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Loriot Y, Kalebasty AR, Fléchon A, Jain RK, Gupta S, Bupathi M, Beuzeboc P, Palmbos P, Balar AV, Kyriakopoulos CE, Pouessel D, Sternberg CN, Tonelli J, Sierecki M, Zhou H, Grivas P, Barthélémy P, Bangs R, Tagawa ST. A plain language summary of the TROPHY-U-01 study: sacituzumab govitecan use in people with locally advanced or metastatic urothelial cancer. Future Oncol 2024. [PMID: 38682560 DOI: 10.2217/fon-2023-1030] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
WHAT IS THIS SUMMARY ABOUT? Sacituzumab govitecan (brand name: TRODELVY®) is a new treatment being studied for people with a type of bladder cancer, called urothelial cancer, that has progressed to a locally advanced or metastatic stage. Locally advanced and metastatic urothelial cancer are usually treated with platinum-based chemotherapy. Metastatic urothelial cancer is also treated with immune checkpoint inhibitors. There are few treatment options for people whose cancer gets worse after receiving these treatments. Sacituzumab govitecan is a suitable treatment option for most people with urothelial cancer because it aims to deliver an anti-cancer drug directly to the cancer in an attempt to limit the potential harmful side effects on healthy cells. This is a summary of a clinical study called TROPHY-U-01, focusing on the first group of participants, referred to as Cohort 1. All participants in Cohort 1 received sacituzumab govitecan. WHAT ARE THE KEY TAKEAWAYS? All participants received previous treatments for their metastatic urothelial cancer, including a platinum-based chemotherapy and a checkpoint inhibitor. The tumor in 31 of 113 participants became significantly smaller or could not be seen on scans after sacituzumab govitecan treatment; an effect that lasted for a median of 7.2 months. Half of the participants were still alive 5.4 months after starting treatment, without their tumor getting bigger or spreading further. Half of them were still alive 10.9 months after starting treatment regardless of tumor size changes. Most participants experienced side effects. These side effects included lower levels of certain types of blood cells, sometimes with a fever, and loose or watery stools (diarrhea). Side effects led 7 of 113 participants to stop taking sacituzumab govitecan. WHAT WERE THE MAIN CONCLUSIONS REPORTED BY THE RESEARCHERS? The study showed that sacituzumab govitecan had significant anti-cancer activity. Though most participants who received sacituzumab govitecan experienced side effects, these did not usually stop participants from continuing sacituzumab govitecan. Doctors can help control these side effects using treatment guidelines, but these side effects can be serious. Clinical Trial Registration: NCT03547973 (ClinicalTrials.gov) (TROPHY-U-1).
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Affiliation(s)
- Yohann Loriot
- Institut de Cancérologie Gustave Roussy, Villejuif, France
| | | | | | - Rohit K Jain
- H Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Sumati Gupta
- Division of Oncology, Department of Medicine, University of Utah's Huntsman Cancer Institute, UT, USA
| | | | | | - Phillip Palmbos
- University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
| | - Arjun V Balar
- Perlmutter Cancer Center at NYU Langone Health, New York, NY, USA
| | | | - Damien Pouessel
- Institut Claudius Regaud/Cancer Comprehensive Center, IUCT, Oncopole, Toulouse, France
| | | | | | | | | | - Petros Grivas
- Fred Hutchinson Cancer Center, University of Washington, Seattle, WA, USA
| | - Philippe Barthélémy
- Hôpitaux Universitaires de Strasbourg/Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | - Rick Bangs
- Patient Advocate, Pittsford, New York, NY, USA
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2
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Loriot Y, Petrylak DP, Rezazadeh Kalebasty A, Fléchon A, Jain RK, Gupta S, Bupathi M, Beuzeboc P, Palmbos P, Balar AV, Kyriakopoulos CE, Pouessel D, Sternberg CN, Tonelli J, Sierecki M, Zhou H, Grivas P, Barthélémy P, Tagawa ST. TROPHY-U-01, a phase II open-label study of sacituzumab govitecan in patients with metastatic urothelial carcinoma progressing after platinum-based chemotherapy and checkpoint inhibitors: updated safety and efficacy outcomes. Ann Oncol 2024; 35:392-401. [PMID: 38244927 DOI: 10.1016/j.annonc.2024.01.002] [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] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Sacituzumab govitecan (SG) is a Trop-2-directed antibody-drug conjugate containing cytotoxic SN-38, the active metabolite of irinotecan. SG received accelerated US Food and Drug Administration approval for locally advanced (LA) or metastatic urothelial carcinoma (mUC) previously treated with platinum-based chemotherapy and a checkpoint inhibitor, based on cohort 1 of the TROPHY-U-01 study. Mutations in the uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene are associated with increased adverse events (AEs) with irinotecan-based therapies. Whether UGT1A1 status could impact SG toxicity and efficacy remains unclear. PATIENTS AND METHODS TROPHY-U-01 (NCT03547973) is a multicohort, open-label, phase II registrational study. Cohort 1 includes patients with LA or mUC who progressed after platinum- and checkpoint inhibitor-based therapies. SG was administered at 10 mg/kg intravenously on days 1 and 8 of 21-day cycles. The primary endpoint was objective response rate (ORR) per central review; secondary endpoints included progression-free survival, overall survival, and safety. Post hoc safety analyses were exploratory with descriptive statistics. Updated analyses include longer follow-up. RESULTS Cohort 1 included 113 patients. At a median follow-up of 10.5 months, ORR was 28% (95% CI 20.2% to 37.6%). Median progression-free survival and overall survival were 5.4 months (95% CI 3.5-6.9 months) and 10.9 months (95% CI 8.9-13.8 months), respectively. Occurrence of grade ≥3 treatment-related AEs and treatment-related discontinuation were consistent with prior reports. UGT1A1 status was wildtype (∗1|∗1) in 40%, heterozygous (∗1|∗28) in 42%, homozygous (∗28|∗28) in 12%, and missing in 6% of patients. In patients with ∗1|∗1, ∗1|∗28, and ∗28|∗28 genotypes, any grade treatment-related AEs occurred in 93%, 94%, and 100% of patients, respectively, and were managed similarly regardless of UGT1A1 status. CONCLUSIONS With longer follow-up, the ORR remains high in patients with heavily pretreated LA or mUC. Safety data were consistent with the known SG toxicity profile. AE incidence varied across UGT1A1 subgroups; however, discontinuation rates remained relatively low for all groups.
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Affiliation(s)
- Y Loriot
- Medical Oncology Department, Institut de Cancérologie Gustave Roussy, Université Paris-Saclay, Villejuif, France.
| | - D P Petrylak
- Genitourinary Oncology, Yale School of Medicine, New Haven
| | | | - A Fléchon
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - R K Jain
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa
| | - S Gupta
- Division of Oncology, Department of Medicine, Huntsman Cancer Institute, Salt Lake City
| | - M Bupathi
- Medical Oncology, Rocky Mountain Cancer Centers, Littleton, USA
| | - P Beuzeboc
- Oncology and Supportive Care Department, Hôpital Foch, Suresnes, France
| | - P Palmbos
- Urologic Oncology Clinic, Rogel Cancer Center, University of Michigan, Ann Arbor
| | - A V Balar
- Genitourinary Oncology Department, New York University Langone Medical Center, New York
| | - C E Kyriakopoulos
- Division of Hematology, Oncology and Palliative Care, University of Wisconsin-Madison, Madison, USA
| | - D Pouessel
- Department of Medical Oncology and Clinical Research Unit, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse (IUCT-Oncopôle), Toulouse, France
| | - C N Sternberg
- Department of Genitourinary Oncology, Weill Cornell Medical College of Cornell University, New York
| | - J Tonelli
- Clinical Development - Oncology, Gilead Sciences, Inc., Parsippany
| | - M Sierecki
- Clinical Development - Oncology, Gilead Sciences, Inc., Parsippany
| | - H Zhou
- Department of Biometrics, Gilead Sciences, Inc., Foster City
| | - P Grivas
- Department of Medicine, University of Washington; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, USA
| | - P Barthélémy
- Medical Oncology Department, Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | - S T Tagawa
- Department of Genitourinary Oncology, Weill Cornell Medical College of Cornell University, New York
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3
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Beckermann KE, Patnaik A, Winer I, Tan W, Bashir B, Kyriakopoulos CE, Sweis RF, Chamberlain M, Rini BI. A phase 1b open-label study to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of py314 in combination with pembrolizumab in patients with advanced renal cell carcinoma. Invest New Drugs 2024; 42:179-184. [PMID: 38372949 DOI: 10.1007/s10637-024-01419-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/11/2024] [Indexed: 02/20/2024]
Abstract
Checkpoint inhibition (CPI) is a standard therapeutic approach in metastatic renal cell carcinoma (RCC). However, not all patients respond to CPI, and the immune suppressive characteristics of the RCC tumor microenvironment may contribute to treatment failure. Triggering Receptor Expressed on Myeloid Cells-2 (TREM2) is a transmembrane protein expressed on a subset of myeloid cells with M2-like anti-inflammatory properties that has previously been associated with disease recurrence after nephrectomy and poor outcomes when expressed at high levels. PY314 is a humanized monoclonal antibody targeting TREM2 that depletes tumor-associated macrophages. In this study, the combination of PY314 and pembrolizumab was investigated in patients with CPI-refractory RCC. Eligible patients had clear cell RCC with disease progression on prior CPI either in combination or sequentially with VEGF-TKI. Patients were treated with PY314 10 mg/kg in combination with pembrolizumab 200 mg IV every 21 days. The primary objective was to assess safety and tolerability and secondary objectives included pharmacokinetics and anti-tumor activity by RECIST v1.1. Seventeen patients were enrolled with a median age of 67 years, 82% male, 100% had prior CPI, and 76% had received three or more prior lines of therapy. The combination of PY314 and pembrolizumab demonstrated an acceptable safety profile with 47.1% any grade treatment-related adverse events (AE) (including only 5.9% grade ≥ 3), the most common being fatigue, pyrexia, nausea, and infusion-related reactions. One patient achieved a partial response (6%), and four patients had stable disease (24%) as their best response. The median PFS was 1.4 months (95% CI 1.2- 3.8). The combination of PY314 and pembrolizumab was safe, but the limited anti-tumor effect observed suggests that TREM2 targeting in conjunction with PD-1 blockade may not overcome resistance to prior CPI. Further investigation is warranted to determine if improved efficacy can be achieved in IO-naïve settings. Trial Registration: NCT04691375.
