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Ramalingam S, Lopez J, Mau-Sorensen M, Thistlethwaite F, Piha-Paul S, Gadgeel S, Drew Y, Jänne P, Mansfield A, Chen G, Forssmann U, Johannsdottir H, Pencheva N, Ervin-Haynes A, Vergote I. OA02.05 First-In-Human Phase 1/2 Trial of Anti-AXL Antibody–Drug Conjugate (ADC) Enapotamab Vedotin (EnaV) in Advanced NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Usmani SZ, Cavenagh JD, Belch AR, Hulin C, Basu S, White D, Nooka A, Ervin-Haynes A, Yiu W, Nagarwala Y, Berger A, Pelligra CG, Guo S, Binder G, Gibson CJ, Facon T. Cost-effectiveness of lenalidomide plus dexamethasone vs. bortezomib plus melphalan and prednisone in transplant-ineligible U.S. patients with newly-diagnosed multiple myeloma. J Med Econ 2016; 19:243-58. [PMID: 26517601 DOI: 10.3111/13696998.2015.1115407] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To conduct a cost-effectiveness assessment of lenalidomide plus dexamethasone (Rd) vs bortezomib plus melphalan and prednisone (VMP) as initial treatment for transplant-ineligible patients with newly-diagnosed multiple myeloma (MM), from a U.S. payer perspective. METHODS A partitioned survival model was developed to estimate expected life-years (LYs), quality-adjusted LYs (QALYs), direct costs and incremental costs per QALY and LY gained associated with use of Rd vs VMP over a patient's lifetime. Information on the efficacy and safety of Rd and VMP was based on data from multinational phase III clinical trials and a network meta-analysis. Pre-progression direct costs included the costs of Rd and VMP, treatment of adverse events (including prophylaxis) and routine care and monitoring associated with MM. Post-progression direct costs included costs of subsequent treatment(s) and routine care and monitoring for progressive disease, all obtained from published literature and estimated from a U.S. payer perspective. Utilities were obtained from the aforementioned trials. Costs and outcomes were discounted at 3% annually. RESULTS Relative to VMP, use of Rd was expected to result in an additional 2.22 LYs and 1.47 QALYs (discounted). Patients initiated with Rd were expected to incur an additional $78,977 in mean lifetime direct costs (discounted) vs those initiated with VMP. The incremental costs per QALY and per LY gained with Rd vs VMP were $53,826 and $35,552, respectively. In sensitivity analyses, results were found to be most sensitive to differences in survival associated with Rd vs VMP, the cost of lenalidomide and the discount rate applied to effectiveness outcomes. CONCLUSIONS Rd was expected to result in greater LYs and QALYs compared with VMP, with similar overall costs per LY for each regimen. Results of this analysis indicated that Rd may be a cost-effective alternative to VMP as initial treatment for transplant-ineligible patients with MM, with an incremental cost-effectiveness ratio well within the levels for recent advancements in oncology.
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Affiliation(s)
- S Z Usmani
- a a Levine Cancer Institute/Carolinas Healthcare System , Charlotte, NC , USA
| | - J D Cavenagh
- b b St. Bartholomew's Hospital , West Smithfield, London , UK
| | - A R Belch
- c c Cross Cancer Institute , University of Alberta , Edmonton, AB , Canada
| | - C Hulin
- d d Bordeaux Hospital University Center (CHU) , Bordeaux , France
| | - S Basu
- e e Royal Wolverhampton Hospitals NHS Trust , Wolverhampton , UK
| | - D White
- f f Dalhousie University and QEII Health Sciences Center , Halifax, NS , Canada
| | - A Nooka
- g g Winship Cancer Institute , Emory University , Atlanta , GA , USA
| | | | - W Yiu
- h h Celgene Corporation , Summit, NJ , USA
| | | | - A Berger
- i i Evidera , Lexington, MA , USA
| | | | - S Guo
- i i Evidera , Lexington, MA , USA
| | - G Binder
- h h Celgene Corporation , Summit, NJ , USA
| | - C J Gibson
- h h Celgene Corporation , Summit, NJ , USA
| | - T Facon
- j j Service des Maladies du Sang , Hôpital Huriez , CHRU Lille, Lille , France
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Facon T, Dimopoulos M, Hulin C, Benboubker L, Belch A, Ludwig H, Pinto A, Attal M, Cavo M, Moreau P, Schots R, Meuleman N, Weisel K, Tiab M, Lee JJ, Butler A, Marek J, Chen G, Ervin-Haynes A, Fermand J. Updated Overall Survival (OS) Analysis of the FIRST Study: Lenalidomide Plus Low-Dose Dexamethasone (Rd) Continuous vs Melphalan, Prednisone, and Thalidomide (MPT) in Patients (Pts) With Newly Diagnosed Multiple Myeloma (NDMM). Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.07.330] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bahlis N, Corso A, Mügge LO, Shen ZX, Desjardins P, Stoppa A, Decaux O, de Revel T, Granell M, Marit G, Nahi H, Demuynck H, Huang SY, Basu S, Ervin-Haynes A, Leupin N, Marek J, Chen G, Facon T. Impact of Response in Patients (Pts) With Stem Cell Transplant (SCT)-Ineligible Newly Diagnosed Multiple Myeloma (NDMM) Treated With Continuous Lenalidomide + Low-Dose Dexamethasone (Rd) in the FIRST Trial. Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.07.196] [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: 10/23/2022]
