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: 01/25/2023] Open
Abstract
231 Background: The recent development of KRAS G12C inhibitors underscores the potential to target KRAS mutations. Right-sided and left-sided colon tumors (RT and LT) exhibit different molecular features. We characterize the prevalence of KRAS-variants, interrelation with primary tumor location, and association with immune biomarkers in CRC. Methods: We retrospectively reviewed CRC tumors of all stages (with known sidedness) that underwent NGS with the Tempus xT assay (DNA-seq of 648 genes at 500x coverage, full transcriptome RNA-seq). Bivariate analyses were performed to compare KRAS alterations, immune biomarkers, and co-mutations by tumor location. P-values comparing individual co-mutations between groups were adjusted for false discovery (FDR). Results: A total of 3,391 CRC were analyzed (RT: n = 442 [13%], transverse: n = 116 [3%], LT; n = 2,833 [84%]) of which 1486 (44%) tumors harbored KRAS mutations. Overall, KRAS mutations were more frequent in RT compared to transverse tumors and LT (52% vs 41% vs 43%, p<0.001, respectively). The most frequent KRAS mutation variants observed were G12D (29 %), G12V (22%), G13D (16%), and G12C (5.7%). There was no significant difference in the prevalence of KRAS variant types between LT and RT (p=0.5). Significant differences in genomic co-mutations with various KRAS variants were observed in the following genes: TP53, FBXW7, and NF1 (FDR- P<0.05). RT and transverse tumors were more likely have MSI-H and TMB-H (>10 mut/mb) status than LT (MSI-H: 18% vs 22% vs 2.2% and TMB-H (20% vs 22% vs 3%, P<0.001), respectively. CRC tumors harboring G13D variants were more likely to be associated with and MSI-H and TMB-H status (and 7.7% and 8.5%) compared to G12D (2.8 % and 3.9 %), G12V (1.8 % and 2.1%), and G12C (0% and 2.4%); P = 0.003 and 0.001. Conclusions: The most frequent KRAS mutation variants observed in CRC tumors were G12D, G12V, G13D, and G12C. There was no significant difference in the prevalence of KRAS variant types between tumors of the left vs right colon. CRC tumors that harbored G13D variants were significantly more likely to be associated with MSI-H and TMB-H status. [Table: see text]
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Affiliation(s)
| | - Scott Kopetz
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Josep Tabernero
- Vall d’Hebron Hospital Campus and Institute of Oncology, Barcelona, Spain
| | | | - Myriam Chalabi
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Jeanne Tie
- Peter MacCallum Cancer Centre, Western Health and Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
| | - Kunal C. Kadakia
- Department of Solid Tumor Oncology and Supportive Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Thomas J. George
- NSABP/NRG Oncology, and The University of Florida Health Cancer Center, Gainesville, FL
| | | | | | | | - Sara Lonardi
- Medical Oncology 3, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | | | - Thierry Andre
- Sorbonne Université, Department of Medical Oncology, Saint-Antoine Hospital, AP-HP, Paris, France
| | - Michael J. Overman
- NSABP/NRG Oncology and University of Texas MD Anderson Cancer Center, and SWOG, Houston, TX
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Van Der Sluis K, van Sandick J, van Dieren J, Vollebergh M, Chalabi M, Grootscholten C, Snaebjornsson P, van den Berg J, Hartemink K, Veenhof A, Kodach L. Assessing the impact of predictive biomarkers’ for immunotherapy on the clinical management of gastric cancer patients: a real life cohort. European Journal of Surgical Oncology 2023. [DOI: 10.1016/j.ejso.2022.11.149] [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: 02/25/2023]
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Verschoor YL, Lambregts DMJ, van den Berg J, Grotenhuis BA, Aalbers A, Van Triest B, Beets-Tan RG, van de Belt M, Dokter S, Balduzzi S, Voest EE, Haanen JBAG, van Leerdam ME, Beets G, Chalabi M. Radiotherapy, atezolizumab, and bevacizumab in rectal cancers with the aim of organ preservation: The TARZAN study. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.158] [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: 01/25/2023] Open
Abstract
158 Background: Rectal cancer is traditionally treated with total mesorectal excision (TME), with/without neoadjuvant radiotherapy (RT) and chemotherapy. This approach often leads to temporary or permanent colostomies and other long-term morbidity such as urinary and sexual dysfunction in over 60% of patients. Organ preservation is increasingly being pursued in patients with a clinical complete response (cCR) following neoadjuvant treatment, thereby aiming to avoid TME-surgery. Based on preclinical data suggesting immunomodulatory effects of RT, and the synergy of combined PD-L1/VEGF blockade in several tumor types, the TARZAN study (NCT04017455) combines these treatments aiming to increase chances of organ preservation in patients with mainly MMR proficient (pMMR) rectal cancer without the need for chemotherapy. Methods: Patients with clinical stage ≤T3ab N0-1 distal-mid rectal tumors without mesorectal fascia involvement underwent 5x5 Gy RT followed by 3 cycles of atezolizumab and bevacizumab. Response was evaluated by MRI and endoscopy. The primary endpoint was clinical complete and near-complete response (CR) rate at 12 weeks after RT. Secondary endpoints included safety, organ preservation, pathologic (near) CR in case of surgery, and relapse free survival. According to a Simon’s 2-stage design, ≥3 responders were needed in stage I (18 patients) to continue accrual into stage II. Here we report data from stage I. Results: Eighteen patients (14 male, median age 63), all with pMMR tumors, were treated. Six tumors were cN1 on MRI, 10/18 tumors were ≥4cm and for 10/18 patients abdominoperineal resection (APR) appeared necessary due to distal tumor location. At the time of response evaluation, (near-)CR was achieved in 10/18 (56%) patients according to the primary endpoint. With a median follow-up of 20 months, 9/18 (50%) patients remain without TME surgery. Of these 9 patients, 5 underwent local excision to achieve organ preservation and in 5 patients no additional intervention was needed (cCR). The remaining 9 patients underwent TME surgery (4 APR), and pathologic assessment revealed near-CR in two patients, and a pCR in one patient. Three patients developed distant recurrences, one in the organ-sparing group. Neoadjuvant treatment was well-tolerated with grade 3 study drug-related adverse events (AEs) in 1 (5%) patient. Grade 3 surgery-related AEs occurred in 5/9 (55%) patients, including 4 anastomotic leaks and 1 abscess. Conclusions: Neoadjuvant RT followed by atezolizumab and bevacizumab resulted in a promising rate of clinical (near-)CRs in 56% of patients without the need for chemotherapy, reaching the primary endpoint. Accrual is ongoing in stage II, in which an additional 20 patients will be treated. Clinical trial information: NCT04017455 .
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Affiliation(s)
- Yara L. Verschoor
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - José van den Berg
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Arend Aalbers
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Baukelien Van Triest
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Regina G.H. Beets-Tan
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Marieke van de Belt
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Simone Dokter
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Sara Balduzzi
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Emile E. Voest
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | - John B. A. G. Haanen
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Geerard Beets
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Myriam Chalabi
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
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8
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de Back T, Nijskens I, Schafrat P, Chalabi M, Kazemier G, Vermeulen L, Sommeijer D. Evaluation of Systemic Treatments of Small Intestinal Adenocarcinomas: A Systematic Review and Meta-analysis. JAMA Netw Open 2023; 6:e230631. [PMID: 36826817 PMCID: PMC9958532 DOI: 10.1001/jamanetworkopen.2023.0631] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
IMPORTANCE Although small intestinal adenocarcinomas (SIAs) are rare, they have a poor prognosis, and the optimal treatment strategies are largely unknown. Because of the lack of high-quality evidence, guidelines for colorectal cancer are often followed in the treatment of SIAs. OBJECTIVE To review the current evidence regarding survival benefit of systemic therapies, including chemotherapy, targeted agents, and immunotherapy, for patients with SIAs. DATA SOURCES Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses, MEDLINE and Embase were searched for articles published from January 1, 2005, until June 1, 2022. STUDY SELECTION Retrospective cohort studies and prospective phase 2 or 3 trials describing survival after systemic therapies for patients with SIAs were eligible for inclusion. Assessment of study eligibility was blinded and performed by 3 reviewers. DATA EXTRACTION AND SYNTHESIS The reviewers independently extracted data. Random effects, inverse variance, pairwise meta-analyses were performed. MAIN OUTCOMES AND MEASURES Primary outcomes were overall survival (OS) and progression-free survival (PFS) of patients with SIAs after systemic therapies. Measures of interest included hazard ratios for survival and median survival times. RESULTS Overall, 57 retrospective cohort and phase 2 studies of 35 176 patients were included. Adjuvant chemotherapy, generally fluoropyrimidine-based, was associated with increased OS in stage I to III SIAs (hazard ratio [HR], 0.60; 95% CI, 0.53-0.68), especially in stage III tumors (HR, 0.55; 95% CI, 0.48-0.64), irrespective of tumor localization. Palliative chemotherapy was also associated with an OS benefit (HR, 0.48; 95% CI, 0.40-0.58). Fluoropyrimidine-oxaliplatin combinations were superior to other regimens (OS: HR, 0.54; 95% CI, 0.30-0.99; PFS: HR, 0.46; 95% CI, 0.30-0.71). Furthermore, bevacizumab added to chemotherapy compared with chemotherapy alone was associated with significantly prolonged PFS (HR, 0.62; 95% CI, 0.43-0.89). Immunotherapy showed a 50% overall response rate in previously treated defective mismatch repair tumors. CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, adjuvant and palliative chemotherapy were both associated with improved survival of patients with SIAs, especially fluoropyrimidine-based regimens and fluoropyrimidine-oxaliplatin combinations. Adding bevacizumab to chemotherapy appears to prolong PFS and deserves further investigation. Immunotherapy seems beneficial and should be considered for patients with defective mismatch repair tumors. International collaborations should be undertaken to confirm and improve efficacy of systemic therapies for patients with SIAs.