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Affiliation(s)
- Kathryn E Beckermann
- Vanderbilt University Medical Center, 2220 Pierce Avenue, PRB 777, Nashville, TN, 37232, USA
| | - Amita Patnaik
- START South Texas Accelerated Research Therapeutics, San Antonio, TX, 78229, USA
| | - Ira Winer
- Department of Oncology, Wayne State University and Karmanos Cancer Institute, Detroit, MI, 48201, USA
| | | | - Babar Bashir
- Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | | | - Randy F Sweis
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Marc Chamberlain
- Starlight/Lantern Pharma, 7700 Windrose Ave. Office 3-187, Piano, TX, USA
| | - Brian I Rini
- Vanderbilt University Medical Center, 2220 Pierce Avenue, PRB 777, Nashville, TN, 37232, USA.
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Walter AW, Lee JW, Streck JM, Gareen IF, Herman BA, Kircher SM, Carlos RC, Kumar SK, Mayer IA, Saba NF, Fenske TS, Neal JW, Atkins MB, Hodi FS, Kyriakopoulos CE, Tempany-Afdhal CM, Shanafelt TD, Wagner LI, Land SR, Ostroff JS, Park ER. The effect of neighborhood socioeconomic disadvantage on smoking status, quit attempts, and receipt of cessation support among adults with cancer: Results from nine ECOG-ACRIN Cancer Research Group trials. Cancer 2024; 130:439-452. [PMID: 37795845 PMCID: PMC10841845 DOI: 10.1002/cncr.35039] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/23/2023] [Accepted: 07/31/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Tobacco use is associated with adverse outcomes among patients diagnosed with cancer. Socioeconomic determinants influence access and utilization of tobacco treatment; little is known about the relationship between neighborhood socioeconomic disadvantage (NSD) and tobacco assessment, assistance, and cessation among patients diagnosed with cancer. METHODS A modified Cancer Patient Tobacco Use Questionnaire (C-TUQ) was administered to patients enrolled in nine ECOG-ACRIN clinical trials. We examined associations of NSD with (1) smoking status, (2) receiving tobacco cessation assessment and support, and (3) cessation behaviors. NSD was classified by tertiles of the Area Deprivation Index. Associations between NSD and tobacco variables were evaluated using logistic regression. RESULTS A total of 740 patients completing the C-TUQ were 70% male, 94% White, 3% Hispanic, mean age 58.8 years. Cancer diagnoses included leukemia 263 (36%), lymphoma 141 (19%), prostate 131 (18%), breast 79 (11%), melanoma 69 (9%), myeloma 53 (7%), and head and neck 4 (0.5%). A total of 402 (54%) never smoked, 257 (35%) had formerly smoked, and 81 (11%) were currently smoking. Patients in high disadvantaged neighborhoods were approximately four times more likely to report current smoking (odds ratio [OR], 3.57; 95% CI, 1.69-7.54; p = .0009), and more likely to report being asked about smoking (OR, 4.24; 95% CI, 1.64-10.98; p = .0029), but less likely to report receiving counseling (OR, 0.11; 95% CI, 0.02-0.58; p = .0086) versus those in the least disadvantaged neighborhoods. CONCLUSIONS Greater neighborhood socioeconomic disadvantage was associated with smoking but less cessation support. Increased cessation support in cancer care is needed, particularly for patients from disadvantaged neighborhoods.
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Affiliation(s)
- Angela Wangari Walter
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Ju-Whei Lee
- ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Joanna M. Streck
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry and Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ilana F. Gareen
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
- Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Benjamin A. Herman
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
- Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| | | | - Ruth C. Carlos
- Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Ingrid A. Mayer
- Vanderbilt University, Nashville, Tennessee, USA
- AstraZeneca, Wilmington, Delaware, USA
| | - Nabil F. Saba
- Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Joel W. Neal
- Stanford Cancer Institute, Stanford University, Palo Alto, California, USA
| | - Michael B. Atkins
- Georgetown Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | - Frank S. Hodi
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | | | - Tait D. Shanafelt
- Stanford Cancer Institute, Stanford University, Palo Alto, California, USA
| | - Lynne I. Wagner
- Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Jamie S. Ostroff
- Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Elyse R. Park
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry and Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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5
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McNeel DG, Emamekhoo H, Eickhoff JC, Kyriakopoulos CE, Wargowski E, Tonelli TP, Johnson LE, Liu G. Phase 2 trial of a DNA vaccine (pTVG-HP) and nivolumab in patients with castration-sensitive non-metastatic (M0) prostate cancer. J Immunother Cancer 2023; 11:e008067. [PMID: 38101860 PMCID: PMC10729272 DOI: 10.1136/jitc-2023-008067] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
PURPOSE We have previously reported that a plasmid DNA vaccine encoding prostatic acid phosphatase (pTVG-HP) had greater clinical activity when given in combination with pembrolizumab to patients with metastatic, castration-resistant prostate cancer. The current trial was conducted to evaluate vaccination with PD-1 blockade, using nivolumab, in patients with early, recurrent (M0) prostate cancer. METHODS Patients with M0 prostate cancer were treated with pTVG-HP (100 µg administered intradermally) and nivolumab (240 mg intravenous infusion) every 2 weeks for 3 months, and then every 4 weeks for 1 year of total treatment. Patients were then followed for an additional year off treatment. The primary objectives were safety and complete prostate-specific antigen (PSA) response (PSA<0.2 ng/mL). RESULTS 19 patients were enrolled. No patients met the primary endpoint of complete PSA response; however, 4/19 (21%) patients had a PSA decline >50%. Median PSA doubling times were 5.9 months pretreatment, 25.6 months on-treatment (p=0.001), and 9.0 months in the subsequent year off-treatment. The overall median radiographic progression-free survival was not reached. Grade 3 or 4 events included adrenal insufficiency, fatigue, lymphopenia, and increased amylase/lipase. 9/19 (47%) patients developed immune-related adverse effects (irAE). The development of irAE and increased CXCL9 were associated with increased PSA doubling time. Quantitative NaF PET/CT imaging showed the resolution of subclinical lesions along with the development of new lesions at each time point. CONCLUSIONS In this population, combining nivolumab with pTVG-HP vaccination was safe, and immunologically active, prolonged the time to disease progression, but did not eradicate disease. Quantitative imaging suggested that additional treatments targeting mechanisms of resistance may be required to eliminate tumors. TRIAL REGISTRATION NUMBER NCT03600350.
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Affiliation(s)
- Douglas G McNeel
- Medicine, University of Wisconsin Madison, Madison, Wisconsin, USA
| | - Hamid Emamekhoo
- Medicine, University of Wisconsin Madison, Madison, Wisconsin, USA
| | - Jens C Eickhoff
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Ellen Wargowski
- Medicine, University of Wisconsin Madison, Madison, Wisconsin, USA
| | | | | | - Glenn Liu
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
- University Of Wisconsin Hospital & Clinics, Madison, Wisconsin, USA
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6
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Streck JM, Lee JW, Walter AW, Rosen RL, Gareen IF, Kircher SM, Herman BA, Carlos RC, Kumar S, Mayer IA, Saba NF, Fenske TS, Neal JW, Atkins MB, Hodi FS, Kyriakopoulos CE, Tempany C, Shanafelt TD, Wagner LI, Land SR, Park ER, Ostroff JS. Cigarette and Alternative Tobacco Product Use among Adult Cancer Survivors Enrolled in 9 ECOG-ACRIN Clinical Trials. Cancer Epidemiol Biomarkers Prev 2023; 32:1552-1557. [PMID: 37410096 PMCID: PMC10773003 DOI: 10.1158/1055-9965.epi-23-0420] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/06/2023] [Accepted: 06/30/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND While cigarette smoking has declined among the U.S. general population, sale and use of non-cigarette alternative tobacco products (ATP; e.g., e-cigarettes, cigars) and dual use of cigarettes/ATPs are rising. Little is known about ATP use patterns in cancer survivors enrolled in clinical trials. We investigated prevalence of tobacco product use, and factors associated with past 30-day use, among patients with cancer in national trials. METHODS Cancer survivors (N = 756) enrolled in 9 ECOG-ACRIN clinical trials (2017-2021) completed a modified Cancer Patient Tobacco Use Questionnaire (C-TUQ) which assessed baseline cigarette and ATP use since cancer diagnosis and in the past 30 days. RESULTS Patients were on average 59 years old, 70% male, and the mean time since cancer diagnosis was 26 months. Since diagnosis, cigarettes (21%) were the most common tobacco product used, followed by smokeless tobacco use (5%), cigars (4%), and e-cigarettes (2%). In the past 30 days, 12% of patients reported smoking cigarettes, 4% cigars, 4% using smokeless tobacco, and 2% e-cigarettes. Since cancer diagnosis, 5.5% of the sample reported multiple tobacco product use, and 3.0% reported multiple product use in the past 30 days. Males (vs. females; OR 4.33; P = 0 < 0.01) and individuals not living with another person who smokes (vs. living with; OR, 8.07; P = 0 < 0.01) were more likely to use ATPs only versus cigarettes only in the past 30 days. CONCLUSIONS Among patients with cancer, cigarettes were the most prevalent tobacco product reported. IMPACT Regardless, ATPs and multiple tobacco product use should be routinely assessed in cancer care settings.