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Hulin C, Shustik C, Belch A, Petrucci M, Dührsen U, Lu J, Song K, Rodon P, Garderet L, Hunter H, Azais I, Eek R, Macro M, Dakhil S, Houck V, Chen G, Ervin-Haynes A, Offner F, Dimopoulos M, Facon T. Continuous Treatment With Lenalidomide and Low-Dose Dexamethasone for Patients With Transplant-Ineligible Newly Diagnosed Multiple Myeloma in the First Trial: Impact of Age. Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.07.324] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dimopoulos M, Cheung M, Roussel M, Liu T, Gamberi B, Kolb B, Derigs H, Eom H, Belhadj K, Lenain P, van der Jagt R, Rigaudeau S, Hall R, Jaccard A, Tosikyan A, Karlin L, Bensinger W, Schots R, Chen G, Marek J, Ervin-Haynes A, Facon T. Continuous Lenalidomide and Low-Dose Dexamethasone for the Treatment of Patients with Newly Diagnosed Multiple Myeloma and Renal Impairment in the First Trial. Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.07.339] [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: 10/23/2022]
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Czuczman MS, Vose J, Zinzani P, Reeder C, Buckstein R, Haioun C, Bouabdallah R, Polikoff J, Ervin-Haynes A, Witzig T. Efficacy and safety of lenalidomide oral monotherapy in patients with relapsed or refractory diffuse large B-cell lymphoma: Results from an international study (NHL-003). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e19504] [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
e19504 Background: Patients with diffuse large-B-cell lymphoma (DLBCL) who are not cured with R-CHOP or high-dose chemotherapy with autologous stem cell rescue have a dismal prognosis. A recent phase II trial (NHL-002) of lenalidomide in patients with relapsed or refractory aggressive non-Hodgkin's lymphoma (NHL) demonstrated a 19% overall response rate (ORR) with a 7-month median duration of response (DR) in the subset of patients with DLBCL. A supporting international phase II trial (NHL-003) of single-agent lenalidomide was initiated for patients with relapsed or refractory aggressive NHL that had received at least one prior treatment and had measurable disease. Herein, we report the data from the DLBCL patients enrolled in this trial. Methods: Patients received 25 mg oral lenalidomide once daily on days 1–21 of every 28-day cycle and continued therapy until disease progression or toxicity. The 1999 IWLRC methodology was used to assess response and progression. Results: One hundred-three DLBCL patients were enrolled and were evaluable for response assessment. The median age was 66 years (21–87) and 70 patients (68%) were male. Median time from diagnosis was 2 years (0.4–18.6), patients had received a median of 3 prior treatment regimens (1–10) and 46 of the patients (45%) had received a prior stem cell transplant (DLBCL-stem cell). Response rates are shown in the Table . Grade 3 or 4 adverse events occurring in more than 5% of patients were neutropenia (34%), thrombocytopenia (18%), asthenia (9%), anemia (8%), leucopenia (7%), back pain (6%) and dyspnea (6%). Conclusions: This international study demonstrates that lenalidomide is active in heavily pre-treated patients with relapsed or refractory DLBCL and has manageable side effects. [Table: see text] [Table: see text]
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Affiliation(s)
- M. S. Czuczman
- Roswell Park Cancer Institute, Buffalo, NY; University of Nebraska, Omaha, NE; Institute of Hematology and Medical Oncology, Bologna, Italy; Mayo Clinic, Scottsdale, AZ; Toronto Sunnybrook Odette Cancer Center, Toronto, ON, Canada; Hôpital Henri Mondor, Créteil, France; Institute Paoli-Calmettes Haematology, Marseille, France; Kaiser Permanente Medical Group, Southern California, CA; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - J. Vose
- Roswell Park Cancer Institute, Buffalo, NY; University of Nebraska, Omaha, NE; Institute of Hematology and Medical Oncology, Bologna, Italy; Mayo Clinic, Scottsdale, AZ; Toronto Sunnybrook Odette Cancer Center, Toronto, ON, Canada; Hôpital Henri Mondor, Créteil, France; Institute Paoli-Calmettes Haematology, Marseille, France; Kaiser Permanente Medical Group, Southern California, CA; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - P. Zinzani
- Roswell Park Cancer Institute, Buffalo, NY; University of Nebraska, Omaha, NE; Institute of Hematology and Medical Oncology, Bologna, Italy; Mayo Clinic, Scottsdale, AZ; Toronto Sunnybrook Odette Cancer Center, Toronto, ON, Canada; Hôpital Henri Mondor, Créteil, France; Institute Paoli-Calmettes Haematology, Marseille, France; Kaiser Permanente Medical Group, Southern California, CA; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - C. Reeder
- Roswell Park Cancer Institute, Buffalo, NY; University of Nebraska, Omaha, NE; Institute of Hematology and Medical Oncology, Bologna, Italy; Mayo Clinic, Scottsdale, AZ; Toronto Sunnybrook Odette Cancer Center, Toronto, ON, Canada; Hôpital Henri Mondor, Créteil, France; Institute Paoli-Calmettes Haematology, Marseille, France; Kaiser Permanente Medical Group, Southern California, CA; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - R. Buckstein
