1
|
Cardillo TM, Zalath MB, Arrojo R, Sharkey RM, Govindan SV, Chang CH, Goldenberg DM. Sacituzumab govitecan plus platinum-based chemotherapy mediates significant antitumor effects in triple-negative breast, urinary bladder, and small-cell lung carcinomas. Oncotarget 2024; 15:144-158. [PMID: 38386805 PMCID: PMC10883684 DOI: 10.18632/oncotarget.28559] [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: 07/24/2023] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Sacituzumab govitecan (SG) is an antibody-drug conjugate composed of an anti-Trop-2-directed antibody conjugated with the topoisomerase I inhibitory drug, SN-38, via a proprietary hydrolysable linker. SG has received United States Food and Drug Administration (FDA) approval to treat metastatic triple-negative breast cancer (TNBC), unresectable locally advanced or metastatic hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer, and accelerated approval for metastatic urothelial cancer. We investigated the utility of combining SG with platinum-based chemotherapeutics in TNBC, urinary bladder carcinoma (UBC), and small-cell lung carcinoma (SCLC). SG plus carboplatin or cisplatin produced additive growth-inhibitory effects in vitro that trended towards synergy. Immunoblot analysis of cell lysates suggests perturbation of the cell-cycle and a shift towards pro-apoptotic signaling evidenced by an increased Bax to Bcl-2 ratio and down-regulation of two anti-apoptotic proteins, Mcl-1 and survivin. Significant antitumor effects were observed with SG plus carboplatin in mice bearing TNBC or SCLC tumors compared to all controls (P < 0.0062 and P < 0.0017, respectively) and with SG plus cisplatin in UBC and SCLC tumor-bearing animals (P < 0.0362 and P < 0.0001, respectively). These combinations were well tolerated by the animals. Combining SG with platinum-based chemotherapeutics demonstrates the benefit in these indications and warrants further clinical investigation.
Collapse
Affiliation(s)
- Thomas M. Cardillo
- Immunomedics, Inc., Morris Plains, NJ 07950 now acquired by Gilead Sciences, Inc., Foster City, CA 94404, USA
- Gilead Sciences, Inc., Foster City, CA 94404, USA
- At the time the work was conducted, all the authors were employees of Immunomedics, Inc
| | - Maria B. Zalath
- Immunomedics, Inc., Morris Plains, NJ 07950 now acquired by Gilead Sciences, Inc., Foster City, CA 94404, USA
- At the time the work was conducted, all the authors were employees of Immunomedics, Inc
| | - Roberto Arrojo
- Immunomedics, Inc., Morris Plains, NJ 07950 now acquired by Gilead Sciences, Inc., Foster City, CA 94404, USA
- At the time the work was conducted, all the authors were employees of Immunomedics, Inc
| | - Robert M. Sharkey
- Immunomedics, Inc., Morris Plains, NJ 07950 now acquired by Gilead Sciences, Inc., Foster City, CA 94404, USA
- At the time the work was conducted, all the authors were employees of Immunomedics, Inc
| | - Serengulam V. Govindan
- Immunomedics, Inc., Morris Plains, NJ 07950 now acquired by Gilead Sciences, Inc., Foster City, CA 94404, USA
- At the time the work was conducted, all the authors were employees of Immunomedics, Inc
| | - Chien-Hsing Chang
- Immunomedics, Inc., Morris Plains, NJ 07950 now acquired by Gilead Sciences, Inc., Foster City, CA 94404, USA
- At the time the work was conducted, all the authors were employees of Immunomedics, Inc
| | - David M. Goldenberg
- Immunomedics, Inc., Morris Plains, NJ 07950 now acquired by Gilead Sciences, Inc., Foster City, CA 94404, USA
- Current address: Center for Molecular Medicine and Immunology, Mendham, NJ 07945, USA; E-mail,
- At the time the work was conducted, this author was Chairman and Chief Scientific Officer of Immunomedics, Inc., which he founded in 1982
| |
Collapse
|
2
|
Goldenberg DM, Sharkey RM, Govindan SV, Cardillo TM. Novel Peptide Camptothecin Drug-linkers for Potent ADCs-Letter. Mol Cancer Ther 2022; 21:237. [PMID: 34996865 DOI: 10.1158/1535-7163.mct-21-0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 03/22/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022]
Affiliation(s)
| | - Robert M Sharkey
- Center for Molecular Medicine and Immunology, Mendham, New Jersey.
| | - Serengulam V Govindan
- Immunomedics, Inc., a subsidiary of Gilead Sciences, Inc., Morris Plains, New Jersey
| | - Thomas M Cardillo
- Immunomedics, Inc., a subsidiary of Gilead Sciences, Inc., Morris Plains, New Jersey
| |
Collapse
|
3
|
Bodet-Milin C, Faivre-Chauvet A, Carlier T, Ansquer C, Rauscher A, Frampas E, Toulgoat F, Masson D, Bourgeois M, Cerato E, Rohmer V, Couturier O, Drui D, Goldenberg DM, Sharkey RM, Barbet J, Kraeber-Bodere F. Anti-CEA Pretargeted Immuno-PET Shows Higher Sensitivity Than DOPA PET/CT in Detecting Relapsing Metastatic Medullary Thyroid Carcinoma: Post Hoc Analysis of the iPET-MTC Study. J Nucl Med 2021; 62:1221-1227. [PMID: 33547213 DOI: 10.2967/jnumed.120.252791] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 07/08/2020] [Accepted: 01/13/2021] [Indexed: 01/07/2023] Open
Abstract
Pretargeting parameters for the use of anti-carcinoembryonic antigen (CEA) bispecific monoclonal antibody TF2 and the 68Ga-labeled IMP288 peptide for immuno-PET have been optimized in a first-in-humans study performed on medullary thyroid carcinoma (MTC) patients (the iPET-MTC study). The aim of this post hoc analysis was to determine the sensitivity of immuno-PET in relapsing MTC patients, in comparison with conventional imaging and 18F-l-dihydroxyphenylalanine (18F-DOPA) PET/CT. Methods: Twenty-five studies were analyzed in 22 patients. All patients underwent immuno-PET 1 and 2 h after 68Ga-IMP288 injection pretargeted by TF2, in addition to neck, thoracic, abdominal, and pelvic CT; bone and liver MRI; and 18F-DOPA PET/CT. The gold standard was histology or confirmation by one other imaging method or by imaging follow-up. Results: In total, 190 lesions were confirmed by the gold standard: 89 in lymph nodes, 14 in lungs, 46 in liver, 37 in bone, and 4 in other sites (subcutaneous tissue, heart, brain, and pancreas). The number of abnormal foci detected by immuno-PET was 210. Among these, 174 (83%) were confirmed as true-positive by the gold standard. Immuno-PET showed a higher overall sensitivity (92%) than 18F-DOPA PET/CT (65%). Regarding metastatic sites, immuno-PET had a higher sensitivity than CT, 18F-DOPA PET/CT, or MRI for lymph nodes (98% vs. 83% for CT and 70% for 18F-DOPA PET/CT), liver (98% vs. 87% for CT, 65% for 18F-DOPA PET/CT, and 89% for MRI), and bone (92% vs. 64% for 18F-DOPA PET/CT and 86% for MRI), whereas sensitivity was lower for lung metastases (29% vs. 100% for CT and 14% for 18F-DOPA PET/CT). Tumor SUVmax at 60 min ranged from 1.2 to 59.0, with intra- and interpatient variability. Conclusion: This post hoc study demonstrates that anti-carcinoembryonic antigen immuno-PET is an effective procedure for detecting metastatic MTC lesions. Immuno-PET showed a higher overall sensitivity than 18F-DOPA PET/CT for disclosing metastases, except for the lung, where CT remains the most effective examination.
Collapse
Affiliation(s)
| | | | - Thomas Carlier
- Université de Nantes, CHU Nantes, CNRS, INSERM, CRCINA, Nantes, France
| | - Catherine Ansquer
- Université de Nantes, CHU Nantes, CNRS, INSERM, CRCINA, Nantes, France
| | | | - Eric Frampas
- Université de Nantes, CHU Nantes, CNRS, INSERM, CRCINA, Nantes, France.,Pharmacy Unit, ICO Cancer Center, Saint-Herblain, France.,Radiology Department, University Hospital, Nantes, France
| | | | - Damien Masson
- Biology Department, University Hospital, Nantes, France
| | - Mickael Bourgeois
- Université de Nantes, CHU Nantes, CNRS, INSERM, CRCINA, Nantes, France
| | - Evelyne Cerato
- Délégation à la Recherche Clinique et à l'Innovation, University Hospital, Nantes, France
| | - Vincent Rohmer
- Endocrinology Department, University Hospital, Angers, France
| | | | - Delphine Drui
- Endocrinology Department, University Hospital, Nantes, France
| | | | | | | | | |
Collapse
|
4
|
Bardia A, Hurvitz SA, Tolaney SM, Loirat D, Punie K, Oliveira M, Brufsky A, Sardesai SD, Kalinsky K, Zelnak AB, Weaver R, Traina T, Dalenc F, Aftimos P, Lynce F, Diab S, Cortés J, O'Shaughnessy J, Diéras V, Ferrario C, Schmid P, Carey LA, Gianni L, Piccart MJ, Loibl S, Goldenberg DM, Hong Q, Olivo MS, Itri LM, Rugo HS. Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer. N Engl J Med 2021; 384:1529-1541. [PMID: 33882206 DOI: 10.1056/nejmoa2028485] [Citation(s) in RCA: 525] [Impact Index Per Article: 175.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Patients with metastatic triple-negative breast cancer have a poor prognosis. Sacituzumab govitecan is an antibody-drug conjugate composed of an antibody targeting the human trophoblast cell-surface antigen 2 (Trop-2), which is expressed in the majority of breast cancers, coupled to SN-38 (topoisomerase I inhibitor) through a proprietary hydrolyzable linker. METHODS In this randomized, phase 3 trial, we evaluated sacituzumab govitecan as compared with single-agent chemotherapy of the physician's choice (eribulin, vinorelbine, capecitabine, or gemcitabine) in patients with relapsed or refractory metastatic triple-negative breast cancer. The primary end point was progression-free survival (as determined by blinded independent central review) among patients without brain metastases. RESULTS A total of 468 patients without brain metastases were randomly assigned to receive sacituzumab govitecan (235 patients) or chemotherapy (233 patients). The median age was 54 years; all the patients had previous use of taxanes. The median progression-free survival was 5.6 months (95% confidence interval [CI], 4.3 to 6.3; 166 events) with sacituzumab govitecan and 1.7 months (95% CI, 1.5 to 2.6; 150 events) with chemotherapy (hazard ratio for disease progression or death, 0.41; 95% CI, 0.32 to 0.52; P<0.001). The median overall survival was 12.1 months (95% CI, 10.7 to 14.0) with sacituzumab govitecan and 6.7 months (95% CI, 5.8 to 7.7) with chemotherapy (hazard ratio for death, 0.48; 95% CI, 0.38 to 0.59; P<0.001). The percentage of patients with an objective response was 35% with sacituzumab govitecan and 5% with chemotherapy. The incidences of key treatment-related adverse events of grade 3 or higher were neutropenia (51% with sacituzumab govitecan and 33% with chemotherapy), leukopenia (10% and 5%), diarrhea (10% and <1%), anemia (8% and 5%), and febrile neutropenia (6% and 2%). There were three deaths owing to adverse events in each group; no deaths were considered to be related to sacituzumab govitecan treatment. CONCLUSIONS Progression-free and overall survival were significantly longer with sacituzumab govitecan than with single-agent chemotherapy among patients with metastatic triple-negative breast cancer. Myelosuppression and diarrhea were more frequent with sacituzumab govitecan. (Funded by Immunomedics; ASCENT ClinicalTrials.gov number, NCT02574455; EudraCT number, 2017-003019-21.).
Collapse
Affiliation(s)
- Aditya Bardia
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Sara A Hurvitz
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Sara M Tolaney
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Delphine Loirat
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Kevin Punie
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Mafalda Oliveira
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Adam Brufsky
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Sagar D Sardesai
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Kevin Kalinsky
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Amelia B Zelnak
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Robert Weaver
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Tiffany Traina
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Florence Dalenc
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Philippe Aftimos
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Filipa Lynce
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Sami Diab
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Javier Cortés
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Joyce O'Shaughnessy
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Véronique Diéras
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Cristiano Ferrario
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Peter Schmid
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Lisa A Carey
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Luca Gianni
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Martine J Piccart
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Sibylle Loibl
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - David M Goldenberg
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Quan Hong
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Martin S Olivo
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Loretta M Itri
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| | - Hope S Rugo
- From the Division of Medical Oncology, Massachusetts General Hospital Cancer Center (A. Bardia), and the Department of Medical Oncology, Dana-Farber Cancer Institute (S.M.T.) - both in Boston; the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles (S.A.H.); the Medical Oncology Department and the Department of Drug Development and Innovation, Institut Curie, Paris (D.L.), Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (F.D.), and the Department of Medical Oncology, Centre Eugène Marquis, Rennes (V.D.) - all in France; the Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven (K.P.), and the Clinical Trials Conduct Unit (P.A.), Institut Jules Bordet-Université Libre de Bruxelles (M.J.P.), Brussels - all in Belgium; the Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (M.O.), and the International Breast Cancer Center, Quiron Group (J.C.) - all in Barcelona; Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh (A. Brufsky); Ohio State University Wexner Medical Center, Columbus (S.D.S.); Columbia University Irving Medical Center (K.K.) and Memorial Sloan Kettering Cancer Center (T.T.) - both in New York; Northside Hospital, Atlanta (A.B.Z.); Florida Cancer Specialists, Tampa (R.W.); Georgetown Lombardi Comprehensive Cancer Center, Washington, DC (F.L.); Rocky Mountain Cancer Centers, Greenwood Village, CO (S.D.); Baylor University Medical Center and Texas Oncology, Dallas (J.O.); Segal Cancer Centre, Jewish General Hospital, Montreal (C.F.); Barts Cancer Institute, Queen Mary University of London, London (P.S.); University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill (L.A.C.); Gianni Bonadonna Foundation, Milan (L.G.); the Department of Medicine and Research, Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany (S.L.); Immunomedics, Morris Plains, NJ (D.M.G., Q.H., M.S.O., L.M.I.); and the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.)
| |
Collapse
|
5
|
Bardia A, Messersmith WA, Kio EA, Berlin JD, Vahdat L, Masters GA, Moroose R, Santin AD, Kalinsky K, Picozzi V, O'Shaughnessy J, Gray JE, Komiya T, Lang JM, Chang JC, Starodub A, Goldenberg DM, Sharkey RM, Maliakal P, Hong Q, Wegener WA, Goswami T, Ocean AJ. Sacituzumab govitecan, a Trop-2-directed antibody-drug conjugate, for patients with epithelial cancer: final safety and efficacy results from the phase I/II IMMU-132-01 basket trial. Ann Oncol 2021; 32:746-756. [PMID: 33741442 DOI: 10.1016/j.annonc.2021.03.005] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [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: 12/24/2020] [Revised: 03/02/2021] [Accepted: 03/06/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Sacituzumab govitecan (SG), a trophoblast cell surface antigen-2 (Trop-2)-directed antibody-drug conjugate, has demonstrated antitumor efficacy and acceptable tolerability in a phase I/II multicenter trial (NCT01631552) in patients with advanced epithelial cancers. This report summarizes the safety data from the overall safety population (OSP) and efficacy data, including additional disease cohorts not published previously. PATIENTS AND METHODS Patients with refractory metastatic epithelial cancers received intravenous SG (8, 10, 12, or 18 mg/kg) on days 1 and 8 of 21-day cycles until disease progression or unacceptable toxicity. Endpoints for the OSP included safety and pharmacokinetic parameters with investigator-evaluated objective response rate (ORR per RECIST 1.1), duration of response, clinical benefit rate, progression-free survival, and overall survival evaluated for cohorts (n > 10 patients) of small-cell lung, colorectal, esophageal, endometrial, pancreatic ductal adenocarcinoma, and castrate-resistant prostate cancer. RESULTS In the OSP (n = 495, median age 61 years, 68% female; UGT1A1∗28 homozygous, n = 46; 9.3%), 41 (8.3%) permanently discontinued treatment due to adverse events (AEs). Most common treatment-related AEs were nausea (62.6%), diarrhea (56.2%), fatigue (48.3%), alopecia (40.4%), and neutropenia (57.8%). Most common treatment-related serious AEs (n = 75; 15.2%) were febrile neutropenia (4.0%) and diarrhea (2.8%). Grade ≥3 neutropenia and febrile neutropenia occurred in 42.4% and 5.3% of patients, respectively. Neutropenia (all grades) was numerically more frequent in UGT1A1∗28 homozygotes (28/46; 60.9%) than heterozygotes (69/180; 38.3%) or UGT1A1∗1 wild type (59/177; 33.3%). There was one treatment-related death due to an AE of aspiration pneumonia. Partial responses were seen in endometrial cancer (4/18, 22.2% ORR) and small-cell lung cancer (11/62, 17.7% ORR), and one castrate-resistant prostate cancer patient had a complete response (n = 1/11; 9.1% ORR). CONCLUSIONS SG demonstrated a toxicity profile consistent with previous published reports. Efficacy was seen in several cancer cohorts, which validates Trop-2 as a broad target in solid tumors.
Collapse
Affiliation(s)
- A Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, USA
| | | | - E A Kio
- Goshen Center for Cancer Care, Goshen, USA
| | - J D Berlin
- Vanderbilt-Ingram Cancer Center, Nashville, USA
| | - L Vahdat
- Weill Cornell Medicine, New York, USA
| | - G A Masters
- Helen F Graham Cancer Center and Research Institute, Newark, USA
| | - R Moroose
- Orlando Health UF Health Cancer Center, Orlando, USA
| | - A D Santin
- Yale University School of Medicine, New Haven, USA
| | - K Kalinsky
- Columbia University Irving Medical Center-Herbert Irving Comprehensive Cancer Center, New York, USA
| | - V Picozzi
- Virginia Mason Cancer Center, Seattle, USA
| | - J O'Shaughnessy
- Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, USA
| | - J E Gray
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - T Komiya
- Parkview Cancer Institute, Fort Wayne, USA
| | - J M Lang
- University of Wisconsin Carbone Cancer Center, Madison, USA
| | - J C Chang
- Houston Methodist Cancer Center, Houston, USA
| | - A Starodub
- Riverside Peninsula Cancer Institute, Newport News, USA
| | - D M Goldenberg
- Immunomedics, Inc., a Subsidiary of Gilead Sciences, Inc., Morris Plains, USA
| | - R M Sharkey
- Immunomedics, Inc., a Subsidiary of Gilead Sciences, Inc., Morris Plains, USA
| | - P Maliakal
- Immunomedics, Inc., a Subsidiary of Gilead Sciences, Inc., Morris Plains, USA
| | - Q Hong
- Immunomedics, Inc., a Subsidiary of Gilead Sciences, Inc., Morris Plains, USA
| | - W A Wegener
- Immunomedics, Inc., a Subsidiary of Gilead Sciences, Inc., Morris Plains, USA
| | - T Goswami
- Immunomedics, Inc., a Subsidiary of Gilead Sciences, Inc., Morris Plains, USA
| | - A J Ocean
- Weill Cornell Medicine, New York, USA.
| |
Collapse
|
6
|
Wallace DJ, Figueras F, Wegener WA, Goldenberg DM. Experience with milatuzumab, an anti-CD74 antibody against immunomodulatory macrophage migration inhibitory factor (MIF) receptor, for systemic lupus erythematosus (SLE). Ann Rheum Dis 2021; 80:954-955. [PMID: 33619162 DOI: 10.1136/annrheumdis-2020-219803] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/25/2021] [Accepted: 02/10/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Daniel J Wallace
- Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Florence Figueras
- Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | | | | |
Collapse
|
7
|
Diéras V, Weaver R, Tolaney SM, Bardia A, Punie K, Brufsky A, Rugo HS, Kalinsky K, Traina T, Klein L, Loirat D, Lynce F, Daniel B, Ademuyiwa F, Hurvitz SA, Goldenberg DM, Hong Q, Olivo M, Itri LM, Carey L. Abstract PD13-07: Subgroup analysis of patients with brain metastases from the phase 3 ASCENT study of sacituzumab govitecan versus chemotherapy in metastatic triple-negative breast cancer. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-pd13-07] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Patients (pts) with metastatic triple-negative breast cancer (mTNBC) who have brain metastases represent a poor prognosis cohort with a high unmet clinical need. Sacituzumab govitecan (SG) is an antibody-drug conjugate composed of an anti-Trop-2 antibody coupled to SN-38, an active metabolite of irinotecan, via a unique hydrolyzable linker that allows for SN-38 release intracellularly and in the tumor microenvironment (bystander effect). SN-38 can cross the blood-brain barrier and is a drug partner in central nervous system (CNS) disease regimens (PMID: 18784279; PMID: 26080460). Although antibody-based therapy raises concerns regarding CNS penetration, activity with SG has been seen in intracranial xenograft models (Brenner Neurooncol Adv 2019). In a subgroup analysis from ASCENT, the efficacy and safety of SG were evaluated in pts with stable brain metastases.