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Affiliation(s)
- Tim de Back
- Center for Experimental and Molecular Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Oncode Institute, Amsterdam, the Netherlands
- Cancer Biology and Immunology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Isabelle Nijskens
- Department of Internal Medicine, Flevohospital, Almere, the Netherlands
| | - Pascale Schafrat
- Center for Experimental and Molecular Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Oncode Institute, Amsterdam, the Netherlands
- Cancer Biology and Immunology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Myriam Chalabi
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Geert Kazemier
- Department of Pathology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Surgery, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Louis Vermeulen
- Center for Experimental and Molecular Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Oncode Institute, Amsterdam, the Netherlands
- Cancer Biology and Immunology, Cancer Center Amsterdam, Amsterdam, the Netherlands
- Department of Medical Oncology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
| | - Dirkje Sommeijer
- Center for Experimental and Molecular Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Cancer Biology and Immunology, Cancer Center Amsterdam, Amsterdam, the Netherlands
- Department of Internal Medicine, Flevohospital, Almere, the Netherlands
- Department of Medical Oncology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
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9
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van der Sluis K, van Sandick JW, van Dieren JM, Vollebergh MA, Grootscholten C, van den Berg JG, Snaebjornsson P, Hartemink KJ, Veenhof AAFA, Chalabi M, Kodach LL. The clinical impact of testing for biomarkers in gastric cancer patients: a real-world cohort. Histopathology 2023; 82:826-836. [PMID: 36694277 DOI: 10.1111/his.14869] [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: 11/04/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND AIMS In gastric cancer (GC), HER2 was the first biomarker for guided therapy registered for clinical use. Considering the recent approvals of immune check-point blockade (ICB) in gastro-oesophageal cancers, testing for mismatch repair deficiency (dMMR), Epstein-Barr virus (EBV) and PD-L1 combined positive score (CPS) is becoming increasingly important. Here we describe a real-world cohort on biomarker assessment in GC patients. METHODS Patients diagnosed with GC between 2017 and 2021 were included. Biomarker results were retrieved from electronic patient files. PD-L1 CPS was determined retrospectively on dMMR and EBV-positive (EBV+) tumours. Data on genomic sequencing were analysed separately. RESULTS Of 363 patients identified, 45% had metastatic disease. In 335 patients (92%) at least one biomarker was tested. The prevalence of HER2+, dMMR and EBV+ tumours was 10% (32 of 319), 7% (20 of 294) and 1% (three of 235), respectively. Of the dMMR and EBV+ tumours, 95% had a PD-L1 CPS ≥ 5. Therapeutic strategy was adjusted in 31 of 55 patients and consisted of anti-HER2 therapies as well as ICB in clinical trials. Genomic alterations were found in 44 of 60 tested patients. TP53 (73%) and PIK3CA (20%) mutations were most common, followed by KRAS mutations (11%) and amplifications (11%). CONCLUSIONS In this real-world cohort, testing for HER2, dMMR and EBV status affected treatment decisions in 56% of the patients. Although most dMMR and EBV+ tumours had a PD-L1 CPS ≥ 5, not all patients with a high probability of treatment response are identified. Based on these results, a stepwise diagnostic strategy is proposed.
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Affiliation(s)
- Karen van der Sluis
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Johanna W van Sandick
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jolanda M van Dieren
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Marieke A Vollebergh
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Cecile Grootscholten
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - José G van den Berg
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Petur Snaebjornsson
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Koen J Hartemink
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Myriam Chalabi
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Liudmila L Kodach
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
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10
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Blomberg OS, Spagnuolo L, Garner H, Voorwerk L, Isaeva OI, van Dyk E, Bakker N, Chalabi M, Klaver C, Duijst M, Kersten K, Brüggemann M, Pastoors D, Hau CS, Vrijland K, Raeven EAM, Kaldenbach D, Kos K, Afonina IS, Kaptein P, Hoes L, Theelen WSME, Baas P, Voest EE, Beyaert R, Thommen DS, Wessels LFA, de Visser KE, Kok M. IL-5-producing CD4 + T cells and eosinophils cooperate to enhance response to immune checkpoint blockade in breast cancer. Cancer Cell 2023; 41:106-123.e10. [PMID: 36525971 DOI: 10.1016/j.ccell.2022.11.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 49.0] [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] [Received: 03/01/2022] [Revised: 09/30/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022]
Abstract
Immune checkpoint blockade (ICB) has heralded a new era in cancer therapy. Research into the mechanisms underlying response to ICB has predominantly focused on T cells; however, effective immune responses require tightly regulated crosstalk between innate and adaptive immune cells. Here, we combine unbiased analysis of blood and tumors from metastatic breast cancer patients treated with ICB with mechanistic studies in mouse models of breast cancer. We observe an increase in systemic and intratumoral eosinophils in patients and mice responding to ICB treatment. Mechanistically, ICB increased IL-5 production by CD4+ T cells, stimulating elevated eosinophil production from the bone marrow, leading to systemic eosinophil expansion. Additional induction of IL-33 by ICB-cisplatin combination or recombinant IL-33 promotes intratumoral eosinophil infiltration and eosinophil-dependent CD8+ T cell activation to enhance ICB response. This work demonstrates the critical role of eosinophils in ICB response and provides proof-of-principle for eosinophil engagement to enhance ICB efficacy.
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Affiliation(s)
- Olga S Blomberg
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands; Department of Immunology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Lorenzo Spagnuolo
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - Hannah Garner
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - Leonie Voorwerk
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Olga I Isaeva
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Ewald van Dyk
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands; Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Noor Bakker
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - Myriam Chalabi
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Gastrointestinal Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Chris Klaver
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Maxime Duijst
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Kelly Kersten
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Marieke Brüggemann
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Dorien Pastoors
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - Cheei-Sing Hau
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - Kim Vrijland
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - Elisabeth A M Raeven
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - Daphne Kaldenbach
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - Kevin Kos
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands; Department of Immunology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Inna S Afonina
- VIB-UGent Center for Inflammation Research, Ghent University, Ghent, Belgium; Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Paulien Kaptein
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Louisa Hoes
- Oncode Institute, Utrecht, the Netherlands; Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Willemijn S M E Theelen
- Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Paul Baas
- Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Emile E Voest
- Oncode Institute, Utrecht, the Netherlands; Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Rudi Beyaert
- VIB-UGent Center for Inflammation Research, Ghent University, Ghent, Belgium; Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Daniela S Thommen
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Lodewyk F A Wessels
- Oncode Institute, Utrecht, the Netherlands; Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Karin E de Visser
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands; Department of Immunology, Leiden University Medical Centre, Leiden, the Netherlands.
| | - Marleen Kok
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
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Abstract
Neoadjuvant treatment with immunotherapy using dostarlimab leads to impressive clinical responses and omission of surgery in patients with mismatch repair (MMR)-deficient rectal cancers, according to a study published in the New England Journal of Medicine.
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Affiliation(s)
- Myriam Chalabi
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
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12
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Chalabi M, Verschoor Y, Van De Haar J, van den Berg J, Kodach L, van Sandick J, van Dieren J, Balduzzi S, Grootscholten M, Veenhof X, Hartemink K, Vollebergh M, Owers E, Bartels-Rutten A, den Hartog-Lievaart P, van Leerdam M, Schumacher T, Haanen J, Voest E. 1219P Neoadjuvant atezolizumab plus chemotherapy in gastric and gastroesophageal junction (G/GEJ) adenocarcinoma: The PANDA study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1337] [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: 11/01/2022] Open
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13
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Van De Haar J, de Vries N, Veninga V, Chalabi M, Ijsselsteijn M, van der Ploeg M, van den Bulk J, Ruano D, Haanen J, Schumacher T, Wessels L, Koning F, de Miranda N, Voest E. 733MO γδT cells are effectors of immune checkpoint blockade in mismatch repair-deficient colon cancers with antigen presentation defects. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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14
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Hong EK, Chalabi M, Landolfi F, Castagnoli F, Park SJ, Sikorska K, Aalbers A, van den Berg J, van Leerdam M, Lee JM, Beets-Tan R. Colon cancer CT staging according to mismatch repair status: Comparison and suggestion of imaging features for high-risk colon cancer. Eur J Cancer 2022; 174:165-175. [PMID: 36029713 DOI: 10.1016/j.ejca.2022.06.060] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/20/2022] [Accepted: 06/25/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Neoadjuvant treatment with either chemotherapy or immunotherapy is gaining momentum in colon cancers (CC). To reduce over-treatment, increasing staging accuracy using computed tomography (CT) is of high importance. PURPOSE To assess and compare CT imaging features of CC between mismatch repair-proficient (pMMR) and MMR-deficient (dMMR) tumours and identify CT features that can distinguish high-risk (pT3-4, N+) CC according to MMR status. METHODS Primary staging CTs of 266 patients who underwent primary surgical resection of a colon tumour were retrospectively and independently evaluated by two radiologists. Logistic regression analysis was performed to identify significant associations between imaging features and positive lymph node status. Receiver operating characteristic (ROC) curves of significantly associated features were assessed and validated in an external cohort of 104 patients. RESULTS Among pT3 tumours only, dMMR CC were significantly larger than pMMR CC in both length and thickness (length 59.39 ± 26.28 mm versus 48.70 ± 23.72, respectively, p = 0.031; thickness 20.54 mm ± 11.17 versus 16.34 ± 8.73, respectively, p = 0.027). For pMMR tumours, nodal internal heterogeneity on CT was significantly associated with a positive lymph node status (odds ratio (OR) = 2.66, p = 0.027), while for dMMR tumours, the largest short diameter of the nodes was associated with lymph node status (OR = 2.01, p = 0.049). The best cut-off value of the largest short diameter of involved nodes was 10.4 mm for dMMR and 7.95 mm for pMMR. In the external validation cohort, AUCs for predicting involved nodes based on the largest short diameter was 0.764 for dMMR tumours using 10 mm size cut-off and 0.624 for pMMR tumours using 7 mm cut-off. CONCLUSION These data show that CT imaging features of primary CC differ between dMMR and pMMR tumours, suggesting that the assessment of CT-based CC staging should take MMR status into consideration, especially for lymph node status, and thus may help in selecting patients for neoadjuvant treatment.
