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Landen CN, Buckanovich RJ, Sill MW, Mannel RS, Walker JL, DiSilvestro PA, Mathews CA, Mutch DG, Hernandez ML, Martin LP, Bishop E, Gill SE, Gordinier ME, Burger RA, Aghajanian C, Liu JF, Moore KN, Bookman MA. Phase I and Randomized Phase II Study of Ruxolitinib With Frontline Neoadjuvant Therapy in Advanced Ovarian Cancer: An NRG Oncology Group Study. J Clin Oncol 2024:JCO2302076. [PMID: 38776484 DOI: 10.1200/jco.23.02076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/25/2024] [Accepted: 03/27/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE The interleukin-6/Janus kinase (JAK)/signal transducers and activators of transcription 3 axis is a reported driver of chemotherapy resistance. We hypothesized that adding the JAK1/2 inhibitor ruxolitinib to standard chemotherapy would be tolerable and improve progression-free survival (PFS) in patients with ovarian cancer in the upfront setting. MATERIALS AND METHODS Patients with ovarian/fallopian tube/primary peritoneal carcinoma recommended for neoadjuvant chemotherapy were eligible. In phase I, treatment was initiated with dose-dense paclitaxel (P) 70 mg/m2 once daily on days 1, 8, and 15; carboplatin AUC 5 intravenously day 1; and ruxolitinib 15 mg orally (PO) twice a day, every 21 days (dose level 1). Interval debulking surgery (IDS) was required after cycle 3. Patients then received three additional cycles of chemotherapy/ruxolitinib, followed by maintenance ruxolitinib. In the randomized phase II, patients were randomly assigned to paclitaxel/carboplatin with or without ruxolitinib at 15 mg PO twice a day for three cycles, IDS, followed by another three cycles of chemotherapy/ruxolitinib, without further maintenance ruxolitinib. The primary phase II end point was PFS. RESULTS Seventeen patients were enrolled in phase I. The maximum tolerated dose and recommended phase II dose were established to be dose level 1. One hundred thirty patients were enrolled in phase II with a median follow-up of 24 months. The regimen was well tolerated, with a trend toward higher grade 3 to 4 anemia (64% v 27%), grade 3 to 4 neutropenia (53% v 37%), and thromboembolic events (12.6% v 2.4%) in the experimental arm. In the randomized phase II, the median PFS in the reference arm was 11.6 versus 14.6 in the experimental, hazard ratio (HR) for PFS was 0.702 (log-rank P = .059). The overall survival HR was 0.785 (P = .24). CONCLUSION Ruxolitinib 15 mg PO twice a day was well tolerated with acceptable toxicity in combination with paclitaxel/carboplatin chemotherapy. The primary end point of prolongation of PFS was achieved in the experimental arm, warranting further investigation.