Methods: In the phase 3 ASCENT study (NCT02574455), 529 pts with mTNBC refractory to or relapsing after at least 2 prior chemotherapies were randomized 1:1 to receive SG (10 mg/kg IV on days 1 and 8 every 21 days) or single-agent treatment of physician’s choice (TPC; capecitabine, eribulin, vinorelbine, or gemcitabine) until disease progression or unacceptable toxicity. Brain MRIs were required in pts with known brain metastases who were eligible if they had stable CNS disease for ≥4 wk by MRI. Per protocol, stable disease was defined as ≥2 wk from discontinuation of antiseizure medication and corticosteroid dose (≤20 mg prednisone equivalent) that was stable or decreasing for ≥2 wk before randomization. In these pts, brain MRIs were required throughout the study. The primary endpoint was progression-free survival (PFS) per independent central review (RECIST v1.1) in brain metastases-negative pts. Secondary endpoints included PFS per investigator assessment, PFS in the full population (in pts with/without brain metastases) by central review, objective response rate (ORR), overall survival (OS), and safety.
Results: Overall, 61 of 529 (12%) enrolled pts had stable brain metastases at screening and were randomized to SG (n=32) or TPC (n=29). Median age was 53 y for SG and 51 y for TPC; all pts were female and had a median of 5 prior anticancer regimens. In this subset, median PFS was 2.8 mo (95% CI, 1.5-3.9) for SG vs 1.6 mo (95% CI, 1.3-2.9) for TPC by central review, and median OS was 6.8 mo (95% CI, 4.7-14.1) for SG vs 7.5 mo (95% CI, 4.7-11.1) for TPC. ORR for SG vs TPC, respectively, was 3% (1/32) vs 0% by central review, with a clinical benefit rate of 9.4% vs. 3.4%. Stable disease was achieved in 15 (47%) pts with SG vs 9 (31%) pts with TPC. In 53 pts who received at least 1 dose of treatment (SG, n=30; TPC, n=23), any-grade treatment-emergent adverse events (>20% with SG) for SG vs TPC were fatigue (63% vs 52%), diarrhea (50% vs 13%), neutropenia (43% vs 35%), nausea (43% vs 26%), decreased appetite (30% vs 17%), decreased neutrophil count (33% vs 22%), anemia (23% vs 35%), alopecia (23% vs 13%), and constipation (23% vs 22%). There were no treatment-related deaths. Two pts treated with SG are continuing study treatment for 16.2 and 6.3 mo as of the data cutoff date.
Conclusions: Data interpretation in this population with poor prognosis is limited by the small sample size. In this exploratory analysis of pts with brain metastases from the phase 3 ASCENT study, SG was numerically better than TPC for tumor response and PFS but not OS. The safety profile was similar to that of the population without brain metastases for both study arms. SG is currently under clinical investigation for pts undergoing elective craniotomy for breast cancer with brain metastases or recurrent glioblastoma (NCT03995706) based on promising preclinical and intracranial clinical data.
Citation Format: Véronique Diéras, Robert Weaver, Sara M. Tolaney, Aditya Bardia, Kevin Punie, Adam Brufsky, Hope S. Rugo, Kevin Kalinsky, Tiffany Traina, Leonard Klein, Delphine Loirat, Filipa Lynce, Brooke Daniel, Foluso Ademuyiwa, Sara A. Hurvitz, David M. Goldenberg, Quan Hong, Martin Olivo, Loretta M. Itri, Lisa Carey. Subgroup analysis of patients with brain metastases from the phase 3 ASCENT study of sacituzumab govitecan versus chemotherapy in metastatic triple-negative breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PD13-07.
Collapse
Affiliation(s)
| | | | | | - Aditya Bardia
- 4Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Kevin Punie
- 5University Hospitals Leuven, Leuven, Belgium
| | - Adam Brufsky
- 6University of Pittsburgh Cancer Institute, Pittsburgh, PA
| | - Hope S. Rugo
- 7University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | | | | | | | | | - Filipa Lynce
- 12Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | | | - Foluso Ademuyiwa
- 14Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Sara A. Hurvitz
- 15University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA
| | | | | | | | | | - Lisa Carey
- 17University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| |
Collapse
|
8
|
Rugo HS, Tolaney SM, Loirat D, Punie K, Bardia A, Hurvitz SA, O'Shaughnessy J, Cortés J, Diéras V, Carey L, Gianni L, Piccart MJ, Loibl S, Goldenberg DM, Hong Q, Olivo M, Itri LM, Kalinsky K. Abstract PS11-09: Impact of UGT1A1 status on the safety profile of sacituzumab govitecan in the phase 3 ASCENT study in patients with metastatic triple-negative breast cancer. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps11-09] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Trophoblast cell-surface antigen-2 (Trop-2) is highly expressed in many epithelial tumors, including triple-negative breast cancer (TNBC). Sacituzumab govitecan (SG) is an antibody-drug conjugate composed of an anti-Trop-2 antibody coupled to SN-38, the active metabolite of irinotecan, via a unique hydrolyzable linker that allows SN-38 release intracellularly and in the tumor microenvironment (bystander effect). SG received accelerated approval in April 2020 for the treatment of patients with metastatic TNBC (mTNBC) who received at least 2 prior therapies for metastatic disease. The most common adverse events (AEs) observed with SG are neutropenia and gastrointestinal toxicity, also seen with irinotecan. To provide further information on SG, additional safety analyses from ASCENT, a randomized, phase 3 confirmatory study of SG versus standard-of-care chemotherapy in patients with mTNBC, will be reported. Methods: In the global, multicenter, open-label, phase 3 ASCENT study (NCT02574455), 529 patients with mTNBC refractory to or relapsing after at least 2 prior chemotherapies were randomized 1:1 to receive SG (10 mg/kg intravenously on days 1 and 8 every 21 days) or single-agent treatment of physician’s choice (capecitabine, eribulin, vinorelbine, or gemcitabine) until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival measured by central independent review per RECIST v1.1. Secondary endpoints included objective response rate, duration of response, overall survival, and safety. An exploratory analysis of incidence of grade 3-5 AEs by UGT1A1 genotype was also performed. Post-hoc analysis of the time to onset and duration of key AEs will be performed, and descriptive analyses on alopecia, nausea and vomiting will also be provided. Results: Exploratory safety analyses by UGT1A1 allele status will be shown as well as time to onset and duration of neutropenia and diarrhea. Further descriptive analyses on alopecia, nausea, and vomiting will be provided along with AE management strategies. Conclusions: These analyses will provide further insights into the safety profile of SG and appropriate AE management strategies for patients with previously treated mTNBC to allow optimal therapeutic exposure.
Citation Format: Hope S. Rugo, Sara M. Tolaney, Delphine Loirat, Kevin Punie, Aditya Bardia, Sara A. Hurvitz, Joyce O'Shaughnessy, Javier Cortés, Véronique Diéras, Lisa Carey, Luca Gianni, Martine J. Piccart, Sibylle Loibl, David M. Goldenberg, Quan Hong, Martin Olivo, Loretta M. Itri, Kevin Kalinsky. Impact of UGT1A1 status on the safety profile of sacituzumab govitecan in the phase 3 ASCENT study in patients with metastatic triple-negative breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS11-09.
Collapse
Affiliation(s)
- Hope S. Rugo
- 1University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | | | | | - Kevin Punie
- 4University Hospitals Leuven, Leuven, Belgium
| | - Aditya Bardia
- 5Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Sara A. Hurvitz
- 6University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA
| | | | - Javier Cortés
- 8IOB Institute of Oncology, Quiron Group, Madrid & Barcelona, Madrid, Spain
| | | | - Lisa Carey
- 10University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | | | | - Sibylle Loibl
- 13Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt, Germany
| | | | | | | | | | | |
Collapse
|
9
|
Hurvitz SA, Tolaney SM, Punie K, Loirat D, Oliveira M, Kalinsky K, Zelnak A, Aftimos P, Dalenc F, Sardesai S, Hamiltion E, Sharma P, Recalde S, Gil EC, Traina T, O'Shaughnessy J, Cortés J, Tsai M, Vahdat L, Diéras V, Carey L, Rugo HS, Goldenberg DM, Hong Q, Olivo M, Itri LM, Bardia A. Abstract GS3-06: Biomarker evaluation in the phase 3 ASCENT study of sacituzumab govitecan versus chemotherapy in patients with metastatic triple-negative breast cancer. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-gs3-06] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Trophoblast cell-surface antigen-2 (Trop-2) is highly expressed in many epithelial tumors, including triple-negative breast cancer (TNBC). Sacituzumab govitecan (SG) is an antibody-drug conjugate composed of an anti-Trop-2 antibody coupled to SN-38, an active metabolite of irinotecan, via a unique hydrolyzable linker that allows for SN-38 release intracellularly and in the tumor microenvironment (bystander effect). Preclinical studies have shown a great range of efficacy with SG in mice bearing tumors with low, moderate, and high Trop-2 expression levels. We report subgroup analyses by Trop-2 expression from ASCENT, a randomized, phase 3 confirmatory study of SG versus standard-of-care chemotherapy in patients with metastatic TNBC (mTNBC). Methods: In the global, multicenter, open-label, phase 3 ASCENT study (NCT02574455), 529 patients with mTNBC refractory to or relapsing after at least 2 prior chemotherapies were randomized 1:1 to receive SG (10 mg/kg intravenously on days 1 and 8 every 21 days) or single-agent treatment of physician’s choice (capecitabine, eribulin, vinorelbine, or gemcitabine) until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS) measured by central independent review per RECIST v1.1. Secondary endpoints included objective response rate (ORR) per RECIST v1.1, duration of response, overall survival (OS), and safety. Exploratory endpoints included biomarker assessments, including Trop-2 and BRCA1/2. Trop-2 expression was assessed using a validated immunohistochemistry assay. Results: Subgroup analyses by biomarker expression including Trop-2 and BRCA1/2 were performed, and outcomes by PFS, OS, ORR, and safety results will be reported. Conclusions: These analyses will provide further insights into the relationship of Trop-2 expression and the activity of SG in previously treated patients with mTNBC.
Citation Format: Sara A. Hurvitz, Sara M. Tolaney, Kevin Punie, Delphine Loirat, Mafalda Oliveira, Kevin Kalinsky, Amelia Zelnak, Philippe Aftimos, Florence Dalenc, Sagar Sardesai, Erika Hamiltion, Priyanka Sharma, Sabela Recalde, Eva Ciruelos Gil, Tiffany Traina, Joyce O'Shaughnessy, Javier Cortés, Michaela Tsai, Linda Vahdat, Véronique Diéras, Lisa Carey, Hope S. Rugo, David M. Goldenberg, Quan Hong, Martin Olivo, Loretta M. Itri, Aditya Bardia. Biomarker evaluation in the phase 3 ASCENT study of sacituzumab govitecan versus chemotherapy in patients with metastatic triple-negative breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr GS3-06.
Collapse
Affiliation(s)
- Sara A. Hurvitz
- 1University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA
| | | | - Kevin Punie
- 3University Hospitals Leuven, Leuven, Belgium
| | | | | | | | | | | | | | - Sagar Sardesai
- 10The Ohio State University Wexner Medical Center, Columbus, OH
| | - Erika Hamiltion
- 11Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN
| | - Priyanka Sharma
- 12University of Kansas Cancer Center - The Richard and Annette Bloch Cancer Care Pavilion, Kansas City, KS
| | - Sabela Recalde
- 13Institut Catala d'Oncologia Hospitalet, Barcelona, Spain
| | | | | | | | - Javier Cortés
- 17IOB Institute of Oncology, Quiron Group, Madrid & Barcelona, Madrid, Spain
| | | | - Linda Vahdat
- 15Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Lisa Carey
- 20University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Hope S. Rugo
- 21University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | | | | | | | | | - Aditya Bardia
- 23Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| |
Collapse
|
10
|
Pichon B, Rousseau C, Blanc-Lapierre A, Delpon G, Ferrer L, Libois V, Le Turnier M, Lenoble C, Bodet-Milin C, Goldenberg DM, Kraeber-Bodere F, Supiot S. Targeting Stereotactic Body Radiotherapy on Metabolic PET- and Immuno-PET-Positive Vertebral Metastases. Biomedicines 2020; 8:biomedicines8120548. [PMID: 33260610 PMCID: PMC7760481 DOI: 10.3390/biomedicines8120548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 10/21/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 12/19/2022] Open
Abstract
(1) Background: Stereotactic body radiotherapy (SBRT) for vertebral metastases (VM) allows the delivery of high radiation doses to tumors while sparing the spinal cord. We report a new approach to clinical target volume (CTV) delineation based on anti-carcinoembryonic antigen (CEA) positron emission tomography (pretargeted immuno-PET; “iPET”) in patients with metastatic breast cancer (BC) or medullary thyroid cancer (MTC). (2) Methods: All patients underwent iPET, spine magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT) using 18F-deoxyglucose (FDG) for BC or 18F-dihydroxy-phenylalanine (F-DOPA) for MTC. Vertebrae locations and vertebral segments of lesions were recorded and the impact on CTV delineation was evaluated. (3) Results: Forty-six VM eligible for SBRT following iPET were evaluated in eight patients (five BC, three MTC). Eighty-one vertebral segments were detected using MRI, 26 with FDG or F-DOPA PET/CT, and 70 using iPET. iPET was able to detect more lesions than MRI for vertebral bodies (44 vs. 34). iPET-based delineation modified MRI-based CTV in 70% (32/46) of cases. (4) Conclusion: iPET allows a precise mapping of affected VM segments, and adds complementary information to MRI in the definition of candidate volumes for VM SBRT. iPET may facilitate determining target volumes for treatment with stereotactic body radiotherapy in metastatic vertebral disease.
Collapse
Affiliation(s)
- Baptiste Pichon
- Department of Radiotherapy and Nuclear Medicine Institut de Cancérologie de l’Ouest (ICO), F-44800 Saint-Herblain, France; (B.P.); (C.R.); (A.B.-L.); (G.D.); (L.F.); (V.L.); (F.K.-B.)
- Department of Radiation Oncology, Clinique Pasteur, 31300 Toulouse, France
| | - Caroline Rousseau
- Department of Radiotherapy and Nuclear Medicine Institut de Cancérologie de l’Ouest (ICO), F-44800 Saint-Herblain, France; (B.P.); (C.R.); (A.B.-L.); (G.D.); (L.F.); (V.L.); (F.K.-B.)
- Centre de Recherche en Cancéro-Immunologie Nantes Angers (CRCINA), Inserm U1232, CNRS ERL 6001, Université de Nantes, F-44000 Nantes, France;
| | - Audrey Blanc-Lapierre
- Department of Radiotherapy and Nuclear Medicine Institut de Cancérologie de l’Ouest (ICO), F-44800 Saint-Herblain, France; (B.P.); (C.R.); (A.B.-L.); (G.D.); (L.F.); (V.L.); (F.K.-B.)
| | - Gregory Delpon
- Department of Radiotherapy and Nuclear Medicine Institut de Cancérologie de l’Ouest (ICO), F-44800 Saint-Herblain, France; (B.P.); (C.R.); (A.B.-L.); (G.D.); (L.F.); (V.L.); (F.K.-B.)
- Centre de Recherche en Cancéro-Immunologie Nantes Angers (CRCINA), Inserm U1232, CNRS ERL 6001, Université de Nantes, F-44000 Nantes, France;
| | - Ludovic Ferrer
- Department of Radiotherapy and Nuclear Medicine Institut de Cancérologie de l’Ouest (ICO), F-44800 Saint-Herblain, France; (B.P.); (C.R.); (A.B.-L.); (G.D.); (L.F.); (V.L.); (F.K.-B.)
- Centre de Recherche en Cancéro-Immunologie Nantes Angers (CRCINA), Inserm U1232, CNRS ERL 6001, Université de Nantes, F-44000 Nantes, France;
| | - Vincent Libois
- Department of Radiotherapy and Nuclear Medicine Institut de Cancérologie de l’Ouest (ICO), F-44800 Saint-Herblain, France; (B.P.); (C.R.); (A.B.-L.); (G.D.); (L.F.); (V.L.); (F.K.-B.)
| | - Matthieu Le Turnier
- Department of nuclear medicine and radiology, Centre Hospitalier Universitaire, F-44000 Nantes, France; (M.L.T.); (C.L.)
| | - Cédric Lenoble
- Department of nuclear medicine and radiology, Centre Hospitalier Universitaire, F-44000 Nantes, France; (M.L.T.); (C.L.)
| | - Caroline Bodet-Milin
- Centre de Recherche en Cancéro-Immunologie Nantes Angers (CRCINA), Inserm U1232, CNRS ERL 6001, Université de Nantes, F-44000 Nantes, France;
- Department of nuclear medicine and radiology, Centre Hospitalier Universitaire, F-44000 Nantes, France; (M.L.T.); (C.L.)
| | | | - Françoise Kraeber-Bodere
- Department of Radiotherapy and Nuclear Medicine Institut de Cancérologie de l’Ouest (ICO), F-44800 Saint-Herblain, France; (B.P.); (C.R.); (A.B.-L.); (G.D.); (L.F.); (V.L.); (F.K.-B.)
- Centre de Recherche en Cancéro-Immunologie Nantes Angers (CRCINA), Inserm U1232, CNRS ERL 6001, Université de Nantes, F-44000 Nantes, France;
- Department of nuclear medicine and radiology, Centre Hospitalier Universitaire, F-44000 Nantes, France; (M.L.T.); (C.L.)
| | - Stéphane Supiot
- Department of Radiotherapy and Nuclear Medicine Institut de Cancérologie de l’Ouest (ICO), F-44800 Saint-Herblain, France; (B.P.); (C.R.); (A.B.-L.); (G.D.); (L.F.); (V.L.); (F.K.-B.)
