1
|
Cordero-Hernandez IS, Ross AC, Dasari A, Halperin DM, Chasen B, Yao JC. Transformation of G1-G2 neuroendocrine tumors to neuroendocrine carcinomas following peptide receptor radionuclide therapy. Endocr Relat Cancer 2024; 31:e230203. [PMID: 38329269 DOI: 10.1530/erc-23-0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 07/07/2023] [Accepted: 02/08/2024] [Indexed: 02/09/2024]
Abstract
We observed that some patients with well-differentiated neuroendocrine tumors (NET) who received peptide receptor radionuclide therapy (PRRT) with Lutetium-177 (177Lu) DOTATATE developed rapid disease progression with biopsy-proven histologic transformation to neuroendocrine carcinoma (NEC), an outcome that has not been previously described. Therefore, we conducted a retrospective review of all patients with well-differentiated G1-G2 NET who received at least one cycle of PRRT with (177Lu) DOTATATE at our center from January 2019 to December 2020. Among 152 patients, we identified 7 patients whose NET transformed to NEC. Median time from start of PRRT to transformation was 8.2 months (range: 2.6-14.4 months). All patients whose tumors underwent transformation had pancreatic tail as the primary site and had prior chemotherapy with temozolomide. No differences in the incidence of transformation were observed according to gender, race, original tumor grade, or number of prior therapies. Six patients received treatment with platinum and etoposide after transformation with two patients having partial response as best response. All patients with transformation died from progressive disease with median overall survival (OS) after transformation of 3.3 months (95% CI 2.1-4.4). Molecular testing of transformed NEC identified mutation(s) in TP53 and/or ATM in all cases. Transformation of NET to NEC following PRRT is associated with aggressive course and dismal prognosis. Patients with pancreatic tail as the primary site who had prior therapy with temozolomide may be at a higher risk. Further investigation is necessary to determine the best treatment sequence in this patient population.
Collapse
Affiliation(s)
- Igryl S Cordero-Hernandez
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alicia C Ross
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Arvind Dasari
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Daniel M Halperin
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Beth Chasen
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - James C Yao
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
2
|
McConathy J, Dhawan M, Goenka AH, Lim EA, Menda Y, Chasen B, Khushman M, Mintz A, Zakharia Y, Sunderland JJ, Bowles O, Xiao J, Simmons AD, Wride K, Enke A, Hope TA. Abstract CT251: LuMIERE: A phase 1/2 study investigating safety, pharmacokinetics, dosimetry, and preliminary antitumor activity of 177Lu-FAP-2286 in patients with advanced or metastatic solid tumors. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-ct251] [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: Fibroblast activation protein (FAP) is a membrane-bound protease that is highly expressed on the surface of cancer-associated fibroblasts (CAFs) present in the tumor microenvironment of most epithelial cancers. With limited expression observed in normal tissues, FAP is a promising therapeutic and imaging target for delivery of radionuclides to cancer tissues. FAP-2286, a low-molecular-weight cyclic peptide that potently and selectively binds to FAP, is attached to a linker and tetraazacyclododecane tetraacetic acid (DOTA) cage that can be used to conjugate radionuclides such as lutetium-177 (177Lu) or gallium-68 (68Ga) for therapeutic or imaging applications, respectively. 177Lu-FAP-2286 has demonstrated antitumor activity in preclinical studies. The LuMIERE study (NCT04939610) is the first phase 1/2 clinical trial of an FAP-targeted radionuclide therapy evaluating 177Lu-FAP-2286 in patients with FAP-expressing solid tumors that are identified with the imaging agent 68Ga-FAP-2286.
Methods: Eligible adult patients with advanced or metastatic solid tumors and measurable disease (per RECIST v1.1) will be selected for treatment with 177Lu-FAP-2286 on the basis of FAP expression using 68Ga-FAP-2286. In phase 1, tumors must be refractory to or have progressed following prior treatment, with no satisfactory alternative treatment options. Phase 1 includes dose escalation of 177Lu-FAP-2286, starting at 3.7 GBq to a maximum of 9.25 GBq. Patients may receive up to 6 cycles of 177Lu-FAP-2286 administered on day 1 of each 6-week cycle. Three to 12 patients will be treated at each dose level in the dose-escalation portion. Tolerability will be assessed across multiple doses for determination of a recommended phase 2 dose (RP2D), which may be further evaluated in a phase 1 dose-expansion portion. FDG-PET/CT scans will be collected prior to treatment, and patients will be imaged by planar and SPECT/CT scans at multiple time points to calculate organ and tumor dosimetry to determine absorbed radiation dose. Disease status will be assessed per RECIST v1.1 every 6 weeks. The primary objective of phase 1 is to evaluate the safety of 177Lu-FAP-2286 and determine the RP2D. Secondary objectives include the assessment of radiation dosimetry, pharmacokinetics, and preliminary efficacy of 177Lu-FAP-2286 and the evaluation of safety and tumor uptake of 68Ga-FAP-2286. Phase 2 will evaluate the efficacy, safety, and dosimetry of 177Lu-FAP-2286 in patients with select FAP-expressing solid tumors.
Citation Format: Jonathan McConathy, Mallika Dhawan, Ajit H. Goenka, Emerson A. Lim, Yusuf Menda, Beth Chasen, Moh'd Khushman, Akiva Mintz, Yousef Zakharia, John J. Sunderland, Owen Bowles, Jim Xiao, Andrew D. Simmons, Kenton Wride, Aaron Enke, Thomas A. Hope. LuMIERE: A phase 1/2 study investigating safety, pharmacokinetics, dosimetry, and preliminary antitumor activity of 177Lu-FAP-2286 in patients with advanced or metastatic solid tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT251.
