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Wen PY, Stein A, van den Bent M, De Greve J, Wick A, de Vos FYFL, von Bubnoff N, van Linde ME, Lai A, Prager GW, Campone M, Fasolo A, Lopez-Martin JA, Kim TM, Mason WP, Hofheinz RD, Blay JY, Cho DC, Gazzah A, Pouessel D, Yachnin J, Boran A, Burgess P, Ilankumaran P, Gasal E, Subbiah V. Dabrafenib plus trametinib in patients with BRAF V600E-mutant low-grade and high-grade glioma (ROAR): a multicentre, open-label, single-arm, phase 2, basket trial. Lancet Oncol 2021; 23:53-64. [PMID: 34838156 DOI: 10.1016/s1470-2045(21)00578-7] [Citation(s) in RCA: 146] [Impact Index Per Article: 48.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/23/2021] [Accepted: 09/29/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Effective treatments are needed to improve outcomes for high-grade glioma and low-grade glioma. The activity and safety of dabrafenib plus trametinib were evaluated in adult patients with recurrent or progressive BRAFV600E mutation-positive high-grade glioma and low-grade glioma. METHODS This study is part of an ongoing open-label, single-arm, phase 2 Rare Oncology Agnostic Research (ROAR) basket trial at 27 community and academic cancer centres in 13 countries (Austria, Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Norway, South Korea, Spain, Sweden, and the USA). The study enrolled patients aged 18 years or older with an Eastern Cooperative Oncology Group performance status of 0, 1, or 2. Patients with BRAFV600E mutation-positive high-grade glioma and low-grade glioma received dabrafenib 150 mg twice daily plus trametinib 2 mg once daily orally until unacceptable toxicity, disease progression, or death. In the high-grade glioma cohort, patients were required to have measurable disease at baseline using the Response Assessment in Neuro-Oncology high-grade glioma response criteria and have been treated previously with radiotherapy and first-line chemotherapy or concurrent chemoradiotherapy. Patients with low-grade glioma were required to have measurable non-enhancing disease (except pilocytic astrocytoma) at baseline using the Response Assessment in Neuro-Oncology low-grade glioma criteria. The primary endpoint, in the evaluable intention-to-treat population, was investigator-assessed objective response rate (complete response plus partial response for high-grade glioma and complete response plus partial response plus minor response for low-grade glioma). This trial is ongoing, but is closed for enrolment, NCT02034110. FINDINGS Between April 17, 2014, and July 25, 2018, 45 patients (31 with glioblastoma) were enrolled into the high-grade glioma cohort and 13 patients were enrolled into the low-grade glioma cohort. The results presented here are based on interim analysis 16 (data cutoff Sept 14, 2020). In the high-grade glioma cohort, median follow-up was 12·7 months (IQR 5·4-32·3) and 15 (33%; 95% CI 20-49) of 45 patients had an objective response by investigator assessment, including three complete responses and 12 partial responses. In the low-grade glioma cohort, median follow-up was 32·2 months (IQR 25·1-47·8). Nine (69%; 95% CI 39-91) of 13 patients had an objective response by investigator assessment, including one complete response, six partial responses, and two minor responses. Grade 3 or worse adverse events were reported in 31 (53%) patients, the most common being fatigue (five [9%]), decreased neutrophil count (five [9%]), headache (three [5%]), and neutropenia (three [5%]). INTERPRETATION Dabrafenib plus trametinib showed clinically meaningful activity in patients with BRAFV600E mutation-positive recurrent or refractory high-grade glioma and low-grade glioma, with a safety profile consistent with that in other indications. BRAFV600E testing could potentially be adopted in clinical practice for patients with glioma. FUNDING Novartis.
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Affiliation(s)
- Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
| | - Alexander Stein
- Department of Internal Medicine II (Oncology Center), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin van den Bent
- Brain Tumor Center and Department of Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jacques De Greve
- University Hospital Vrije Universiteit Brussel, Brussels, Belgium
| | - Antje Wick
- Department of Neurology, University of Heidelberg, National Center for Tumor Diseases, Heidelberg, Germany
| | - Filip Y F L de Vos
- Department of Medical Oncology, University Medical Center Utrecht, University Utrecht, Utrecht, Netherlands
| | - Nikolas von Bubnoff
- University Medical Center Freiburg, Freiburg, Germany; Department of Hematology and Oncology, Medical Center, University of Schleswig-Holstein, Lübeck, Germany
| | - Myra E van Linde
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Albert Lai
- Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Gerald W Prager
- Department of Medicine I, AKH Wien, Medical University of Vienna, Vienna, Austria
| | - Mario Campone
- Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Angelica Fasolo
- Department of Medical Oncology, Ospedale San Raffaele IRCCS, Milan, Italy
| | | | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Warren P Mason
- University Health Network, University of Toronto, Toronto, ON, Canada
| | | | - Jean-Yves Blay
- Center Leon Berard & University Claude Bernard Lyon I, Lyon, France
| | - Daniel C Cho
- New York Medical College, Valhalla, New York, NY, USA
| | - Anas Gazzah
- Gustave Roussy Cancer Institute, Villejuif, France
| | - Damien Pouessel
- Department of Medical Oncology & Clinical Research Unit, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Jeffrey Yachnin
- Karolinska University Hospital, Theme Cancer, Center for Clinical Cancer Studies, Solna, Sweden
| | - Aislyn Boran
- Global Drug Development, Oncology Development Unit, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Paul Burgess
- Global Drug Development, Oncology Development Unit, Novartis Pharma AG, Basel, Switzerland
| | - Palanichamy Ilankumaran
- Global Drug Development, Oncology Development Unit, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Eduard Gasal
- Global Drug Development, Oncology Development Unit, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Vivek Subbiah
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Esposito M, Akman HB, Giron P, Ceregido MA, Schepers R, Ramos Paez LC, La Monaca E, De Greve J, Coux O, De Trez C, Lindon C, Gutierrez GJ. USP13 controls the stability of Aurora B impacting progression through the cell cycle. Oncogene 2020; 39:6009-6023. [PMID: 32772043 DOI: 10.1038/s41388-020-01396-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 07/16/2020] [Indexed: 12/15/2022]
Abstract
Aurora B kinase plays essential roles in mitosis. Its protein levels increase before the onset of mitosis and sharply decrease during mitosis exit. The latter decrease is due to a balance between the actions of the E3 ubiquitin ligase anaphase-promoting complex or cyclosome (activated by the Cdh1 adapter), and the deubiquitinating enzyme USP35. Aurora B also executes important functions in interphase. Abnormal modulation of Aurora B in interphase leads to cell cycle defects often linked to aberrant chromosomal condensation and segregation. Very little is however known about how Aurora B levels are regulated in interphase. Here we found that USP13-associates with and stabilizes Aurora B in cells, especially before their entry into mitosis. In order for USP13 to exert its stabilizing effect on Aurora B, their association is promoted by the Aurora B-mediated phosphorylation of USP13 at Serine 114. We also present evidence that USP13 instigates Aurora B deubiquitination and/or protect it from degradation in a non-catalytic manner. In addition, we report that genetic or chemical modulation of the cellular levels/activity of USP13 affects unperturbed cell-cycle progression. Overall our study unveils the molecular and cellular connections of the USP13-Aurora B axis, which potentially participates in the rewiring of the cell cycle happening in cancer cells.
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Affiliation(s)
- Mara Esposito
- Laboratory of Pathophysiological Cell Signaling, Department of Biology, Faculty of Science and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - H Begum Akman
- Department of Pharmacology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1PD, UK
| | - Philippe Giron
- Laboratory of Pathophysiological Cell Signaling, Department of Biology, Faculty of Science and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.,Laboratory of Molecular and Medical Oncology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - M Angeles Ceregido
- Laboratory of Pathophysiological Cell Signaling, Department of Biology, Faculty of Science and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.,GlaxoSmithKline, Avenue Pascal, 2-4-6, 1300, Wavre, Belgium
| | - Rogier Schepers
- Laboratory of Pathophysiological Cell Signaling, Department of Biology, Faculty of Science and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.,VIB-KU Leuven Center for Cancer Biology, Campus Gasthuisberg, Herestraat, 49-B912, Leuven, Belgium
| | - Luis C Ramos Paez
- Laboratory of Pathophysiological Cell Signaling, Department of Biology, Faculty of Science and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.,Ablynx NV, Technologiepark 21, Zwijnaarde, 9052, Ghent, Belgium
| | - Esther La Monaca
- Laboratory of Pathophysiological Cell Signaling, Department of Biology, Faculty of Science and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.,Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Jacques De Greve
- Laboratory of Molecular and Medical Oncology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Olivier Coux
- CNRS-CRBM, 1919 Route de Mende, 34293, Montpellier, France
| | - Carl De Trez
- Laboratory of Cellular and Molecular Immunology, Department of Bioengineering, Faculty of Science and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Catherine Lindon
- Department of Pharmacology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1PD, UK
| | - Gustavo J Gutierrez
- Laboratory of Pathophysiological Cell Signaling, Department of Biology, Faculty of Science and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium. .,Galapagos NV, Generaal De Wittelaan L11 A3, 2800, Mechelen, Belgium.