- Centre de Recherche en Cancéro-Immunologie Nantes Angers (CRCINA), Inserm U1232, CNRS ERL 6001, Université de Nantes, F-44000 Nantes, France;
- Correspondence: ; Tel.: +33-240679913; Fax: +33-240679722
| |
Collapse
|
11
|
Cardillo TM, Rossi DL, Zalath MB, Liu D, Arrojo R, Sharkey RM, Chang CH, Goldenberg DM. Predictive biomarkers for sacituzumab govitecan efficacy in Trop-2-expressing triple-negative breast cancer. Oncotarget 2020; 11:3849-3862. [PMID: 33196706 PMCID: PMC7597411 DOI: 10.18632/oncotarget.27766] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/23/2020] [Indexed: 12/21/2022] Open
Abstract
Sacituzumab govitecan (SG) is an antibody-drug conjugate composed of a humanized anti-Trop-2 IgG antibody conjugated via a hydrolysable linker to SN-38, the topoisomerase I-inhibitory active component of irinotecan. We investigated whether Trop-2-expression and homologous recombination repair (HRR) of SN-38-mediated double-strand DNA (dsDNA) breaks play a role in the sensitivity of triple-negative breast cancer (TNBC) to SG. Activation of HRR pathways, as evidenced by Rad51 expression, was assessed in SG-sensitive cell lines with low and moderate Trop-2-expression (SK-MES-1 squamous cell lung carcinoma and HCC1806 TNBC, respectively), compared to a low Trop-2-expressing, less SG-sensitive TNBC cell line (MDA-MB-231). Further, two Trop-2-transfectants of MDA-MB-231, C13 and C39 (4- and 25-fold higher Trop-2, respectively), were treated in mice with SG to determine whether increasing Trop-2 expression improves SG efficacy. SG mediated >2-fold increase in Rad51 in MDA-MB-231 but had no effect in SK-MES-1 or HCC1806, resulting in lower levels of dsDNA breaks in MDA-MB-231. SG and saline produced similar effects in parental MDA-MB-231 tumor-bearing mice (median survival time (MST) = 21d and 19.5d, respectively). However, in mice bearing higher Trop-2-expressing C13 and C39 tumors after Trop-2 transfection, SG provided a significant survival benefit, even compared to irinotecan (MST = 97d vs. 35d for C13, and 81d vs. 28d for C39, respectively; P < 0.0007). These results suggest that SG could provide better clinical benefit than irinotecan in patients with HRR-proficient tumors expressing high levels of Trop-2, as well as to patients with HRR-deficient tumors expressing low/moderate levels of Trop-2.
Collapse
Affiliation(s)
| | | | | | - Donglin Liu
- Immunomedics, Inc., Morris Plains, NJ 07950, USA.,Currently employed with FrontAim Biomedicines Inc., Princeton, NJ 08540, USA
| | | | - Robert M Sharkey
- Immunomedics, Inc., Morris Plains, NJ 07950, USA.,At the time the work was conducted, these authors were employees of Immunomedics, Inc., Morris Plains, NJ 07950, USA
| | - Chien-Hsing Chang
- Immunomedics, Inc., Morris Plains, NJ 07950, USA.,At the time the work was conducted, these authors were employees of Immunomedics, Inc., Morris Plains, NJ 07950, USA
| | - David M Goldenberg
- Immunomedics, Inc., Morris Plains, NJ 07950, USA.,Current address: Center for Molecular Medicine and Immunology, Mendham, NJ 07945, USA.,At the time the work was conducted, this author was Chairman and Chief Scientific Officer of Immunomedics, Inc., Morris Plains, NJ 07950, USA
| |
Collapse
|
12
|
Kalinsky K, Diamond JR, Vahdat LT, Tolaney SM, Juric D, O'Shaughnessy J, Moroose RL, Mayer IA, Abramson VG, Goldenberg DM, Sharkey RM, Maliakal P, Hong Q, Goswami T, Wegener WA, Bardia A. Sacituzumab govitecan in previously treated hormone receptor-positive/HER2-negative metastatic breast cancer: final results from a phase I/II, single-arm, basket trial. Ann Oncol 2020; 31:1709-1718. [PMID: 32946924 DOI: 10.1016/j.annonc.2020.09.004] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [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: 07/15/2020] [Revised: 09/01/2020] [Accepted: 09/06/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Trophoblast cell-surface antigen-2 (Trop-2) is expressed in epithelial cancers, including hormone receptor-positive (HR+) metastatic breast cancer (mBC). Sacituzumab govitecan (SG; Trodelvy®) is an antibody-drug conjugate composed of a humanized anti-Trop-2 monoclonal antibody coupled to SN-38 at a high drug-to-antibody ratio via a unique hydrolyzable linker that delivers SN-38 intracellularly and in the tumor microenvironment. SG was granted accelerated FDA approval for metastatic triple-negative BC treatment in April 2020. PATIENTS AND METHODS We analyzed a prespecified subpopulation of patients with HR+/human epidermal growth factor receptor 2-negative (HER2-) HR+/HER2- mBC from the phase I/II, single-arm trial (NCT01631552), who received intravenous SG (10 mg/kg) and whose disease progressed on endocrine-based therapy and at least one prior chemotherapy for mBC. End points included objective response rate (ORR; RECIST version 1.1) assessed locally, duration of response (DOR), clinical benefit rate, progression-free survival (PFS), overall survival (OS), and safety. RESULTS Fifty-four women were enrolled between 13 February 2015 and 1 June 2017. Median (range) age was 54 (33-79) years and all received at least two prior lines of therapy for mBC. At data cut-off (1 March 2019), 12 patients were still alive. Key grade ≥3 treatment-related toxicities included neutropenia (50.0%), anemia (11.1%), and diarrhea (7.4%). Two patients discontinued treatment due to treatment-related adverse events. No treatment-related deaths occurred. At a median follow-up of 11.5 months, the ORR was 31.5% [95% confidence interval (CI), 19.5%-45.6%; 17 partial responses]; median DOR was 8.7 months (95% CI 3.7-12.7), median PFS was 5.5 months (95% CI 3.6-7.6), and median OS was 12 months (95% CI 9.0-18.2). CONCLUSIONS SG shows encouraging activity in patients with pretreated HR+/HER2- mBC and a predictable, manageable safety profile. Further evaluation in a randomized phase III trial (TROPiCS-02) is ongoing (NCT03901339). TRIAL REGISTRATION ClinicalTrials.gov NCT01631552; https://clinicaltrials.gov/ct2/show/NCT01631552.
Collapse
Affiliation(s)
- K Kalinsky
- Department of Medicine, Division of Hematology/Oncology, Columbia University Irving Medical Center-Herbert Irving Comprehensive Cancer Center, New York, USA.
| | - J R Diamond
- Department of Medicine, Medical Oncology, University of Colorado Cancer Center, Aurora, USA
| | - L T Vahdat
- Department of Medicine, Weill Cornell Medical College, New York, USA
| | - S M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - D Juric
- Department of Hematology/Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, USA
| | - J O'Shaughnessy
- Department of Medical Oncology, Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, USA
| | - R L Moroose
- Department of Hematology/Oncology, Orlando Health UF Health Cancer Center, Orlando, USA
| | - I A Mayer
- Department of Hematology/Oncology, Vanderbilt-Ingram Cancer Center, Nashville, USA
| | - V G Abramson
- Department of Hematology/Oncology, Vanderbilt-Ingram Cancer Center, Nashville, USA
| | - D M Goldenberg
- Clinical Development, Immunomedics, Inc., Morris Plains, USA
| | - R M Sharkey
- Clinical Development, Immunomedics, Inc., Morris Plains, USA
| | - P Maliakal
- Clinical Development, Immunomedics, Inc., Morris Plains, USA
| | - Q Hong
- Clinical Development, Immunomedics, Inc., Morris Plains, USA
| | - T Goswami
- Clinical Development, Immunomedics, Inc., Morris Plains, USA
| | - W A Wegener
- Clinical Development, Immunomedics, Inc., Morris Plains, USA
| | - A Bardia
- Department of Hematology/Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, USA
| |
Collapse
|
13
|
Santin A, Komiya T, Goldenberg DM, Sharkey RM, Hong Q, Wegener WA, Goswami T, Bardia A. Sacituzumab govitecan (SG) in patients (pts) with previously treated metastatic endometrial cancer (mEC): results from a phase I/II study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.6081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6081 Background: Unselected pts with EC who progressed on prior chemotherapy have a poor prognosis with limited treatment options. SG is a novel antibody-drug conjugate that targets Trop-2, a cell surface glycoprotein highly expressed in many epithelial tumors. It is conjugated to deliver SN-38, the active metabolite of irinotecan, via a proprietary hydrolyzable linker. Preclinical studies show SG has activity against chemotherapy-resistant EC and significant bystander effect against EC with heterogenous Trop-2 expression (Perrone E. Mol Oncol. 2019). Methods: The phase I/II basket study (NCT01631552) evaluated pts unselected for Trop-2 with advanced solid tumors who received intravenous SG (days 1 and 8 of 21-day cycles), until progression or unacceptable toxicity. CT/MRI scans were obtained at 8-week intervals for response assessment by RECIST 1.1. We report results for mEC pts who progressed after ≥1 prior systemic therapy and were treated with SG 10 mg/kg. Endpoints include safety, objective response rate (ORR), clinical benefit rate (CBR), duration of response (DOR), progression-free survival (PFS), and overall survival (OS). Results: 18 mEC pts (all women; 17 white and 1 black; median age 69 years [range, 41–76]) had a median 3.5 (range 2–6) prior lines of therapy. All pts received prior treatment with platinum therapies. At a median follow-up of 12.7 months, the ORR (95% CI) was 22.2% (6.4–47.6), with 4 partial responses. CBR (95% CI) was 44.4% (21.5–69.2), with 8 of 18 pts having either an objective response or stable disease ≥6 months. The DOR of responders ranged from 9.1 to 26.6 months, with 2 of 4 responders having a duration of ≥18 months. Median PFS (95% CI) was 3.2 months (1.9–9.4), and median OS (95% CI) was 11.9 months (4.7–not calculable). Key grade ≥3 TRAEs in the overall basket study safety population (n=495) included neutropenia (28%), neutrophil count decrease (14%), anemia (10%), diarrhea (8%), fatigue (6%), and febrile neutropenia (5%). A similar safety profile was seen in the mEC cohort. Conclusions: Median OS in unselected pts with mEC who progressed on prior platinum therapy is ~10 months with an ORR of ~10%. SG monotherapy showed clinical activity in pts with relapsed/refractory mEC, consistent with previous preclinical findings, and support further clinical investigation (NCT04251416). The phase II TROPiCS-03 (NCT03964727) study in pts with metastatic solid tumors selected based on elevated Trop-2 expression by a validated IHC assay will also provide further insights. Clinical trial information: NCT01631552.
Collapse
Affiliation(s)
| | | | | | | | - Quan Hong
- Immunomedics, Inc., Morris Plains, NJ
| | | | | | - Aditya Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| |
Collapse
|
14
|
Abstract
INTRODUCTION We describe a new, third-generation of antibody-drug conjugates (ADCs) having a high drug payload against topoisomerase I, important for DNA function, and targeting selective tumor antigens, predominantly TROP-2. AREAS COVERED The historical development of ADCs is reviewed before presenting the current line of improved, third-generation ADCs targeting topoisomerase I, thus affecting DNA and causing double-stranded DNA breaks. Emphasis is given to explaining why sacituzumab govitecan represents a paradigm change in ADCs by achieving a high therapeutic index due to its novel target, TROP-2, an internalizing antigen/antibody, proprietary linker chemistry, and high drug payload, resulting in a high tumor concentration of the drug given in repeated doses with acceptable tolerability, particularly evidencing a lower percentage of 'late' diarrhea than its prodrug, irinotecan. PubMed was used for the primary search conducted. EXPERT OPINION The properties and clinical results of third-generation ADCs, based on sacituzumab govitecan, are discussed, including prospects for future applications, particularly combination therapies with PARP inhibitors and immune checkpoint inhibitors. Since one topoisomerase I ADC has just received regulatory approval for HER2+ breast cancer, and sacituzumab govitecan is under FDA review for accelerated approval in the therapy of triple-negative breast cancer, the prospects for these novel ADCs are discussed.
Collapse
Affiliation(s)
| | - Robert M Sharkey
- Center for Molecular Medicine and Immunology , Mendham, New Jersey, USA
| |
Collapse
|
15
|
Rousseau C, Goldenberg DM, Colombié M, Sébille JC, Meingan P, Ferrer L, Baumgartner P, Cerato E, Masson D, Campone M, Rauscher A, Fleury V, Labbe C, Chauvet AF, Fresnel JS, Toquet C, Barbet J, Sharkey RM, Campion L, Kraeber-Bodéré F. Initial Clinical Results of a Novel Immuno-PET Theranostic Probe in Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer. J Nucl Med 2020; 61:1205-1211. [PMID: 32169921 DOI: 10.2967/jnumed.119.236000] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 12/04/2019] [Indexed: 12/21/2022] Open
Abstract
This prospective study evaluated the imaging performance of a novel pretargeting immunologic PET (immuno-PET) method in patients with human epidermal growth factor receptor 2 (HER2)-negative, carcinoembryonic antigen (CEA)-positive metastatic breast cancer, compared with CT, bone MRI, and 18F-FDG PET. Methods: Twenty-three patients underwent whole-body immuno-PET after injection of 150 MBq of 68Ga-IMP288, a histamine-succinyl-glycine peptide given after initial targeting of a trivalent anti-CEA, bispecific, antipeptide antibody. The gold standards were histology and imaging follow-up. Tumor SUVs (SUVmax and SUVmean) were measured, and tumor burden was analyzed using total tumor volume and total lesion activity. Results: The total lesion sensitivity of immuno-PET and 18F-FDG PET were 94.7% (1,116/1,178) and 89.6% (1,056/1,178), respectively. Immuno-PET had a somewhat higher sensitivity than CT or 18F-FDG PET in lymph nodes (92.4% vs. 69.7% and 89.4%, respectively) and liver metastases (97.3% vs. 92.1% and 94.8%, respectively), whereas sensitivity was lower for lung metastases (48.3% vs. 100% and 75.9%, respectively). Immuno-PET showed higher sensitivity than MRI or 18F-FDG PET for bone lesions (95.8% vs. 90.7% and 89.3%, respectively). In contrast to 18F-FDG PET, immuno-PET disclosed brain metastases. Despite equivalent tumor SUVmax, SUVmean, and total tumor volume, total lesion activity was significantly higher with immuno-PET than with 18F-FDG PET (P = 0.009). Conclusion: Immuno-PET using anti-CEA/anti-IMP288 bispecific antibody, followed by 68Ga-IMP288, is a potentially sensitive theranostic imaging method for HER2-negative, CEA-positive metastatic breast cancer patients and warrants further research.
Collapse
Affiliation(s)
- Caroline Rousseau
- Nuclear Medicine, ICO Cancer Center, Nantes, France .,CRCINA, University of Nantes, INSERM UMR1232, CNRS-ERL6001, Nantes, France
| | - David M Goldenberg
- Immunomedics, Inc., Morris Plains, New Jersey.,IBC Pharmaceuticals, Inc., Morris Plains, New Jersey
| | | | | | | | - Ludovic Ferrer
- CRCINA, University of Nantes, INSERM UMR1232, CNRS-ERL6001, Nantes, France.,Physics, ICO Cancer Center, Nantes, France
| | | | | | - Damien Masson
- Biology Department, University Hospital, Nantes, France
| | | | | | | | | | | | | | - Claire Toquet
- Pathology Department, University Hospital, Nantes, France
| | | | | | - Loic Campion
- CRCINA, University of Nantes, INSERM UMR1232, CNRS-ERL6001, Nantes, France.,Biometrics, ICO Cancer Center, Nantes, France
| | - Françoise Kraeber-Bodéré
- Nuclear Medicine, ICO Cancer Center, Nantes, France.,CRCINA, University of Nantes, INSERM UMR1232, CNRS-ERL6001, Nantes, France.,Nuclear Medicine, University Hospital, Nantes, France
| |
Collapse
|
16
|
Goldenberg DM, Cardillo TM, Govindan SV, Rossi EA, Sharkey RM. Correction: Trop-2 is a novel target for solid cancer therapy with sacituzumab govitecan (IMMU-132), an antibody-drug conjugate (ADC). Oncotarget 2020; 11:942. [PMID: 32206190 PMCID: PMC7075468 DOI: 10.18632/oncotarget.27512] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
[This corrects the article DOI: 10.18632/oncotarget.4318.].
Collapse
|
17
|
Elekonawo FMK, Bos DL, Goldenberg DM, Boerman OC, Rijpkema M. Carcinoembryonic antigen-targeted photodynamic therapy in colorectal cancer models. EJNMMI Res 2019; 9:108. [PMID: 31828541 PMCID: PMC6906275 DOI: 10.1186/s13550-019-0580-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 09/05/2019] [Accepted: 11/28/2019] [Indexed: 01/15/2023] Open
Abstract
Background In colorectal cancer, survival of patients is drastically reduced when complete resection is hampered by involvement of critical structures. Targeted photodynamic therapy (tPDT) is a local and targeted therapy which could play a role in eradicating residual tumor cells after incomplete resection. Since carcinoembryonic antigen (CEA; CEACAM5) is abundantly overexpressed in colorectal cancer, it is a potential target for tPDT of colorectal cancer. Methods To address the potential of CEA-targeted PDT, we compared colorectal cancer cell lines with different CEA-expression levels (SW-48, SW-480, SW-620, SW-1222, WiDr, HT-29, DLD-1, LS174T, and LoVo) under identical experimental conditions. We evaluated the susceptibility to tPDT by varying radiant exposure and concentration of our antibody conjugate (DTPA-hMN-14-IRDye700DX). Finally, we assessed the efficacy of tPDT in vivo in 18 mice (BALB/cAnNRj-Foxn1nu/nu) with subcutaneously xenografted LoVo tumors. Results In vitro, the treatment effect of tPDT varied per cell line and was dependent on both radiant exposure and antibody concentration. Under standardized conditions (94.5 J/cm2 and 0.5 μg/μL antibody conjugate concentration), the effect of tPDT was higher in cells with higher CEA availability: SW-1222, LS174T, LoVo, and SW-48 (22.8%, 52.8%, 49.9%, and 51.9% reduction of viable cells, respectively) compared to cells with lower CEA availability. Compared to control groups (light or antibody conjugate only), tumor growth rate was reduced in mice with s.c. LoVo tumors receiving tPDT. Conclusion Our findings suggest cells (and tumors) have different levels of susceptibility for tPDT even though they all express CEA. Furthermore, tPDT can effectively reduce tumor growth in vivo.