Collapse
Affiliation(s)
| | | | | | | | | | - Beth Chasen
- 6The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Moh'd Khushman
- 1University of Alabama School of Medicine, Birmingham, AL
| | - Akiva Mintz
- 4Columbia University Medical Center, New York, NY
| | | | | | | | - Jim Xiao
- 7Clovis Oncology, Inc., Boulder, CO
| | | | | | | | | |
Collapse
|
3
|
Mahvash A, Odisio B, Abdelsalam M, Kuban J, Metwalli Z, Chasen B, Murthy R, Kaseb A, Kappadath S. Abstract No. 201 Radioembolization for HCC patients with personalized yttrium-90 dosimetry for curative intent (RAPY90D): interim results. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
4
|
Johnson JM, Chen MM, Rohren EM, Prabhu S, Chasen B, Mawlawi O, Liu HL, Gule-Monroe MK. Delayed FDG PET Provides Superior Glioblastoma Conspicuity Compared to Conventional Image Timing. Front Neurol 2021; 12:740280. [PMID: 34867723 PMCID: PMC8635110 DOI: 10.3389/fneur.2021.740280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/14/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Glioblastomas are malignant, often incurable brain tumors. Reliable discrimination between recurrent disease and treatment changes is a significant challenge. Prior work has suggested glioblastoma FDG PET conspicuity is improved at delayed time points vs. conventional imaging times. This study aimed to determine the ideal FDG imaging time point in a population of untreated glioblastomas in preparation for future trials involving the non-invasive assessment of true progression vs. pseudoprogression in glioblastoma. Methods: Sixteen pre-treatment adults with suspected glioblastoma received FDG PET at 1, 5, and 8 h post-FDG injection within the 3 days prior to surgery. Maximum standard uptake values were measured at each timepoint for the central enhancing component of the lesion and the contralateral normal-appearing brain. Results: Sixteen patients (nine male) had pathology confirmed IDH-wildtype, glioblastoma. Our results revealed statistically significant improvements in the maximum standardized uptake values and subjective conspicuity of glioblastomas at later time points compared to the conventional (1 h time point). The tumor to background ratio at 1, 5, and 8 h was 1.4 ± 0.4, 1.8 ± 0.5, and 2.1 ± 0.6, respectively. This was statistically significant for the 5 h time point over the 1 h time point (p > 0.001), the 8 h time point over the 1 h time point (p = 0.026), and the 8 h time point over the 5 h time point (p = 0.036). Conclusions: Our findings demonstrate that delayed imaging time point provides superior conspicuity of glioblastoma compared to conventional imaging. Further research based on these results may translate into improvements in the determination of true progression from pseudoprogression.
Collapse
Affiliation(s)
- Jason Michael Johnson
- Department of Neuroradiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- *Correspondence: Jason Michael Johnson
| | - Melissa M. Chen
- Department of Neuroradiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Eric M. Rohren
- Department of Radiology, Baylor College of Medicine, Houston, TX, United States
| | - Sujit Prabhu
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Beth Chasen
- Department of Nuclear Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Osama Mawlawi
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ho-Ling Liu
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | |
Collapse
|
5
|
Kaseb AO, Kappadath SC, Lee SS, Raghav KP, Mohamed YI, Xiao L, Morris JS, Ohaji C, Avritscher R, Odisio BC, Kuban J, Abdelsalam ME, Chasen B, Elsayes KM, Elbanan M, Wolff RA, Yao JC, Mahvash A. A Prospective Phase II Study of Safety and Efficacy of Sorafenib Followed by 90Y Glass Microspheres for Patients with Advanced or Metastatic Hepatocellular Carcinoma. J Hepatocell Carcinoma 2021; 8:1129-1145. [PMID: 34527608 PMCID: PMC8437411 DOI: 10.2147/jhc.s318865] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/07/2021] [Accepted: 08/13/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose The most common cause of death in advanced/metastatic hepatocellular carcinoma (HCC) is liver failure due to tumor progression. While retrospective studies and meta-analyses of systemic therapy combined with liver-directed therapy have been performed, prospective studies of safety/efficacy of antiangiogenesis followed by intra-arterial therapies are lacking. We tested our hypothesis that sorafenib followed by yttrium 90 glass microspheres (90Y GMs) is safe and that survival outcomes may improve by controlling hepatic tumors. Methods We enrolled 38 Child–Pugh A patients with advanced/metastatic HCC. In sum, 34 received sorafenib, followed after 4 weeks by 90Y GMs. Analysis of safety and survival outcomes was performed to assess adverse events, median progression-free survival, and overall survival. Results A total of 34 patients were evaluable: 14 (41.2%) with chronic hepatitis, nine (26.5%) with vascular invasion, and eleven (32.4%) with extrahepatic diseases. Safety analysis revealed that the combination therapy was well tolerated. Grade III–IV adverse events comprised fatigue (n=3), diarrhea (n=2), nausea (n=1), vomiting (n=2), hypertension (n=4), thrombocytopenia (n=1), hyperbilirubinemia (n=1), proteinuria (n=1), hyponatremia (n=1), and elevated alanine or aspartate aminotransferase (n=5). Median progression-free and overall survival were 10.4 months (95% CI 5.8–14.4) and 13.2 months (95% CI 7.9–18.9), respectively. Twelve patients (35.3%) achieved partial responses and 16 (47.0%) stable disease. Median duration of sorafenib was 20 (3–90) weeks, and average dose was 622 (466–800) mg daily. Dosimetry showed similar mean doses between planned and delivered calculations to normal liver and tumor:normal liver uptake ratio, with no significant correlation with adverse events at 3 and 6 months post-90Y treatment. Conclusion This is the first prospective study to evaluate sorafenib followed by 90Y in patients with advanced HCC. The study validated our hypothesis of safety with encouraging efficacy signals of the sequencing treatment, and provides proof of concept for future combination modalities for patients with advanced or metastatic HCC. Clinical Trial Registration Number NCT01900002.
Collapse
Affiliation(s)
- Ahmed Omar Kaseb
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S Cheenu Kappadath
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sunyoung S Lee
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kanwal Pratap Raghav
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yehia I Mohamed
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lianchun Xiao
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey S Morris
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chimela Ohaji
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rony Avritscher
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bruno C Odisio
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joshua Kuban
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mohamed E Abdelsalam
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Beth Chasen
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Khaled M Elsayes
- Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mohamed Elbanan
- Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Robert A Wolff
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - James C Yao
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Armeen Mahvash
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
6
|
Mueller-Schoell A, Puebla-Osorio N, Michelet R, Green MR, Künkele A, Huisinga W, Strati P, Chasen B, Neelapu SS, Yee C, Kloft C. Early Survival Prediction Framework in CD19-Specific CAR-T Cell Immunotherapy Using a Quantitative Systems Pharmacology Model. Cancers (Basel) 2021; 13:2782. [PMID: 34205020 PMCID: PMC8199881 DOI: 10.3390/cancers13112782] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 03/28/2021] [Revised: 05/22/2021] [Accepted: 05/28/2021] [Indexed: 12/20/2022] Open
Abstract
Chimeric antigen receptor (CAR)-T cell therapy has revolutionized treatment of relapsed/refractory non-Hodgkin lymphoma (NHL). However, since 36-60% of patients relapse, early response prediction is crucial. We present a novel population quantitative systems pharmacology model, integrating literature knowledge on physiology, immunology, and adoptive cell therapy together with 133 CAR-T cell phenotype, 1943 cytokine, and 48 metabolic tumor measurements. The model well described post-infusion concentrations of four CAR-T cell phenotypes and CD19+ metabolic tumor volume over 3 months after CAR-T cell infusion. Leveraging the model, we identified a low expansion subpopulation with significantly lower CAR-T cell expansion capacities amongst 19 NHL patients. Together with two patient-/therapy-related factors (autologous stem cell transplantation, CD4+/CD8+ T cells), the low expansion subpopulation explained 2/3 of the interindividual variability in the CAR-T cell expansion capacities. Moreover, the low expansion subpopulation had poor prognosis as only 1/4 of the low expansion subpopulation compared to 2/3 of the reference population were still alive after 24 months. We translated the expansion capacities into a clinical composite score (CCS) of 'Maximum naïve CAR-T cell concentrations/Baseline tumor burden' ratio and propose a CCSTN-value > 0.00136 (cells·µL-1·mL-1 as predictor for survival. Once validated in a larger cohort, the model will foster refining survival prediction and solutions to enhance NHL CAR-T cell therapy response.