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Boeckx B, Shahi RB, Smeets D, De Brakeleer S, Decoster L, Van Brussel T, Galdermans D, Vercauter P, Decoster L, Alexander P, Berchem G, Ocak S, Vuylsteke P, Deschepper K, Lambrechts M, Cappoen N, Teugels E, Lambrechts D, De Greve J. The genomic landscape of nonsmall cell lung carcinoma in never smokers. Int J Cancer 2020; 146:3207-3218. [DOI: 10.1002/ijc.32797] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/11/2019] [Accepted: 10/15/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Bram Boeckx
- Laboratory of Translational GeneticsVIB Center for Cancer Biology, VIB Leuven Belgium
- Laboratory of Translational Genetics, Department of Human GeneticsUniversity of Leuven (KULeuven) Leuven Belgium
| | - Rajendra B. Shahi
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
| | - Dominiek Smeets
- Laboratory of Translational GeneticsVIB Center for Cancer Biology, VIB Leuven Belgium
- Laboratory of Translational Genetics, Department of Human GeneticsUniversity of Leuven (KULeuven) Leuven Belgium
| | - Sylvia De Brakeleer
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
| | - Lore Decoster
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
| | - Thomas Van Brussel
- Laboratory of Translational GeneticsVIB Center for Cancer Biology, VIB Leuven Belgium
- Laboratory of Translational Genetics, Department of Human GeneticsUniversity of Leuven (KULeuven) Leuven Belgium
| | | | | | - Lynn Decoster
- Department of PulmonologyAZ Turnhout Turnhout Belgium
| | | | - Guy Berchem
- Centre Hospitalier de Luxembourg Luxembourg City Luxemburg
| | - Sebahat Ocak
- CHU UCL Namur (Godinne Site) Yvoir Belgium
- Institut de Recherche Expérimentale et Clinique (IREC), Pneumology Pole, Université Catholique de Louvain (UCL) Ottignies‐Louvain‐la‐Neuve Belgium
| | - Peter Vuylsteke
- Université Catholique de Louvain, CHU UCL Namur, Site Sainte Elisabeth Namur Belgium
| | | | | | - Nadia Cappoen
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
| | - Erik Teugels
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
| | - Diether Lambrechts
- Laboratory of Translational GeneticsVIB Center for Cancer Biology, VIB Leuven Belgium
- Laboratory of Translational Genetics, Department of Human GeneticsUniversity of Leuven (KULeuven) Leuven Belgium
| | - Jacques De Greve
- Laboratory of Medical and Molecular Oncology (LMMO), Department of Medical Oncology, Oncologisch Centrum, UZ BrusselVrije Universiteit Brussel (VUB) Brussels Belgium
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Retz M, Seseke F, Banna GL, De Giorgi U, Powles T, Basso U, McDermott RS, Llado A, Su WP, Cebotaru CL, Puente J, Montesa A, De Greve J, Kahan Z, Anido Herranz U, de Ducla S, Pavlova J, Fear S, Sternberg CN. Impact of renal impairment on clinical outcomes in patients (pts) with locally advanced or metastatic (LA/M) urinary tract carcinoma (UTC) treated with atezolizumab (atezo): Analysis of the international SAUL study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.5036] [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
5036 Background: Atezo, which targets PD-L1, is an approved therapy for LA/M urothelial carcinoma based on the IMvigor210 and IMvigor211 trials. The single-arm SAUL study (NCT02928406) showed consistent activity and safety in a broader population, including understudied scenarios, eg pts with renal impairment or other IMvigor211 exclusion criteria. Methods: Pts with LA/M UTC received atezo 1200 mg q3w until disease progression or unacceptable toxicity. The primary endpoint was safety; secondary endpoints included overall response rate (ORR) and overall survival (OS). Post hoc analyses explored outcomes in pts classified as: chemotherapy (CT) ineligible (calculated creatine clearance [CrCl] 15– < 30 mL/min); cisplatin ineligible and carboplatin eligible (CrCl 30– < 60 mL/min); or cisplatin eligible (CrCl ≥60 mL/min). Results: Of 1004 enrolled pts, 46 (5%) were classified as CT ineligible and 420 (42%) as cisplatin ineligible. Results are summarized below. Conclusions: These post hoc analyses suggest pts typically considered cisplatin or CT ineligible are candidates for atezo. Pts with renal impairment achieved similar ORR and DCR to pts with CrCl ≥60 mL/min, without increased toxicity. Imbalances in pt characteristics may explain numerical differences in OS. Clinical trial information: NCT02928406 . [Table: see text]
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Affiliation(s)
- Margitta Retz
- Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
| | | | | | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Meldola, Italy
| | - Thomas Powles
- Barts Cancer Institute, Experimental Cancer Medicine Centre, Queen Mary University of London, St Bartholomew’s Hospital, London, United Kingdom
| | - Umberto Basso
- Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy
| | | | - Anna Llado
- Istituto Oncologico della Svizzera Italiana (IOSI), Bellinzona, Switzerland
| | - Wen-Pin Su
- National Cheng Kung Uni Hospital, Tainan, Taiwan
| | | | | | - Alvaro Montesa
- Unidad de Investigación en Tumores Genitourinarios Centro Nacional de Investigaciones Oncológicas (CNIO)-Instituto de Investigación Biomédica de Málaga (IBIMA), Hospitales Universitarios Regional y V de la Victoria de Málaga, Málaga, Spain
| | | | - Zsuzsanna Kahan
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Kozpont, Onkoterapias Klinik, Szeged, Hungary
| | - Urbano Anido Herranz
- Complejo Hospitalario Universitario de Santiago (CHUS), Santiago De Compostela, Spain
| | | | | | - Simon Fear
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Cora N. Sternberg
- San Camillo and Forlanini Hospitals, Rome, Italy and Englander Institute of Precision Medicine, Weill Cornell Medicine (current affiliation), New York, NY
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De Greve J, Giron P. Targeting the tyrosine kinase inhibitor-resistant mutant EGFR pathway in lung cancer without targeting EGFR? Transl Lung Cancer Res 2020; 9:1-3. [PMID: 32206546 PMCID: PMC7082287 DOI: 10.21037/tlcr.2020.01.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jacques De Greve
- Laboratory of Medical and Molecular Oncology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Philippe Giron
- Laboratory of Medical and Molecular Oncology, Vrije Universiteit Brussel, Brussels, Belgium
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Fontaine C, Renard V, Van den Bulk H, Vuylsteke P, Glorieux P, Dopchie C, Decoster L, Vanacker L, de Azambuja E, De Greve J, Awada A, Wildiers H. Weekly carboplatin plus neoadjuvant anthracycline-taxane-based regimen in early triple-negative breast cancer: a prospective phase II trial by the Breast Cancer Task Force of the Belgian Society of Medical Oncology (BSMO). Breast Cancer Res Treat 2019; 176:607-615. [PMID: 31069589 DOI: 10.1007/s10549-019-05259-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/26/2019] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the pCR rate and toxicity of the addition of weekly carboplatin (Cp) to paclitaxel (wP) and dose-dense (dd) epirubicin/cyclophosphamide (EC) in an open-label phase II study in TNBC patients. METHODS Patients were included if they had stage II and III TNBC and received wP (80 mg/m2/week) concurrent with weekly Cp (AUC = 2) for 12 weeks, followed by bi-weekly epirubicin (90 mg/m2) and cyclophosphamide (600 mg/m2) plus granulocyte colony-stimulating factor (G-CSF) for four cycles, followed by surgery. The primary endpoint was the rate of pCR [(ypT0/isypN0)]. Secondary endpoints included safety and drug delivery. RESULTS Sixty-three eligible patients were included. Median age was 51 years (range 29-74); 88.9% had stage II disease, 46% were clinically node positive, and 77.8% had grade 3 tumors. Fifty-four percent achieved a pCR. Twelve percent missed two or more doses of wP, whereas at least two cycles of EC were missed in 9.5%. The rate of tolerance without delays or dose reductions is very low (16%). Sixty-two percent had G3/4 neutropenia. Febrile neutropenia occurred in 18 patients of which more than eighty percent occurred during EC despite primary prophylaxis with G-CSF. Thrombocytopenia grade 3/4 was noticed in 11 pts. Three patients developed grade 3 peripheral neuropathy. CONCLUSION The addition of weekly carboplatin to neoadjuvant paclitaxel and dd EC leads to a pCR rate comparable to prior studies (54%). However, hematological toxicity and febrile neutropenia rate was unexpectedly high. Future investigations could focus on reversing the sequence, which may lead to better hematological tolerability.
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Affiliation(s)
- Christel Fontaine
- Medical Oncology Department, Oncologisch Centrum, UZ Brussel, Brussels, Belgium.
| | - Vincent Renard
- Medical Oncology Department, AZ Sint-Lucas, Ghent, Belgium
| | | | | | - Philip Glorieux
- Medical Oncology Department, Cliniques Sud-Luxembourg, Virton, Belgium
| | | | - Lore Decoster
- Medical Oncology Department, Oncologisch Centrum, UZ Brussel, Brussels, Belgium
| | - Leen Vanacker
- Medical Oncology Department, Oncologisch Centrum, UZ Brussel, Brussels, Belgium
| | - Evandro de Azambuja
- Medical Oncology Department, Institut Jules Bordet, L'Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Jacques De Greve
- Medical Oncology Department, Oncologisch Centrum, UZ Brussel, Brussels, Belgium
| | - Ahmad Awada
- Medical Oncology Department, Institut Jules Bordet, L'Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Hans Wildiers
- Department of General Medical Oncology and Department of Oncology, University Hospitals Leuven, Louvain, Belgium
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Wen P, De Greve J, Mason W, Hofheinz RD, Dietrich S, de Vos F, van den Bent M, Mookerjee B, Boran A, Burgess P, Rangwala F, Gazzah A. RARE-11. EFFICACY AND SAFETY OF DABRAFENIB + TRAMETINIB IN PATIENTS WITH RECURRENT/REFRACTORY BRAF V600E–MUTATED LOW-GRADE GLIOMA (LGG). Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Patrick Wen
- Center For Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Warren Mason
- University of Toronto University Health Network, Toronto, ON, Canada
| | | | | | | | | | - Bijoyesh Mookerjee
- Global Clinical Program, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Aislyn Boran
- Oncology Precision Medicine, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Paul Burgess
- Oncology Global Development Unit, Novartis Pharma AG, Basel, Switzerl
| | - Fatima Rangwala
- Global Clinical Program, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Anas Gazzah
- Gustave Roussy Cancer Institute, Villejuif, France
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8
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Decoster L, Cappoen N, Aftimos PG, Raicevic G, Rolfo CD, Rottey S, Duhoux FP, Collignon J, Hebrant A, Vandenbulcke M, De Greve J. An explorative phase 2 study of afatinib for advanced cancers carrying an EGFR, a HER2 or a HER3 mutation: A Precision trial of the Belgian Society of Medical Oncology. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps2615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
| | | | - Philippe Georges Aftimos
- Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Sylvie Rottey
- Ghent University Hospital, Heymans Institute of Pharmacology, Ghent, Belgium
| | - Francois P. Duhoux
- Department of Medical Oncology, King Albert II Cancer Institute, Cliniques universitaires Saint-Luc and Institut de Recherche Expérimentale et Clinique (Pôle MIRO), Université Catholique de Louvain, Brussels, Belgium
| | | | - Aline Hebrant
- Wetenschappelijk Instituut Volksgezondheid België, Brussels, Belgium
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Giron P, Noeparast A, De Brakeleer S, De Ridder U, Teugels E, De Greve J. Type II RAF inhibition predicts superior ERK suppression compared to type I RAF inhibition in different BRAF mutant types recurrently found in lung cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e23154] [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
e23154 Background: Somatic driver BRAF mutations account for 6-8% of lung cancers. As opposed to melanoma in which V600E mutant BRAF predominates, the majority of lung cancer-derived BRAF mutations are non-V600. Yet, the efficacy of RAF-inhibitors and the possible resistance mechanisms in non-V600 BRAF mutant cells remain to be uncovered. Recently, we have shown that non-V600 BRAF mutations recurrently found in lung cancer predict sensitivity to the combination of type I RAF inhibitor Dabrafenib and a MEK inhibitor Trametinib. As a single agent, Dabrafenib shows only weak suppression of mutant BRAF-induced ERK signaling; moreover it can induce ERK paradoxical activation in CRAF overexpressing cells. Methods: Several recombinant BRAF expression vectors were generated by performing site-directed mutagenesis. We compared the effects of Dabrafenib and a type II RAF inhibitor (AZD-628) at clinically relevant dose as single agents or in combination with MEK inhibitor Trametinib on ERK activity in HEK293T cells expressing several tumor-derived BRAF mutants and a non-V600 BRAF mutant lung cancer cell line (H1666). Viability and caspase3/7 activation assays were performed using the H1666 cell line model. Results: In contrast to Dabrafenib, AZD-628 does not induce paradoxical ERK activation in CRAF expressing cells. Increased CRAF expression desensitizes BRAF-mutant expressing cells to Dabrafenib but not to AZD-628. Notably, AZD-628 has superior ERK-inhibitory effect in HEK293T cells co-expressing several different BRAF-mutants with CRAF and in H1666 cells. Combination of Trametinib and AZD-628 has superior MEK-inhibitory and pro-apoptotic effect in H1666 cells compared to combined Trametinib/Dabrafenib. Moreover, upon down titration of the RAF inhibitors with a steady dose of Trametinib, AZD-628 resulted in overall stronger effect on viability compared to Dabrafenib. Conclusions: In our in vitro model, we obtained strong indications that at conventional doses, type II RAF-inhibitor AZD628 is superior to type I RAF-inhibitor Dabrafenib in combination with MEK inhibitor Trametinib for the treatment of non-V600 BRAF mutant lung cancer.