- Roswell Park Cancer Institute, Buffalo, NY; University of Nebraska, Omaha, NE; Institute of Hematology and Medical Oncology, Bologna, Italy; Mayo Clinic, Scottsdale, AZ; Toronto Sunnybrook Odette Cancer Center, Toronto, ON, Canada; Hôpital Henri Mondor, Créteil, France; Institute Paoli-Calmettes Haematology, Marseille, France; Kaiser Permanente Medical Group, Southern California, CA; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - C. Haioun
- Roswell Park Cancer Institute, Buffalo, NY; University of Nebraska, Omaha, NE; Institute of Hematology and Medical Oncology, Bologna, Italy; Mayo Clinic, Scottsdale, AZ; Toronto Sunnybrook Odette Cancer Center, Toronto, ON, Canada; Hôpital Henri Mondor, Créteil, France; Institute Paoli-Calmettes Haematology, Marseille, France; Kaiser Permanente Medical Group, Southern California, CA; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - R. Bouabdallah
- Roswell Park Cancer Institute, Buffalo, NY; University of Nebraska, Omaha, NE; Institute of Hematology and Medical Oncology, Bologna, Italy; Mayo Clinic, Scottsdale, AZ; Toronto Sunnybrook Odette Cancer Center, Toronto, ON, Canada; Hôpital Henri Mondor, Créteil, France; Institute Paoli-Calmettes Haematology, Marseille, France; Kaiser Permanente Medical Group, Southern California, CA; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - J. Polikoff
- Roswell Park Cancer Institute, Buffalo, NY; University of Nebraska, Omaha, NE; Institute of Hematology and Medical Oncology, Bologna, Italy; Mayo Clinic, Scottsdale, AZ; Toronto Sunnybrook Odette Cancer Center, Toronto, ON, Canada; Hôpital Henri Mondor, Créteil, France; Institute Paoli-Calmettes Haematology, Marseille, France; Kaiser Permanente Medical Group, Southern California, CA; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - A. Ervin-Haynes
- Roswell Park Cancer Institute, Buffalo, NY; University of Nebraska, Omaha, NE; Institute of Hematology and Medical Oncology, Bologna, Italy; Mayo Clinic, Scottsdale, AZ; Toronto Sunnybrook Odette Cancer Center, Toronto, ON, Canada; Hôpital Henri Mondor, Créteil, France; Institute Paoli-Calmettes Haematology, Marseille, France; Kaiser Permanente Medical Group, Southern California, CA; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - T. Witzig
- Roswell Park Cancer Institute, Buffalo, NY; University of Nebraska, Omaha, NE; Institute of Hematology and Medical Oncology, Bologna, Italy; Mayo Clinic, Scottsdale, AZ; Toronto Sunnybrook Odette Cancer Center, Toronto, ON, Canada; Hôpital Henri Mondor, Créteil, France; Institute Paoli-Calmettes Haematology, Marseille, France; Kaiser Permanente Medical Group, Southern California, CA; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
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Habermann TM, Witzig TE, Lossos IS, Vose JM, Wiernik PH, Weiss L, Ervin-Haynes A, Pietronigro D, Zeldis JB, Czuczman M. Safety of lenalidomide monotherapy in patients with relapsed or refractory aggressive non-Hodgkin’s lymphom. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8603] [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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Witzig TE, Vose JM, Justice G, Kaplan HG, Reeder CB, Pietronigro D, Takeshita K, Ervin-Haynes A, Zeldis JB, Wiernik PH. Lenalidomide oral monotherapy in relapsed/refractory small lymphocytic non-Hodgkin’s lymphoma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8573] [Citation(s) in RCA: 3] [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: 11/20/2022] Open
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Czuczman MS, Reeder CB, Polikoff J, Chowhan NM, Esseessee I, Greenberg R, Ervin-Haynes A, Pietronigro D, Zeldis JB, Witzig TE. International study of lenalidomide in relapsed/refractory aggressive non-Hodgkin’s lymphoma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8509] [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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Bedikian AY, Kim K, Papadopoulos N, Hwu W, Ervin-Haynes A, Pietronigro D, Zeldis J, Hwu P. Preliminary results from a phase I/II study of the combination of lenalidomide and DTIC in patients with metastatic malignant melanoma previously untreated with systemic chemotherapy. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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