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Affiliation(s)
- Charles N Landen
- Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA
| | - Ronald J Buckanovich
- UPMC Hillman Cancer Center and Magee-Womens Research Institute and Foundation, Pittsburgh, PA
| | - Michael W Sill
- Clinical Trials Development Division, NRG Oncology Statistical and Data Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Robert S Mannel
- University of Oklahoma Health Sciences, Stephenson Cancer Center, Oklahoma City, OK
| | - Joan L Walker
- University of Oklahoma Health Sciences, Stephenson Cancer Center, Oklahoma City, OK
| | | | - Cara A Mathews
- Women & Infants Program in Women's Oncology, Providence, RI
| | - David G Mutch
- Gynecologic Oncology, Washington University, St Louis, MO
| | | | - Lainie P Martin
- Hospital of the University of Pennsylvania, Abramson Cancer Center, Philadelphia, PA
| | - Erin Bishop
- Froedtert & Medical College of Wisconsin, Milwaukee, WI
| | - Sarah E Gill
- Gynecologic Oncology, SJC Oncology Services-Georgia, LLC, Savannah, GA
| | | | - Robert A Burger
- Hospital of the University of Pennsylvania, Abramson Cancer Center, Philadelphia, PA
- Mersana Therapeutics, Cambridge, MA
| | - Carol Aghajanian
- Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY
| | - Joyce F Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Kathleen N Moore
- University of Oklahoma Health Sciences, Stephenson Cancer Center, Oklahoma City, OK
| | - Michael A Bookman
- Department of Medical Oncology, Kaiser-Permanente Northern California, San Francisco, CA
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Liu JF, Xiong N, Wenham RM, Wahner-Hendrickson A, Armstrong DK, Chan N, O'Malley DM, Lee JM, Penson RT, Cristea MC, Abbruzzese JL, Matsuo K, Olawaiye AB, Barry WT, Cheng SC, Polak M, Swisher EM, Shapiro GI, Kohn EC, Ivy SP, Matulonis UA. A phase 2 trial exploring the significance of homologous recombination status in patients with platinum sensitive or platinum resistant relapsed ovarian cancer receiving combination cediranib and olaparib. Gynecol Oncol 2024; 187:105-112. [PMID: 38759516 DOI: 10.1016/j.ygyno.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/27/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE Combination cediranib/olaparib has reported activity in relapsed ovarian cancer. This phase 2 trial investigated the activity of cediranib/olaparib in relapsed ovarian cancer and its association with homologous recombination deficiency (HRD). METHODS Seventy patients were enrolled to cohorts of either platinum-sensitive or platinum-resistant ovarian cancer and received olaparib tablets 200 mg twice daily and cediranib tablets 30 mg once daily under a continuous dosing schedule. HRD testing was performed on pre-treatment, on-treatment and archival biopsies by sequencing key homologous recombination repair (HRR) genes and by genomic LOH analysis. The primary objective for the platinum-sensitive cohort was the association of HRD, defined as presence of HRR gene mutation, with progression-free survival (PFS). The primary objective for the platinum-resistant cohort was objective response rate (ORR), with a key secondary endpoint evaluating the association of HRD status with activity. RESULTS In platinum-sensitive ovarian cancer (N = 35), ORR was 77.1% (95% CI 59.9-89.6%) and median PFS was 16.4 months (95% CI 13.2-18.6). Median PFS in platinum-sensitive HRR-HRD cancers (N = 22) was 16.8 months (95% CI 11.3-18.6), and 16.4 months (95% CI 9.4-NA) in HRR-HR proficient cancers (N = 13; p = 0.57). In platinum-resistant ovarian cancer (N = 35), ORR was 22.9% (95% CI 10.4-40.1%) with median PFS 6.8 months (95% CI 4.2-9.1). Median PFS in platinum-resistant HRR-HRD cancers (N = 7) was 10.5 months (95% CI 3.6-NA) and 5.6 months (95% CI 3.6-7.6) in HRR-HR proficient cancers (N = 18; p = 0.23). CONCLUSIONS Cediranib/olaparib had clinical activity in both platinum-sensitive and -resistant ovarian cancer. Presence of HRR gene mutations was not associated with cediranib/olaparib activity in either setting.
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Affiliation(s)
- Joyce F Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States of America.
