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Gotlib J, Castells M, Elberink HO, Siebenhaar F, Hartmann K, Broesby-Olsen S, George TI, Panse J, Alvarez-Twose I, Radia DH, Tashi T, Bulai Livideanu C, Sabato V, Heaney M, Van Daele P, Cerquozzi S, Dybedal I, Reiter A, Pongdee T, Barete S, Ustun C, Schwartz L, Ward BR, Schafhausen P, Vadas P, Bose P, DeAngelo DJ, Rein L, Vachhani P, Triggiani M, Bonadonna P, Rafferty M, Butt NM, Oh ST, Wortmann F, Ungerstedt J, Guilarte M, Taparia M, Kuykendall AT, Arana Yi C, Ogbogu P, Gaudy-Marqueste C, Mattsson M, Shomali W, Giannetti MP, Bidollari I, Lin HM, Sulllivan E, Mar B, Scherber R, Roche M, Akin C, Maurer M. Avapritinib versus Placebo in Indolent Systemic Mastocytosis. NEJM Evid 2023; 2:EVIDoa2200339. [PMID: 38320129 DOI: 10.1056/evidoa2200339] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Avapritinib in Indolent Systemic MastocytosisIn a randomized trial, patients with indolent systemic mastocytosis were treated with avapritinib or placebo along with supportive care. The trial primary end point was the change in mean total symptom scores at 24 weeks. Avapritinib-treated patients had a decrease in mean total symptom score of 15.6 points compared with 9.2 points in the placebo group.
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Affiliation(s)
- Jason Gotlib
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA
| | - Mariana Castells
- Department of Medicine, Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Hanneke Oude Elberink
- Department of Allergology, University Medical Center, Groningen Research Institute Asthma and COPD, University of Groningen, Groningen, the Netherlands
| | - Frank Siebenhaar
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin
- Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin
| | - Karin Hartmann
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Sigurd Broesby-Olsen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - Tracy I George
- Associated Regional and University Pathologists, Inc. Laboratories, Department of Pathology, University of Utah School of Medicine, Salt Lake City
| | - Jens Panse
- Department of Oncology, Hematology, Hemostaseology, and Stem Cell Transplantation, University Hospital Aachen, Medical Faculty, Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany
- Center for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf (ABCD), Aachen, Germany
| | - Iván Alvarez-Twose
- Institute of Mastocytosis Studies of Castilla-La Mancha, Virgen del Valle Hospital, Toledo, Spain
| | - Deepti H Radia
- Guy's & St. Thomas' National Health Service Foundation Trust, London
| | - Tsewang Tashi
- Huntsman Cancer Institute, University of Utah, Salt Lake City
| | - Cristina Bulai Livideanu
- Department of Dermatology, Centre of Reference for Mastocytosis, Toulouse University Hospital, Toulouse, France
| | - Vito Sabato
- Department of Immunology, Allergology and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Mark Heaney
- Department of Medicine, Columbia University Medical Center, New York
| | - Paul Van Daele
- Department of Internal Medicine and Immunology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Sonia Cerquozzi
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ingunn Dybedal
- Department of Hematology, Oslo University Hospital, Oslo
| | - Andreas Reiter
- Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Thanai Pongdee
- Division of Allergic Diseases, Mayo Clinic, Rochester, MN
| | - Stéphane Barete
- Unit of Dermatology, Centre of Reference for Mastocytosis, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris
| | - Celalettin Ustun
- Department of Internal Medicine, Division of Hematology, Oncology and Cell Therapy, Section of Bone Marrow Transplantation and Cellular Therapy, Rush Medical College, Chicago
| | | | | | - Philippe Schafhausen
- Department of Oncology, Hematology, and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Vadas
- Department of Medicine, Division of Clinical Immunology and Allergy, St. Michael's Hospital, University of Toronto, Toronto
| | - Prithviraj Bose
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | | | - Lindsay Rein
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Pankit Vachhani
