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Crombie JL, Graff T, Falchi L, Karimi YH, Bannerji R, Nastoupil L, Thieblemont C, Ursu R, Bartlett N, Nachar V, Weiss J, Osterson J, Patel K, Brody J, Abramson JS, Lunning M, Shah NN, Ayed A, Kamdar M, Parsons B, Caimi P, Flinn I, Herrera A, Sharman J, McKenna M, Armand P, Kahl B, Smith S, Zelenetz A, Budde LE, Hutchings M, Phillips T, Dickinson M. Consensus recommendations on the management of toxicity associated with CD3×CD20 bispecific antibody therapy. Blood 2024; 143:1565-1575. [PMID: 38252906 DOI: 10.1182/blood.2023022432] [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: 09/12/2023] [Revised: 12/19/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
ABSTRACT Bispecific antibodies (BsAb) that target CD3 and CD20 represent a new milestone in the treatment of patients with B-cell non-Hodgkin lymphoma. These drugs have demonstrated remarkable single-agent activity in patients with heavily pretreated disease, and 3 drugs have so far received regulatory approvals in various countries. However, BsAbs can potentially lead to severe toxicity associated with T-cell activation, particularly cytokine release syndrome (CRS). The anticipated widespread use of these off-the-shelf products poses challenges for implementation and highlights the need for guidance in anticipating, mitigating, and managing adverse events. In clinical trials, guidance for the evaluation and treatment of CRS and neurotoxicity associated with BsAb therapy has been modeled after algorithms originally created for chimeric antigen receptor (CAR) T-cell therapies and other immune effector therapies, yet notable differences in timing, quality, and severity exist between the toxicities of BsAbs and CAR T-cell therapies. We therefore convened an international panel of academic and community practice physicians, advanced practitioners, registered nurses, and pharmacists with experience using CD3×CD20 BsAbs in clinical trial and off-trial settings to provide comprehensive, consensus-based recommendations specific to the assessment and management of CD3×CD20 BsAb-related toxicities.
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Affiliation(s)
| | - Tara Graff
- Mission Cancer and Blood, Des Moines, IA
| | - Lorenzo Falchi
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yasmin H Karimi
- Hematology Clinic, Rogel Cancer Center, University of Michigan Health System, Ann Arbor, MI
| | - Rajat Bannerji
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | | | - Catherine Thieblemont
- Department of Hemato-oncology, Assistance Publique Hôpitaux de Paris, INSERM U1153, Hôpital Saint Louis, Paris, France
| | - Renata Ursu
- Department of Neurology, Assistance Publique Hôpitaux de Paris, Hôpital Saint Louis, Paris, France
| | | | - Victoria Nachar
- Hematology Clinic, Rogel Cancer Center, University of Michigan Health System, Ann Arbor, MI
| | - Jonathan Weiss
- Hematology Clinic, Rogel Cancer Center, University of Michigan Health System, Ann Arbor, MI
| | | | - Krish Patel
- Center for Blood Disorders and Cellular Therapy, Swedish Cancer Institute, Seattle, WA
| | - Joshua Brody
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jeremy S Abramson
- Center for Lymphoma, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Matthew Lunning
- Division of Oncology and Hematology, University of Nebraska, Omaha, NE
| | | | - Ayed Ayed
- Cancer Specialists of North Florida, Jacksonville, FL
| | - Manali Kamdar
- Division of Hematology, Hematologic Malignancies and Stem Cell Transplantation, University of Colorado Cancer Center, Aurora, CO
| | - Benjamin Parsons
- Department of Hematology and Oncology, Gundersen Lutheran Health System, La Crosse, WI
| | - Paolo Caimi
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
| | - Ian Flinn
- Tennessee Oncology and OneOncology, Nashville, TN
| | | | - Jeffrey Sharman
- Department of Medical Oncology, Willamette Valley Cancer Institute and Research Center/US Oncology Research, Eugene, OR
| | | | | | - Brad Kahl
- Washington University in St. Louis, St. Louis, MO
| | - Sonali Smith
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
- Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | - Andrew Zelenetz
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Martin Hutchings
- Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Tycel Phillips
- Hematology Clinic, Rogel Cancer Center, University of Michigan Health System, Ann Arbor, MI
| | - Michael Dickinson
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
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2
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Johnson PC, Woyach JA, Ulrich A, Marcotte V, Nipp RD, Lage DE, Nelson AM, Newcomb RA, Rice J, Lavoie MW, Ritchie CS, Bartlett N, Stephens DM, Ding W, Owen C, Stone R, Ruppert AS, Mandrekar SJ, Byrd JC, El-Jawahri A, Le-Rademacher J, Rosko A. Geriatric assessment measures are predictive of outcomes in chronic lymphocytic leukemia. J Geriatr Oncol 2023; 14:101538. [PMID: 37329769 PMCID: PMC10599966 DOI: 10.1016/j.jgo.2023.101538] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/05/2023] [Accepted: 05/25/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Chronic lymphocytic leukemia (CLL) commonly affects older adults. However, few studies have examined the relationship between baseline geriatric domains and clinical outcomes in this population. Here, we aim to evaluate the use of a comprehensive geriatric assessment in older (>65 years) untreated patients with CLL to predict outcomes. MATERIALS AND METHODS We conducted a planned analysis of 369 patients with CLL age 65 or older treated in a phase 3 randomized trial of bendamustine plus rituximab versus ibrutinib plus rituximab versus ibrutinib alone (A041202). Patients underwent evaluations of geriatric domains including functional status, psychological status, social activity, cognition, social support, and nutritional status. We examined associations among baseline geriatric domains with grade 3+ adverse events using multivariable logistic regression and overall survival (OS) and progression-free survival (PFS) using multivariable Cox regression models. RESULTS In this study, the median age was 71 years (range: 65-87). In the combined multivariable model, the following geriatric domains were significantly associated with PFS: Medical Outcomes Study (MOS) - social activities survey score (hazard ratio [HR] [95% confidence interval (CI)] 0.974(0.961, 0.988), p = 0.0002) and nutritional status (≥5% weight loss in the preceding six months: (HR [95% CI] 2.717[1.696, 4.354], p < 0.001). MOS - social activities score [HR (95% CI) 0.978(0.958, 0.999), p = 0.038] was associated with OS. No geriatric domains were significantly associated with toxicity. There were no statistically significant interactions between geriatric domains and treatment. DISCUSSION Geriatric domains of social activity and nutritional status were associated with OS and/or PFS in older adults with CLL. These findings highlight the importance of assessing geriatric domains to identify high-risk patients with CLL who may benefit from additional support during treatment.
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Affiliation(s)
- P Connor Johnson
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Jennifer A Woyach
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
| | - Angela Ulrich
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, USA
| | - Veronique Marcotte
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, USA
| | - Ryan D Nipp
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Daniel E Lage
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ashley M Nelson
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Richard A Newcomb
- Dana-Farber/Partners CancerCare, Harvard Medical School, Boston, MA, USA
| | - Julia Rice
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Nancy Bartlett
- Washington University - Siteman Cancer Center, St. Louis, MO, USA
| | | | | | - Carolyn Owen
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Alberta, Canada
| | - Richard Stone
- Dana-Farber/Partners CancerCare, Harvard Medical School, Boston, MA, USA
| | - Amy S Ruppert
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | | | - John C Byrd
- University of Cincinnati, Cincinnati, OH, USA
| | - Areej El-Jawahri
- Dana-Farber/Partners CancerCare, Harvard Medical School, Boston, MA, USA
| | | | - Ashley Rosko
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
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3
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Roddie C, Lekakis LJ, Marzolini MAV, Ramakrishnan A, Zhang Y, Hu Y, Peddareddigari VGR, Khokhar N, Chen R, Basilico S, Raymond M, Vargas FA, Duffy K, Brugger W, O’Reilly MA, Wood L, Linch DC, Peggs KS, Bachier C, Budde EL, Lee Batlevi C, Bartlett N, Irvine D, Tholouli E, Osborne W, Ardeshna KM, Pule MA. Dual targeting of CD19 and CD22 with bicistronic CAR-T cells in patients with relapsed/refractory large B-cell lymphoma. Blood 2023; 141:2470-2482. [PMID: 36821767 PMCID: PMC10646794 DOI: 10.1182/blood.2022018598] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/13/2023] [Accepted: 02/09/2023] [Indexed: 02/25/2023] Open
Abstract
Relapse after CD19-directed chimeric antigen receptor T-cell (CAR-T) therapy for large B-cell lymphoma (LBCL) is commonly ascribed to antigen loss or CAR-T exhaustion. Multiantigen targeting and programmed cell death protein-1 blockade are rational approaches to prevent relapse. Here, we test CD19/22 dual-targeting CAR-T (AUTO3) plus pembrolizumab in relapsed/refractory LBCL (NCT03289455). End points include toxicity (primary) and response rates (secondary). Fifty-two patients received AUTO3 and 48/52 received pembrolizumab. Median age was 59 years (range, 27-83), 46/52 had stage III/ IV disease and median follow-up was 21.6 months. AUTO3 was safe; grade 1-2 and grade 3 cytokine release syndrome affected 18/52 (34.6%) and 1/52 (1.9%) patients, neurotoxicity arose in 4 patients (2/4, grade 3-4), and hemophagocytic lymphohistiocytosis affected 2 patients. Outpatient administration was tested in 20 patients, saving a median of 14 hospital days per patient. Overall response rates were 66% (48.9%, complete response [CR]; 17%, partial response). Median duration of remission (DOR) for CR patients was not reached and for all responding patients was 8.3 months (95% confidence interval [CI]: 3.0-not evaluable). 54.4% (CI: 32.8-71.7) of CR patients and 42.6% of all responding patients were projected to remain progression-free at ≥12 months. AUTO3 ± pembrolizumab for relapsed/refractory LBCL was safe and delivered durable remissions in 54.4% of complete responders, associated with robust CAR-T expansion. Neither dual-targeting CAR-T nor pembrolizumab prevented relapse in a significant proportion of patients, and future developments include next-generation-AUTO3, engineered for superior expansion in vivo, and selection of CAR binders active at low antigen densities.
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Affiliation(s)
- Claire Roddie
- Cancer Institute, University College London, London, United Kingdom
- Department of Haematology, University College London Hospital, London, United Kingdom
| | - Lazaros J. Lekakis
- Department of Hematology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - Maria A. V. Marzolini
- Department of Haematology, University College London Hospital, London, United Kingdom
| | | | - Yiyun Zhang
- Department of Haematology, Autolus Ltd, London, United Kingdom
| | - Yanqing Hu
- Department of Haematology, Autolus Ltd, London, United Kingdom
| | | | - Nushmia Khokhar
- Department of Haematology, Autolus Ltd, London, United Kingdom
| | - Robert Chen
- Department of Haematology, Autolus Ltd, London, United Kingdom
| | - Silvia Basilico
- Department of Haematology, Autolus Ltd, London, United Kingdom
| | - Meera Raymond
- Department of Haematology, Autolus Ltd, London, United Kingdom
| | | | - Kevin Duffy
- Department of Haematology, Autolus Ltd, London, United Kingdom
| | - Wolfram Brugger
- Department of Haematology, Autolus Ltd, London, United Kingdom
| | - Maeve A. O’Reilly
- Department of Haematology, University College London Hospital, London, United Kingdom
| | - Leigh Wood
- Department of Haematology, University College London Hospital, London, United Kingdom
| | - David C. Linch
- Cancer Institute, University College London, London, United Kingdom
| | - Karl S. Peggs
- Cancer Institute, University College London, London, United Kingdom
- Department of Haematology, University College London Hospital, London, United Kingdom
| | - Carlos Bachier
- Department of Hematology, Methodist Hospital, San Antonio, TX
| | | | - Connie Lee Batlevi
- Department of Hematology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Nancy Bartlett
- Department of Hematology, Washington University School of Medicine, St Louis, MO
| | - David Irvine
- Department of Haematology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Eleni Tholouli
- Department of Haematology, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Wendy Osborne
- Department of Haematology, Freeman Hospital, Newcastle, United Kingdom
| | - Kirit M. Ardeshna
- Department of Haematology, University College London Hospital, London, United Kingdom
| | - Martin A. Pule
- Cancer Institute, University College London, London, United Kingdom
- Department of Haematology, Autolus Ltd, London, United Kingdom
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4
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Shone A, Koyn Z, Kamiyama B, Perez E, Barrus L, Bartlett N, Allain J, Andruczyk D. HIDRA-MAT liquid metal droplet injector for liquid metal applications in HIDRA. Fusion Engineering and Design 2022. [DOI: 10.1016/j.fusengdes.2022.113193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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5
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Gomez F, Mosior M, Skidmore Z, Schmidt A, Rodrigues-Martins F, Krysiak K, Ramirez C, Duncavage E, Triska G, Trani L, Bartlett N, Cashen A, Mehta-Shah N, Kreisel F, Griffith M, Fehniger T, Griffith O. Abstract PO-06: Ultradeep sequencing of classical Hodgkin lymphoma (cHL) identifies recurrent somatic mutations and demonstrates the production of reproducible data from rare malignant cells. Blood Cancer Discov 2020. [DOI: 10.1158/2643-3249.lymphoma20-po-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose/Background: cHL patients who receive standard therapy have a high rate of event-free and overall survival. However, some patients (~10%) will be refractory to initial therapy and up to 1/3 will relapse. Thus, improved methods of prognostication and new treatment targets are needed. High-throughput sequencing can identify recurrent somatic mutations that drive lymphomagenesis and impact treatment response. However, Hodgkin-Reed-Sternberg (HRS) cells have a low (~1%) abundance in cHL biopsies, creating a challenge for comprehensive and accurate detection of somatic mutations in bulk lymphoma biopsies. Genomic studies of cHL have characterized HRS somatic mutations through the analysis of malignant cells obtained using purification techniques, cell-free DNA, or DNA amplified through whole-genome amplification. We hypothesized that ultradeep sequencing of bulk lymphoma biopsies provides a more accessible approach to HRS characterization while also creating robust and reproducible data.
Methods: We performed exome sequencing on 32 fresh frozen samples from 31 cHL patients obtained prior to treatment (27) or after relapse (4) with paired normal skin samples (31). The Illumina HiSeq platform (2 x 150bp reads) was used with multiple independent library constructions and a 1,000X median coverage goal. Sequence data were aligned to GRCh38. SNVs and INDELs were called using multiple algorithms. We employed several variant filtering strategies, including manual review, to remove common polymorphisms and false positives. Because we discovered mutations with VAFs close to the platform error rate (~1%), we used an orthogonal sequencing strategy (Haloplex) to validate all somatic variants.