| | - Niya Xiong
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, United States of America
| | - Robert M Wenham
- Department of Gynecologic Oncology, Moffitt Cancer Center, Tampa, FL, United States of America
| | | | - Deborah K Armstrong
- Department of Medical Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, United States of America
| | - Nancy Chan
- Department of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States of America
| | - David M O'Malley
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States of America
| | - Jung-Min Lee
- Women's Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States of America
| | - Richard T Penson
- Department of Medical Oncology, Massachusetts General Hospital, Boston, MA, United States of America
| | - Mihaela C Cristea
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - James L Abbruzzese
- Department of Medical Oncology, Duke Cancer Institute, Durham, NC, United States of America
| | - Koji Matsuo
- Department of Obstetrics & Gynecology, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States of America
| | - Alexander B Olawaiye
- Department of OBGYN, University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America
| | - William T Barry
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, United States of America
| | - Su-Chun Cheng
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, United States of America
| | - Madeline Polak
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States of America
| | - Elizabeth M Swisher
- Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, United States of America
| | - Geoffrey I Shapiro
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States of America
| | - Elise C Kohn
- Women's Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States of America; Clinical Investigations Branch, NCI Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD, United States of America
| | - S Percy Ivy
- Investigational Drug Branch, NCI Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD, United States of America
| | - Ursula A Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States of America
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Liu JF, Gaillard S, Wahner Hendrickson AE, Yeku O, Diver E, Gunderson Jackson C, Arend R, Ratner E, Samnotra V, Gupta D, Chung J, Zhang H, Compton N, Baines A, Bacqué E, Liu X, Felicetti B, Konecny GE. Niraparib, Dostarlimab, and Bevacizumab as Combination Therapy in Pretreated, Advanced Platinum-Resistant Ovarian Cancer: Findings From Cohort A of the OPAL Phase II Trial. JCO Precis Oncol 2024; 8:e2300693. [PMID: 38754056 DOI: 10.1200/po.23.00693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE To report the results of OPAL (ClinicalTrials.gov identifier: NCT03574779) cohort A, a single-arm substudy of niraparib plus dostarlimab and bevacizumab for the treatment of advanced, platinum-resistant ovarian cancer (PROC). METHODS Participants with PROC who received 1-2 previous lines of therapy were treated with niraparib (200 or 300 mg once daily), dostarlimab (500 mg once every 3 weeks for four 21-day cycles, followed by 1,000 mg once every 6 weeks), and bevacizumab (15 mg/kg once every 3 weeks). The primary end point was investigator-assessed objective response rate (ORR) per RECIST v1.1. Safety was also assessed. Exploratory biomarker end points included evaluation of changes in the tumor molecular profile and microenvironment using baseline and on-treatment tumor samples. RESULTS Of 41 enrolled participants (median age, 66.0 years [range, 37-83 years]), 9.8% had tumors that were BRCA-mutated, 19.5% were homologous recombination (HR)-deficient, and 17.1% were HR repair (HRR)-mutated. As of the cutoff date, all participants discontinued treatment. The ORR was 17.1% (80% CI, 9.8 to 27.0), including one complete response (2.4%); the disease control rate was 73.2% (80% CI, 62.3 to 82.2). Two participants withdrew before first postbaseline scan because of adverse events (AEs). Grade ≥3 treatment-emergent AEs were reported in 92.7% of participants, with the most common being hypertension (26.8%). Response was not correlated with BRCA, HRR, HR deficiency (HRD), or PD-L1 status. Changes suggesting immune activation were observed in on-treatment samples after triplet therapy. CONCLUSION Results demonstrated modest activity of niraparib, dostarlimab, and bevacizumab in participants with PROC, many of whom had prognostic factors for poor treatment response. Most participants with response were bevacizumab-naïve. No association was found with HRD, BRCA, or PD-L1 status. AEs were consistent with previous monotherapy reports, except that hypertension was reported more frequently.