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Massimo Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - Patrizia Bonadonna
- Allergy Unit and Asthma Center, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Mark Rafferty
- The Beatson West of Scotland Cancer Centre, Glasgow, Scotland
| | - Nauman M Butt
- The Clatterbridge Cancer Centre, Bebington, Wirral, United Kingdom
| | - Stephen T Oh
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, Washington University, St. Louis
| | - Friederike Wortmann
- Oberärztin Hämatologie/Onkologie bei Uksh Campus Lübeck, Universitätsklinikum Schleswig-Holstein, Universität zu Lübeck, Lübeck, Schleswig-Holstein, Germany
| | - Johanna Ungerstedt
- Department of Medicine, Huddinge (H7), Karolinska University Hospitale, Stockholm
| | - Mar Guilarte
- Hospital UniversitariVall d'Hebron, Institut de Recerca Vall d'Hebron (VHIR), Barcelona
| | | | | | - Cecilia Arana Yi
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ
| | - Princess Ogbogu
- Division of Pediatric Allergy, Immunology and Rheumatology, Department of Pediatrics, University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland
| | - Caroline Gaudy-Marqueste
- Service de Dermatologie et de cancérologie cutanée, Assistance Publique-Hopitaux de Marseille, Aix-Marseille Université, Marseille, France
| | - Mattias Mattsson
- Department of Hematology, Uppsala University Hospital and Department of Immunology, Genetics and Pathology, Uppsala, Sweden
| | - William Shomali
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA
| | - Matthew P Giannetti
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston
| | | | - Hui-Min Lin
- Blueprint Medicines Corporation, Cambridge, MA
| | | | - Brenton Mar
- Blueprint Medicines Corporation, Cambridge, MA
| | | | - Maria Roche
- Blueprint Medicines Corporation, Cambridge, MA
| | - Cem Akin
- University of Michigan, Ann Arbor, MI
| | - Marcus Maurer
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin
- Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin
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Shields AL, Taylor F, Lamoureux RE, Padilla B, Severson K, Green T, Boral AL, Akin C, Siebenhaar F, Mar B. Psychometric evaluation of the Indolent Systemic Mastocytosis Symptom Assessment Form (ISM-SAF ©) and determination of a threshold score for moderate symptoms. Orphanet J Rare Dis 2023; 18:69. [PMID: 36964624 PMCID: PMC10039595 DOI: 10.1186/s13023-023-02661-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/11/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND The Indolent Systemic Mastocytosis Symptom Assessment Form (ISM-SAF) (©Blueprint Medicines Corporation), a 12-item daily diary that assesses 11 signs and symptoms of indolent systemic mastocytosis (ISM) and smoldering systemic mastocytosis (SSM), was psychometrically evaluated among patients with ISM. Additionally, thresholds of the ISM-SAF total symptom score (TSS) to distinguish patients with moderate to severe symptoms from those with mild symptoms were evaluated. METHODS The ISM-SAF was completed daily as an electronic diary in a prospective, observational study utilizing an online survey of patients with ISM in the United States. Descriptive statistics, psychometric analyses, and analyses to estimate ISM-SAF TSS clinical cutoff values were conducted. RESULTS A total of 103 patients (81.6% female; mean age = 50.2 [± 12.6]) with a self-reported diagnosis of ISM or SSM (58 of whom also had a medically documented diagnosis) contributed to the analyses. Psychometric analysis supported the trustworthiness of the biweekly TSS, which was reliable (α > 0.8, ICC > 0.9), construct-valid, and able to distinguish among clinically distinct groups as specified by the Patient Global Impression of Severity, 12-item Short-Form Health Survey, and Mastocytosis Quality of Life Questionnaire (p < 0.01). A biweekly ISM-SAF TSS from 21 to 28 begins to distinguish the moderately to severely symptomatic ISM/SSM patients from mildly symptomatic patients. CONCLUSION The biweekly TSS of ISM-SAF was reliable, construct-valid, and able to distinguish among clinically distinct groups. A cut-off value of 28 is a conservative threshold that can be used for screening purposes in future clinical studies to identify patients with at least a moderate severity of ISM symptoms.