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Affiliation(s)
- Eun Kyoung Hong
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Seoul National University Hospital, Seoul, South Korea; GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Myriam Chalabi
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - Federica Landolfi
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Radiology Unit, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Francesca Castagnoli
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Radiology, University of Brescia, Brescia, Italy
| | - Sae Jin Park
- Seoul National University Hospital, Seoul, South Korea
| | - Karolina Sikorska
- Department of Biostatistics, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Arend Aalbers
- Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jose van den Berg
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Monique van Leerdam
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jeong Min Lee
- Seoul National University Hospital, Seoul, South Korea
| | - Regina Beets-Tan
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands.
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15
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Verschoor YL, Kodach L, van den Berg J, van Sandick JW, van Dieren J, Balduzzi S, Grootscholten C, Veenhof X, Hartemink K, Vollebergh MA, Owers E, Bartels-Rutten A, den Hartog P, van Leerdam ME, Schumacher T, Voest EE, Haanen JBAG, Chalabi M. Neoadjuvant atezolizumab plus docetaxel/oxaliplatin/capecitabine in non-metastatic gastric and gastroesophageal junction adenocarcinoma: The PANDA trial. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.4059] [Citation(s) in RCA: 1] [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: 11/20/2022] Open
Abstract
4059 Background: Immune checkpoint blockade improves clinical outcomes for patients with gastric and gastro-esophageal junction (GEJ) cancers, but its efficacy and impact on the tumor microenvironment in non-metastatic, resectable disease remains largely unknown. Peri-operative FLOT, the current standard-of-care, leads to pathologic complete responses (pCR) and major pathologic responses (MPR) in 16% and 37% of patients, respectively. An important open question is whether PDL-1 blockade monotherapy can prime the tumor microenvironment in a favorable manner, prior to combination with chemotherapy. Methods: We report results from the phase 2 PANDA trial (NCT03448835) of neoadjuvant atezolizumab (anti-PDL-1) plus docetaxel, oxaliplatin, and capecitabine (DOC) in patients with resectable gastric or GEJ adenocarcinoma. Patients received a single cycle of atezolizumab monotherapy, followed by 4 cycles of atezolizumab+DOC. Tumor tissue was collected at baseline, after atezolizumab monotherapy, the first atezolizumab+DOC, and at resection. The primary endpoints were safety and feasibility in 20 patients, and secondary endpoints included MPR (<10% viable tumor rest) and disease-free survival. Results: Twenty patients, of which 18 with mismatch repair (MMR) proficient and two with MMR-deficient tumors, were evaluable for safety and efficacy analyses. MPR was observed in 14/20 patients (70%; 95% CI 46–88%), including 9 pCR (45%; 95% CI 23-68%). Among patients with intestinal type adenocarcinoma, 12/15 (80%; 95% CI 52-96%) had an MPR, with 9/15 (60%; 95% CI 32-84%) pCR. Treatment was well tolerated, with two patients (10%) experiencing a grade 3 immune adverse event. At a median follow-up of 29 months (IQR 16-34), 15 patients (75%) were alive and disease-free. None of the patients with an MPR recurred. All patients underwent resections without treatment-related delays and no unexpected surgical complications were documented. Translational analyses, including baseline PDL-1 CPS score and whole exome sequencing (WES), plus CD8 T-cell infiltration and RNA sequencing at 4 timepoints will be presented at the meeting. Conclusions: Our data show that the addition of atezolizumab to neoadjuvant chemotherapy leads to promising pathologic responses in gastric/GEJ adenocarcinoma, which appears to be higher than in historical controls, with no recurrences in responders. These data should be validated in a large randomized controlled trial. Clinical trial information: NCT03448835.
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Affiliation(s)
| | | | - José van den Berg
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - Sara Balduzzi
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Cecile Grootscholten
- Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Xander Veenhof
- Antoni van Leeuwenhoek/Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Koen Hartemink
- Antoni van Leeuwenhoek/Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - E.C. Owers
- Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | | | - Peggy den Hartog
- The Netherlands Cancer Institute Amsterdam, Nieuw-Vennep, Netherlands
| | | | - Ton Schumacher
- Netherlands Cancer Institute (NKI-AVL), Amsterdam, Netherlands
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16
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Verschoor YL, van den Berg J, Beets G, Sikorska K, Aalbers A, van Lent A, Grootscholten C, Huibregtse I, Marsman H, Oosterling S, van de Belt M, Kok M, Schumacher T, van Leerdam ME, Haanen JBAG, Voest EE, Chalabi M. Neoadjuvant nivolumab, ipilimumab, and celecoxib in MMR-proficient and MMR-deficient colon cancers: Final clinical analysis of the NICHE study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.3511] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3511 Background: The combination of PD-1 and CTLA4 blockade has changed the treatment landscape for several cancer types. Although this treatment is highly effective in metastatic mismatch-repair deficient (dMMR) colorectal cancers, metastatic MMR-proficient (pMMR) tumors do not respond. The NICHE study was the first neoadjuvant immunotherapy study in colon cancer (CC) to show impressive responses in 100% of dMMR ( n= 20) and 27% of pMMR ( n= 15) CC. In contrast, pathologic response to neoadjuvant chemotherapy using standard of care folfox is approximately 5% in dMMR tumors. Here we present the final efficacy data for the original NICHE study cohorts. Methods: Patients with non-metastatic, resectable dMMR or pMMR CC were treated with a single dose of ipilimumab 1mg/kg and two doses of nivolumab 3mg/kg and underwent surgery within 6 weeks. In addition, patients with pMMR tumors were randomized to receive celecoxib. The primary endpoints were safety and feasibility, and secondary endpoints included pathologic response rate and disease-free survival in 30 patients with dMMR and 30 with pMMR tumors. Pathologic response was defined as 50% or less viable tumor rest (VTR), and major pathologic response (MPR) as <10% VTR. Results: Thirty patients with pMMR and 32 with dMMR tumors were evaluable for the efficacy analyses. In the pMMR cohort, pathologic response was observed in 9/30 (30%, 95% CI 14-46%) patients, consisting of 7 MPR (including 3 pathologic complete responses {pCR}) and 2 partial responses. Four out of 9 pMMR responders had received celecoxib. Five patients received adjuvant chemotherapy. At a median follow-up of 25 months (IQR 12-35 months), 3 patients (all non-responders) in the pMMR group had disease recurrence. In the 32 patients with dMMR tumors, pathologic response was observed in 100% of patients, with 31/32 MPR (97%, 95% CI 91-100%) and one partial response. Pathologic complete response was observed in 22/32 (69%, 95% CI 53-85%) patients. None of the patients in the dMMR cohort had disease recurrence. Surgery was delayed in one patient with a pMMR tumor due to myositis. Grade 3 immune-related adverse events were observed in 12% of patients, consistent with our previous report on the primary endpoint. There were no grade 4 immune-related AEs nor unexpected surgical complications. Conclusions: These data confirm our previously published results of the NICHE study, with responses to neoadjuvant nivolumab plus ipilimumab in 30% of pMMR and 100% of dMMR CC in the completed original cohorts. Validation of the dMMR responses in a large group of dMMR patients is ongoing and has the potential to change current practice. Clinical trial information: NCT03026140.