Results: We observed 4,020 somatic variants. On average, we observed 32 protein-coding mutations/case, excluding one hypermutated case in which 3,084 variants were observed. We identified a potential loss-of-function insertion in MSH6 that could explain the hypermutated phenotype. We achieved a 99% validation rate across the cohort for somatic variants discovered in exomes. We confirmed known recurrently mutated cHL genes (e.g., SOCS1 [43%], STAT6 [20%], TNFAIP3 [40%]). We identified several significantly recurrent mutated genes not well characterized in cHL, including IGLL5 [26%] and IL4R [13%]. All IL4R mutations are potential loss-of-function mutations that could result in greater activation of STAT6 through ablation of ITIM negative modulation. We identified an enrichment of SOCS1 and IGLL5 mutations that is likely the result of aberrant somatic hypermutation. Pathway analysis also identified an enrichment of mutations in MAPK pathways.
Conclusion: These data suggest that cHL somatic mutations can be confidently identified via ultradeep exome sequencing without cell purification. We show that cHL genomes harbor somatic variation that inform new targets for treatment and prognostication.
Citation Format: Felicia Gomez, Matthew Mosior, Zachary Skidmore, Alina Schmidt, Fernanda Rodrigues-Martins, Kilannin Krysiak, Cody Ramirez, Eric Duncavage, Grace Triska, Lee Trani, Nancy Bartlett, Amanda Cashen, Neha Mehta-Shah, Friederike Kreisel, Malachi Griffith, Todd Fehniger, Obi Griffith. Ultradeep sequencing of classical Hodgkin lymphoma (cHL) identifies recurrent somatic mutations and demonstrates the production of reproducible data from rare malignant cells [abstract]. In: Proceedings of the AACR Virtual Meeting: Advances in Malignant Lymphoma; 2020 Aug 17-19. Philadelphia (PA): AACR; Blood Cancer Discov 2020;1(3_Suppl):Abstract nr PO-06.
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Affiliation(s)
- Felicia Gomez
- Washington University School of Medicine, St. Louis, MO
| | | | | | - Alina Schmidt
- Washington University School of Medicine, St. Louis, MO
| | | | | | - Cody Ramirez
- Washington University School of Medicine, St. Louis, MO
| | | | - Grace Triska
- Washington University School of Medicine, St. Louis, MO
| | - Lee Trani
- Washington University School of Medicine, St. Louis, MO
| | | | - Amanda Cashen
- Washington University School of Medicine, St. Louis, MO
| | | | | | | | - Todd Fehniger
- Washington University School of Medicine, St. Louis, MO
| | - Obi Griffith
- Washington University School of Medicine, St. Louis, MO
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6
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Ramirez C, Frenkel F, Plotnikova O, Belousov V, Bagaev A, Ocheredko E, Kiwala S, Hundal J, Skidmore Z, Watkins M, Becker-Hapak M, Mooney T, Walker J, Fronick C, Fulton R, Schreiber R, Bartlett N, Kahl B, Ataullakhanov R, Griffith M, Griffith O, Fehniger T. 45. Identification of predicted neoantigen vaccine candidates in follicular lymphoma patients. Cancer Genet 2020. [DOI: 10.1016/j.cancergen.2020.04.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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7
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Illidge T, Horwitz S, Iyer S, Bartlett N, Kim W, Tilly H, Belada D, Feldman T, Illés Á, Jacobsen E, Hüttmann A, Zinzani P, O'Connor O, Trepicchio W, Miao H, Rao S, Onsum M, Manley T, Advani R. RESPONSE TO A+CHP BY CD30 EXPRESSION IN THE ECHELON-2 TRIAL. Hematol Oncol 2019. [DOI: 10.1002/hon.92_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- T. Illidge
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health; University of Manchester, National Institutes of Health and Research Biomedical Research Centre, Manchester Academic Health Sciences Centre, Christie Hospital National Health Service Foundation Trust; Manchester United Kingdom
| | - S. Horwitz
- Department of Medicine; Lymphoma Service, Memorial Sloan Kettering Cancer Center; New York United States
| | - S. Iyer
- Department of Lymphoma and Myeloma; Division of Cancer Medicine, MD Anderson Cancer Center; Houston United States
| | - N. Bartlett
- Department of Medicine; Oncology Division, Washington University School of Medicine, Siteman Cancer Center; Saint Louis United States
| | - W. Kim
- Division of Hematology-Oncology; Department of Medicine, Samsung Medical Center; Seoul Republic of Korea
| | - H. Tilly
- Department of Hematology; Centre Henri Becquerel, Université of Rouen Normandie; Rouen France
| | - D. Belada
- 4th Department of Internal Medicine - Haematology; Charles University, Hospital and Faculty of Medicine; Hradec Králové Czech Republic
| | - T. Feldman
- Hematology Division; Hackensack University Medical Center; Hackensack United States
| | - Á. Illés
- Department of Hematology; University of Debrecen, Faculty of Medicine; Debrecen Hungary
| | - E. Jacobsen
- Division of Hematologic Malignancies; Dana-Farber Cancer Institute; Boston United States
| | - A. Hüttmann
- Department of Haematology; Universitatsklinikum Essen; Essen Germany
| | - P. Zinzani
- Institute of Hematology; “Seràgnoli” University of Bologna; Bologna France
| | - O.A. O'Connor
- Department of Medicine; Columbia University Medical Center; New York United States
| | - W. Trepicchio
- Clinical Development; Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceuticals Limited; Cambridge United States
| | - H. Miao
- Clinical Development; Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceuticals Limited; Cambridge United States
| | - S. Rao
- Development; Seattle Genetics, Inc.; Bothell United States
| | - M. Onsum
- Development; Seattle Genetics, Inc.; Bothell United States
| | - T. Manley
- Development; Seattle Genetics, Inc.; Bothell United States
| | - R. Advani
- Medicine - Med/Oncology; Stanford Cancer Institute; Stanford United States
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8
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Lavezzi SM, de Jong J, Neyens M, Cramer P, Demirkan F, Fraser G, Bartlett N, Dilhuydy MS, Loscertales J, Avigdor A, Rule S, Samoilova O, Goy A, Ganguly S, Salman M, Howes A, Mahler M, De Nicolao G, Poggesi I. Systemic Exposure of Rituximab Increased by Ibrutinib: Pharmacokinetic Results and Modeling Based on the HELIOS Trial. Pharm Res 2019; 36:93. [PMID: 31044267 DOI: 10.1007/s11095-019-2605-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/06/2019] [Indexed: 01/17/2023]
Abstract
INTRODUCTION In the HELIOS trial, bendamustine/rituximab (BR) plus ibrutinib (BR-I) improved disease outcomes versus BR plus placebo in previously treated chronic lymphocytic leukemia/small lymphocytic lymphoma. Here, we describe the pharmacokinetic (PK) observations, along with modeling to further explore the interaction between ibrutinib and rituximab. METHODS 578 subjects were randomized to ibrutinib or placebo with BR (6 cycles). Ibrutinib PK samples and tumor measurements were obtained from all subjects; a subset was evaluated for bendamustine and rituximab PK. Population rituximab PK was assessed using nonlinear mixed-effects modeling. RESULTS Dose-normalized plasma concentration-time bendamustine data were comparable between the arms. Systemic rituximab exposure was higher with BR-I versus BR; mean trough serum concentrations were 2- to 3-fold higher in the first three cycles and 1.2- to 1.7-fold higher subsequently. No relevant safety differences were observed. In the modeling, including treatment arm as a categorical covariate and tumor burden as a continuous time-varying covariate on overall rituximab clearance significantly improved fitting of the data. CONCLUSIONS BR-I led to higher dose-normalized systemic rituximab exposure versus BR and more rapid steady-state achievement. The modeling data suggest that rituximab disposition is, at least in part, target mediated. Determining the clinical significance of these findings requires further assessments. TRIAL REGISTRATION This study is registered at https://clinicaltrials.gov/ct2/show/NCT01611090 .
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Affiliation(s)
- Silvia Maria Lavezzi
- Department of Electrical, Computer and Biomedical Engineering, Università degli Studi di Pavia, Pavia, Italy.,Quantitative Clinical Development, PAREXEL International, Dublin 8, Ireland
| | | | | | - Paula Cramer
- German CLL Study Group, University Hospital of Cologne, Cologne, Germany
| | | | - Graeme Fraser
- Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada
| | - Nancy Bartlett
- Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri, USA
| | | | | | - Abraham Avigdor
- Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel
| | | | - Olga Samoilova
- Nizhny Novgorod Regional Clinical Hospital, Nizhny Novgorod, Russia
| | - Andre Goy
- John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, USA
| | | | | | | | | | - Giuseppe De Nicolao
- Department of Electrical, Computer and Biomedical Engineering, Università degli Studi di Pavia, Pavia, Italy
| | - Italo Poggesi
- Global Clinical Pharmacology, Quantitative Sciences, Janssen-Cilag SpA, Via Michelangelo Buonarroti 23, 20093, Cologno Monzese, MI, Italy.
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9
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Gomez F, Skidmore Z, Schmidt A, Rodrigues-Martins F, Krysiak K, Ramirez C, Mosior M, Duncavage E, Triska G, Trani L, Bartlett N, Cashen A, Mehta-Shah N, Kahl B, Kreisel F, Griffith M, Fehniger T, Griffith O. 23. Ultra-deep sequencing of classical Hodgkin lymphoma (cHL) reveals novel somatic mutations and exemplifies the utility of deep sequencing in the characterization of rare malignant cells. Cancer Genet 2019. [DOI: 10.1016/j.cancergen.2019.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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10
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Rimsza LM, Li H, Braziel RM, Spier CM, Persky DO, Dunlap J, LeBlanc M, Bartlett N, Leonard JP, Smith SM, Press OW, Friedberg JW. Impact of histological grading on survival in the SWOG S0016 follicular lymphoma cohort. Haematologica 2018; 103:e151-e153. [PMID: 29472351 DOI: 10.3324/haematol.2017.175059] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Lisa M Rimsza
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, AZ, USA
| | - Hongli Li
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Rita M Braziel
- Department of Pathology, Oregon Health Sciences University, Portland, OR, USA
| | | | - Daniel O Persky
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Jennifer Dunlap
- Department of Pathology, Oregon Health Sciences University, Portland, OR, USA
| | | | - Nancy Bartlett
- Washington University-Siteman Cancer Center, St. Louis, MO, USA
| | - John P Leonard
- Weill Cornell Medicine and New York Presbyterian Hospital, New York, NY, USA
| | - Sonali M Smith
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Oliver W Press
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Wierda WG, Zelenetz AD, Gordon LI, Abramson JS, Advani RH, Andreadis CB, Bartlett N, Byrd JC, Caimi P, Fayad LE, Fisher RI, Glenn MJ, Habermann TM, Harris NL, Hernandez-Ilizaliturri F, Hoppe RT, Horwitz SM, Kaminski MS, Kelsey CR, Kim YH, Krivacic S, LaCasce AS, Martin MG, Nademanee A, Porcu P, Press O, Rabinovitch R, Reddy N, Reid E, Roberts K, Saad AA, Snyder ED, Sokol L, Swinnen LJ, Vose JM, Yahalom J, Dwyer MA, Sundar H. NCCN Guidelines Insights: Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, Version 1.2017. J Natl Compr Canc Netw 2017; 15:293-311. [PMID: 28275031 DOI: 10.6004/jnccn.2017.0030] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are different manifestations of the same disease and managed in much the same way. The advent of novel CD20 monoclonal antibodies led to the development of effective chemoimmunotherapy regimens. More recently, small molecule inhibitors targeting kinases involved in a number of critical signaling pathways and a small molecule inhibitor of the BCL-2 family of proteins have demonstrated activity for the treatment of patients with CLL/SLL. These NCCN Guidelines Insights highlight important updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for CLL/SLL for the treatment of patients with newly diagnosed or relapsed/refractory CLL/SLL.
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Affiliation(s)
| | | | - Leo I Gordon
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | - Nancy Bartlett
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | - John C Byrd
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Paolo Caimi
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | - Luis E Fayad
- The University of Texas MD Anderson Cancer Center
| | | | | | | | | | | | | | | | | | | | | | | | | | - Michael G Martin
- St. Jude Children’s Research Hospital/The University of Tennessee Health Science Center
| | | | - Pierluigi Porcu
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Oliver Press
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | | | | | | | - Ayman A Saad
- University of Alabama at Birmingham Comprehensive Cancer Center
| | - Erin D Snyder
- University of Alabama at Birmingham Comprehensive Cancer Center
| | | | - Lode J Swinnen
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
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Gomez F, Krysiak K, Ramirez C, Bartlett N, Cashen A, Kreisel F, Duncavage E, Griffith M, Fehniger T, Griffith O. Abstract 2448: Deep exome sequencing reveals recurrent somatic mutations in Hodgkin's lymphoma. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-2448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
High-throughput sequencing provides insights into cancer pathogenesis. The application of genomics technologies to cancers characterized by rare cell populations is a challenge. DNA extracted from bulk tumor samples is a mixture of malignant and non-malignant cells. This is a problem in cancers defined by rare cell populations because it complicates the task of identifying true somatic mutations. Hodgkin lymphoma (HL) exemplifies this challenge. The pathologic hallmark of HL is Hodgkin-Reed-Sternberg (HRS) cells. HRS cells have a low abundance within an affected lymph node (1-30% of tumor microenvironment). Because HRS cells are rare, a limited number of studies have described characteristic genomic events. These studies have examined HL cell lines, and, recently, a small number of flow-sorted HRS-cells (Reichel et. al. 2015). We hypothesized that recurrent somatic mutations can be identified in HRS cells using bulk HL biopsies and ultra deep exome sequencing.
The Illumina HiSeq X,which can generate> 1.6 Tb of sequence data per run, is a applicable tool for the discovery of somatic mutations in HL. Frozen tumor (lymph node)/normal (skin) pairs from 31 patients with HL were examined. Three KAPA libraries were constructed per sample. The libraries were pooled, size selected, and captured using an IDT xGen capture reagent. The pools were sequenced across eight lanes of a HiSeq X. A total of 7.04 x 1012 bases were sequenced across all samples with an average of 1.10 x 1011 bases per sample. The mean depth of coverage achieved across all samples was 783.4x (425.9x - 1091.9x). Given the low abundance of HRS cells we anticipated most somatic sites would have a VAF of 1% -5%. Given the level of coverage we anticipate that most somatic variants will have >5 reads of support.