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Affiliation(s)
| | - Ju-Whei Lee
- Dana-Farber Cancer Institute/ECOG-ACRIN Biostatistics Center
| | | | | | | | | | | | | | | | | | | | | | | | | | - F. Stephen Hodi
- Dana-Farber Cancer Institute/ECOG-ACRIN Biostatistics Center
| | | | | | | | | | | | - Elyse R. Park
- Massachusetts General Hospital/Harvard Medical School
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7
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Sperger JM, Helzer KT, Stahlfeld CN, Jiang D, Singh A, Kaufmann KR, Niles DJ, Heninger E, Rydzewski NR, Wang L, Wang L, Yang R, Ren Y, Engle JW, Huang P, Kyriakopoulos CE, Slovin SF, Soule HR, Zhao SG, Kohli M, Tagawa ST, Cai W, Dehm SM, Lang JM. Expression and Therapeutic Targeting of TROP-2 in Treatment-Resistant Prostate Cancer. Clin Cancer Res 2023; 29:2324-2335. [PMID: 36939530 PMCID: PMC10261916 DOI: 10.1158/1078-0432.ccr-22-1305] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 04/28/2022] [Revised: 07/29/2022] [Accepted: 03/14/2023] [Indexed: 03/21/2023]
Abstract
PURPOSE Men with metastatic castration-resistant prostate cancer (mCRPC) frequently develop resistance to androgen receptor signaling inhibitor (ARSI) treatment; therefore, new therapies are needed. Trophoblastic cell-surface antigen (TROP-2) is a transmembrane protein identified in prostate cancer and overexpressed in multiple malignancies. TROP-2 is a therapeutic target for antibody-drug conjugates (ADC). EXPERIMENTAL DESIGN TROP-2 gene (TACSTD2) expression and markers of treatment resistance from prostate biopsies were analyzed using data from four previously curated cohorts of mCRPC (n = 634) and the PROMOTE study (dbGaP accession phs001141.v1.p1, n = 88). EPCAM or TROP-2-positive circulating tumor cells (CTC) were captured from peripheral blood for comparison of protein (n = 15) and gene expression signatures of treatment resistance (n = 40). We assessed the efficacy of TROP-2-targeting agents in a mouse xenograft model generated from prostate cancer cell lines. RESULTS We demonstrated that TACSTD2 is expressed in mCRPC from luminal and basal tumors but at lower levels in patients with neuroendocrine prostate cancer. Patients previously treated with ARSI showed no significant difference in TACSTD2 expression, whereas patients with detectable AR-V7 expression showed increased expression. We observed that TROP-2 can serve as a cell surface target for isolating CTCs, which may serve as a predictive biomarker for ADCs. We also demonstrated that prostate cancer cell line xenografts can be targeted specifically by labeled anti-TROP-2 agents in vivo. CONCLUSIONS These results support further studies on TROP-2 as a therapeutic and diagnostic target for mCRPC.
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Affiliation(s)
- Jamie M. Sperger
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin
| | - Kyle T. Helzer
- Department of Human Oncology, University of Wisconsin–Madison, Madison, Wisconsin
| | | | - Dawei Jiang
- Department of Radiology, University of Wisconsin, Madison, Wisconsin
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Laboratory of Evolutionary Theranostics, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, China
| | - Anupama Singh
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin
| | | | - David J. Niles
- Department of Biomedical Engineering, University of Wisconsin–Madison, Madison, Wisconsin
| | - Erika Heninger
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin
| | | | | | | | - Rendong Yang
- Masonic Cancer Center and Departments of Laboratory Medicine and Pathology and Urology, University of Minnesota, Minneapolis, Minnesota
- The Hormel Institute, University of Minnesota, Austin, Minnesota
| | - Yanan Ren
- The Hormel Institute, University of Minnesota, Austin, Minnesota
| | - Jonathan W. Engle
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
| | - Peng Huang
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Laboratory of Evolutionary Theranostics, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Christos E. Kyriakopoulos
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin
| | | | - Howard R. Soule
- Department of Science, Prostate Cancer Foundation, Santa Monica, California
| | - Shuang G. Zhao
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin
- Department of Human Oncology, University of Wisconsin–Madison, Madison, Wisconsin
| | | | - Scott T. Tagawa
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College, New York
| | - Weibo Cai
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin
- Department of Radiology, University of Wisconsin, Madison, Wisconsin
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
| | - Scott M. Dehm
- Masonic Cancer Center and Departments of Laboratory Medicine and Pathology and Urology, University of Minnesota, Minneapolis, Minnesota
| | - Joshua M. Lang
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin
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8
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Pan E, Xie W, Ajmera A, Araneta A, Jamieson C, Folefac E, Hussain A, Kyriakopoulos CE, Olson A, Parikh M, Parikh R, Saraiya B, Ivy SP, Van Allen EM, Lindeman NI, Kochupurakkal BS, Shapiro GI, McKay RR. A Phase I Study of Combination Olaparib and Radium-223 in Men with Metastatic Castration-Resistant Prostate Cancer (mCRPC) with Bone Metastases (COMRADE). Mol Cancer Ther 2023; 22:511-518. [PMID: 36780008 PMCID: PMC10769512 DOI: 10.1158/1535-7163.mct-22-0583] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/18/2022] [Accepted: 02/03/2023] [Indexed: 02/14/2023]
Abstract
Given that radium-223 is a radiopharmaceutical that induces DNA damage, and olaparib is a PARP inhibitor that interferes with DNA repair mechanisms, we hypothesized their synergy in metastatic castration-resistant prostate cancer (mCRPC). We sought to demonstrate the safety and efficacy of olaparib + radium-223. We conducted a multicenter phase I 3+3 dose escalation study of olaparib with fixed dose radium-223 in patients with mCRPC with bone metastases. The primary objective was to establish the RP2D of olaparib, with secondary objectives of safety, PSA response, alkaline phosphatase response, radiographic progression-free survival (rPFS), overall survival, and efficacy by homologous recombination repair (HRR) gene status. Twelve patients were enrolled; all patients received a prior androgen receptor signaling inhibitor (ARSI; 100%) and 3 patients (25%) prior docetaxel. Dose-limiting toxicities (DLT) included cytopenias, fatigue, and nausea. No DLTs were seen in the observation period however delayed toxicities guided the RP2D. The RP2D of olaparib was 200 mg orally twice daily with radium-223. The most common treatment-related adverse events were fatigue (92%) and anemia (58%). The rPFS at 6 months was 58% (95% confidence interval, 27%-80%). Nine patients were evaluable for HRR gene status; 1 had a BRCA2 alteration (rPFS 11.8 months) and 1 had a CDK12 alteration (rPFS 3.1 months). Olaparib can be safely combined with radium-223 at the RP2D 200 mg orally twice daily with fixed dose radium-223. Early clinical benefit was observed and will be investigated in a phase II study.
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Affiliation(s)
- Elizabeth Pan
- University of California San Diego, La Jolla, California
| | - Wanling Xie
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Archana Ajmera
- University of California San Diego, La Jolla, California
| | - Arlene Araneta
- University of California San Diego, La Jolla, California
| | | | | | - Arif Hussain
- University of Maryland Medical System, Baltimore, Maryland
| | | | - Adam Olson
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Mamta Parikh
- University of California Davis, Sacramento, California
| | - Rahul Parikh
- University of Kansas Medical Center, Kansas City, Kansas
| | - Biren Saraiya
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - S. Percy Ivy
- National Cancer Institute at the National Institutes of Health, Rockville, Maryland
| | | | | | | | | | - Rana R. McKay
- University of California San Diego, La Jolla, California
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9
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Baus CJ, Kelley B, Dow-Hillgartner E, Kyriakopoulos CE, Schulz LT, Lepak AJ, LoConte NK. Neutropenic Fever-Associated Admissions Among Patients With Solid Tumors Receiving Chemotherapy During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e234881. [PMID: 36972053 PMCID: PMC10043746 DOI: 10.1001/jamanetworkopen.2023.4881] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
This cohort study examines the rates of neutropenic fever–associated admissions and outpatient antibiotic use among patients with cancer receiving chemotherapy before and during the COVID-19 pandemic.
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Affiliation(s)
| | - Broc Kelley
- University of Wisconsin School of Medicine and Public Health, Madison
| | - Elizabeth Dow-Hillgartner
- University of Wisconsin School of Pharmacy, Madison
- University of Wisconsin Carbone Cancer Center, Madison
| | - Christos E Kyriakopoulos
- University of Wisconsin Carbone Cancer Center, Madison
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison
| | | | - Alexander J Lepak
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison
| | - Noelle K LoConte
- University of Wisconsin Carbone Cancer Center, Madison
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison
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10
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Taylor AK, Kosoff D, Emamekhoo H, Lang JM, Kyriakopoulos CE. PARP inhibitors in metastatic prostate cancer. Front Oncol 2023; 13:1159557. [PMID: 37168382 PMCID: PMC10165068 DOI: 10.3389/fonc.2023.1159557] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 02/06/2023] [Accepted: 04/13/2023] [Indexed: 05/13/2023] Open
Abstract
Poly-ADP ribose polymerase inhibitors (PARPi) are an emerging therapeutic option for the treatment of prostate cancer. Their primary mechanism of action is via induction of synthetic lethality in cells with underlying deficiencies in homologous recombination repair (HRR). In men with metastatic castrate-resistant prostate cancer (mCRPC) and select HRR pathway alterations, PARPi treatment has been shown to induce objective tumor responses as well as improve progression free and overall survival. Presently, there are two PARPi, olaparib and rucaparib, that are FDA approved in the treatment of mCRPC. Ongoing research is focused on identifying which HRR alterations are best suited to predict response to PARPi so that these therapies can be most effectively utilized in the clinic. While resistance to PARPi remains a concern, combination therapies may represent a mechanism to overcome or delay resistance.