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Affiliation(s)
| | - José van den Berg
- Antoni van Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - Arend Aalbers
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | | | - Cecile Grootscholten
- Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | | | | | | | | | - Marleen Kok
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Ton Schumacher
- Netherlands Cancer Institute (NKI-AVL), Amsterdam, Netherlands
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17
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Pages F, El Sissy C, Kirilovsky A, Custers P, Dizdarevic E, Lagorce C, Castillo-Martin M, van den Berg J, Iseas S, Sanchez Loria F, Gerard JP, Dimofte G, Perez RO, Habr-Gama A, Figueiredo N, Hansen T, Chalabi M, Galon J, Beets G, Zeitoun G. International validation of the Immunoscore-biopsy (IS B) to guide selection and monitoring of patients treated with watch-and-wait (WW) strategy for rectal cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.3517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3517 Background: The WW strategy for patients with rectal cancer who achieved a clinical complete response (cCR) after neoadjuvant therapy (nT) allows to avoid major resection and the associated morbidity and mortality. Standardized criteria to select and monitor WW patients, including biomarkers predicting recurrence after nT, are lacking. The prognostic impact of the immune infiltrate in colorectal cancers is now demonstrated and has been implemented into clinics through the Immunoscore, the first standardized digital-pathology-based assay, recommended by academic institutions. We evidenced that an Immunoscore adapted to biopsies (ISB) performed at diagnosis, predicts the response to nT and the risk of recurrence after nT. Its clinical utility was suggested in a test cohort of WW patients (El Sissy et al., Clin Cancer Res 2020). The aim of this study was to confirm the ability of the ISB to predict clinical outcomes, improve patients’ eligibility for the WW strategy, and optimize a follow-up schedule. Methods: A total of 304 WW patients from 10 centers across 7 countries were included. Tumor biopsies before treatment were immunostained for CD3+ and CD8+ T-cells and converted to ISB using the pre-defined cut-off. The primary endpoint was time-to-recurrence (TTR). Secondary endpoint was disease-free-survival (DFS). As immune response originates in draining lymph nodes, signs of immune activation were carried out in lymph nodes of additional patients managed by radical surgery with complete pathological response (pCR; n = 12) or non-pCR (n = 12) by 3' RNA-Seq and immunofluorescence technologies. Results: High-ISB patients presented with the lowest risk of recurrence after WW. 5-year recurrence-free rates were 97% (92%-100%), 61% (49%-76%), and 56% (44%-73%) with ISB High, Intermediate, and Low, respectively (HR [Low-vs-High] = 14.3, 95% CI 1.8-100). In patients with cCR after nT (n = 209), High-ISB showed a significant association with prolonged TTR and DFS (Logrank P = 0.005 and P = 0.006, respectively). When ISB was evaluated as a continuous variable, the risk of recurrence was increasing along with decreasing ISB (Wald tests, all P < 0.005). In multivariate analyses, ISB was independent of age, sex, location, and cTNM stage and was the single parameter correlated with TTR (HR [ISB High-vs-Low] = 0.08, 95% CI 0.01-0.6; P = 0.015) and DFS (P = 0.013). Unlike for patients with cCR, no difference according to ISB was observed for those with incomplete response (n = 41) or treated with brachytherapy (n = 34). Finally, intranodal signs of T-cell and B-cell activation were only evidenced in patients with pCR. Conclusions: ISB provides a reliable biomarker to predict clinical outcomes, improve eligibility, and optimize patients’ follow-up. Intranodal T-cell and B-cell activation further supports the immune benefit of both organ and lymph node preservation.
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Affiliation(s)
- Franck Pages
- Department of Immunology, Hôpital Européen Georges Pompidou, University of Paris, Paris, France
| | - Carine El Sissy
- Department of Immunology, Hôpital Européen Georges Pompidou, University of Paris, Paris, France
| | - Amos Kirilovsky
- Department of Immunology, Hôpital Européen Georges Pompidou, University of Paris, Paris, France
| | - Petra Custers
- Department of Surgery, Netherlands Cancer Institute,Antoni van Leeuwenhoek, Amsterdam, Netherlands
| | - Edina Dizdarevic
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Christine Lagorce
- Department of Pathology, Hôpital Européen Georges Pompidou, University of Paris, Paris, France
| | - Mireia Castillo-Martin
- Service of Pathology, Champalimaud Foundation Biobank (CFB)/Champalimaud Centre for the Unknown/Champalimaud Foundation, Lisbon, Portugal
| | | | - Soledad Iseas
- Oncology Unit, Gastroenterology Hospital, Dr. Carlos Bonorino Udaondo, Ciudad Autónoma De Buenos Aires, Argentina
| | - Fernando Sanchez Loria
- GI Clinical Oncology & GI Surgical Oncology, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - Jean-Pierre Gerard
- Department of Radiation Oncology, Centre Antoine Lacassagne, Côte d'Azur University, Nice, France
| | - Gabriel Dimofte
- Department of Surgery, Grigore T. Popa University of Medicine and Pharmacy; Department of Surgery, Regional Institute of Oncology, Iasi, Romania
| | - Rodrigo O Perez
- Department of Colorectal Surgery, Insituto Angelita and Joaquim Gama, São Paulo, Brazil
| | - Angelita Habr-Gama
- Department of Colorectal Surgery, Angelita and Joaquim Gama Institute; Hospital Alemão Oswaldo Cruz; University of São Paulo School of Medicine, São Paulo, Brazil
| | - Nuno Figueiredo
- Colorectal Surgery, Digestive Department, Champalimaud Foundation; Colorectal Surgery, Lusiadas Hospital Lisboa, Lisbon, Portugal
| | - Torben Hansen
- Department of Oncology, Vejle Hospital, University of Southern Denmark; Danish Colorectal Cancer Center South, Vejle University Hospital; Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark
| | - Myriam Chalabi
- Gastrointestinal Oncology, Netherlands Cancer Institute; Molecular Oncology and Immunology, Netherlands Cancer Institute; Medical Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Jerome Galon
- INSERM UMRS1138, Immunology and Cancer Department, Cordeliers Research Center, Paris, France
| | - Geerard Beets
- Department of Surgery, Netherlands Cancer Institute,Antoni van Leeuwenhoek, Amsterdam, Netherlands
| | - Guy Zeitoun
- Department of Immunology, Hôpital Européen Georges Pompidou, University of Paris, Paris, France
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18
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Van Der Sluis K, van Sandick J, van Dieren J, Vollebergh M, Chalabi M, Snaebjornsson P, van den Berg J, Kodach L. Use of predictive bio-markers in gastric cancer in a single centre daily clinical practice. European Journal of Surgical Oncology 2022. [DOI: 10.1016/j.ejso.2021.12.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Koemans WJ, van Dieren JM, van den Berg JG, Meijer GA, Snaebjornsson P, Chalabi M, Lecot F, Riedl R, Krijgsman O, Hofland I, Broeks A, Voncken FEM, Peppelenbosch MP, Sosef MN, van Sandick JW, Kodach LL. High CD8 + tumour-infiltrating lymphocyte density associates with unfavourable prognosis in oesophageal adenocarcinoma following poor response to neoadjuvant chemoradiotherapy. Histopathology 2021; 79:238-251. [PMID: 33660299 DOI: 10.1111/his.14361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/07/2020] [Revised: 02/04/2021] [Accepted: 03/02/2021] [Indexed: 11/29/2022]
Abstract
AIMS Determining prognosis following poor response to neoadjuvant chemoradiotherapy (nCRT) in oesophageal adenocarcinoma (OAC) remains challenging. An immunosuppressive tumour microenvironment (TME) as well as immune infiltrate density and composition are considered to play a critical role in the immune interaction between host and tumour and can predict therapy response and survival in many cancers, including gastrointestinal malignancies. The aim of this study was to establish the TME characteristics associated with survival following a poor response to nCRT. METHODS AND RESULTS The prognostic significance of OAC-associated CD3+ , CD4+ , CD8+ , forkhead box protein 3 (FoxP3+ ) and programmed cell death ligand 1 (PD-L1) expression was studied by immunohistochemistry and quantified by automated image analysis in 123 patients who underwent nCRT and curative resection. Results from good and poor responders were contrasted and immune infiltration was related to disease course in both groups. Subsequently a cohort of 57 patients with a moderate response to nCRT was analysed in a similar fashion. Tumour cell percentage positively correlated to immune infiltration markers. In good and moderate responders, none of the immune infiltrate parameters was associated with survival; in poor responders CD8+ was an independent negative predictor of OS in univariate analysis (P = 0.03) and high CD8+ infiltration was associated with worse OS (15 versus 32 months, P = 0.042). CONCLUSION A high CD8+ density is an independent biomarker of poor OS in poor responders to nCRT, but not in good and moderate responders. Our results suggest that patients with a poor response to nCRT but concomitant high CD8+ counts in the resection specimen require adjuvant therapy.