Instrument data were processed using the McDonnell Genome Institute somatic variant calling pipeline that includes 5 SNV callers and 3 indel callers. We used these steps to filter variants: min. 50x coverage, max. 5000x coverage, min. 1% tumor VAF, max. 5%, normal VAF, and min. 5 variant reads in the tumor. Here we report preliminary data on mutations in five pilot samples. The remaining 26 will be presented at the meeting. We confirmed 7 previously identified recurrent mutations in HL (Reichel et al. 2015). Within our pilot data 13 recurrently mutated genes were found. The most interesting of our recurrent genes is TNFAIP3, which was the second most frequently mutated gene in Reichel et al. 2015. These data suggest that ultra deep sequencing of tumor samples containing rare HRS cells can identify recurrent somatic mutations. Thus, ultra deep exome sequencing may be a useful discovery tool for rare tumor populations, and will improve our understanding of HL.
Citation Format: Felicia Gomez, Kilannin Krysiak, Cody Ramirez, Nancy Bartlett, Amanda Cashen, Friederike Kreisel, Eric Duncavage, Malachi Griffith, Todd Fehniger, Obi Griffith. Deep exome sequencing reveals recurrent somatic mutations in Hodgkin's lymphoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2448. doi:10.1158/1538-7445.AM2017-2448
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13
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Gopal A, Levy R, Houot R, Patel S, Hatake K, Popplewell L, Chen Y, Davis C, Huang B, Cesari R, Thall A, Woolfson A, Bartlett N. A PHASE I STUDY OF UTOMILUMAB (PF-05082566), A 4-1BB/CD137 AGONIST, IN COMBINATION WITH RITUXIMAB IN PATIENTS WITH CD20+
NON-HODGKIN'S LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_127] [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: 11/10/2022]
Affiliation(s)
- A. Gopal
- Division of Oncology; University of Washington/Seattle Cancer Care Alliance; Seattle WA USA
| | - R. Levy
- Division of Oncology; Stanford Cancer Center; Stanford CA USA
| | - R. Houot
- Department of Hematology; University Hospital; Rennes France
| | - S. Patel
- San Diego Moores Cancer Center; University of California; La Jolla USA
| | - K. Hatake
- Department of Medical Oncology and Hematology; The Cancer Institute Hospital, Japanese Foundation for Cancer Research; Tokyo Japan
| | - L. Popplewell
- Department of Hematology; City of Hope National Medical Center; Duarte CA USA
| | - Y. Chen
- Pfizer; Oncology; La Jolla CA USA
| | - C. Davis
- Pfizer; Oncology; La Jolla CA USA
| | | | | | - A. Thall
- Pfizer; Oncology; La Jolla CA USA
| | | | - N. Bartlett
- Division of Oncology; Washington University School of Medicine; Saint Louis MO USA
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14
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Roth L, O'Donohue T, Chen Z, Bartlett N, Martin-Doyle W, Barth M, Davies K, Christian B, Casulo C, Godfrey J, Oberley M, Alexander S, Weitzman S, Appel B, Svoboda J, Afify Z, Pauly M, Dave H, Gardner R, Stephens D, Zeitler W, Forlenza C, Levine J, Williams M, Bollard C, Leonard J. OUTCOMES OF ADULTS, ADOLESCENTS, AND CHILDREN WITH PRIMARY MEDIASTINAL B-CELL LYMPHOMA TREATED WITH DOSE-ADJUSTED EPOCH-R THERAPY: a MULTICENTER RETROSPECTIVE ANALYSIS. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- L.G. Roth
- Pediatrics; Weill Cornell Medical College; New York USA
| | - T. O'Donohue
- Pediatrics; Weill Cornell Medical College; New York USA
| | - Z. Chen
- Healthcare Policy and Research; Weill Cornell Medical College; New York New York USA
| | - N. Bartlett
- Department of Medicine; Washington University School of Medicine; St. Louis Missouri USA
| | - W. Martin-Doyle
- Department of Medicine; Brigham and Women's Hospital; Boston Massachusetts USA
| | - M.J. Barth
- Department of Pediatrics; Roswell Park Cancer Institute and University at Buffalo; Buffalo New York USA
| | - K. Davies
- Department of Pediatrics; Dana Farber Cancer Institute; Boston Massachusetts USA
| | - B. Christian
- Division of Hematology; The Ohio State University and Arthur G. James Cancer Hospital; Columbus Ohio USA
| | - C. Casulo
- Department of Medicine; University of Rochester Medical Center; Rochester New York USA
| | - J. Godfrey
- Department of Medicine; University of Chicago; Chicago Illinois USA
| | - M.J. Oberley
- Department of Pediatrics; Keck School of Medicine; Los Angeles California USA
| | - S. Alexander
- Division of Haematology/Oncology; Hospital for Sick Children; Toronto Ontario Canada
| | - S. Weitzman
- Division of Haematology/Oncology; Hospital for Sick Children; Toronto Ontario Canada
| | - B. Appel
- Department of Pediatrics; Hackensack University Medical Center; Hackensack New Jersey USA
| | - J. Svoboda
- Lymphoma Program, Abramson Cancer Center; University of Pennsylvania; Philadelphia Pennsylvania USA
| | - Z. Afify
- Department of Pediatrics; University of Utah; Salt Lake City Utah USA
| | - M. Pauly
- Department of Pediatrics; Emory University; Atlanta Georgia USA
| | - H. Dave
- Department of Pediatrics; The George Washington University and Children's National Health System; Washington District of Columbia USA
| | - R. Gardner
- Department of Pediatrics; Seattle Children's Hospital; Seattle WA USA
| | - D.M. Stephens
- Department of Medicine; University of Utah; Salt Lake City Utah USA
| | - W.A. Zeitler
- Department of Medicine; University of Iowa; Iowa City Iowa USA
| | - C. Forlenza
- Department of Pediatrics; Memorial Sloan Kettering Cancer Center; New York New York USA
| | - J. Levine
- Department of Pediatrics; Columbia University; New York New York USA
| | - M.E. Williams
- Hematology/Oncology Division and Cancer Center; University of Virginia School of Medicine; Charlottesville Virginia USA
| | - C.M. Bollard
- Department of Pediatrics; The George Washington University and Children's National Health System; Washington District of Columbia USA
| | - J.P. Leonard
- Department of Medicine; Weill Cornell Medical College; New York New York USA
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Tilly H, Sharman J, Bartlett N, Morschhauser F, Haioun C, Munoz J, Chen A, Lamy T, Wang L, Penuel E, Hirata J, Lee C, Salles G. POLA-R-CHP: POLATUZUMAB VEDOTIN COMBINED WITH RITUXIMAB, CYCLOPHOSPHAMIDE, DOXORUBICIN, PREDNISONE FOR PATIENTS WITH PREVIOUSLY UNTREATED DIFFUSE LARGE B-CELL LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_79] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- H. Tilly
- Centre Henri Becquerel; University of Rouen; Rouen France
| | - J. Sharman
- Willamette Valley Cancer Institute; Springfield, OR, US Oncology Research; The Woodlands, TX USA
| | - N. Bartlett
- Siteman Cancer Center; Washington University School of Medicine; St Louis Missouri USA
| | - F. Morschhauser
- Service des Maladies du sang; Washington University School of Medicine University Hospital of Lille; Lille France
| | - C. Haioun
- INSERM U955 Université Paris-Est; Hôpital Henri-Mondor, Unité Hémopathies Lymphoïdes; Creteil France
| | - J. Munoz
- Department of Lymphoma/Myeloma; Banner MD Anderson Cancer Center; Gilbert Arizona USA
| | - A. Chen
- Hematology & Oncology; Oregon Health and Science University; Portland Oregon USA
| | - T. Lamy
- Hematology Department; INSERM U917 / University Hospital of Rennes; Rennes France
| | - L. Wang
- Product Development Biometrics Biostatistics; Genentech, Inc.; South San Francisco California USA
| | - E. Penuel
- Oncology Biomarker Department; Genentech, Inc; South San Francisco California USA
| | - J. Hirata
- Product Development Oncology; Genentech, Inc; South San Francisco California USA
| | - C. Lee
- Product Development Oncology; Genentech, Inc; South San Francisco California USA
| | - G. Salles
- Service d'Hématologie Clinique; South Lyon Hospital Complex; Lyon France
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Zinzani P, Ribrag V, Moskowitz C, Michot J, Kuruvilla J, Bartlett N, Balakumaran A, Chatterjee A, Chlosta S, Shipp M, Armand P. PHASE 1B STUDY OF PEMBROLIZUMAB IN PATIENTS WITH RELAPSED/REFRACTORY PRIMARY MEDIASTINAL LARGE B-CELL LYMPHOMA (RRPMBCL): UPDATED RESULTS FROM THE KEYNOTE-013 TRIAL. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_50] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- P. Zinzani
- Institute of Hematology “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - V. Ribrag
- Medicine, Institut Gustave Roussy; Villejuif France
| | - C.H. Moskowitz
- Oncology; Memorial Sloan Kettering Cancer Center; New York USA
| | - J. Michot
- Medicine, Institut Gustave Roussy; Villejuif France
| | - J. Kuruvilla
- Oncology; Princess Margaret Cancer Centre and University of Toronto; Toronto Canada
| | - N. Bartlett
- Divisions of Hematology & Oncology; Washington University; St Louis USA
| | | | - A. Chatterjee
- Clinical Research, Merck & Co., Inc.; Kenilworth USA
| | - S. Chlosta
- Clinical Research, Merck & Co., Inc.; Kenilworth USA
| | - M.A. Shipp
- Division of Hematologic Neoplasia; Dana-Farber Cancer Institute; Boston USA
| | - P. Armand
- Lymphoma Clinical Research; Dana-Farber Cancer Institute; Boston USA
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17
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Cramer P, Demirkan F, Fraser G, Pristupa A, Bartlett N, Dilhuydy M, Loscertales J, Avigdor A, Rule S, Samoilova O, Goy A, Ganguly S, Poggesi I, Lavezzi S, De Nicolao G, de Jong J, Neyens M, Salman M, Howes A, Mahler M. IBRUTINIB INCREASES THE SYSTEMIC EXPOSURE OF RITUXIMAB: PHARMACOKINETIC RESULTS FROM THE HELIOS TRIAL. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- P. Cramer
- Department I of Internal Medicine and German CLL Study Group; University Hospital of Cologne; Cologne Germany
| | - F. Demirkan
- Hematology; Dokuz Eylul University; Izmir Turkey
| | - G. Fraser
- Oncology; McMaster University, Juravinski Cancer Centre; Hamilton Canada
| | - A. Pristupa
- Hematology; Ryazan Regional Clinical Hospital; Ryazan Russian Federation
| | - N. Bartlett
- Medicine; Washington University School of Medicine, Siteman Cancer Center; St. Louis USA
| | - M. Dilhuydy
- Hematology and Cell Therapy, Hôpital Haut-Lévèque; Bordeaux France
| | - J. Loscertales
- Hematology; Hospital Universitario de La Princesa, IIS-IP; Madrid Spain
| | - A. Avigdor
- Hematology and Bone-Marrow Transplantation, Chaim Sheba Medical Center; Tel Hashomer Israel
| | - S. Rule
- Haematology; Derriford Hospital; Plymouth UK
| | - O. Samoilova
- Hematology; Nizhny Novgorod Regional Clinical Hospital; Nizhny Novgorod Russian Federation
| | - A. Goy
- Lymphoma; John Theurer Cancer Center at Hackensack University Medical Center; Hackensack USA
| | - S. Ganguly
- Hematologic Malignancies and Cellular Therapeutics; University of Kansas Medical Center; Kansas City USA
| | - I. Poggesi
- Clinical Pharmacology, Janssen R&D; Cologno Monzese Italy
| | - S.M. Lavezzi
- Electrical, Computer, and Biomedical Engineering, University of Pavia; Pavia Italy
| | - G. De Nicolao
- Electrical, Computer, and Biomedical Engineering, University of Pavia; Pavia Italy
| | - J. de Jong