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Affiliation(s)
| | | | | | | | | | | | | | - Cem Akin
- University of Michigan, Ann Arbor, MI, USA
| | - Frank Siebenhaar
- Institute of Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Fraunhofer Institute of Translational Medicine and Pharmacology ITMP, Immunology and Allergology IA, Berlin, Germany
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Mar B, Ekambaram M, Li KC, Zwirner J, Mei ML. The Influence of Saliva and Blood Contamination on Bonding Between Resin-modified Glass Ionomer Cements and Resin Composite. Oper Dent 2023; 48:218-225. [PMID: 36745507 DOI: 10.2341/21-173-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the influence of blood and saliva contamination on the microshear bond strength (μSBS) between resin-modified glass ionomer cement (RMGIC) and resin composite (RC). METHODS AND MATERIALS Eighty RMGIC discs were allocated into four groups (n=20). Group 1 received universal dental adhesive application in a self-etch mode followed by a build-up with RC. Group 2 received saliva as a contaminant, Group 3 received blood as a contaminant, Group 4 received a 1:1 blood-saliva mixture as a contaminant. Specimens from Groups 2, 3, and 4 were submerged into their respective contaminants for 15 seconds and dried prior to the adhesive application, followed by the protocol for Group 1. All specimens were stored in distilled water for 24 hours. Subsequently, the bonded specimens were subjected to μSBS testing using a universal testing machine. Failure mode of the debonded RMGIC surfaces was examined using scanning electron microscopy. RESULTS The μSBS from groups 1-4 were 10.76 ± 3.03 MPa, 9.36 ± 2.54 MPa, 6.55 ± 1.67 MPa and 8.42 ± 2.79 MPa, respectively. Contamination by blood and blood-saliva significantly decreased the μSBS (p<0.001, p=0.029). Saliva contamination alone had no statistically significant effect on the μSBS (p=0.524). A statistically significant difference in the mode of failure was detected between the experimental groups (p=0.012). CONCLUSION Saliva contamination has no influence on μSBS between RMGIC and RC when it is dried thoroughly, while blood and blood-saliva contamination reduced μSBS between RMGIC and RC even when dried thoroughly.
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Affiliation(s)
- B Mar
- Benjamin Mar, BDS, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - M Ekambaram
- Manikandan Ekambaram, BDS, MDS, PhD, Discipline of Paediatric Dentistry, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - K C Li
- Kai Chun Li, PhD, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - J Zwirner
- Johann Zwirner, MD, Dr Med, Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand, Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Institute of Legal Medicine, University of Leipzig, Leipzig, Germany
| | - M L Mei
- *May Lei Mei, BDS, MDS, PhD, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Padilla B, Shields AL, Taylor F, Li X, Mcdonald J, Green T, Boral AL, Lin HM, Akin C, Siebenhaar F, Mar B. Psychometric evaluation of the Indolent Systemic Mastocytosis Symptom Assessment Form (ISM-SAF) in a phase 2 clinical study. Orphanet J Rare Dis 2021; 16:434. [PMID: 34663404 PMCID: PMC8522163 DOI: 10.1186/s13023-021-02037-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/21/2021] [Accepted: 09/19/2021] [Indexed: 11/25/2022] Open
Abstract
Background Indolent systemic mastocytosis (ISM) is a rare, clonal mast cell neoplasm characterized by severe, unpredictable symptoms. The Indolent Systemic Mastocytosis Symptom Assessment Form (ISM-SAF) items compose a Total Symptom Score (TSS), Gastrointestinal Symptom Score (GSS), and Skin Symptom Score (SSS) to assess symptom severity. This study evaluated the psychometric performance of ISM-SAF among ISM patients. Methods In PIONEER, a Phase 2 trial evaluating safety and efficacy of selective kinase inhibitor avapritinib in patients with ISM, the 12-item ISM-SAF was administered daily. Psychometric evaluation of score reliability, validity, and clinical interpretation was conducted using the trial data. Results Thirty-eight patients contributed to analyses (78.9% female; mean age = 49). Baseline internal consistency reliability (α) for bi-weekly TSS, GSS, and SSS was 0.86, 0.83, and 0.82, respectively. Test–retest reliability among patients exhibiting no change in Patient Global Impression of Symptom Severity (PGIS) between Baseline and Day 15 exceeded 0.74 universally. Construct validity and known-groups analysis showed moderate to strong ISM-SAF score correlation (r = 0.382–0.881) to supportive patient-reported questionnaires (e.g., PGIS and Mastocytosis Quality of Life Questionnaire) symptom and skin scores, and ability to distinguish among clinically unique groups. Correlations of ISM-SAF and other assessment change scores reflect evidence of score sensitivity. Clinically important difference and response estimates were 7–10 and 19, respectively. Discussion ISM-SAF produced reliable, construct-valid, sensitive scores when administered in PIONEER to patients in the target population. Results of this study support the use of the ISM-SAF as a reliable and valid measure to evaluate disease symptomology in ISM patients. Trial registration ClinicalTrials.gov, NCT03731260. Registered 10 October 2018, https://clinicaltrials.gov/ct2/show/study/NCT03731260. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-02037-3.