Collapse
Affiliation(s)
- Fortuné M K Elekonawo
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Desirée L Bos
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - David M Goldenberg
- Center for Molecular Medicine and Immunology, Mendham, NJ, USA.,Immunomedics, Inc. and IBC Pharmaceuticals, Inc., Morris Plains, NJ, USA
| | - Otto C Boerman
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Mark Rijpkema
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| |
Collapse
|
18
|
Elekonawo FMK, Lütje S, Franssen GM, Bos DL, Goldenberg DM, Boerman OC, Rijpkema M. A pretargeted multimodal approach for image-guided resection in a xenograft model of colorectal cancer. EJNMMI Res 2019; 9:86. [PMID: 31485790 PMCID: PMC6726731 DOI: 10.1186/s13550-019-0551-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 06/06/2019] [Accepted: 08/09/2019] [Indexed: 12/18/2022] Open
Abstract
Background Image-guided surgery may improve surgical outcome for colorectal cancer patients. Here, we evaluated the feasibility of a pretargeting strategy for multimodal imaging in colorectal cancer using an anti-carcinoembryonic antigen (CEA) x anti-histamine-succinyl-glycine (HSG) bispecific antibody (TF2) in conjunction with the dual-labeled diHSG peptide (RDC018), using both a fluorophore for near-infrared fluorescence imaging and a chelator for radiolabeling. Methods Nude mice with subcutaneous (s.c) CEA-expressing LS174T human colonic tumors and CEA-negative control tumors were injected with TF2. After 16 h, different doses of 111In-labeled IMP-288 (non-fluorescent) or its fluorescent derivative RDC018 were administered to compare biodistributions. MicroSPECT/CT and near-infrared fluorescence imaging were performed 2 and 24 h after injection. Next, the biodistribution of the dual-labeled humanized anti-CEA IgG antibody [111In]In-DTPA-hMN-14-IRDye800CW (direct targeting) was compared with the biodistribution of 111In-RDC018 in mice with TF2-pretargeted tumors, using fluorescence imaging and gamma counting. Lastly, mice with intraperitoneal LS174T tumors underwent near-infrared fluorescence image-guided resection combined with pre- and post-resection microSPECT/CT imaging. Results 111In-RDC018 showed specific tumor targeting in pretargeted CEA-positive tumors (21.9 ± 4.5 and 10.0 ± 4.7% injected activity per gram (mean ± SD %IA/g), at 2 and 24 hours post-injection (p.i.), respectively) and a biodistribution similar to 111In-IMP288. Both fluorescence and microSPECT/CT images confirmed preferential tumor accumulation. At post mortem dissection, intraperitoneal tumors were successfully identified and removed using pretargeting with TF2 and 111In-RDC018. Conclusion A pretargeted approach for multimodal image-guided resection of colorectal cancer in a preclinical xenograft model is feasible, enables preoperative SPECT/CT, and might facilitate intraoperative fluorescence imaging. Electronic supplementary material The online version of this article (10.1186/s13550-019-0551-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Fortuné M K Elekonawo
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Susanne Lütje
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Gerben M Franssen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Desirée L Bos
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - David M Goldenberg
- Garden State Cancer Center, Center for Molecular Medicine and Immunology, Morris Plains, NJ, USA
| | - Otto C Boerman
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Mark Rijpkema
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| |
Collapse
|
19
|
Abstract
Antibody-drug conjugates (ADCs) that exploit the active metabolite SN-38, which is derived from the popular anticancer drug, irinotecan (a camptothecin that inhibits the nuclear topoisomerase I enzyme, inducing double-stranded DNA breaks during the mitotic S-phase of affected cells), represent a substantial advance in the ADC field. SN-38 has been conjugated to a humanized antibody against trophoblast cell surface antigen 2 (TROP-2), which is involved in cancer signaling pathways and has increased expression by many cancer cell types, yielding the ADC sacituzumab govitecan. By conjugating a higher number of SN-38 molecules to the immunoglobulin (drug-to-antibody ratio = 7-8:1), and giving higher (10 mg/kg) and repeated therapy cycles (Days 1 and 8 of 21-day cycles), enhanced drug uptake by the targeted cancer cells is achieved. Based on a unique conjugation method, the lactone ring of the SN-38 molecule is stabilized and the molecule is protected from glucuronidation, a process that contributes to the untoward late diarrhea experienced with irinotecan. Finally, while the ADC is internalized, the use of a moderately stable linker permits release of SN-38 in an acidic environment of the tumor cell and its microenvironment, contributing to a bystander effect on neighboring cancer cells. Here, we discuss the development of sacituzumab govitecan and clinical results obtained using it for the management of patients with advanced, refractive breast, lung, and urinary bladder cancers. Sacituzumab govitecan, which is undergoing accelerated approval review by the US Food and Drug Administration while also being studied in Phase 3 clinical studies, was granted Breakthrough Therapy status from the FDA for advanced, refractory, metastatic triple-negative breast cancer patients.
Collapse
Affiliation(s)
- David M Goldenberg
- a Clinical Research, Center for Molecular Medicine and Immunology , Mendham , NJ , USA
| | - Robert M Sharkey
- a Clinical Research, Center for Molecular Medicine and Immunology , Mendham , NJ , USA
| |
Collapse
|
20
|
Bodet-Milin C, Bailly C, Touchefeu Y, Frampas E, Bourgeois M, Rauscher A, Lacoeuille F, Drui D, Arlicot N, Goldenberg DM, Faivre-Chauvet A, Barbet J, Rousseau C, Kraeber-Bodéré F. Clinical Results in Medullary Thyroid Carcinoma Suggest High Potential of Pretargeted Immuno-PET for Tumor Imaging and Theranostic Approaches. Front Med (Lausanne) 2019; 6:124. [PMID: 31214593 PMCID: PMC6558173 DOI: 10.3389/fmed.2019.00124] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/17/2019] [Indexed: 12/03/2022] Open
Abstract
Monoclonal antibody (mAb)-based therapies have experienced considerable growth in cancer management. When labeled with radionuclides, mAbs also represent promising probes for imaging or theranostic approaches. Initially, mAbs have been radiolabeled with single-photon emitters, such as 131I, 99mTc, or 111In, for diagnostic purposes or to improve radioimmunotherapy (RIT) using dosimetry estimations. Today, more accurate imaging is achieved using positron- emission tomography (PET). Thanks to the important technical advances in the production of PET emitters and their related radiolabeling methods, the last decade has witnessed the development of a broad range of new probes for specific PET imaging. Immuno-PET, which combines the high sensitivity and resolution of a PET camera with the specificity of a monoclonal antibody, is fully in line with this approach. As RIT, immuno-PET can be performed using directly radiolabeled mAbs or using pretargeting to improve imaging contrast. Pretargeted immuno-PET has been developed against different antigens, and promising results have been reported in tumor expressing carcinoembryonic antigen (CEA; CEACAM5) using a bispecific mAb (BsmAb) and a radiolabeled peptide. Medullary thyroid carcinoma (MTC) is an uncommon thyroid cancer subtype which accounts for <10% of all thyroid neoplasms. Characterized by an intense expression of CEA, MTC represents a relevant tumor model for immuno-PET. High sensitivity of pretargeted immunoscintigraphy using murine or chimeric anti-CEA BsMAb and pretargeted haptens-peptides labeled with 111In or 131I were reported in metastatic MTC patients 20 years ago. Recently, an innovative clinical study reported high tumor uptake and contrast using pretargeted anti-CEA immuno-PET in relapsed MTC patients. This review focuses on MTC as an example, but the same pretargeting technique has been applied with success for clinical PET imaging of other CEA-expressing tumors and other pretargeting systems. In particular, those exploiting bioorthogonal chemistry also appear interesting in preclinical animal models, suggesting the high potential of pretargeting for diagnostic and theranostic applications.
Collapse
Affiliation(s)
- Caroline Bodet-Milin
- Nuclear Medicine, University Hospital, Nantes, France
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Clément Bailly
- Nuclear Medicine, University Hospital, Nantes, France
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Yann Touchefeu
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Hepato-Gastro-enterology, University Hospital, Nantes, France
| | - Eric Frampas
- Nuclear Medicine, University Hospital, Nantes, France
- Radiology, University Hospital, Nantes, France
| | - Mickael Bourgeois
- Nuclear Medicine, University Hospital, Nantes, France
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Aurore Rauscher
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Nuclear Medicine, ICO Cancer Center, Saint-Herblain, France
| | | | - Delphine Drui
- Endocrinology Department, University Hospital, Nantes, France
| | | | - David M. Goldenberg
- IBC Pharmaceuticals, Inc., Morris Plains, NJ, United States
- Immunomedics, Inc., Morris Plains, NJ, United States
| | - Alain Faivre-Chauvet
- Nuclear Medicine, University Hospital, Nantes, France
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | | | - Caroline Rousseau
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Nuclear Medicine, ICO Cancer Center, Saint-Herblain, France
| | - Françoise Kraeber-Bodéré
- Nuclear Medicine, University Hospital, Nantes, France
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Nuclear Medicine, ICO Cancer Center, Saint-Herblain, France
| |
Collapse
|
21
|
Bardia A, Mayer IA, Vahdat LT, Tolaney SM, Isakoff SJ, Diamond JR, O'Shaughnessy J, Moroose RL, Santin AD, Abramson VG, Shah NC, Rugo HS, Goldenberg DM, Sweidan AM, Iannone R, Washkowitz S, Sharkey RM, Wegener WA, Kalinsky K. Sacituzumab Govitecan-hziy in Refractory Metastatic Triple-Negative Breast Cancer. N Engl J Med 2019; 380:741-751. [PMID: 30786188 DOI: 10.1056/nejmoa1814213] [Citation(s) in RCA: 460] [Impact Index Per Article: 92.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Standard chemotherapy is associated with low response rates and short progression-free survival among patients with pretreated metastatic triple-negative breast cancer. Sacituzumab govitecan-hziy is an antibody-drug conjugate that combines a humanized monoclonal antibody, which targets the human trophoblast cell-surface antigen 2 (Trop-2), with SN-38, which is conjugated to the antibody by a cleavable linker. Sacituzumab govitecan-hziy enables delivery of high concentrations of SN-38 to tumors. METHODS We conducted a phase 1/2 single-group, multicenter trial involving patients with advanced epithelial cancers who received sacituzumab govitecan-hziy intravenously on days 1 and 8 of each 21-day cycle until disease progression or unacceptable toxic effects. A total of 108 patients received sacituzumab govitecan-hziy at a dose of 10 mg per kilogram of body weight after receiving at least two previous anticancer therapies for metastatic triple-negative breast cancer. The end points included safety; the objective response rate (according to Response Evaluation Criteria in Solid Tumors, version 1.1), which was assessed locally; the duration of response; the clinical benefit rate (defined as a complete or partial response or stable disease for at least 6 months); progression-free survival; and overall survival. Post hoc analyses determined the response rate and duration, which were assessed by blinded independent central review. RESULTS The 108 patients with triple-negative breast cancer had received a median of 3 previous therapies (range, 2 to 10). Four deaths occurred during treatment; 3 patients (2.8%) discontinued treatment because of adverse events. Grade 3 or 4 adverse events (in ≥10% of the patients) included anemia and neutropenia; 10 patients (9.3%) had febrile neutropenia. The response rate (3 complete and 33 partial responses) was 33.3% (95% confidence interval [CI], 24.6 to 43.1), and the median duration of response was 7.7 months (95% CI, 4.9 to 10.8); as assessed by independent central review, these values were 34.3% and 9.1 months, respectively. The clinical benefit rate was 45.4%. Median progression-free survival was 5.5 months (95% CI, 4.1 to 6.3), and overall survival was 13.0 months (95% CI, 11.2 to 13.7). CONCLUSIONS Sacituzumab govitecan-hziy was associated with durable objective responses in patients with heavily pretreated metastatic triple-negative breast cancer. Myelotoxic effects were the main adverse reactions. (Funded by Immunomedics; IMMU-132-01 ClinicalTrials.gov number, NCT01631552.).
Collapse
Affiliation(s)
- Aditya Bardia
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Ingrid A Mayer
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Linda T Vahdat
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Sara M Tolaney
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Steven J Isakoff
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Jennifer R Diamond
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Joyce O'Shaughnessy
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Rebecca L Moroose
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Alessandro D Santin
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Vandana G Abramson
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Nikita C Shah
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Hope S Rugo
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - David M Goldenberg
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Ala M Sweidan
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Robert Iannone
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Sarah Washkowitz
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Robert M Sharkey
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - William A Wegener
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| | - Kevin Kalinsky
- From the Massachusetts General Hospital Cancer Center (A.B., S.J.I.) and Dana-Farber Cancer Institute (S.M.T.), Harvard Medical School, Boston; Vanderbilt-Ingram Cancer Center, Nashville (I.A.M., V.G.A.); Weill Cornell Medical College (L.T.V.) and New York-Presbyterian-Columbia University Irving Medical Center (K.K.), New York; University of Colorado Cancer Center, Aurora (J.R.D.); Texas Oncology, Baylor University Medical Center, US Oncology, Dallas (J.O.); Orlando Health University of Florida Health Cancer Center, Orlando (R.L.M., N.C.S.); Yale University School of Medicine, New Haven, CT (A.D.S.); University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco (H.S.R.); Immunomedics, Morris Plains, NJ (D.M.G., R.I., S.W., R.M.S., W.A.W.); and AIS Consulting, Ann Arbor, MI (A.M.S.)
| |
Collapse
|
22
|
Kalinsky K, Isakoff SJ, Tolaney SM, Juric D, Mayer IA, Vahdat LT, Diamond JR, O'Shaughnessy J, Moroose RL, Santin AD, Shah NC, Abramson V, Goldenberg DM, Sharkey RM, Washkowitz SA, Wegener WA, Iannone R, Bardia A. Abstract P2-11-01: Safety and efficacy of sacituzumab govitecan (anti-Trop-2-SN-38 antibody-drug conjugate) as ≥3rd-line therapeutic option for treatment-refractory HER2-negative metastatic breast cancer (HER2Neg mBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-11-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Sacituzumab govitecan is an antibody-drug conjugate consisting of SN-38, the active metabolite of irinotecan, conjugated to a humanized mAb targeting Trop-2 (trophoblastic antigen-2), which is highly expressed in many epithelial cancers. A phase I/II basket trial (NCT01631552) investigated its activity in patients (pts) with advanced epithelial cancers. Herein, we summarize pooled safety and efficacy findings in 162 pts with HER2-negative metastatic breast cancer (mBC) accrued between 7/2013 and 6/2017 who received at least 2 prior therapies for metastatic disease and were treated with sacituzumab govitecan at the 10 mg/kg dose level.
Methods: Patients with triple-negative (N=108) and patients with hormone-receptor positive (N=54) mBC received 10 mg/kg sacituzumab govitecan on days 1 & 8 of a 21-day cycle continued until progression or unacceptable toxicity. All pts had measurable disease by CT or MRI. Efficacy was assessed locally by RECIST 1.1 including overall response rate (ORR) and Kaplan-Meier estimates of duration of response (DOR), progression-free survival (PFS) and overall survival (OS). Adverse events (AE) were evaluated according to CTCAE v4.0
Results: The patient cohort (161 female /1 male; median age 55 yrs, range 31-80) received a median of 4 prior therapies for metastatic disease (range 2-17), with prior chemotherapy agents in the metastatic setting including taxane (68%), capecitabine (60%), platinum (59%), gemcitabine (44%), eribulin (41%), and anthracycline (38%). 77 pts have died, with 57 in long-term follow-up and 28 still on treatment at data cutoff. The median number of administered sacituzumab govitecan doses was 14 (range 1-88). Treatment was generally well tolerated. 29% of pts had dose reductions, 3% discontinued treatment due to drug-related AEs, and there were no treatment-related deaths. Based on currently available AE data, grade ≥ 3 toxicity included neutropenia (43%), anemia (9.5%), diarrhea (7.0%) and febrile neutropenia (6.3%). For the TNBC subgroup, with a median follow-up of 9.3 months, the ORR was 33% (3 CRs + 33 PRs /108) with a median DOR of 8.3 months (95% CI: 4.8 – 11.6). For the ER+ subgroup, with a median follow-up of 10.0 months, the ORR was 31% (17 PRs/54) with a median DOR of 7.4 months (95% CI: 4.4 – 18.3). The combined HER2Neg ORR was 33% (3 CRs+50 PRs/162), with a median DOR of 8.3 months (95% CI: 4.9 - 10.8), PFS of 5.6 months (95% CI: 5.1 – 6.9) and OS of 13.0 months (95% CI: 11.5 - 15.0). The ORR was comparable for pts ≤ 50 yrs. old [32.2% (19/59)] vs. > 50 yrs old [33.0% (34/103)] and little different for pts with 2 prior therapies [35.4% (17/48)] vs. >2 prior therapies [31.6% (36/114)].
Conclusions: Monotherapy with sacituzumab govitecan was well tolerated with a manageable safety profile, and achieved a 30+% objective response rate among heavily pre-treated patients with HER2-negative metastatic breast cancer regardless of ER status.
Citation Format: Kalinsky K, Isakoff SJ, Tolaney SM, Juric D, Mayer IA, Vahdat LT, Diamond JR, O'Shaughnessy J, Moroose RL, Santin AD, Shah NC, Abramson V, Goldenberg DM, Sharkey RM, Washkowitz SA, Wegener WA, Iannone R, Bardia A. Safety and efficacy of sacituzumab govitecan (anti-Trop-2-SN-38 antibody-drug conjugate) as ≥3rd-line therapeutic option for treatment-refractory HER2-negative metastatic breast cancer (HER2Neg mBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-11-01.
Collapse
Affiliation(s)
- K Kalinsky
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - SJ Isakoff
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - SM Tolaney
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - D Juric
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - IA Mayer
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - LT Vahdat
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - JR Diamond
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - J O'Shaughnessy
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - RL Moroose
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - AD Santin
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - NC Shah
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - V Abramson
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - DM Goldenberg
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - RM Sharkey
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - SA Washkowitz
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - WA Wegener
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - R Iannone
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| | - A Bardia
- Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Vanderbilt-Ingram Cancer Center, Nashville, TN; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; Yale University School of Medicine, New Haven, CT; Immunomedics, Inc., Morris Plains, NJ
| |
Collapse
|
23
|
Govindan SV, Cardillo TM, Goldenberg DM. CHAPTER 8. Topoisomerase Inhibitors as Antibody–Drug Conjugate (ADC) Payloads. Cytotoxic Payloads for Antibody–Drug Conjugates 2019. [DOI: 10.1039/9781788012898-00166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
24
|
Goldenberg DM, Stein R, Sharkey RM. The emergence of trophoblast cell-surface antigen 2 (TROP-2) as a novel cancer target. Oncotarget 2018; 9:28989-29006. [PMID: 29989029 PMCID: PMC6034748 DOI: 10.18632/oncotarget.25615] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [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: 04/30/2018] [Accepted: 05/31/2018] [Indexed: 12/31/2022] Open
Abstract
TROP-2 is a glycoprotein first described as a surface marker of trophoblast cells, but subsequently shown to be increased in many solid cancers, with lower expression in certain normal tissues. It regulates cancer growth, invasion and spread by several signaling pathways, and has a role in stem cell biology and other diseases. This review summarizes TROP-2's properties, especially in cancer, and particularly its role as a target for antibody-drug conjugates (ADC) or immunotherapy. When the irinotecan metabolite, SN-38, is conjugated to a humanized anti-TROP-2 antibody (sacituzumab govitecan), it shows potent broad anticancer activity in human cancer xenografts and in patients with advanced triple-negative breast, non-small cell and small-cell lung, as well as urothelial cancers.
