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Wonglhow J, Sunpaweravong P, Sathitruangsak C, Lucien Geater S, Dechaphunkul A. 127P LABS score: The prognostic tool for advanced hepatocellular carcinoma treated with FOLFOX4 and real-world efficacy from a single-center retrospective study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Chao Y, Maglakelidze M, Bulat L, Yau T, Tanasanvimon S, Charoentum C, Arpornwirat W, Maneechavakajorn J, Dechaphunkul A, Ungtrakul T, Yen CJ, Bai LY, Chou WC, Weidermann U, Garner-Spitzer E, Ede N, Chong L, Good A. A Phase Ib Study of IMU-131 HER2/neu peptide vaccine plus chemotherapy in patients with HER2/neu overexpressing metastatic or advanced adenocarcinoma of the stomach or gastroesophageal junction. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz422.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Guo Y, Ahn MJ, Chan A, Wang CH, Kang JH, Kim SB, Bello M, Arora RS, Zhang Q, He X, Li P, Dechaphunkul A, Kumar V, Kamble K, Li W, Kandil A, Cohen EEW, Geng Y, Zografos E, Tang PZ. Afatinib versus methotrexate as second-line treatment in Asian patients with recurrent or metastatic squamous cell carcinoma of the head and neck progressing on or after platinum-based therapy (LUX-Head & Neck 3): an open-label, randomised phase III trial. Ann Oncol 2019; 30:1831-1839. [PMID: 31501887 PMCID: PMC6927323 DOI: 10.1093/annonc/mdz388] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Treatment options are limited for patients with recurrent or metastatic squamous cell carcinoma of the head and neck (HNSCC) following progression after first-line platinum-based therapy, particularly in Asian countries. PATIENTS AND METHODS In this randomised, open-label, phase III trial, we enrolled Asian patients aged ≥18 years, with histologically or cytologically confirmed recurrent/metastatic HNSCC following first-line platinum-based therapy who were not amenable for salvage surgery or radiotherapy, and had an Eastern Cooperative Oncology Group (ECOG) performance status of 0/1. Patients were randomised (2 : 1) to receive oral afatinib (40 mg/day) or intravenous methotrexate (40 mg/m2/week), stratified by ECOG performance status and prior EGFR-targeted antibody therapy. The primary end point was progression-free survival (PFS) assessed by an independent central review committee blinded to treatment allocation. RESULTS A total of 340 patients were randomised (228 afatinib; 112 methotrexate). After a median follow-up of 6.4 months, afatinib significantly decreased the risk of progression/death by 37% versus methotrexate (hazard ratio 0.63; 95% confidence interval 0.48-0.82; P = 0.0005; median 2.9 versus 2.6 months; landmark analysis at 12 and 24 weeks, 58% versus 41%, 21% versus 9%). Improved PFS was complemented by quality of life benefits. Objective response rate was 28% with afatinib and 13% with methotrexate. There was no significant difference in overall survival. The most common grade ≥3 drug-related adverse events were rash/acne (4% with afatinib versus 0% with methotrexate), diarrhoea (4% versus 0%), fatigue (1% versus 5%), anaemia (<1% versus 5%) and leukopenia (0% versus 5%). CONCLUSIONS Consistent with the phase III LUX-Head & Neck 1 trial, afatinib significantly improved PFS versus methotrexate, with a manageable safety profile. These results demonstrate the efficacy and feasibility of afatinib as a second-line treatment option for certain patients with recurrent or metastatic HNSCC. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01856478.
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Affiliation(s)
- Y Guo
- Department of Medical Oncology, Shanghai East Hospital, Tongji University, Shanghai, China.