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Corcoran RB, Do KT, Kim JE, Cleary JM, Parikh AR, Yeku OO, Xiong N, Weekes CD, Veneris J, Ahronian LG, Mauri G, Tian J, Norden BL, Michel AG, Van Seventer EE, Siravegna G, Camphausen K, Chi G, Fetter IJ, Brugge JS, Chen H, Takebe N, Penson RT, Juric D, Flaherty KT, Sullivan RJ, Clark JW, Heist RS, Matulonis UA, Liu JF, Shapiro GI. Phase I/II Study of Combined BCL-xL and MEK Inhibition with Navitoclax and Trametinib in KRAS or NRAS Mutant Advanced Solid Tumors. Clin Cancer Res 2024; 30:1739-1749. [PMID: 38456660 PMCID: PMC11061595 DOI: 10.1158/1078-0432.ccr-23-3135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/11/2023] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE MEK inhibitors (MEKi) lack monotherapy efficacy in most RAS-mutant cancers. BCL-xL is an anti-apoptotic protein identified by a synthetic lethal shRNA screen as a key suppressor of apoptotic response to MEKi. PATIENTS AND METHODS We conducted a dose escalation study (NCT02079740) of the BCL-xL inhibitor navitoclax and MEKi trametinib in patients with RAS-mutant tumors with expansion cohorts for: pancreatic, gynecologic (GYN), non-small cell lung cancer (NSCLC), and other cancers harboring KRAS/NRAS mutations. Paired pretreatment and day 15 tumor biopsies and serial cell-free (cf)DNA were analyzed. RESULTS A total of 91 patients initiated treatment, with 38 in dose escalation. Fifty-eight percent had ≥3 prior therapies. A total of 15 patients (17%) had colorectal cancer, 19 (11%) pancreatic, 15 (17%) NSCLC, and 32 (35%) GYN cancers. The recommended phase II dose (RP2D) was established as trametinib 2 mg daily days 1 to 14 and navitoclax 250 mg daily days 1 to 28 of each cycle. Most common adverse events included diarrhea, thrombocytopenia, increased AST/ALT, and acneiform rash. At RP2D, 8 of 49 (16%) evaluable patients achieved partial response (PR). Disease-specific differences in efficacy were noted. In patients with GYN at the RP2D, 7 of 21 (33%) achieved a PR and median duration of response 8.2 months. No PRs occurred in patients with colorectal cancer, NSCLC, or pancreatic cancer. MAPK pathway inhibition was observed in on-treatment tumor biopsies. Reductions in KRAS/NRAS mutation levels in cfDNA correlated with clinical benefit. CONCLUSIONS Navitoclax in combination with trametinib was tolerable. Durable clinical responses were observed in patients with RAS-mutant GYN cancers, warranting further evaluation in this population.
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Affiliation(s)
- Ryan B. Corcoran
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Khanh T. Do
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Jeong E. Kim
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - James M. Cleary
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Aparna R. Parikh
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Oladapo O. Yeku
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Niya Xiong
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Colin D. Weekes
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Jennifer Veneris
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Leanne G. Ahronian
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Gianluca Mauri
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, and Department of Hematology Oncology, and Molecular Medicine, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Jun Tian
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Bryanna L. Norden
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Alexa G. Michel
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Emily E. Van Seventer
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Giulia Siravegna
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Kyle Camphausen
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Gary Chi
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Isobel J. Fetter
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Joan S. Brugge
- Department of Cell Biology, Harvard Medical School, Boston, Massachusetts
| | - Helen Chen
- National Institute of Health, National Cancer Institute, Division of Cancer Treatment and Diagnosis, Cancer Therapy Evaluation Program, Bethesda, Maryland
| | - Naoko Takebe
- National Institute of Health, National Cancer Institute, Division of Cancer Treatment and Diagnosis, Cancer Therapy Evaluation Program, Bethesda, Maryland
| | - Richard T. Penson
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Dejan Juric
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Keith T. Flaherty
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Ryan J. Sullivan
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Jeffrey W. Clark
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Rebecca S. Heist
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Ursula A. Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Joyce F. Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Geoffrey I. Shapiro
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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Konstantinopoulos PA, Xiong N, Krasner C, Liu JF, Sawyer H, Polak M, Needham H, Geddes M, Koppermann L, Shea M, Castro C, Cheng SC, Matulonis UA, Lee EK. Combined aromatase, CDK4/6 and PI3K blockade using letrozole/abemaciclib/LY3023414 in endometrial cancer. Gynecol Oncol Rep 2024; 52:101348. [PMID: 38425459 PMCID: PMC10901901 DOI: 10.1016/j.gore.2024.101348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/11/2024] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Abstract
Several lines of preclinical evidence indicate that combining PI3K and CDK4/6 inhibitors may further enhance the efficacy of hormonal therapy by overcoming de novo and acquired resistance to PI3K and CDK4/6 blockade. We evaluated the combination of abemaciclib, letrozole and LY3023414 (an orally available, selective inhibitor of the class I PI3K isoforms and mTORC1/2) in recurrent endometrial cancer (EC). This study was terminated prematurely after 5 patients initiated protocol therapy due to discontinuation of further development of LY3023414. We report our findings from these patients, including one with recurrent endometrioid EC with AKT1, CTNNB1 and ESR1 hotspot mutations who had previously progressed through letrozole/everolimus and achieved a partial response to letrozole/abemaciclib/LY3023414.