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Affiliation(s)
- Philippe Giron
- Laboratory for Medical and Molecular Oncology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Amir Noeparast
- Medical Oncology, Oncologisch Centrum UZ Brussel, Brussels, Belgium
| | | | - Ulrike De Ridder
- Laboratory for Medical and Molecular Oncology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Erik Teugels
- Medical Oncology, Oncologisch Centrum UZ Brussel, Brussels, Belgium
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10
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Noor A, Umelo IA, Kronenberger P, Teugels E, De Greve J. Targeting polo-like kinase 1 and TRAIL to enhance apoptosis in non-small cell lung cancer (NSCLC) cells. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e14104] [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
e14104 Background: TNF-related apoptosis-ligand (TRAIL) can selectively induce apoptosis in cancer cells without causing damage to normal cells. However, some tumors are resistant to TRAIL monotherapy and clinical studies assessing targeted agents towards the TRAIL receptor have failed to show robust therapeutic activity. A number of studies have reported that the combination of targeted agents against the TRAIL receptor with standard systemic therapy and another targeted therapy considerably increased anti-tumor activity in experimental NSCLC models. Polo like kinase 1 (PLK1) is an emerging anti-mitotic target for NSCLC with high selectivity. Depleting PLK1 has been shown to reduce cell proliferation and induce apoptosis in NSCLC cells but not in normal cells. Both PLK1 and TRAIL-induced apoptosis pathways are important in supporting the malignant phenotype. We postulated that inhibiting PLK1 could enhance TRAIL-induced apoptosis. We therefore combined human recombinant TRAIL (rhTRAIL) and the PLK1 inhibitor RO3280, and studied the effect of combinatorial treatment on NSCLC cells. Methods: Cell growth was assessed by MTS assay and apoptotic activity by FACS and western blot analysis. The effect of combinatorial treatment on MAPK/ERK, PI3K/Akt and JAK/STAT signaling pathways that play an essential role in the survival of NSCLC cells were investigated by western blot analysis. Results: In this study, we demonstrate that the combination of a rhTRAIL with RO3280 synergistically reduces cell growth and strongly increases apoptotic activity in NSCLC cells. In response to RO3280 treatment, STAT3 activity is inhibited, possibly contributing to the sensitization of NSCLC cells to TRAIL-induced apoptosis. Blockade of STAT3 activity with a STAT3 inhibitor (stattic) and siRNA-mediated knockdown of STAT3 significantly enhances TRAIL-induced apoptosis in NSCLC cells. Conclusions: Our results suggest that this synergistic effect might occur through the inhibition of STAT3 activity which in turn may further contribute to the sensitization of the NSCLC cells to TRAIL therapy. Taken together, our results support the further exploration of PLK1 inhibitors in combination with TRAIL therapy in the treatment of NSCLC.
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Affiliation(s)
- Alfiah Noor
- Medical Oncology, Oncologisch Centrum UZ Brussel, Jette, Belgium
| | | | | | - Erik Teugels
- Medical Oncology, Oncologisch Centrum UZ Brussel, Brussels, Belgium
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11
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Hollebecque A, Meyer T, Moore KN, Machiels JPH, De Greve J, López-Picazo JM, Oaknin A, Kerger JN, Boni V, Evans TJ, Kristeleit RS, Rao S, Soumaoro I, Cao ZA, Topalian SL. An open-label, multicohort, phase I/II study of nivolumab in patients with virus-associated tumors (CheckMate 358): Efficacy and safety in recurrent or metastatic (R/M) cervical, vaginal, and vulvar cancers. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.5504] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [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
5504 Background: Treatment options for cervical, vaginal, and vulvar (GYN) cancers are limited after first-line therapy. Human papillomavirus (HPV) infection is associated with squamous cell carcinomas of the cervix (≥90%) and vulva/vagina (40–70%), and may elicit an immune reaction. Programmed death (PD)-1 and its major ligand PD-L1 are expressed in GYN cancers and inhibit immune responses. Nivolumab disrupts PD-1–mediated signaling, restoring antitumor immunity. Methods: In CheckMate 358 (NCT02488759), an ongoing multicohort study of 5 virus-associated cancers, PD-L1–unselected adults with R/M GYN cancers, ECOG PS 0–1, and ≤2 prior systemic therapies for R/M disease were eligible to receive nivolumab 240 mg every 2 weeks until progression or unacceptable toxicity. Primary endpoints were objective response rate (ORR) and safety; secondary endpoints were duration of response (DoR), progression-free survival (PFS), and overall survival (OS). Results: Of 24 treated patients (pts), 19 had cervical and 5 had vaginal or vulvar cancer; median age was 51 y. At a median follow-up of 31 wks (range: 6–38), ORR was 20.8% (Table), and disease control rate (ORR + SD) was 70.8%. All responses were in pts with cervical cancer (ORR, 26.3%) and were observed regardless of PD-L1 or HPV status or number of prior R/M therapies. Median PFS was 5.5 mo (95% CI: 3.5, NR); median OS was NR. Conclusions: Nivolumab demonstrated encouraging clinical activity in pts with cervical cancer and a manageable safety profile in virus-associated GYN cancers, supporting further evaluation in these pts. Updated clinical and biomarker data to be presented. Clinical trial information: NCT02488759. [Table: see text]
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Affiliation(s)
| | - Tim Meyer
- University College London Cancer Institute, London, United Kingdom
| | | | | | | | | | - Ana Oaknin
- Vall d’Hebron University Hospital Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Valentina Boni
- START Madrid-CIOCC Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - T.R. Jeffry Evans
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | | | | | | | | | - Suzanne Louise Topalian
- The Sidney Kimmel Comprehensive Cancer Center and Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD
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12
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Delord JP, Hollebecque A, De Boer JP, De Greve J, Machiels JPH, Leidner RS, Ferris RL, Rao S, Soumaoro I, Cao ZA, Kang H, Topalian SL. An open-label, multicohort, phase I/II study to evaluate nivolumab in patients with virus-associated tumors (CheckMate 358): Efficacy and safety in recurrent or metastatic (R/M) nasopharyngeal carcinoma (NPC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.6025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6025 Background: Treatment options for patients (pts) with R/M NPC are limited to palliative chemotherapy. NPC is often associated with the Epstein–Barr virus (EBV), a potential antigen for immune recognition, and high expression levels of the immune checkpoint receptor programmed death-1 (PD-1) and its major ligand PD-L1. Nivolumab disrupts PD-1–mediated signaling, restoring T-cell antitumor function. Methods: In CheckMate 358 (NCT02488759), PD-L1–unselected adults with R/M NPC, ECOG PS of 0–1, and ≤2 prior systemic therapies in the R/M setting were eligible to receive nivolumab 240 mg every 2 weeks until progression or unacceptable toxicity, as part of an ongoing multicohort study of 5 virus-associated cancers. Human papillomavirus-associated NPC and keratinizing squamous cell carcinoma (WHO Type 1) were excluded. Primary endpoints were objective response rate (ORR) and safety; secondary endpoints were duration of response (DoR), progression-free survival (PFS), and overall survival (OS). Results: Of 24 treated pts with R/M NPC, median age was 51 years, 88% were male, 62% were white, 88% were European, and 88% had EBV+ tumors. At a median follow-up of 26 weeks (range: 4–40), ORR was 20.8% and appeared to be higher in pts with no prior R/M therapy (Table). The disease control rate (ORR + SD) was 45.8%. Responses were observed regardless of PD-L1 or EBV status. Median PFS was 2.4 mo (95% CI: 1.5, NR); median OS was NR. Conclusions: Nivolumab demonstrated clinical activity and a manageable safety profile in R/M NPC, supporting ongoing research with nivolumab in this disease. Updated efficacy and biomarker data will be presented. Clinical trial information: NCT02488759. [Table: see text]
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Affiliation(s)
| | | | - J. P. De Boer
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | | | | | | | - Robert L. Ferris
- University of Pittsburgh Medical Center Cancer Center Pavilion, Pittsburgh, PA
| | | | | | | | - Hyunseok Kang
- The Sidney Kimmel Comprehensive Cancer Center and Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD
| | - Suzanne Louise Topalian
- The Sidney Kimmel Comprehensive Cancer Center and Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD
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13
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Noeparast A, De Greve J, De Brakeleer S, Bahadur Shahi R, Teugels E. A lung cancer-derived CRAF mutation to activate ERK pathway and to predict sensitivity to LY3009120 and trametinib. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e23197] [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
e23197 Background: During the Belgian FIELT II clinical study, two non-small cell lung cancers among 41 were found to harbor a CRAF mutation. One of these mutations (P207S) was previously found in fibrosarcoma and characterized as not activating the ERK pathway at higher levels compared to the wild-type CRAF. The other mutation (P261A) has never been reported in cancer but found in Noonan syndrome. CRAF mutations can be oncogenic thereby activation of the ERK pathway. Serine 259 is a negative regulatory site and its phosphorylation is essential for keeping the CRAF auto-inhibited. P261A CRAF prevents phosphorylation of S259 but its role in cancer and its possible response to small molecule inhibitors has yet to be uncovered. Methods: We generated recombinant CRAF expression vectors by site-directed mutagenesis and investigated the ERK pathway activation status induced by CRAF mutants, in HEK293T cells and BEAS-2B (lung epithelial) cells. We tested the effect of candidate inhibitors at a clinically relevant dose on ERK pathway activity in BEAS-2B cells expressing CRAF mutants. Results: Expression of P261A CRAF in both HEK293T and BEAS-2B cells leads to increased ERK pathway activation compared to wtCRAF, accompanied by decreased phosphorylation of S259. P207S CRAF induces ERK pathway activity at levels comparable to wtCRAF and we observed that co-expression of BRAF with P207S CRAF does not lead to increased ERK activity compared to wtCRAF/BRAF. RAF-inhibitors LY3009120 and AZD-628 suppress ERK pathway activity induced by P261A CRAF in BEAS-2B cells. LY3009120 showed stronger ERK-inhibitory effect compared to AZD-628. In contrast, Dabrafenib (RAF-inhibitor) treatment of mutant or wtCRAF expressing cells leads to paradoxical ERK activation. Combinatorial treatment of LY3009120 with Trametinib (MEK-inhibitor) leads to stronger ERK-inhibitory effects compared to either single agent treatment in cells expressing mutant CRAF. Conclusions: The P261A CRAF mutation is ERK pathway activating and predicts sensitivity to LY3009120 and Trametinib. CRAF inhibition should be clinically explored in lung cancers and perhaps other cancers with sensitizing CRAF mutations.
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Affiliation(s)
- Amir Noeparast
- Medical Oncology, Oncologisch Centrum UZ Brussel, Brussels, Belgium
| | | | | | - Rajendra Bahadur Shahi
- Laboratory of Molecular Oncology and Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Erik Teugels
- Medical Oncology, Oncologisch Centrum UZ Brussel, Brussels, Belgium
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14
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Heesch S, Bukur V, Buck J, Diekmann J, Diken M, Ewen K, Haas H, Kemmer-Brueck A, Kloke BP, Kreiter S, Kuhn AN, Kuehlcke K, Loewer M, Paruzynski A, Schultheiß K, Schwarck D, Schmidt M, André F, De Greve J, Kuendig T, Lindman H, Pascolo S, Sjöblom T, Thielemans K, Zitvogel L, Türeci Ö, Sahin U. Abstract CT020: MERIT: introducing individualized cancer vaccines for the treatment of TNBC - a phase I trial. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-ct020] [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
The majority of metastatic cancers remain incurable since the current methods of treatment often fail to target the heterogeneous nature of each individual patient's tumor. Personalized approaches targeting each individual patient's tumor may therefore bring significant improvements. The Mutanome Engineered RNA Immuno-Therapy (MERIT) consortium will clinically validate a pioneering RNA-based immunotherapy concept for the treatment of triple negative breast cancer (TNBC) by targeting shared tumor antigens and individual neo-antigens in TNBC patients.