| | - M-J Ahn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - A Chan
- State Key Laboratory in Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - C-H Wang
- Department of Medical Oncology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - J-H Kang
- The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul
| | - S-B Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - M Bello
- Department of Oncology, St Luke's Medical Center, Quezon City, Philippines
| | - R S Arora
- Department Oncology, Sujan Surgical Cancer Hospital and Amravati Cancer Foundation, Amravati, India
| | - Q Zhang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - X He
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Science, Beijing
| | - P Li
- West China Hospital, Sichuan University, Chengdu, China
| | - A Dechaphunkul
- Division of Medical Oncology, Prince of Songkla University, Songkhla, Thailand
| | - V Kumar
- Department of Surgical Oncology, King George's Medical University, Lucknow
| | - K Kamble
- Department of Medicine, Government Medical College and Hospital, Nagpur, India
| | - W Li
- Department of Hematology and Oncology, First Hospital Affiliated to Jilin University, Jilin, China
| | - A Kandil
- Internal Medicine, Alexandria University Hospital, Alexandria, Egypt
| | - E E W Cohen
- Department of Medicine, University of California, San Diego, USA
| | - Y Geng
- Biostatistics, Boehringer Ingelheim (China) Investment Co., Ltd, China
| | - E Zografos
- Clinical Development and Medical Affairs, Boehringer Ingelheim Ltd, Bracknell, Berkshire, UK
| | - P Z Tang
- Department of Oncology, Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wiedermann U, Garner-Spitzer E, Chao Y, Bulat I, Dechaphunkul A, Arpornwirat W, Charoentum C, Yen C, Yau T, Maglakelidzde M, Tanasanvimon S, Maneechavakajorn J, Sookprasert A, Bai LY, Chou WC, Ungtrakul T, Zielinski C, Chong L, Ede N, Good A. Comprehensive results of a phase Ib study with a HER2/neu B-cell peptide vaccine administered with cisplatin and 5-fluorouracil or capecitabine chemotherapy show safety, immunogenicity and clinical response in patients with HER2/Neu overexpressing advanced gastric cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.038] [Citation(s) in RCA: 1] [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: 11/13/2022] Open
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Rattanakhot N, Dechaphunkul A, Sunpaweravong P, Sathitruangsak C, Maisrikrod A, Songserm M, Jiratrachu R, Sangthawan D, Peerawong T, Phungrassami T, Rordlamool P, Sakdejayont S. Cancer care through the fire and flames: 3-year experience in the utilisation of electronic consultation and referral system at the red zone in Southern Thailand. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz272.009] [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: 11/13/2022] Open
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Clingan P, Mant A, Richardson G, Kowalski D, Koralewski P, Lugowska I, Dechaphunkul A, Charoentum C, Sookprasert A, Sriuranpong V, Akopov A, Kozlov V, Fadeeva N, Kasparov B, Kovalenko N, Oschepkov V, Gorelik L, Kunes Y, Oliviero J, Harris D. Safety, efficacy, and pharmacokinetic (PK) profile of cosibelimab, an anti‐PD‐L1 antibody, in patients (pts) with advanced cancers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.031] [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: 11/13/2022] Open
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Zhang L, Lu S, Feng J, Dechaphunkul A, Chang J, Wang D, Chessari S, Lanzarotti C, Jordan K, Aapro M. A randomized phase III study evaluating the efficacy of single-dose NEPA, a fixed antiemetic combination of netupitant and palonosetron, versus an aprepitant regimen for prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving highly emetogenic chemotherapy (HEC). Ann Oncol 2019; 29:452-458. [PMID: 29092012 PMCID: PMC5834144 DOI: 10.1093/annonc/mdx698] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Co-administration of multiple antiemetics that inhibit several molecular pathways involved in emesis is required to optimize chemotherapy-induced nausea and vomiting (CINV) control in patients receiving highly emetogenic chemotherapy (HEC). NEPA, a fixed combination of a highly selective NK1 receptor antagonist, netupitant (300 mg), and the pharmacologically distinct 5-HT3RA, palonosetron (PALO 0.50 mg), has shown superior CINV prevention compared with PALO in cisplatin and anthracycline/cyclophosphamide-based settings. This study is the first head-to-head comparison of NEPA versus an aprepitant (APR)/granisetron (GRAN) regimen. Patients and methods This randomized, double-blind phase III study conducted in Asia was designed with the primary objective to demonstrate non-inferiority of a single oral dose