8533 Background: In metastatic melanoma (MM) no single agent has shown objective response greater than 21%, and none have made an impact on overall survival. DTIC is approved for MM with response rates of 7% to 21%. Lenalidomide, an immunomodulatory drug of the IMiDs class, was reported to enhance immune responses in MM patients. This study was designed to assess the safety and activity of lenalidomide in combination with DTIC in patients with metastatic melanoma (MM). Methods: Twenty-eight chemotherapy naive patients with unresectable stage III and IV MM enrolled in the study. All patients received 25 mg lenalidomide orally once daily on days 1–14 every 21 days and continued therapy as tolerated or until disease progression. DTIC was given IV over 1 hour on day 1 every 21 days. There were three dose levels for DTIC: 600 mg/m2, 800 mg/m2 and 1,000 mg/m2. Each dose level had 3–6 patients enrolled. Thirteen additional patients were to be enrolled at the MTD. Response and progression were evaluated using the RECIST criteria every 6 weeks. Results: As of December 21, 2006 twenty-six patients were evaluable for response. Median age was 65 (46–83) and 13 were female. Median ECOG was 1. Two patients (8%) exhibited an objective response (2 partial responses (PR)), 10 had stable disease (SD) for a tumor control rate (TCR) of 46 % and 14 progressive disease (PD). Thirteen patients have been enrolled at the MTD of 25 mg lenalidomide + 800 mg/m2 DTIC and most are still receiving therapy. Grade 3 or 4 adverse events occurred in 12 (43%) of the 28 patients receiving drug. Grade 3 events included: transient elevation of transaminases, increased temperature, headache, dizziness, low hemoglobin, and leg edema. Four patients (14%) experienced a Grade 4 adverse reaction (pulmonary emboli, low hemoglobin, cerebral hemorrhage, and cerebral ischemia). The most common Grade 1/2 adverse events included: fatigue, nausea, pruritis, muscle cramps, taste alteration, skin rash, and constipation. Conclusions: The MTD has been established at 25 mg lenalidomide + 800 mg/m2 DTIC. Preliminary results indicate that lenalidomide in combination with DTIC has manageable side effects in patients with MM. Evaluation of efficacy is ongoing. No significant financial relationships to disclose.
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Affiliation(s)
- A. Y. Bedikian
- MD Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ
| | - K. Kim
- MD Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ
| | - N. Papadopoulos
- MD Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ
| | - W. Hwu
- MD Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ
| | - A. Ervin-Haynes
- MD Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ
| | - D. Pietronigro
- MD Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ
| | - J. Zeldis
- MD Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ
| | - P. Hwu
- MD Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ
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Wiernik PH, Lossos IS, Tuscano J, Justice G, Vose JM, Pietronigro D, Takeshita K, Ervin-Haynes A, Zeldis J, Habermann T. Preliminary results from a phase II study of lenalidomide oral monotherapy in relapsed/refractory aggressive non-Hodgkin lymphoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8052] [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
8052 Background: Lenalidomide (Revlimid), an immunomodulatory drug of the IMiDs class, is approved in the US for treatment of relapsed/refractory multiple myeloma and myelodysplastic syndromes associated with a deletion 5q[31] cytogenetic abnormality. Lenalidomide also has activity in chronic lymphocytic leukemia and cutaneous T-cell lymphoma. This study was designed to assess the safety and efficacy of lenalidomide in patients with relapsed/refractory aggressive non-Hodgkin's lymphoma (NHL). Methods: Patients with relapsed/refractory aggressive NHL with measurable disease after at least 1 prior treatment regimen were eligible. Patients received 25 mg lenalidomide orally once daily on Days 1–21 every 28 days and continued therapy for 52 weeks as tolerated or until disease progression. Response and progression were evaluated using the IWLRC methodology. Results: As of enrollment cut-off, 50 patients were enrolled and 49 received drug. Forty-one patients were evaluable for response. The median age was 65 (46–84) and 18 were female. Histology was diffuse large B-cell lymphoma [DLBCL] (n=21), follicular center lymphoma grade 3 [FL] (n=3), mantle cell lymphoma [MCL] (n=14) and transformed [TSF] (n=3). Median time from diagnosis to lenalidomide was 3.2 (0.4–32) years and median number of prior treatment regimens was 3 (1–7). Fourteen patients (34%) exhibited an objective response (5 complete responses unconfirmed (CRu) and 9 partial responses (PR)), 12 had stable disease (SD) for a tumor control rate (TCR) of 63% and 15 progressive disease (PD). Responses were seen in each of the aggressive histologic subtypes studied: DLBCL (5/21), MCL (6/14), FL (2/3), and TSF (1/3). Five of 11 patients (45%) with a prior stem cell transplant responded. Progression free survival although ongoing is currently > 239 (>191 - >373) days in patients experiencing CRu and > 160 (>54 - >251) days in patients with PR. Most common Grade 4 adverse events were neutropenia (8.2%) and thrombocytopenia (8.2%) while most common Grade 3 adverse events were neutropenia (22%), leukopenia (14%) and thrombocytopenia (12%). Conclusion: Lenalidomide oral monotherapy is active with manageable side effects in relapsed/refractory aggressive NHL. No significant financial relationships to disclose.