- Clinical Pharmacology, Janssen R&D; San Diego USA
| | - M. Neyens
- Clinical Pharmacology-Pharmacometrics, Janssen R&D; Beerse Belgium
| | - M. Salman
- Clinical Oncology, Janssen R&D; Raritan USA
| | - A. Howes
- Clinical Oncology, Janssen R&D; High Wycombe UK
| | - M. Mahler
- Clinical Oncology, Janssen R&D; Raritan USA
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Lundqvist A, van Hoef V, Zhang X, Wennerberg E, Lorent J, Witt K, Sanz LM, Liang S, Murray S, Larsson O, Kiessling R, Mao Y, Sidhom JW, Bessell CA, Havel J, Schneck J, Chan TA, Sachsenmeier E, Woods D, Berglund A, Ramakrishnan R, Sodre A, Weber J, Zappasodi R, Li Y, Qi J, Wong P, Sirard C, Postow M, Newman W, Koon H, Velcheti V, Callahan MK, Wolchok JD, Merghoub T, Lum LG, Choi M, Thakur A, Deol A, Dyson G, Shields A, Haymaker C, Uemura M, Murthy R, James M, Wang D, Brevard J, Monaghan C, Swann S, Geib J, Cornfeld M, Chunduru S, Agrawal S, Yee C, Wargo J, Patel SP, Amaria R, Tawbi H, Glitza I, Woodman S, Hwu WJ, Davies MA, Hwu P, Overwijk WW, Bernatchez C, Diab A, Massarelli E, Segal NH, Ribrag V, Melero I, Gangadhar TC, Urba W, Schadendorf D, Ferris RL, Houot R, Morschhauser F, Logan T, Luke JJ, Sharfman W, Barlesi F, Ott PA, Mansi L, Kummar S, Salles G, Carpio C, Meier R, Krishnan S, McDonald D, Maurer M, Gu X, Neely J, Suryawanshi S, Levy R, Khushalani N, Wu J, Zhang J, Basher F, Rubinstein M, Bucsek M, Qiao G, Hembrough T, Spacek J, Vocka M, Zavadova E, Skalova H, Dundr P, Petruzelka L, Francis N, Tilman RT, Hartmann A, MacDonald C, Netikova I, Ballesteros-Merino C, Stump J, Tufman A, Berger F, Neuberger M, Hatz R, Lindner M, Sanborn RE, Handy J, Hylander B, Fox B, Bifulco C, Huber RM, Winter H, Reu S, Sun C, Xiao W, Tian Z, Arora K, Desai N, Repasky E, Kulkarni A, Rajurkar M, Rivera M, Deshpande V, Ting D, Tsai K, Nosrati A, Goldinger S, Hamid O, Algazi A, Chatterjee S, Tumeh P, Hwang J, Liu J, Chen L, Dummer R, Rosenblum M, Daud A, Tsao TS, Ashworth-Sharpe J, Johnson D, Daenthanasanmak A, Bhaumik S, Bieniarz C, Couto J, Farrell M, Ghaffari M, Habensus I, Hubbard A, Jones T, Kelly B, Kosmeder J, Chakraborty P, Lee C, Marner E, Meridew J, Polaske N, Racolta A, Uribe D, Zhang H, Zhang J, Zhang W, Zhu Y, Toth K, Morrison L, Pestic-Dragovich L, Tang L, Tsujikawa T, Borkar RN, Azimi V, Kumar S, Thibault G, Mori M, El Rassi E, Meek M, Clayburgh DR, Kulesz-Martin MF, Flint PW, Coussens LM, Villabona L, Masucci GV, Geiss G, Birditt B, Mei Q, Huang A, Garrett-Mayer E, White AM, Eagan MA, Ignacio E, Elliott N, Dunaway D, Dennis L, Warren S, Beechem J, Dunaway D, Jung J, Nishimura M, Merritt C, Sprague I, Webster P, Liang Y, Warren S, Beechem J, Wenthe J, Enblad G, Karlsson H, Essand M, Paulos C, Savoldo B, Dotti G, Höglund M, Brenner MK, Hagberg H, Loskog A, Bernett MJ, Moore GL, Hedvat M, Bonzon C, Beeson C, Chu S, Rashid R, Avery KN, Muchhal U, Desjarlais J, Hedvat M, Bernett MJ, Moore GL, Bonzon C, Rashid R, Yu X, Chu S, Avery KN, Muchhal U, Desjarlais J, Kraman M, Kmiecik K, Allen N, Faroudi M, Zimarino C, Wydro M, Mehrotra S, Doody J, Srinivasa SP, Govindappa N, Reddy P, Dubey A, Periyasamy S, Adekandi M, Dey C, Joy M, van Loo PF, Zhao F, Veninga H, Shamsili S, Throsby M, Dolstra H, Bakker L, Alva A, Gschwendt J, Loriot Y, Bellmunt J, Feng D, Evans K, Poehlein C, Powles T, Antonarakis ES, Drake CG, Wu H, Poehlein C, De Bono J, Bannerji R, Byrd J, Gregory G, Xiao C, Opat S, Shortt J, Yee AJ, Raje N, Thompson S, Balakumaran A, Kumar S, Rini BI, Choueiri TK, Mariani M, Holtzhausen A, Albiges L, Haanen JB, Atkins MB, Larkin J, Schmidinger M, Magazzù D, di Pietro A, Motzer RJ, Borch TH, Andersen R, Hanks BA, Kongsted P, Pedersen M, Nielsen M, Met Ö, Donia M, Svane IM, Boudadi K, Wang H, Vasselli J, Baughman JE, Scharping N, Wigginton J, Abdallah R, Ross A, Drake CG, Antonarakis ES, Canter RJ, Park J, Wang Z, Grossenbacher S, Luna JI, Menk AV, Withers S, Culp W, Chen M, Monjazeb A, Kent MS, Murphy WJ, Chandran S, Somerville R, Wunderlich J, Danforth D, Moreci R, Yang J, Sherry R, Klebanoff C, Goff S, Paria B, Sabesan A, Srivastava A, Rosenberg SA, Kammula U, Curti B, Whetstone R, Richards J, Faries M, Andtbacka RHI, Grose M, Shafren D, Diaz LA, Le DT, Yoshino T, André T, Bendell J, Dadey R, Koshiji M, Zhang Y, Kang SP, Lam B, Jäger D, Bauer TM, Wang JS, Lee JK, Manji GA, Kudchadkar R, Watkins S, Kauh JS, Tang S, Laing N, Falchook G, Garon EB, Halmos B, Rina H, Leighl N, Lee SS, Walsh W, Ferris R, Dragnev K, Piperdi B, Rodriguez LPA, Shinwari N, Wei Z, Gustafson MP, Maas ML, Deeds M, Armstrong A, Bornschlegl S, Delgoffe GM, Peterson T, Steinmetz S, Gastineau DA, Parney IF, Dietz AB, Herzog T, Backes FJ, Copeland L, Del Pilar Estevez Diz M, Hare TW, Peled J, Huh W, Kim BG, Moore KM, Oaknin A, Small W, Tewari KS, Monk BJ, Kamat AM, Bellmunt J, Choueiri TK, Devlin S, Nam K, De Santis M, Dreicer R, Hahn NM, Perini R, Siefker-Radtke A, Sonpavde G, de Wit R, Witjes JA, Keefe S, Staffas A, Bajorin D, Kline J, Armand P, Kuruvilla J, Moskowitz C, Hamadani M, Ribrag V, Zinzani PL, Chlosta S, Thompson S, Lumish M, Balakumaran A, Bartlett N, Kyi C, Sabado R, Saenger Y, William L, Donovan MJ, Sacris E, Mandeli J, Salazar AM, Rodriguez KP, Friedlander P, Bhardwaj N, Powderly J, Brody J, Nemunaitis J, Emens L, Luke JJ, Patnaik A, McCaffery I, Miller R, Ahr K, Laport G, Coveler AL, Smith DC, Grilley-Olson JE, Gajewski TF, Goel S, Gardai SJ, Law CL, Means G, Manley T, Perales M, Curti B, Marrone KA, Rosner G, Anagnostou V, Riemer J, Wakefield J, Zanhow C, Baylin S, Gitlitz B, Brahmer J, Giralt S, McDermott DF, Signoretti S, Li W, Schloss C, Michot JM, Armand P, Ding W, Ribrag V, Christian B, Balakumaran A, Taur Y, Marinello P, Chlosta S, Zhang Y, Shipp M, Zinzani PL, Najjar YG, Lin, Butterfield LH, Tarhini AA, Davar D, Pamer E, Zarour H, Rush E, Sander C, Kirkwood JM, Fu S, Bauer T, Molineaux C, Bennett MK, Orford KW, Papadopoulos KP, van den Brink MRM, Padda SK, Shah SA, Colevas AD, Narayanan S, Fisher GA, Supan D, Wakelee HA, Aoki R, Pegram MD, Villalobos VM, Jenq R, Liu J, Takimoto CH, Chao M, Volkmer JP, Majeti R, Weissman IL, Sikic BI, Page D, Yu W, Conlin A, Annels N, Ruzich J, Lewis S, Acheson A, Kemmer K, Perlewitz K, Moxon NM, Mellinger S, Bifulco C, Martel M, Koguchi Y, Pandha H, Fox B, Urba W, McArthur H, Pedersen M, Westergaard MCW, Borch TH, Nielsen M, Kongsted P, Juhler-Nøttrup T, Donia 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Westergaard MCW, Bianchi V, Legut M, Attaf M, Dolton G, Szomolay B, Ott S, Lyngaa R, Hadrup SR, Sewell AK, Svane IM, Fan A, Kumai T, Celis E, Frank I, Stramer A, Blaskovich MA, Wardell S, Fardis M, Bender J, Lotze MT, Goff SL, Zacharakis N, Assadipour Y, Prickett TD, Gartner JJ, Somerville R, Black M, Xu H, Chinnasamy H, Kriley I, Lu L, Wunderlich J, Robbins PF, Rosenberg S, Feldman SA, Trebska-McGowan K, Kriley I, Malekzadeh P, Payabyab E, Sherry R, Rosenberg S, Goff SL, Gokuldass A, Blaskovich MA, Kopits C, Rabinovich B, Lotze MT, Green DS, Kamenyeva O, Zoon KC, Annunziata CM, Hammill J, Helsen C, Aarts C, Bramson J, Harada Y, Yonemitsu Y, Helsen C, Hammill J, Mwawasi K, Denisova G, Bramson J, Giri R, Jin B, Campbell T, Draper LM, Stevanovic S, Yu Z, Weissbrich B, Restifo NP, Trimble CL, Rosenberg S, Hinrichs CS, Tsang K, Fantini M, Hodge JW, Fujii R, Fernando I, Jochems C, Heery C, Gulley J, Soon-Shiong P, Schlom J, Jing W, Gershan J, Blitzer G, Weber J, McOlash L, Johnson BD, Kiany S, Gangxiong H, Kleinerman ES, Klichinsky M, Ruella M, Shestova O, Kenderian S, Kim M, Scholler J, June CH, Gill S, Moogk D, Zhong S, Yu Z, Liadi I, Rittase W, Fang V, Dougherty J, Perez-Garcia A, Osman I, Zhu C, Varadarajan N, Restifo NP, Frey A, Krogsgaard M, Landi D, Fousek K, Mukherjee M, Shree A, Joseph S, Bielamowicz K, Byrd T, Ahmed N, Hegde M, Lee S, Byrd D, Thompson J, Bhatia S, Tykodi S, Delismon J, Chu L, Abdul-Alim S, Ohanian A, DeVito AM, Riddell S, Margolin K, Magalhaes I, Mattsson J, Uhlin M, Nemoto S, Villarroel PP, Nakagawa R, Mule JJ, Mailloux AW, Mata M, Nguyen P, Gerken C, DeRenzo C, Spencer DM, Gottschalk S, Mathieu M, Pelletier S, Stagg J, Turcotte S, Minutolo N, Sharma P, Tsourkas A, Powell DJ, Mockel-Tenbrinck N, Mauer D, Drechsel K, Barth C, Freese K, Kolrep U, Schult S, Assenmacher M, Kaiser A, Mullinax J, Hall M, Le J, Kodumudi K, Royster E, Richards A, Gonzalez R, Sarnaik A, Pilon-Thomas S, Nielsen M, Krarup-Hansen A, Hovgaard D, Petersen MM, Loya AC, Junker N, Svane IM, Rivas C, Parihar R, Gottschalk S, Rooney CM, Qin H, Nguyen S, Su P, Burk C, Duncan B, Kim BH, Kohler ME, Fry T, Rao AA, Teyssier N, Pfeil J, Sgourakis N, Salama S, Haussler D, Richman SA, Nunez-Cruz S, Gershenson Z, Mourelatos Z, Barrett D, Grupp S, Milone M, Rodriguez-Garcia A, Robinson MK, Adams GP, Powell DJ, Santos J, Havunen R, Siurala M, Cervera-Carrascón V, Parviainen S, Antilla M, Hemminki A, Sethuraman J, Santiago L, Chen JQ, Dai Z, Wardell S, Bender J, Lotze MT, Sha H, Su S, Ding N, Liu B, Stevanovic S, Pasetto A, Helman SR, Gartner JJ, Prickett TD, Robbins PF, Rosenberg SA, Hinrichs CS, Bhatia S, Burgess M, Zhang H, Lee T, Klingemann H, Soon-Shiong P, Nghiem P, Kirkwood JM, Rossi JM, Sherman M, Xue A, Shen YW, Navale L, Rosenberg SA, Kochenderfer JN, Bot A, Veerapathran A, Gokuldass A, Stramer A, Sethuraman J, Blaskovich MA, Wiener D, Frank I, Santiago L, Rabinovich B, Fardis M, Bender J, Lotze MT, Waller EK, Li JM, Petersen C, Blazar BR, Li J, Giver CR, Wang Z, Grossenbacher SK, Sturgill I, Canter RJ, Murphy WJ, Zhang C, Burger MC, Jennewein L, Waldmann A, Mittelbronn M, Tonn T, Steinbach JP, Wels WS, Williams JB, Zha Y, Gajewski TF, Williams LC, Krenciute G, Kalra M, Louis C, Gottschalk S, Xin G, Schauder D, Jiang A, Joshi N, Cui W, Zeng X, Menk AV, Scharping N, Delgoffe GM, Zhao Z, Hamieh M, Eyquem J, Gunset G, Bander N, Sadelain M, Askmyr D, Abolhalaj M, Lundberg K, Greiff L, Lindstedt M, Angell HK, Kim KM, Kim ST, Kim S, Sharpe AD, Ogden J, Davenport A, Hodgson DR, Barrett C, Lee J, Kilgour E, Hanson J, Caspell R, Karulin A, Lehmann P, Ansari T, Schiller A, Sundararaman S, Lehmann P, Hanson J, Roen D, Karulin A, Lehmann P, Ayers M, Levitan D, Arreaza G, Liu F, Mogg R, Bang YJ, O’Neil B, Cristescu R, Friedlander P, Wassman K, Kyi C, Oh W, Bhardwaj N, Bornschlegl S, Gustafson MP, Gastineau DA, Parney IF, Dietz AB, Carvajal-Hausdorf D, Mani N, Velcheti V, Schalper K, Rimm D, Chang S, Levy R, Kurland J, Krishnan S, Ahlers CM, Jure-Kunkel M, Cohen L, Maecker H, Kohrt H, Chen S, Crabill G, Pritchard T, McMiller T, Pardoll D, Pan F, Topalian S, Danaher P, Warren S, Dennis L, White AM, D’Amico L, Geller M, Disis ML, Beechem J, Odunsi K, Fling S, Derakhshandeh R, Webb TJ, Dubois S, Conlon K, Bryant B, Hsu J, Beltran N, Müller J, Waldmann T, Duhen R, Duhen T, Thompson L, Montler R, Weinberg A, Kates M, Early B, Yusko E, Schreiber TH, Bivalacqua TJ, Ayers M, Lunceford J, Nebozhyn M, Murphy E, Loboda A, Kaufman DR, Albright A, Cheng J, Kang SP, Shankaran V, Piha-Paul SA, Yearley J, Seiwert T, Ribas A, McClanahan TK, Cristescu R, Mogg R, Ayers M, Albright A, Murphy E, Yearley J, Sher X, Liu XQ, Nebozhyn M, Lunceford J, Joe A, Cheng