of NEPA compared with a 3-day oral APR/GRAN regimen in chemotherapy-naïve patients receiving cisplatin-based HEC. All patients also received oral dexamethasone (DEX) on days 1–4. The primary efficacy endpoint was complete response (CR: no emesis/no rescue medication) during the overall (0–120 h) phase. Non-inferiority was defined as a lower 95% CI greater than the non-inferiority margin set at − 10%. Secondary efficacy endpoints included no emesis, no rescue medication, and no significant nausea (NSN). Results Treatment groups were comparable for the 828 patients analyzed: predominantly male (71%); mean age 54.5 years; ECOG 0–1 (98%); lung cancer (58%). NEPA demonstrated non-inferiority to APR/GRAN for overall CR [NEPA 73.8% versus APR/GRAN 72.4%, 95% CI (−4.5%, 7.5%)]. No emesis [NEPA 75.0% versus APR/GRAN 74.0%, 95% CI (−4.8%, 6.9%)] and NSN rates [NEPA 75.7% versus APR/GRAN 70.4%, 95% CI (−0.6%, 11.4%)] were similar between groups, but significantly more NEPA patients did not take rescue medication [NEPA 96.6% versus APR/GRAN 93.5%, 95% CI (0.2%, 6.1%)]. NEPA was well tolerated with a similar safety profile to APR/GRAN. Conclusions In this first study comparing NK1RA regimens and DEX, NEPA administered only on day 1 was non-inferior to a 3-day oral APR/GRAN regimen in preventing CINV associated with HEC.
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Affiliation(s)
- L Zhang
- State Key Laboratory of Oncology in South China, Guangzhou, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Medical Oncology Department, Sun Yat-Sen University Cancer Center, Guangzhou, China.
| | - S Lu
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - J Feng
- Medical Oncology, Jiangsu Cancer Hospital, Nanjing, China
| | - A Dechaphunkul
- Division of Medical Oncology, Internal Medicine, Prince of Songkla University, Songkhla, Thailand
| | - J Chang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - D Wang
- Cancer Center, Daping Hospital, Third Military Medical University, Chongqing, China
| | - S Chessari
- Corporate Clinical Development, Helsinn Healthcare, Lugano, Switzerland
| | - C Lanzarotti
- Statistics and Data Management, Helsinn Healthcare, Lugano, Switzerland
| | - K Jordan
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - M Aapro
- Cancer Center, Clinique de Genolier, Genolier, Switzerland
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Dechaphunkul T, Ngamphaiboon N, Danchaivijitr P, Jiratrachu R, Dechaphunkul A. Prophylactic percutaneous endoscopic gastrostomy in patients with nasopharyngeal carcinoma receiving concurrent chemoradiotherapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy438.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Planchard D, Boyer M, Lee JS, Dechaphunkul A, Cheema P, Takahashi T, Todd A, McKeown A, Rukazenkov Y, Ohe Y. Osimertinib vs standard of care (SoC) EGFR-TKI as first-line therapy in patients (pts) with untreated EGFRm advanced NSCLC: FLAURA post-progression outcomes. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Dechaphunkul A, Lu S, Olivari S, Zhang L. Efficacy of single dose NEPA, a fixed combination of netupitant and palonosetron, versus a 3-day regimen of aprepitant/granisetron (APR/GRAN) for prevention of nausea in patients receiving high dose cisplatin. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy444.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Danchaivijitr P, Dechaphunkul A, Paoin C, Setakornnukul J, Dechaphunkul T, Jiratrachu R, Niyomnaitham S, Suktitipat B, Sookthon C, Pattaranutaporn P, Jiarpinitnun C, Ngamphaiboon N. Survival benefit of adjuvant chemotherapy vs active surveillance in locally advanced nasopharyngeal carcinoma: A multicenter retrospective study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.029] [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: 11/12/2022] Open
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Dechaphunkul A, Danchaivijitr P, Jiratrachu R, Dechaphunkul T, Sookthon C, Jiarpinitnun C, Paoin C, Setakornnukul J, Niyomnaitham S, Suktitipat B, Pattaranutaporn P, Ngamphaiboon N. Comparison of 3-weekly cisplatin versus 3-weekly carboplatin in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) receiving concurrent chemoradiotherapy (CCRT): A multicenter retrospective study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.032] [Citation(s) in RCA: 1] [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: 11/13/2022] Open