Collapse
Affiliation(s)
- Anna Mueller-Schoell
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, 12169 Berlin, Germany; (A.M.-S.); (R.M.)
- Graduate Research Training Program PharMetrX, 12169 Berlin, Germany
| | - Nahum Puebla-Osorio
- Department of Lymphoma and Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (N.P.-O.); (M.R.G.); (P.S.)
| | - Robin Michelet
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, 12169 Berlin, Germany; (A.M.-S.); (R.M.)
| | - Michael R. Green
- Department of Lymphoma and Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (N.P.-O.); (M.R.G.); (P.S.)
| | - Annette Künkele
- Department of Pediatric Oncology and Hematology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt–Universität zu Berlin, Augustenburger Platz 1, 1335 Berlin, Germany;
- German Cancer Consortium (DKTK), Partner Site Berlin, CCC (Campus Mitte), 10178 Berlin, Germany
| | - Wilhelm Huisinga
- Institute of Mathematics, University of Potsdam, 14476 Potsdam, Germany;
| | - Paolo Strati
- Department of Lymphoma and Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (N.P.-O.); (M.R.G.); (P.S.)
| | - Beth Chasen
- Department of Nuclear Medicine, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Sattva S. Neelapu
- Department of Lymphoma and Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (N.P.-O.); (M.R.G.); (P.S.)
| | - Cassian Yee
- Department of Melanoma Medical Oncology, UT MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Immunology, UT MD Anderson Cancer Center, Houston, TX 70030, USA
| | - Charlotte Kloft
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, 12169 Berlin, Germany; (A.M.-S.); (R.M.)
| |
Collapse
|
7
|
Teyateeti A, Mahvash A, Long JP, Abdelsalam ME, Avritscher R, Chasen B, Kaseb AO, Kuban JD, Murthy R, Odisio BC, Teyateeti A, Macapinlac HA, Kappadath SC. Survival Outcomes for Yttrium-90 Transarterial Radioembolization With and Without Sorafenib for Unresectable Hepatocellular Carcinoma Patients. J Hepatocell Carcinoma 2020; 7:117-131. [PMID: 32984089 PMCID: PMC7500841 DOI: 10.2147/jhc.s248314] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 02/04/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose To assess the overall survival (OS) and progression-free survival (PFS) of unresectable hepatocellular carcinoma (HCC) patients undergoing yttrium-90 glass–microsphere transarterial radioembolization (TARE) with and without concurrent sorafenib. Methods OS and PFS were analyzed in 55 patients with an intrahepatic tumor (IHT) ≤50% without advanced or aggressive disease features (ADFs), which was referred to presence of infiltrative/ill-defined HCC, macrovascular invasion, or extrahepatic disease treated with only TARE (TARE_alone) and in 74 patients with IHT ≤50% with ADFs or IHT >50% treated with TARE and sorafenib (TARE_sorafenib). Prognostic factors for OS and PFS were identified using univariate and multivariate analyses. Results Median OS and PFS of TARE_alone patients were 21.6 (95% CI 6.1–37.1) and 9.1(95% CI 5.2–13.0) months, respectively, and for TARE_sorafenib patients 12.4 (95% CI 9.1–15.6) and 5.1 (95% CI 2.6–7.5) months, respectively. Better OS was associated with serum AFP <400 (HR 0.27, p=0.02) in TARE_alone, and IHT ≤50% (HR 0.39, p=0.004) and AFP <400 (HR 0.5, p=0.027) in TARE_sorafenib. Unilobar involvement (HR 0.43, p=0.029) and AFP <400 ng/mL (HR 0.52, p=0.015) correlated with better PFS in TARE_alone and TARE_sorafenib, respectively. Adverse events (AEs) were more frequent in TARE_sorafenib than TARE_alone (92.4 vs 80.3%), but only 9.3% were grade 3 or higher AEs. Conclusion TARE_alone provided the most prominent survival benefit in IHT ≤50%–without ADF patients who had unilobar HCC and serum AFP <400 ng/mL. TARE and sorafenib yielded the best outcomes in patients with IHT ≤50% and serum AFP <400 ng/mL, with some additional grade 1–2 AEs compared to TARE only.
Collapse
Affiliation(s)
- Ajalaya Teyateeti
- Department of Nuclear Medicine, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Armeen Mahvash
- Department of Interventional Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - James P Long
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mohamed E Abdelsalam
- Department of Interventional Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rony Avritscher
- Department of Interventional Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Beth Chasen
- Department of Nuclear Medicine, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ahmed O Kaseb
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joshua D Kuban
- Department of Interventional Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ravi Murthy
- Department of Interventional Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bruno C Odisio
- Department of Interventional Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Achiraya Teyateeti
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Homer A Macapinlac
- Department of Nuclear Medicine, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S Cheenu Kappadath
- Department of Imaging Physics, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
8
|
Bhutani MS, Klapman JB, Tuli R, El-Haddad G, Hoffe S, Wong FCL, Chasen B, Fogelman DR, Lo SK, Nissen NN, Hendifar AE, Varadhachary G, Katz MHG, Erwin WD, Koay EJ, Tamm EP, Singh BS, Mehta R, Wolff RA, Soman A, Cazacu IM, Herman JM. An open-label, single-arm pilot study of EUS-guided brachytherapy with phosphorus-32 microparticles in combination with gemcitabine +/- nab-paclitaxel in unresectable locally advanced pancreatic cancer (OncoPaC-1): Technical details and study protocol. Endosc Ultrasound 2020; 9:24-30. [PMID: 31670288 PMCID: PMC7038730 DOI: 10.4103/eus.eus_44_19] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Current treatment options for patients with unresectable locally advanced pancreatic cancer (LAPC) include chemotherapy alone or followed by chemoradiation or stereotactic body radiotherapy. However, the prognosis for these patients remains poor, with a median overall survival <12 months. Therefore, novel treatment options are needed. Currently, there is no brachytherapy device approved for pancreatic cancer treatment. Hereby, we present the protocol of a prospective, multicenter, interventional, open-label, single-arm pilot study (OncoPac-1, Clinicaltrial.gov-NCT03076216) aiming to determine the safety and efficacy of Phosphorus-32 when implanted directly into pancreatic tumors using EUS guidance, for patients with unresectable LAPC undergoing chemotherapy (gemcitabine ± nab-paclitaxel).