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Affiliation(s)
- P. H. Wiernik
- New York Medical College, Bronx, NY; University of Miami, Miami, FL; University of California Davis Cancer Center, Sacramento, CA; Pacific Coast Hematology/Oncology Medical Group, Fountain Valley, CA; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - I. S. Lossos
- New York Medical College, Bronx, NY; University of Miami, Miami, FL; University of California Davis Cancer Center, Sacramento, CA; Pacific Coast Hematology/Oncology Medical Group, Fountain Valley, CA; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - J. Tuscano
- New York Medical College, Bronx, NY; University of Miami, Miami, FL; University of California Davis Cancer Center, Sacramento, CA; Pacific Coast Hematology/Oncology Medical Group, Fountain Valley, CA; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - G. Justice
- New York Medical College, Bronx, NY; University of Miami, Miami, FL; University of California Davis Cancer Center, Sacramento, CA; Pacific Coast Hematology/Oncology Medical Group, Fountain Valley, CA; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - J. M. Vose
- New York Medical College, Bronx, NY; University of Miami, Miami, FL; University of California Davis Cancer Center, Sacramento, CA; Pacific Coast Hematology/Oncology Medical Group, Fountain Valley, CA; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - D. Pietronigro
- New York Medical College, Bronx, NY; University of Miami, Miami, FL; University of California Davis Cancer Center, Sacramento, CA; Pacific Coast Hematology/Oncology Medical Group, Fountain Valley, CA; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - K. Takeshita
- New York Medical College, Bronx, NY; University of Miami, Miami, FL; University of California Davis Cancer Center, Sacramento, CA; Pacific Coast Hematology/Oncology Medical Group, Fountain Valley, CA; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - A. Ervin-Haynes
- New York Medical College, Bronx, NY; University of Miami, Miami, FL; University of California Davis Cancer Center, Sacramento, CA; Pacific Coast Hematology/Oncology Medical Group, Fountain Valley, CA; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - J. Zeldis
- New York Medical College, Bronx, NY; University of Miami, Miami, FL; University of California Davis Cancer Center, Sacramento, CA; Pacific Coast Hematology/Oncology Medical Group, Fountain Valley, CA; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
| | - T. Habermann
- New York Medical College, Bronx, NY; University of Miami, Miami, FL; University of California Davis Cancer Center, Sacramento, CA; Pacific Coast Hematology/Oncology Medical Group, Fountain Valley, CA; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; Mayo Clinic, Rochester, MN
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Witzig TE, Vose J, Pietronigro D, Takeshita K, Ervin-Haynes A, Zeldis J, Wiernik PH. Preliminary results from a phase II study of lenalidomide oral monotherapy in relapsed/refractory indolent non-Hodgkin lymphoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8066 Background: Lenalidomide, an immunomodulatory drug, is approved in the US for treatment of relapsed/refractory multiple myeloma and myelodysplastic syndromes associated with a deletion 5q[31] cytogenetic abnormality. Lenalidomide also has activity in chronic lymphocytic leukemia and cutaneous T-cell lymphoma. This study was designed to assess the safety and efficacy of lenalidomide monotherapy in patients with relapsed/refractory indolent non-Hodgkin's lymphoma (NHL). Methods: Patients with relapsed/refractory indolent NHL with measurable disease after at least 1 prior treatment regimen were eligible. Patients received 25 mg lenalidomide orally once daily on Days 1–21 every 28 days and continued therapy for 52 weeks as tolerated or until disease progression. Response and progression were evaluated using the IWLRC methodology. Results: As of enrollment cut-off, 43 patients received drug and 27 were evaluable for response. The median age was 63 (43–82) and 12 were female. Histology was small lymphocytic lymphoma [SLL] (n=12), follicular center lymphoma grades 1,2 [FCL] (n=12) and nodal marginal B-cell lymphoma [NML] (n=3). Median time from diagnosis to lenalidomide was 4.3 (0.4- 24) years and median number of prior treatment regimens was 3 (1–17). Seven patients (26%) exhibited an objective response (2 complete responses (CR), 1 complete response unconfirmed (CRu) and 4 partial responses (PR)), 9 had stable disease (SD) for a tumor control rate (TCR) of 59% and 11 progressive disease (PD). Responses were produced in each of the indolent histologic subtypes studied: SLL (3/12), FCL (3/12) and NML (1/3). Since most responses develop at ≥ 4 months, additional responses may be seen in early SD patients with longer follow-up. Five patients (12%) exhibited Grade 4 neutropenia, and Grade 3 adverse events were neutropenia (16%) and thrombocytopenia (14%). Conclusion: Lenalidomide oral monotherapy is active with manageable side effects in relapsed/refractory indolent NHL. [Table: see text]