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Affiliation(s)
| | - Niya Xiong
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | | | | | | | | | | | - Meghan Shea
- Beth Israel Deaconess Medical Center, Boston, MA, USA
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Konstantinopoulos PA, Cheng SC, Lee EK, da Costa AABA, Gulhan D, Wahner Hendrickson AE, Kochupurakkal B, Kolin DL, Kohn EC, Liu JF, Penson RT, Stover EH, Curtis J, Sawyer H, Polak M, Chowdhury D, D'Andrea AD, Färkkilä A, Shapiro GI, Matulonis UA. Randomized Phase II Study of Gemcitabine With or Without ATR Inhibitor Berzosertib in Platinum-Resistant Ovarian Cancer: Final Overall Survival and Biomarker Analyses. JCO Precis Oncol 2024; 8:e2300635. [PMID: 38635934 DOI: 10.1200/po.23.00635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/28/2023] [Accepted: 02/29/2024] [Indexed: 04/20/2024] Open
Abstract
PURPOSE The multicenter, open-label, randomized phase 2 NCI-9944 study (NCT02595892) demonstrated that addition of ATR inhibitor (ATRi) berzosertib to gemcitabine increased progression-free survival (PFS) compared to gemcitabine alone (hazard ratio [HR]=0.57, one-sided log-rank P = .044, which met the one-sided significance level of 0.1 used for sample size calculation). METHODS We report here the final overall survival (OS) analysis and biomarker correlations (ATM expression by immunohistochemistry, mutational signature 3 and a genomic biomarker of replication stress) along with post-hoc exploratory analyses to adjust for crossover from gemcitabine to gemcitabine/berzosertib. RESULTS At the data cutoff of January 27, 2023 (>30 months of additional follow-up from the primary analysis), median OS was 59.4 weeks with gemcitabine/berzosertib versus 43.0 weeks with gemcitabine alone (HR 0.79, 90% CI 0.52 to 1.2, one-sided log-rank P = .18). An OS benefit with addition of berzosertib to gemcitabine was suggested in patients stratified into the platinum-free interval ≤3 months (N = 26) subgroup (HR, 0.48, 90% CI 0.22 to 1.01, one-sided log-rank P =.04) and in patients with ATM-negative/low (N = 24) tumors (HR, 0.50, 90% CI 0.23 to 1.08, one-sided log-rank P = .06). CONCLUSION The results of this follow-up analysis continue to support the promise of combined gemcitabine/ATRi therapy in platinum resistant ovarian cancer, an active area of investigation with several ongoing clinical trials.