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Thongwatchara P, Thongsuksai P, Dechaphunkul T, Dechaphunkul A. Frequency of PIK3CA mutations in head and neck squamous cell carcinoma (HNSCC) in southern Thailand. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zhang L, Lu S, Dechaphunkul A, Chessari S, Lanzarotti C, Jordan K, Aapro M. Phase 3 efficacy results of a single dose of NEPA, a fixed combination of netupitant and palonosetron, versus a 3-day regimen of aprepitant/granisetron (APR/GRAN) for prevention of chemotherapy-induced nausea and vomiting (CINV) in Chinese patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cho B, Chewaskulyong B, Lee K, Dechaphunkul A, Sriuranpong V, Imamura F, Ohe Y, Nogami N, Kurata T, Okamoto I, Zhou C, Cheng Y, Cho E, Jye V, Lee JS, Mann H, Saggese M, Reungwetwattana T. Osimertinib vs standard of care (SoC) EGFR-TKI as first-line treatment in patients with EGFR-TKI sensitising mutation (EGFRm) positive advanced non-small cell lung cancer (NSCLC): FLAURA Asian subset. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx729.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lu S, Zhang L, Dechaphunkul A, Lanzarotti C, Jordan K, Aapro M. MA 08.02 Efficacy of Single-Dose NEPA versus 3-Day Aprepitant Regimen for Prevention of CINV: A Phase 3 Lung Cancer Subset Analysis. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.516] [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: 11/26/2022]
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Reungwetwattana T, Laohavinij S, Lamlertthon W, Chewaskulyong B, Dechaphunkul A, Detarkom S, Muntham D, Poovorawan N, Srimuninnimit V, Sriuranpong V. P3.01-042 Efficacy & Tolerability of Afatinib in NSCLC Patients Prior Exposure to 1st Generation EGFR TKI: Thailand Multicenter Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1483] [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: 11/16/2022]
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Ohe Y, Ramalingam S, Reungwetwattana T, Chewaskulyong B, Dechaphunkul A, Lee K, Imamura F, Nogami N, Cheng Y, Cho B, Cho E, Vansteenkiste J, Voon P, Zhou C, Gray J, Hodge R, Rukazenkov Y, Soria JC. Osimertinib vs standard of care EGFR-TKI as first-line treatment in patients with EGFRm advanced NSCLC: FLAURA. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx671.002] [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: 11/13/2022] Open
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Zhang L, Lu S, Feng J, Dechaphunkul A, Chessari S, Lanzarotti C, Jordan K, Aapro M. Quality of life (QOL) evaluation of patients in a phase 3 study comparing NEPA with an aprepitant regimen for prevention of chemotherapy-induced nausea and vomiting (CINV). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.008] [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: 11/13/2022] Open
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Ramalingam S, Reungwetwattana T, Chewaskulyong B, Dechaphunkul A, Lee K, Imamura F, Nogami N, Ohe Y, Cheng Y, Cho B, Cho E, Vansteenkiste J, Voon P, Zhou C, Gray J, Hodge R, Rukazenkov Y, Soria JC. Osimertinib vs standard of care (SoC) EGFR-TKI as first-line therapy in patients (pts) with EGFRm advanced NSCLC: FLAURA. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.050] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Soulières D, Faivre S, Mesía R, Remenár E, Li S, Karpenko A, Dechaphunkul A, Keilholz U, Kiss L, Lin J, Nagarkar R, Tamás L, Kim S, Erfán J, Alyasova A, Yovine A, Le Mouhaër S, Solovieff N, Turri S, Licitra L. OC-021: Biomarker results from BERIL-1: buparlisib and paclitaxel in patients with platinum-pretreated SCCHN. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30169-x] [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: 11/16/2022]
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Guo J, Chang WC, Dechaphunkul A, Fan Y, Kim T, Lin CC, Maneechavakajorn J, Shin S, Song X, Cheng ST, Thongprasert S, Wong C, Wu D, Zhang X, Bettinger S, Zhang P, Mookerjee B. 414TiP An open-label phase 2a study of combination dabrafenib (D) and trametinib (T) in Asian patients (pts) with advanced BRAF V600–mutant acral lentiginous melanoma (ALM) or cutaneous melanoma (CM). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw589.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Guo J, Chang WC, Dechaphunkul A, Fan Y, Kim T, Lin CC, Maneechavakajorn J, Shin S, Song X, Cheng ST, Thongprasert S, Wong B, Wu D, Zhang X, Bettinger S, Zhang P, Mookerjee B. 414TiP An open-label phase 2a study of combination dabrafenib (D) and trametinib (T) in Asian patients (pts) with advanced BRAF V600-mutant acral lentiginous melanoma (ALM) or cutaneous melanoma (CM). Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00572-x] [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: 11/15/2022] Open