MERIT combines two personalized treatment concepts: (i) treatment with vaccines containing “off-the-shelf” mRNAs selected from a pre-synthesized mRNA vaccine warehouse (MERIT WAREHOUSE) that encode shared breast cancer tumor antigens expressed in the respective patient's tumor; (ii) treatment with mRNAs engineered on-demand that encode patient-specific mutated neo-antigens identified by next generation sequencing (NGS) and ranked according to the predicted immunogenicity (MERIT MUTANOME). The mRNAs are administered intravenously as a nanoparticulate lipoplex formulation, which specifically targets APCs and consequently induces antigen-specific T cell responses.
MERIT is a multi-center phase I trial (NCT02316457) conducted in four European countries to assess the feasibility, safety and biological efficacy of this personalized immunotherapy. TNBC patients (pT1cN0M0 - anyTanyNM0) after surgery and adjuvant chemotherapy will be allocated to one of two study arms. Patients in ARM1 will receive eight vaccination cycles with a personalized set of shared tumor antigens selected from the WAREHOUSE that correspond to the patient tumor's antigen-expression profile. Patients in ARM2 will be first treated with the personalized WAREHOUSE vaccine approach followed by six vaccination cycles of on-demand manufactured MUTANOME vaccine targeting the unique mutation signature of the individual patient. During the clinical trial, patients will receive the individualized combination of the RNAs in parallel to standard radiotherapy. The clinical trial is approved and the study start is planned for Q1 2016.
The consortium has built a multi-disciplinary clinical workflow and trial design tailored to this unique therapeutic concept, which covers the whole individualized drug development cycle from target discovery, validation to GMP manufacturing and drug release for each individual patient. We will present the therapeutic concept and study protocol as well as the methodologies required for this highly innovative phase I trial.
The personalized immunotherapy overcomes the current limitations of fixed, off-the-shelf therapeutics and thus might increase the clinical benefit for TNBC patients.
This project is a collaborative effort of five partners from academia and industry funded by the European Commission's FP7 and led by BioNTech AG.
Citation Format: Sandra Heesch, Valesca Bukur, Janina Buck, Jan Diekmann, Mustafa Diken, Kerstin Ewen, Heinrich Haas, Alexandra Kemmer-Brueck, Björn-Philipp Kloke, Sebastian Kreiter, Andreas N. Kuhn, Klaus Kuehlcke, Martin Loewer, Anna Paruzynski, Kathrin Schultheiß, Doreen Schwarck, Marcus Schmidt, Fabrice André, Jacques De Greve, Thomas Kuendig, Henrik Lindman, Steve Pascolo, Tobias Sjöblom, Kris Thielemans, Laurence Zitvogel, Özlem Türeci, Ugur Sahin. MERIT: introducing individualized cancer vaccines for the treatment of TNBC - a phase I trial. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr CT020.
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Affiliation(s)
| | | | - Janina Buck
- 2BioNTech RNA Pharmaceuticals GmbH, Mainz, Germany
| | | | - Mustafa Diken
- 3TRON - Translational Oncology at the University Medical Center Mainz, Mainz, Germany
| | - Kerstin Ewen
- 2BioNTech RNA Pharmaceuticals GmbH, Mainz, Germany
| | | | | | | | - Sebastian Kreiter
- 3TRON - Translational Oncology at the University Medical Center Mainz, Mainz, Germany
| | | | | | - Martin Loewer
- 3TRON - Translational Oncology at the University Medical Center Mainz, Mainz, Germany
| | | | | | | | | | - Fabrice André
- 6Gustave Roussy Comprehensive Cancer Center, Villejuif Cedex, France
| | | | | | | | | | | | | | - Laurence Zitvogel
- 6Gustave Roussy Comprehensive Cancer Center, Villejuif Cedex, France
| | - Özlem Türeci
- 11III. Medical Department, University Medical Center of the Johannes Gutenberg University, Mainz, Mainz, Germany
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15
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Subbiah V, Bang YJ, Lassen UN, Wainberg ZA, Soria JC, Wen PY, Zenz T, Moreau P, Brunsvig P, De Braud FG, De Greve J, De Jonge MJ, Hofheinz RD, Italiano A, Stein A, Willenbacher W, Schellens JH, Zielinski C, Rangwala FA, Kreitman RJ. ROAR: a phase 2, open-label study in patients (pts) with BRAF V600E–mutated rare cancers to investigate the efficacy and safety of dabrafenib (D) and trametinib (T) combination therapy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.tps2604] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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)
- Vivek Subbiah
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Yung-Jue Bang
- Seoul National University Hospital, Seoul, South Korea
| | | | - Zev A. Wainberg
- Department of Medicine, Division of Hematology Oncology, UCLA School of Medicine, Los Angeles, CA
| | | | | | | | - Philippe Moreau
- Centre Hospitalier Universitaire Hôtel-Dieu de Nantes, Nantes, France
| | | | | | | | | | | | | | - Alexander Stein
- University Cancer Center Hamburg, University of Hamburg, Hamburg, Germany
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16
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Plummer R, Verheul HM, Langenberg MHG, Leunen K, Molife LR, Rolfo CD, Soerensen PG, De Greve J, Rottey S, Jerusalem GHM, Italiano A, Spicer JF, Dirix LY, Goessl CD, Birkett J, Spencer S, Learoyd M, Dean EJ. Pharmacokinetic (PK) effects and safety of olaparib in combination with tamoxifen, anastrozole, or letrozole: Phase I study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.2562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ruth Plummer
- Northern Centre for Cancer Care, Newcastle upon Tyne, United Kingdom
| | - Henk M.W. Verheul
- Department of Medical Oncology, VU University Medical Center, Amsterdam, Netherlands
| | | | - Karin Leunen
- Universitair Ziekenhuizen Leuven, Leuven, Belgium
| | - L Rhoda Molife
- The Royal Marsden and Institute of Cancer Research, Sutton, United Kingdom
| | | | | | | | - Sylvie Rottey
- Ghent University Hospital, Heymans Institute of Pharmacology, Ghent, Belgium
| | | | - Antoine Italiano
- Institut Bergonié, Department of Medical Oncology, Bordeaux, France
| | - James F. Spicer
- King's College London at Guy's Hospital, London, United Kingdom
| | - Luc Yves Dirix
- GZA Ziekenhuizen campus Sint-Augustinus, Antwerp, Belgium
| | | | | | | | | | - Emma Jane Dean
- University of Manchester, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
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17
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Adriaenssens N, Fontaine C, Vanhoeij M, Lamote J, De Greve J. The influence of multidisciplinary rehabilitation on physical well-being and quality of life of breast cancer survivors. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.3_suppl.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
143 Background: Breast cancer treatment has adverse effects. The aim of this study was to examine the effects of a multidisciplinary oncologic rehabilitation program on health related quality of life (HRQoL), cancer related fatigue (CRF), muscle strength, physical fitness and anthropometrics in breast cancer survivors. Methods: This quasi-experimental study included 30 early breast cancer patients in the first year following treatment. Patients completed a 12-week exercise program for 4 hours a week combined with lifestyle guidance for 2 hours a week. The supervised training sessions consisted of aerobic exercises combined with muscular strengthening exercises. Measurements were carried out at baseline (T0), at the end of the intervention (T1) and at 12-weeks follow-up (T2). HRQoL (EORTC QLQ-C30 questionnaire) and CRF (FACIT-Fatigue questionnaire), were measured at T0, T1 and T2. Muscle strength (handgrip dynamometer) was measured at T0 and T1. Physical fitness and anthropometrics were assessed at T0 and T1 using spiro ergometrics, bioimpedance and waist- and hip circumference. Results: Significant positive changes in HRQoL were found, especially for physical functioning (p = 0.004) and dyspnea (p = 0,003) at T1, but HRQoL decreased at T2. Weight, BMI, waist - and hip circumference and fat free mass decreased significantly (respectively p = 0,030; p = 0,047; p = 0,020; p = 0,041 and p = 0,003). Body impedance increased significantly over time (p = 0,034). There was a significant improvement in CRF at T1 (p = 0.03), that was no longer significant at T2. No significant improvements were found in muscle strength at the affected side (p = 0.16) and the non-affected side (p = 0.95). Physical fitness increased significantly for VO2max at the maximal progressive cycle test (p = 0.005). Conclusions: This study reports significant improvements in HRQoL, anthropometric characteristics, CRF and physical fitness after a 12-week rehabilitation program. The declines between T1 and T2 may be explained by discontinuation of physical activity. Further research should use randomized clinical trials to examine the effectiveness of rehabilitation programs with different contents, duration and initiation.
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Affiliation(s)
- Nele Adriaenssens
- Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Jette, Belgium
| | - Christel Fontaine
- Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Jan Lamote
- Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Jette, Belgium
| | - Jacques De Greve
- Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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18
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Adriaenssens N, De Ridder M, Lamote J, Fontaine C, Van Parijs H, Storme G, Versmessen H, Miedema G, De Greve J, Vinh-Hung V. Health-related quality of life in breast cancer patients prior to and 3 years following adjuvant radiotherapy: Comparison between conventional and short-course, image-guided radiotherapy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.3_suppl.247] [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
247 Background: Breast cancer is nowadays the most common cause of cancer death in the female population. A very commonly used treatment is radiotherapy (RT). Due to improvements of medical imaging and RT, a combination can be used resulting in image guided radiotherapy (TT). The aim of the present study is to investigate the difference in health related quality of life (HRQoL) of breast cancer patients before and 3 years after post-operative conventional radiotherapy (CRT) and TT. Methods: 120 participating patients were randomly allocated to either CRT or TT. The CRT group received 50Gy/25 fractions over a 5 week period (2Gy/fraction) and an additional boost of 16Gy in 8 fractions over 2 weeks. The TT group received 42 Gy in 15 fractions over 3 weeks (2.8 Gy/fraction) and simultaneously an integrated boost of 0,6Gy/fraction. HRQoL was evaluated using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and -BR23 (breast cancer module). Questionnaires were filled in before treatment (T0), right after finishing RT (T1) and at 3 months (T2), 1 year (T3), 2 years (T4) and 3 years (T5) follow up. Results: At T1 no statistically significant differences between the two treatment arms were found except global health status for which TT group scored worse than CRT. At T5, less severe constipation, diarrhoea, breast symptoms, upset by hair loss and more severe insomnia was found in TT compared to CRT, but the differences did not reach significance. Functional scales were comparable in treatment arms. Conclusions: Between the two treatment arms, no statistically significant differences were found at T5 but clinically meaningful differences in symptom scales favoured TT. Our study confirms the preliminary results of Versmessen et al. (BMC Cancer, 2012) in particular that a shorter more intensive fractionation schedule, using TT did not impair HRQoL in breast cancer patients. Clinical trial information: NCT00459628.