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Affiliation(s)
- Brad Padilla
- Adelphi Values, 290 Congress Street 6th Floor, Boston, MA, 02210, USA
| | - Alan L Shields
- Adelphi Values, 290 Congress Street 6th Floor, Boston, MA, 02210, USA
| | - Fiona Taylor
- Adelphi Values, 290 Congress Street 6th Floor, Boston, MA, 02210, USA.
| | - Xiaoran Li
- Adelphi Values, 290 Congress Street 6th Floor, Boston, MA, 02210, USA
| | - Jeffrey Mcdonald
- Adelphi Values, 290 Congress Street 6th Floor, Boston, MA, 02210, USA
| | | | | | | | - Cem Akin
- University of Michigan, Ann Arbor, MI, USA
| | - Frank Siebenhaar
- Dermatological Allergology, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Taylor F, Akin C, Lamoureux RE, Padilla B, Green T, Boral AL, Mazar I, Mar B, Shields AL, Siebenhaar F. Development of symptom-focused outcome measures for advanced and indolent systemic mastocytosis: the AdvSM-SAF and ISM-SAF ©. Orphanet J Rare Dis 2021; 16:414. [PMID: 34627355 PMCID: PMC8501694 DOI: 10.1186/s13023-021-02035-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/26/2021] [Accepted: 09/19/2021] [Indexed: 12/01/2022] Open
Abstract
Background Advanced systemic mastocytosis (AdvSM), indolent systemic mastocytosis (ISM), and smoldering systemic mastocytosis (SSM) are rare diseases characterized by neoplastic mast cell infiltration of more than one organ. A content-valid patient-reported outcome (PRO) questionnaire that assesses relevant signs and symptoms that are important and understandable to individuals with a condition is critical for assessing new treatment benefit as well as supporting product labeling claims. Notably, no such PRO questionnaire has been developed in accordance with regulatory and scientific guidelines for use in AdvSM, ISM, and SSM patient populations. To fill that gap, this study documents the development and content validity of instruments evaluating signs and symptoms of systemic mastocytosis. Methods A review of peer-reviewed literature, advice meetings with clinical therapeutic area experts, patient concept elicitation interviews, concept selection and questionnaire construction meetings, and patient cognitive debriefing interviews were conducted, and regulatory feedback was incorporated. Results For AdvSM, 26 sign- and symptom-level concepts were identified in literature, 39 by clinicians, and 33 by patients. For ISM/SSM, 38 sign- and symptom-level concepts were identified in the literature, 39 by clinicians, and 57 by patients. Two patient-reported instruments, the Advanced Systemic Mastocytosis Symptom Assessment Form (AdvSM-SAF) and Indolent Systemic Mastocytosis Symptom Assessment Form (ISM-SAF)(©Blueprint Medicines Corporation), were developed based on consolidated findings. Cognitive debriefing interviews with AdvSM and ISM patients showed the AdvSM-SAF and ISM-SAF were understood and interpreted as intended by the majority of patients. Conclusion The AdvSM-SAF and ISM-SAF are content-valid tools measuring symptoms from AdvSM and ISM patients’ perspective. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-02035-5.