J, Plimack E, Ott PA, McClanahan TK, Loboda A, Kaufman DR, Forrest-Hay A, Guyre CA, Narumiya K, Delcommenne M, Hirsch HA, Deshpande A, Reeves J, Shu J, Zi T, Michaelson J, Law D, Trehu E, Sathyanaryanan S, Hodkinson BP, Hutnick NA, Schaffer ME, Gormley M, Hulett T, Jensen S, Ballesteros-Merino C, Dubay C, Afentoulis M, Reddy A, David L, Fox B, Jayant K, Agrawal S, Agrawal R, Jeyakumar G, Kim S, Kim H, Silski C, Suisham S, Heath E, Vaishampayan U, Vandeven N, Viller NN, O’Connor A, Chen H, Bossen B, Sievers E, Uger R, Nghiem P, Johnson L, Kao HF, Hsiao CF, Lai SC, Wang CW, Ko JY, Lou PJ, Lee TJ, Liu TW, Hong RL, Kearney SJ, Black JC, Landis BJ, Koegler S, Hirsch B, Gianani R, Kim J, He MX, Zhang B, Su N, Luo Y, Ma XJ, Park E, Kim DW, Copploa D, Kothari N, doo Chang Y, Kim R, Kim N, Lye M, Wan E, Kim N, Lye M, Wan E, Kim N, Lye M, Wan E, Knaus HA, Berglund S, Hackl H, Karp JE, Gojo I, Luznik L, Hong HS, Koch SD, Scheel B, Gnad-Vogt U, Kallen KJ, Wiegand V, Backert L, Kohlbacher O, Hoerr I, Fotin-Mleczek M, Billingsley JM, Koguchi Y, Conrad V, Miller W, Gonzalez I, Poplonski T, Meeuwsen T, Howells-Ferreira A, Rattray R, Campbell M, Bifulco C, Dubay C, Bahjat K, Curti B, Urba W, Vetsika EK, Kallergi G, Aggouraki D, Lyristi Z, Katsarlinos P, Koinis F, Georgoulias V, Kotsakis A, Martin NT, Aeffner F, Kearney SJ, Black JC, Cerkovnik L, Pratte L, Kim R, Hirsch B, Krueger J, Gianani R, Martínez-Usatorre A, Jandus C, Donda A, Carretero-Iglesia L, Speiser DE, Zehn D, Rufer N, Romero P, Panda A, Mehnert J, Hirshfield KM, Riedlinger G, Damare S, Saunders T, Sokol L, Stein M, Poplin E, Rodriguez-Rodriguez L, Silk A, Chan N, Frankel M, Kane M, Malhotra J, Aisner J, Kaufman HL, Ali S, Ross J, White E, Bhanot G, Ganesan S, Monette A, Bergeron D, Amor AB, Meunier L, Caron C, Morou A, Kaufmann D, Liberman M, Jurisica I, Mes-Masson AM, Hamzaoui K, Lapointe R, Mongan A, Ku YC, Tom W, Sun Y, Pankov A, Looney T, Au-Young J, Hyland F, Conroy J, Morrison C, Glenn S, Burgher B, Ji H, Gardner M, Mongan A, Omilian AR, Conroy J, Bshara W, Angela O, Burgher B, Ji H, Glenn S, Morrison C, Mongan A, Obeid JM, Erdag G, Smolkin ME, Deacon DH, Patterson JW, Chen L, Bullock TN, Slingluff CL, Obeid JM, Erdag G, Deacon DH, Slingluff CL, Bullock TN, Loffredo JT, Vuyyuru R, Beyer S, Spires VM, Fox M, Ehrmann JM, Taylor KA, Korman AJ, Graziano RF, Page D, Sanchez K, Ballesteros-Merino C, Martel M, Bifulco C, Urba W, Fox B, Patel SP, De Macedo MP, Qin Y, Reuben A, Spencer C, Guindani M, Bassett R, Wargo J, Racolta A, Kelly B, Jones T, Polaske N, Theiss N, Robida M, Meridew J, Habensus I, Zhang L, Pestic-Dragovich L, Tang L, Sullivan RJ, Logan T, Khushalani N, Margolin K, Koon H, Olencki T, Hutson T, Curti B, Roder J, Blackmon S, Roder H, Stewart J, Amin A, Ernstoff MS, Clark JI, Atkins MB, Kaufman HL, Sosman J, Weber J, McDermott DF, Weber J, Kluger H, Halaban R, Snzol M, Roder H, Roder J, Asmellash S, Steingrimsson A, Blackmon S, Sullivan RJ, Wang C, Roman K, Clement A, Downing S, Hoyt C, Harder N, Schmidt G, Schoenmeyer R, Brieu N, Yigitsoy M, Madonna G, Botti G, Grimaldi A, Ascierto PA, Huss R, Athelogou M, Hessel H, Harder N, Buchner A, Schmidt G, Stief C, Huss R, Binnig G, Kirchner T, Sellappan S, Thyparambil S, Schwartz S, Cecchi F, Nguyen A, Vaske C. 31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016): part one. J Immunother Cancer 2016. [PMCID: PMC5123387 DOI: 10.1186/s40425-016-0172-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Horwitz SM, Zelenetz AD, Gordon LI, Wierda WG, Abramson JS, Advani RH, Andreadis CB, Bartlett N, Byrd JC, Fayad LE, Fisher RI, Glenn MJ, Habermann TM, Lee Harris N, Hernandez-Ilizaliturri F, Hoppe RT, Kaminski MS, Kelsey CR, Kim YH, Krivacic S, LaCasce AS, Lunning M, Nademanee A, Press O, Rabinovitch R, Reddy N, Reid E, Roberts K, Saad AA, Sokol L, Swinnen LJ, Vose JM, Yahalom J, Zafar N, Dwyer M, Sundar H, Porcu P. NCCN Guidelines Insights: Non-Hodgkin's Lymphomas, Version 3.2016. J Natl Compr Canc Netw 2016; 14:1067-79. [DOI: 10.6004/jnccn.2016.0117] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kipps T, Ghia P, Tedeschi A, Barr P, Robak T, Owen C, Bairey O, Hillmen P, Bartlett N, Li J, Simpson D, Grosicki S, Deverux S, McCarthy H, Coutre S, Offner F, Moreno C, Zhou C, Styles L, James D, Burger J. Analysis of Quality of Life and Well-being from the Randomized Phase 3 Study of Ibrutinib Versus Chlorambucil in Older Patients with Treatment-naïve CLL (RESONATE-2TM). Clinical Lymphoma Myeloma and Leukemia 2016. [DOI: 10.1016/j.clml.2016.07.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Levy R, Bartlett N, Friedberg J, Reagan P, Gordon L, Bergman C, Coffman R, Janssen R, Candia A, Khodadoust M, Frank M, Long S, Czerwinski D, Chu M, Kohrt H. Abstract CT047: SD-101, a novel intratumoral class C CpG-ODN, given with low-dose radiation in patients with untreated low-grade B-cell lymphoma: interim results of a phase I trial. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-ct047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Prior studies have shown preliminary clinical efficacy in combining CPG-ODN with radiation therapy (XRT) to patients with indolent B-cell lymphoma. We report Phase 1 data of combination XRT and SD-101, a synthetic class C CPG-ODN, selected for strong induction of type I interferon.
Methods: This dose-escalation Phase I trial (3+3 design) enrolled patients with untreated indolent B-cell lymphoma. The primary endpoints were safety and alpha-interferon-gene induction. Secondary endpoints included efficacy assessment using Cheson (1999) criteria and quantification of changes in tumor-infiltrating lymphocytes. Patients had a single lesion treated with XRT (2 Gy daily X 2 days) followed by weekly intratumoral SD-101 × 5 doses. Pharmacodynamic assessment included flow cytometry assessment of T-cell infiltrates in a FNA sample of the treated tumor and RT-PCR RNA assay of whole blood to assess induction of alpha-interferon genes. Efficacy assessment included imaging (CT at 3, 6, and every 6 months thereafter).
Results: As of 23 Dec 2015, 13 patients total were enrolled and treated with SD-101 doses of 1, 2, 4 or 8 mg/dose. There were no dose limiting toxicities. Twelve patients received all planned doses of XRT and SD-101. One patient (8 mg) withdrew consent for treatment after receiving 1 SD-101 dose due to Grade 2 confusion and flu-like symptoms. The most common adverse events (AEs) (decreasing frequency) were chills, malaise, myalgia, fatigue, headache, pyrexia, and nausea, typically resolving within 48 hours. One serious AE occurred (Grade 3 Pulmonary Embolism (4 mg)) which was incidental and asymptomatic. There were 2 dose delays due to an AE (Grade 3 neutropenia) in the same patient (8 mg) that resolved without treatment. The other AE was Grade 3 malaise reported in 2 patients (8 mg). At study Day 90, a reduction of the product of diameters in treated tumors occurred in 12 patients (median -45.3%; range [-87, +100]) and in non-treated tumors occurred in 11 patients (median -8.1%; range [-48, +45]). An induction of alpha-interferon genes occurred at all dose levels with similar level of induction. At the treated site, regulatory T-cells (T Regs) were reduced in 8 of 10 patients (average decrease 22.3 + 9.5%) at Day 8. There was an average reduction of 83.3 + 9.9% in follicular T helper cells (Tfh) at Day 8 (n = 9 with baseline Tfh).
Conclusions: SD-101 combined with radiation therapy showed preliminary abscopal anti-tumor activity and was well tolerated. A maximum tolerated dose has not yet been reached at the doses explored. Target engagement of the TLR-9 receptor (induction of interferon-alpha genes) was observed across all dose groups. A decrease in the proportion of T Regs and Tfh cells suggests modulation of their inhibitory effects and tumor growth promoting effects, respectively. The study is currently enrolling 2 expansion cohorts at 1 mg and 8 mg.
Citation Format: Ronald Levy, Nancy Bartlett, Jonathan Friedberg, Patrick Reagan, Leo Gordon, Craig Bergman, Robert Coffman, Robert Janssen, Albert Candia, Michael Khodadoust, Matthew Frank, Steven Long, Debra Czerwinski, Michael Chu, Holbrook Kohrt. SD-101, a novel intratumoral class C CpG-ODN, given with low-dose radiation in patients with untreated low-grade B-cell lymphoma: interim results of a phase I trial. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr CT047.
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Riedell P, Cashen A, Bartlett N, Gao F. Factors Associated with Progression-Free Survival in Mantle Cell Lymphoma Patients Treated with Autologous Stem Cell Transplant. Biol Blood Marrow Transplant 2016. [DOI: 10.1016/j.bbmt.2015.11.637] [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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Zelenetz AD, Gordon LI, Wierda WG, Abramson JS, Advani RH, Andreadis CB, Bartlett N, Byrd JC, Fayad LE, Fisher RI, Glenn MJ, Habermann TM, Lee Harris N, Hernandez-Ilizaliturri F, Hoppe RT, Horwitz SM, Kaminski MS, Kelsey CR, Kim YH, Krivacic S, LaCasce AS, Lunning M, Nademanee A, Porcu P, Press O, Rabinovitch R, Reddy N, Reid E, Roberts K, Saad AA, Sokol L, Swinnen LJ, Vose JM, Yahalom J, Zafar N, Dwyer M, Sundar H. Diffuse Large B-Cell Lymphoma Version 1.2016. J Natl Compr Canc Netw 2016; 14:196-231. [DOI: 10.6004/jnccn.2016.0023] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Singanayagam A, Glanville N, Pearson R, James P, Cuthbertson L, Cox M, Moffatt M, Cookson W, Bartlett N, Johnston S. T1 Fluticasone propionate alters the resident airway microbiota and impairs anti-viral and anti-bacterial immune responses in the airways. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Zelenetz AD, Gordon LI, Wierda WG, Abramson JS, Advani RH, Andreadis CB, Bartlett N, Byrd JC, Czuczman MS, Fayad LE, Fisher RI, Glenn MJ, Habermann TM, Harris NL, Hoppe RT, Horwitz SM, Kelsey CR, Kim YH, Krivacic S, LaCasce AS, Nademanee A, Porcu P, Press O, Rabinovitch R, Reddy N, Reid E, Saad AA, Sokol L, Swinnen LJ, Tsien C, Vose JM, Wilson L, Yahalom J, Zafar N, Dwyer M, Sundar H. Chronic lymphocytic leukemia/small lymphocytic lymphoma, version 1.2015. J Natl Compr Canc Netw 2015; 13:326-62. [PMID: 25736010 PMCID: PMC4841457 DOI: 10.6004/jnccn.2015.0045] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are different manifestations of the same disease, which are managed in the same way. The advent of novel monoclonal antibodies (ofatumumab and obinutuzumab) led to the development of effective chemoimmunotherapy regimens. The recently approved small molecule kinase inhibitors (ibrutinib and idelalisib) are effective treatment options for CLL in elderly patients with decreased tolerance for aggressive regimens and in patients with poor prognostic features who do not benefit from conventional chemoimmunotherapy regimens. This portion of the NCCN Guidelines for Non-Hodgkin's Lymphomas describes the recent specific to the incorporation of recently approved targeted therapies for the management of patients with newly diagnosed and relapsed or refractory CLL/SLL.