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Affiliation(s)
- T. E. Witzig
- Mayo Clinic, Rochester, MN; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; New York Medical College, Bronx, NY
| | - J. Vose
- Mayo Clinic, Rochester, MN; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; New York Medical College, Bronx, NY
| | - D. Pietronigro
- Mayo Clinic, Rochester, MN; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; New York Medical College, Bronx, NY
| | - K. Takeshita
- Mayo Clinic, Rochester, MN; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; New York Medical College, Bronx, NY
| | - A. Ervin-Haynes
- Mayo Clinic, Rochester, MN; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; New York Medical College, Bronx, NY
| | - J. Zeldis
- Mayo Clinic, Rochester, MN; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; New York Medical College, Bronx, NY
| | - P. H. Wiernik
- Mayo Clinic, Rochester, MN; University of Nebraska, Omaha, NE; Celgene Corporation, Summit, NJ; New York Medical College, Bronx, NY
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14
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Beer MW, Ung C, Bacus SS, McCollum AD, Ervin-Haynes A, Schinagl R, Youssoufian H, Rowinsky E. Heterogeneity of epidermal growth factor receptor (EGFR) expression and variation in immunohistochemistry (IHC) testing may affect access to EGFR-targeted therapy in patients with advanced colorectal cancer (CRC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10104] [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
10104 Introduction: Cetuximab, an IgG1 MAb directed at the EGFR, has demonstrated benefit in pts with CRC and is currently indicated in EGFR expressing CRC. However, previous reports show heterogeneous EGFR expression between anatomic sites and suggest that results from IHC testing vary between labs. To assess this variability and the resultant impact on pt access to EGFR-targeted therapy, we compared EGFR results reported to clinicians by hospital and reference labs with those obtained at a single central lab. Methods: Formalin-fixed, paraffin-embeded CRC specimens submitted through the Targeted Diagnostics Advocacy Program (tdap) were assayed using the Dako EGFR pharmDx kit and scored using the FDA-approved package insert. If the initial specimen tested EGFR negative (−), additional specimens were requested for assay. Prior EGFR results, lab, and specimen ID were documented through review of anatomic pathology reports. Results: Of 332 evaluable CRC pts tested, 245 pts (74%) were previously reported as EGFR(−). After retesting, 167 (68%) pts were found to be EGFR The originally tested tumor block was retested in 82 pts and 41 pts (50%) were found to be EGFR (+). Retest results were similar for both hospital and reference labs. Of 66 pts with >1 specimen from the same anatomic site tested, 21 (32%) were discordant (at least 1 (+) and one (−) result). Results from different anatomic sites were compared for 65 pts, 34 (52%) of which were discordant (+). Overall, 231 pts (70%) tested EGFR(+). Conclusion: This study shows marked heterogeneity in EGFR expression by IHC both within and across anatomic sites from the same pt as well as variability in both hospital and reference pathology labs. This variability undoubtedly has an adverse impact on pt access to EGFR-targeted therapy. The impact of EGFR heterogeneity may be reduced through the assay of multiple specimens. [Table: see text] [Table: see text]
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Affiliation(s)
- M. W. Beer
- Targeted Molecular Diagnostics, Westmont, IL; Texas Oncology PA, Dallas, TX; ImClone Systems Incorporated, Branchburg, NJ
| | - C. Ung
- Targeted Molecular Diagnostics, Westmont, IL; Texas Oncology PA, Dallas, TX; ImClone Systems Incorporated, Branchburg, NJ
| | - S. S. Bacus
- Targeted Molecular Diagnostics, Westmont, IL; Texas Oncology PA, Dallas, TX; ImClone Systems Incorporated, Branchburg, NJ
| | - A. D. McCollum
- Targeted Molecular Diagnostics, Westmont, IL; Texas Oncology PA, Dallas, TX; ImClone Systems Incorporated, Branchburg, NJ
| | - A. Ervin-Haynes
