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Geyer CE, Loibl S, Rastogi P, Seiler S, Costantino JP, Nekljudova VN, Cortazar P, Lucas PC, Denkert C, Mamounas EP, Jackisch C, Wolmark N. Abstract OT3-05-01: A randomized double-blind phase III clinical trial of neoadjuvant chemotherapy (NAC) with atezolizumab or placebo in patients (pts) with triple negative breast cancer (TNBC) followed by adjuvant atezolizumab or placebo: NSABP B-59/GBG 96-GeparDouze. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot3-05-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
TNBC is associated with higher percentages of pathological complete response (pCR) to neoadjuvant chemotherapy (NAC), and women with a pCR have a favorable prognosis. However, Liedtke (2008) and Loibl (2017) found that women with residual disease have a substantially higher risk of recurrence than women with other subtypes of breast cancer. Additionally, Adams (2017) and Schmid (2017) found that therapeutic blockade of PD-L1 binding by atezolizumab has resulted in relevant anti-tumor efficacy.
Methods:
Design
This is a phase III, double blind, placebo-control trial evaluating neoadjuvant atezolizumab with NAC followed by adjuvant atezolizumab in TNBC. Pts are stratified by region (North America; Europe), tumor size (1.1-3.0cm; >3.0cm), AC/EC schedule (q2w; q3w), and nodal status (positive; negative), then randomized 1:1 to receive atezolizumab/placebo 1200 mg IV every 3 wks concurrently with both sequential regimens of weekly paclitaxel 80 mg/m2 IV for 12 doses with every 3-wk carboplatin AUC of 5 IV for 4 doses followed by AC/EC every 2-3 wks (per investigator discretion) for 4 cycles. Following surgery, pts resume atezolizumab/placebo 1200 mg IV every 3 wks as adjuvant therapy for 6 months. Radiotherapy based on local standards is co-administered with atezolizumab/placebo.
Eligibility criteria
Centrally-confirmed ER-neg, PR-neg, HER2-neg invasive breast cancer by ASCO/CAP guidelines. Primary tumor must be stage T2 or T3 if cN0 or cN1 with negative biopsy or T1c, T2, or T3 if cN1 with positive biopsy or cN2 or cN3. LVEF >55% and no significant cardiac history.
Statistical methods
Co-primary endpoints are event-free survival (EFS) and pCR breast/nodes. Secondary endpoints include pCR breast, overall survival, distant disease-free survival, safety and toxicity. Trial is an academic collaboration between NSABP and GBG with support from Genentech/Roche.
NCT03281954
Support: Genentech/Roche
Citation Format: Geyer, Jr. CE, Loibl S, Rastogi P, Seiler S, Costantino JP, Nekljudova VN, Cortazar P, Lucas PC, Denkert C, Mamounas EP, Jackisch C, Wolmark N. A randomized double-blind phase III clinical trial of neoadjuvant chemotherapy (NAC) with atezolizumab or placebo in patients (pts) with triple negative breast cancer (TNBC) followed by adjuvant atezolizumab or placebo: NSABP B-59/GBG 96-GeparDouze [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-05-01.