Collapse
Affiliation(s)
- Manoop S Bhutani
- Department of Gastroenterology, Hepatology and Nutrition, Houston, TX, USA
| | - Jason B Klapman
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Richard Tuli
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ghassan El-Haddad
- Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Sarah Hoffe
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Franklin C L Wong
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Beth Chasen
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David R Fogelman
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Simon K Lo
- Division of Digestive and Liver Diseases, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Nicholas N Nissen
- Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Andrew E Hendifar
- Department of Hematology/Oncology, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Gauri Varadhachary
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Matthew H G Katz
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - William D Erwin
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eugene J Koay
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eric P Tamm
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ben S Singh
- Department of Gastroenterology, Hepatology and Nutrition, Houston, TX, USA
| | - Rutika Mehta
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Robert A Wolff
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ashish Soman
- Department of OncoSil Medical Ltd., Sydney, Australia
| | - Irina M Cazacu
- Department of Gastroenterology, Hepatology and Nutrition, Houston, TX, USA
| | - Joseph M Herman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
9
|
Jimenez C, Erwin W, Chasen B. Targeted Radionuclide Therapy for Patients with Metastatic Pheochromocytoma and Paraganglioma: From Low-Specific-Activity to High-Specific-Activity Iodine-131 Metaiodobenzylguanidine. Cancers (Basel) 2019; 11:cancers11071018. [PMID: 31330766 PMCID: PMC6678905 DOI: 10.3390/cancers11071018] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [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: 06/13/2019] [Revised: 07/03/2019] [Accepted: 07/17/2019] [Indexed: 12/13/2022] Open
Abstract
Low-specific-activity iodine-131–radiolabeled metaiodobenzylguanidine (I-131-MIBG) was introduced last century as a potential systemic therapy for patients with malignant pheochromocytomas and paragangliomas. Collective information derived from mainly retrospective studies has suggested that 30–40% of patients with these tumors benefit from this treatment. A low index of radioactivity, lack of therapeutic standardization, and toxicity associated with intermediate to high activities (absorbed radiation doses) has prevented the implementation of I-131-MIBG’s in clinical practice. High-specific-activity, carrier-free I-131-MIBG has been developed over the past two decades as a novel therapy for patients with metastatic pheochromocytomas and paragangliomas that express the norepinephrine transporter. This drug allows for a high level of radioactivity, and as yet is not associated with cardiovascular toxicity. In a pivotal phase two clinical trial, more than 90% of patients achieved partial responses and disease stabilization with the improvement of hypertension. Furthermore, many patients exhibited long-term persistent antineoplastic effects. Currently, the high-specific-activity I-131-MIBG is the only approved therapy in the US for patients with metastatic pheochromocytomas and paragangliomas. This review will discuss the historical development of high-specific-activity I-131-MIBG, its benefits and adverse events, and future directions for clinical practice applicability and trial development.
Collapse
Affiliation(s)
- Camilo Jimenez
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1461, Houston, TX 77030, USA.
| | - William Erwin
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1461, Houston, TX 77030, USA
| | - Beth Chasen
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| |
Collapse
|
10
|
Stewart KI, Chasen B, Erwin W, Fleming N, Westin SN, Dioun S, Frumovitz M, Ramirez PT, Lu KH, Wong F, Aloia TA, Soliman PT. Preoperative PET/CT does not accurately detect extrauterine disease in patients with newly diagnosed high-risk endometrial cancer: A prospective study. Cancer 2019; 125:3347-3353. [PMID: 31225906 DOI: 10.1002/cncr.32329] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND The identification of extrauterine disease is critical to the management of patients with high-risk endometrial cancer. The purpose of the current study was to determine the accuracy of preoperative positron emission tomography (PET)/computed tomography (CT) in the detection of extrauterine disease. METHODS Women with high-risk endometrial cancer were enrolled prospectively and underwent preoperative PET/CT followed by surgery, including sentinel lymph node biopsy and lymphadenectomy. Primary tumor factors on PET/CT were correlated with lymph node pathology. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for the detection of lymphadenopathy and peritoneal disease by PET/CT. RESULTS A total of 112 patients were enrolled and underwent PET/CT between April 2013 and May 2016, 108 of whom were evaluable. On PET/CT, 21 patients (19.4%) were found to have extrauterine disease, 18 (17%) had positive lymph nodes, and 8 (7%) had peritoneal disease. A total of 108 patients underwent surgery, 103 of whom (95%) underwent lymphadenectomy. The sensitivity of PET/CT to detect positive lymph nodes was 45.8%, with a specificity of 91.1%, positive predictive value of 61.1%, and negative predictive value of 84.7%. The false-negative rate was 54.2%. There was no difference in primary tumor characteristics on imaging noted between patients with positive and negative lymph nodes. The sensitivity of PET/CT to detect peritoneal disease was 37.5%, with a specificity of 97.8%, positive predictive value of 75%, and negative predictive value of 90.0%. The false-negative rate was 62.5%. CONCLUSIONS Preoperative PET/CT did not reliably predict the presence of extrauterine disease in women with high-risk endometrial cancer. Given the high false-negative rates, PET/CT should not be used in the preoperative treatment planning of these patients.
Collapse
Affiliation(s)
- Katherine I Stewart
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Beth Chasen
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - William Erwin
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Nicole Fleming
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shannon N Westin
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shayan Dioun
- Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, New York
| | - Michael Frumovitz
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Pedro T Ramirez
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Karen H Lu
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Franklin Wong
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Thomas A Aloia
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Pamela T Soliman
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
11
|
Mahvash A, Chasen B, Dimayuga MB, Santiago G, Patel M, Odisio B, Le D, Kuban J, Abdelsalam M, Avritscher R, Murthy R, Kappadath S. 03:36 PM Abstract No. 329 Feasibility of single-session in-room Yttrium-90 radioembolization (RE) diagnostic angiography and treatment. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
12
|
Al Feghali KA, Yeboa DN, Chasen B, Gule MK, Johnson JM, Chung C. The Use of 68Ga-DOTATATE PET/CT in the Non-invasive Diagnosis of Optic Nerve Sheath Meningioma: A Case Report. Front Oncol 2018; 8:454. [PMID: 30386741 PMCID: PMC6198069 DOI: 10.3389/fonc.2018.00454] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 08/03/2018] [Accepted: 09/26/2018] [Indexed: 12/31/2022] Open
Abstract
We hereby report the case of a patient with optic nerve sheath meningioma (ONSM), whose diagnosis and multidisciplinary management was guided by the use of Gallium-68 (68Ga)-labeled dodecanetetraacetic acid-tyrosine-3-octreotate (DOTATATE) positron emission tomography (PET)/computed tomography (CT) scan. We briefly review the diagnosis and management of ONSM, and review the literature on the role and current status of nuclear imaging with somatostatin receptor ligands in the non-invasive diagnosis and management of meningiomas.