- Targeted Molecular Diagnostics, Westmont, IL; Texas Oncology PA, Dallas, TX; ImClone Systems Incorporated, Branchburg, NJ
| | - R. Schinagl
- Targeted Molecular Diagnostics, Westmont, IL; Texas Oncology PA, Dallas, TX; ImClone Systems Incorporated, Branchburg, NJ
| | - H. Youssoufian
- Targeted Molecular Diagnostics, Westmont, IL; Texas Oncology PA, Dallas, TX; ImClone Systems Incorporated, Branchburg, NJ
| | - E. Rowinsky
- Targeted Molecular Diagnostics, Westmont, IL; Texas Oncology PA, Dallas, TX; ImClone Systems Incorporated, Branchburg, NJ
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15
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Kuenen B, Witteveen E, Ruijter R, Ervin-Haynes A, Tjin-A-ton M, Fox F, Ding C, Giaccone G, Voest EE. A phase I study of IMC-11F8, a fully human anti-epidermal growth factor receptor (EGFR) IgG1 monoclonal antibody in patients with solid tumors. Interim results. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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
3024 Background: This ongoing phase I study is being conducted to determine the safety profile and recommended dose of IMC-11F8, a fully-human IgG1 monoclonal antibody that targets the EGFR. Methods: Patients (pts) with advanced solid tumors who are refractory to or have no available standard therapy are eligible to receive IMC-11F8 intravenously either weekly or every other week for 6 weeks (1 cycle). The initial cohort of patients will receive 100 mg of IMC-11F8. In the absence of a dose-limiting toxicity (DLT), dose escalation will be 200, 400, 600, 800, and 1000 mg in successive cohorts. Prior to the initial cycle, pts receive one IMC-11F8 infusion at their assigned cohort followed by a 2-week pharmacokinetic (PK) period. Pts with stable disease or better after cycle 1 are eligible to receive additional cycles of IMC-11F8. Results: 31 of 40 pts have been enrolled in the 100-, 200-, 400-, 600-, and 800-mg cohorts. Pt characteristics are M/F 20/11, median age 58 years (37 - 76), median ECOG score 1 (0–2). No DLTs have been observed. Only grade 1/2 skin rashes were reported. The most frequent adverse events were nausea, vomiting, fatigue, and headache. No infusion reactions were observed. 2 pts (1 confirmed) have achieved a PR, 1 pt with melanoma in the 200-mg cohort with 39+ weeks of weekly IMC-11F8 treatment and 1 pt with rectal cancer in the 400-mg cohort with 20+ weeks of IMC-11F8 administered every other week. 5 pts in the 200- to 600-mg cohorts have stable disease and have received from 11+ to 35+ weeks of IMC-11F8 treatment. A noncompartmental analysis of 20 pts demonstrated that IMC-11F8 exhibits nonlinear PK. As IMC-11F8 escalated from 100 to 600 mg, T1/2 increased from 67 to 84 hrs, Cmax increased from 30 to 368 μg/mL, AUCinf increased from 1753 to 67295, and CL decreased from 57.0 to 8.9 mL/hr. Conclusions: These interim results indicate that IMC-11F8 is well tolerated in this patient population. Although a maximum tolerated dose has not been established, IMC-11F8 has shown activity at two different dose levels. [Table: see text]
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Affiliation(s)
- B. Kuenen
- Free University Hospital of Amsterdam, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; ImClone Systems Incorporated, Branchburg, NJ; University Medical Center, Utrecht, The Netherlands
| | - E. Witteveen
- Free University Hospital of Amsterdam, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; ImClone Systems Incorporated, Branchburg, NJ; University Medical Center, Utrecht, The Netherlands
| | - R. Ruijter
- Free University Hospital of Amsterdam, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; ImClone Systems Incorporated, Branchburg, NJ; University Medical Center, Utrecht, The Netherlands
| | - A. Ervin-Haynes
- Free University Hospital of Amsterdam, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; ImClone Systems Incorporated, Branchburg, NJ; University Medical Center, Utrecht, The Netherlands
| | - M. Tjin-A-ton
- Free University Hospital of Amsterdam, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; ImClone Systems Incorporated, Branchburg, NJ; University Medical Center, Utrecht, The Netherlands
| | - F. Fox
- Free University Hospital of Amsterdam, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; ImClone Systems Incorporated, Branchburg, NJ; University Medical Center, Utrecht, The Netherlands
| | - C. Ding
- Free University Hospital of Amsterdam, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; ImClone Systems Incorporated, Branchburg, NJ; University Medical Center, Utrecht, The Netherlands
| | - G. Giaccone