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Affiliation(s)
- Fiona Taylor
- Adelphi Values, 225 Franklin St 10th Floor, Boston, MA, 02110, USA.
| | - Cem Akin
- University of Michigan, Ann Arbor, MI, USA
| | | | - Brad Padilla
- Adelphi Values, 225 Franklin St 10th Floor, Boston, MA, 02110, USA
| | | | | | - Iyar Mazar
- Adelphi Values, 225 Franklin St 10th Floor, Boston, MA, 02110, USA.,Sanofi, Cambridge, MA, USA
| | | | - Alan L Shields
- Adelphi Values, 225 Franklin St 10th Floor, Boston, MA, 02110, USA
| | - Frank Siebenhaar
- Dermatological Allergology, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Taylor F, Li X, Yip C, Padilla B, Mar B, Green T, Oren R, Boral AL, Lin HM, Shields AL, Gotlib J. Psychometric evaluation of the Advanced Systemic Mastocytosis Symptom Assessment Form (AdvSM-SAF). Leuk Res 2021; 108:106606. [PMID: 34004551 DOI: 10.1016/j.leukres.2021.106606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/09/2021] [Accepted: 04/25/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The Advanced Systemic Mastocytosis Symptom Assessment Form (AdvSM-SAF) was developed to evaluate symptoms of advanced systemic mastocytosis (AdvSM). This study aimed to psychometrically evaluate AdvSM-SAF scores and provide score interpretation guidelines. METHODS The 10-item AdvSM-SAF was administered daily (scored as a seven-day average) in EXPLORER, an open-label Phase 1 study in AdvSM. Score distribution, reliability, construct-related validity, sensitivity to change, and interpretation guidelines were evaluated for AdvSM-SAF items, gastrointestinal symptom score (GSS), skin symptom score (SSS), and total symptom score (TSS). RESULTS Thirty-one patients contributed to the analyses. At Baseline, the GSS, SSS, and TSS had adequate internal consistency (α > 0.7) and test-retest reliability (intraclass correlation coefficients >0.7). AdvSM-SAF scores were moderately to strongly correlated with variables as expected, and distinguished among clinically distinct groups. Observed relationships between change scores in the AdvSM-SAF and other assessments reflect evidence that AdvSM-SAF scores change in concert with other assessments designed to measure similar constructs. The magnitude of AdvSM-SAF weekly TSS mean change scores based on different anchor groupings was as expected (improvement > stable > worsening). Candidate clinically meaningful between-group difference estimates (GSS = 2-4, SSS = 2-3, and TSS = 4-7 points) and within-person change estimates (GSS = 6-9, SSS = 1-4, TSS = 9-14) for AdvSM-SAF weekly scores were generated. CONCLUSION The AdvSM-SAF produced reliable, construct-valid, and sensitive scores when administered in the target patient population. These results, along with its strong development history and evidence of content validity, indicate that the AdvSM-SAF is fit for the purpose of measuring treatment benefit in individuals with AdvSM.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Jason Gotlib
- Stanford University Medical Center, Palo Alto, CA, USA
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Akin C, Elberink HO, Gotlib J, Sabato V, Hartmann K, Broesby-Olsen S, Castells M, Deininger M, Heaney M, George T, Radia D, Triggiani M, van Daele P, DeAngelo D, Schmidt-Kittler O, Lin HM, Morrison A, Mar B, Sibenhaar F, Maurer M. PIONEER: A Randomized, Double-Blind, Placebo-Controlled, Phase 2 Study of Avapritinib in Patients with Indolent or Smoldering Systemic Mastocytosis (SM) With Symptoms Inadequately Controlled by Standard Therapy. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.062] [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: 10/24/2022]
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George S, Bauer S, Jones R, Serrano C, von Mehren M, Kang YK, Schöffski P, Cassier P, Eskens F, Mir O, Tap W, Chawla S, Rutkowski P, Shi H, Schmidt-Kittler O, Mar B, Heinrich M. Correlation of ctDNA and response in patients (pts) with PDGFRα D842 GIST treated with avapritinib. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kahn JD, Miller PG, Silver AJ, Sellar RS, Bhatt S, Gibson C, McConkey M, Adams D, Mar B, Mertins P, Fereshetian S, Krug K, Zhu H, Letai A, Carr SA, Doench J, Jaiswal S, Ebert BL. PPM1D-truncating mutations confer resistance to chemotherapy and sensitivity to PPM1D inhibition in hematopoietic cells. Blood 2018; 132:1095-1105. [PMID: 29954749 PMCID: PMC6137556 DOI: 10.1182/blood-2018-05-850339] [Citation(s) in RCA: 144] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/23/2018] [Indexed: 12/26/2022] Open
Abstract