Collapse
Affiliation(s)
- David M. Goldenberg
- Center for Molecular Medicine and Immunology, Belleville, NJ, USA
- IBC Pharmaceuticals, Inc., Morris Plains, NJ, USA
| | - Rhona Stein
- Center for Molecular Medicine and Immunology, Belleville, NJ, USA
| | - Robert M. Sharkey
- Center for Molecular Medicine and Immunology, Belleville, NJ, USA
- Immunomedics, Inc., Morris Plains, NJ, USA
| |
Collapse
|
25
|
Foubert F, Gouard S, Saï-Maurel C, Chérel M, Faivre-Chauvet A, Goldenberg DM, Barbet J, Bailly C, Bodet-Milin C, Carlier T, Kraeber-Bodéré F, Touchefeu Y, Frampas E. Sensitivity of pretargeted immunoPET using 68Ga-peptide to detect colonic carcinoma liver metastases in a murine xenograft model: Comparison with 18FDG PET-CT. Oncotarget 2018; 9:27502-27513. [PMID: 29938001 PMCID: PMC6007947 DOI: 10.18632/oncotarget.25514] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 12/06/2017] [Accepted: 05/12/2018] [Indexed: 12/27/2022] Open
Abstract
PURPOSE The aim of this study was to compare the performances pretargeted immunoPET 68Ga-PETimaging (68Ga-pPET) with anti carcino-embryonic antigen (CEA) and anti-histamine-succinyl-glycine (HSG) recombinant humanized bispecific monoclonal antibody (TF2) and 68Ga-labeled HSG peptide (IMP288) to conventional 18FDG-PET in an orthotopic murine model of liver metastases of human colonic cancer. METHODS Hepatic tumor burden following intra-portal injection of luciferase-transfected LS174T cells in nude mice was confirmed using bioluminescence. One group of animals was injected intravenously with TF2 and with 68Ga-IMP288 24 hours later (n=8). Another group received 18FDG (n=8), and a third had both imaging modalities (n=7). PET acquisitions started 1 hour after injection of the radioconjugate. Biodistributions in tumors and normal tissues were assessed one hour after imaging. RESULTS Tumor/organ ratios were significantly higher with 68Ga-pPET compared to 18FDG-PET (P<0.05) with both imaging and biodistribution data. 68Ga-pPET sensitivity for tumor detection was 67% vs. 31% with 18FDG PET (P=0.049). For tumors less than 200 mg, the sensitivity was 44% with 68Ga-pPET vs. 0% for 18FDG PET (P=0.031). A strong correlation was demonstrated between tumor uptakes measured on PET images and biodistribution analyses (r2=0.85). CONCLUSION 68Ga-pPET was more sensitive than 18FDG-PET for the detection of human colonic liver metastases in an orthotopic murine xenograft model. Improved tumor/organ ratios support the use of pretargeting method for imaging and therapy of CEA-expressing tumors.
Collapse
Affiliation(s)
- Fanny Foubert
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Hepato-Gastroenterology Department, Institut des Maladies de l’Appareil Digestif, University Hospital, Nantes, France
| | - Sébastien Gouard
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | | | - Michel Chérel
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Nuclear Medicine Department, ICO René Gauducheau Cancer Center, Saint Herblain, France
| | - Alain Faivre-Chauvet
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Nuclear Medicine Department, University Hospital, Nantes, France
| | - David M. Goldenberg
- IBC Pharmaceuticals Inc., Morris Plains, New Jersey, USA
- Immunomedics Inc., Morris Plains, New Jersey, USA
| | - Jacques Barbet
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- GIP ARRONAX, Saint-Herblain, Nantes, France
| | - Clément Bailly
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Nuclear Medicine Department, University Hospital, Nantes, France
| | - Caroline Bodet-Milin
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Nuclear Medicine Department, ICO René Gauducheau Cancer Center, Saint Herblain, France
- Nuclear Medicine Department, University Hospital, Nantes, France
| | - Thomas Carlier
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Nuclear Medicine Department, University Hospital, Nantes, France
| | - Françoise Kraeber-Bodéré
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Nuclear Medicine Department, ICO René Gauducheau Cancer Center, Saint Herblain, France
- Nuclear Medicine Department, University Hospital, Nantes, France
| | - Yann Touchefeu
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Hepato-Gastroenterology Department, Institut des Maladies de l’Appareil Digestif, University Hospital, Nantes, France
| | - Eric Frampas
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
- Radiology Department, University Hospital, Nantes, France
| |
Collapse
|
26
|
Han C, Bellone S, Schwartz PE, Govindan SV, Sharkey RM, Goldenberg DM, Santin AD. Sacituzumab Govitecan (IMMU-132) in treatment-resistant uterine serous carcinoma: A case report. Gynecol Oncol Rep 2018; 25:37-40. [PMID: 29977989 PMCID: PMC6030029 DOI: 10.1016/j.gore.2018.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 05/11/2018] [Accepted: 05/20/2018] [Indexed: 01/05/2023] Open
Abstract
Background Uterine serous carcinoma (USC) is a biologically aggressive variant of uterine cancer. Effective treatment options for recurrent, chemotherapy-resistant USC are extremely limited. Case We describe a 74-year-old woman with recurrent and widespread treatment-resistant disease, who experienced a dramatic response to sacituzumab govitecan, a novel antibody-drug conjugate (ADC) targeting human trophoblast-cell-surface antigen (TROP-2), after failing multiple chemotherapy and immunotherapy. The impressive clinical response (66% reduction of target lesions by RECIST 1.1 with a duration response of over 10 months) was confirmed with serial CT scans in the absence of significant adverse events. Conclusion Sacituzumab govitecan may present a new treatment option for recurrent USC patients harboring Trop-2+ tumors resistant to chemotherapy. Clinical trials with sacituzumab govitecan are warranted. Uterine serous carcinoma (USC) is a rare but aggressive variant of uterine cancer. Sacituzumab-govitecan (IMMU-132) is an antibody-drug conjugate targeting TROP-2. IMMU-132 may represent a new treatment option for USC overexpressing TROP-2.
Collapse
Affiliation(s)
- Chanhee Han
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, United States
| | - Stefania Bellone
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, United States
| | - Peter E Schwartz
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, United States
| | | | - Robert M Sharkey
- Immunomedics, Inc., 300 The American Road, Morris Plains, NJ 07950, United States
| | - David M Goldenberg
- Immunomedics, Inc., 300 The American Road, Morris Plains, NJ 07950, United States
| | - Alessandro D Santin
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, United States
| |
Collapse
|
27
|
Bardia A, Diamond JR, Vahdat LT, Tolaney SM, O'Shaughnessy J, Moroose RL, Mayer IA, Abramson VG, Juric D, Sharkey RM, Washkowitz SA, Wegener WA, Goldenberg DM, Kalinsky K. Efficacy of sacituzumab govitecan (anti-Trop-2-SN-38 antibody-drug conjugate) for treatment-refractory hormone-receptor positive (HR+)/HER2- metastatic breast cancer (mBC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.1004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Aditya Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | | | | | | | - Joyce O'Shaughnessy
- Texas Oncology - Baylor Charles A. Sammons Cancer Center and The US Oncology Network, Dallas, TX
| | | | | | | | - Dejan Juric
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | | | | | | | | | | |
Collapse
|
28
|
Gasparini M, Bombardieri E, Tondini C, Maffioli L, Hughes L, Burraggi GL, Goldenberg DM. Clinical Utility of Radioimmunoscintigraphy of Non-Hodgkin's Lymphoma with Radiolabelled LL2 Monoclonal Antibody., Lymphoscan™: Preliminary Results. Tumori 2018; 81:173-8. [PMID: 7571023 DOI: 10.1177/030089169508100304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background Adequate clinical staging of non-Hodgkin's lymphoma patients is essential because only localized disease can be treated satisfactorily. Many imaging procedures are necessary to stage the disease accurately. The objective of this study was to evaluate the efficacy of an anti-lymphoma antibody in the Fab’ fragment form, labelled with 99mTc, to detect malignant lesions. Methods Radioimmunodetection (RAID) with 99mTc-labelled B-cell lymphoma monoclonal antibody IMMU-LL2-Fab’ (LymphoSCAN™; Immunomedics, Morris Plain, NJ, USA) was investigated in 10 patients (5 females and 5 males; age range, 20-72 years) with histologically proved non-Hodgkin's lymphoma. Of the 10 lymphomas, 7 were intermediate grade and 3 were low grade. Whole body images with multiple planar views were obtained at 30 min, 4-6 and 24 h after i.v. injection of 1 mg LL2-Fab’ labelled with 740-925 MBq of 99mTc. SPET of the chest or abdomen was performed in all patients 5-8 h after the immunoreagent injection. Results No adverse reactions were observed in any patient after Mab infusion, and no appreciable changes were seen in the blood counts, renal or liver function tests. A total of 18 of 21 (85.7%) lymphoma lesions were detected by RAID. All the tumor localizations were confirmed by clinical examination and with other imaging techniques, such as CT scan, MRI or gallium scan. In this series of patients no false-positive results were noted. As regards the biodistribution of the immunoreagent, no appreciable bone marrow activity was seen; splenic targeting was demonstrated in all patients; the tumor-to-non-tumor ratios ranged from 1.2 to 2.8 ad measured by the ROI technique; no difference in uptake was noted for different tumor grades. The images obtained 24 h after injection did not reveal new lesions, but areas of doubtful uptake were seen as positive focal areas in the delayed scan. Conclusions LymphoSCAN™ seems to be useful for detection, staging and follow-up of non-Hodgkin's lymphoma patients.
Collapse
Affiliation(s)
- M Gasparini
- Nuclear Medicine Department, National Cancer Institute, Milan, Italy
| | | | | | | | | | | | | |
Collapse
|
29
|
Gottenberg JE, Dörner T, Bootsma H, Devauchelle-Pensec V, Bowman SJ, Mariette X, Bartz H, Oortgiesen M, Shock A, Koetse W, Galateanu C, Bongardt S, Wegener WA, Goldenberg DM, Meno-Tetang G, Kosutic G, Gordon C. Efficacy of Epratuzumab, an Anti-CD22 Monoclonal IgG Antibody, in Systemic Lupus Erythematosus Patients With Associated Sjögren's Syndrome: Post Hoc Analyses From the EMBODY Trials. Arthritis Rheumatol 2018; 70:763-773. [PMID: 29381843 PMCID: PMC5947119 DOI: 10.1002/art.40425] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 01/23/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE EMBODY 1 (ClinicalTrials.gov identifier: NCT01262365) and EMBODY 2 (ClinicalTrials.gov identifier: NCT01261793) investigated the efficacy and safety of epratuzumab, a CD22-targeted humanized monoclonal IgG antibody, in patients with systemic lupus erythematosus (SLE). The studies showed no significant difference from placebo in primary or secondary clinical outcome measures but did demonstrate B cell-specific immunologic activity. The aim of this post hoc analysis was to determine whether epratuzumab had a different clinical efficacy profile in SLE patients with versus those without an associated diagnosis of Sjögren's syndrome (SS). METHODS The efficacy and safety of epratuzumab were compared between 2 patient subpopulations randomized in EMBODY 1 and 2: SLE patients with and those without a diagnosis of associated SS. British Isles Lupus Assessment Group (BILAG) total score, BILAG-based Combined Lupus Assessment (BICLA) clinical response to treatment, biologic markers (including B cells, IgG, IgM, and IgA), and safety were assessed. RESULTS A total of 1,584 patients were randomized in the EMBODY 1 and EMBODY 2 trials; 113 patients were anti-SSA positive and had a diagnosis of associated SS, and 1,375 patients (86.8%) had no diagnosis of associated SS (918 patients were randomized to receive epratuzumab and 457 to receive placebo). For patients with associated SS, but not those without associated SS, a higher proportion of patients receiving epratuzumab achieved a BICLA response and a reduction from baseline in BILAG total score. B cell reduction was faster in patients with associated SS. The sensitivity of B cells to epratuzumab as measured by the mean concentration producing 50% of the maximum B cell count depletion was lower for patients with associated SS (9.5 μg/ml) versus the total EMBODY population (87.1 μg/ml). No difference in the frequency of adverse events in those receiving placebo was reported. CONCLUSION Patients with SLE and associated SS treated with epratuzumab showed improvement in SLE disease activity, which was associated with bioactivity, such as decreases in B cell number and IgM level.
Collapse
Affiliation(s)
- Jacques-Eric Gottenberg
- Centre de Référence National Pour les Maladies Auto-Immunes Systémiques Rares, CNRS, Institut de Biologie Moléculaire et Cellulaire, Immunopathologie et Chimie Thérapeutique, Laboratory of Excellence MEDALIS, Strasbourg University Hospital, Strasbourg, France
| | | | | | | | - Simon J Bowman
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Xavier Mariette
- Université Paris-Sud, AP-HP, Hôpitaux Universitaires Paris-Sud, INSERM U1184, Le Kremlin-Bicêtre, France
| | | | | | | | | | | | | | | | | | | | | | - Caroline Gordon
- University of Birmingham and NIHR/Wellcome Trust Clinical Research Facility, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| |
Collapse
|
30
|
Bardia A, Rugo HS, Horne H, Wegener WA, Goldenberg DM, O'Shaughnessy J. Abstract OT2-07-05: A phase III, randomized trial of sacituzumab govitecan (IMMU-132) vs treatment of physician choice (TPC) for metastatic triple-negative breast cancer (mTNBC). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot2-07-05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Metastatic TNBC has an aggressive course with limited therapy options and poor survival. Sacituzumab govitecan (IMMU-132) is a novel antibody drug conjugate consisting of SN-38, the active metabolite of the topoisomerase I inhibitor, irinotecan, conjugated to a humanized mAb targeting Trop-2, which is highly expressed in most epithelial cancers, including TNBC. We previously reported that patients (pts) with mTNBC treated with IMMU-132 after a median of 5 prior therapies from initial diagnosis achieved a 30% objective response rate (ORR), 8.9 mo median duration of response (DOR), and an acceptable safety profile with nausea, neutropenia, and diarrhea the most common toxicities (Bardia et al., JCO, 2017). IMMU-132 was awarded Breakthrough Designation by the FDA based on this data. Accordingly, we are enrolling additional patients with relapsed/refractory mTNBC with intention of seeking regulatory approval as a ≥3rd-line therapeutic option.
Trial design: An international, open-label, Phase III study in pts with refractory/relapsed mTNBC after ≥2 prior chemotherapies for advanced disease or >1 therapy for pts who progress within 12 months of adjuvant therapy (NCT02574455). Pts are randomized 1:1 to receive either IMMU-132 (10 mg/kg IV, days 1 and 8 every 21 days) or TPC from one of 4 prespecified single-agent regimens (capecitabine, eribulin, vinorelbine or gemcitabine). Pts continue treatment until progression requiring discontinuation or unacceptable toxicity. The primary endpoint is progression-free survival (PFS) and additional endpoints include overall survival (OS), ORR, DOR, safety and quality of life. Independent, blinded reads of scans will be performed.
Eligibility criteria: Adults >18 yrs old, with metastatic breast cancer, triple-negative by most recent biopsy, measurable disease by CT or MRI as per RECIST1.1, ECOG performance score 0 or 1, adequate safety laboratories. Refractory/relapsed after ≥2 prior standard chemotherapy regimens for advanced disease, or >1 therapy for pts who progress within 12 months of adjuvant therapy. Pts must have received taxane and be eligible by investigator to receive at least one of the TPC agents. Pts with treated, non-progressive brain metastases are eligible.
Specific aims: To compare IMMU-132 to TPC as measured by PFS, OS, ORR, DOR,QOL, adverse events, safety laboratories, incidence of dose delays and reductions, and treatment discontinuations due to toxicity.
Statistical methods: Assuming a median PFS of 3 mo. and OS of 10 mo. with TPC vs. 5 and 15 mo. with IMMU-132, respectively, a study size of 328 patients has >95% and >80% power to detect a statistically significant difference in PFS and OS, respectively, between the two treatment arms.
Present accrual and target accrual: Trial enrollment will begin prior to SABCS 2017 with approximately 328 patients expected to be enrolled over 18 months at approximately 100 institutions in North America, Europe and potentially elsewhere.
Contact: Immu132@Immunomedics.com
Citation Format: Bardia A, Rugo HS, Horne H, Wegener WA, Goldenberg DM, O'Shaughnessy J. A phase III, randomized trial of sacituzumab govitecan (IMMU-132) vs treatment of physician choice (TPC) for metastatic triple-negative breast cancer (mTNBC) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-07-05.
Collapse
Affiliation(s)
- A Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA; Immunomedics, Inc., Morris Plains, NJ; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; The Phase III Trial Investigators
| | - HS Rugo
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA; Immunomedics, Inc., Morris Plains, NJ; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; The Phase III Trial Investigators
| | - H Horne
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA; Immunomedics, Inc., Morris Plains, NJ; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; The Phase III Trial Investigators
| | - WA Wegener
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA; Immunomedics, Inc., Morris Plains, NJ; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; The Phase III Trial Investigators
| | - DM Goldenberg
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA; Immunomedics, Inc., Morris Plains, NJ; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; The Phase III Trial Investigators
| | - J O'Shaughnessy
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA; Immunomedics, Inc., Morris Plains, NJ; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; The Phase III Trial Investigators
| |
Collapse
|
31
|
Bardia A, Vahdat LT, Diamond JR, Kalinsky K, O'Shaughnessy J, Moroose RL, Isakoff SJ, Tolaney SM, Santin AD, Abramson V, Shah NC, Govindan SV, Maliakal P, Sharkey RM, Wegener WA, Goldenberg DM, Mayer IA. Abstract P1-12-01: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-12-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
Collapse
Affiliation(s)
- A Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - LT Vahdat
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - JR Diamond
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - K Kalinsky
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - J O'Shaughnessy
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - RL Moroose
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - SJ Isakoff
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - SM Tolaney
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - AD Santin
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - V Abramson
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - NC Shah
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - SV Govindan
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - P Maliakal
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - RM Sharkey
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - WA Wegener
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - DM Goldenberg
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| | - IA Mayer
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Weill Cornell Medicine, New York, NY; University of Colorado Cancer Center, Aurora, CO; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; Texas Oncology, Baylor University Medical Center, US Oncology, Dallas, TX; UF Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Yale University School of Medicine, New Haven, CT; Vanderbilt-Ingram Cancer Center, Nashville, TN; Immunomedics, Inc., Morris Plains, NJ
| |
Collapse
|
32
|
Cardillo TM, Govindan SV, Zalath MB, Rossi DL, Wang Y, Chang CH, Goldenberg DM. IMMU-140, a Novel SN-38 Antibody-Drug Conjugate Targeting HLA-DR, Mediates Dual Cytotoxic Effects in Hematologic Cancers and Malignant Melanoma. Mol Cancer Ther 2017; 17:150-160. [PMID: 29133623 DOI: 10.1158/1535-7163.mct-17-0354] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/13/2017] [Accepted: 10/24/2017] [Indexed: 11/16/2022]
Abstract
HLA-DR is a member of the MHC class II antigen family expressed on hematologic and solid tumors. Antibodies directed against HLA-DR have demonstrated some clinical success, but toxicities limited development. IMMU-140 is an anti-HLA-DR antibody-drug conjugate composed of the active metabolite of irinotecan, SN-38, conjugated to a humanized anti-HLA-DR IgG4 antibody (IMMU-114); the IgG4 naked antibody is devoid of immune functions. Our aim was to determine if SN-38, the metabolite of a drug not commonly used in hematopoietic cancers, would be effective and safe when targeted to HLA-DR-expressing tumors. IMMU-140 had dual-therapeutic mechanisms, as evidenced by its retention of nonoverlapping anti-HLA-DR nonclassical apoptotic signaling and classical apoptosis mediated by its SN-38 payload. In seven human disease models [acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), multiple myeloma (MM), acute myeloid leukemia (AML), diffuse large B-cell lymphoma (DLBCL), Hodgkin lymphoma (HL), and melanoma], IMMU-140 provided significant therapeutic efficacy compared with controls, in vitro, in 3D spheroid models, and in vivo Except for MM and HL, IMMU-140 imparted significantly improved antitumor effects compared with parental IMMU-114. Even in intractable AML and ALL, where IMMU-114 only had modest antitumor effects, IMMU-140 therapy mediated >80% improvement in survival. Therapy was well tolerated, as demonstrated by no marked loss in body weight. Combined with doxorubicin, IMMU-140 produced significantly greater antitumor effects in HL than with monotherapy and without any added toxicity. The dual-therapeutic action of IMMU-140 resulted in promising therapeutic activity in a range of hematopoietic tumors and melanoma, and therefore warrants clinical development. Mol Cancer Ther; 17(1); 150-60. ©2017 AACR.