Collapse
Affiliation(s)
- Karine A Al Feghali
- Division of Radiation Oncology, Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Debra N Yeboa
- Division of Radiation Oncology, Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Beth Chasen
- Division of Diagnostic Imaging, Department of Nuclear Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Maria K Gule
- Division of Diagnostic Imaging, Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jason M Johnson
- Division of Diagnostic Imaging, Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Caroline Chung
- Division of Radiation Oncology, Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| |
Collapse
|
13
|
Strosberg J, Wolin E, Chasen B, Kulke M, Bushnell D, Caplin M, Baum RP, Kunz P, Hobday T, Hendifar A, Oberg K, Sierra ML, Thevenet T, Margalet I, Ruszniewski P, Krenning E. Health-Related Quality of Life in Patients With Progressive Midgut Neuroendocrine Tumors Treated With 177Lu-Dotatate in the Phase III NETTER-1 Trial. J Clin Oncol 2018; 36:2578-2584. [PMID: 29878866 DOI: 10.1200/jco.2018.78.5865] [Citation(s) in RCA: 226] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose Neuroendocrine tumor (NET) progression is associated with deterioration in quality of life (QoL). We assessed the impact of 177Lu-Dotatate treatment on time to deterioration in health-related QoL. Methods The NETTER-1 trial is an international phase III study in patients with midgut NETs. Patients were randomly assigned to treatment with 177Lu-Dotatate versus high-dose octreotide. European Organisation for Research and Treatment of Cancer quality-of-life questionnaires QLQ C-30 and G.I.NET-21 were assessed during the trial to determine the impact of treatment on health-related QoL. Patients completed the questionnaires at baseline and every 12 weeks until tumor progression. QoL scores were converted to a 100-point scale according to European Organisation for Research and Treatment of Cancer instructions, and individual changes from baseline scores were assessed. Time to QoL deterioration (TTD) was defined as the time from random assignment to the first QoL deterioration ≥ 10 points for each patient in the corresponding domain scale. All analyses were conducted on the intention-to-treat population. Patients with no deterioration were censored at the last QoL assessment date. Results TTD was significantly longer in the 177Lu-Dotatate arm (n = 117) versus the control arm (n = 114) for the following domains: global health status (hazard ratio [HR], 0.406), physical functioning (HR, 0.518), role functioning (HR, 0.580), fatigue (HR, 0.621), pain (HR, 0.566), diarrhea (HR, 0.473), disease-related worries (HR, 0.572), and body image (HR, 0.425). Differences in median TTD were clinically significant in several domains: 28.8 months versus 6.1 months for global health status, and 25.2 months versus 11.5 months for physical functioning. Conclusion This analysis from the NETTER-1 phase III study demonstrates that, in addition to improving progression-free survival, 177Lu-Dotatate provides a significant QoL benefit for patients with progressive midgut NETs compared with high-dose octreotide.
Collapse
Affiliation(s)
- Jonathan Strosberg
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Edward Wolin
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Beth Chasen
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Matthew Kulke
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - David Bushnell
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Martyn Caplin
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Richard P Baum
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Pamela Kunz
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Timothy Hobday
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Andrew Hendifar
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Kjell Oberg
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Maribel Lopera Sierra
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Thomas Thevenet
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Ines Margalet
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Philippe Ruszniewski
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | - Eric Krenning
- Jonathan Strosberg, Moffitt Cancer Center, Tampa, FL; Edward Wolin, Montefiore Einstein Center for Cancer Care, Bronx, NY; Beth Chasen, University of Texas MD Anderson Cancer Center, Houston, TX; Matthew Kulke, Dana-Farber Cancer Institute, Boston, MA; David Bushnell, University of Iowa, Iowa City, IA; Martyn Caplin, Royal Free Hospital, London, United Kingdom; Richard P. Baum, Zentralklinik, Bad Berka, Germany; Pamela Kunz, Stanford University Medical Center, Stanford; Andrew Hendifar, Cedars Sinai Medical Center, Los Angeles, CA; Timothy Hobday, Mayo Clinic College of Medicine, Rochester, MN; Kjell Oberg, University Hospital, Uppsala University, Uppsala, Sweden; Maribel Lopera Sierra, Thomas Thevenet, and Ines Margalet, Advanced Accelerator Applications, Geneva, Switzerland; Philippe Ruszniewski, Hopital Beaujon and Paris Diderot University, Clichy, France; and Eric Krenning, Erasmus Medical Center, Rotterdam, Netherlands
| | | |
Collapse
|
14
|
Stewart K, Chasen B, Erwin W, Fleming N, Westin S, Frumovitz M, Ramirez P, Dioun S, Lu K, Wong F, Soliman P. The utility of preoperative PET/CT in the detection of extrauterine disease in high-risk endometrial cancer: A prospective study. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.074] [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: 11/26/2022]
|
15
|
Strosberg J, Wolin E, Chasen B, Kulke M, Bushnell D, Caplin M, Baum R, Kunz P, Hobday T, Hendifar A, Öberg K, Lopera Sierra M, Ruszniewski P, Krenning E. Improved time to quality of life deterioration in patients with progressive midgut neuroendocrine tumors treated with 177Lu-DOTATATE: The NETTER-1 phase III trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx368.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
16
|
Strosberg JR, Wolin EM, Chasen B, Kulke MH, Bushnell DL, Caplin ME, Baum RP, Kunz PL, Hobday TJ, Hendifar AE, Oberg KE, Lopera Sierra M, Kwekkeboom DJ, Ruszniewski PB, Krenning E. Quality-of-life findings in patients with midgut neuroendocrine tumors: Results of the NETTER-1 phase III trial. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.348] [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
348 Background: Neuroendocrine tumor progression is associated with decline in quality of life, both due to tumor and hormone-related symptoms. The Phase III NETTER-1 trial randomized patients with advanced, progressive midgut NETs to receive treatment with 177Lu-DOTATATE (177Lu; Lutathera) versus high-dose (60 mg) Octreotide LAR (Oct). EORTC questionnaires C30 and GINET21 were assessed during the trial in order to determine the impact of treatment on health-related quality of life (HRQoL). Methods: Patients completed EORTC QLQ-30 and QLQ-G.I.NET21 questionnaires at baseline and every 12 weeks thereafter until disease progression. Raw scores were converted to a 100-point scale and individual changes from baseline scores were assessed. Clinically relevant ( ≥ 10 point) deterioration/improvement was considered clinically significant. Results: Clinically and statistically significant improvements in QoL were observed in the 177Lu arm versus the Oct arm at certain time points in key domains of HRQoL including global health status and diarrhea. In mean, global health status improved in 28% of patients on 177Lu arm vs. 15% on Oct, and worsened in 18% of patients on 177Lu vs. 26% on Oct. Diarrhea improved in 39% of patients on 177Lu vs. 23% on Oct, and worsened in 19% of patients on 177Lu vs. 23% on Oct. There was a trend towards improvement in pain that was not statistically significant. Flushing appeared to improve compared to baseline in both arms of the study with no clear advantage to treatment with 177Lu vs. Oct. Conclusions: QoL analysis suggests benefit in important domains associated with 177Lu treatment compared to high-dose octreotide in patients with advanced midgut NETs, and confirms the treatment value of 177Lu on patient QoL, in addition to the meaningful increase in progression-free survival already reported. Clinical trial information: NCT01578239.