Truncating mutations in the terminal exon of protein phosphatase Mg2+/Mn2+ 1D (PPM1D) have been identified in clonal hematopoiesis and myeloid neoplasms, with a striking enrichment in patients previously exposed to chemotherapy. In this study, we demonstrate that truncating PPM1D mutations confer a chemoresistance phenotype, resulting in the selective expansion of PPM1D-mutant hematopoietic cells in the presence of chemotherapy in vitro and in vivo. Clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR-associated protein-9 nuclease mutational profiling of PPM1D in the presence of chemotherapy selected for the same exon 6 mutations identified in patient samples. These exon 6 mutations encode for a truncated protein that displays elevated expression and activity due to loss of a C-terminal degradation domain. Global phosphoproteomic profiling revealed altered phosphorylation of target proteins in the presence of the mutation, highlighting multiple pathways including the DNA damage response (DDR). In the presence of chemotherapy, PPM1D-mutant cells have an abrogated DDR resulting in altered cell cycle progression, decreased apoptosis, and reduced mitochondrial priming. We demonstrate that treatment with an allosteric, small molecule inhibitor of PPM1D reverts the phosphoproteomic, DDR, apoptotic, and mitochondrial priming changes observed in PPM1D-mutant cells. Finally, we show that the inhibitor preferentially kills PPM1D-mutant cells, sensitizes the cells to chemotherapy, and reverses the chemoresistance phenotype. These results provide an explanation for the enrichment of truncating PPM1D mutations in the blood of patients exposed to chemotherapy and in therapy-related myeloid neoplasms, and demonstrate that PPM1D can be a targeted in the prevention of clonal expansion of PPM1D-mutant cells and the treatment of PPM1D-mutant disease.
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Affiliation(s)
- Josephine D Kahn
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Broad Institute of MIT and Harvard, Cambridge, MA
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Peter G Miller
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Broad Institute of MIT and Harvard, Cambridge, MA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Alexander J Silver
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Rob S Sellar
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Broad Institute of MIT and Harvard, Cambridge, MA
- UCL Cancer Institute, University College London, London, United Kingdom
| | - Shruti Bhatt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Christopher Gibson
- Broad Institute of MIT and Harvard, Cambridge, MA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Marie McConkey
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Dylan Adams
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Brenton Mar
- Broad Institute of MIT and Harvard, Cambridge, MA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Philipp Mertins
- Proteomics Platform, Broad Institute of MIT and Harvard, Cambridge, MA
- Proteomics Platform, Max Delbruck Center for Molecular Medicine in the Helmholtz Society, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | | | - Karsten Krug
- Proteomics Platform, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Haoling Zhu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Anthony Letai
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | | | - John Doench
- Genetic Perturbation Platform, Broad Institute of MIT and Harvard, Cambridge, MA; and
| | - Siddhartha Jaiswal
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Broad Institute of MIT and Harvard, Cambridge, MA
- Department of Pathology, School of Medicine, Stanford University, Stanford, CA
| | - Benjamin L Ebert
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Broad Institute of MIT and Harvard, Cambridge, MA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
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10
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Ajore R, Raiser D, McConkey M, Jöud M, Boidol B, Mar B, Saksena G, Weinstock DM, Armstrong S, Ellis SR, Ebert BL, Nilsson B. Deletion of ribosomal protein genes is a common vulnerability in human cancer, especially in concert with TP53 mutations. EMBO Mol Med 2017; 9:498-507. [PMID: 28264936 PMCID: PMC5376749 DOI: 10.15252/emmm.201606660] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Heterozygous inactivating mutations in ribosomal protein genes (RPGs) are associated with hematopoietic and developmental abnormalities, activation of p53, and altered risk of cancer in humans and model organisms. Here we performed a large‐scale analysis of cancer genome data to examine the frequency and selective pressure of RPG lesions across human cancers. We found that hemizygous RPG deletions are common, occurring in about 43% of 10,744 cancer specimens and cell lines. Consistent with p53‐dependent negative selection, such lesions are underrepresented in TP53‐intact tumors (P ≪ 10−10), and shRNA‐mediated knockdown of RPGs activated p53 in TP53‐wild‐type cells. In contrast, we did not see negative selection of RPG deletions in TP53‐mutant tumors. RPGs are conserved with respect to homozygous deletions, and shRNA screening data from 174 cell lines demonstrate that further suppression of hemizygously deleted RPGs inhibits cell growth. Our results establish RPG haploinsufficiency as a strikingly common vulnerability of human cancers that associates with TP53 mutations and could be targetable therapeutically.