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Affiliation(s)
- Amy K. Taylor
- Department of Medicine, University of Wisconsin, Madison, WI, United States
| | - David Kosoff
- Department of Medicine, University of Wisconsin, Madison, WI, United States
- University of Wisconsin Carbone Cancer Center, Madison, WI, United States
| | - Hamid Emamekhoo
- Department of Medicine, University of Wisconsin, Madison, WI, United States
- University of Wisconsin Carbone Cancer Center, Madison, WI, United States
| | - Joshua M. Lang
- Department of Medicine, University of Wisconsin, Madison, WI, United States
- University of Wisconsin Carbone Cancer Center, Madison, WI, United States
| | - Christos E. Kyriakopoulos
- Department of Medicine, University of Wisconsin, Madison, WI, United States
- University of Wisconsin Carbone Cancer Center, Madison, WI, United States
- *Correspondence: Christos E. Kyriakopoulos,
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11
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Bootsma M, McKay RR, Emamekhoo H, Bade RM, Schehr JL, Mannino MC, Singh A, Wolfe SK, Schultz ZD, Sperger J, Xie W, Signoretti S, Kyriakopoulos CE, Kosoff D, Abel EJ, Helzer KT, Rydzewski N, Bakhtiar H, Shi Y, Blitzer G, Bassetti M, Floberg J, Yu M, Sethakorn N, Sharifi M, Harari PM, Choueiri TK, Lang JM, Zhao SG. Longitudinal Molecular Profiling of Circulating Tumor Cells in Metastatic Renal Cell Carcinoma. J Clin Oncol 2022; 40:3633-3641. [PMID: 35617646 PMCID: PMC9622626 DOI: 10.1200/jco.22.00219] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/29/2022] [Accepted: 04/19/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Liquid biopsies in metastatic renal cell carcinoma (mRCC) provide a unique approach to understand the molecular basis of treatment response and resistance. This is particularly important in the context of immunotherapies, which target key immune-tumor interactions. Unlike metastatic tissue biopsies, serial real-time profiling of mRCC is feasible with our noninvasive circulating tumor cell (CTC) approach. METHODS We collected 457 longitudinal liquid biopsies from 104 patients with mRCC enrolled in one of two studies, either a prospective cohort or a phase II multicenter adaptive immunotherapy trial. Using a novel CTC capture and automated microscopy platform, we profiled CTC enumeration and expression of HLA I and programmed cell death-ligand 1 (PD-L1). Given their diametric immunological roles, we focused on the HLA I to PD-L1 ratio (HP ratio). RESULTS Patients with radiographic responses showed significantly lower CTC abundances throughout treatment. Furthermore, patients whose CTC enumeration trajectory was in the highest quartile (> 0.12 CTCs/mL annually) had shorter overall survival (median 17.0 months v 21.1 months, P < .001). Throughout treatment, the HP ratio decreased in patients receiving immunotherapy but not in patients receiving tyrosine kinase inhibitors. Patients with an HP ratio trajectory in the highest quartile (≥ 0.0012 annually) displayed significantly shorter overall survival (median 18.4 months v 21.2 months, P = .003). CONCLUSION In the first large longitudinal CTC study in mRCC to date to our knowledge, we identified the prognostic importance of CTC enumeration and the change over time of both CTC enumeration and the HP ratio. These insights into changes in both tumor burden and the molecular profile of tumor cells in response to different treatments provide potential biomarkers to predict and monitor response to immunotherapy in mRCC.
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Affiliation(s)
- Matthew Bootsma
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI
| | - Rana R. McKay
- Moores Cancer Center, University of California San Diego, La Jolla, CA
| | - Hamid Emamekhoo
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Rory M. Bade
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Jennifer L. Schehr
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Matthew C. Mannino
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Anupama Singh
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Serena K. Wolfe
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Zachery D. Schultz
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Jamie Sperger
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | | | - Sabina Signoretti
- Dana-Farber Cancer Institute, Boston, MA
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Christos E. Kyriakopoulos
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - David Kosoff
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Edwin J. Abel
- Urology, University of Wisconsin-Madison, Madison, WI
| | - Kyle T. Helzer
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI
| | - Nicholas Rydzewski
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI
| | - Hamza Bakhtiar
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI
| | - Yue Shi
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI
| | - Grace Blitzer
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI
| | - Michael Bassetti
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI
| | - John Floberg
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI
| | - Menggang Yu
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI
| | - Nan Sethakorn
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Marina Sharifi
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Paul M. Harari
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI
| | | | - Joshua M. Lang
- Department of Medicine, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Shuang G. Zhao
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
- William S. Middleton Memorial Veterans Hospital, Madison, WI
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12
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Zhao SG, Sperger JM, Schehr JL, McKay RR, Emamekhoo H, Singh A, Schultz ZD, Bade RM, Stahlfeld CN, Gilsdorf CS, Hernandez CI, Wolfe SK, Mayberry RD, Krause HM, Bootsma M, Helzer KT, Rydzewski N, Bakhtiar H, Shi Y, Blitzer G, Kyriakopoulos CE, Kosoff D, Wei XX, Floberg J, Sethakorn N, Sharifi M, Harari PM, Huang W, Beltran H, Choueiri TK, Scher HI, Rathkopf DE, Halabi S, Armstrong AJ, Beebe DJ, Yu M, Sundling KE, Taplin ME, Lang JM. A clinical-grade liquid biomarker detects neuroendocrine differentiation in prostate cancer. J Clin Invest 2022; 132:e161858. [PMID: 36317634 PMCID: PMC9621140 DOI: 10.1172/jci161858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/23/2022] [Indexed: 11/07/2022] Open
Abstract
BackgroundNeuroendocrine prostate cancer (NEPC) is an aggressive subtype, the presence of which changes the prognosis and management of metastatic prostate cancer.MethodsWe performed analytical validation of a Circulating Tumor Cell (CTC) multiplex RNA qPCR assay to identify the limit of quantification (LOQ) in cell lines, synthetic cDNA, and patient samples. We next profiled 116 longitudinal samples from a prospectively collected institutional cohort of 17 patients with metastatic prostate cancer (7 NEPC, 10 adenocarcinoma) as well as 265 samples from 139 patients enrolled in 3 adenocarcinoma phase II trials of androgen receptor signaling inhibitors (ARSIs). We assessed a NEPC liquid biomarker via the presence of neuroendocrine markers and the absence of androgen receptor (AR) target genes.ResultsUsing the analytical validation LOQ, liquid biomarker NEPC detection in the longitudinal cohort had a per-sample sensitivity of 51.35% and a specificity of 91.14%. However, when we incorporated the serial information from multiple liquid biopsies per patient, a unique aspect of this study, the per-patient predictions were 100% accurate, with a receiver-operating-curve (ROC) AUC of 1. In the adenocarcinoma ARSI trials, the presence of neuroendocrine markers, even while AR target gene expression was retained, was a strong negative prognostic factor.ConclusionOur analytically validated CTC biomarker can detect NEPC with high diagnostic accuracy when leveraging serial samples that are only feasible using liquid biopsies. Patients with expression of NE genes while retaining AR-target gene expression may indicate the transition to neuroendocrine differentiation, with clinical characteristics consistent with this phenotype.FundingNIH (DP2 OD030734, 1UH2CA260389, R01CA247479, and P30 CA014520), Department of Defense (PC190039 and PC200334), and Prostate Cancer Foundation (Movember Foundation - PCF Challenge Award).