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Affiliation(s)
- Nele Adriaenssens
- Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Jette, Belgium
| | | | - Jan Lamote
- Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Jette, Belgium
| | - Christel Fontaine
- Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | | | | | | | | | - Jacques De Greve
- Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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19
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Keyaerts M, Xavier C, Heemskerk J, Devoogdt N, Everaert H, Ackaert C, Vanhoeij M, Duhoux FP, Gevaert T, Simon P, Schallier D, Fontaine C, Vaneycken I, Vanhove C, De Greve J, Lamote J, Caveliers V, Lahoutte T. Phase I Study of 68Ga-HER2-Nanobody for PET/CT Assessment of HER2 Expression in Breast Carcinoma. J Nucl Med 2015; 57:27-33. [DOI: 10.2967/jnumed.115.162024] [Citation(s) in RCA: 244] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 10/01/2015] [Indexed: 12/26/2022] Open
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20
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Heesch S, Britten CM, Bukur V, Buck J, Castle J, Diekmann J, Diken M, Frenzel K, Kreiter S, Kuhn AN, Kuehlcke K, Loewer M, Haas H, Kemmer-Brueck A, Kloke BP, Otte B, Paruzynski A, Petri S, Schwarck-Kokarakis D, Schmidt M, André F, De Greve J, Kuendig T, Lindman H, Pascolo S, Sjöblom T, Thielemans K, Zitvogel L, Tuereci O, Sahin U. Abstract CT201: The Mutanome Engineered RNA Immuno-Therapy (MERIT) project. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-ct201] [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
The Mutanome Engineered RNA Immuno-Therapy (MERIT) consortium will clinically and industrially validate a pioneering RNA-based immunotherapy concept that targets individual tumor antigens and tumor-specific mutations in triple negative breast cancer (TNBC) patients. This biomarker-guided, personalized therapy is a collaborative effort of five partners from academia and industry and is funded by the European Commission's FP7 and led by BioNTech AG. TNBC is an aggressive, molecularly heterogeneous cancer that accounts for 20% of all breast cancer patients. The 5-year survival rate is less than 80%. The molecular heterogeneity across TNBCs results in a lack of common targetable molecular alterations, and thus targeted therapies frequently fail to provide clinical benefit. The MERIT concept attempts to address this unmet medical need. The personalized treatment consists in (i) injecting vaccines containing “off the shelf” mRNAs selected from a pre-synthesized mRNA vaccine warehouse (MERIT WAREHOUSE) that encode tumor specific antigens expressed in the respective patient's tumor; and (ii) thereafter mRNAs engineered on-demand that encode patient-specific sequence stretches incorporating non-synonymous mutations identified by next generation sequencing (NGS) and ranked by predicted immunogenicity (MERIT MUTANOME). The mRNAs are administered intravenously as a nanoparticulate lipoplex formulation and are selectively delivered to splenic APCs. The encoded antigens are translated into proteins that are rapidly processed. Subsequent peptide presentation on the surface of APCs induces antigen-specific T cell responses. The central part of the MERIT project, a multi-center first in human trial, will assess the feasibility, safety and biological efficacy of this innovative personalized immunotherapy in TNBC patients. After discussing the regulatory challenges with the German national regulatory agency (PEI), a phase I study is now in preparation. The trial will start in Q2 2015 in five academic centers in Europe and will recruit thirty TNBC patients. Furthermore, the project includes a comprehensive T-cell immunomonitoring and biomarker program. Moreover, an extensive research program will address the optimization of algorithms for improved prediction of immunogenic mutations. Additionally, compounds to enhance vaccine efficacy will be developed and improved to support further clinical development. We have established a RNA delivery platform as well as a MERIT WAREHOUSE containing mRNAs coding for a selection of TNBC specific antigens. Additionally, we have built a multi-disciplinary clinical workflow and trial design tailored to this unique therapeutic concept. We will describe the therapeutic concept and the critical skills, and methodologies required for this project, including cancer genomics, NGS, bioinformatics, tumor immunomics, industrial drug development, GMP manufacturing, clinical immunotherapy and immunological monitoring.
Citation Format: Sandra Heesch, Cedrik M. Britten, Valesca Bukur, Janina Buck, John Castle, Jan Diekmann, Mustafa Diken, Katrin Frenzel, Sebastian Kreiter, Andreas N. Kuhn, Klaus Kuehlcke, Martin Loewer, Heinrich Haas, Alexandra Kemmer-Brueck, Bjoern-Philipp Kloke, Burkhard Otte, Anna Paruzynski, Sebastian Petri, Doreen Schwarck-Kokarakis, Marcus Schmidt, Fabrice André, Jacques De Greve, Thomas Kuendig, Henrik Lindman, Steve Pascolo, Tobias Sjöblom, Kris Thielemans, Laurence Zitvogel, Oezlem Tuereci, Ugur Sahin. The Mutanome Engineered RNA Immuno-Therapy (MERIT) project. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr CT201. doi:10.1158/1538-7445.AM2015-CT201
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Affiliation(s)
| | | | | | - Janina Buck
- 2BioNTech RNA Pharmaceuticals GmbH, Mainz, Germany
| | | | - Jan Diekmann
- 2BioNTech RNA Pharmaceuticals GmbH, Mainz, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Laurence Zitvogel
- 11Gustave Roussy Comprehensive Cancer Center, Villejuif Cedex, France
| | - Oezlem Tuereci
- 12University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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Noeparast A, Verschelden G, Umelo I, De Brakeleer S, Decoster L, Teugels E, De Greve J. Investigation of non-V600 BRAF mutations commonly found in NSCLC for their sensitivity to dabrafenib or trametinib. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.11091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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)
- Amir Noeparast
- Medical Oncology, Oncologisch Centrum, UZ Brussel, Brussels, Belgium
| | - Gil Verschelden
- Medical Oncology, Oncologisch Centrum UZ Brussel, Brussels, Belgium
| | - Ijeoma Umelo
- Medical Oncology, Oncologisch Centrum UZ Brussel, Brussels, Belgium
| | | | | | - Erik Teugels
- Medical Oncology, Oncologisch Centrum, UZ Brussel, Brussels, Belgium
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Rafii S, Gourley C, Ang JE, Kumar R, Geuna E, Rye T, Ashcroft L, Powell B, Shapira-Frommer R, Friedlander M, Chen LM, Matulonis U, Kaufman B, De Greve J, Oza AM, Banerjee SN, Gore ME, Molife LR, Kaye SB, Yap TA. What clinical factors influence advanced BRCA1/2 mutant ovarian cancer patient (BMOC pt) outcomes to poly(ADP-ribose) polymerase inhibitor (PARPi) treatment? J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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)
- Saeed Rafii
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Charlie Gourley
- University of Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - Joo Ern Ang
- Royal Marsden Hospital, Sutton Surrey, United Kingdom
| | - Rajiv Kumar
- The Royal Marsden Hospital, London, United Kingdom
| | - Elena Geuna
- The Institute Of Cancer Research and Royal Marsden, Osasco, Italy
| | - Tzyvia Rye
- University of Edinburgh Clinical Trials Unit, Edinburgh, United Kingdom
| | - Linda Ashcroft
- Clinical Trials Unit, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | | | | | | | | | - Bella Kaufman
- Sheba Medical Center; affiliated with Sackler Faculty of Medicine (Tel Aviv Univ), Ramat Gan, Israel
| | | | - Amit M. Oza
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | | | | | - Stanley B. Kaye
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
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Keyaerts M, Xavier C, Heemskerk J, Devoogdt N, Everaert H, Gevaert T, Vanhoeij M, Duhoux FP, Simon P, Schallier DCC, Fontaine C, Vaneycken I, Vanhove C, De Greve J, Lamote J, Caveliers V, Lahoutte T. Nanobody-based PET/CT imaging of HER2 expression in breast carcinoma: Phase I results and potential to assess tumor heterogeneity. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e11600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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
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Sahin U, Jaeger D, Marme F, Mavratzas A, Krauss J, De Greve J, Vergote I, Tureci O. First-in-human phase I/II dose-escalation study of IMAB027 in patients with recurrent advanced ovarian cancer (OVAR): Preliminary data of phase I part. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5537] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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)
| | - Dirk Jaeger
- National Center for Tumor Diseases, University Hospitals Heidelberg, Heidelberg, Germany
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Vanacker L, Smeets D, Hoorens A, Teugels E, Algaba R, Dehou MF, De Becker A, Lambrechts D, De Greve J. Mixed adenoneuroendocrine carcinoma of the colon: molecular pathogenesis and treatment. Anticancer Res 2014; 34:5517-5521. [PMID: 25275049] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We report a case of a mixed adenoneuroendocrine carcinoma developed in a colorectal adenocarcinoma with lymph node and liver metastases exclusively emanating from the neuroendocrine carcinoma component. The patient underwent right hemicolectomy and postoperatively received chemotherapy with cisplatin and etoposide and subsequent high-dose induction chemotherapy, followed by autologous stem cell transplantation. Following this treatment, there was a complete remission. Currently, thirty months after treatment, the patient is in unmaintained complete remission. Comparative exome sequencing of germline DNA and DNA from the two separate malignant components revealed six somatic changes in cancer consensus genes. Both components shared somatic mutations in Adenomatous polyposis coli (APC), Kirsten rat sarcoma viral oncogene homolog (KRAS), B-cell CLL/lymphoma 9 (BCL9) and Forkhead Box P1 (FOXP1) genes. Mutation in SWI/SNF related, matrix associated, actin dependent regulator of chromatin, subfamily a, member 4 (SMARCA4) was only found in the neuroendocrine carcinoma component. The finding of several identical somatic mutations in both components supports a clonal relationship between the neuroendocrine carcinoma and the adenocarcinoma. We suggest that a mutation in SMARCA4 could be responsible for the transformation of the adenocarcinoma component into the neuroendocrine phenotype.