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Affiliation(s)
| | - Su-Chun Cheng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Elizabeth K Lee
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Alexandre André B A da Costa
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA
- Center for DNA Damage and Repair, Dana-Farber Cancer Institute, Boston, MA
| | - Doga Gulhan
- Department of Biomedical Informatics and Ludwig Center at Harvard, Harvard Medical School, Boston, MA
| | | | - Bose Kochupurakkal
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA
- Center for DNA Damage and Repair, Dana-Farber Cancer Institute, Boston, MA
| | - David L Kolin
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - Elise C Kohn
- Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD
| | - Joyce F Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Richard T Penson
- Department of Medical Oncology, Massachusetts General Hospital, Boston, MA
| | - Elizabeth H Stover
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Jennifer Curtis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Hannah Sawyer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Madeline Polak
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Dipanjan Chowdhury
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Alan D D'Andrea
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA
- Center for DNA Damage and Repair, Dana-Farber Cancer Institute, Boston, MA
| | - Anniina Färkkilä
- Research Program in Systems Oncology, FIMM and HiLife, University of Helsinki, Helsinki, Finland
| | - Geoffrey I Shapiro
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Ursula A Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
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7
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Wang YM, Liu YS, Li J, Zhang Q, Yan TT, Ren DF, Zhu L, Zhang GY, Yang Y, Liu JF, Chen TY, Zhao YR, He YL. [Prognostic nutritional index application value for acute-on-chronic liver failure co-infection]. Zhonghua Gan Zang Bing Za Zhi 2024; 32:235-241. [PMID: 38584105 DOI: 10.3760/cma.j.cn501113-20240109-00021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Objective: To explore the predictive value of the prognostic nutritional index (PNI) in concurrently infected patients with acute-on-chronic liver failure (ACLF). Methods: 220 cases with ACLF diagnosed and treated at the First Affiliated Hospital of Xi'an Jiaotong University from January 2011 to December 2016 were selected. Patients were divided into an infection and non-infection group according to whether they had co-infections during the course of the disease. Clinical data differences were compared between the two groups of patients. Binary logistic regression analysis was used to screen out influencing factors related to co-infection. The receiver operating characteristic curve was used to evaluate the predictive value of PNI for ACLF co-infection. The measurement data between groups were compared using the independent sample t-test and the Mann-Whitney U rank sum test. The enumeration data were analyzed using the Fisher exact probability test or the Pearson χ(2) test. The Pearson method was performed for correlation analysis. The independent risk factors for liver failure associated with co-infection were analyzed by multivariate logistic analysis. Results: There were statistically significant differences in ascites, hepatorenal syndrome, PNI score, and albumin between the infection and the non-infection group (P < 0.05). Among the 220 ACLF cases, 158 (71.82%) were infected with the hepatitis B virus (HBV). The incidence rate of infection during hospitalization was 69.09% (152/220). The common sites of infection were intraabdominal (57.07%) and pulmonary infection (29.29%). Pearson correlation analysis showed that PNI and MELD-Na were negatively correlated (r = -0.150, P < 0.05). Multivariate logistic analysis results showed that low PNI score (OR=0.916, 95%CI: 0.865~0.970), ascites (OR=4.243, 95%CI: 2.237~8.047), and hepatorenal syndrome (OR=4.082, 95%CI : 1.106~15.067) were risk factors for ACLF co-infection (P < 0.05). The ROC results showed that the PNI curve area (0.648) was higher than the MELD-Na score curve area (0.610, P < 0.05). The effectiveness of predicting infection risk when PNI was combined with ascites and hepatorenal syndrome complications was raised. Patients with co-infections had a good predictive effect when PNI ≤ 40.625. The sensitivity and specificity were 84.2% and 41.2%, respectively. Conclusion: Low PNI score and ACLF co-infection have a close correlation. Therefore, PNI has a certain appraisal value for ACLF co-infection.
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Affiliation(s)
- Y M Wang
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Y S Liu
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - J Li
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Q Zhang
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - T T Yan
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - D F Ren
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - L Zhu
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - G Y Zhang
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Y Yang
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - J F Liu
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - T Y Chen
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Y R Zhao
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Y L He
- Department of Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China Shaanxi Clinical Research Center for Infectious Diseases, Xi'an 710061, China Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
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8
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Li TY, Zhang YL, Zhou XL, Li B, Liu JF. [Advancements in the research of congenital anosmia]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 59:180-186. [PMID: 38369800 DOI: 10.3760/cma.j.cn115330-20231010-00135] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Affiliation(s)
- T Y Li
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - Y L Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - X L Zhou
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - B Li
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - J F Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
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9
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St Laurent J, Liu JF. Treatment Approaches for Platinum-Resistant Ovarian Cancer. J Clin Oncol 2024; 42:127-133. [PMID: 37910841 DOI: 10.1200/jco.23.01771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/25/2023] [Accepted: 09/13/2023] [Indexed: 11/03/2023] Open
Abstract
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.