- Free University Hospital of Amsterdam, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; ImClone Systems Incorporated, Branchburg, NJ; University Medical Center, Utrecht, The Netherlands
| | - E. E. Voest
- Free University Hospital of Amsterdam, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; ImClone Systems Incorporated, Branchburg, NJ; University Medical Center, Utrecht, The Netherlands
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Camidge DR, Eckhardt SG, Diab S, Gore L, Chow L, O’Bryant C, Temmer E, Ervin-Haynes A, Katz T, Fox F, Cohen RB. A phase I dose-escalation study of weekly IMC-1121B, a fully human anti-vascular endothelial growth factor receptor 2 (VEGFR2) IgG1 monoclonal antibody (Mab), in patients (pts) with advanced cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3032] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [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
3032 Background: Anti-VEGFR2 antibodies are effective in a variety of preclinical leukemia and solid tumor models. IMC-1121B is a fully human anti-VEGFR2 IgG1 Mab. Methods: Cohorts of 3–6 pts (ECOG PS ≤ 2) with advanced cancer and no significant cardiovascular, thrombotic or bleeding disorders received escalating doses of IMC-1121B. A single initial dose with extended PK sampling was followed by 4 x weekly infusions per treatment cycle starting at 2mg/kg. 7 dose levels up to a maximum of 16 mg/kg are planned. Human anti-human antibodies (HAHA) directed against IMC-1121B were assessed at baseline and before each Week 4 dose. Tumor response was assessed every 2 cycles. PD analyses include DCE-MRI, serum VEGF and sVEGFR1/2 levels, and peripheral blood mononucleocyte gene expression profiling at baseline and post-dosing. Results: 12 pts (8 M; 4 F), median age 58 years (range: 36–76), have entered the study: cohort 1 (2mg/kg) n=6, cohort 2 (4mg/kg) n=4 and cohort 3 (6mg/kg) n=2. No toxicities ≥ grade 2, considered definitely or probably related to study drug, have occurred. Toxicities ≥ grade 2 possibly drug-related include anorexia, vomiting, anemia, depression, fatigue, and insomnia. To date, there has been one unconfirmed partial response (melanoma) and 5 pts with stable disease for >3 months (colon: 2, breast, gastric, thyroid). Preliminary non-compartmental PK analysis reveals dose-dependent elimination and non-linear exposure, consistent with saturable clearance mechanism(s): mean t1/2 = 63.62, 93.46, 99.63 hrs, mean Cmax = 43.67, 80.25, 264 ug/mL, and AUC0-Inf = 3860, 9242, 27437 hr*ug/mL, at the 2, 4, and 6 mg/kg dose levels, respectively. Conclusions: Weekly administration of IMC-1121B is well tolerated at doses up to 6mg/kg/week. There is early evidence of a non-linear dose-PK relationship. Dose escalation continues. Updated safety, PK, PD, HAHA, and efficacy data will be presented. [Table: see text]
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Affiliation(s)
- D. R. Camidge
- University of Colorado Cancer Center, Denver, CO; Fox Chase Cancer Center, Philadelphia, PA; ImClone Systems Incorporated, Branchburg, NJ
| | - S. G. Eckhardt
- University of Colorado Cancer Center, Denver, CO; Fox Chase Cancer Center, Philadelphia, PA; ImClone Systems Incorporated, Branchburg, NJ
| | - S. Diab
- University of Colorado Cancer Center, Denver, CO; Fox Chase Cancer Center, Philadelphia, PA; ImClone Systems Incorporated, Branchburg, NJ
| | - L. Gore
- University of Colorado Cancer Center, Denver, CO; Fox Chase Cancer Center, Philadelphia, PA; ImClone Systems Incorporated, Branchburg, NJ
| | - L. Chow
- University of Colorado Cancer Center, Denver, CO; Fox Chase Cancer Center, Philadelphia, PA; ImClone Systems Incorporated, Branchburg, NJ
| | - C. O’Bryant
- University of Colorado Cancer Center, Denver, CO; Fox Chase Cancer Center, Philadelphia, PA; ImClone Systems Incorporated, Branchburg, NJ
| | - E. Temmer
- University of Colorado Cancer Center, Denver, CO; Fox Chase Cancer Center, Philadelphia, PA; ImClone Systems Incorporated, Branchburg, NJ
| | - A. Ervin-Haynes
- University of Colorado Cancer Center, Denver, CO; Fox Chase Cancer Center, Philadelphia, PA; ImClone Systems Incorporated, Branchburg, NJ
| | - T. Katz
- University of Colorado Cancer Center, Denver, CO; Fox Chase Cancer Center, Philadelphia, PA; ImClone Systems Incorporated, Branchburg, NJ
| | - F. Fox
- University of Colorado Cancer Center, Denver, CO; Fox Chase Cancer Center, Philadelphia, PA; ImClone Systems Incorporated, Branchburg, NJ
| | - R. B. Cohen
- University of Colorado Cancer Center, Denver, CO; Fox Chase Cancer Center, Philadelphia, PA; ImClone Systems Incorporated, Branchburg, NJ
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