Collapse
Affiliation(s)
| | | | | | | | - Yang Wang
- Immunomedics, Inc., Morris Plains, New Jersey
| | | | | |
Collapse
|
33
|
Sharkey RM, Govindan SV, Cardillo TM, Donnell J, Xia J, Rossi EA, Chang CH, Goldenberg DM. Selective and Concentrated Accretion of SN-38 with a CEACAM5-Targeting Antibody-Drug Conjugate (ADC), Labetuzumab Govitecan (IMMU-130). Mol Cancer Ther 2017; 17:196-203. [PMID: 29079710 DOI: 10.1158/1535-7163.mct-17-0442] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/27/2017] [Accepted: 10/06/2017] [Indexed: 11/16/2022]
Abstract
Labetuzumab govitecan (IMMU-130), an antibody-drug conjugate (ADC) with an average of 7.6 SN-38/IgG, was evaluated for its potential to enhance delivery of SN-38 to human colonic tumor xenografts. Mice bearing LS174T or GW-39 human colonic tumor xenografts were injected with irinotecan or IMMU-130 (SN-38 equivalents ∼500 or ∼16 μg, respectively). Serum and homogenates of tumors, liver, and small intestine were extracted, and SN-38, SN-38G (glucuronidated SN-38), and irinotecan concentrations determined by reversed-phase HPLC. Irinotecan cleared quickly from serum, with only 1% to 2% injected dose/mL after 5 minutes; overall, approximately 20% was converted to SN-38 and SN-38G. At 1 hour with IMMU-130, 45% to 63% injected dose/mL of the SN-38 was in the serum, with >90% bound to the ADC over 3 days, and with low levels of SN-38G. Total SN-38 levels decreased more quickly than the IgG, confirming a gradual SN-38 release from the ADC. AUC analysis found that SN-38 levels were approximately 11- and 16-fold higher in LS174T and GW-39 tumors, respectively, in IMMU-130-treated animals. This delivery advantage is amplified >30-fold when normalized to SN-38 equivalents injected for each product. Levels of SN-38 and SN-38G were appreciably lower in the liver and small intestinal contents in animals given IMMU-130. On the basis of the SN-38 equivalents administered, IMMU-130 potentially delivers >300-fold more SN-38 to CEA-producing tumors compared with irinotecan, while also reducing levels of SN-38 and SN-38G in normal tissues. These observations are consistent with preclinical and clinical data showing efficacy and improved safety. Mol Cancer Ther; 17(1); 196-203. ©2017 AACR.
Collapse
Affiliation(s)
| | | | | | | | - Jing Xia
- Immunomedics, Inc, Morris Plains, New Jersey
| | | | | | | |
Collapse
|
34
|
Dotan E, Cohen SJ, Starodub AN, Lieu CH, Messersmith WA, Simpson PS, Guarino MJ, Marshall JL, Goldberg RM, Hecht JR, Wegener WA, Sharkey RM, Govindan SV, Goldenberg DM, Berlin JD. Phase I/II Trial of Labetuzumab Govitecan (Anti-CEACAM5/SN-38 Antibody-Drug Conjugate) in Patients With Refractory or Relapsing Metastatic Colorectal Cancer. J Clin Oncol 2017; 35:3338-3346. [PMID: 28817371 PMCID: PMC8259133 DOI: 10.1200/jco.2017.73.9011] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [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: 12/13/2022] Open
Abstract
Purpose The objectives were to evaluate dosing schedules of labetuzumab govitecan, an antibody-drug conjugate targeting carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5) for tumor delivery of 7-ethyl-10-hydroxycamptothecin (SN-38), in an expanded phase II trial of patients with relapsed or refractory metastatic colorectal cancer. Patients and Methods Eligible patients with at least one prior irinotecan-containing therapy received labetuzumab govitecan once weekly at 8 and 10 mg/kg, or two times per week at 4 and 6 mg/km on weeks 1 and 2 of 3-week repeated cycles. End points were safety, response, pharmacokinetics, and immunogenicity. Results Eighty-six patients who had undergone a median of five prior therapies (range, one to 13) were each enrolled into one of the four cohorts. On the basis of Response Evaluation Criteria in Solid Tumors 1.1, 38% of these patients had a tumor as well as plasma carcinoembryonic antigen reduction from baseline after labetuzumab govitecan treatment; one patient achieved a partial response with a sustained response spanning > 2 years, whereas 42 patients had stable disease as the best overall response. Median progression-free survival and overall survival were 3.6 and 6.9 months, respectively. The major toxicities (grade ≥ 3) among all cohorts were neutropenia (16%), leukopenia (11%), anemia (9%), and diarrhea (7%). The antibody-drug conjugate's mean half-life was 16.5 hours for the four cohorts. Anti-drug/anti-antibody antibodies were not detected. The two once-weekly dose schedules, showing comparable toxicity and efficacy, were chosen for further study. Conclusion Monotherapy with labetuzumab govitecan demonstrated a manageable safety profile and therapeutic activity in heavily pretreated patients with metastatic colorectal cancer, all with prior irinotecan therapy. Further studies of labetuzumab govitecan treatment alone or in combination with other therapies in earlier settings are indicated.
Collapse
Affiliation(s)
- Efrat Dotan
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Steven J. Cohen
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Alexander N. Starodub
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Christopher H. Lieu
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Wells A. Messersmith
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Pamela S. Simpson
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Michael J. Guarino
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - John L. Marshall
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Richard M. Goldberg
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - J. Randolph Hecht
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - William A. Wegener
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Robert M. Sharkey
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Serengulam V. Govindan
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - David M. Goldenberg
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Jordan D. Berlin
- Efrat Dotan and Steven J. Cohen, Fox Chase Cancer Center, Philadelphia, PA; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Christopher H. Lieu and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Pamela S. Simpson and Michael J. Guarino, Helen F. Graham Cancer Center & Research Institute, Newark, DE; John L. Marshall, Ruesch Center for the Cure of GI Cancers, Georgetown University Hospital, Washington, DC; Richard M. Goldberg, The Ohio State University Comprehensive Cancer Center, Columbus, OH; J. Randolph Hecht, University of California, Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA; William A. Wegener, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ; and Jordan D. Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN
| |
Collapse
|
35
|
Chang CH, Goldenberg DM. Enhancing the antitumor potency of T cells redirected by bispecific antibodies. Oncoscience 2017; 4:120-121. [PMID: 29142899 PMCID: PMC5672892 DOI: 10.18632/oncoscience.366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 01/13/2023] Open
Affiliation(s)
- Chien-Hsing Chang
- IBC Pharmaceuticals Inc., and Immunomedics Inc., Morris Plains, New Jersey, USA
| | - David M Goldenberg
- IBC Pharmaceuticals Inc., and Immunomedics Inc., Morris Plains, New Jersey, USA
| |
Collapse
|
36
|
Chang CH, Wang Y, Li R, Rossi DL, Liu D, Rossi EA, Cardillo TM, Goldenberg DM. Combination Therapy with Bispecific Antibodies and PD-1 Blockade Enhances the Antitumor Potency of T Cells. Cancer Res 2017; 77:5384-5394. [PMID: 28819027 DOI: 10.1158/0008-5472.can-16-3431] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/24/2017] [Accepted: 08/04/2017] [Indexed: 11/16/2022]
Abstract
The DOCK-AND-LOCK (DNL) method is a platform technology that combines recombinant engineering and site-specific conjugation to create multispecific, multivalent antibodies of defined composition with retained bioactivity. We have applied DNL to generate a novel class of trivalent bispecific antibodies (bsAb), each comprising an anti-CD3 scFv covalently conjugated to a stabilized dimer of different antitumor Fabs. Here, we report the further characterization of two such constructs, (E1)-3s and (14)-3s, which activate T cells and target Trop-2- and CEACAM5-expressing cancer cells, respectively. (E1)-3s and (14)-3s, in the presence of human T cells, killed target cells grown as monolayers at subnanomolar concentrations, with a similar potency observed for drug-resistant cells. Antitumor efficacy was demonstrated for (E1)-3s coadministered with human peripheral blood mononuclear cells (PBMC) in NOD/SCID mice harboring xenografts of MDA-MB-231, a triple-negative breast cancer line constitutively expressing Trop-2 and PD-L1. Growth inhibition was observed following treatment with (E1)-3s or (14)-3s combined with human PBMC in 3D spheroids generated from target cell lines to mimic the in vivo behavior and microenvironment of these tumors. Moreover, addition of an antagonistic anti-PD-1 antibody increased cell death in 3D spheroids and extended survival of MDA-MB-231-bearing mice. These preclinical results emphasize the potential of combining T-cell-redirecting bsAbs with antagonists or agonists that mitigate T-cell inhibition within the tumor microenvironment to improve immunotherapy of solid cancers in patients. They also support the use of 3D spheroids as a predictive alternative to in vivo models for evaluating T-cell functions. Cancer Res; 77(19); 5384-94. ©2017 AACR.
Collapse
Affiliation(s)
- Chien-Hsing Chang
- Immunomedics, Inc., Morris Plains, New Jersey. .,IBC Pharmaceuticals, Inc., Morris Plains, New Jersey
| | - Yang Wang
- Immunomedics, Inc., Morris Plains, New Jersey
| | - Rongxiu Li
- Immunomedics, Inc., Morris Plains, New Jersey
| | | | - Donglin Liu
- Immunomedics, Inc., Morris Plains, New Jersey.,IBC Pharmaceuticals, Inc., Morris Plains, New Jersey
| | | | | | - David M Goldenberg
- Immunomedics, Inc., Morris Plains, New Jersey.,IBC Pharmaceuticals, Inc., Morris Plains, New Jersey
| |
Collapse
|
37
|
Stenler S, Lundin KE, Hansen L, Petkov S, Mozafari N, Isaguliants M, Blomberg P, Smith CIE, Goldenberg DM, Chang CH, Ljungberg K, Hinkula J, Wahren B. Immunization with HIV-1 envelope T20-encoding DNA vaccines elicits cross-clade neutralizing antibody responses. Hum Vaccin Immunother 2017; 13:2849-2858. [PMID: 28696158 PMCID: PMC5718786 DOI: 10.1080/21645515.2017.1338546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Genetic immunization is expected to induce the expression of antigens in a native form. The encoded peptide epitopes are presented on endogenous MHC molecules, mimicking antigen presentation during a viral infection. We have explored the potential of enfuvirtide (T20), a short HIV peptide with antiviral properties, to enhance immune response to HIV antigens. To generate an expression vector, the T20 sequence was cloned into a conventional plasmid, the novel minicircle construct, and a replicon plasmid. In addition, 3 conventional plasmids that express the envelope of HIV-1 subtypes A, B and C and contain T20 in their gp41 sequences were also tested. Results: All combinations induced HIV-specific antibodies and cellular responses. The addition of T20 as a peptide and as an expression cassette in the 3 DNA vectors enhanced antibody responses. The highest anti-HIV-1 Env titers were obtained by the replicon T20 construct. This demonstrates that besides its known antiviral activity, T20 promotes immune responses. We also confirm that the combination of slightly divergent antigens improves immune responses. Conclusions: The antiretroviral T20 HIV-1 sequence can be used as an immunogen to elicit binding and neutralizing antibodies against HIV-1. These, or similarly modified gp41 genes/peptides, can be used as priming or boosting components for induction of broadly neutralizing anti-HIV antibodies. Future comparative studies will reveal the optimal mode of T20 administration.
Collapse
Affiliation(s)
- S Stenler
- a Karolinska Cell Therapy Center , Karolinska University Hospital , Stockholm , Sweden
| | - K E Lundin
- b Department of Laboratory Medicine, Clinical Research Center , Karolinska Institutet , Huddinge , Sweden
| | - L Hansen
- c Department of Microbiology, Tumor and Cell Biology , Karolinska Institutet , Stockholm , Sweden
| | - S Petkov
- c Department of Microbiology, Tumor and Cell Biology , Karolinska Institutet , Stockholm , Sweden
| | - N Mozafari
- b Department of Laboratory Medicine, Clinical Research Center , Karolinska Institutet , Huddinge , Sweden
| | - M Isaguliants
- c Department of Microbiology, Tumor and Cell Biology , Karolinska Institutet , Stockholm , Sweden
| | - P Blomberg
- a Karolinska Cell Therapy Center , Karolinska University Hospital , Stockholm , Sweden
| | - C I E Smith
- b Department of Laboratory Medicine, Clinical Research Center , Karolinska Institutet , Huddinge , Sweden
| | - D M Goldenberg
- d Immunomedics, Inc., Morris Plains , NJ , USA.,e IBC Pharmaceuticals, Inc., Morris Plains , NJ , USA
| | - C-H Chang
- d Immunomedics, Inc., Morris Plains , NJ , USA.,e IBC Pharmaceuticals, Inc., Morris Plains , NJ , USA
| | - K Ljungberg
- c Department of Microbiology, Tumor and Cell Biology , Karolinska Institutet , Stockholm , Sweden
| | - J Hinkula
- f Department of Molecular Virology , Linköping University , Linköping , Sweden
| | - B Wahren
- c Department of Microbiology, Tumor and Cell Biology , Karolinska Institutet , Stockholm , Sweden
| |
Collapse
|
38
|
Gray JE, Heist RS, Starodub AN, Camidge DR, Kio EA, Masters GA, Purcell WT, Guarino MJ, Misleh J, Schneider CJ, Schneider BJ, Ocean A, Johnson T, Gandhi L, Kalinsky K, Scheff R, Messersmith WA, Govindan SV, Maliakal PP, Mudenda B, Wegener WA, Sharkey RM, Goldenberg DM. Therapy of Small Cell Lung Cancer (SCLC) with a Topoisomerase-I-inhibiting Antibody-Drug Conjugate (ADC) Targeting Trop-2, Sacituzumab Govitecan. Clin Cancer Res 2017; 23:5711-5719. [PMID: 28679770 DOI: 10.1158/1078-0432.ccr-17-0933] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/22/2017] [Accepted: 06/28/2017] [Indexed: 11/16/2022]
Abstract
Purpose: We evaluated a Trop-2-targeting antibody conjugated with SN-38 in metastatic small cell lung cancer (mSCLC) patients.Experimental Design: Sacituzumab govitecan was studied in patients with pretreated (median, 2; range, 1-7) mSCLC who received either 8 or 10 mg/kg i.v. on days 1 and 8 of 21-day cycles. The primary endpoints were safety and objective response rate (ORR); duration of response, progression-free survival (PFS), and overall survival (OS) were secondary endpoints.Results: Sixty percent of patients showed tumor shrinkage from baseline CTs. On an intention-to-treat basis (N = 50), the ORR was 14% (17% for the 10-mg/kg group); the median response duration, 5.7 months; the clinical benefit rate (CBR ≥4 months), 34%; median PFS, 3.7 months; and median OS, 7.5 months. There was a suggested improvement in PR, CBR, and PFS with sacituzumab govitecan in second-line patients who were sensitive to first-line therapy, but no difference between first-line chemosensitive versus chemoresistant patients in the overall population. There was a statistically significant higher OS in those patients who received prior topotecan versus no topotecan therapy in a small subgroup. Grade ≥3 adverse events included neutropenia (34%), fatigue (13%), diarrhea (9%), and anemia (6%). Trop-2 tumor staining was not required for patient selection. No antibodies to the drug conjugate or its components were detected on serial blood collections.Conclusions: Sacituzumab govitecan appears to have a safe and effective therapeutic profile in heavily pretreated mSCLC patients, including those who are chemosensitive or chemoresistant to first-line chemotherapy. Additional studies as a monotherapy or combination therapy are warranted. Clin Cancer Res; 23(19); 5711-9. ©2017 AACR.
Collapse
Affiliation(s)
- Jhanelle E Gray
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.
| | - Rebecca S Heist
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | | | | | - Ebenezer A Kio
- Indiana University Health Center for Cancer Care, Goshen, Indiana
| | - Gregory A Masters
- Helen F. Graham Cancer Center & Research Institute, Newark, Delaware
| | | | - Michael J Guarino
- Helen F. Graham Cancer Center & Research Institute, Newark, Delaware
| | - Jamal Misleh
- Helen F. Graham Cancer Center & Research Institute, Newark, Delaware
| | | | | | | | - Tirrell Johnson
- University of Florida Health Cancer Center, Orlando, Florida
| | - Leena Gandhi
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Kevin Kalinsky
- Columbia University Medical Center-Herbert Irving Comprehensive Cancer Center, New York, New York
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Cardillo TM, Sharkey RM, Govindan SV, Donnel J, Zalath M, Goldenberg DM. Abstract 4081: Superior SN-38 pharmacodynamic and tumor-accretion profiles of labetuzumab govitecan (IMMU-130) versus irinotecan in experimental human colonic cancer models. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: IMMU-130 is an antibody-drug conjugate (ADC) undergoing clinical investigation in patients with metastatic colorectal cancer (ClinicalTrials.gov, NCT01605318). It is composed of a humanized anti-CEACAM5 IgG conjugated via a cleavable linker to SN-38, a topoisomerase-I inhibitor and active form of irinotecan. We investigated the potential advantage of IMMU-130 versus irinotecan for SN-38 delivery in nude mice bearing CEA-expressing human colonic tumor xenografts (LS174T or GW-39).
METHODS: Mice were injected with irinotecan (~ 900 µg; SN-38 equivalents = ~500 µg) or 1.0 mg of IMMU-130 (16 µg SN-38 equivalents). Irinotecan-treated animals were necropsied 5 min, 1, 2, 6-8 h post-injection, while IMMU-130-treated animals were evaluated at 1, 6, 24, 48-72 h. Serum and homogenates of tumors, liver, and small intestinal contents were extracted, and SN-38, SN-38G, and irinotecan concentrations were determined by reversed-phase HPLC. For IMMU-130-treated specimens, SN-38 concentrations were assessed in the extracted samples (Free SN-38), as well as in acid-hydrolyzed samples to determine Total SN-38 (Free + bound). IgG was measured by ELISA.
RESULTS: Irinotecan cleared quickly from serum, with [SN-38]averaging ~900 ng/mL to 200 ng/mL from 5 min to 6 h. SN-38G and SN-38 levels were similar. With IMMU-130, Free SN-38 was detected in serum over the entire monitoring period, but levels were only a small fraction of the Total SN-38 (~10%). Importantly, Free SN-38G was very low, being detected only within the first 6 h. Total SN-38 levels dropped more quickly than the IgG, confirming in vitro studies showing gradual SN-38 release from the ADC. In tumors, for irinotecan-treated animals, SN-38 peaked at 5 min, representing ≤0.2%/g of the SN-38 equivalent given. In IMMU-130-treated animals, no Free SN-38 was detected in tumors, but levels of Total SN-38 peaked at 6 h, with ~5%/g of the injected SN-38 dose present at that time, and were sustained longer than SN-38 delivered by irinotecan. Area under the curve analysis found SN-38 levels were ~10- and 17-fold higher in LS174T and GW-39 tumors, respectively, from IMMU-130-dosed versus irinotecan-dosed animals. This delivery advantage is amplified > 30-fold when normalized to SN-38 equivalents injected for each product, illustrating the improved bioavailability with IMMU-130-targeted SN-38. Levels of SN-38 and SN-38G were appreciably lower in the liver and small intestinal contents, which likely explains the lower incidence of severe diarrhea reported in patients given IMMU-130.
