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Walls GM, Oughton JB, Chalmers AJ, Brown S, Collinson F, Forster MD, Franks KN, Gilbert A, Hanna GG, Hannaway N, Harrow S, Haswell T, Hiley CT, Hinsley S, Krebs M, Murden G, Phillip R, Ryan AJ, Salem A, Sebag-Montefoire D, Shaw P, Twelves CJ, Walker K, Young RJ, Faivre-Finn C, Greystoke A. CONCORDE: A phase I platform study of novel agents in combination with conventional radiotherapy in non-small-cell lung cancer. Clin Transl Radiat Oncol 2020; 25:61-66. [PMID: 33072895 PMCID: PMC7548952 DOI: 10.1016/j.ctro.2020.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 12/18/2022] Open
Abstract
Lung cancer is the leading cause of cancer mortality worldwide and most patients are unsuitable for 'gold standard' treatment, which is concurrent chemoradiotherapy. CONCORDE is a platform study seeking to establish the toxicity profiles of multiple novel radiosensitisers targeting DNA repair proteins in patients treated with sequential chemoradiotherapy. Time-to-event continual reassessment will facilitate efficient dose-finding.
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Key Words
- ATM, Ataxia telangiectasia mutated
- ATR, Ataxia telangiectasia and Rad3 related
- CRT, Chemoradiotherapy
- CT, Computed tomography
- CTCAE, Common terminology criteria for adverse events
- CTRad, Clinical and Translational Radiotherapy Research Working Group
- Continual reassessment method
- DDRi, DNA damage response inhibitor
- DLT, Dose limiting toxicity
- DNA damage repair inhibitor
- DNA, Deoxyribonucleic acid
- DNA-PK, DNA-dependent protein kinase
- ECOG, Eastern Cooperative Oncology Group
- EORTC, European Organisation for Research and Treatment of Cancer
- ICRU, International Commission on Radiation Units and Measurements
- IMPs, Investigational medicinal products
- LA, Locally advanced
- MRC, Medical Research Council
- NCRI, National Cancer Research Institute
- NSCLC, Non-small cell lung cancer
- Non-small cell lung cancer
- PARP, Poly (ADP-ribose) polymerase
- PET, Positron emission tomography
- PFS, Progression free survival
- PROMs, Patient-reported outcome measures
- Platform trial
- RECIST, Response evaluation criteria in solid tumours
- RP2D, Recommended phase II dose
- RT, Radiotherapy
- SACT, Systemic anti-cancer therapy
- SRC, Safety review committee
- Sequential chemoradiotherapy
- TNM, Tumour node metastasis
- TiTE-CRM, Time to event continual reassessment method
- cfDNA, Cell-free DNA
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Affiliation(s)
- Gerard M. Walls
- Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Northern Ireland, UK
| | - Jamie B. Oughton
- Leeds Institute of Clinical Trials Research, University of Leeds, England, UK
| | | | - Sarah Brown
- Leeds Institute of Clinical Trials Research, University of Leeds, England, UK
| | - Fiona Collinson
- Leeds Institute of Clinical Trials Research, University of Leeds, England, UK
| | | | - Kevin N. Franks
- St James’ Institute of Oncology, University of Leeds, England, UK
| | | | - Gerard G. Hanna
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia
| | | | - Stephen Harrow
- The Beatson West of Scotland Cancer Centre, Glasgow, Scotland, UK
| | | | | | - Samantha Hinsley
- Leeds Institute of Clinical Trials Research, University of Leeds, England, UK
- Institute of Cancer Sciences, University of Glasgow, Scotland, UK
| | - Matthew Krebs
- Faculty of Biology, Medicine and Health, University of Manchester, England, UK
| | - Geraldine Murden
- Leeds Institute of Clinical Trials Research, University of Leeds, England, UK
| | - Rachel Phillip
- Leeds Institute of Clinical Trials Research, University of Leeds, England, UK
| | - Anderson J. Ryan
- Oxford Institute for Radiation Oncology, University of Oxford, Oxford, England, UK
| | - Ahmed Salem
- The Christie NHS Foundation Trust/University of Manchester, Manchester, England, UK
| | | | - Paul Shaw
- Velindre University NHS Trust, Cardiff, Wales, UK
| | - Chris J. Twelves
- St James’ Institute of Oncology, University of Leeds, England, UK
| | - Katrina Walker
- Leeds Institute of Clinical Trials Research, University of Leeds, England, UK
| | - Robin J. Young
- Academic Unit of Clinical Oncology, Weston Park Hospital, Sheffield, England, UK
| | - Corinne Faivre-Finn
- Oxford Institute for Radiation Oncology, University of Oxford, Oxford, England, UK
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Hentze JL, Høgdall C, Kjær SK, Blaakær J, Høgdall E. Searching for new biomarkers in ovarian cancer patients: Rationale and design of a retrospective study under the Mermaid III project. Contemp Clin Trials Commun 2017; 8:167-174. [PMID: 29696206 PMCID: PMC5898550 DOI: 10.1016/j.conctc.2017.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/28/2017] [Accepted: 10/04/2017] [Indexed: 02/06/2023] Open
Abstract
Ovarian cancer is a silent killer and, due to late diagnosis, the primary cause of death amongst gynecological cancers, killing approximately 376 women annually in Denmark. The discovery of a specific and sensitive biomarker for ovarian cancer could improve early diagnosis, but also treatment, by predicting which patients will benefit from specific treatment strategies. The Mermaid III project is consisting of 3 parts including "Early detection, screening and long-term survival," "Biomarkers and/or prognostic markers" and "The infection theory." The present paper gives an overview of the part regarding biomarkers and/or prognostic markers, with a focus on rationale and design. The study described has 3 major branches: microRNAs, epigenetics and Next Generation Sequencing. Tissue and blood from ovarian cancer patients, already enrolled in the prospective ongoing pelvic mass cohort, will be examined. Relevant microRNAs and DNA methylation patterns will be investigated using array technology. Patient exomes will be fully sequenced, and identified genetic variations will be validated with Next Generation Sequencing. In all cases, data will be correlated with clinical information on the patient, in order to identify possible biomarkers. A thorough investigation of biomarkers in ovarian cancer, including large numbers of different markers, has never been done before. Besides from improving diagnosis and treatment, other outcomes could be markers for screening, knowledge of the molecular aspects of cancer and the discovery of new drugs. Moreover, biomarkers are a prerequisite for the development of precision medicine. This study will attack the ovarian cancer problem from several angles, thereby increasing the chance of successfully contributing to saving lives.