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Affiliation(s)
- Jessica St Laurent
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Dana Farber Cancer Institute, Boston, MA
| | - Joyce F Liu
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA
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10
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Zhao CQ, Sun XC, Wan YZ, Ye J, Tan GL, Liu JF, Wang YJ, Cheng FL, An YF. [The principle and practice of vidian neurectomy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 59:51-56. [PMID: 38212135 DOI: 10.3760/cma.j.cn115330-20231010-00129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
The latest research findings on bidirectional regulation of neuro-immunity through traditional neural circuits shed new light on the theoretical basis of the role of vidian neurectomy (VN). This article aims to provide a comprehensive understanding of VN, including the history of VN, the principle of neuroimmuno-interaction, the applied anatomy of VN as well as the methods of transnasal endoscopic surgery. Additionally, we introduce the concept of the nose-brain axis, which was proposed based on the advancement in the area of neuro-immune interactions.
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Affiliation(s)
- C Q Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital, Shanxi Medical University, Taiyuan 030000, China
| | - X C Sun
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Y Z Wan
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan 250022, China
| | - J Ye
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - G L Tan
- Department of Otorhinolaryngology Head and Neck Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - J F Liu
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Y J Wang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital, Shanxi Medical University, Taiyuan 030000, China
| | - F L Cheng
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital, Shanxi Medical University, Taiyuan 030000, China
| | - Y F An
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital, Shanxi Medical University, Taiyuan 030000, China
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11
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Yan S, Tu CY, Du CY, Luo J, Liu JF, Liu TQ, Liu Q, Liu J, Li XH, Wang LC, Fang ZP, Yi WM, Chen YJ, Li QL, Ni Y, Wu JC, Qin CJ, Gu YL, Lu Z, Lun ZJ, Du LX, Chen G, Zheng QC, Sun KJ, Han WQ, Yu J. [Effect of recombinant human thrombin for hemostasis in liver resection: a randomized controlled phase Ⅲ clinical trial]. Zhonghua Yi Xue Za Zhi 2023; 103:3416-3423. [PMID: 37963740 DOI: 10.3760/cma.j.cn112137-20230911-00438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Objective: To evaluate the hemostatic efficacy, safety and immunogenicity of recombinant human thrombin in the treatment of liver wounds that still ooze after conventional surgical hemostasis. Methods: A multicenter, stratified randomized, double-blind, placebo-controlled phase Ⅲ trial with a planned enrollment of 510 subjects at 33 centers, with a 2∶1 randomization to the thrombin group versus the placebo group. An interim analysis will be conducted after approximately 70% of the subjects have completed the observation period. The primary efficacy endpoint was the rate of hemostasis within 6 minutes at the point of bleeding that could be evaluated. Safety analysis was performed one month after surgery, and the positive rates of anti-drug antibody (ADA) and neutralizing antibody were evaluated. Results: At the interim analysis, a total of 348 subjects had been randomized and received the study drug (215 were male and 133 were female). They were aged 19-69 (52.9±10.9)years. Among them, 232 were in the thrombin group and 116 were in the placebo group, with balanced and comparable demographics and baseline characteristics between the two groups. The hemostasis rate at 6 minutes was 71.6% (95%CI:65.75%-77.36%) in the thrombin group and 44.0% (95%CI: 34.93%-53.00%) in the placebo group, respectively (P<0.001). No grade≥3 drug-related adverse events and no drug-related deaths were reported from the study.No recombinant human thrombin-induced immunologically-enhanced ADA or immunologically-induced ADA was detected after topical use in subjects. Conclusion: Recombinant human thrombin has shown significant hemostatic efficacy and good safety in controlling bleeding during liver resection surgery, while also demonstrating low immunogenicity characteristics.