CONCLUSION: IMMU-130 delivers >300-fold more SN-38 to CEA-producing tumors compared to irinotecan, while also reducing levels of potentially harmful SN-38 and SN-38G in normal tissues. These observations are consistent with preclinical data showing improved efficacy and safety.
Citation Format: Thomas M. Cardillo, Robert M. Sharkey, Serengulam V. Govindan, Jennifer Donnel, Maria Zalath, David M. Goldenberg. Superior SN-38 pharmacodynamic and tumor-accretion profiles of labetuzumab govitecan (IMMU-130) versus irinotecan in experimental human colonic cancer models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4081. doi:10.1158/1538-7445.AM2017-4081
Collapse
|
40
|
Gray JE, Heist RS, Starodub AN, Camidge DR, Kio E, Masters G, Purcell WT, Guarino MJ, Misleh J, Schneider CJ, Schneider BJ, Ocean AJ, Johnson T, Gandhi L, Kalinsky K, Govindan SV, Maliakal P, Mudenda B, Wegener WA, Sharkey RM, Goldenberg DM. Abstract CT155: Phase 2 study of sacituzumab govitecan (IMMU-132), an anti-Trop-2/SN-38 antibody-drug conjugate (ADC), in patients with pretreated metastatic small-cell lung cancer (mSCLC). Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-ct155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Sacituzumab govitecan (IMMU-132) is an antibody-drug conjugate (ADC) delivering SN-38, a topoisomerase-1 inhibitor, to mSCLC cells expressing Trop-2. We are studying the safety/tolerability and efficacy of IMMU-132 in patients with relapsed/refractory mSCLC who had received a platinum-containing first-line regimen.
Experimental Procedure: Patients received 8 or 10 mg/kg IV IMMU-132 on days 1 and 8 of repeated 21-day cycles. Objective tumor response (ORR) was determined by RECISTv1.1 in patients receiving at least one treatment cycle, and progression-free survival (PFS) and overall survival (OS) in all patients by Kaplan-Meier methods. (ClinicalTrials.gov, NCT01631552)
Summary of New Unpublished Data: A total of 53 patients (23/30 M/F, median 63 years old) with 1-7 (median 2) prior lines of therapy were enrolled between November, 2013 and June, 2016. Immunohistochemistry of evaluable archival tumor specimens for Trop-2 expression (N=26) showed 92% positivity (61% moderately to strongly positive). They received up to 32 treatment cycles (median 5); the most frequent Grade >3 adverse events were neutropenia (34%), fatigue (13%) and diarrhea (9%). Four patients did not complete one cycle of treatment. In the other 49 patients (14 at 8 mg/kg, 35 at 10 mg/kg), there were 7 confirmed PRs and 21 SDs as best response. The resulting ORR rate was 14% (7/49), with a median duration and time-to-progression of a response of 4.0 and 7.6 mos, respectively, and the clinical benefit rate (PR+SD >4 mos) was 35% (17/49). The ORR rate was similar in pts who were sensitive (>3 mos response) or resistant (<3 mos) to 1st-line therapy [13% (3/23) vs 15% (4/26), respectively]. In 2nd-line setting, IMMU-132 had a confirmed ORR rate of 14% (3/21), and a clinical benefit rate of 38% (8/21). This compares well to recent results with topotecan having an ORR of 13-16% in 2nd-line. Comparing dose levels, ORR was 17% (6/35) with 10 mg/kg vs 7% (1/14) with 8 mg/kg, with little difference in toxicity. Median PFS and OS in all 53 patients was 3.7 mos (95% CI, 2.0 - 4.3) and 7.0 mos (95% CI, 5.5 - 8.3), respectively, and included 6 long-term survivors (12.7 - 25.4 months). No antibody response to the ADC or antibody was detected despite multiple therapy cycles.
Conclusion: These interim results demonstrate encouraging activity in patients with late-stage mSCLC having a high expression of Trop-2. Even after failing 1st-line platinum chemotherapy or 2nd-line topotecan therapy, IMMU-132 showed promising activity, and has a manageable toxicity profile. IMMU-132 given at 10 mg/kg on day 1 and 8 of a 3-week cycle was selected for further clinical evaluation in this population.
Citation Format: Jhanelle E. Gray, Rebecca S. Heist, Alexander N. Starodub, D. Ross Camidge, Ebenezer Kio, Gregory Masters, W. Thomas Purcell, Michael J. Guarino, Jamal Misleh, Charles J. Schneider, Bryan J. Schneider, Allyson J. Ocean, Tirrell Johnson, Leena Gandhi, Kevin Kalinsky, Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, David M. Goldenberg. Phase 2 study of sacituzumab govitecan (IMMU-132), an anti-Trop-2/SN-38 antibody-drug conjugate (ADC), in patients with pretreated metastatic small-cell lung cancer (mSCLC) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr CT155. doi:10.1158/1538-7445.AM2017-CT155
Collapse
Affiliation(s)
| | - Rebecca S. Heist
- 2Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | | | | | - Ebenezer Kio
- 3Indiana University Health Center for Cancer Care, Goshen, IN
| | - Gregory Masters
- 5Helen F. Graham Cancer Center & Research Institute, Newark, DE
| | | | | | - Jamal Misleh
- 5Helen F. Graham Cancer Center & Research Institute, Newark, DE
| | | | - Bryan J. Schneider
- 6Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY
| | - Allyson J. Ocean
- 6Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY
| | | | - Leena Gandhi
- 2Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Kevin Kalinsky
- 8Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY
| | | | | | | | | | | | | |
Collapse
|
41
|
Sharkey RM, Ocean AJ, Starodub AN, Bardia A, Guarino M, Messersmith WA, Berlin JD, Picozzi VJ, Moroose R, Wegener WA, Maliakal P, Govindan SV, Goldenberg DM. Abstract 3734: Pharmacokinetics of sacituzumab govitecan (IMMU-132), an antibody-drug conjugate (ADC) targeting Trop-2, in patients with diverse advanced solid tumors. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-3734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Sacituzumab govitecan (IMMU-132), an ADC targeting Trop-2, an antigen present in many solid tumors, uses SN-38, a topoisomerase I inhibitor that has nanomolar potency derived from irinotecan (IRI), and a pH sensitive linker that releases SN-38 gradually (in vitro, 50% released per 1 day in serum). Clinical studies in patients (pts) with diverse solid tumors have shown manageable toxicity (dose-limiting neutropenia, diarrhea but lower incidence than IRI) and encouraging efficacy.
METHODS: Conjugate and IgG were monitored in pts given 8 (N = 24) or 10 mg/kg (N = 29) by ELISA. SN-38 and glucuronidated SN-38 (SN-38G) were measured by reversed-phase HPLC. SN-38 and SN-38G levels are expressed as the amount of drug dissociated from the conjugate (i.e., Free SN-38) and the amount bound to the IgG (Total SN-38). UGT1A1 status was determined in baseline blood sample from 146 pts.
RESULTS: IMMU-132 cleared with a half-life of 11.7-18.9 h, depending on the assay, while the IgG half-life was 4-5 days, which agrees with in vitro drug-release data. Levels of Free SN-38 at 30 min or 1 d after injection were <2% and ~ 5% of Total SN-38, respectively, indicating most SN-38 in serum is bound to the conjugate. Free SN-38 clears with a half-life of ~20 h, which is consistent with SN-38 clearance in IRI therapy. No correlation was found between Free SN-38 in serum at 30 min and the incidence of severe neutropenia. Total and Free levels of SN-38G were similar, supporting in vitro results indicating that SN-38 is not glucuronidated while bound to the IgG. Free SN-38G levels were lower than Free SN-38 (SN-38G/SN-38 AUC ratio = 0.52), explaining the lower incidence of severe diarrhea. PK parameters for 8 and 10 mg/kg group were similar; no major differences in toxicity. UGT1A1 status showed 43% and 44% with *1*1 and *1*28 haplotype, respectively, and 13% with *28*28 haplotype, which is associated with higher risk of severe neutropenia and diarrhea for IRI therapy. With IMMU-132, 58% of the *28*28 pts had severe neutropenia compared to ~40% of the *1*1 and *1*28 pts, and 16% of the *28*28 pts had grade 3 diarrhea compared to 5-8% of the *1*1 and *1*28. In 3 of 4 cancer indications, objective response rate and clinical benefit ratio favored the 10 mg/kg group.
CONCLUSION: IMMU-132 cleared as predicted from in vitro serum stability data, with no difference between the 8 and 10 mg/kg groups. Current data show neutropenia did not correlate with Free SN-38 levels in serum at 30 min, and low SN-38G levels support the lower incidence of severe diarrhea. While pts with the *28*28 haplotype had a somewhat higher incidence of severe neutropenia or diarrhea than *1*1 and *1*28 pts, the overall incidence of each is small, suggesting toxicity management rather than screening is appropriate. With no major difference in safety and PK, but improved responses with 10 mg/kg, 10 mg/kg is selected for future clinical studies.
Citation Format: Robert M. Sharkey, Allyson J. Ocean, Alexander N. Starodub, Aditya Bardia, Michael Guarino, Wells A. Messersmith, Jordan D. Berlin, Vincent J. Picozzi, Rebecca Moroose, William A. Wegener, Pius Maliakal, Serengulam V. Govindan, David M. Goldenberg. Pharmacokinetics of sacituzumab govitecan (IMMU-132), an antibody-drug conjugate (ADC) targeting Trop-2, in patients with diverse advanced solid tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3734. doi:10.1158/1538-7445.AM2017-3734
Collapse
Affiliation(s)
| | | | | | - Aditya Bardia
- 4Massachusetts General Hospital Cancer Center, Boston, MA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Cardillo TM, Mostafa AA, Rossi DL, Liu D, Chang CH, Sharkey RM, Goldenberg DM. Abstract 3193: Treatment of high Trop-2-expressing triple-negative breast cancer (TNBC) with sacituzumab govitecan (IMMU-132) overcomes homologous recombination repair (HRR) rescue mediated by Rad51. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-3193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: IMMU-132 is an antibody-drug conjugate composed of a humanized anti-Trop-2 IgG conjugated via a cleavable linker to SN-38, a topoisomerase I inhibitor and active component of irinotecan. It is currently under clinical investigation in a range of solid tumors (NCT01631552). We investigated the hypothesis that IMMU-132, through its targeting of Trop-2 in solid tumors, will be superior to irinotecan in overcoming Rad51-mediated HRR repair of DNA breaks in TNBC tumors with high Trop-2 expression.
Methods: Rad51 and DNA-breaks (γ-H2A.X) were determined by Western blot. Cells with different Trop-2 levels were exposed to IMMU-132 for 24 h (25 - 100 nM SN-38 equivalents), including squamous cell lung carcinoma (SK-MES-1; ~30,000 Trop-2/cell) and TNBC (HCC1806, ~90,000 Trop-2/cell and MDA-MB-231, ~30,000 Trop-2/cell). Also, two Trop-2-transfectants of MDA-MB-231, designated C13 and C39 (4- and 25-fold higher Trop-2 levels, respectively), were likewise exposed to IMMU-132. Mice bearing MDA-MB-231, C13, or C39 tumors were treated with irinotecan (MTD, 40 mg/kg; q2dx5) or IMMU-132 (0.5 mg; 9 μg SN-38 equivalent, twice wkly x 4). Tumors were measured and mice weighed twice weekly. Study survival endpoint was tumor progression to >1.0 cm3.
Results: SK-MES-1 and HCC1806 are sensitive to IMMU-132 therapy whereas MDA-MB-231 is resistant. IMMU-132 mediated a >2-fold increase in Rad51 levels in MDA-MB-231 cells, but had no effect in SK-MES-1 or HCC1806. At 25 nM IMMU-132, there were lower levels of DNA breaks detected in MDA-MB-231 relative to SK-MES-1 and HCC1806 (2-fold increase in MDA-MB-231 vs. >3-fold). At higher concentrations of IMMU-132 (100 nM), all 3 cell lines demonstrated similar levels of DNA breaks (~5-fold above background), suggesting that higher levels of SN-38 can overcome Rad51-mediated repair. Both the C13 and C39 clones had a similar response as parental MDA-MB-231 upon IMMU-132 exposure. Mice bearing MDA-MB-231, C13, or C39 tumors treated with irinotecan demonstrated significant improvements in median survival times (MST) compared to saline (P<0.0009). As expected, IMMU-132 was no different than saline in mice bearing MDA-MB-231 tumors (MST=21d and 19.5d, respectively). However, in mice bearing high Trop-2 C13 and C39 tumors, IMMU-132 provided a significant survival benefit compared to irinotecan-treated mice (MST>70d vs. 35d, respectively for C13 and >70d vs. 28d for C39; P<0.0007), supporting the hypothesis that IMMU-132 is able to deliver more SN-38 to tumors with high Trop-2 than can be achieved by irinotecan, and can thus overcome Rad51-mediated HRR.
Conclusion: IMMU-132, with its unique SN-38-delivery platform, has the potential to provide clinical benefit both to chemo-sensitive solid tumors with low Trop-2 expression, as well as to chemo-resistant tumors with high Trop-2 expression.
Citation Format: Thomas M. Cardillo, Ali A. Mostafa, Diane L. Rossi, Donglin Liu, Chien-Hsing Chang, Robert M. Sharkey, David M. Goldenberg. Treatment of high Trop-2-expressing triple-negative breast cancer (TNBC) with sacituzumab govitecan (IMMU-132) overcomes homologous recombination repair (HRR) rescue mediated by Rad51 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3193. doi:10.1158/1538-7445.AM2017-3193
Collapse
|
43
|
Bardia A, Mayer IA, Diamond JR, Moroose RL, Isakoff SJ, Starodub AN, Shah NC, O’Shaughnessy J, Kalinsky K, Guarino M, Abramson V, Juric D, Tolaney SM, Berlin J, Messersmith WA, Ocean AJ, Wegener WA, Maliakal P, Sharkey RM, Govindan SV, Goldenberg DM, Vahdat LT. Efficacy and Safety of Anti-Trop-2 Antibody Drug Conjugate Sacituzumab Govitecan (IMMU-132) in Heavily Pretreated Patients With Metastatic Triple-Negative Breast Cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2016.70.8297.2017.2.test] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Aditya Bardia
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Ingrid A. Mayer
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Jennifer R. Diamond
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Rebecca L. Moroose
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Steven J. Isakoff
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Alexander N. Starodub
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Nikita C. Shah
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Joyce O’Shaughnessy
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Kevin Kalinsky
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Michael Guarino
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Vandana Abramson
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Dejan Juric
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Sara M. Tolaney
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Jordan Berlin
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Wells A. Messersmith
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Allyson J. Ocean
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - William A. Wegener
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Pius Maliakal
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Robert M. Sharkey
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Serengulam V. Govindan
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - David M. Goldenberg
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| | - Linda T. Vahdat
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida
| |
Collapse
|
44
|
Ocean AJ, Starodub AN, Bardia A, Vahdat LT, Isakoff SJ, Guarino M, Messersmith WA, Picozzi VJ, Mayer IA, Wegener WA, Maliakal P, Govindan SV, Sharkey RM, Goldenberg DM. Sacituzumab govitecan (IMMU-132), an anti-Trop-2-SN-38 antibody-drug conjugate for the treatment of diverse epithelial cancers: Safety and pharmacokinetics. Cancer 2017; 123:3843-3854. [DOI: 10.1002/cncr.30789] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/29/2017] [Accepted: 04/19/2017] [Indexed: 12/27/2022]
Affiliation(s)
| | | | - Aditya Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School; Boston Massachusetts
| | | | - Steven J. Isakoff
- Massachusetts General Hospital Cancer Center, Harvard Medical School; Boston Massachusetts
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Heist RS, Guarino MJ, Masters G, Purcell WT, Starodub AN, Horn L, Scheff RJ, Bardia A, Messersmith WA, Berlin J, Ocean AJ, Govindan SV, Maliakal P, Mudenda B, Wegener WA, Sharkey RM, Goldenberg DM, Camidge DR. Therapy of Advanced Non-Small-Cell Lung Cancer With an SN-38-Anti-Trop-2 Drug Conjugate, Sacituzumab Govitecan. J Clin Oncol 2017; 35:2790-2797. [PMID: 28548889 DOI: 10.1200/jco.2016.72.1894] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose Trop-2, expressed in most solid cancers, may be a target for antibody-drug conjugates (ADCs) in non-small-cell lung cancer (NSCLC). We studied sacituzumab govitecan (IMMU-132), a Trop-2 ADC, for the targeting of SN-38. Patients and Methods We evaluated IMMU-132 in a single-arm multicenter trial in patients with pretreated metastatic NSCLC who received either 8 or 10 mg/kg on days 1 and 8 of 21-day cycles. The primary end points were safety and objective response rate (ORR). Progression-free survival and overall survival were secondary end points. Results Fifty-four patients were treated. In the response-assessable study population (n = 47), which had a median of three prior therapies (range, two to seven), the ORR was 19%; median response duration, 6.0 months (95% CI, 4.8 to 8.3 months); and clinical benefit rate (complete response + partial response + stable disease ≥ 4 months), 43%. ORR in the intention-to-treat (ITT) population was 17% (nine of 54). Responses occurred with a median onset of 3.8 months, including patients who had relapsed or progressed after immune checkpoint inhibitor therapy. Median ITT progression-free survival was 5.2 months (95% CI, 3.2 to 7.1 months) and median ITT overall survival, 9.5 months (95% CI, 5.9 to 16.7 months). Grade 3 or higher adverse events included neutropenia (28%), diarrhea (7%), nausea (7%), fatigue (6%), and febrile neutropenia (4%). One patient developed a transient immune response, despite patients receiving a median of 10 doses. More than 90% of 26 assessable archival tumor specimens were highly positive (2+, 3+) for Trop-2 by immunohistochemistry, which suggests that Trop-2 is not a predictive biomarker for response. Conclusion IMMU-132 was well-tolerated and induced durable responses in heavily pretreated patients with metastatic NSCLC. This ADC should be studied further in this disease and in other patients with Trop-2-expressing tumors.