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Affiliation(s)
- Willem J Koemans
- Department of Surgical Oncology, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jolanda M van Dieren
- Department of Gastrointestinal Oncology, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jose G van den Berg
- Department of Pathology, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Gerrit A Meijer
- Department of Pathology, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Petur Snaebjornsson
- Department of Pathology, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Myriam Chalabi
- Department of Gastrointestinal Oncology, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Frederig Lecot
- Department of Surgery, Zuyderland Hospital, Heerlen, the Netherlands
| | - Robert Riedl
- Department of Pathology, Zuyderland Hospital, Heerlen, the Netherlands
| | - Oscar Krijgsman
- Departments of Molecular Oncology and Immunology, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Ingrid Hofland
- Departments of Core Facility, Molecular Pathology and Biobanking, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Annegien Broeks
- Departments of Core Facility, Molecular Pathology and Biobanking, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Francine E M Voncken
- Department of Radiotherapy, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Maikel P Peppelenbosch
- Departments of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Meindert N Sosef
- Department of Surgery, Zuyderland Hospital, Heerlen, the Netherlands
| | - Johanna W van Sandick
- Department of Surgical Oncology, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Liudmila L Kodach
- Department of Pathology, Antoni van Leeuwenhoek, the Netherlands Cancer Institute, Amsterdam, the Netherlands
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20
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Ooft SN, Weeber F, Dijkstra KK, McLean CM, Kaing S, van Werkhoven E, Schipper L, Hoes L, Vis DJ, van de Haar J, Prevoo W, Snaebjornsson P, van der Velden D, Klein M, Chalabi M, Boot H, van Leerdam M, Bloemendal HJ, Beerepoot LV, Wessels L, Cuppen E, Clevers H, Voest EE. Patient-derived organoids can predict response to chemotherapy in metastatic colorectal cancer patients. Sci Transl Med 2020; 11:11/513/eaay2574. [PMID: 31597751 DOI: 10.1126/scitranslmed.aay2574] [Citation(s) in RCA: 383] [Impact Index Per Article: 95.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 09/17/2019] [Indexed: 12/16/2022]
Abstract
There is a clear and unmet clinical need for biomarkers to predict responsiveness to chemotherapy for cancer. We developed an in vitro test based on patient-derived tumor organoids (PDOs) from metastatic lesions to identify nonresponders to standard-of-care chemotherapy in colorectal cancer (CRC). In a prospective clinical study, we show the feasibility of generating and testing PDOs for evaluation of sensitivity to chemotherapy. Our PDO test predicted response of the biopsied lesion in more than 80% of patients treated with irinotecan-based therapies without misclassifying patients who would have benefited from treatment. This correlation was specific to irinotecan-based chemotherapy, however, and the PDOs failed to predict outcome for treatment with 5-fluorouracil plus oxaliplatin. Our data suggest that PDOs could be used to prevent cancer patients from undergoing ineffective irinotecan-based chemotherapy.
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Affiliation(s)
- Salo N Ooft
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands.,Oncode Institute, 3521 AL Utrecht, Netherlands
| | - Fleur Weeber
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands.,Oncode Institute, 3521 AL Utrecht, Netherlands
| | - Krijn K Dijkstra
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands.,Oncode Institute, 3521 AL Utrecht, Netherlands
| | - Chelsea M McLean
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands.,Oncode Institute, 3521 AL Utrecht, Netherlands
| | - Sovann Kaing
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands.,Oncode Institute, 3521 AL Utrecht, Netherlands
| | - Erik van Werkhoven
- Department of Biometrics, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands
| | - Luuk Schipper
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands.,Oncode Institute, 3521 AL Utrecht, Netherlands
| | - Louisa Hoes
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands.,Oncode Institute, 3521 AL Utrecht, Netherlands
| | - Daniel J Vis
- Oncode Institute, 3521 AL Utrecht, Netherlands.,Department of Molecular Carcinogenesis, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands
| | - Joris van de Haar
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands.,Oncode Institute, 3521 AL Utrecht, Netherlands.,Department of Molecular Carcinogenesis, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands
| | - Warner Prevoo
- Department of Radiology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands
| | - Petur Snaebjornsson
- Department of Pathology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands
| | - Daphne van der Velden
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands.,Oncode Institute, 3521 AL Utrecht, Netherlands
| | - Michelle Klein
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands.,Oncode Institute, 3521 AL Utrecht, Netherlands
| | - Myriam Chalabi
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands
| | - Henk Boot
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands
| | - Monique van Leerdam
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands
| | - Haiko J Bloemendal
- Department of Internal Medicine/Oncology, Radboud University Medical Center Nijmegen, 6525 GA Nijmegen, Netherlands
| | - Laurens V Beerepoot
- Department of Internal Medicine, Elisabeth-TweeSteden Hospital, 5042 AD Tilburg, Netherlands
| | - Lodewyk Wessels
- Oncode Institute, 3521 AL Utrecht, Netherlands.,Department of Molecular Carcinogenesis, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands.,Faculty of Electrical Engineering, Mathematics and Computer Science, Delft University of Technology, 2628 CD Delft, Netherlands
| | - Edwin Cuppen
- Oncode Institute, 3521 AL Utrecht, Netherlands.,Division Biomedical Genetics, Centre for Molecular Medicine, University Medical Centre Utrecht, 3584 CX Utrecht, Netherlands.,Hartwig Medical Foundation, 1098 XH Amsterdam, Netherlands
| | - Hans Clevers
- Oncode Institute, 3521 AL Utrecht, Netherlands.,Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences and University Medical Centre Utrecht, 3584 CT Utrecht, Netherlands.,Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, Netherlands
| | - Emile E Voest
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands. .,Oncode Institute, 3521 AL Utrecht, Netherlands.,Department of Gastrointestinal Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, Netherlands
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21
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Voorwerk L, Garner H, Blomberg O, Spagnuolo L, Chalabi M, van Dyk E, Isaeva O, Bakker N, Klaver C, Duijst M, Kersten K, Hoes L, van Dorp J, van der Heijden M, Theelen W, Voest E, Wessels L, de Visser K, Kok M. LBA10 Critical role of eosinophils during response to immune checkpoint blockade in breast cancer and other cancer types. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2237] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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22
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Chalabi M, Cardona A, Nagarkar DR, Dhawahir Scala A, Gandara DR, Rittmeyer A, Albert ML, Powles T, Kok M, Herrera FG. Efficacy of chemotherapy and atezolizumab in patients with non-small-cell lung cancer receiving antibiotics and proton pump inhibitors: pooled post hoc analyses of the OAK and POPLAR trials. Ann Oncol 2020; 31:525-531. [PMID: 32115349 DOI: 10.1016/j.annonc.2020.01.006] [Citation(s) in RCA: 163] [Impact Index Per Article: 40.8] [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: 07/30/2019] [Revised: 12/08/2019] [Accepted: 01/04/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Preclinical data have shown that proton pump inhibitors (PPI) can modulate the microbiome, and single-arm studies suggested that antibiotics (ATB) may decrease the efficacy of immune checkpoint inhibitors (ICI), but randomized controlled trial data are lacking. This pooled analysis evaluated the effect of ATB and PPI on outcome in patients randomized between ICI and chemotherapy. PATIENTS AND METHODS This retrospective analysis used pooled data from the phase II POPLAR (NCT01903993) and phase III OAK (NCT02008227) trials, which included 1512 patients with previously treated non-small-cell lung cancer (NSCLC) randomly assigned to receive atezolizumab (n = 757) or docetaxel (n = 755). The main objective of this analysis was to assess the impact of ATB and PPI use on overall survival (OS) and progression-free survival (PFS). RESULTS A total of 169 (22.3%) patients in the atezolizumab group and 202 (26.8%) in the docetaxel group received ATB, and 234 (30.9%) and 260 (34.4%), respectively, received PPI. Multivariate analysis in all patients revealed that ATB were associated with shorter OS [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.04-1.39], as was PPI (HR 1.26, 95% CI 1.10-1.44). Within the atezolizumab population, OS was significantly shorter in patients who received ATB (8.5 versus 14.1 months, HR 1.32, 95% CI 1.06-1.63, P = 0.01) or PPI (9.6 versus 14.5 months, HR 1.45, 95% CI 1.20-1.75, P = 0.0001). PPI use was associated with shorter PFS in the atezolizumab population (1.9 versus 2.8 months, HR 1.30, 95% CI 1.10-1.53, P = 0.001). There was no association between ATB and PPI use and PFS or OS within the docetaxel population. CONCLUSION In this unplanned analysis from two randomized trials, data suggest that ATB or PPI use in patients with metastatic NSCLC is associated with poor outcome and may influence the efficacy of ICI.
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Affiliation(s)
- M Chalabi
- Molecular Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - A Cardona
- PD Biometrics, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - D R Nagarkar
- Cancer Immunology, Genentech, Inc., South San Francisco, USA
| | | | - D R Gandara
- Department of Thoracic Oncology, UC Davis Comprehensive Cancer Center, Sacramento, USA
| | - A Rittmeyer
- Department of Thoracic Oncology, Pulmonary Clinic Immenhausen, Immenhausen, Germany
| | - M L Albert
- Cancer Immunology, Genentech, Inc., South San Francisco, USA
| | - T Powles
- Centre for Experimental Cancer Medicine, Barts Cancer Institute, London, UK
| | - M Kok
- Molecular Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Tumor Biology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - F G Herrera
- Immune Oncology Service, Lausanne University Hospital, Ludwig Institute for Cancer Research, Lausanne, Switzerland.