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Affiliation(s)
- Shuang G. Zhao
- Department of Human Oncology and
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Jamie M. Sperger
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Jennifer L. Schehr
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Rana R. McKay
- Moores Cancer Center, University of California, San Diego, La Jolla, California, USA
| | - Hamid Emamekhoo
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Anupama Singh
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Zachery D. Schultz
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Rory M. Bade
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Charlotte N. Stahlfeld
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Cole S. Gilsdorf
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Camila I. Hernandez
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Serena K. Wolfe
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | | | - Hannah M. Krause
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Matt Bootsma
- Department of Human Oncology and
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Kyle T. Helzer
- Department of Human Oncology and
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Nicholas Rydzewski
- Department of Human Oncology and
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Hamza Bakhtiar
- Department of Human Oncology and
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Yue Shi
- Department of Human Oncology and
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Grace Blitzer
- Department of Human Oncology and
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Christos E. Kyriakopoulos
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - David Kosoff
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Xiao X. Wei
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - John Floberg
- Department of Human Oncology and
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Nan Sethakorn
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Marina Sharifi
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Paul M. Harari
- Department of Human Oncology and
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Wei Huang
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Pathology and Laboratory Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Himisha Beltran
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Toni K. Choueiri
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Howard I. Scher
- Genitourinary Oncology Service, Department of Medicine and
- Biomarker Development Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Susan Halabi
- Department of Biostatistics and Bioinformatics and
| | - Andrew J. Armstrong
- Duke Cancer Institute Center for Prostate and Urologic Cancers, Department of Medicine, Duke University, Durham, North Carolina, USA
| | - David J. Beebe
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Pathology and Laboratory Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Biomedical Engineering and
| | - Menggang Yu
- Department of Biostatistics and Medical Informatics, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Kaitlin E. Sundling
- Wisconsin State Lab of Hygiene, Madison, Wisconsin, USA
- Department of Pathology and Laboratory Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Mary-Ellen Taplin
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Joshua M. Lang
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
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13
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McNeel DG, Eickhoff JC, Wargowski E, Johnson LE, Kyriakopoulos CE, Emamekhoo H, Lang JM, Brennan MJ, Liu G. Phase 2 trial of T-cell activation using MVI-816 and pembrolizumab in patients with metastatic, castration-resistant prostate cancer (mCRPC). J Immunother Cancer 2022; 10:jitc-2021-004198. [PMID: 35277461 PMCID: PMC8919462 DOI: 10.1136/jitc-2021-004198] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2022] [Indexed: 12/16/2022] Open
Abstract
Background We previously reported a trial using a DNA vaccine encoding prostatic acid phosphatase (MVI-816, pTVG-HP), given over 12 weeks concurrently or sequentially with pembrolizumab, in patients with mCRPC. We report the final analysis of this trial following two additional treatment arms in which patients with mCRPC continued concurrent treatment until progression. Materials and methods Patients with mCRPC were treated with MVI-816 and pembrolizumab every 3 weeks (arm 3, n=20) or MVI-816 every 2 weeks and pembrolizumab every 4 weeks (arm 4, n=20). The primary objectives were safety, 6-month progression-free survival (PFS), median time to radiographic progression, and objective response rates. Secondary objectives included immunological evaluations. Results In 25 patients with measurable disease, there were no complete response and one confirmed partial response in a patient who subsequently found to have an MSIhi tumor. 4/40 patients (10%) had a prostate-specific antigen decline >50%. The estimated overall radiographic PFS rate at 6 months was 47.2% (44.4% arm 3, 61.5% arm 4). Accounting for all off-study events, overall median time on treatment was 5.6 months (95% CI: 5.4 to 10.8 months), 5.6 months for arm 3 and 8.1 months for arm 4 (p=0.64). Thirty-two per cent of patients remained on trial beyond 6 months without progression. Median overall survival was 22.9 (95% CI: 16.2 to 25.6) months. One grade 4 event (hyperglycemia) was observed. Immune-related adverse events (irAEs) >grade 1 were observed in 42% of patients overall. Interferon-γ and/or granzyme B immune response to prostatic acid phosphatase was detected in 2/20 patients in arm 3 and 6/20 patients in arm 4. Plasma cytokines associated with immune activation and CD8+ T-cell recruitment were augmented at weeks 6 and 12. The development of irAE was significantly associated with a prolonged time on treatment (HR=0.42, p=0.003). Baseline DNA homologous recombination repair mutations were not associated with longer time to progression. Conclusions Findings here demonstrate that combining programmed cell death 1 blockade with MVI-816 is safe, can augment tumor-specific T cells, and can result in a favorable 6-month disease control rate. Correlative studies suggest T-cell activation by vaccination is critical to the mechanism of action of this combination. Future randomized clinical trials are needed to validate these findings. Trial registration number NCT02499835.
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Affiliation(s)
- Douglas G McNeel
- Department of Medicine, Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jens C Eickhoff
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ellen Wargowski
- Department of Medicine, Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Laura E Johnson
- Department of Medicine, Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Christos E Kyriakopoulos
- Department of Medicine, Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Hamid Emamekhoo
- Department of Medicine, Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Joshua M Lang
- Department of Medicine, Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Mary Jane Brennan
- Department of Medicine, Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Glenn Liu
- Department of Medicine, Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
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14
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Tagawa ST, Balar AV, Petrylak DP, Kalebasty AR, Loriot Y, Fléchon A, Jain RK, Agarwal N, Bupathi M, Barthelemy P, Beuzeboc P, Palmbos P, Kyriakopoulos CE, Pouessel D, Sternberg CN, Hong Q, Goswami T, Itri LM, Grivas P. TROPHY-U-01: A Phase II Open-Label Study of Sacituzumab Govitecan in Patients With Metastatic Urothelial Carcinoma Progressing After Platinum-Based Chemotherapy and Checkpoint Inhibitors. J Clin Oncol 2021; 39:2474-2485. [PMID: 33929895 PMCID: PMC8315301 DOI: 10.1200/jco.20.03489] [Citation(s) in RCA: 215] [Impact Index Per Article: 71.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/12/2021] [Accepted: 03/22/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Patients with metastatic urothelial carcinoma (mUC) who progress on platinum-based combination chemotherapy (PLT) and checkpoint inhibitors (CPIs) have limited options that offer objective response rates (ORRs) of approximately 10% with a median overall survival (OS) of 7-8 months. Sacituzumab govitecan (SG) is a TROP-2-directed antibody-drug conjugate with an SN-38 payload that has shown preliminary activity in mUC. METHODS TROPHY-U-01 (ClinicalTrials.gov identifier: NCT03547973) is a multicohort, open-label, phase II, registrational study. Cohort 1 includes patients with locally advanced or unresectable or mUC who had progressed after prior PLT and CPI. Patients received SG 10 mg/kg on days 1 and 8 of 21-day cycles. The primary outcome was centrally reviewed ORR; secondary outcomes were progression-free survival, OS, duration of response, and safety. RESULTS Cohort 1 included 113 patients (78% men; median age, 66 years; 66.4% visceral metastases; median of three [range, 1-8] prior therapies). At a median follow-up of 9.1 months, the ORR was 27% (31 of 113; 95% CI, 19.5 to 36.6); 77% had decrease in measurable disease. Median duration of response was 7.2 months (95% CI, 4.7 to 8.6 months), with median progression-free survival and OS of 5.4 months (95% CI, 3.5 to 7.2 months) and 10.9 months (95% CI, 9.0 to 13.8 months), respectively. Key grade ≥ 3 treatment-related adverse events included neutropenia (35%), leukopenia (18%), anemia (14%), diarrhea (10%), and febrile neutropenia (10%), with 6% discontinuing treatment because of treatment-related adverse events. CONCLUSION SG is an active drug with a manageable safety profile with most common toxicities of neutropenia and diarrhea. SG has notable efficacy compared with historical controls in pretreated mUC that has progressed on both prior PLT regimens and CPI. The results from this study supported accelerated approval of SG in this population.
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Affiliation(s)
| | - Arjun V. Balar
- Perlmutter Cancer Center at NYU Langone Health, New York, NY
| | | | | | - Yohann Loriot
- Institut de Cancérologie Gustave Roussy, Villejuif, France
| | | | - Rohit K. Jain
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | | | - Philippe Barthelemy
- Hôpitaux Universitaires de Strasbourg/Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | | | - Phillip Palmbos
- University of Michigan Comprehensive Cancer Center, Ann Arbor, MI
| | | | - Damien Pouessel
- Institut Claudius Regaud/Cancer Comprehensive Center, IUCT, Toulouse, France
| | | | - Quan Hong
- Immunomedics, a subsidiary of Gilead Sciences, Inc, Morris Plains, NJ
| | - Trishna Goswami
- Immunomedics, a subsidiary of Gilead Sciences, Inc, Morris Plains, NJ
| | - Loretta M. Itri
- Immunomedics, a subsidiary of Gilead Sciences, Inc, Morris Plains, NJ
| | - Petros Grivas
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA
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15
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Costello BA, Bhavsar NA, Zakharia Y, Pal SK, Vaishampayan U, Jim H, Fishman MN, Molina AM, Kyriakopoulos CE, Tsao CK, Appleman LJ, Gartrell BA, Hussain A, Stadler WM, Agarwal N, Pachynski RK, Hutson TE, Hammers HJ, Ryan CW, Mardekian J, Borham A, George DJ, Harrison MR. A Prospective Multicenter Evaluation of Initial Treatment Choice in Metastatic Renal Cell Carcinoma Prior to the Immunotherapy Era: The MaRCC Registry Experience. Clin Genitourin Cancer 2021; 20:1-10. [PMID: 34364796 PMCID: PMC10186183 DOI: 10.1016/j.clgc.2021.07.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/07/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The Metastatic Renal Cell Carcinoma (MaRCC) Registry provides prospective data on real-world treatment patterns and outcomes in patients with metastatic renal cell carcinoma (mRCC). METHODS AND MATERIALS Patients with mRCC and no prior systemic therapy were enrolled at academic and community sites. End of study data collection was in March 2019. Outcomes included overall survival (OS). A survey of treating physicians assessed reasons for treatment initiations and discontinuations. RESULTS Overall, 376 patients with mRCC initiated first-line therapy; 171 (45.5%) received pazopanib, 75 (19.9%) sunitinib, and 74 (19.7%) participated in a clinical trial. Median (95% confidence interval) OS was longest in the clinical trial group (50.3 [35.8-not reached] months) versus pazopanib (39.0 [29.7-50.9] months) and sunitinib 26.2 [19.9-61.5] months). Non-clear cell RCC (21.5% of patients) was associated with worse median OS than clear cell RCC (18.0 vs. 47.3 months). Differences in baseline characteristics, treatment starting dose, and relative dose exposure among treatment groups suggest selection bias. Survey results revealed a de-emphasis on quality of life, toxicity, and patient preference compared with efficacy in treatment selection. CONCLUSION The MaRCC Registry gives insights into real-world first-line treatment selection, outcomes, and physician rationale regarding initial treatment selection prior to the immunotherapy era. Differences in outcomes between clinical trial and off-study patients reflect the difficulty in translating trial results to real-world patients, and emphasize the need to broaden clinical trial eligibility. Physician emphasis on efficacy over quality of life and toxicity suggests more data and education are needed regarding these endpoints.