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Affiliation(s)
- CE Geyer
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - S Loibl
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - P Rastogi
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - S Seiler
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - JP Costantino
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - VN Nekljudova
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - P Cortazar
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - PC Lucas
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - C Denkert
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - EP Mamounas
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - C Jackisch
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - N Wolmark
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
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Cortazar P, Zhang L, Untch M, Mehta K, Constantino J, Wolmark N, Bonnefoi H, Piccart M, Gianni L, Valagussa P, Zujewski JA, Justice R, Loibl S, Swain SM, Bogaerts J, Baselga J, Prowell TM, Rastogi P, Sridhara R, Tang S, Pazdur R, Mamounas E, von Minckwitz G. Abstract P5-17-01: A definition of a high-risk early-breast cancer population based on data from the collaborative trials in neoadjuvant breast cancer (CTNeoBC) meta-analysis. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p5-17-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Pathological complete response (pCR) is a proposed surrogate endpoint for predicting long-term clinical benefit on endpoints such as event-free survival (EFS) or overall survival (OS). The CTNeoBC meta-analysis did not validate the surrogacy of pCR for EFS or OS, and there is no precedent for its use as a regulatory endpoint in oncology. Use of the accelerated approval pathway has been proposed for neoadjuvant therapies that substantially improve pCR as a means to expedite widespread access to highly effective therapies for high-risk, early breast cancer. Potential risks of this approach include approving an agent that ultimately does not demonstrate clinical benefit and, in the interim, exposing curable patients to the toxicity of therapy without certainty of benefit. To mitigate the risks of this pathway, enrollment to neoadjuvant trials intended to support accelerated approval should be restricted to patients presenting with high-risk early-stage breast cancer. The 5-year EFS rate by breast cancer subtype in the CTNeoBC meta-analysis population is presented. Methods: We identified 12 neoadjuvant randomized trials (N = 12,993) with pCR clearly defined and long-term follow-up available for EFS and OS. Trials included AGO 1 (n = 668), ECTO (n = 1355), EORTC 10994/BIG 1-00 (n = 1856), GeparDuo (n = 907), GeparQuattro (n = 1495), GeparTrio (n = 2072), GeparTrio-Pilot (n = 285), NOAH (n = 234), NSABP B18 (n = 760), NSABP B27 (n = 2411), PREPARE (n = 733), and TECHNO (n = 217). The key objective of this analysis was to establish a definition of “high-risk” based on the Kaplan-Meier estimates of the 5-year EFS rate in the different clinical breast cancer subtypes (hormone receptor-positive, HER2-positive and triple-negative) analyzed by tumor stage and tumor grade at presentation. Results: The 5-year EFS rate was less than 65% in all the breast cancer subtypes with stage III disease. For patients with stage II disease, the impact of tumor grade varied by hormone receptor status. Patients with hormone receptor-negative breast cancer, regardless of HER2 status had a poor prognosis that was independent of tumor grade. For patients with hormone receptor-positive tumors, regardless of HER2 status, high grade histology was associated with an increased risk of recurrence.
5-year Event-Free Survival Rate (EFS) 5-year EFS Rate Estimate (95% confidence interval)TNMStage IIStage III Grade IIGrade IIIGrade IIGrade IIIHormone Receptor + HER2-83% (80%, 85%)71% (65%, 77%)63% (58%, 69%)51% (42%, 59%)HER2+ HR+81% (75%, 86%)69% (60%, 76%)50% (41%, 59%)48% (37%, 59%)HER2+ HR-61% (51%, 70%)66% (57%, 73%)58% (46%, 69%)46% (36%, 55%)Triple Negative66% (58%, 72%)72% (67%, 76%)38% (27%, 48%)37% (29%, 45%)
Conclusions: This analysis estimated the 5-year EFS rate in the breast cancer subtypes from the CTNeoBC meta-analysis population. The HER2-positive population in the meta-analysis was at particularly high risk because most of the patients had locally advanced breast cancer and only 39% of these patients received trastuzumab therapy. We propose defining less than 75% 5-year EFS rate as “high-risk” for the purposes of designing neoadjuvant trials that intend to use pCR to support accelerated approval.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-17-01.
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Affiliation(s)
- P Cortazar
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - L Zhang
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - M Untch
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - K Mehta
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - J Constantino
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - N Wolmark
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - H Bonnefoi
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - M Piccart
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - L Gianni
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - P Valagussa
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - JA Zujewski
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - R Justice
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - S Loibl
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - SM Swain
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - J Bogaerts
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - J Baselga
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - TM Prowell
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - P Rastogi
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - R Sridhara
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - S Tang
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - R Pazdur
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - E Mamounas
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
| | - G von Minckwitz
- FDA; HELIOS Klinikum Berlin-Buch, Berlin, Germany, D-13125; GBG Forschungs GmbH, Germany; NSABP, Pittsburgh, PA; Institut Bergonié, INSERM U916; Jules Bordet Institute, Brussels, Belgium; San Raffaele Scientific Insitute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; Cancer Therapy Evaluation Program, NCI, Bethesda, MD; Medstar Washington Hospital Center, Washington, DC; EORTC Headquarters, Brussels, Belgium; Memorial Sloan-Kettering Cancer Center, New York; Orlando Health MD Anderson Cancer Center
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