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Godiny M, Mohammadi B, Norooznezhad M, Chalabi M. Endodontic Rotary Systems: Comparison between Gentlefile and Pro Taper Universal for removal of Enterococcus faecalis. J Clin Exp Dent 2020; 15:e277-e280. [PMID: 37152499 PMCID: PMC10155944 DOI: 10.4317/jced.60147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/07/2022] [Indexed: 03/08/2023] Open
Abstract
Background As a resistant bacterium species in infected root canals, Enterococcus faecalis needs to be removed in any endodontic treatment. So, we aimed to compare the effectiveness of two rotary systems, Gentlefile and Pro Taper Universal, in removing Enterococcus faecalis (E. faecalis) from the infected root canal system. Material and Methods Forty single-root premolar teeth were collected and randomly divided into two groups: Gentlefile (n=18) and Pro Taper Universal (n=18). In addition, four teeth were used as a negative control. The root canals were prepared and infected with E. faecalis and incubated for 4 weeks. Samples were obtained from the root canal immediately before and after instrumentation. A reduction in bacteria was determined by the colony count method. Results Colony numbers of E. faecalis were significantly different before and after instrumentation in all groups (p<0.001). Furthermore, Gentlefile group illustrated a higher percentage of bacterial reduction (96.1%) compared to Pro Taper Universal group (90%). Accordingly, Gentlefile group was found to be significantly (p<0.001) more effective in decreasing bacterial populations than Pro Taper Universal group. Conclusions Although both rotary systems were highly effective in bacterial reduction from root canals, Gentlefile demonstrated better bacterial reduction percentage from root canals than Pro Taper Universal. Key words:Enterococcus faecalis, Gentlefile, Pro Taper Universal, Rotary systems.
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Voest E, van der Velden D, Hoes L, Van Der Wijngaart H, Van Berge Henegouwen M, Van Werkhoven E, Roepman P, Huitema A, van Herpen C, de Groot D, Devriese L, de Jonge M, Chalabi M, Smit E, Mehra N, Labots M, Sleijfer S, Cuppen E, Verheul H, Gelderblom H. Drug Rediscovery Protocol: Expanded use of existing anticancer drugs. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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25
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van der Velden DL, Hoes LR, van der Wijngaart H, van Berge Henegouwen JM, van Werkhoven E, Roepman P, Schilsky RL, de Leng WWJ, Huitema ADR, Nuijen B, Nederlof PM, van Herpen CML, de Groot DJA, Devriese LA, Hoeben A, de Jonge MJA, Chalabi M, Smit EF, de Langen AJ, Mehra N, Labots M, Kapiteijn E, Sleijfer S, Cuppen E, Verheul HMW, Gelderblom H, Voest EE. The Drug Rediscovery protocol facilitates the expanded use of existing anticancer drugs. Nature 2019; 574:127-131. [DOI: 10.1038/s41586-019-1600-x] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 08/14/2019] [Indexed: 12/19/2022]
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Abstract
Mismatch repair deficiency (dMMR) results in microsatellite instability (MSI) and is strongly associated with responsiveness to programmed death-1 receptor (PD-1)-blocking antibodies. Probably the main driver for the observed high efficacy of immune checkpoint inhibitors in dMMR tumours is the remarkably high tumour mutational burden. MSI can be detected using immunohistochemistry and/or PCR. In addition, next-generation sequencing is becoming increasingly available to clinical laboratories as a cost-effective and scalable method to evaluate multiple genetic aberrations including MSI. Efficacy of PD-1-blockade in MSI tumours is similar for patients with colorectal cancer (CRC; objective response rate (ORR) 36%) or a different cancer type (ORR 46% across 14 other cancer types). Based on these results, PD-1-blocking antibody pembrolizumab was the first tumour-agnostic treatment to be granted Food and Drug Administration approval based on the presence of MSI as a biomarker. Currently, there is no approved PD-1-blocking antibody for MSI cancers in Europe. Here, we present our experience with the screening for MSI and the treatment of patients with advanced disease of MSI CRC and non-CRC with immunotherapy.
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Affiliation(s)
- Marleen Kok
- Medical Oncology, Nederlands Kanker Instituut - Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, The Netherlands
| | - Myriam Chalabi
- Medical Oncology, Nederlands Kanker Instituut - Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, The Netherlands
| | - John Haanen
- Medical Oncology, Nederlands Kanker Instituut - Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, The Netherlands.
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27
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Rovers KP, Bakkers C, Simkens GAAM, Burger JWA, Nienhuijs SW, Creemers GJM, Thijs AMJ, Brandt-Kerkhof ARM, Madsen EVE, Ayez N, de Boer NL, van Meerten E, Tuynman JB, Kusters M, Sluiter NR, Verheul HMW, van der Vliet HJ, Wiezer MJ, Boerma D, Wassenaar ECE, Los M, Hunting CB, Aalbers AGJ, Kok NFM, Kuhlmann KFD, Boot H, Chalabi M, Kruijff S, Been LB, van Ginkel RJ, de Groot DJA, Fehrmann RSN, de Wilt JHW, Bremers AJA, de Reuver PR, Radema SA, Herbschleb KH, van Grevenstein WMU, Witkamp AJ, Koopman M, Haj Mohammad N, van Duyn EB, Mastboom WJB, Mekenkamp LJM, Nederend J, Lahaye MJ, Snaebjornsson P, Verhoef C, van Laarhoven HWM, Zwinderman AH, Bouma JM, Kranenburg O, van 't Erve I, Fijneman RJA, Dijkgraaf MGW, Hemmer PHJ, Punt CJA, Tanis PJ, de Hingh IHJT. Perioperative systemic therapy and cytoreductive surgery with HIPEC versus upfront cytoreductive surgery with HIPEC alone for isolated resectable colorectal peritoneal metastases: protocol of a multicentre, open-label, parallel-group, phase II-III, randomised, superiority study (CAIRO6). BMC Cancer 2019; 19:390. [PMID: 31023318 PMCID: PMC6485075 DOI: 10.1186/s12885-019-5545-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 03/28/2019] [Indexed: 02/08/2023] Open
Abstract
Background Upfront cytoreductive surgery with HIPEC (CRS-HIPEC) is the standard treatment for isolated resectable colorectal peritoneal metastases (PM) in the Netherlands. This study investigates whether addition of perioperative systemic therapy to CRS-HIPEC improves oncological outcomes. Methods This open-label, parallel-group, phase II-III, randomised, superiority study is performed in nine Dutch tertiary referral centres. Eligible patients are adults who have a good performance status, histologically or cytologically proven resectable PM of a colorectal adenocarcinoma, no systemic colorectal metastases, no systemic therapy for colorectal cancer within six months prior to enrolment, and no previous CRS-HIPEC. Eligible patients are randomised (1:1) to perioperative systemic therapy and CRS-HIPEC (experimental arm) or upfront CRS-HIPEC alone (control arm) by using central randomisation software with minimisation stratified by a peritoneal cancer index of 0–10 or 11–20, metachronous or synchronous PM, previous systemic therapy for colorectal cancer, and HIPEC with oxaliplatin or mitomycin C. At the treating physician’s discretion, perioperative systemic therapy consists of either four 3-weekly neoadjuvant and adjuvant cycles of capecitabine with oxaliplatin (CAPOX), six 2-weekly neoadjuvant and adjuvant cycles of 5-fluorouracil/leucovorin with oxaliplatin (FOLFOX), or six 2-weekly neoadjuvant cycles of 5-fluorouracil/leucovorin with irinotecan (FOLFIRI) followed by four 3-weekly (capecitabine) or six 2-weekly (5-fluorouracil/leucovorin) adjuvant cycles of fluoropyrimidine monotherapy. Bevacizumab is added to the first three (CAPOX) or four (FOLFOX/FOLFIRI) neoadjuvant cycles. The first 80 patients are enrolled in a phase II study to explore the feasibility of accrual and the feasibility, safety, and tolerance of perioperative systemic therapy. If predefined criteria of feasibility and safety are met, the study continues as a phase III study with 3-year overall survival as primary endpoint. A total of 358 patients is needed to detect the hypothesised 15% increase in 3-year overall survival (control arm 50%; experimental arm 65%). Secondary endpoints are surgical characteristics, major postoperative morbidity, progression-free survival, disease-free survival, health-related quality of life, costs, major systemic therapy related toxicity, and objective radiological and histopathological response rates. Discussion This is the first randomised study that prospectively compares oncological outcomes of perioperative systemic therapy and CRS-HIPEC with upfront CRS-HIPEC alone for isolated resectable colorectal PM. Trial registration Clinicaltrials.gov/NCT02758951, NTR/NTR6301, ISRCTN/ISRCTN15977568, EudraCT/2016–001865-99.