Collapse
Affiliation(s)
| | | | - Beth Chasen
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | - Timothy J. Hobday
- Department of Oncology, Mayo Clinic College of Medicine, Rochester, MN
| | | | | | | | | | | | - Eric Krenning
- Erasmus University Medical Center, Rotterdam, Netherlands
| |
Collapse
|
17
|
Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, Mittra E, Kunz PL, Kulke MH, Jacene H, Bushnell D, O'Dorisio TM, Baum RP, Kulkarni HR, Caplin M, Lebtahi R, Hobday T, Delpassand E, Van Cutsem E, Benson A, Srirajaskanthan R, Pavel M, Mora J, Berlin J, Grande E, Reed N, Seregni E, Öberg K, Lopera Sierra M, Santoro P, Thevenet T, Erion JL, Ruszniewski P, Kwekkeboom D, Krenning E. Phase 3 Trial of 177Lu-Dotatate for Midgut Neuroendocrine Tumors. N Engl J Med 2017. [PMID: 28076709 DOI: 10.1056/nejmoa1607427/suppl_file/nejmoa1607427_disclosures.pdf] [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] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
BACKGROUND Patients with advanced midgut neuroendocrine tumors who have had disease progression during first-line somatostatin analogue therapy have limited therapeutic options. This randomized, controlled trial evaluated the efficacy and safety of lutetium-177 (177Lu)-Dotatate in patients with advanced, progressive, somatostatin-receptor-positive midgut neuroendocrine tumors. METHODS We randomly assigned 229 patients who had well-differentiated, metastatic midgut neuroendocrine tumors to receive either 177Lu-Dotatate (116 patients) at a dose of 7.4 GBq every 8 weeks (four intravenous infusions, plus best supportive care including octreotide long-acting repeatable [LAR] administered intramuscularly at a dose of 30 mg) (177Lu-Dotatate group) or octreotide LAR alone (113 patients) administered intramuscularly at a dose of 60 mg every 4 weeks (control group). The primary end point was progression-free survival. Secondary end points included the objective response rate, overall survival, safety, and the side-effect profile. The final analysis of overall survival will be conducted in the future as specified in the protocol; a prespecified interim analysis of overall survival was conducted and is reported here. RESULTS At the data-cutoff date for the primary analysis, the estimated rate of progression-free survival at month 20 was 65.2% (95% confidence interval [CI], 50.0 to 76.8) in the 177Lu-Dotatate group and 10.8% (95% CI, 3.5 to 23.0) in the control group. The response rate was 18% in the 177Lu-Dotatate group versus 3% in the control group (P<0.001). In the planned interim analysis of overall survival, 14 deaths occurred in the 177Lu-Dotatate group and 26 in the control group (P=0.004). Grade 3 or 4 neutropenia, thrombocytopenia, and lymphopenia occurred in 1%, 2%, and 9%, respectively, of patients in the 177Lu-Dotatate group as compared with no patients in the control group, with no evidence of renal toxic effects during the observed time frame. CONCLUSIONS Treatment with 177Lu-Dotatate resulted in markedly longer progression-free survival and a significantly higher response rate than high-dose octreotide LAR among patients with advanced midgut neuroendocrine tumors. Preliminary evidence of an overall survival benefit was seen in an interim analysis; confirmation will be required in the planned final analysis. Clinically significant myelosuppression occurred in less than 10% of patients in the 177Lu-Dotatate group. (Funded by Advanced Accelerator Applications; NETTER-1 ClinicalTrials.gov number, NCT01578239 ; EudraCT number 2011-005049-11 .).
Collapse
Affiliation(s)
- Jonathan Strosberg
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Ghassan El-Haddad
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Edward Wolin
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Andrew Hendifar
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - James Yao
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Beth Chasen
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Erik Mittra
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Pamela L Kunz
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Matthew H Kulke
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Heather Jacene
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - David Bushnell
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Thomas M O'Dorisio
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Richard P Baum
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Harshad R Kulkarni
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Martyn Caplin
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Rachida Lebtahi
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Timothy Hobday
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Ebrahim Delpassand
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Eric Van Cutsem
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Al Benson
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Rajaventhan Srirajaskanthan
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Marianne Pavel
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Jaime Mora
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Jordan Berlin
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Enrique Grande
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Nicholas Reed
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Ettore Seregni
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Kjell Öberg
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Maribel Lopera Sierra
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Paola Santoro
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Thomas Thevenet
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Jack L Erion
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Philippe Ruszniewski
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Dik Kwekkeboom
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Eric Krenning
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| |
Collapse
|
18
|
Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, Mittra E, Kunz PL, Kulke MH, Jacene H, Bushnell D, O'Dorisio TM, Baum RP, Kulkarni HR, Caplin M, Lebtahi R, Hobday T, Delpassand E, Van Cutsem E, Benson A, Srirajaskanthan R, Pavel M, Mora J, Berlin J, Grande E, Reed N, Seregni E, Öberg K, Lopera Sierra M, Santoro P, Thevenet T, Erion JL, Ruszniewski P, Kwekkeboom D, Krenning E. Phase 3 Trial of 177Lu-Dotatate for Midgut Neuroendocrine Tumors. N Engl J Med 2017; 376:125-135. [PMID: 28076709 PMCID: PMC5895095 DOI: 10.1056/nejmoa1607427] [Citation(s) in RCA: 1871] [Impact Index Per Article: 267.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients with advanced midgut neuroendocrine tumors who have had disease progression during first-line somatostatin analogue therapy have limited therapeutic options. This randomized, controlled trial evaluated the efficacy and safety of lutetium-177 (177Lu)-Dotatate in patients with advanced, progressive, somatostatin-receptor-positive midgut neuroendocrine tumors. METHODS We randomly assigned 229 patients who had well-differentiated, metastatic midgut neuroendocrine tumors to receive either 177Lu-Dotatate (116 patients) at a dose of 7.4 GBq every 8 weeks (four intravenous infusions, plus best supportive care including octreotide long-acting repeatable [LAR] administered intramuscularly at a dose of 30 mg) (177Lu-Dotatate group) or octreotide LAR alone (113 patients) administered intramuscularly at a dose of 60 mg every 4 weeks (control group). The primary end point was progression-free survival. Secondary end points included the objective response rate, overall survival, safety, and the side-effect profile. The final analysis of overall survival will be conducted in the future as specified in the protocol; a prespecified interim analysis of overall survival was conducted and is reported here. RESULTS At the data-cutoff date for the primary analysis, the estimated rate of progression-free survival at month 20 was 65.2% (95% confidence interval [CI], 50.0 to 76.8) in the 177Lu-Dotatate group and 10.8% (95% CI, 3.5 to 23.0) in the control group. The response rate was 18% in the 177Lu-Dotatate group versus 3% in the control group (P<0.001). In the planned interim analysis of overall survival, 14 deaths occurred in the 177Lu-Dotatate group and 26 in the control group (P=0.004). Grade 3 or 4 neutropenia, thrombocytopenia, and lymphopenia occurred in 1%, 2%, and 9%, respectively, of patients in the 177Lu-Dotatate group as compared with no patients in the control group, with no evidence of renal toxic effects during the observed time frame. CONCLUSIONS Treatment with 177Lu-Dotatate resulted in markedly longer progression-free survival and a significantly higher response rate than high-dose octreotide LAR among patients with advanced midgut neuroendocrine tumors. Preliminary evidence of an overall survival benefit was seen in an interim analysis; confirmation will be required in the planned final analysis. Clinically significant myelosuppression occurred in less than 10% of patients in the 177Lu-Dotatate group. (Funded by Advanced Accelerator Applications; NETTER-1 ClinicalTrials.gov number, NCT01578239 ; EudraCT number 2011-005049-11 .).