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Affiliation(s)
- Leen Vanacker
- Laboratory of Molecular Oncology, Department of Medical Oncology, Brussels, Belgium
| | - Dominiek Smeets
- Vesalius Research Cancer, Flemish Institute for Biotechnology, Leuven, Belgium Laboratory for Translational Genetics, Department of Oncology, Catholic University Leuven, Belgium
| | | | - Erik Teugels
- Laboratory of Molecular Oncology, Department of Medical Oncology, Brussels, Belgium
| | - Roberto Algaba
- Department of Surgery and Pathology, Iris Hospitals South Campus Joseph Bracops, Brussels, Belgium
| | - Marie Françoise Dehou
- Department of Surgery and Pathology, Iris Hospitals South Campus Joseph Bracops, Brussels, Belgium
| | - Ann De Becker
- Department of Clinical Hematology, Brussels, Belgium
| | - Diether Lambrechts
- Vesalius Research Cancer, Flemish Institute for Biotechnology, Leuven, Belgium Laboratory for Translational Genetics, Department of Oncology, Catholic University Leuven, Belgium
| | - Jacques De Greve
- Laboratory of Molecular Oncology, Department of Medical Oncology, Brussels, Belgium
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De Greve J, De Brakeleer S, Desmedt C, Joris S, Sotiriou C, Piccart-Gebhart MJ, Pauwels I, Teugels E. Frequent BRCA1/2 and BARD1 germline mutations in triple-negative breast cancer patients. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.1107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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)
- Jacques De Greve
- Familial Cancer Clinic and Medical Oncology, University Hospital Brussels, UZ Brussel, Brussels, Belgium
| | | | | | | | - Christos Sotiriou
- Jules Bordet Institute, Breast Cancer Translational Research Laboratory, Brussels, Belgium
| | | | - Ingrid Pauwels
- Familial Cancer Clinic and Medical Oncology, Brussels University Hospital, UZ Brussel, Brussels, Belgium
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Lheureux S, Ledermann JA, Kaye SB, Gourley C, Friedlander M, Bowtell D, De Greve J, deFazio A, Shapira-Frommer R, De Bono JS, Audeh MW, Kohn EC, Alsop K, Scott CL, Matulonis U, Kaufman B, Burger B, Robertson JD, Ho T, Oza AM. Characterization of ovarian cancer long-term responders on olaparib. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.5534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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)
| | | | - Stanley B. Kaye
- Drug Development Unit at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK, London, United Kingdom
| | - Charlie Gourley
- Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | | | | | - Jacques De Greve
- Familial Cancer Clinic and Medical Oncology, University Hospital Brussels, UZ Brussel, Brussels, Belgium
| | - Anna deFazio
- Westmead Institute for Cancer Research, University of Sydney at Westmead Millennium Institute, Sydney, Australia
| | - Ronnie Shapira-Frommer
- Ella Institute for Research and Treatment of Melanoma, Sheba Medical Center, Affiliated to Sackler Faculty of Medicine Tel Aviv University, Tel Hashomer, Israel
| | | | - M. William Audeh
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Elise C. Kohn
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | | | | | - Bella Kaufman
- The Breast Cancer Unit, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | | | | | | | - Amit M. Oza
- Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
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Sermijn E, Delesie L, Deschepper E, Pauwels I, Bonduelle M, Teugels E, De Greve J. Impact of an interventional counseling procedure in BRCA families: Efficacy and safety. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.1552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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)
- Erica Sermijn
- Familial Cancer Clinic and Medical Oncology, Brussels University Hospital, UZ Brussel, Brussels, Belgium
| | - Liesbeth Delesie
- Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Ellen Deschepper
- Department of Public Health, Biostatistics Unit, Ghent University Hospital, Ghent, Belgium
| | - Ingrid Pauwels
- Familial Cancer Clinic and Medical Oncology, Brussels University Hospital, UZ Brussel, Brussels, Belgium
| | - Maryse Bonduelle
- Familial Cancer Clinic and Medical Genetics, Brussels University Hospital, UZ Brussel, Brussels, Belgium
| | - Erik Teugels
- Familial Cancer Clinic and Medical Oncology, University Hospital Brussels, UZ Brussel, Brussels, Belgium
| | - Jacques De Greve
- Familial Cancer Clinic and Medical Oncology, University Hospital Brussels, UZ Brussel, Brussels, Belgium
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Derks-Smeets IAP, de Die-Smulders CEM, Mackens S, van Golde R, Paulussen AD, Dreesen J, Tournaye H, Verdyck P, Tjan-Heijnen VCG, Meijer-Hoogeveen M, De Greve J, Geraedts J, De Rycke M, Bonduelle M, Verpoest WM. Hereditary breast and ovarian cancer and reproduction: an observational study on the suitability of preimplantation genetic diagnosis for both asymptomatic carriers and breast cancer survivors. Breast Cancer Res Treat 2014; 145:673-81. [DOI: 10.1007/s10549-014-2951-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 04/02/2014] [Indexed: 11/28/2022]
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Ades F, Azambuja ED, Daugaard G, Ameye L, Moulin C, Paesmans M, Jong DD, Decoster L, Greve JD, Ismael G, Møller AK, Piccart M, Awada A. Comparison of a gene expression profiling strategy to standard clinical work-up for determination of tumour origin in cancer of unknown primary (CUP). J Chemother 2013; 25:239-46. [DOI: 10.1179/1973947813y.0000000085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Ang JE, Gourley C, Powell CB, High H, Shapira-Frommer R, Castonguay V, De Greve J, Atkinson T, Yap TA, Sandhu S, Banerjee S, Chen LM, Friedlander ML, Kaufman B, Oza AM, Matulonis U, Barber LJ, Kozarewa I, Fenwick K, Assiotis I, Campbell J, Chen L, de Bono JS, Gore ME, Lord CJ, Ashworth A, Kaye SB. Efficacy of chemotherapy in BRCA1/2 mutation carrier ovarian cancer in the setting of PARP inhibitor resistance: a multi-institutional study. Clin Cancer Res 2013; 19:5485-93. [PMID: 23922302 DOI: 10.1158/1078-0432.ccr-13-1262] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Preclinical data suggest that exposure to PARP inhibitors (PARPi) may compromise benefit to subsequent chemotherapy, particularly platinum-based regimens, in patients with BRCA1/2 mutation carrier ovarian cancer (PBMCOC), possibly through the acquisition of secondary BRCA1/2 mutations. The efficacy of chemotherapy in the PARPi-resistant setting was therefore investigated. EXPERIMENTAL DESIGN We conducted a retrospective review of PBMCOC who received chemotherapy following disease progression on olaparib, administered at ≥200 mg twice daily for one month or more. Tumor samples were obtained in the post-olaparib setting where feasible and analyzed by massively parallel sequencing. RESULTS Data were collected from 89 patients who received a median of 3 (range 1-11) lines of pre-olaparib chemotherapy. The overall objective response rate (ORR) to post-olaparib chemotherapy was 36% (24 of 67 patients) by Response Evaluation Criteria in Solid Tumors (RECIST) and 45% (35 of 78) by RECIST and/or Gynecologic Cancer InterGroup (GCIG) CA125 criteria with median progression-free survival (PFS) and overall survival (OS) of 17 weeks [95% confidence interval (CI), 13-21] and 34 weeks (95% CI, 26-42), respectively. For patients receiving platinum-based chemotherapy, ORRs were 40% (19 of 48) and 49% (26/53), respectively, with a median PFS of 22 weeks (95% CI, 15-29) and OS of 45 weeks (95% CI, 15-75). An increased platinum-to-platinum interval was associated with an increased OS and likelihood of response following post-olaparib platinum. No evidence of secondary BRCA1/2 mutation was detected in tumor samples of six PARPi-resistant patients [estimated frequency of such mutations adjusted for sample size: 0.125 (95%-CI: 0-0.375)]. CONCLUSIONS Heavily pretreated PBMCOC who are PARPi-resistant retain the potential to respond to subsequent chemotherapy, including platinum-based agents. These data support the further development of PARPi in PBMCOC.
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Affiliation(s)
- Joo Ern Ang
- Authors' Affiliations: The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton; Edinburgh Cancer Research UK Center, Medical Research Council Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh; The Cancer Research UK Gene Function Laboratory; Breakthrough Breast Cancer Research Center; Tumour Profiling Unit, The Institute of Cancer Research, London, United Kingdom; University of California San Francisco, San Francisco, California; Department of Medical Oncology, Prince of Wales Clinical School, Prince of Wales Hospital, Sydney, Australia; The Chaim Sheba Medical Center, Tel Hashomer, Israel; Princess Margaret Hospital, Toronto, Canada; Oncologisch Centrum Vrije Universiteit Brussel, Brussels, Belgium; and Dana Farber Cancer Center, Boston, Massachusetts
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De Greve J, Moran T, Graas MP, Galdermans D, Vuylsteke P, Canon JL, Chand VK, Fu Y, Massey D, Vansteenkiste J. Phase II study of afatinib, an irreversible ErbB family blocker, in demographically and genotypically defined non-small cell lung cancer (NSCLC) patients. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.8063] [Citation(s) in RCA: 7] [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: 11/20/2022] Open
Abstract
8063 Background: EGFR mutation+ (M+) NSCLC pts have an improved response to EGFR TKIs vs non-M+ pts. Data on EGFR FISH+ (gene amplified) and HER2 M+ pts are, however, limited. Afatinib is an irreversible ErbB Family Blocker with efficacy in Ph II/III trials in EGFR M+ NSCLC. This exploratory, open-label trial assessed afatinib in 3 genotypically and demographically defined NSCLC groups. Methods: Never/ex-smokers with stage IIIB/IV lung adenocarcinoma with EGFR M+ tumors who had failed prior EGFR TKIs, HER2 M+ tumors independent of prior therapy, or EGFR FISH+ tumors who received ≤3 prior chemotherapies were enrolled. Afatinib 50 mg qd was administered until disease progression or intolerable adverse events. Tumor assessments (RECIST 1.0) were performed every 8 wks. Pts who progressed on afatinib but experienced clinical benefit could continue treatment with afatinib 40 mg qd + paclitaxel 80 mg/m² qw on days 1, 8 and 15 every 28-day cycle. Primary endpoint: Confirmed objective response. Results: 41 pts were treated: 63% female; median age 63 yrs; 68% never smokers; 32% ex-smokers. 33 pts received afatinib monotherapy only; 8 pts received afatinib followed by afatinib/paclitaxel combination therapy. 78% (n=32) of pts were EGFR M+, 5% (n=2) were EGFR FISH+ and 17% (n=7) were HER2 M+. For afatinib monotherapy, 1 confirmed partial response (PR) was observed (EGFR FISH+), stable disease (SD) was seen in 5/7 HER2 M+, 2/2 EGFR FISH+ and 17/32 EGFR M+ pts, and overall disease control (DC) rate was 59% (n=24); mean duration of DC was 26 wks.Median PFS was 16 wks (17 wks in HER2 M+ pts). Of 8 afatinib/paclitaxel-treated pts, 1 had a confirmed PR and 2 had SD; median PFS was 7 wks. Most frequently reported drug-related AEs in afatinib monotherapy pts were diarrhea (n=39; grade ≥3 n=13), rash/acne (n=33; grade ≥3 n=4) and stomatitis (n=19; grade ≥3 n=2). In the combination arm these were diarrhea (n=4; grade ≥3 n=1) and nausea (n=3; grade ≥3 n=0). Conclusions: Efficacy of afatinib in EGFR M+ NSCLC pts has been established in previous trials. Novel activity of afatinib in HER2 M+ and EGFR FISH+ NSCLC pts has been demonstrated here, with a manageable safety profile of afatinib in the overall population. Clinical trial information: NCT00730925.
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Affiliation(s)
| | - Teresa Moran
- Institut Catala d´Oncologia, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | | | | | | | | | | | - Yali Fu
- Boehringer Ingelheim GmbH, Ridgefield, CT
| | - Dan Massey
- Boehringer Ingelheim GmbH, Bracknell, United Kingdom
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Hanssens S, Fontaine C, Decoster L, Schallier DCC, Luyten R, Watthy C, Van Hemelrijck R, De Greve J. The effect of a varied exercise program (VEP) on shoulder function and lymphedema (LE) in breast cancer survivors (BCs): A pilot study. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.27_suppl.82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
82 Background: A common physical sequel after adjuvant therapy is a decrease in shoulder movement of the upper-limb of the affected side and the development of LE. Resistance exercise is known to be safe and does not increase the risk of LE. The objective of this study is to evaluate the effect of a VEP on shoulder range of motion and upper-limb LE after adjuvant therapy in BCs. Methods: 22 BCs treated with surgery and adjuvant therapy were randomly assigned to the VEP (n=12) or the control (n=10). The VEP aimed at improving aerobic endurance, joint mobility and muscle strength. The frequency of the VEP was 2 times a week, during 3 months, with a total of 30 sessions. Primary endpoints included the range shoulder motion and arm volumes of both arms. The secondary outcome was quality of life (QoL) as measured by the EORTC QLQ-C30. All outcome measures were assessed at baseline and after 3 months. Results: After ending the VEP, in the exercise group, the movements such as abduction (p=0.04), external rotation (p=0.02), extension (p=0.03) and flexion (p=0.01) of the affected arm increased significantly but there was no change for internal rotation (0.27). No significant changes in arm volume (p=0.06) were found after 3 months compared to baseline, whereas the quality of life did improve significantly (p=0.01). After 3 months the range of motion of the shoulder of the affected arm (sum of abduction, external rotation, extension and flexion) in the exercise group tended to be better although this was not significant (p=0.50). The arm volume difference between the two groups was not significant (p=0.10) but it was for the QoL (p=0.02). Conclusions: A VEP lead to significant specific improvements in arm mobility compared to baseline. These BCs also compared favourably to the control cohort, but this was not significant. The study confirms that exercising the ipsilateral arm and shoulder has no detrimental effect on LE and has a positive impact on the QoL. Standard guidelines concerning physical therapy to ameliorate shoulder function and LE are not available. Additional patients will be enrolled to develop standard recommendations for physical therapy to improve shoulder and limb function in BCs.