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Affiliation(s)
- Ram Ajore
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - David Raiser
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Marie McConkey
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Magnus Jöud
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Bernd Boidol
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Brenton Mar
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | | | - Steven R Ellis
- Department of Biochemistry and Molecular Biology, University of Louisville, Louisville, KY, USA
| | - Benjamin L Ebert
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA .,Broad Institute, 7 Cambridge Center, Cambridge, MA, USA
| | - Björn Nilsson
- Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden .,Broad Institute, 7 Cambridge Center, Cambridge, MA, USA
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11
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Hochberg J, Mar B, Ayello J, Day N, van de Ven C, Ricci A, Gurnani L, Cairo E, Campana D, Cairo M. Significant Ex-Vivo Expansion of Cord Blood (CB) Natural Killer (NK) Cells and Concomitant Decrease in CB T-Cells by Genetically Reengineered K562 Cells (K562-mbIL15-41BBL). Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.135] [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: 11/25/2022]
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12
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Hu Z, Gomes I, Horrigan SK, Kravarusic J, Mar B, Arbieva Z, Chyna B, Fulton N, Edassery S, Raza A, Westbrook CA. A novel nuclear protein, 5qNCA (LOC51780) is a candidate for the myeloid leukemia tumor suppressor gene on chromosome 5 band q31. Oncogene 2001; 20:6946-54. [PMID: 11687974 DOI: 10.1038/sj.onc.1204850] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2001] [Revised: 07/09/2001] [Accepted: 07/17/2001] [Indexed: 11/08/2022]
Abstract
Interstitial deletion or loss of chromosome 5, del(5q) or -5, is a frequent finding in myeloid leukemias and myelodysplasias, suggesting the presence of a tumor suppressor gene within the deleted region. In our search for this gene, we identified a candidate, 5qNCA (LOC51780), which lies within a consistently-deleted segment of 5q31. 5qNCA expresses a 7.2-kb transcript with a 5286-bp open reading frame which is present at high levels in heart, skeletal muscle, kidney, placenta, and liver as well as CD34+ cells and AML cell lines. 5qNCA encodes a 191-kD nuclear protein which contains a highly-conserved C-terminus containing a zinc finger with the unique spacing Cys-X2-Cys-X7-His-X2-Cys-X2-Cys-X4-Cys-X2-Cys and a jmjC domain, which is often found in proteins that regulate chromatin remodeling. Expression of 5qNCA in a del(5q) cell line results in suppression of clonogenic growth. Preliminary sequence results in AML and MDS samples and cell lines has revealed a possible mutation in the KG-1 cell line resulting in a THR to ALA substitution that has not been found in over 100 normal alleles to date. We propose 5qNCA is a good candidate for the del(5q) tumor suppressor gene based on its predicted function and growth suppressive activities, and suggest that further mutational and functional study of this interesting gene is warranted.