Collapse
Affiliation(s)
- Jonathan Strosberg
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Ghassan El-Haddad
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Edward Wolin
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Andrew Hendifar
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - James Yao
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Beth Chasen
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Erik Mittra
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Pamela L Kunz
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Matthew H Kulke
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Heather Jacene
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - David Bushnell
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Thomas M O'Dorisio
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Richard P Baum
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Harshad R Kulkarni
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Martyn Caplin
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Rachida Lebtahi
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Timothy Hobday
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Ebrahim Delpassand
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Eric Van Cutsem
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Al Benson
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Rajaventhan Srirajaskanthan
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Marianne Pavel
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Jaime Mora
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Jordan Berlin
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Enrique Grande
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Nicholas Reed
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Ettore Seregni
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Kjell Öberg
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Maribel Lopera Sierra
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Paola Santoro
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Thomas Thevenet
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Jack L Erion
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Philippe Ruszniewski
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Dik Kwekkeboom
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| | - Eric Krenning
- From the Moffitt Cancer Center, Tampa, FL (J.S., G.E.-H.); Markey Cancer Center, University of Kentucky, Lexington (E.W.); Cedars Sinai Medical Center, Los Angeles (A.H.), and Stanford University School of Medicine, Stanford (E.M., P.L.K.) - both in California; University of Texas M.D. Anderson Cancer Center (J.Y., B.C.) and Excel Diagnostics Imaging Clinic (E.D.), Houston; Dana-Farber Cancer Institute, Boston (M.H.K., H.J.); University of Iowa, Iowa City (D.B., T.M.O.); Zentralklinik, Bad Berka (R.P.B., H.R.K.), and Charité-Universitätsmedizin, Berlin (M.P.) - both in Germany; Royal Free Hospital (M.C.) and King's College Hospital NHS Foundation Trust (R.S.), London, and Beatson Oncology Centre, Glasgow (N.R.) - all in the United Kingdom; Hôpital Beaujon, Clichy (R.L., P.R.), and Advanced Accelerator Applications, St. Genis-Pouilly (T.T.) - both in France; Mayo Clinic College of Medicine, Rochester, MN (T.H.); University Hospitals and KU Leuven, Leuven, Belgium (E.V.C.); Robert H. Lurie Comprehensive Cancer Center, Chicago (A.B.); Hospital Universitari de Bellvitge, Barcelona (J.M.), and Hospital Universitario Ramón y Cajal, Madrid (E.G.) - both in Spain; Vanderbilt University Medical Center, Nashville (J.B.); Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan (E.S.); University Hospital, Uppsala University, Uppsala, Sweden (K.O.); Advanced Accelerator Applications USA, New York (M.L.S., P.S., J.L.E.); and Erasmus Medical Center, Rotterdam, the Netherlands (D.K., E.K.)
| |
Collapse
|
19
|
Strosberg J, Wolin E, Chasen B, Kulke M, Bushnell D, Caplin M, Baum R, Kunz P, Hobday T, Hendifar A, Oberg K, Sierra ML, Kwekkeboom D, Ruszniewski P, Krenning E. NETTER-1 phase III in patients with midgut neuroendocrine tumors treated with 177Lu-dotatate: Efficacy, safety, QoL results and subgroup analysis. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw369.05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
20
|
Strosberg J, Wolin E, Chasen B, Kulke M, Bushnell D, Chaplin M, Baum R, Kunz P, Hobday T, Oberg K, Lopera Sierra M, Kwekkeboom D, Ruszniewski P, Krenning E, Hendifar A. O-009 NETTER-1 phase III: efficacy and safety results in patients with midgut neuroendocrine tumors treated with 177Lu-dotatate. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw198.09] [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
|
21
|
Strosberg JR, Wolin EM, Chasen B, Kulke MH, Bushnell DL, Caplin ME, Baum RP, Hobday TJ, Hendifar AE, Oberg KE, Lopera Sierra M, Kwekkeboom DJ, Ruszniewski PB, Krenning E, Kunz PL. NETTER-1 phase III: Efficacy and safety results in patients with midgut neuroendocrine tumors treated with 177Lu-DOTATATE. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.4005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Beth Chasen
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | - Timothy J. Hobday
- Department of Oncology, Mayo Clinic College of Medicine, Rochester, MN
| | - Andrew Eugene Hendifar
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | | | | | | | | | | |
Collapse
|
22
|
Baum R, Strosberg J, Wolin E, Chasen B, Kulke M, Bushnell D, Caplin M, Hobday T, Hendifar A, Oberg K, Lopera Sierra M, Kwekkeboom D, Ruszniewsk P, Krenning E, Mittra E. SP-0570: Neuroendocrine tumours - personalised diagnosis and treatment using radiolabelled peptides. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31820-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
23
|
Strosberg JR, Wolin EM, Chasen B, Kulke MH, Bushnell DL, Caplin ME, Baum RP, Kunz PL, Hobday TJ, Hendifar AE, Oberg KE, Lopera Sierra M, Kwekkeboom DJ, Ruszniewski PB, Krenning E. NETTER-1 phase III: Progression-free survival, radiographic response, and preliminary overall survival results in patients with midgut neuroendocrine tumors treated with 177-Lu-Dotatate. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.4_suppl.194] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [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