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MESH Headings
- Algorithms
- Comorbidity
- Disease Management
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/epidemiology
- Leukemia, Lymphocytic, Chronic, B-Cell/etiology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Neoplasm Staging
- Prognosis
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Zelenetz AD, Gordon LI, Wierda WG, Abramson JS, Advani RH, Andreadis CB, Bartlett N, Byrd JC, Czuczman MS, Fayad LE, Fisher RI, Glenn MJ, Harris NL, Hoppe RT, Horwitz SM, Kelsey CR, Kim YH, Krivacic S, LaCasce AS, Nademanee A, Porcu P, Press O, Rabinovitch R, Reddy N, Reid E, Saad AA, Sokol L, Swinnen LJ, Tsien C, Vose JM, Yahalom J, Zafar N, Dwyer M, Sundar H. Non-Hodgkin’s Lymphomas, Version 4.2014. J Natl Compr Canc Netw 2014; 12:1282-303. [DOI: 10.6004/jnccn.2014.0125] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Zelenetz AD, Gordon LI, Wierda WG, Abramson JS, Advani RH, Andreadis CB, Bartlett N, Bellam N, Byrd JC, Czuczman MS, Fayad LE, Fisher RI, Glenn MJ, Harris NL, Hoppe RT, Horwitz SM, Kelsey CR, Kim YH, Krivacic S, LaCasce AS, Nademanee A, Porcu P, Press O, Rabinovitch R, Reddy N, Reid E, Sokol L, Swinnen LJ, Tsien C, Vose JM, Yahalom J, Zafar N, Dwyer M, Sundar H. Non-Hodgkin's lymphomas, version 2.2014. J Natl Compr Canc Netw 2014; 12:916-46. [PMID: 24925202 DOI: 10.6004/jnccn.2014.0086] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Non-Hodgkin's lymphomas (NHLs) are a heterogeneous group of lymphoproliferative disorders originating in B lymphocytes, T lymphocytes, or natural killer cells. Follicular lymphoma (FL) is the most common subtype of indolent NHL, accounting for approximately 22% of all newly diagnosed cases of NHL. The incorporation of rituximab to chemotherapy regimens has become a widely accepted standard of care for first-line therapy for patients with FL. Maintenance and consolidation therapy with rituximab and radioimmunotherapy have also been associated with improved progression-free survival in patients experiencing response to first-line therapy. Despite therapeutic advances that have improved outcomes, FL is generally considered a chronic disease characterized by multiple recurrences with current therapies. This manuscript discusses the recommendations outlined in the NCCN Guidelines for the diagnosis and management of patients with FL.
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MESH Headings
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Disease-Free Survival
- Humans
- Lymphoma, Follicular/diagnosis
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/pathology
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/pathology
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/pathology
- Radioimmunotherapy
- Rituximab
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Martin P, Jung SH, Johnson JL, Pitcher B, Elstrom RL, Bartlett N, Blum KA, Richards KL, Leonard J, Cheson BD. CALGB 50803 (Alliance): A phase II trial of lenalidomide plus rituximab in patients with previously untreated follicular lymphoma. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.8521] [Citation(s) in RCA: 11] [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)
| | - Sin-Ho Jung
- Duke University School of Medicine, Durham, NC
| | | | - Brandy Pitcher
- Alliance Statistical Center, Duke University Medical Center, Durham, NC
| | | | - Nancy Bartlett
- Siteman Cancer Center, Washington University School of Medicine in St. Louis, St. Louis, MO
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Ansell SM, Younes A, Connors JM, Gallamini A, Kim WS, Friedberg JW, Feldman TA, Collins G, Bartlett N, Wang J, Brady K, Sachs J, Huebner D, Hunder NNH, Radford J. Phase 3 study of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A+AVD) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) as front-line treatment for advanced classical Hodgkin lymphoma (HL): Echelon-1 study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.tps8613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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)
| | | | - Joseph M. Connors
- British Columbia Cancer Agency and the University of British Columbia, Vancouver, BC, Canada
| | | | | | | | | | | | - Nancy Bartlett
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Jingyuan Wang
- Takeda Pharmaceuticals International Co., Cambridge, MA
| | - Kelly Brady
- Takeda Pharmaceuticals International Co., Cambridge, MA
| | - Jessica Sachs
- Takeda Pharmaceuticals International Co., Cambridge, MA
| | - Dirk Huebner
- Takeda Pharmaceuticals International Co., Cambridge, MA
| | | | - John Radford
- University of Manchester and The Christie NHS Foundation Trust, Manchester, United Kingdom
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Segal NH, Gopal AK, Bhatia S, Kohrt HE, Levy R, Pishvaian MJ, Houot R, Bartlett N, Nghiem P, Kronenberg SA, Thall AD, Mugundu G, Huang B, Davis C. A phase 1 study of PF-05082566 (anti-4-1BB) in patients with advanced cancer. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.3007] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [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)
| | - Ajay K. Gopal
- University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Shailender Bhatia
- University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA
| | - Holbrook Edwin Kohrt
- Department of Medicine, Division of Oncology, Stanford Cancer Institute/Stanford University School of Medicine, Stanford, CA
| | - Ronald Levy
- Department of Medicine, Division of Oncology, Stanford University, Stanford, CA
| | | | - Roch Houot
- Centre Hospitalier Universitaire Pontchaillou, Rennes, France
| | - Nancy Bartlett
- Siteman Cancer Center, Washington University School of Medicine in St. Louis, St. Louis, MO
| | | | | | | | | | - Bo Huang
- Pfizer Oncology Global Research and Development, New London, CT
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George PM, Oliver E, Schreiber BE, Holmes AM, Southwood M, Wort SJ, Bartlett N, Dorfmuller P, Morrell NW, Coghlan G, Humbert M, Zhao L, Mitchell JA. S143 Evidence that Type I interferon drives pulmonary arterial hypertension. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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32
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Pingali SR, Jewell S, Havlat L, Bast M, Thompson J, Eastwood D, Bartlett N, Armitage JO, Wagner-Johnston N, Vose J, Fenske TS. Clinical or survival benefit to routine surveillance imaging for classical Hodgkin lymphoma patients in first complete remission. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.8505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8505 Background: Routine surveillance imaging (RSI) for patients in complete remission from classical Hodgkin lymphoma (cHL) is common practice. RSI offers the theoretical benefit of detecting asymptomatic relapse, which may allow for more successful second-line therapy. Despite this, evidence for a clinical benefit of RSI is lacking. We compared outcomes in cHL patients undergoing RSI versus clinical surveillance (CS) in which scans are only obtained to evaluate concerning signs or symptoms. Methods: Patients with cHL diagnosed at three tertiary care centers from 2001-2010, who achieved complete remission (CR) following frontline therapy, were analyzed retrospectively. Patients were stratified into two groups based on the surveillance strategy employed. Baseline patient characteristics, prognostic features, treatment records, and outcomes were collected. The primary objective was to compare overall survival for patients undergoing RSI versus CS. As a secondary objective we compared the success of second-line therapy for relapsed patients in each group. Results: 207 patients met eligibility criteria, with 131 RSI patients and 76 CS patients. Patient characteristics (age, gender, stage, sedimentation rate, Hasenclever index, bulky disease and B symptoms) were similar in each group. Chemotherapy consisted of ABVD in 79% and Stanford V in 15%. Patients in the RSI group more commonly received ABVD (91% vs. 57%) and less often radiation therapy (38% vs. 68%). Mean number of scans was 4.77 in RSI and 1.11 in CS groups, respectively. With a median follow up of 4 years, the overall survival was similar in both groups (p=0.74), with 5 (3.8%) deaths in the RSI group and 4 (5.3%) in the CS group. Six (4.6%) relapses occurred in the RSI group (4 of which were detected by RSI), and 5 (6.6%) in the CS group (p=0.64 for relapse at 5 years). All relapsed patients achieved second CR with second-line therapy. Conclusions: RSI did not yield a survival advantage in cHL patients who achieved CR after frontline therapy.Given the radiation exposure, cost, and risk for additional procedures associated with RSI, we conclude CS is the preferred strategy in cHL patients in first complete remission.
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Affiliation(s)
- Sai Ravi Pingali
- Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI
| | - Sarah Jewell
- Washington University in St. Louis, St. Louis, MO
| | - Luiza Havlat
- University of Nebraska Medical Center, Omaha, NE
| | - Martin Bast
- University of Nebraska Medical Center, Omaha, NE
| | | | | | - Nancy Bartlett
- Washington University School of Medicine in St. Louis; Siteman Cancer Center, St. Louis, MO
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Glass J, Won M, Schultz CJ, Brat D, Bartlett N, Suh JH, Fisher BJ, Liepman MK, Mehta MP. Preirradiation chemotherapy with methotrexate, rituximab, and temozolomide and post-irradiation temozolomide for primary central nervous system lymphoma: RTOG 0227 phase II study results. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.2033] [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
2033 Background: This prospective phase II study tested a methotrexate (MTX), temozolomide (TMZ) and rituximab (RTX) pre-irradiation regimen with hyperfractionated whole brain radiation therapy (hWBRT) followed by post-irradiation TMZ for patients with primary CNS lymphoma (PCNSL). The primary phase II endpoint was the 2-year overall survival (OS) rate compared with the 2-year OS from RTOG 93-10 (MTX, procarbazine, vincristine, whole brain radiation therapy, cytarabine). Secondary endpoints were pre-irradiation chemotherapy tumor response rates (compared to RTOG 93-10), progression free survival (PFS), acute and late neurologic toxicities, and quality of life. Methods: 53 patients (28 women, 25 men), median age 57.5 years, median Zubrod 1 were treated with RTX 375 mg/m2 3 days prior to first cycle of MTX; 5 cycles of intravenous MTX 3.5 g/m2 with leucovorin rescue on weeks 1, 3, 5, 7, 9; TMZ 100 mg/m2 daily for 5 days weeks 4 and 8; hWBRT 1.2 Gy twice daily fractions 5 days/week on weeks 11, 12, 13 for a total of 36 Gy and TMZ 200 mg/m2 daily for 5 days on weeks 14, 18, 22, 26, 30, 34, 38, 42, 46, 50. Results: Dosing of pre-irradiation temozolomide at 100 mg/m2 was determined in the phase I portion of the study. With a median follow-up of 3.6 years, 2-year OS and PFS rates were 80.8% and 63.6%, respectively. Compared with historical controls from RTOG 93-10, 2-year OS and PFS were significantly improved (p = 0.006 and 0.03). The overall response rate to the pre-irradiation chemotherapy was 37.7% (complete response 11.3%, partial response 26.4%). 38% experienced grade 3 and 25% experienced grade 4 toxicities before the start of hWBRT. 33% experienced grade 3 and 21% experienced grade 4 toxicities attributable to post-hWBRT chemotherapy. Conclusions: The combination of MTX, TMZ, RTX followed by hWBRT and TMZ for PCNSL is safe with demonstrated improved 2 year OS and PFS compared with RTOG 93-10. Further investigations regarding the role of hWBRT and post-hWBRT TMZ are indicated. This project was supported by RTOG grant U10 CA21661 and CCOP grant U10 CA37422 from the National Cancer Institute (NCI) and Schering-Plough. Clinical trial information: NCT00068250.
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Affiliation(s)
- Jon Glass
- Thomas Jefferson University, Philadelphia, PA
| | - Minhee Won
- Radiation Therapy Oncology Group, Philadelphia, PA
| | | | | | - Nancy Bartlett
- Washington University School of Medicine in St. Louis; Siteman Cancer Center, St. Louis, MO
| | | | - Barbara Jean Fisher
- Department of Radiation Oncology, London Regional Cancer Program, London, ON, Canada
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Zelenetz AD, Wierda WG, Abramson JS, Advani RH, Andreadis CB, Bartlett N, Bellam N, Byrd JC, Czuczman MS, Fayad LE, Glenn MJ, Gockerman JP, Gordon LI, Harris NL, Hoppe RT, Horwitz SM, Kelsey CR, Kim YH, Krivacic S, LaCasce AS, Nademanee A, Porcu P, Press O, Pro B, Reddy N, Sokol L, Swinnen L, Tsien C, Vose JM, Yahalom J, Zafar N, Dwyer MA, Naganuma M. Non-Hodgkin's lymphomas, version 1.2013. J Natl Compr Canc Netw 2013; 11:257-72; quiz 273. [PMID: 23486452 DOI: 10.6004/jnccn.2013.0037] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
These NCCN Guidelines Insights summarize several key updates to the NCCN Guidelines for Non-Hodgkin's Lymphomas (NHL) and provide a discussion of the clinical evidence that support the updates. The updates discussed in this article feature recommendations for additional treatment options in patients with chronic lymphocytic leukemia and guidance surrounding the management of hepatitis virus reactivation/infections in high-risk patients with NHL undergoing antitumor therapy.
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Zelenetz AD, Wierda WG, Abramson JS, Advani RH, Andreadis CB, Bartlett N, Bellam N, Byrd JC, Czuczman MS, Fayad L, Glenn MJ, Gockerman JP, Gordon LI, Harris NL, Hoppe RT, Horwitz SM, Kelsey CR, Kim YH, Krivacic S, LaCasce AS, Nademanee A, Porcu P, Press O, Pro B, Reddy N, Sokol L, Swinnen L, Tsien C, Vose JM, Yahalom J, Zafar N, Naganuma M, Dwyer MA. Non-Hodgkin's Lymphomas, version 3.2012. J Natl Compr Canc Netw 2012; 10:1487-98. [PMID: 23221787 DOI: 10.6004/jnccn.2012.0155] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
These NCCN Guidelines Insights summarize several key updates to the 2012 NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Non-Hodgkin's Lymphomas (NHL) and describe the clinical evidence supporting the updates. The featured updates include changes to the recommendations for treatment options in patients with chronic lymphocytic leukemia (including in elderly or frail patients and patients with poor-risk cytogenetics), guidance surrounding surveillance imaging for follow-up of patients with NHL, and the addition of first-line consolidation options for patients with mantle cell lymphoma.
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Forero-Torres A, Bartlett N, Beaven A, Myint H, Nasta S, Northfelt DW, Whiting NC, Drachman JG, Lobuglio AF, Moskowitz CH. Pilot study of dacetuzumab in combination with rituximab and gemcitabine for relapsed or refractory diffuse large B-cell lymphoma. Leuk Lymphoma 2012; 54:277-83. [PMID: 22775314 DOI: 10.3109/10428194.2012.710328] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Dacetuzumab, a CD40-targeted, humanized antibody, mediates antitumor activity through effector cell functions and direct apoptotic signal transduction. Preclinical studies demonstrated synergistic activity between dacetuzumab, gemcitabine and rituximab against non-Hodgkin lymphoma in vivo. A phase 1b safety/efficacy study of dacetuzumab in combination with rituximab and gemcitabine was conducted in relapsed/refractory diffuse large B-cell lymphoma (DLBCL). Patients received dacetuzumab at doses of 8 or 12 mg/kg IV weekly with rituximab (375 mg/m(2) IV weekly in cycle 1, then every 28 days) and gemcitabine (1000 mg/m(2) IV, days 1, 8 and 15, or days 1 and 15). Thirty-three patients with a median age of 67 years were enrolled. Common adverse events (≥ 15%) were grade 1/2 cytokine release syndrome, nausea, fatigue, thrombocytopenia, headache, decreased appetite, dyspnea, neutropenia, pyrexia, anemia, diarrhea, edema, constipation and cough. Dacetuzumab-related grade 3/4 adverse events occurred infrequently. Six of 30 evaluable patients achieved a complete response (CR) and eight a partial response (PR) per investigator assessment for an overall response rate (ORR) of 47%.