Collapse
Affiliation(s)
- Rebecca Suk Heist
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Michael J Guarino
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Gregory Masters
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - W Thomas Purcell
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Alexander N Starodub
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Leora Horn
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Ronald J Scheff
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Aditya Bardia
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Wells A Messersmith
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Jordan Berlin
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Allyson J Ocean
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Serengulam V Govindan
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Pius Maliakal
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Boyd Mudenda
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - William A Wegener
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Robert M Sharkey
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - David M Goldenberg
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - D Ross Camidge
- Rebecca Suk Heist and Aditya Bardia, Massachusetts General Hospital Cancer Center; Rebecca Suk Heist and Aditya Bardia, Harvard Medical School, Boston, MA; Michael J. Guarino and Gregory Masters, Helen F. Graham Cancer Center & Research Institute, Newark, DE; W. Thomas Purcell, Wells A. Messersmith, and D. Ross Camidge, University of Colorado Cancer Center, Aurora, CO; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Leora Horn and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Ronald J. Scheff and Allyson J. Ocean, Weill Cornell Medicine, New York, NY; and Serengulam V. Govindan, Pius Maliakal, Boyd Mudenda, William A. Wegener, Robert M. Sharkey, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| |
Collapse
|
46
|
Bardia A, Mayer IA, Diamond JR, Moroose RL, Isakoff SJ, Starodub AN, Shah NC, O'Shaughnessy J, Kalinsky K, Guarino M, Abramson V, Juric D, Tolaney SM, Berlin J, Messersmith WA, Ocean AJ, Wegener WA, Maliakal P, Sharkey RM, Govindan SV, Goldenberg DM, Vahdat LT. Efficacy and Safety of Anti-Trop-2 Antibody Drug Conjugate Sacituzumab Govitecan (IMMU-132) in Heavily Pretreated Patients With Metastatic Triple-Negative Breast Cancer. J Clin Oncol 2017; 35:2141-2148. [PMID: 28291390 DOI: 10.1200/jco.2016.70.8297] [Citation(s) in RCA: 247] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose Trop-2, expressed in most triple-negative breast cancers (TNBCs), may be a potential target for antibody-drug conjugates. Sacituzumab govitecan, an antibody-drug conjugate, targets Trop-2 for the selective delivery of SN-38, the active metabolite of irinotecan. Patients and Methods We evaluated sacituzumab govitecan in a single-arm, multicenter trial in patients with relapsed/refractory metastatic TNBC who received a 10 mg/kg starting dose on days 1 and 8 of 21-day repeated cycles. The primary end points were safety and objective response rate; secondary end points were progression-free survival and overall survival. Results In 69 patients who received a median of five prior therapies (range, one to 12) since diagnosis, the confirmed objective response rate was 30% (partial response, n = 19; complete response, n = 2), the median response duration was 8.9 (95% CI, 6.1 to 11.3) months, and the clinical benefit rate (complete response + partial response + stable disease ≥ 6 months) was 46%. These responses occurred early, with a median onset of 1.9 months. Median progression-free survival was 6.0 (95% CI, 5.0 to 7.3) months, and median overall survival was 16.6 (95% CI, 11.1 to 20.6) months. Grade ≥ 3 adverse events included neutropenia (39%), leukopenia (16%), anemia (14%), and diarrhea (13%); the incidence of febrile neutropenia was 7%. The majority of archival tumor specimens (88%) were moderately to strongly positive for Trop-2 by immunohistochemistry. No neutralizing antibodies to the ADC or antibody were detected, despite repeated cycles developed. Conclusion Sacituzumab govitecan was well tolerated and induced early and durable responses in heavily pretreated patients with metastatic TNBC. As a therapeutic target and predictive biomarker, Trop-2 warrants further research.
Collapse
Affiliation(s)
- Aditya Bardia
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Ingrid A Mayer
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Jennifer R Diamond
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Rebecca L Moroose
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Steven J Isakoff
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Alexander N Starodub
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Nikita C Shah
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Joyce O'Shaughnessy
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Kevin Kalinsky
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Michael Guarino
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Vandana Abramson
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Dejan Juric
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Sara M Tolaney
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Jordan Berlin
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Wells A Messersmith
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Allyson J Ocean
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - William A Wegener
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Pius Maliakal
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Robert M Sharkey
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Serengulam V Govindan
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - David M Goldenberg
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| | - Linda T Vahdat
- Aditya Bardia, Steven J. Isakoff, and Dejan Juric, Massachusetts General Hospital Cancer Center; Aditya Bardia, Steven J. Isakoff, Dejan Juric, and Sara M. Tolaney, Harvard Medical School; Sara M. Tolaney, Dana-Farber Cancer Institute, Boston, MA; Ingrid A. Mayer, Vandana Abramson, and Jordan Berlin, Vanderbilt-Ingram Cancer Center, Nashville, TN; Jennifer R. Diamond and Wells A. Messersmith, University of Colorado Cancer Center, Aurora, CO; Rebecca L. Moroose and Nikita C. Shah, University of Florida Health Cancer Center, Orlando, FL; Alexander N. Starodub, Indiana University Health Center for Cancer Care, Goshen, IN; Joyce O'Shaughnessy, Texas Oncology-Baylor Charles A. Sammons Cancer Center; Joyce O'Shaughnessy, US Oncology, Dallas, TX; Kevin Kalinsky, Columbia University Herbert Irving Comprehensive Cancer Center; Allyson J. Ocean and Linda T. Vahdat, Weill Cornell Medicine, New York, NY; Michael Guarino, Helen F. Graham Cancer Center, Newark, DE; William A. Wegener, Pius Maliakal, Robert M. Sharkey, Serengulam V. Govindan, and David M. Goldenberg, Immunomedics, Morris Plains, NJ
| |
Collapse
|
47
|
Chang CH, Wang Y, Rossi DL, Li R, Rossi EA, Cardillo TM, Goldenberg DM. Combining PD-1 blockade with T-cell redirecting bispecific antibodies for solid cancer therapy. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.7_suppl.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
98 Background: Bispecific antibodies (bsAbs) for redirecting T cells to cancers have shown promise in both preclinical and clinical studies. However, clinical results have been disappointing in solid cancers. We have applied the DOCK-AND-LOCK method to generate a novel class of trivalent bsAbs, each comprising an anti-CD3 scFv covalently conjugated to a stabilized dimer of different anti-tumor Fabs. Herein we report the characterization of two such constructs, (E1)-3s and (14)-3s, which activate T cells and target Trop-2- and CEACAM5-expressing cancer cells, respectively. Methods: Human breast and colonic cancer cell lines were grown in monolayer cultures or as 3D spheroids for in vitro evaluation. NOD/SCID mice carrying xenografts of MDA-MB-231 (a TNBC line constitutively expressing Trop-2 and PD-L1) were used for in vivo studies. A human PD-1 antagonistic murine hybridoma antibody was subsequently converted to its chimeric form (IMMU-cPD-1). Human PBMCs, or T cells isolated from buffy coats by negative selection, were used as effector cells in cytotoxicity assays. The effect of IMMU-cPD-1 on cancer cells pretreated with IFN-γ to induce the expression of PD-L1 was compared with those not pretreated. Results: (E1)-3s and (14)-3s, in the presence of human T cells, killed target cells grown as monolayers at low picomolar concentrations, with similar potency observed for drug-resistant cells. The antitumor efficacy was demonstrated for (E1)-3s plus human PBMCs in NOD/SCID mice bearing MDA-MB-231, and for human PBMCs combined with (E1)-3s or (14)-3s in 3D spheroids generated from target cell lines to mimic the in vivo behavior and microenvironment of these tumors. Moreover, with the addition of IMMU-cPD-1, the benefit of PD-1 blockade was indicated by increased cell death in 3D spheroids and longer survival of MDA-MB-231-bearing mice. Conclusions: These results highlight the potency of (E1)-3s and (14)-3s as T-cell redirecting bsAbs, emphasize the potential of combining such bsAbs with immune checkpoint inhibitors to improve the therapeutic activity in the immunotherapy of solid cancers, and provide a basis for using 3D spheroids as an alternative to in vivo models for evaluating T-cell functions.
Collapse
Affiliation(s)
| | - Yang Wang
- Immunomedics, Inc., Morris Plains, NJ
| | | | | | | | | | | |
Collapse
|
48
|
Heskamp S, Hernandez R, Molkenboer-Kuenen JDM, Essler M, Bruchertseifer F, Morgenstern A, Steenbergen EJ, Cai W, Seidl C, McBride WJ, Goldenberg DM, Boerman OC. α- Versus β-Emitting Radionuclides for Pretargeted Radioimmunotherapy of Carcinoembryonic Antigen-Expressing Human Colon Cancer Xenografts. J Nucl Med 2017; 58:926-933. [PMID: 28232604 DOI: 10.2967/jnumed.116.187021] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 11/14/2016] [Accepted: 01/31/2017] [Indexed: 02/06/2023] Open
Abstract
Pretargeted radioimmunotherapy (PRIT) with the β-emitting radionuclide 177Lu is an attractive approach to treat carcinoembryonic antigen (CEA)-expressing tumors. The therapeutic efficacy of PRIT might be improved using α-emitting radionuclides such as 213Bi. Herein, we report and compare the tumor-targeting properties and therapeutic efficacy of 213Bi and 177Lu for PRIT of CEA-expressing xenografts, using the bispecific monoclonal antibody TF2 (anti-CEA × anti-histamine-succinyl-glycine [HSG]) and the di-HSG-DOTA peptide IMP288. Methods: The in vitro binding characteristics of 213Bi-IMP288 were compared with those of 177Lu-IMP288. Tumor targeting of 213Bi-IMP288 and 177Lu-IMP288 was studied in mice bearing subcutaneous LS174T tumors that were pretargeted with TF2. Finally, the effect of 213Bi-IMP288 (6, 12, or 17 MBq) and 177Lu-IMP288 (60 MBq) on tumor growth and survival was assessed. Toxicity was determined by monitoring body weight, analyzing blood samples for hematologic and renal toxicity (hemoglobin, leukocytes, platelets, creatinine), and immunohistochemical analysis of the kidneys. Results: The in vitro binding characteristics of 213Bi-IMP288 (dissociation constant, 0.45 ± 0.20 nM) to TF2-pretargeted LS174T cells were similar to those of 177Lu-IMP288 (dissociation constant, 0.53 ± 0.12 nM). In vivo accumulation of 213Bi-IMP288 in LS174T tumors was observed as early as 15 min after injection (9.2 ± 2.0 percentage injected dose [%ID]/g). 213Bi-IMP288 cleared rapidly from the circulation; at 30 min after injection, the blood levels were 0.44 ± 0.28 %ID/g. Uptake in normal tissues was low, except for the kidneys, where uptake was 1.8 ± 1.1 %ID/g at 30 min after injection. The biodistribution of 213Bi-IMP288 was comparable to that of 177Lu-IMP288. Mice treated with a single dose of 213Bi-IMP288 or 177Lu-IMP288 showed significant inhibition of tumor growth. Median survival for the groups treated with phosphate-buffered saline, 6 MBq 213Bi-IMP288, 12 MBq 213Bi-IMP288, and 60 MBq 177Lu-IMP288 was 22, 31, 45, and 42 d, respectively. Mice receiving 17 MBq 213Bi-IMP288 showed significant weight loss, resulting in a median survival of only 24 d. No changes in hemoglobin, platelets, or leukocytes were observed in the treatment groups. However, immunohistochemical analysis of the kidneys of mice treated with 17 or 12 MBq 213Bi-IMP288 showed signs of tubular damage, indicating nephrotoxicity. Conclusion: To our knowledge, this study shows for the first time that PRIT with TF2 and 213Bi-IMP288 is feasible and at least as effective as 177Lu-IMP288. However, at higher doses, kidney toxicity was observed. Future studies are warranted to determine the optimal dosing schedule to improve therapeutic efficacy while reducing renal toxicity.
Collapse
Affiliation(s)
- Sandra Heskamp
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Reinier Hernandez
- Medical Physics Department, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Markus Essler
- Klinik und Poliklinik fur Nuklearmedizin, University of Bonn, Bonn, Germany
| | - Frank Bruchertseifer
- European Commission, Joint Research Centre-Directorate for Nuclear Safety and Security, Karlsruhe, Germany
| | - Alfred Morgenstern
- European Commission, Joint Research Centre-Directorate for Nuclear Safety and Security, Karlsruhe, Germany
| | - Erik J Steenbergen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Weibo Cai
- Medical Physics Department, University of Wisconsin-Madison, Madison, Wisconsin
| | - Christof Seidl
- Department of Nuclear Medicine, Technische Universität München, Munich, Germany.,Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany; and
| | | | | | - Otto C Boerman
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
49
|
Tagawa ST, Ocean AJ, Lam ET, Saylor PJ, Bardia A, Hajdenberg J, Morgans AK, Kalinsky K, Galsky M, Faltas B, Molina AM, Lim EA, Maliakal P, Sharkey RM, Mudenda B, Wegener WA, Goldenberg DM. Therapy for chemopretreated metastatic urothelial cancer (mUC) with the antibody-drug conjugate (ADC) sacituzumab govitecan (IMMU-132). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.6_suppl.327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
327 Background: Patients (pts) with mUC pre-treated with platinum-containing chemotherapy have limited therapeutic options, with checkpoint-inhibitor immunotherapy (IO) responses in a minority of pts. We present an interim update of the safety and activity of sacituzumab govitecan (IMMU-132), an anti-Trop-2-SN-38 ADC, as therapy for chemotherapy-pretreated mUC pts (ClinicalTrials.gov, NCT01631552). Methods: We enrolled 32 pts with mUC and ECOG PS 0-1 who failed ≥ 1 prior standard therapy (median=3; range, 1-5). IMMU-132 was administered at 8 or 10 mg/kg on days 1 and 8 every 21 days, continued until disease progression (PD) or unacceptable toxicity. Response-evaluable pts received ≥ 2 doses, and had ≥ 1 post-baseline response assessment. Results: Twenty-five pts [median age 68 yrs (range: 50-91), 24 males] are currently assessable for safety and response; 23 had prior platinum-containing therapy; 46% had >2 prior therapies; 4 also had IO agents. Sites of metastases included liver (N=4; 16%), lungs (N=7; 28%), bone (N=4; 16%), and lymph nodes (N=16; 64%). Pts received a median of 7 cycles (range, 2-23) of IMMU-132. ORR was 36% (9/25) [1 complete (CR) and 8 partial responses (PR)]; 44% (11/25) had stable disease (SD). Further, pts with 1 line of prior chemotherapy had an ORR of 53.8% (7/13), and 16.7% for those with 2 to 5 prior therapy lines. Median PFS for all patients is 7.2 mos (95% CI, 4.9-10.7); median survival is not reached yet. Of the 4 pts with progression after prior IO, there were 1 PR and 2 SDs with IMMU-132. Duration of response for CR/PR pts is currently 5.1 mos (95% CI, 4.1-12.9) and 10/11 pts (5 with ≥ 20% tumor reduction) had stable disease > 4 mos. Grade 4 neutropenia (16%) lasted < 7 days, and non-hematological grade 3 AEs included fatigue (12%) and hypophosphatemia (8%). No treatment-related deaths were observed. Analysis of Trop-2 expression revealed 1+ to 3+ positive staining in 95% of 19 archival patient specimens. Conclusions: With an ORR of 36% and a median PFS of 7.2 months in a heavily pretreated population, these interim results suggest that IMMU-132 is a promising agent as 2nd line or later therapy for platinum- or IO- pretreated mUC pts. Clinical trial information: NCT01631552.
Collapse
Affiliation(s)
| | | | | | | | - Aditya Bardia
- Massachusetts General Hospital Cancer Center, Boston, MA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Bardia A, Diamond JR, Mayer IA, Isakoff SJ, Abramson V, Starodub AN, O'Shaughnessy J, Kalinsky K, Moroose R, Shah N, Juric D, Shapiro GI, Guarino M, Ocean AJ, Messersmith WA, Berlin JD, Wegener WA, Sharkey RM, Goldenberg DM, Vahdat LT. Abstract P4-22-15: Sacituzumab govitecan (IMMU-132), an anti-Trop-2-SN-38 antibody-drug conjugate (ADC) for the treatment of relapsed/refractory, metastatic triple-negative breast cancer (mTNBC): Updated results. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-22-15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. mTNBC has an aggressive course with limited effective therapy options and a median progression-free survival (PFS) of 2-4 months (mos) with standard therapy. Sacituzumab govitecan (IMMU-132) is an ADC targeting Trop-2, an antigen present in many epithelial cancers, including TNBC, and delivering SN-38, a topoisomerase I inhibitor as its therapeutic moiety. IMMU-132 was awarded Breakthrough Therapy designation by FDA based on its previously reported activity in relapsed/refractory mTNBC patients. Here we present updated results from the mTNBC cohort of an ongoing phase I/II study (ClinicalTrials.gov, NCT01631552).
Methods. mTNBC patients (pts) received IMMU-132 10 mg/kg on days 1 and 8 every 21 days. Trop-2 expression was not required for enrollment, but available tumor specimens underwent immunohistological (IHC) testing. Efficacy was assessed locally by RECIST 1.1; ORR, PFS and overall survival (OS) were determined for all pts. Pharmacokinetic parameters were estimated in select pts with adequate blood sampling. Immunogenicity to IMMU-132 was examined in all pts.
Results. We previously reported preliminary efficacy results in 51 mTNBC patients. Here we present data on 69 patients with data cutoff June 5, 2016. Median age was 56 years (31-81) and a median of 5 prior therapies (range 1-12), with 66 evaluable for response; ORR was 29% (19/66) 2 confirmed complete (CR) and 17 confirmed partial responses (PR). The median intention-to-treat PFS is 5.6 mos (95% CI, 3.6-7.1 mos) and median OS is 14.3 mos (95% CI, 10.5-18.8 mos). PRs included 2 pts whose tumors did not respond to anti-PD-L1 therapy. The duration of response in the 19 confirmed responders (8 continuing therapy) is 11.5 mos (95% CI = 7.6 to 12.7). The clinical benefit rate (CR+PR+SD>6 mos) for the 66 assessable patients is currently 45.5%. The majority (88%) of archival tumor specimens were moderately (2+) to strongly (3+) positive by IHC for Trop-2, precluding using Trop-2 expression as a selection criterion. Among current adverse events, grade >3 drug-related toxicities included neutropenia (35%), leukopenia (16%), anemia (13%), vomiting (9%), diarrhea (10%), and febrile neutropenia (4%). Clearance kinetics in 8 pts showed IMMU-132 and IgG had a terminal half-life of 15.3 ± 2.7 h and 86.5 ± 40.5 h, respectively, with area under the curve for free SN-38 (unbound) only 3% of the total amount of SN-38 (e.g., IgG bound). Thus, most SN-38 remains bound to the conjugate, and is released at a rate predicted from in vitro serum stability studies. No pt developed anti-IMMU-132 antibodies.
Conclusion The Trop-2-targeting ADC, IMMU-132, delivering cytotoxic doses of SN-38, shows high objective and durable tumor responses with manageable toxicity in heavily-pretreated pts with mTNBC in this updated cohort, supporting further development in this population with an unmet medical need.
Citation Format: Bardia A, Diamond JR, Mayer IA, Isakoff SJ, Abramson V, Starodub AN, O'Shaughnessy J, Kalinsky K, Moroose R, Shah N, Juric D, Shapiro GI, Guarino M, Ocean AJ, Messersmith WA, Berlin JD, Wegener WA, Sharkey RM, Goldenberg DM, Vahdat LT. Sacituzumab govitecan (IMMU-132), an anti-Trop-2-SN-38 antibody-drug conjugate (ADC) for the treatment of relapsed/refractory, metastatic triple-negative breast cancer (mTNBC): Updated results [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-22-15.
Collapse
Affiliation(s)
- A Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - JR Diamond
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - IA Mayer
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - SJ Isakoff
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - V Abramson
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - AN Starodub
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - J O'Shaughnessy
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - K Kalinsky
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - R Moroose
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - N Shah
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - D Juric
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - GI Shapiro
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - M Guarino
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - AJ Ocean
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - WA Messersmith
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - JD Berlin
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - WA Wegener
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - RM Sharkey
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - DM Goldenberg
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| | - LT Vahdat
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; University of Colorado Cancer Center, Aurora, CO; Vanderbilt-Ingram Cancer Center, Nashville, TN; Indiana University Health Center for Cancer Care, Goshen, IN; Texas Oncology Sammons Cancer Center, Dallas, TX; Columbia University-Herbert Irving Comprehensive Cancer Center, New York, NY; University of Florida Health Cancer Center, Orlando, FL; The Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Helen F Graham Cancer Center, Newark, DE; Weill Cornell Medicine, New York, NY; Immunomedics, Inc., Morris Plains, NJ
| |
Collapse
|