194 Background: Currently, there are limited therapeutic options for patients with advanced midgut neuroendocrine tumors progressing on first-line somatostatin analog therapy. Methods: NETTER-1 is the first Phase III multicentric, randomized, controlled trial evaluating 177Lu-DOTA0-Tyr3-Octreotate (Lutathera) in patients with inoperable, progressive, somatostatin receptor positive midgut NETs. 230 patients with Grade 1-2 metastatic midgut NETs were randomized to receive Lutathera 7.4 GBq every 8 weeks (x4 administrations) versus Octreotide LAR 60 mg every 4-weeks. The primary endpoint was PFS per RECIST 1.1 criteria, with objective tumor assessment performed by an independent reading center every 12 weeks. Secondary objectives included objective response rate, overall survival, toxicity, and health-related quality of life. Results: Enrolment was completed in February 2015, with a target of 230 patients randomized (1:1) in 36 European and 15 sites in the United States. At the time of statistical analysis, the number of centrally confirmed disease progressions or deaths was 23 in the Lutathera group and 67 in the Octreotide LAR 60 mg group. The median PFS was not reached for Lutathera and was 8.4 months with 60 mg Octreotide LAR [95% CI: 5.8-11.0 months], p < 0.0001, with a hazard ratio of 0.21 [95% CI: 0.13-0.34]. Within the current evaluable patient dataset for tumor responses (n = 201), the number of CR+PR was 19 (18.8%) in the Lutathera group and 3 (3.0%) in the Octreotide LAR 60 mg group (p < 0.0004). Although the OS data were not mature enough for a definitive analysis, the number of deaths was 13 in the Lutathera group and 22 in the Octreotide LAR 60 mg group (p < 0.019 at interim analysis) which suggests an improvement in overall survival. Conclusions: The Phase III NETTER-1 trial provides evidence for a clinically meaningful and statistically significant increase in PFS and ORR, and also suggests a survival benefit in patients with advanced midgut NETs treated with Lutathera. Clinical trial information: NCT01578239.
Collapse
Affiliation(s)
| | | | - Beth Chasen
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | - Timothy J. Hobday
- Department of Oncology, Mayo Clinic College of Medicine, Rochester, MN
| | - Andrew Eugene Hendifar
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | | | | | | | | |
Collapse
|
24
|
Strosberg J, Wolin E, Chasen B, Kulke M, Bushnell D, Caplin M, Baum R, Mittra E, Hobday T, Hendifar A, Oberg K, Lopera Sierra M, Ruszniewski P, Kwekkeboom D. 6LBA 177-Lu-Dotatate significantly improves progression-free survival in patients with midgut neuroendocrine tumours: Results of the phase III NETTER-1 trial. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31929-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
25
|
Peungjesada S, Aloia TA, Fox P, Chasen B, Shin S, Baiomy A, Loyer EM. 18F-FDG Uptake at the Surgical Margin after Hepatic Resection: Patterns of Uptake and Differential Diagnosis. Eur Radiol 2015; 25:2453-9. [DOI: 10.1007/s00330-015-3631-5] [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] [Received: 09/26/2014] [Revised: 01/07/2015] [Accepted: 01/21/2015] [Indexed: 12/24/2022]
|
26
|
Mahvash A, Odisio B, Avritscher R, Chasen B, Murthy R. Temporary balloon occlusion of the common hepatic artery during Y90 radioembolization planning and treatment in patients with patent hepatoenteric collaterals. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.248] [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: 10/25/2022] Open
|
27
|
Oki Y, Chuang H, Chasen B, Jessop A, Pan T, Fanale M, Dabaja B, Fowler N, Romaguera J, Fayad L, Hagemeister F, Rodriguez MA, Neelapu S, Samaniego F, Kwak L, Younes A. The prognostic value of interim positron emission tomography scan in patients with classical Hodgkin lymphoma. Br J Haematol 2014; 165:112-6. [PMID: 24386943 DOI: 10.1111/bjh.12715] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 12/02/2013] [Indexed: 11/28/2022]
Abstract
The prognostic value of interim positron emission tomography (PET) was evaluated after 2 cycles of doxorubicin, bleomycin, vinblastin and dacarbazine in classical Hodgkin lymphoma patients (n = 229), based on Deauville criteria. In early stage non-bulky disease, bulky stage II disease, advanced stage low International Prognostic Score (IPS ≤2) and advanced stage (IPS ≥3), 3-year progression-free survival rates in PET2-negative vs. PET2-positive groups were 95·9% vs. 76·9% (P < 0·0018), 83·3% vs. 20·0% (P = 0·017), 77·0% vs. 30·0% (P < 0·001) and 71·0% vs. 44·4%(P = 0·155), respectively. The outcome after positive PET2 was better than previously reported. The results from non-randomized studies of PET2-guided therapy would be valuable with careful interpretation.
Collapse
Affiliation(s)
- Yasuhiro Oki
- Department of Lymphoma/Myeloma, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Odisio B, Shreyaah S, Mahvash A, Avritscher R, Chasen B, Murthy R, Garrett C. KRAS mutant metastatic colorectal cancer;is there a role for Yttrium-90 microsphere radioembolotherapy? J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
29
|
Gadani S, Mahvash A, Avritscher R, Chasen B, Kaseb A, Murthy R. Yttirum-90 resin microspheres as an adjunct to sorafenib in patients with unresectable HCC: a retrospective study for evaluation of survival benefit and adverse events. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
|
30
|
Speer M, Abdelsalam M, Chasen B, Murthy R, Mahvash A, Avritscher R. Abstract No. 378: The retroportal artery and other less well-known hepatoenteric pathways: moving beyond GDA and right gastric embolization. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
31
|
Mahvash A, Shreyaah S, Chasen B, Avritscher R, Murthy R. Abstract No. 161: Balloon-catheter occlusion technique for adminstration of Y90 microspheres in patients with patent hepatoenteric arteries. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.206] [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: 10/28/2022] Open
|
32
|
Haygood T, Malhotra K, Ng C, Chasen B, McEnery K, Chasen M. Migration of central lines from the superior vena cava to the azygous vein. Clin Radiol 2012; 67:49-54. [DOI: 10.1016/j.crad.2011.05.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 05/10/2011] [Accepted: 05/31/2011] [Indexed: 10/15/2022]
|
33
|
Murthy R, Mahvash A, Avritscher R, Erwin W, Chasen B, Eng C. Yttrium microspheres with cetuximab plus irinotecan for patients with advanced colorectal cancer metastases to liver. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps197] [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
|
34
|
|