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Key Words
- CA125, Cancer Antigen 125
- CPH-I, Copenhagen Index
- DGCD, Danish Gynecologic Cancer Database
- Diagnostic/prognostic biomarkers
- Epigenetics
- FFPE, Formalin fixed and paraffin embedded
- FIGO, International Federation of Gynecology and Obstetrics
- HE4, Human Epididymis Protein 4
- MALOVA, MALignant OVArian cancer study
- MicroRNA
- NGS, Next Generation Sequencing
- Next Generation Sequencing
- O.C.T., Optimal cutting temperature
- OC, Ovarian cancer
- OS, Overall survival
- Ovarian cancer
- PARP, poly(adenosine diphosphate [ADP]-ribose) polymerase
- PFS, Progression free survival
- RMI, Risk of Malignancy Index
- ROCA, Risk of Ovarian Cancer Algorithm
- ROMA, Risk of Ovarian Malignancy Algorithm
- UKCTOCS, UK Collaborative Trial of OC Screening
- miRNAs, MicroRNAs
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Affiliation(s)
- Julie L. Hentze
- Department of Pathology, Herlev Hospital, Herlev, Copenhagen University Hospital, Denmark
| | - Claus Høgdall
- Department of Gynecology, The Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Susanne K. Kjær
- Department of Gynecology, The Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jan Blaakær
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Estrid Høgdall
- Department of Pathology, Herlev Hospital, Herlev, Copenhagen University Hospital, Denmark
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Abstract
Currently, the backbone of therapy for metastatic disease is cytotoxic chemotherapy, along with the recent addition of targeted therapy based on molecular markers with KRAS testing. Despite the improvement in survival for metastatic colon cancer, newer agents are still needed. The clinical activity of TroVax in metastatic colon cancer has been studied in a small number of clinical trials. There is evidence that supports the vaccine's ability to induce humoral and cellular responses, as demonstrated by positive 5T4 and MVA-specific antibody titers and cellular proliferation assays. Future strategies should focus on investigating the immunomodulatory effects of chemotherapy in conjunction with TroVax, understanding the optimal dosing and schedule of the combination, and examining potential predictive biomarkers to determine which patients may benefit from immunotherapy from those who do not.
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Key Words
- 5T4-antigen
- ADCC, Antibody-dependent cell-mediated cytotoxicity
- CEA, Carcinoembryonic antigen
- CRC, Colorectal cancer
- DT, Doubling time
- EBNA-1, Epstein Barr-Virus nuclear antigen-1
- EGFR, Epidermal growth factor receptor
- HRPC, Hormone refractory prostate cancer
- IHC, Immunohistochemoical
- ITT, Intention to treat
- LMP-2, Latent membrane protein-2 antigens
- MSKCC, Memorial Sloan-Kettering Cancer Center
- MVAs, Modified vaccinia Ankara
- NSCLC, Non-small cell lung cancer
- OS, Overall survival
- PD-1, Programmed death 1 receptor
- PD-L1, Programmed-death ligand 1
- PFS, Progression free survival
- PMNs, Peripheral blood mononuclear cells
- RCC, Renal cell carcinoma
- T-FOLFIRI, Trovax and FOLFIRI
- T-FOLFOX, Trovax and FOLFOX
- TAAs, Tumor-associated antigens
- TILs, Tumor-infiltrating lymphocytes
- TTP, Time to progression
- TroVax
- VEGF, Vascular-endothelial growth factor
- immunotherapy
- mCRC, Metastatic colon cancer
- mRCC, Metastatic renal cell carcinoma
- metastatic colon cancer
- modified vaccinia Ankara
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Affiliation(s)
- Julie Rowe
- a Division of Oncology; Department of Internal Medicine ; The University of Texas Health Science Center at Houston and Memorial Hermann Cancer Center ; Houston , TX USA
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