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Affiliation(s)
| | | | - Lore Decoster
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussels, Brussels, Belgium
| | | | | | | | | | - Jacques De Greve
- Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Brussels, Belgium
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Ang JE, Gourley C, High HA, Shapira-Frommer R, Powell CB, Castonguay V, De Greve J, Yap TA, Fong PC, Olmos D, Banerjee SN, Chen LM, Friedlander M, Kaufman B, Oza AM, De Bono JS, Gore ME, Kaye SB. Use of chemotherapy (CT) in BRCA1/2-deficient ovarian cancer (BDOC) patients (pts) with poly-ADP-ribose polymerase inhibitor (PARPi) resistance: A multi-institutional study. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.5022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5022 Background: Emerging clinical data point to the clinical utility of PARPi in BDOC. However, the impact of PARPi exposure on the prospects of response to further CT remains unclear. In our previous single centre study, we provided the first clinical data relating to the use of post-PARPi CT (JCO 2010: 28(15S), A5041). Our aim here was to re-examine this issue in a larger multi-institutional population. Methods: We included pts with advanced BDOC who received CT, having progressed on ≥200 mg bd olaparib. Pt, tumor and treatment characteristics and clinical outcomes were documented. Relationships between post-PARPi CT overall survival (OS) and other variables were explored using Cox regression. Results: We collected data on 75 pts (median age 51 y [range 31-77], BRCA1:BRCA2 54:21, mean 3 previous lines of CT [95% CI 2.5-3.4], pre-PARPi platinum (Plt) resistance rate 49% and olaparib RECIST-response rate [RR] 39% [95% CI 28-50]). Following olaparib, most pts received Plt alone or in combination with taxane (Tx) or liposomal doxorubicin (PLD). Weekly Plt was used in 36% of all Plt-treated pts, mainly in combination with weekly Tx. Overall RECIST and CA125 (GCIG) RRs were 38% and 48%, respectively; these responses occurred independently of PARPi response or pre-PARPi Plt sensitivity (all p>.1). The median progression free survival and OS of RECIST responders were 7.9 m (95% CI 5.8-10.9) and 10.5 m (95% CI 1.4-19.6), respectively. In all pts, the median OS from the start of post-PARPi CT was 7.9 m (95% CI 5.7-10.1) while that from diagnosis was 64.9 m (95% CI 52.9-76.9). Factors associated with improved OS on post-PARPi CT in the MVA included best olaparib response of non-disease progression (p=.003, HR 0.28), optimal initial debulking (p=.01, HR 0.36) and pre-PARPi Plt sensitivity (p=.05, HR 0.46). Conclusions: These data indicate potential for meaningful responses to CT in BDOC pts with PARPi resistance. Analysis to identify molecular predictors of response is ongoing. [Table: see text]
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Affiliation(s)
- Joo Ern Ang
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, United Kingdom
| | - Charlie Gourley
- Edinburgh Cancer Research Centre, MRC IGMM, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | | | | | - C. Bethan Powell
- University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA
| | | | | | - Timothy Anthony Yap
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, United Kingdom
| | - Peter C.C. Fong
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, United Kingdom
| | - David Olmos
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, United Kingdom
| | - Susana N. Banerjee
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, United Kingdom
| | - Lee-may Chen
- University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA
| | | | | | - Amit M. Oza
- Princess Margaret Hospital, Toronto, ON, Canada
| | - Johann Sebastian De Bono
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, United Kingdom
| | - Martin Eric Gore
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, United Kingdom
| | - Stanley B. Kaye
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, United Kingdom
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Decoster L, Kenis C, Van Puyvelde K, De Greve J, Conings G, Knapen MC, Lobelle JP, Milisen K, Vanorle K, Flamaing J, Wildiers H. The influence of age plus standard clinical approach with or without comprehensive geriatric assessment (CGA) on treatment decisions in older cancer patients: Final results. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.9035] [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
9035 Background: The aim of this prospective study was to examine how age and standard clinical approach with and without CGA results determine treatment decisions in older cancer patients (pts). Methods: This study,conducted in 2 Belgian university hospitals, included pts ≥ 70 years with a malignant tumor (breast, colorectal, ovarian, lung, prostate and hematological) if a new cancer therapy was considered. All pts underwent a uniform CGA. Results were communicated to the treating physician. After the treatment decision, an interview with the treating physician was performed, using a predefined questionnaire: 1/ What would be your oncological treatment proposal in case the pt was 55y without other comorbidity? 2/ Is this different from your treatment proposal for this pt according to age and standard clinical approach without CGA results? 3/ Is this different from your treatment proposal for this pt with CGA results? Results: From October 2009 till July 2011, 937 pts were included in the study. Median age was 76y (range 70-95) and 63.5% was female. A total of 902 (96.3%) questionnaires were completed and 56.2% of the physicians were aware of the CGA results at treatment decision. In 381 pts (42.2%; 95%CI 39.0-45.5) age and standard clinical approach led to a different treatment decision compared to younger pts without comorbidity. This influence was most prominent for chemotherapy decisions: 309 patients did not receive standard chemotherapy (reduced dose (13), less toxic regimen (163), less toxic regimen at reduced dose (5) or no chemotherapy (128)). When the physician was aware of the CGA, these results influenced their treatment in 6.7% (95%CI: 4.5-8.9), mostly concerning chemotherapy. In 8 pts CGA results encouraged the treating physician to choose a more aggressive chemotherapy regimen and in 11 pts CGA results led to a decision of palliative care. Conclusions: Based on this prospective trial, we conclude that physicians use adapted treatment regimens in older versus younger pts, only based on age and standard clinical approach. CGA results change the treatment decision in 6.7% and sometimes trigger the use of a more aggressive treatment.
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Affiliation(s)
- Lore Decoster
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Brussel, Belgium
| | - Cindy Kenis
- Department of General Medical Oncology, UZ Leuven, Leuven, Belgium
| | | | - Jacques De Greve
- Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Brussels, Belgium
| | - Godelieve Conings
- Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Brussel, Belgium
| | | | | | - Koen Milisen
- Centre for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Katrien Vanorle
- Department of General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - Johan Flamaing
- Department of Geriatric Medicine, UZ Leuven, Leuven, Belgium
| | - Hans Wildiers
- Department of General Medical Oncology, University Hospital Leuven, Leuven, Belgium
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Abou-Alfa GK, Amadori D, Santoro A, Figer A, De Greve J, Lathia C, Voliotis D, Anderson S, Moscovici M, Ricci S. Safety and Efficacy of Sorafenib in Patients with Hepatocellular Carcinoma (HCC) and Child-Pugh A versus B Cirrhosis. Gastrointest Cancer Res 2011; 4:40-44. [PMID: 21673874 PMCID: PMC3109886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Accepted: 06/25/2010] [Indexed: 05/30/2023]
Abstract
BACKGROUND We performed a retrospective analysis of data from a phase II study evaluating sorafenib in patients with advanced hepatocellular carcinoma (HCC) to assess differences in safety and efficacy based on Child-Pugh (CP) status (A/B). METHODS Patients received sorafenib 400 mg PO bid. We analyzed safety, pharmacokinetic (PK), and efficacy data in the two CP groups. RESULTS Ninety-eight patients were CP A; 38 were CP B, with a median duration of therapy of 4 and 1.8 months, respectively. Grade 3/4 adverse events in the CP A and B groups, respectively, included hyperbilirubinemia (14% and 53%), ascites (3% and 5%), and encephalopathy (3% and 13%). Median overall survival (OS) in the CP A group was 9.5 months, compared with 3.2 months in the CP B population. Responses were limited in both groups. AUC and C(max) values were comparable between the two groups. CONCLUSIONS Due to the lack of randomization against placebo or no therapy in this study, it is unclear if the more frequent worsening of liver cirrhosis and outcome of CP B patients are drug related or due to disease progression, or both. As expected, outcome was poorer in patients with CP B than in those with CP A cirrhosis. The hyperbilirubinemia seen in both groups may be at least partly related to inhibition of UGT1A1 by sorafenib. PK profiles were similar in the two groups. More data are needed to confirm and more fully understand the safety and efficacy of sorafenib in patients with advanced HCC and CP B cirrhosis.
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Affiliation(s)
| | | | | | - Arie Figer
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Jacques De Greve
- Academisch Ziekenhuis van de Vrije Universiteit, Brussel (AZ-VUB), Brussels, Belgium
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Leyder M, Laubach M, Breugelmans M, Keymolen K, De Greve J, Foulon W. Specific congenital malformations after exposure to cyclophosphamide, epirubicin and 5-fluorouracil during the first trimester of pregnancy. Gynecol Obstet Invest 2010; 71:141-4. [PMID: 21160143 DOI: 10.1159/000317264] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Accepted: 06/14/2010] [Indexed: 11/19/2022]
Abstract
The treatment of pregnant women with chemotherapeutic drugs leads to congenital malformations in 10-20% of newborn children. We present a case of an ongoing 19-week-long pregnancy which was diagnosed in a 39-year-old woman who was being treated with CEF (cyclophosphamide, epirubicin, 5-fluorouracil) chemotherapy for an infiltrating ductal carcinoma of the breast. After termination of the pregnancy, subsequent examination of the fetus revealed micrognathia and bilateral malformations of the hands and feet. The peak exposure of the fetus to the chemotherapeutic agents was in the 5th to 6th week of the pregnancy. Both the nature of the malformations and the timing of the administration of chemotherapy are similar to another case reported previously. We conclude that chemotherapy treatments with CEF in the 5th to 6th week of pregnancy specifically generate hand and foot abnormalities and micrognathia, which is consistent with an inhibition of proliferation, leading to cell death at this embryonic stage.
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Affiliation(s)
- Mina Leyder
- Service of Prenatal Medicine, UZ Brussel, Brussels, Belgium.
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38
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Fong PC, Yap TA, Boss DS, Carden CP, Mergui-Roelvink M, Gourley C, De Greve J, Lubinski J, Shanley S, Messiou C, A'Hern R, Tutt A, Ashworth A, Stone J, Carmichael J, Schellens JHM, de Bono JS, Kaye SB. Poly(ADP)-ribose polymerase inhibition: frequent durable responses in BRCA carrier ovarian cancer correlating with platinum-free interval. J Clin Oncol 2010; 28:2512-9. [PMID: 20406929 DOI: 10.1200/jco.2009.26.9589] [Citation(s) in RCA: 725] [Impact Index Per Article: 51.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Selective tumor cell cytotoxicity can be achieved through a synthetic lethal strategy using poly(ADP)-ribose polymerase (PARP) inhibitor therapy in BRCA1/2 mutation carriers in whom tumor cells have defective homologous recombination (HR) DNA repair. Platinum-based chemotherapy responses correlate with HR DNA repair capacity. Olaparib is a potent, oral PARP inhibitor that is well tolerated, with antitumor activity in BRCA1/2 mutation carriers. PATIENTS AND METHODS Patients with BRCA1/2-mutated ovarian cancer were treated with olaparib within a dose-escalation and single-stage expansion of a phase I trial. Antitumor activity was subsequently correlated with platinum sensitivity. RESULTS Fifty patients were treated: 48 had germline BRCA1/2 mutations; one had a BRCA2 germline sequence change of unknown significance, and another had a strong family history of BRCA1/2-associated cancers who declined mutation testing. Of the 50 patients, 13 had platinum-sensitive disease, 24 had platinum-resistant disease, and 13 had platinum-refractory disease (according to platinum-free interval). Twenty (40%; 95% CI, 26% to 55%) achieved Response Evaluation Criteria in Solid Tumors (RECIST) complete or partial responses and/or tumor marker (CA125) responses, and three (6.0%) maintained RECIST disease stabilization for more than 4 months, giving an overall clinical benefit rate of 46% (95% CI, 32% to 61%). Median response duration was 28 weeks. There was a significant association between the clinical benefit rate and platinum-free interval across the platinum-sensitive, resistant, and refractory subgroups (69%, 45%, and 23%, respectively). Post hoc analyses indicated associations between platinum sensitivity and extent of olaparib response (radiologic change, P = .001; CA125 change, P = .002). CONCLUSION Olaparib has antitumor activity in BRCA1/2 mutation ovarian cancer, which is associated with platinum sensitivity.