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Affiliation(s)
- Koen P Rovers
- Department of Surgery, Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, Netherlands
| | - Checca Bakkers
- Department of Surgery, Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, Netherlands
| | - Geert A A M Simkens
- Department of Surgery, Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, Netherlands
| | - Jacobus W A Burger
- Department of Surgery, Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, Netherlands
| | - Simon W Nienhuijs
- Department of Surgery, Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, Netherlands
| | - Geert-Jan M Creemers
- Department of Medical Oncology, Catharina Hospital, PO Box 1350, 5602, Eindhoven, ZA, Netherlands
| | - Anna M J Thijs
- Department of Medical Oncology, Catharina Hospital, PO Box 1350, 5602, Eindhoven, ZA, Netherlands
| | | | - Eva V E Madsen
- Department of Surgical Oncology, Erasmus Medical Centre, PO Box 2040, 3000, Rotterdam, CA, Netherlands
| | - Ninos Ayez
- Department of Surgical Oncology, Erasmus Medical Centre, PO Box 2040, 3000, Rotterdam, CA, Netherlands
| | - Nadine L de Boer
- Department of Surgical Oncology, Erasmus Medical Centre, PO Box 2040, 3000, Rotterdam, CA, Netherlands
| | - Esther van Meerten
- Department of Medical Oncology, Erasmus MC Cancer Institute, PO Box 2040, 3000, Rotterdam, CA, Netherlands
| | - Jurriaan B Tuynman
- Department of Surgery, Amsterdam University Medical Centres, Location VUMC, PO Box 7057, 1007, Amsterdam, MB, Netherlands
| | - Miranda Kusters
- Department of Surgery, Amsterdam University Medical Centres, Location VUMC, PO Box 7057, 1007, Amsterdam, MB, Netherlands
| | - Nina R Sluiter
- Department of Surgery, Amsterdam University Medical Centres, Location VUMC, PO Box 7057, 1007, Amsterdam, MB, Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Amsterdam University Medical Centres, Location VUMC, PO Box 7057, 1007, Amsterdam, MB, Netherlands
| | - Hans J van der Vliet
- Department of Medical Oncology, Amsterdam University Medical Centres, Location VUMC, PO Box 7057, 1007, Amsterdam, MB, Netherlands
| | - Marinus J Wiezer
- Department of Surgery, St. Antonius Hospital, PO Box 2500, 3430, Nieuwegein, EM, Netherlands
| | - Djamila Boerma
- Department of Surgery, St. Antonius Hospital, PO Box 2500, 3430, Nieuwegein, EM, Netherlands
| | - Emma C E Wassenaar
- Department of Surgery, St. Antonius Hospital, PO Box 2500, 3430, Nieuwegein, EM, Netherlands
| | - Maartje Los
- Department of Medical Oncology, St. Antonius Hospital, PO Box 2500, 3430, Nieuwegein, EM, Netherlands
| | - Cornelis B Hunting
- Department of Medical Oncology, St. Antonius Hospital, PO Box 2500, 3430, Nieuwegein, EM, Netherlands
| | - Arend G J Aalbers
- Department of Surgical Oncology, Netherlands Cancer Institute, PO Box 90203, 1006, Amsterdam, BE, Netherlands
| | - Niels F M Kok
- Department of Surgical Oncology, Netherlands Cancer Institute, PO Box 90203, 1006, Amsterdam, BE, Netherlands
| | - Koert F D Kuhlmann
- Department of Surgical Oncology, Netherlands Cancer Institute, PO Box 90203, 1006, Amsterdam, BE, Netherlands
| | - Henk Boot
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, PO Box 90203, 1006, Amsterdam, BE, Netherlands
| | - Myriam Chalabi
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, PO Box 90203, 1006, Amsterdam, BE, Netherlands
| | - Schelto Kruijff
- Department of Surgery, University Medical Centre Groningen, PO Box 30001, 9700 RB, Groningen, RB, Netherlands
| | - Lukas B Been
- Department of Surgery, University Medical Centre Groningen, PO Box 30001, 9700 RB, Groningen, RB, Netherlands
| | - Robert J van Ginkel
- Department of Surgery, University Medical Centre Groningen, PO Box 30001, 9700 RB, Groningen, RB, Netherlands
| | - Derk Jan A de Groot
- Department of Medical Oncology, University Medical Centre Groningen, PO Box 30001, 9700, Groningen, RB, Netherlands
| | - Rudolf S N Fehrmann
- Department of Medical Oncology, University Medical Centre Groningen, PO Box 30001, 9700, Groningen, RB, Netherlands
| | - Johannes H W de Wilt
- Department of Surgery, Radboud University Medical Centre, PO Box 9101, 6500, Nijmegen, HB, Netherlands
| | - Andreas J A Bremers
- Department of Surgery, Radboud University Medical Centre, PO Box 9101, 6500, Nijmegen, HB, Netherlands
| | - Philip R de Reuver
- Department of Surgery, Radboud University Medical Centre, PO Box 9101, 6500, Nijmegen, HB, Netherlands
| | - Sandra A Radema
- Department of Medical Oncology, Radboud University Medical Centre, PO Box 9101, 6500, Nijmegen, HB, Netherlands
| | - Karin H Herbschleb
- Department of Medical Oncology, Radboud University Medical Centre, PO Box 9101, 6500, Nijmegen, HB, Netherlands
| | | | - Arjen J Witkamp
- Department of Surgery, University Medical Centre Utrecht, PO Box 85500, 3508, Utrecht, GA, Netherlands
| | - Miriam Koopman
- Department of Medical Oncology, University Medical Centre Utrecht, PO Box 85500, 3508, Utrecht, GA, Netherlands
| | - Nadia Haj Mohammad
- Department of Medical Oncology, University Medical Centre Utrecht, PO Box 85500, 3508, Utrecht, GA, Netherlands
| | - Eino B van Duyn
- Department of Surgery, Medisch Spectrum Twente, PO Box 50000, 7500, Enschede, KA, Netherlands
| | - Walter J B Mastboom
- Department of Surgery, Medisch Spectrum Twente, PO Box 50000, 7500, Enschede, KA, Netherlands
| | - Leonie J M Mekenkamp
- Department of Medical Oncology, Medisch Spectrum Twente, PO Box 50000, 7500, Enschede, KA, Netherlands
| | - Joost Nederend
- Department of Radiology, Catharina Hospital, PO Box 1350, 5602, Eindhoven, ZA, Netherlands
| | - Max J Lahaye
- Department of Radiology, Netherlands Cancer Institute, PO Box 90203, 1006, Amsterdam, BE, Netherlands
| | - Petur Snaebjornsson
- Department of Pathology, Netherlands Cancer Institute, PO Box 90203, 1006, Amsterdam, BE, Netherlands
| | - Cornelis Verhoef
- Department of Surgical Oncology, Erasmus Medical Centre, PO Box 2040, 3000, Rotterdam, CA, Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Amsterdam University Medical Centres, Location AMC, PO Box 22660, 1100, Amsterdam, DD, Netherlands
| | - Aeilko H Zwinderman
- Department of Clinical Epidemiology, Biostatistics & Bioinformatics, Amsterdam University Medical Centres, Location AMC, PO Box 22660, 1100, Amsterdam, DD, Netherlands
| | - Jeanette M Bouma
- Clinical Trial Department, Netherlands Comprehensive Cancer Organisation (IKNL), PO Box 19079, 3501, Utrecht, DB, Netherlands
| | - Onno Kranenburg
- UMC Utrecht Cancer Centre, University Medical Centre Utrecht, PO Box 85500, 3508, Utrecht, GA, Netherlands
| | - Iris van 't Erve
- Department of Pathology, Netherlands Cancer Institute, PO Box 90203, 1006, Amsterdam, BE, Netherlands
| | - Remond J A Fijneman
- Department of Pathology, Netherlands Cancer Institute, PO Box 90203, 1006, Amsterdam, BE, Netherlands
| | - Marcel G W Dijkgraaf
- Department of Clinical Epidemiology, Biostatistics & Bioinformatics, Amsterdam University Medical Centres, Location AMC, PO Box 22660, 1100, Amsterdam, DD, Netherlands
| | - Patrick H J Hemmer
- Department of Surgery, University Medical Centre Groningen, PO Box 30001, 9700 RB, Groningen, RB, Netherlands
| | - Cornelis J A Punt
- Department of Medical Oncology, Amsterdam University Medical Centres, Location AMC, PO Box 22660, 1100, Amsterdam, DD, Netherlands
| | - Pieter J Tanis
- Department of Surgery, Amsterdam University Medical Centres, Location AMC, PO Box 22660, 1100, Amsterdam, DD, Netherlands
| | - Ignace H J T de Hingh
- Department of Surgery, Catharina Hospital, PO Box 1350, 5602 ZA, Eindhoven, Netherlands.
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Chalabi M, Fanchi L, Van den Berg J, Beets G, Lopez-Yurda M, Aalbers A, Grootscholten C, Snaebjornsson P, Maas M, Mertz M, Nuijten E, Kuiper M, Kok M, Van Leerdam M, Schumacher T, Voest E, Haanen J. Neoadjuvant ipilimumab plus nivolumab in early stage colon cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.047] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Dijkstra KK, Cattaneo CM, Weeber F, Chalabi M, van de Haar J, Fanchi LF, Slagter M, van der Velden DL, Kaing S, Kelderman S, van Rooij N, van Leerdam ME, Depla A, Smit EF, Hartemink KJ, de Groot R, Wolkers MC, Sachs N, Snaebjornsson P, Monkhorst K, Haanen J, Clevers H, Schumacher TN, Voest EE. Generation of Tumor-Reactive T Cells by Co-culture of Peripheral Blood Lymphocytes and Tumor Organoids. Cell 2018; 174:1586-1598.e12. [PMID: 30100188 DOI: 10.1016/j.cell.2018.07.009] [Citation(s) in RCA: 565] [Impact Index Per Article: 94.2] [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: 07/05/2017] [Revised: 05/24/2018] [Accepted: 07/05/2018] [Indexed: 02/07/2023]
Abstract
Cancer immunotherapies have shown substantial clinical activity for a subset of patients with epithelial cancers. Still, technological platforms to study cancer T-cell interactions for individual patients and understand determinants of responsiveness are presently lacking. Here, we establish and validate a platform to induce and analyze tumor-specific T cell responses to epithelial cancers in a personalized manner. We demonstrate that co-cultures of autologous tumor organoids and peripheral blood lymphocytes can be used to enrich tumor-reactive T cells from peripheral blood of patients with mismatch repair-deficient colorectal cancer and non-small-cell lung cancer. Furthermore, we demonstrate that these T cells can be used to assess the efficiency of killing of matched tumor organoids. This platform provides an unbiased strategy for the isolation of tumor-reactive T cells and provides a means by which to assess the sensitivity of tumor cells to T cell-mediated attack at the level of the individual patient.