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Tang P, Ahn MJ, Zhang Q, Chan A, Kim SB, Wang CH, He X, Guo W, Kang J, Dechaphunkul A, Li P, Kandil A, Cohen E, Hu GQ, Geng Y, Ehrnrooth E, Guo Y. 340TiP Phase III study of afatinib vs methotrexate (MTX) for second-line recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients after platinum-based chemotherapy (CT) in Asia/Middle East/North Africa: LUX-Head & Neck 3 (LUX-H&N3). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv527.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pervez N, El-Gehani F, Joseph K, Dechaphunkul A, Kamal M, Pertschy D, Venner P, Ghosh S, North S. Genitourinary small-cell carcinoma: a single-institution experience. ACTA ACUST UNITED AC 2013; 20:258-64. [PMID: 24155630 DOI: 10.3747/co.20.1338] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Small-cell carcinomas (sccs) of the genitourinary (gu) tract are rare systemic diseases, and there is no standard treatment strategy for patients with this malignancy. The objectives of the present study were to report the management and outcome of patients with scc of the gu tract treated at a tertiary-care institution from 1982 to 2009. METHODS In a chart review of all patients diagnosed with scc of the gu tract between 1982 and 2009, data on demographics, clinical and pathologic characteristics, treatment, and patient outcomes were collected. RESULTS The 58 patients identified had scc in the following primary sites: urinary bladder (n = 35), prostate (n = 17), and upper urinary tract (n = 6). In 38 patients (66%), the scc was of pure histology; in the remainder, histology was mixed. Overall, 28 patients had limited-stage disease; 24 had extensive-stage disease; and staging was unknown in 6 patients. Median survival for the entire cohort was 7.5 months, with extensive-stage disease being identified as a poor prognostic factor (survival was 22.0 months for limited-stage patients and 4.1 months for extensive-stage patients, p < 0.001). Based on site, prostate patients fared worst, with a median survival of only 5.1 months. Compared with best supportive care, treatment was associated with better outcomes (median survival: 12.3 months vs. 2.3 months, p < 0.0001). CONCLUSIONS Small-cell cancer of the gu tract is an aggressive cancer, with a poor prognosis overall. Although there is no standard of care, patients should be treated using a multimodality approach analogous to that used in the treatment of small-cell lung cancer.
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Affiliation(s)
- N Pervez
- Department of Radiation Oncology, University of Alberta and Cross Cancer Institute, Edmonton, AB
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Dechaphunkul A, Mulder K, El-Gehani F, Ghosh S, Deschenes J, Spratlin J. Clinicopathologic characteristics and survival outcomes of patients with advanced esophageal, gastroesophageal junction, and gastric adenocarcinoma: a single-institution experience. ACTA ACUST UNITED AC 2013; 19:302-7. [PMID: 23300355 DOI: 10.3747/co.19.1081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
UNLABELLED Most patients with gastric or gastroesophageal junction (gej) cancer are diagnosed with inoperable advanced or metastatic disease. In these cases, chemotherapy is the only treatment demonstrating survival benefit. The present study compares clinicopathologic characteristics and survival outcomes for patients with advanced esophageal, gej, and gastric adenocarcinoma treated with first-line chemotherapy [epirubicin-cisplatin-5-fluorouracil (ecf), epirubicin-cisplatin-capecitabine (ecx), or etoposide-leucovorin-5-fluorouracil (elf)] or best supportive care (bsc) at our institution with those for historical controls. METHODS We retrospectively reviewed medical information for 401 patients with newly diagnosed advanced esophageal, gej, or gastric adenocarcinoma treated with first-line chemotherapy (ecf, ecx, or elf) or bsc from January 1, 2004, through December 31, 2010. Descriptive statistics were used to compare the data collected with data for historical control patients. RESULTS Of the study patients, 93% were diagnosed with metastatic disease (n = 374), and 63% received bsc only (n = 251). The main reasons that patients received bsc only included poor Eastern Cooperative Oncology Group performance status (55%), patient decision (31%), and comorbidities (14%). Of the remaining patients, 98 (24%) received ecf or ecx and 52 (13%) received elf as first-line treatment. Median overall survival was significantly longer in patients treated with ecf or ecx or with elf than in those receiving bsc (12.7 months vs. 12.7 months vs. 5.5 months respectively). Chemotherapy also significantly reduced the risk of death (64% reduction with ecf or ecx, 58% with elf). CONCLUSIONS We confirmed the substantial overall survival benefit of combination chemotherapy compared with bsc, with better survival in our patient population than in historical controls. However, novel treatment options are still warranted to improve outcomes in this patient population.