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Advani R, Oki Y, Shustov AR, Grove LE, Bartlett N. Brentuximab vedotin for relapsed or refractory non-Hodgkin lymphoma: Preliminary results from a phase II study. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.8070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8070 Background: Brentuximab vedotin is a CD30-directed antibody-drug conjugate approved for the treatment of Hodgkin lymphoma and systemic anaplastic large cell lymphoma (ALCL) after failure of other therapies. Based on the high objective response rate observed in patients with systemic ALCL, a type of non-Hodgkin lymphoma that is characterized by homogeneous CD30 expression, a study was initiated in other non-Hodgkin lymphomas that express the CD30 target. Methods: A phase 2 open-label single-arm study is underway in patients with relapsed or refractory CD30-positive non-Hodgkin lymphoma, excluding ALCL (NCT01421667). Brentuximab vedotin is administered IV at 1.8 mg/kg every 3 weeks until disease progression or unacceptable toxicity. The primary endpoint is objective response rate assessed by the Revised Response Criteria for Malignant Lymphoma (Cheson 2007). Tumor specimens are assessed by central lab in order to characterize the relationship of CD30 expression with antitumor activity. Results: Ten patients (age range 28–83; 5 M, 5 F) have enrolled to date. Diagnoses include diffuse large B-cell lymphoma (DLBCL, n=2), EBV-positive DLBCL of the elderly (n=3), primary mediastinal B-cell lymphoma (n=2), peripheral T-cell lymphoma NOS (n=2), and angioimmunoblastic T-cell lymphoma (AITL). Patients had received 1–6 prior chemotherapy regimens; 3 patients had prior stem cell transplants. Of 6 patients who have completed the cycle 2 response assessment, 2 attained complete remission, 1 with DLBCL (90% CD30+) and 1 with AITL (8% CD30+), 1 had stable disease, and 3 had progressive disease. Treatment-related serious adverse events observed to date were rash, febrile neutropenia, and mastoiditis. Conclusions: Preliminary results suggest that brentuximab vedotin may have antitumor activity in patients with relapsed or refractory CD30-expressing non-Hodgkin lymphomas, in addition to the efficacy previously observed in systemic ALCL. Updated study results will be presented.
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Affiliation(s)
| | - Yasuhiro Oki
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | | | | | - Nancy Bartlett
- Washington University, Siteman Cancer Center, St. Louis, MO
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Bartlett N, Brice P, Chen RW, Fanale MA, Gopal AK, Matous J, Rosenblatt JD, Grove LE, Forero-Torres A. Retreatment with brentuximab vedotin in CD30‑positive hematologic malignancies: A phase II study. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.8027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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
8027 Background: Brentuximab vedotin comprises an anti-CD30 antibody conjugated by a protease-cleavable linker to a microtubule-disrupting agent, MMAE. In pivotal phase 2 studies in patients (pts) with relapsed/refractory Hodgkin lymphoma (HL) or systemic anaplastic large cell lymphoma (sALCL), objective response rates were 75% and 86% and median durations of response were 6.7 and 12.6 mo, respectively. A phase 2 study was initiated to investigate if pts who have previously responded to brentuximab vedotin could achieve another remission with retreatment (ClinicalTrials.gov #NCT00947856). Methods: Pts had a CD30-positive hematologic malignancy, achieved an objective response (per Cheson 2007) with prior brentuximab vedotin treatment, and experienced relapse after discontinuing treatment. Brentuximab vedotin was administered IV 1.8 mg/kg every 21 days; antitumor activity was assessed by the investigator. Results: 14 HL pts and 8 sALCL (5 ALK-negative) pts were enrolled (median age 34 yr, range 16–72). Pts had received a median of 4 prior chemotherapy regimens (range 2–12). Median time since the previous brentuximab vedotin treatment was 6.9 mo (range 1–44). Median number of retreatment cycles was 7 (range 1+ to 32+). Adverse events (AEs) in >25% of pts were nausea (41%), fatigue (36%), peripheral sensory neuropathy (36%), and diarrhea (27%). The most common Grade 3/4 AEs were anemia, fatigue, and hyperglycemia (3 pts each). Of the 11 pts who had pre-existing peripheral neuropathy, 3 (27%) had worsening with retreatment. Best clinical responses in pts with HL were 3 CR, 5 PR, 3 SD, 3 PD. Among pts with sALCL, 5 achieved a CR, 1 had PD, and 2 were not yet evaluated. Of the 8 pts with CR in retreatment, previous best responses to brentuximab vedotin treatment were 4 PR and 4 CR. Median duration of retreatment response was 10.8 mo (range 0+ to 10.8), and in pts who achieved CR, the median duration of response was not reached (range 0+ to 10.5 mo); 11 pts remain on retreatment. Conclusions: Retreatment with brentuximab vedotin was generally well tolerated. Objective responses were observed (13 of 20; 65%) in this heavily pretreated population. Enrollment to the phase 2 retreatment study is ongoing.
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Affiliation(s)
- Nancy Bartlett
- Washington University, Siteman Cancer Center, St. Louis, MO
| | | | | | | | - Ajay K. Gopal
- University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA
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Leonard J, Jung SH, Johnson JL, Bartlett N, Blum KA, Cheson BD. CALGB 50401: A randomized trial of lenalidomide alone versus lenalidomide plus rituximab in patients with recurrent follicular lymphoma. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.8000] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [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
8000 Background: Lenalidomide (L) and rituximab (R) are active as single agents in follicular (FL) and other B-cell lymphomas, although combination strategies have not been previously assessed in a randomized fashion. Methods: CALGB 50401 is a randomized phase II study, initially designed to evaluate 3 regimens: R alone (375 mg/m2 weekly x 4), L alone (15 mg cycle 1, then escalated to 20 mg cycles 2-12, administered days 1-21 q 28 days x 12 cycles) or the combination of L+ R (other 2 arms combined). The R alone arm was discontinued due to slow accrual with 3 enrolled subjects. Eligibility included recurrent FL, prior therapy with rituximab alone or in combination, and TTP of ≥ 6 months from last rituximab dose. Prophylactic ASA or LMW heparin was recommended for patients at high risk for thrombosis. Results: Of 94 pts registered to L or LR, 89 (45 L and 44 LR) received at least one dose and had adequate data for analysis. Baseline characteristics include median age 63 (range 34-85) and 60% with intermediate- or high-risk FLIPI. Grade 3-4 adverse events (AE) were most commonly neutropenia (16% L,19% LR), fatigue (9% L, 14% LR) and thrombosis (16% - 7 pts L, 4% - 2 pts LR, p=0.158), and overall were seen in 49% (L) and 52% (LR) with 9% grade 4 in each arm. The full regimen was completed in 33% (L) and 59% (LR) of patients, with the difference due to more progressions or non-responders in the L group. In both arms about 19% of subjects discontinued therapy early due to AEs and dose intensity was over 80%. Objective response rates are L - 49% (13% CR) and LR - 75% (32% CR). With a median follow-up of 1.5 years (range 0.1- 3.6 years), median EFS is 1.2 years (L) and 2.0 years (LR), p=0.0063, log-rank test. Conclusions: Lenalidomide + rituximab is more active than lenalidomide alone in patients with recurrent FL with similar toxicity. A trend toward lower thrombosis risk with LR may relate to greater anti-tumor efficacy. The LR regimen warrants further study in FL including as a backbone for addition of novel agents in relapsed and frontline settings.
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Affiliation(s)
| | - Sin-Ho Jung
- Duke University School of Medicine, Durham, NC
| | | | - Nancy Bartlett
- Washington University, Siteman Cancer Center, St. Louis, MO
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Maeda LS, Geiger JL, Savage KJ, Rose J, Pinter-Brown LC, Lunning MA, Abramson JS, Bartlett N, Vose J, Drape J, Muffly LS, McMillan A, Evens AM, Smith SM, Horwitz SM, Ansell SM, Advani R. Characteristics and outcomes of extranodal NK/t-cell lymphoma (ENKL): A North American (NA) multi-institutional experience. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.8060] [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
8060 Background: ENKL is a rare and aggressive subtype of peripheral T-cell lymphoma. Due to its geographic predilection there is a paucity of data on clinical experiences from non-Asian countries. The purpose of this study was to analyze characteristics and outcomes of patients (pts) with ENKL identified from major academic centers in NA. Methods: Pts with newly diagnosed CD56+ ENKL were retrospectively identified. Analyses included disease characteristics, ethnicity, therapy, and outcomes. Results: 115 pts (63.5% Caucasian, 20% Asian, 16.5% other) were identified across 10 centers diagnosed between 5/1990-5/2011 (Era 1: pre-2000, n=16; Era 2: 2000-2005, n=45; Era 3: post-2005, n=54). Median age was 52 years (19-88). 75 (65%) had stage I/II disease and were treated with combined modality therapy (CMT) n=48, chemotherapy (CT) n=14 or radiotherapy (RT) n=14. 40 pts had stage III/IV disease and were treated with CT (n=23), CMT (n=12) or RT (n=5). CT regimens used alone or in CMT were either anthracycline-based (n=68) or other (n=29). 63% of stage I/II pts and 40% with stage III/IV achieved complete remission (CR). 30 pts underwent a stem cell transplant (SCT); 14 in first CR and 16 at progression/relapse (autologous, n=21; allogeneic, n=9). Pts with stage I/II disease had a better progression-free survival (PFS) and overall survival (OS) compared with stage III/IV (12 vs 5.2 months (p=0.003) and 41.5 vs 8.9 months (p<0.0001), respectively). For all stages, treatment with CMT compared with CT or RT alone was also associated with better PFS and OS, 18.0 vs 3.9 months (p<0.0001), and 41.5 vs 10.2 months (p=0.002) respectively. Non-anthracycline-based regimens were associated with better PFS (p=0.001) and OS (p=0.045). No survival differences were seen between Asian and non-Asian pts. Conclusions: This series represents one of the largest experiences of ENKL in NA. Our data are consistent with Asian studies in: 1) majority of pts present with early stage disease; 2) overall poor outcome; 3) superiority of CMT and non-anthracycline regimens. Advances in understanding biology and international collaborative efforts are required to improve outcome in this rare entity.
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Affiliation(s)
| | | | | | - Jim Rose
- British Columbia Cancer Agency, Vancouver, BC, Canada
| | | | | | | | - Nancy Bartlett
- Washington University, Siteman Cancer Center, St. Louis, MO
| | - Julie Vose
- University of Nebraska Medical Center, Omaha, NE
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Evens AM, Hong F, Gordon LI, Fisher RI, Bartlett N, Connors JM, Wagner H, Gospodarowicz MK, Cheson BD, Advani R, Kahl BS, Hoppe RT, Horning SJ. Efficacy and tolerability of ABVD and Stanford V for elderly advanced-stage Hodgkin lymphoma (HL): Analysis from the phase III randomized U.S. Intergroup Trial E2496. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pro B, Advani R, Brice P, Bartlett N, Rosenblatt JD, Illidge T, Matous J, Ramchandren R, Fanale MA, Connors JM, Yang Y, Sievers EL, Kennedy DA, Shustov AR. Durable remissions with brentuximab vedotin (SGN-35): Updated results of a phase II study in patients with relapsed or refractory systemic anaplastic large cell lymphoma (sALCL). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8032] [Citation(s) in RCA: 12] [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: 11/20/2022] Open
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43
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Wildes TM, Farrington L, Yeung CCS, Harrington A, Foyil KV, Kreisel F, Bartlett N, Fenske T. Hyper-CVAD and rituximab-hyperCVAD in Burkitt lymphoma (BL): A multi-institutional experience. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e18541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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44
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Zelenetz AD, Abramson JS, Advani RH, Andreadis CB, Bartlett N, Bellam N, Byrd JC, Czuczman MS, Fayad LE, Glenn MJ, Gockerman JP, Gordon LI, Harris NL, Hoppe RT, Horwitz SM, Kelsey CR, Kim YH, LaCasce AS, Nademanee A, Porcu P, Press O, Pro B, Reddy N, Sokol L, Swinnen LJ, Tsien C, Vose JM, Wierda WG, Yahalom J, Zafar N. Non-Hodgkin's lymphomas. J Natl Compr Canc Netw 2011; 9:484-560. [PMID: 21550968 DOI: 10.6004/jnccn.2011.0046] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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45
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O'Connor OA, Pro B, Pinter-Brown L, Bartlett N, Popplewell L, Coiffier B, Lechowicz MJ, Savage KJ, Shustov AR, Gisselbrecht C, Jacobsen E, Zinzani PL, Furman R, Goy A, Haioun C, Crump M, Zain JM, Hsi E, Boyd A, Horwitz S. Pralatrexate in patients with relapsed or refractory peripheral T-cell lymphoma: results from the pivotal PROPEL study. J Clin Oncol 2011; 29:1182-9. [PMID: 21245435 DOI: 10.1200/jco.2010.29.9024] [Citation(s) in RCA: 448] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Peripheral T-cell lymphoma (PTCL) is a poor prognosis subtype of non-Hodgkin's lymphoma with no accepted standard of care. This study evaluated the efficacy and tolerability of pralatrexate, a novel antifolate with promising activity. PATIENTS AND METHODS Patients with independently confirmed PTCL who progressed following ≥ 1 line of prior therapy received pralatrexate intravenously at 30 mg/m(2)/wk for 6 weeks in 7-week cycles. Primary assessment of response was made by independent central review using the International Workshop Criteria. The primary end point was overall response rate. Secondary end points included duration of response, progression-free survival (PFS), and overall survival (OS). RESULTS Of 115 patients enrolled, 111 were treated with pralatrexate. The median number of prior systemic therapies was three (range, 1 to 12). The response rate in 109 evaluable patients was 29% (32 of 109), including 12 complete responses (11%) and 20 partial responses (18%), with a median DoR of 10.1 months. Median PFS and OS were 3.5 and 14.5 months, respectively. The most common grade 3/4 adverse events were thrombocytopenia (32%), mucositis (22%), neutropenia (22%), and anemia (18%). CONCLUSION To our knowledge, PROPEL (Pralatrexate in Patients with Relapsed or Refractory Peripheral T-Cell Lymphoma) is the largest prospective study conducted in patients with relapsed or refractory PTCL. Pralatrexate induced durable responses in relapsed or refractory PTCL irrespective of age, histologic subtypes, amount of prior therapy, prior methotrexate, and prior autologous stem-cell transplant. These data formed the basis for the US Food and Drug Administration approval of pralatrexate, the first drug approved for this disease.