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Affiliation(s)
- Krijn K Dijkstra
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Chiara M Cattaneo
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Fleur Weeber
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Myriam Chalabi
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands; Department of Gastroenterologic Oncology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Joris van de Haar
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Lorenzo F Fanchi
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Maarten Slagter
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Daphne L van der Velden
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Sovann Kaing
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Sander Kelderman
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Nienke van Rooij
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Monique E van Leerdam
- Department of Gastroenterologic Oncology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Annekatrien Depla
- Department of Gastroenterology and Hepatology, EC Slotervaart Hospital, 1066 CX Amsterdam, the Netherlands
| | - Egbert F Smit
- Department of Thoracic Oncology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Koen J Hartemink
- Department of Surgery, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Rosa de Groot
- Department of Hematopoeisis, Sanquin Research, 1066 CX Amsterdam, the Netherlands
| | - Monika C Wolkers
- Department of Hematopoeisis, Sanquin Research, 1066 CX Amsterdam, the Netherlands; Landsteiner Laboratory, Amsterdam Medical Center, 1105 AZ Amsterdam, the Netherlands
| | - Norman Sachs
- Hubrecht Institute, University Medical Center Utrecht, 3584 CT Utrecht, the Netherlands
| | - Petur Snaebjornsson
- Department of Pathology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Kim Monkhorst
- Department of Pathology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - John Haanen
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Hans Clevers
- Hubrecht Institute, University Medical Center Utrecht, 3584 CT Utrecht, the Netherlands; Princess Maxima Center for Pediatric Oncology, 3584 CS Utrecht, the Netherlands; Oncode Institute, the Netherlands
| | - Ton N Schumacher
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands; Oncode Institute, the Netherlands
| | - Emile E Voest
- Department of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands.
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Kok M, Voorwerk L, Horlings H, Sikorska K, van der Vijver K, Slagter M, Warren S, Ong S, Wiersma T, Russell N, Lalezari F, de Maaker M, Kemper I, Mandjes IA, Chalabi M, Sonke GS, Salgado R, Linn SC, Schumacher T, Blank CU. Adaptive phase II randomized trial of nivolumab after induction treatment in triple negative breast cancer (TONIC trial): Final response data stage I and first translational data. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.1012] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Marleen Kok
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Hugo Horlings
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Koen van der Vijver
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | | | | | | | - Terry Wiersma
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | | | - Inge Kemper
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - Gabe S. Sonke
- Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands
| | - Roberto Salgado
- Center for Oncological Research (CORE) - campus Sint-Augustinus - University of Antwerp, Antwerpen, Belgium
| | - Sabine C. Linn
- Department of Medical Oncology- Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, Netherlands
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Kok M, Horlings HM, Snaebjornsson P, Chalabi M, Schumacher TN, Blank CU, Linn SC, van Dieren J. Profound Immunotherapy Response in Mismatch Repair-Deficient Breast Cancer. JCO Precis Oncol 2017; 1:1-3. [DOI: 10.1200/po.17.00052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Marleen Kok
- All authors: Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Hugo M. Horlings
- All authors: Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Myriam Chalabi
- All authors: Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - Sabine C. Linn
- All authors: Netherlands Cancer Institute, Amsterdam, Netherlands
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Chalabi M, Van Leerdam M, Aalbers A, Van den Berg J, Beets G, Grootscholten C, Snaebjornsson P, Kuiper M, Den Hartog P, Weeber F, Dijkstra K, Kok M, Cullen D, Schumacher T, Haanen J, Voest E. Nivolumab, ipilimumab and COX2-inhibition in early stage colon cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kok M, Horlings H, van de Vijver K, Wiersma T, Russell N, Voorwerk L, Sikorska K, van Werkhoven E, Mandjes I, Kemper I, Foekema J, Wilgenhof S, Chalabi M, Stouthard J, Sonke G, Cullen D, Salgado R, Schumacher T, Blank C, Linn S. Adaptive phase II randomized non-comparative trial of nivolumab after induction treatment in triple negative breast cancer: TONIC-trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wittekamp BH, Chalabi M, van Mook WNKA, Winkens B, Verbon A, Bergmans DCJJ. Catheter-related bloodstream infections: a prospective observational study of central venous and arterial catheters. ACTA ACUST UNITED AC 2013; 45:738-45. [DOI: 10.3109/00365548.2013.804632] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Chalabi M, Rezaie F, Moghim S, Mogharehabed A, Rezaei M, Mehraban B. Periodontopathic bacteria and herpesviruses in chronic periodontitis. Mol Oral Microbiol 2010; 25:236-40. [DOI: 10.1111/j.2041-1014.2010.00571.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Faghri J, Moghim S, Abed AM, Rezaei F, Chalabi M. Prevalence of Porphyromonas gingivalis and Bacteroides forsythus in chronic periodontitis by multiplex PCR. Pak J Biol Sci 2009; 10:4123-7. [PMID: 19090291 DOI: 10.3923/pjbs.2007.4123.4127] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present research decided to study prevalence of Porphyromonas gingivalis and Bacteroides forsythus in chronic periodontitis patient by use of Multiplex PCR. The subgingival plaque samples from 61 patients suffering from chronic periodontitis with probing depth PD > or = 6 and 40 healthy controls were collected by sterile curette. In this study we used two species-specific Forward primers in combination with a single Reverse primer. These primers target variable and conserved region of 16S rRNA gene, respectively. The study included 61 patients (34 women, 27 men; 24-69 years of age; mean 43) and 40 periodontally healthy controls (22 Women, 18 men, 21-69 years in age; mean 41.35%). Porphyromonas gingivalis was detected in 51 samples (83.61%) and 16 samples (40%) of chronic periodontitis patients and healthy subjects, respectively and Bacteroides forsythus was detected in 32 samples (52.50%) of chronic periodontitis patients and was not detected in any sample from healthy persons. We set up Multiplex PCR in order to detect P. gingivalis and B. forsythus simultaneously. The present data suggest that P. gingivalis is a more important cofactor in etiology of chronic periodontitis. Further studies are needed to determine spectrum of pathogenicity of the disease and effective management of diagnosis and treatment in order to decrease the risk of periodontic complicates such as systemic infection.
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Affiliation(s)
- J Faghri
- Department of Microbiology, Isfahan Medical University, Iran
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Moghim SH, Chalabi M, Abed AM, Rezaei F, Tamizifar H. Prevalence of Epstein-Barr virus type 1 in patients with chronic periodontitis by nested-PCR. Pak J Biol Sci 2007; 10:4547-4550. [PMID: 19093530 DOI: 10.3923/pjbs.2007.4547.4550] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The present study evaluated the subgingival presence of Epstein-Barr virus type 1 (EBV-1) in patients with chronic periodontitis with nested-PCR. Subgingival plaque samples from 61 patients with chronic periodontitis with Probing Depth (PD) > or = 6 and 40 healthy controls were collected by sterile curette. DNA was extracted. A nested Polymerase Chain Reaction (PCR) method determined presence of EBV-1. The study included 61 patients (34 women, 27 men; 24-69 years of age; mean 43) and 40 periodontally health controls (22 Women, 18 men, 21-69 years in age; mean 41.35%). EBV type 1 was detected in 37 samples (60.7%) and 1 samples (2.5%) of chronic periodontitis patients and healthy subjects, respectively. This study demonstrated that EBV-1 infection is associated with the activity of chronic periodontitis.
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Affiliation(s)
- S H Moghim
- Department of Microbiology, Isfahan Medical University, Isfahan, Iran
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Masoud AA, Chalabi M, Omer F, Bhat V. Successful Transthoracic Drainage of a Large Pneumatocele in a Premature Infant. Qatar Med J 2005. [DOI: 10.5339/qmj.2005.1.20] [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: 11/03/2022] Open
Abstract
Pulmonary pneumatocele is an unusual complication of bacteria Pneumonia in the neonatal period. They usually develop during the recovery phase, and generally resolve spontaneously within seeks to months [1], We present a premature newborn that developed a large pneumatocele secondary to staphylococcus aureus pneumonia that was treated successfully with a test tube inserted into the pneumatocele. This resulted in complete resolution of the pneumatocele in four days.
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Affiliation(s)
- A. A. Masoud
- *Departments of Neonatology, Hamad Medical Corporation, Doha, Qatar
| | - M. Chalabi
- *Departments of Neonatology, Hamad Medical Corporation, Doha, Qatar
| | - F. Omer
- *Departments of Neonatology, Hamad Medical Corporation, Doha, Qatar
| | - V. Bhat
- **Department of Radiology, Hamad Medical Corporation, Doha, Qatar
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