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Affiliation(s)
| | | | | | | | | | | | | | - Ana M Molina
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, NY
| | | | - Che-Kai Tsao
- Tisch Cancer Institute, Mount Sinai Medical Center, New York, NY
| | | | - Benjamin A Gartrell
- Departments of Medical Oncology and Urology, Montefiore Medical Center, Bronx, NY
| | - Arif Hussain
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD
| | - Walter M Stadler
- University of Chicago, Department of Medicine, Section of Hematology/Oncology, Comprehensive Cancer Center, Chicago, IL
| | - Neeraj Agarwal
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Russell K Pachynski
- Siteman Cancer Center, Department of Medicine, Washington University School of Medicine, St. Louis, MO
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16
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Harrison MR, Costello BA, Bhavsar NA, Vaishampayan U, Pal SK, Zakharia Y, Jim HSL, Fishman MN, Molina AM, Kyriakopoulos CE, Tsao C, Appleman LJ, Gartrell BA, Hussain A, Stadler WM, Agarwal N, Pachynski RK, Hutson TE, Hammers HJ, Ryan CW, Inman BA, Mardekian J, Borham A, George DJ. Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC). Cancer 2021; 127:2204-2212. [PMID: 33765337 PMCID: PMC8251950 DOI: 10.1002/cncr.33494] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 06/17/2020] [Revised: 10/29/2020] [Accepted: 12/01/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Systemic therapy (ST) can be deferred in patients who have metastatic renal cell carcinoma (mRCC) and slow-growing metastases. Currently, this subset of patients managed with active surveillance (AS) is not well described in the literature. METHODS This was a prospective observational study of patients with mRCC across 46 US community and academic centers. The objective was to describe baseline characteristics and demographics of patients with mRCC initially managed by AS, reasons for AS, and patient outcomes. Descriptive statistics were used to characterize demographics, baseline characteristics, and patient-related outcomes. Wilcoxon 2-sample rank-sum tests and χ2 tests were used to assess differences between ST and AS cohorts in continuous and categorical variables, respectively. Kaplan-Meier survival curves were used to assess survival. RESULTS Of 504 patients, mRCC was initially managed by AS (n = 143) or ST (n = 305); 56 patients were excluded from the analysis. Disease was present in 69% of patients who received AS, whereas the remaining 31% had no evidence of disease. At data cutoff, 72 of 143 patients (50%) in the AS cohort had not received ST. The median overall survival was not reached (95% CI, 122 months to not estimable) in patients who received AS versus 30 months (95% CI, 25-44 months) in those who received ST. Quality of life at baseline was significantly better in patients who were managed with AS versus ST. CONCLUSIONS AS occurs frequently (32%) in real-world clinical practice and appears to be a safe and appropriate alternative to immediate ST in selected patients.
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Affiliation(s)
| | | | - Nrupen A. Bhavsar
- Duke Cancer InstituteDuke University Medical CenterDurhamNorth Carolina
| | | | - Sumanta K. Pal
- Medical Oncology and Experimental TherapeuticsCity of Hope Comprehensive Cancer CenterDuarteCalifornia
| | - Yousef Zakharia
- Department of MedicineUniversity of Iowa Hospitals and ClinicsIowa CityIowa
| | | | | | - Ana M. Molina
- Division of Hematology and Medical OncologyDepartment of MedicineWeill Cornell MedicineNew YorkNew York
| | | | - Che‐Kai Tsao
- Tisch Cancer Institute, Mount Sinai Medical CenterNew YorkNew York
| | - Leonard J. Appleman
- The University of Pittsburgh Medical Center (UPMC) Cancer PavilionPittsburghPennsylvania
| | - Benjamin A. Gartrell
- Department of Medical OncologyMontefiore Medical CenterBronxNew York,Department of UrologyMontefiore Medical CenterBronxNew York
| | - Arif Hussain
- Department of MedicineUniversity of MarylandBaltimoreMaryland
| | - Walter M. Stadler
- Section of Hematology/OncologyDepartment of MedicineComprehensive Cancer CenterUniversity of ChicagoChicagoIllinois
| | - Neeraj Agarwal
- Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUtah
| | - Russell K. Pachynski
- Siteman Cancer Center, Department of MedicineWashington University School of MedicineSt LouisMissouri
| | | | - Hans J. Hammers
- Division of Hematology‐OncologyUniversity of Texas SouthwesternDallasTexas
| | - Christopher W. Ryan
- Department of Medicine, Division of Hematology and Medical OncologyOregon Health and Science UniversityPortlandOregon
| | - Brant A. Inman
- Duke Cancer InstituteDuke University Medical CenterDurhamNorth Carolina
| | | | | | - Daniel J. George
- Duke Cancer InstituteDuke University Medical CenterDurhamNorth Carolina
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17
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Lozar T, Brunner MJ, Shah SI, Kyriakopoulos CE, Emamekhoo H. A case of metastatic renal cell carcinoma with concomitant Castleman's disease treated with immunotherapy. Urol Case Rep 2021; 38:101720. [PMID: 34094876 PMCID: PMC8163955 DOI: 10.1016/j.eucr.2021.101720] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 11/17/2022] Open
Abstract
Castleman's disease (CD) is an uncommon lymphoproliferative process that can present concurrent to other solid organ malignancy, especially in selected populations. Concomitant CD and renal cell carcinoma (RCC) are challenging in terms of diagnosis and treatment. Assessment of CD involvement is a crucial step in selecting the optimal treatment strategy. Here we report a case of metastatic RCC and concurrent CD treated with surgery and immunotherapy.
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Affiliation(s)
- Taja Lozar
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- McArdle Laboratory for Cancer Research, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Sujal I. Shah
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Christos E. Kyriakopoulos
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Hamid Emamekhoo
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Corresponding author. Department of Medicine, Hematology-Oncology Division, University of Wisconsin Carbone Cancer Center, 1111 Highland Ave, Rm 7009 Madison, WI, 53597, USA.
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18
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McKay RR, McGregor BA, Xie W, Braun DA, Wei X, Kyriakopoulos CE, Zakharia Y, Maughan BL, Rose TL, Stadler WM, McDermott DF, Harshman LC, Choueiri TK. Optimized Management of Nivolumab and Ipilimumab in Advanced Renal Cell Carcinoma: A Response-Based Phase II Study (OMNIVORE). J Clin Oncol 2020; 38:4240-4248. [PMID: 33108238 PMCID: PMC7768333 DOI: 10.1200/jco.20.02295] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [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] [Accepted: 09/25/2020] [Indexed: 01/05/2023] Open
Abstract
PURPOSE In this phase II response-adaptive trial, we investigated the rational application of immune checkpoint blockade in renal cell carcinoma (RCC; ClinicalTrials.gov identifier: NCT03203473). METHODS We enrolled patients with metastatic RCC with no prior checkpoint inhibitor exposure. All patients received nivolumab alone with subsequent arm allocation based on response. Patients with a confirmed partial response (PR) or complete response (CR) within 6 months discontinued nivolumab and were observed (arm A). Patients with stable disease or progressive disease (PD) after no more than 6 months of nivolumab received two doses of ipilimumab (arm B). The primary endpoints were the proportion of patients with PR/CR at 1 year after nivolumab discontinuation (arm A) and proportion of nivolumab nonresponders who converted to PR/CR after ipilimumab (arm B). RESULTS Overall, 83 patients initiated treatment, of whom 96% had clear-cell histology, 51% were treatment naïve, and 67% had intermediate/poor-risk disease. Median follow-up was 19.5 months. Within 6 months, induction nivolumab resulted in a confirmed PR in 12% of patients (n = 10). Fourteen patients were not allocated to a study arm (seven because of toxicity, seven because of PD). Twelve patients (14%) were allocated to arm A and discontinued nivolumab, of whom five (42%; 90% CI, 18% to 68%) remained off nivolumab at ≥ 1 year. Of 57 patients (69%) allocated to arm B, two patients converted to a confirmed PR (4%; 90% CI, 1% to 11%), and no CRs were observed. CONCLUSION In this study, nivolumab followed by two doses of ipilimumab resulted in no CRs and a low PR/CR conversion. The number of patients evaluated for nivolumab discontinuation was too small to assess the value of this approach. Currently, our data do not support a response-adaptive strategy for checkpoint blockade in advanced RCC.