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Affiliation(s)
- A Dechaphunkul
- Department of Oncology and Faculty of Medicine, Cross Cancer Institute, University of Alberta, Edmonton, AB. ; Holistic Center for Cancer Study and Care ( hoccpsu ), Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Dechaphunkul A, Phukaoloun M, Kanjanapradit K, Graham K, Ghosh S, Santos C, Mackey JR. P4-09-26: Prognostic Significance of Tissue Inhibitor of Metalloproteinase-1 (TIMP-1) in Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p4-09-26] [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: Despite advances of systemic treatment in breast cancer guided by hormonal status and HER2 amplification, new prognostic and predictive factors are still warranted to optimize treatments among these patients. Tissue Inhibitor of Metalloproteinase-1 (TIMP-1), a physiologic inhibitor of Matrix Metalloproteinases (MMPs), can act in both pro- and anti-tumoral effects. The prognostic significance of TIMP-1 in breast cancer is still controversial. This study aims to determine the prognostic significance of TIMP-1 in breast cancer. Material and Methods: One-hundred and seventy-six primary breast cancers from women with early stage disease treated with standard adjuvant therapy were analyzed by gene expression microarrays and immunohistochemistry for TIMP-1. Immunohistochemical analysis was independently reviewed by two pathologists.
Results: At the optimized cut-off point, patients with high TIMP-1 RNA levels had a significantly shorter time to relapse, with a hazard ratio (HR) of 1.6 (p = 0.039), but without significant differences in overall survival (HR 1.29, p = 0.37). Although cytoplasmic overexpression of TIMP-1 protein was not correlated with early relapse (HR 1.2, p = 0.35), high expression was associated with shorter overall survival (HR 1.73, p = 0.027). In multivariate analysis, when considering stage, histologic grade, hormonal and HER2 status, TIMP-1 RNA levels remained independently prognostic for early relapse (HR 1.68, p = 0.04).
Discussion: Elevated TIMP-1 RNA levels are independently prognostic for early recurrence, whereas protein overexpression of TIMP-1 is correlated with short overall survival in primary breast cancer.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-09-26.
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Affiliation(s)
- A Dechaphunkul
- 1Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - M Phukaoloun
- 1Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - K Kanjanapradit
- 1Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - K Graham
- 1Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - S Ghosh
- 1Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - C Santos
- 1Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - JR Mackey
- 1Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada; Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Dechaphunkul A, Nirattisaikul S, Kayasut K, Viriyachaiyo V, Juthong S, Keeratichananont W, Navasakulpong A, Sunpaweravong P. Phase II study of histology-guided chemotherapy in stage IIIb/IV non-small cell lung cancer with pemetrexed plus platinum for nonsquamous carcinomas and taxane plus platinum for squamous and nonsquamous carcinomas. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e18058] [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: 11/20/2022] Open
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Sunpaweravong P, Sunpaweravong S, Sangthawan D, Pinaikul S, Attasaranya S, Dechaphunkul A, Mitarnun W, Fungthammasarn T. Cetuximab plus chemoradiation with cisplatin and 5-fluorouracil (5-FU) in locally advanced unresectable esophageal squamous cell carcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14548] [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: 11/20/2022] Open
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