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Affiliation(s)
- Owen A O'Connor
- New York University (NYU) Cancer Institute, NYU Langone Medical Center, New York, NY, USA. owen.o'
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Bartlett N, Grove LE, Kennedy DA, Sievers EL, Forero-Torres A. Objective responses with brentuximab vedotin (SGN-35) retreatment in CD30-positive hematologic malignancies: A case series. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8062] [Citation(s) in RCA: 18] [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: 11/20/2022] Open
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47
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Smith SM, Bartlett N, Johnson JL, Lister J, Cashen AF, Jung S, Schöder H, Egan K, Cheson BD. Galiximab, an anti-CD80 primatized monoclonal antibody, in relapsed Hodgkin lymphoma: Final results of CALGB 50602. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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O'Connor O, Pro B, Pinter-Brown L, Popplewell L, Bartlett N, Lechowicz M, Savage K, Coiffier B, Saunders M, Horwitz S. PROPEL: Results of the pivotal, multicenter, phase II study of pralatrexate in patients with relapsed or refractory peripheral T-cell lymphoma (PTCL). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8561] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8561 Background: Pralatrexate is a novel targeted antifolate designed to accumulate preferentially in cancer cells. PROPEL, a pivotal phase 2, non-randomized, open-label, international study, is the largest prospective study in patients (pts) with relapsed or refractory PTCL. Methods: Pts received 30 mg/m2 of pralatrexate intravenously weekly for 6 of 7 weeks, supplemented with B12 and folic acid. Primary endpoint = objective response rate (ORR); secondary endpoints = response duration, progression-free survival, and overall survival. Eligibility criteria: histologically confirmed PTCL, disease progression after ≥ 1 prior treatment, and ECOG performance status ≤ 2. Pathology was confirmed by independent central review, response to therapy was assessed by independent central review using International Workshop Criteria (IWC). Results: 115 pts were enrolled, 109 were evaluable for efficacy. 111 treated pts included 76 males (68%) and 35 females (32%). Pts had failed a median of 3 prior regimens and thus were heavily pre-treated. 78 pts (70%) failed CHOP, 18 (16%) had previous autologous stem cell transplant. 25% of pts never responded to any prior therapy; 53% did not respond to last prior therapy. The majority (59 pts, 53%) had PTCL not-otherwise specified. The ORR by central review was 27% (n = 29). 11 pts (10% overall, 38% of responders) had a complete response (CR), 18 pts (17%) had a partial response (PR), and 23 (21%) had stable disease. ORR by investigators assessment was 39% (n = 42). The median duration of response cannot be accurately estimated at this time, though responses of > 1 year have been observed. 69% of responses were after just 1 cycle. 5 responding pts went on to transplant. The most frequent Grade (Gr) 3–4 adverse events were mucosal inflammation (Gr 3 = 17%, Gr 4 = 4%) and thrombocytopenia (Gr 3 = 14%, Gr 4 = 19%). Conclusions: The results of PROPEL show that pralatrexate exhibits substantial activity in pts with relapsed or refractory PTCL, as assessed by a rigorous central review, with durable CRs /PRs, irrespective of the amount of prior therapy. [Table: see text]
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Affiliation(s)
- O. O'Connor
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - B. Pro
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - L. Pinter-Brown
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - L. Popplewell
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - N. Bartlett
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - M. Lechowicz
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - K. Savage
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - B. Coiffier
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - M. Saunders
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
| | - S. Horwitz
- Columbia University, New York, NY; M. D. Anderson Cancer Center, Houston, TX; University of California at Los Angeles, Los Angeles, CA; City of Hope, Duarte, CA; Washington University, St. Louis, MO; Emory University, Atlanta, GA; British Columbia Cancer Agency, Vancouver, BC, Canada; Centre Hospitalier Lyon Sud, Lyon, France; Allos Therapeutics, Westminster, CO; Memorial Sloan-Kettering Cancer Center, New York, NY
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Bartlett N, Forero-Torres A, Rosenblatt J, Fanale M, Horning SJ, Thompson S, Sievers EL, Kennedy DA. Complete remissions with weekly dosing of SGN-35, a novel antibody-drug conjugate (ADC) targeting CD30, in a phase I dose-escalation study in patients with relapsed or refractory Hodgkin lymphoma (HL) or systemic anaplastic large cell lymphoma (sALCL). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8500] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8500 Background: A defining feature of HL and sALCL is CD30 expression on malignant cells. The ADC SGN-35 comprises an anti-CD30 antibody conjugated to the antitubulin agent monomethyl auristatin E (MMAE). SGN-35 causes cell cycle arrest and apoptosis by binding to CD30 on the tumor cell surface, internalizing, and releasing MMAE into the cell. In a previous phase 1 study with q3 wk dosing, 54% of pts achieved an objective response (CR/PR) at SGN-35 doses ≥1.2 mg/kg [ASH 2008 abstract 1006]. Methods: To assess if more frequent dosing might maximize anti-tumor activity with acceptable tolerability, a multicenter, phase 1, weekly dosing, dose-escalation study (3+3 design) was conducted in pts with refractory or recurrent HL or sALCL. SGN-35 was administered weekly at doses of 0.4–1 mg/kg (2-hr IV infusions). Pts with stable disease or better (Cheson 2007) after two 28-day cycles (6 doses) were eligible to continue SGN-35 treatment. Results: In 17 pts, median age was 38 yrs (range 25–67). Pts received a median of 4 prior therapies; 65% received an autologous SCT. MTD has not been defined. One related G3 event (diarrhea) and no related G4 events occurred. The most common related adverse events were G1/G2 rash, nausea, and peripheral neuropathy. Exposure to SGN-35 (AUC) increased relative to dose level. Multiple CRs were observed at higher doses ( table ); observed time to response in the 1 mg/kg dose group was approximately 8 wks. The 7 pts with CRs all remain on treatment. Enrollment to SGN-35 monotherapy continues at 1.2 mg/kg; combination therapy will be subsequently explored. Conclusions: SGN-35 was generally well tolerated and induced CRs in 7 of 8 evaluable pts at the two highest doses in heavily pretreated patients. Pivotal trials of this antibody-drug conjugate will initiate in early 2009. [Table: see text] [Table: see text]
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Affiliation(s)
- N. Bartlett
- Washington University Siteman Cancer Center, St. Louis, MO; University Alabama at Birmingham, Birmingham, AL; University Miami Sylvester Comprehensive Cancer Center, Miami, FL; University of Texas M. D. Anderson Cancer Center, Houston, TX; Stanford University, Stanford, CA; Seattle Genetics, Inc., Bothell, WA
| | - A. Forero-Torres
- Washington University Siteman Cancer Center, St. Louis, MO; University Alabama at Birmingham, Birmingham, AL; University Miami Sylvester Comprehensive Cancer Center, Miami, FL; University of Texas M. D. Anderson Cancer Center, Houston, TX; Stanford University, Stanford, CA; Seattle Genetics, Inc., Bothell, WA
| | - J. Rosenblatt
- Washington University Siteman Cancer Center, St. Louis, MO; University Alabama at Birmingham, Birmingham, AL; University Miami Sylvester Comprehensive Cancer Center, Miami, FL; University of Texas M. D. Anderson Cancer Center, Houston, TX; Stanford University, Stanford, CA; Seattle Genetics, Inc., Bothell, WA
| | - M. Fanale
- Washington University Siteman Cancer Center, St. Louis, MO; University Alabama at Birmingham, Birmingham, AL; University Miami Sylvester Comprehensive Cancer Center, Miami, FL; University of Texas M. D. Anderson Cancer Center, Houston, TX; Stanford University, Stanford, CA; Seattle Genetics, Inc., Bothell, WA
| | - S. J. Horning
- Washington University Siteman Cancer Center, St. Louis, MO; University Alabama at Birmingham, Birmingham, AL; University Miami Sylvester Comprehensive Cancer Center, Miami, FL; University of Texas M. D. Anderson Cancer Center, Houston, TX; Stanford University, Stanford, CA; Seattle Genetics, Inc., Bothell, WA
| | - S. Thompson
- Washington University Siteman Cancer Center, St. Louis, MO; University Alabama at Birmingham, Birmingham, AL; University Miami Sylvester Comprehensive Cancer Center, Miami, FL; University of Texas M. D. Anderson Cancer Center, Houston, TX; Stanford University, Stanford, CA; Seattle Genetics, Inc., Bothell, WA
| | - E. L. Sievers
- Washington University Siteman Cancer Center, St. Louis, MO; University Alabama at Birmingham, Birmingham, AL; University Miami Sylvester Comprehensive Cancer Center, Miami, FL; University of Texas M. D. Anderson Cancer Center, Houston, TX; Stanford University, Stanford, CA; Seattle Genetics, Inc., Bothell, WA
| | - D. A. Kennedy
- Washington University Siteman Cancer Center, St. Louis, MO; University Alabama at Birmingham, Birmingham, AL; University Miami Sylvester Comprehensive Cancer Center, Miami, FL; University of Texas M. D. Anderson Cancer Center, Houston, TX; Stanford University, Stanford, CA; Seattle Genetics, Inc., Bothell, WA
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Saven A, Schwartzberg L, Kaywin P, Bartlett N, Dean L, Shahin S, Dreiling L. Randomized, double-blind, phase 2, study evaluating same-day vs next-day administration of pegfilgrastim with R-CHOP in non-Hodgkin’s lymphoma patients. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7570] [Citation(s) in RCA: 10] [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: 11/20/2022] Open
Abstract
7570 Background: R-CHOP is associated with a high risk of febrile neutropenia (FN). Pegfilgrastim is indicated to lower infection incidence, manifested by FN, when administered once-per-cycle 24 hrs after chemotherapy (CT). However, eliminating an office visit the day after CT is desirable. Methods: Pts ≥ 18 years with previously untreated non-Hodgkin’s lymphoma (NHL) who received R-CHOP (rituximab 375 mg/m2, C 750 mg/m2, H 50 mg/m2, O 1.4 mg/m2, prednisone 100 mg; for 6 cycles Q21D) were randomized 1:1 to pegfilgrastim 6mg within 4 hours or ∼24hrs after CT. The primary endpoint was the duration of severe (grade 4) neutropenia (DSN) in cycle 1. Same-day administration was considered noninferior to next-day if the upper limit of the 2-sided 95% CI for the difference in mean cycle 1 DSN (same day - next day) was <2 days. Results: 77 pts (8 mantle-cell, 69 diffuse large B-cell) were enrolled of 90 planned (due to slow accrual). 75 pts (36 same-day, 39 next-day) received CT and pegfilgrastim. Most pts had stage 3/4 disease (69% same-day, 74% next-day), no bone marrow involvement (75% same-day, 69% next-day) and ECOG status 0 or 1 (94% same-day, 97% next-day). Difference in mean cycle 1 DSN was 0.9 days (95% CI: 0.3–1.4) longer in the same-day than the next-day group (mean [SD]: 2.1 [1.22] vs 1.2 [1.20] days; grade 4 neutropenia incidence: 86% vs 64%). In cycle 1, more pts had a DSN ≥ 3 days in the same-day (36%) than the next-day group (15%). In cycle 4, mean DSN was longer in the same-day than the next-day group (mean [SD] 1.4 [1.40] vs 0.7 [0.94] days; grade 4 neutropenia incidence: 57% vs 42%). Pts in the 2 groups had similar occurrence of FN (17% vs 15%) and serious adverse events (33% vs 36%) across the study. Full dose on schedule, and the incidence of IV anti-infective use or hospitalization due to FN were also similar between groups. Conclusions: In cycles 1 and 4, the mean DSN was nearly 1 day longer for pts in the same-day group compared with the next-day group. Although the protocol-specified 2-day non-inferiority margin for DSN was met, for pts with NHL receiving R-CHOP, we recommend administering pegfilgrastim 24 hours after CT per labeling guidelines. [Table: see text]
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Affiliation(s)
- A. Saven
- Ida M. and Cecil H. Green Cancer Center, Scripps C, La Jolla, CA; West Clinic, Memphis, TN; Oncology/Hematology Group of South Florida, Miami, FL; University Siteman Cancer Center, St. Louis, MO; Amgen, Inc., Thousand Oaks, CA
| | - L. Schwartzberg
- Ida M. and Cecil H. Green Cancer Center, Scripps C, La Jolla, CA; West Clinic, Memphis, TN; Oncology/Hematology Group of South Florida, Miami, FL; University Siteman Cancer Center, St. Louis, MO; Amgen, Inc., Thousand Oaks, CA
| | - P. Kaywin
- Ida M. and Cecil H. Green Cancer Center, Scripps C, La Jolla, CA; West Clinic, Memphis, TN; Oncology/Hematology Group of South Florida, Miami, FL; University Siteman Cancer Center, St. Louis, MO; Amgen, Inc., Thousand Oaks, CA
| | - N. Bartlett
- Ida M. and Cecil H. Green Cancer Center, Scripps C, La Jolla, CA; West Clinic, Memphis, TN; Oncology/Hematology Group of South Florida, Miami, FL; University Siteman Cancer Center, St. Louis, MO; Amgen, Inc., Thousand Oaks, CA
| | - L. Dean
- Ida M. and Cecil H. Green Cancer Center, Scripps C, La Jolla, CA; West Clinic, Memphis, TN; Oncology/Hematology Group of South Florida, Miami, FL; University Siteman Cancer Center, St. Louis, MO; Amgen, Inc., Thousand Oaks, CA
| | - S. Shahin
- Ida M. and Cecil H. Green Cancer Center, Scripps C, La Jolla, CA; West Clinic, Memphis, TN; Oncology/Hematology Group of South Florida, Miami, FL; University Siteman Cancer Center, St. Louis, MO; Amgen, Inc., Thousand Oaks, CA
| | - L. Dreiling
- Ida M. and Cecil H. Green Cancer Center, Scripps C, La Jolla, CA; West Clinic, Memphis, TN; Oncology/Hematology Group of South Florida, Miami, FL; University Siteman Cancer Center, St. Louis, MO; Amgen, Inc., Thousand Oaks, CA
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