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Affiliation(s)
| | | | | | | | - Xiao Wei
- Dana-Farber Cancer Institute, Boston, MA
| | | | - Yousef Zakharia
- University of Iowa Health Care, Holden Comprehensive Cancer Center, Iowa City, IA
| | | | - Tracy L. Rose
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
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19
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Kyriakopoulos CE, Heath EI, Ferrari A, Sperger JM, Singh A, Perlman SB, Roth AR, Perk TG, Modelska K, Porcari A, Duggan W, Lang JM, Jeraj R, Liu G. Exploring Spatial-Temporal Changes in 18F-Sodium Fluoride PET/CT and Circulating Tumor Cells in Metastatic Castration-Resistant Prostate Cancer Treated With Enzalutamide. J Clin Oncol 2020; 38:3662-3671. [PMID: 32897830 DOI: 10.1200/jco.20.00348] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Intrapatient treatment response heterogeneity is under-recognized. Quantitative total bone imaging (QTBI) using 18F-NaF positron emission tomography/computed tomography (PET/CT) scans is a tool that allows characterization of interlesional treatment response heterogeneity in bone. Understanding spatial-temporal response is important to identify individuals who may benefit from treatment beyond progression. PATIENTS AND METHODS Men with progressive metastatic castration-resistant prostate cancer (mCRPC) with at least two lesions on bone scintigraphy were enrolled and treated with enzalutamide 160 mg daily (ClinicalTrials.gov identifier: NCT02384382). 18F-NaF PET/CT scans were obtained at baseline (PET1), week 13 (PET2), and at the time of prostate-specific antigen (PSA) progression, standard radiographic or clinical progression, or at 2 years without progression (PET3). QTBI was used to determine lesion-level response. The primary end point was the proportion of men with at least one responding bone lesion on PET3 using QTBI. RESULTS Twenty-three men were enrolled. Duration on treatment ranged from 1.4 to 34.1 months. In general, global standardized uptake value (SUV) metrics decreased while on enzalutamide (PET2) and increased at the time of progression (PET3). The most robust predictor of PSA progression was change in SUVhetero (PET1 to PET3; hazard ratio, 3.88; 95% CI, 1.24 to 12.1). Although overall functional disease burden improved during enzalutamide treatment, an increase in total burden (SUVtotal) was seen at the time of progression, as measured by 18F-NaF PET/CT. All (22/22) evaluable men had at least one responding bone lesion at PET3 using QTBI. CONCLUSION We found that the proportion of progressing lesions was low, indicating that a substantial number of lesions appear to continue to benefit from enzalutamide beyond progression. Selective targeting of nonresponding lesions may be a reasonable approach to extend benefit.
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Affiliation(s)
| | - Elisabeth I Heath
- Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI
| | - Anna Ferrari
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Jamie M Sperger
- University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI
| | - Anupama Singh
- University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI
| | - Scott B Perlman
- University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI.,Department of Radiology, University of Wisconsin, Madison, WI
| | - Alison R Roth
- University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI.,Department of Medical Physics, University of Wisconsin, Madison, WI
| | - Timothy G Perk
- University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI.,Department of Medical Physics, University of Wisconsin, Madison, WI
| | | | | | | | - Joshua M Lang
- University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI
| | - Robert Jeraj
- University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI.,Department of Medical Physics, University of Wisconsin, Madison, WI.,AIQ Solutions, Madison, WI
| | - Glenn Liu
- University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI.,AIQ Solutions, Madison, WI
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20
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Kyriakopoulos CE, Eickhoff JC, Ferrari AC, Schweizer MT, Wargowski E, Olson BM, McNeel DG. Multicenter Phase I Trial of a DNA Vaccine Encoding the Androgen Receptor Ligand-binding Domain (pTVG-AR, MVI-118) in Patients with Metastatic Prostate Cancer. Clin Cancer Res 2020; 26:5162-5171. [PMID: 32513836 DOI: 10.1158/1078-0432.ccr-20-0945] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/29/2020] [Accepted: 06/01/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Preclinical studies demonstrated that a DNA vaccine (pTVG-AR, MVI-118) encoding the androgen receptor ligand-binding domain (AR LBD) augmented antigen-specific CD8+ T cells, delayed prostate cancer progression and emergence of castration-resistant disease, and prolonged survival of tumor-bearing mice. This vaccine was evaluated in a multicenter phase I trial. PATIENTS AND METHODS Patients with metastatic castration-sensitive prostate cancer (mCSPC) who had recently begun androgen deprivation therapy were randomly assigned to receive pTVG-AR on one of two treatment schedules over one year, and with or without GM-CSF as a vaccine adjuvant. Patients were followed for 18 months. Primary objectives were safety and immune response. Secondary objectives included median time to PSA progression, and 18-month PSA-PFS (PPFS). RESULTS Forty patients were enrolled at three centers. Twenty-seven patients completed treatment and 18 months of follow-up. Eleven patients (28%) had a PSA progression event before the 18-month time point. No grade 3 or 4 adverse events were observed. Of 30 patients with samples available for immune analysis, 14 (47%) developed Th1-type immunity to the AR LBD, as determined by IFNγ and/or granzyme B ELISPOT. Persistent IFNγ immune responses were observed irrespective of GM-CSF adjuvant. Patients who developed T-cell immunity had a significantly prolonged PPFS compared with patients without immunity (HR = 0.01; 95% CI, 0.0-0.21; P = 0.003). CONCLUSIONS pTVG-AR was safe and immunologically active in patients with mCSPC. Association between immunity and PPFS suggests that treatment may delay the time to castration resistance, consistent with preclinical findings, and will be prospectively evaluated in future trials.See related commentary by Shenderov and Antonarakis, p. 5056.
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Affiliation(s)
- Christos E Kyriakopoulos
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin
| | - Jens C Eickhoff
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Biostatistics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Anna C Ferrari
- Department of Oncology, Albert Einstein College of Medicine, Montefiore Medical Center for Cancer Care, New York, New York
| | - Michael T Schweizer
- University of Washington/Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Ellen Wargowski
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Douglas G McNeel
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin.
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21
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Zarling L, Emamekhoo H, Bhutani G, Ziemlewicz T, Matkowskyj KA, Kyriakopoulos CE. Polycystic Liver Disease in a Patient With Metastatic Renal Cell Carcinoma: A Case Report. Anticancer Res 2020; 40:1527-1534. [PMID: 32132053 DOI: 10.21873/anticanres.14098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/20/2020] [Revised: 01/28/2020] [Accepted: 02/03/2020] [Indexed: 11/10/2022]
Abstract
We report a case of rapid evolution of polycystic liver disease in a 76-year-old patient with metastatic renal cell carcinoma who underwent treatment with numerous antineoplastic agents. The aim was to identify a causative etiology for these hepatic cysts of unclear origin. The cystic lesions of the patient were ultimately innumerable and developed rapidly, more than tripling the total liver volume from complete absence over the course of 24 months. The hepatic lesions continued to grow despite an otherwise moderate tumor response. Prior to patient death, the patient remained relatively asymptomatic from the cyst burden and was without signs of grossly metastatic disease. This rapid development of polycystic liver disease most likely represents a previously unseen medication side-effect of cabozantinib or pazopanib. It is important to identify adverse effects of novel antineoplastic agents in this time of oncological medical discovery.
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Affiliation(s)
- Lucas Zarling
- University of Wisconsin School of Medicine and Public Health, Madison, WI, U.S.A.
| | - Hamid Emamekhoo
- University of Wisconsin School of Medicine and Public Health, Madison, WI, U.S.A.,University of Wisconsin Carbone Cancer Center, Madison, WI, U.S.A
| | - Gauri Bhutani
- University of Wisconsin School of Medicine and Public Health, Madison, WI, U.S.A
| | - Timothy Ziemlewicz
- University of Wisconsin School of Medicine and Public Health, Madison, WI, U.S.A
| | - Kristina A Matkowskyj
- University of Wisconsin School of Medicine and Public Health, Madison, WI, U.S.A.,University of Wisconsin Carbone Cancer Center, Madison, WI, U.S.A
| | - Christos E Kyriakopoulos
- University of Wisconsin School of Medicine and Public Health, Madison, WI, U.S.A.,University of Wisconsin Carbone Cancer Center, Madison, WI, U.S.A
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22
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Heath EI, Nanus DM, Slovin S, Strand C, Higano C, Simons VH, Johnson C, Kyriakopoulos CE, Reichert ZR, Lory S, George DJ, Mucci LA, Marcus JD, Trendel JA, Bock CH. Prostate Cancer National Summit's Call to Action. Clin Genitourin Cancer 2019; 17:161-168. [PMID: 31085057 DOI: 10.1016/j.clgc.2019.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/01/2019] [Accepted: 04/09/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Elisabeth I Heath
- Karmanos Cancer Institute and Department of Oncology, Wayne State University School of Medicine, Detroit, MI.
| | - David M Nanus
- Division of Hematology and Oncology, Department of Medicine, Weill Cornell Medicine and Meyer Cancer Center, New York, NY
| | - Susan Slovin
- Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Celestia Higano
- Fred Hutchinson Cancer Research Center and Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | | | - Crawford Johnson
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, and Sidney Kimmel Comprehensive Cancer Center, Department of Urology, Johns Hopkins University, Baltimore, MD
| | - Christos E Kyriakopoulos
- Division of Hematology/Oncology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Zachery R Reichert
- Division of Hematology/Oncology, Department of Internal Medicine and University of Michigan Comprehensive Cancer Center, Ann Arbor, MI
| | | | - Daniel J George
- Division of Medical Oncology, Department of Medicine and Duke Cancer Institute, Duke University Medical Center, Durham, NC
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | | | - Jill A Trendel
- Karmanos Cancer Institute and Department of Oncology, Wayne State University School of Medicine, Detroit, MI
| | - Cathryn H Bock
- Karmanos Cancer Institute and Department of Oncology, Wayne State University School of Medicine, Detroit, MI
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23
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Kyriakopoulos CE, Chen YH, Carducci MA, Liu G, Jarrard DF, Hahn NM, Shevrin DH, Dreicer R, Hussain M, Eisenberger M, Kohli M, Plimack ER, Vogelzang NJ, Picus J, Cooney MM, Garcia JA, DiPaola RS, Sweeney CJ. Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer: Long-Term Survival Analysis of the Randomized Phase III E3805 CHAARTED Trial. J Clin Oncol 2018; 36:1080-1087. [PMID: 29384722 PMCID: PMC5891129 DOI: 10.1200/jco.2017.75.3657] [Citation(s) in RCA: 598] [Impact Index Per Article: 99.7] [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] [Indexed: 12/18/2022] Open
Abstract
Purpose Docetaxel added to androgen-deprivation therapy (ADT) significantly increases the longevity of some patients with metastatic hormone-sensitive prostate cancer. Herein, we present the outcomes of the CHAARTED (Chemohormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer) trial with more mature follow-up and focus on tumor volume. Patients and Methods In this phase III study, 790 patients with metastatic hormone-sensitive prostate cancer were equally randomly assigned to receive either ADT in combination with docetaxel 75 mg/m2 for up to six cycles or ADT alone. The primary end point of the study was overall survival (OS). Additional analyses of the prospectively defined low- and high-volume disease subgroups were performed. High-volume disease was defined as presence of visceral metastases and/or ≥ four bone metastases with at least one outside of the vertebral column and pelvis. Results At a median follow-up of 53.7 months, the median OS was 57.6 months for the chemohormonal therapy arm versus 47.2 months for ADT alone (hazard ratio [HR], 0.72; 95% CI, 0.59 to 0.89; P = .0018). For patients with high-volume disease (n = 513), the median OS was 51.2 months with chemohormonal therapy versus 34.4 months with ADT alone (HR, 0.63; 95% CI, 0.50 to 0.79; P < .001). For those with low-volume disease (n = 277), no OS benefit was observed (HR, 1.04; 95% CI, 0.70 to 1.55; P = .86). Conclusion The clinical benefit from chemohormonal therapy in prolonging OS was confirmed for patients with high-volume disease; however, for patients with low-volume disease, no OS benefit was discerned.