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MESH Headings
- Acute Disease
- Amino Acid Motifs
- Amino Acid Sequence
- Cell Division
- Chromosomes, Human, Pair 5
- Cloning, Molecular
- Genes, Tumor Suppressor
- Humans
- Jumonji Domain-Containing Histone Demethylases
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/metabolism
- Leukemia, Myeloid/pathology
- Molecular Sequence Data
- Mutation
- Myelodysplastic Syndromes/genetics
- Myelodysplastic Syndromes/metabolism
- Myelodysplastic Syndromes/pathology
- Nuclear Proteins/chemistry
- Nuclear Proteins/genetics
- Nuclear Proteins/physiology
- RNA, Neoplasm/biosynthesis
- Sequence Homology, Amino Acid
- Tissue Distribution
- Tumor Cells, Cultured
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Affiliation(s)
- Z Hu
- Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois 60607-7170, USA
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13
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Ruiz-Suárez L, Castro T, Mar B, Ruiz-Santoyo M, Cruz X. Do we need an Ad hoc chemical mechanism for Mexico City's photochemical smog? ACTA ACUST UNITED AC 1993. [DOI: 10.1016/0960-1686(93)90115-f] [Citation(s) in RCA: 4] [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: 10/27/2022]
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14
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Segura A, Mar B, Martinez-Pastor J, Chevy A. Three-dimensional electrons and two-dimensional electric subbands in the transport properties of tin-doped n-type indium selenide: Polar and homopolar phonon scattering. Phys Rev B Condens Matter 1991; 43:4953-4965. [PMID: 9997871 DOI: 10.1103/physrevb.43.4953] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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15
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Colina A, Martí J, Frías F, Mar B, Bordas JM. [Cystic jejunal lymphangioma in an adult]. Rev Esp Enferm Dig 1991; 79:64-5. [PMID: 2031778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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16
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Baffi R, Dolch G, Garnick R, Huang YF, Mar B, Matsuhiro D, Niepelt B, Parra C, Stephan M. A total organic carbon analysis method for validating cleaning between products in biopharmaceutical manufacturing. J Parenter Sci Technol 1991; 45:13-9. [PMID: 2007965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The validation of cleaning procedures for biopharmaceutical products produced by recombinant DNA (rDNA) technology presents a diverse analytical challenge. This is because of the need for quantitation of a broad range of potential residual cellular components, including proteins, carbohydrates, and nucleic acids, as well as trace levels of detergents at various manufacturing stages. The validation of a Total Organic Carbon (TOC) analysis method for use in cleaning validation studies is presented. The method has a limit of detection of approximately 0.1 ppm, with a limit of quantitation of 0.5 ppm. TOC analysis has an accuracy of 50 to 70% or better in the 0.5- to 10-ppm range and demonstrates an overall variability of approximately 5%. The method is broadly applicable to a variety of impurities and contaminants that are likely to be encountered following the manufacture of rDNA products.
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Affiliation(s)
- R Baffi
- Genentech, Inc., South San Francisco, California
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17
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Marti J, Colina A, Bordas JM, Frías FJ, Mar B. [Refractory hypercalcemia as the first manifestation of esophageal cancer]. An Med Interna 1990; 7:604-5. [PMID: 2103225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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18
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Martí J, Colina A, Arrinda JM, Mar B, Goena I. [Chronic iron-deficiency anemia due to colonic angiodysplasia in an adult]. Rev Med Univ Navarra 1990; 34:95-6. [PMID: 2130426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The case of a 42-years-old man is presented, who was admitted for recurrent iron-deficiency [correction of ferropenic] anemia. The endoscopic and radiographic studies did not disclose the origin of the anemia. Arteriographic study detected lesions compatible with angiodysplasia. Surgery was performed and the diagnosis confirmed in the resection specimen.
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Affiliation(s)
- J Martí
- Servicios de Medicina Interna y Cirugía, Hospital de Zumárraga, Guipúzcoa
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19
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Díaz-Legaspe AJ, Goena I, Colina A, Mar B, Bordas JM, Frías FJ. [Posterolateral diaphragmatic hernia in adults. Bochdalek's hernia. Report of a case]. Rev Med Univ Navarra 1989; 33:207-10. [PMID: 2490186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
One case of diaphragmatic posterolateral hernia (Bochdalek hernia) in a 30 years-old woman is reported. We emphasize his congenital origin, the embriological aspects and his uncommon presentation after the infancy. The clinical and diagnostic aspects and his surgical treatment are also analyzed.
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Affiliation(s)
- A J Díaz-Legaspe
- Hospital Neustra Señora de la Antigua, Servicio de Cirugía General, Zumárraga, Guipúzcoa
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