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Affiliation(s)
- Peter C Fong
- Drug Development Unit, Royal Marsden National Health Service Foundation Trust, Sutton, Surrey, UK
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Bral S, Duchateau M, Versmessen H, Verdries D, Engels B, De Ridder M, Tournel K, Collen C, Everaert H, Schallier D, De Greve J, Storme G. Toxicity report of a phase 1/2 dose-escalation study in patients with inoperable, locally advanced nonsmall cell lung cancer with helical tomotherapy and concurrent chemotherapy. Cancer 2010; 116:241-50. [PMID: 19918925 DOI: 10.1002/cncr.24732] [Citation(s) in RCA: 8] [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: 11/06/2022]
Abstract
BACKGROUND The objective of the current study was to evaluate the feasibility and toxicity of radiation dose escalation with concurrent chemotherapy using helical tomotherapy (HT) in patients with inoperable, locally advanced, stage III nonsmall cell lung cancer (LANSCLC) (grading determined according to the American Joint Committee on Cancer 6th edition grading system). METHODS This phase 1/2 study was designed to determine the maximum tolerated dose (MTD) of radiotherapy in patients with LANSCLC administered concurrently with docetaxel and cisplatin. Radiotherapy was delivered using HT. A dose per fraction escalation was applied starting at 2 grays (Gy), with an increase of 6% per dose cohort (DC). The Radiation Therapy Oncology Group acute radiation morbidity score was used to monitor pulmonary, esophageal, and cardiac toxicity. RESULTS Dose escalation was performed in 34 patients over 5 DCs to a dose per fraction of 2.48 Gy. No differences were observed in acute toxicity between the different DCs. However, a significant increase in late lung toxicity in DC IV, which received a fraction size of 2.36 Gy, necessitated a halt in further dose escalation with the MTD defined as 2.24 Gy per fraction. The overall incidence of acute grade > or =3 esophageal and pulmonary toxicity was 24% and 3%, respectively (grading determined according to the Radiation Therapy Oncology Group-European Organisation for Research and Treatment of Cancer toxicity scoring system). The overall incidence of late lung toxicity was 21%, but the incidence was an acceptable 13% in DCs I, II, and III. The local response rate was 61% on computed tomography images. CONCLUSIONS The use of HT to 67.2 Gy with concurrent cisplatin/docetaxel was feasible and resulted in acceptable toxicity. A full phase 2 study has been initiated to establish the true local response rate at the MTD of 2.24 Gy per fraction.
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Affiliation(s)
- Samuel Bral
- Department of Radiation Oncology, Oncology Center, Brussels University Hospital, Brussels, Belgium.
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Makkat S, Luypaert R, Stadnik T, Bourgain C, Sourbron S, Dujardin M, De Greve J, De Mey J. Deconvolution-based dynamic contrast-enhanced MR imaging of breast tumors: correlation of tumor blood flow with human epidermal growth factor receptor 2 status and clinicopathologic findings--preliminary results. Radiology 2008; 249:471-82. [PMID: 18780825 DOI: 10.1148/radiol.2492071147] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE To prospectively determine whether breast carcinomas possess characteristic values of tumor blood flow (TBF) that correlate with pathologic and molecular prognostic markers. MATERIALS AND METHODS The institutional ethics committee approved this study. After informed consent was obtained, 57 women (age range, 31-80 years) with histologically proved breast cancer underwent routine magnetic resonance (MR) mammography, which included a whole-breast dynamic contrast material-enhanced (DCE) sequence. A second contrast material bolus was injected during dynamic single-section turbo field-echo imaging of the section where the lesion was maximally enhanced. The relative signal intensity changes were deconvolved in a pixelwise fashion to yield the TBF. Formalin-fixed paraffin-embedded tumor specimens on slides were evaluated for histologic size and grade, as well as for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) protein. In patients with a HER2 protein score of 2+ or 3+, HER2 gene status was assessed. For all prognostic parameters, the Mann-Whitney U test was used to compare median TBF in the HER2-positive group with that in the HER2-negative group. RESULTS Significantly higher TBF was observed in tumors larger than 2 cm in diameter and in PR-negative and HER2 gene-amplified tumors (P < .05). In the HER2-positive and HER2-negative groups, ER-positive PR-positive tumors had a lower median TBF than did ER-negative PR-negative tumors, and the difference was significant in the HER2-positive group (P < .05). CONCLUSION Pixelwise deconvolution analysis of DCE MR data in patients with breast cancer can provide preoperative information regarding TBF. These results also support the hypothesis that there is increased TBF in HER2-positive tumors.
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Affiliation(s)
- Smitha Makkat
- Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
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Neven P, Paridaens R, Pelgrims G, Martens M, Bols A, Goeminne JC, Vindevoghel A, Demol J, Stragier B, De Greve J, Fontaine C, Van Den Weyngaert D, Becquart D, Borms M, Cocquyt V, Van Den Broecke R, Selleslags J, Awada A, Dirix L, Van Dam P, Azerad MA, Vandenhoven G, Christiaens MR, Vergote I. Fulvestrant (Faslodex) in advanced breast cancer: clinical experience from a Belgian cooperative study. Breast Cancer Res Treat 2007; 109:59-65. [PMID: 17592772 DOI: 10.1007/s10549-007-9628-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Accepted: 05/22/2007] [Indexed: 10/23/2022]
Abstract
Fulvestrant (Faslodex) is a new estrogen receptor (ER) antagonist with no agonist effects that is licensed for the treatment of postmenopausal women with hormone-sensitive advanced breast cancer (ABC) who have progressed/recurred on prior antiestrogen therapy. The Faslodex Compassionate Use Program (CUP) provides expanded access to fulvestrant in countries where it is not yet available for patients who are not eligible to enter clinical trials. This analysis pools data from 402 patients who received fulvestrant as part of the CUP in Belgium, predominantly as 3rd- to 5th-line endocrine therapy for ABC. Two patients experienced partial responses and 118 experienced stable disease lasting>or=6 months, resulting in an overall clinical benefit rate of 29.9%. Fulvestrant was active in patients with multiple sites of metastases, visceral metastases, human epidermal growth factor receptor 2-positive disease and after heavy endocrine pre-treatment. Fulvestrant was well tolerated, with only six patients (1.5%) discontinuing treatment following adverse events. These data support the findings of previous CUP analyses and Phase II and III trials, suggesting that fulvestrant is a valuable addition to the treatment sequence for postmenopausal women with ABC who have progressed/recurred on prior endocrine therapy.
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Affiliation(s)
- Patrick Neven
- Multidisciplinary Breast Centre & Gynaecological Oncology, UZ KULeuven, Leuven, Belgium.
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But Hadzic J, Secerov A, Zwitter M, Lamovec J, Kern I, Kavsek G, Hergouth KM, De Greve J. Metastatic Adenocarcinoma of the Lung in a 27-Year-Old Pregnant Woman. J Thorac Oncol 2007; 2:450-2. [PMID: 17473662 DOI: 10.1097/01.jto.0000268680.33238.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Jasna But Hadzic
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
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Abou-Alfa GK, Schwartz L, Ricci S, Amadori D, Santoro A, Figer A, De Greve J, Douillard JY, Lathia C, Schwartz B, Taylor I, Moscovici M, Saltz LB. Phase II Study of Sorafenib in Patients With Advanced Hepatocellular Carcinoma. J Clin Oncol 2006; 24:4293-300. [PMID: 16908937 DOI: 10.1200/jco.2005.01.3441] [Citation(s) in RCA: 888] [Impact Index Per Article: 49.3] [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: 12/13/2022] Open
Abstract
Purpose This phase II study of sorafenib, an oral multikinase inhibitor that targets Raf kinase and receptor tyrosine kinases, assessed efficacy, toxicity, pharmacokinetics, and biomarkers in advanced hepatocellular carcinoma (HCC) patients. Methods Patients with inoperable HCC, no prior systemic treatment, and Child–Pugh (CP) A or B, received continuous, oral sorafenib 400 mg bid in 4-week cycles. Tumor response was assessed every two cycles using modified WHO criteria. Sorafenib pharmacokinetics were measured in plasma samples. Biomarker analysis included phosphorylated extracellular signal regulated kinase (pERK) in pretreatment biopsies (immunohistochemistry) and blood-cell RNA expression patterns in selected patients. Results Of 137 patients treated (male, 71%; median age, 69 years), 72% had CP A, and 28% had CP B. On the basis of independent assessment, three (2.2%) patients achieved a partial response, eight (5.8%) had a minor response, and 46 (33.6%) had stable disease for at least 16 weeks. Investigator-assessed median time to progression (TTP) was 4.2 months, and median overall survival was 9.2 months. Grade 3/4 drug-related toxicities included fatigue (9.5%), diarrhea (8.0%), and hand–foot skin reaction (5.1%). There were no significant pharmacokinetic differences between CP A and B patients. Pretreatment tumor pERK levels correlated with TTP. A panel of 18 expressed genes was identified that distinguished “nonprogressors” from “progressors” with an estimated 100% accuracy. Conclusion Although single-agent sorafenib has modest efficacy in HCC, the manageable toxicity and mechanisms of action support a role for combination regimens with other anticancer agents.
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Caers J, Fontaine C, Vinh-Hung V, De Mey J, Ponnet G, Oost C, Lamote J, De Greve J, Van Camp B, Lacor P. Catheter tip position as a risk factor for thrombosis associated with the use of subcutaneous infusion ports. Support Care Cancer 2004; 13:325-31. [PMID: 15538639 DOI: 10.1007/s00520-004-0723-1] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2004] [Accepted: 09/22/2004] [Indexed: 02/08/2023]
Abstract
AIMS The use of subcutaneous infusion ports has become standard practice to provide a long-term venous access in oncological patients. The aim of this retrospective study was to assess the different complications of infusion ports in our population and to identify predisposing factors. PATIENTS AND METHODS We reviewed the medical records of 437 patients who were followed at the Oncology/Haematology Department of our hospital. Of these patients, there were 370 (84.4%) with solid tumours and 58 (13.2%) with haematological disease. The position of the catheter tip was evaluated by reviewing the available chest radiographs or phlebographies. MAIN RESULTS Analysis of the records showed that 346 patients (79.17%) had no complications. The most common complications after implantation were thrombosis (8.46%), catheter dysfunction (4.8%) and infections (4.4%). Univariate and multivariate analysis showed that catheter tip positioning was the most important predisposing risk factor for thrombosis. Catheter tips positioned in the brachiocephalic vein or in the cranial part of the superior vena cava were associated with a high risk of thrombosis. Other significant risk factors were gender and initial diagnosis. Female patients and patients with lung cancer also had an elevated risk of developing a thrombosis. CONCLUSIONS Compared to other reports, we noted a higher rate of thrombosis and port dysfunction. Since catheter tip position was a predisposing factor for developing a thrombosis, correct catheter position has to be ensured during placement. Prophylactic antithrombotic treatment might be beneficial in the event of failure to position the catheter correctly.
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Affiliation(s)
- Jo Caers
- Department of Internal Medicine, Academic Hospital, Free University of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium.
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Teodoro WR, Greve JD, Takayama LM, Gomes MD. [Collagen in tendons from human supraspinal muscle]. Mem Inst Oswaldo Cruz 1991; 86 Suppl 3:113-4. [PMID: 1845235 DOI: 10.1590/s0074-02761991000700020] [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] [Indexed: 12/29/2022] Open
Affiliation(s)
- W R Teodoro
- Departamento de Cínica Médica, Faculdade de Medicina, Universidade São Paulo, Brasil
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