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Affiliation(s)
- Christos E. Kyriakopoulos
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Yu-Hui Chen
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Michael A. Carducci
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Glenn Liu
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - David F. Jarrard
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Noah M. Hahn
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Daniel H. Shevrin
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Robert Dreicer
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Maha Hussain
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Mario Eisenberger
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Manish Kohli
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Elizabeth R. Plimack
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Nicholas J. Vogelzang
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Joel Picus
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Matthew M. Cooney
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Jorge A. Garcia
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Robert S. DiPaola
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
| | - Christopher J. Sweeney
- Christos E. Kyriakopoulos, Glenn Liu, and David F. Jarrard, University of Wisconsin (UW) School of Medicine and Public Health and UW Carbone Cancer Center, Madison, WI; Yu-Hui Chen and Christopher J. Sweeney, Dana-Farber Cancer Institute; Yu-Hui Chen, Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group; Christopher J. Sweeney, Harvard Medical School, Boston, MA; Michael A. Carducci, Noah M. Hahn, and Mario Eisenberger, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; Daniel H. Shevrin, NorthShore University HealthSystem, Evanston; Maha Hussain, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Robert Dreicer, University of Virginia Cancer Center, Charlottesville, VA; Manish Kohli, Mayo Clinic, Rochester, MN; Elizabeth R. Plimack, Fox Chase Cancer Center, Temple Health, Philadelphia, PA; Nicholas J. Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Joel Picus, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO; Matthew M. Cooney, Seidman Cancer Center, University Hospitals Cleveland Medical Center; Jorge A. Garcia, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; and Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY
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Kyriakopoulos CE, Antonarakis ES. Surrogate end points in early prostate cancer clinical states: ready for implementation? Ann Transl Med 2017; 5:502. [PMID: 29299463 DOI: 10.21037/atm.2017.10.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Christos E Kyriakopoulos
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Emmanuel S Antonarakis
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
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Kyriakopoulos CE, Braden AM, Kolesar JM, Eickhoff JC, Bailey HH, Heideman J, Liu G, Wisinski KB. A phase I study of tivantinib in combination with temsirolimus in patients with advanced solid tumors. Invest New Drugs 2017; 35:290-297. [PMID: 28004284 PMCID: PMC5809175 DOI: 10.1007/s10637-016-0418-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 12/13/2016] [Indexed: 02/07/2023]
Abstract
Background A wide variety of human cancers exhibit dysregulated c-Met activity that has implications in oncogenesis. Phosphorylation of c-Met results in activation of the PI3K/AKT/mTOR pathway. Combined blockade of c-Met and mTOR pathways has shown efficacy in preclinical studies. Tivantinib is a c-Met inhibitor and temsirolimus is a selective mTOR inhibitor. We aimed to determine the maximum tolerated dose (MTD) and the recommended phase II dose (RP2D), dose-limiting toxicities (DLT), adverse events (AEs), clinical activity and pharmacokinetic (PK) parameters of the combination. Methods This open-label phase I study used a 3 + 3 dose escalation design. Patients (pts) were treated with escalating doses of tivantinib (120-360 mg tablets orally twice daily) and temsirolimus (20 mg IV weekly) followed by dose expansion at the MTD. Separate cohorts were planned for extensive (normal) and poor tivantinib metabolizers based on CYP2C19 genotypes. Cycles were 28 days besides cycle 1 that was 35 days to allow for PK analysis. Results Twenty-nine pts. [median age 58 (range 28-77)] were enrolled (21 in dose escalation and 8 in dose expansion). All were extensive CYP2C19 metabolizers. The most common types of cancer were colorectal, ovarian and non-small cell lung. Sixteen out of 21 and 6 out of 8 pts. were evaluable for DLT evaluation per protocol in the dose escalation and dose expansion phases, respectively. Pts remained on study for a median of 71 days (range 18-296). The MTD and RP2D was tivantinib 240 mg twice daily and temsirolimus 20 mg weekly. DLTs included grade (gr) 4 neutropenia (2 pts.; 1 with gr 3 febrile neutropenia), gr 3 abdominal pain (1 pt) and gr 2 mucositis resulting in inadequate drug delivery. The most common treatment related AEs grade ≥ 2 included: anemia (gr 2 in 9 pts., gr 3 in 3 pts), fatigue (gr 2 in 10 pts), anorexia (gr 2 in 9 pts), hypoalbuminemia (gr 2 in 6 pts., gr 3 in 2 pts), hypophosphatemia (gr 2 in 2 pts., gr 3 in 5 pts) and nausea (gr 2 in 6 pts., gr 3 in 1 pt). One pt. with ovarian cancer had a confirmed partial response and remained on study for 10 months, a second patient with ovarian cancer had stable disease and remained on study for 6 months and a third pt. with squamous cell carcinoma of the tongue had stable disease and remained on study for 7 months. Pharmacokinetic analysis showed that there is no interaction in the plasma concentrations between tivantinib and temsirolimus. Conclusions The combination of tivantinib with temsirolimus appears to be well tolerated with evidence of clinical activity.
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Affiliation(s)
- Christos E Kyriakopoulos
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA.
| | - Amy M Braden
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Jill M Kolesar
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Jens C Eickhoff
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Howard H Bailey
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Jennifer Heideman
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Glenn Liu
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Kari B Wisinski
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA
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Kyriakopoulos CE, Chittoria N, Choueiri TK, Kroeger N, Lee JL, Srinivas S, Knox JJ, Bjarnason GA, Ernst SD, Wood LA, Vaishampayan UN, Agarwal N, Pal SK, Kanesvaran R, Rha SY, Yuasa T, Donskov F, North SA, Heng DY, Rini BI. Outcome of Patients With Metastatic Sarcomatoid Renal Cell Carcinoma: Results From the International Metastatic Renal Cell Carcinoma Database Consortium. Clin Genitourin Cancer 2015; 13:e79-85. [DOI: 10.1016/j.clgc.2014.08.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 08/11/2014] [Indexed: 12/22/2022]
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Tan PS, Haaland B, Montero AJ, Kyriakopoulos CE, Lopes G. Hormonal Therapeutics Enzalutamide and Abiraterone Acetate in the Treatment of Metastatic Castration-Resistant Prostate Cancer (mCRPC) Post-docetaxel-an Indirect Comparison. Clin Med Insights Oncol 2014; 8:29-36. [PMID: 24678245 PMCID: PMC3964205 DOI: 10.4137/cmo.s13671] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 01/02/2014] [Accepted: 01/06/2014] [Indexed: 01/18/2023]
Abstract
INTRODUCTION This study aims to make an indirect comparison between enzalutamide and abiraterone acetate for mCRPC post-docetaxel. METHODS A search for published phase 3 trials was performed with PubMed. Indirect comparisons of enzalutamide (AFFIRM) to abiraterone acetate (COU-AA-301) on outcomes overall survival (OS), time to prostate-specific-antigen (PSA) progression, radiographic progression-free survival (PFS), and PSA response were constructed in the context of log-linear regression models. RESULTS There was no statistically significant difference in OS (hazard ratio (HR) 0.85, 95% CI 0.68–1.07). However, there was some evidence that enzalutamide may outperform abiraterone acetate with respect to secondary outcomes: time to PSA progression (HR 0.40, 95% CI 0.30–0.53), radiographic PFS (HR 0.61, 95% CI 0.50–0.74), and PSA response rates (RRs) (OR 10.69, 95% CI 3.92–29.20). CONCLUSION While there was no statistically significant difference in OS, enzalutamide may be advantageous for secondary endpoints. Findings of this indirect comparison serve to be hypothesis-generating for future head-to-head trials.
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Affiliation(s)
- Pui S Tan
- Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore
| | - Benjamin Haaland
- Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore. ; Department of Statistics and Applied Probability, National University of Singapore, Singapore
| | | | | | - Gilberto Lopes
- Hospital do Coração Cancer Center (HCor Onco), Brazil. ; Centro Paulista de Oncologia, Brazil. ; Oncoclinicas do Brasil, Brazil. ; Johns Hopkins University, Baltimore, MD, USA
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