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Affiliation(s)
- S Yan
- Department of Hepatobiliary and Pancreatic Surgery, the Second Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China
| | - C Y Tu
- Department of General Surgery, Lishui Central Hospital, Lishui 323020, China
| | - C Y Du
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China
| | - J Luo
- Department of Hepatobiliary and Intestinal Surgery, Hunan Cancer Hospital, Changsha 410031, China
| | - J F Liu
- Department of Hepatobiliary and Pancreatic Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, China
| | - T Q Liu
- Department of General Surgery, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
| | - Q Liu
- Department of Hepatobiliary Surgery, Liuzhou People's Hospital, Liuzhou 545006, China
| | - J Liu
- Department of Hepatobiliary Surgery, Guizhou Provicial People's Hospital, Guiyang 550002, China
| | - X H Li
- Department of Hepatobiliary Surgery, Liaocheng People's Hospital, Liaocheng 252000, China
| | - L C Wang
- Department of General Surgery, the Third People's Hospital of Hainan Province, Sanya 572000, China
| | - Z P Fang
- Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Linhai 317099, China
| | - W M Yi
- Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, Changsha 410005, China
| | - Y J Chen
- Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510120, China
| | - Q L Li
- Department of Hepatobiliary and Pancreatic Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Y Ni
- Department of Hepatobiliary and Pancreatic Surgery, Shenzhen Second People's Hospital, Shenzhen 518035, China
| | - J C Wu
- Department of Hepatobiliary Surgery, Hainan Provincial People's Hospital, Haikou 570311, China
| | - C J Qin
- Department of General Surgery, Huaihe Hospital of Henan University, Kaifeng 475000, China
| | - Y L Gu
- Department of Hepatobiliary Surgery, Affiliated Hospital of Jiangnan Univeisity, Wuxi 214122, China
| | - Z Lu
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
| | - Z J Lun
- Department of Hepatobiliary Vascular Surgery, Zaozhuang Municipal Hospital, Zaozhuang 277101, China
| | - L X Du
- Department of Hepatobiliary Surgery, Shanxi Provincial People's Hospital, Xi'an 710068, China
| | - G Chen
- Department of Hepatobiliary and Pancreatic Surgery, the First People's Hospital of Kunming, Kunming 650034, China
| | - Q C Zheng
- Department of Hepatobiliary Surgery, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022, China
| | - K J Sun
- Department of Hepatobiliary Surgery, Zibo Central Hospital, Zibo 255036, China
| | - W Q Han
- Department of Urinary Surgery, Hunan Cancer Hospital, Changsha 410031, China
| | - J Yu
- Department of Hepatobiliary and Pancreatic Surgery, the First Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China
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12
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Zhang ZK, Wang YJ, Liu JF. [Arrested pneumatization of the sphenoid sinus: imaging characteristics]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:986-991. [PMID: 37767655 DOI: 10.3760/cma.j.cn115330-20230301-00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Objective: To explore and analyze the imaging features of arrested pneumatization of the sphenoid sinus, so as to provide reference for identifying sphenoid lesions. Methods: From May 2018 to September 2019, a retrospective analysis was conducted on 350 patients (183 males and 167 females, aged between 18 and 73 years) who had been completed the sinus CT examination in the outpatient department of Beijing Chaoyang Hospital Affiliated to Capital Medical University. Their imaging data were collected and the CT/MRI characteristics of the sphenoid body were observed. SPSS 26.0 software was used for statistical analysis. Results: The rate of arrested pneumatization of the sphenoid sinus was 2.0% (7/350), which occurred in the pteroid process, the slope region, and the sphenoid sinus body, respectively. CT showed a nondilated mixed-density lesion (7/7) in the pneumatizable sphenoid body. Within these regions, both fat and soft tissue density (7/7) were present. Internal curve calcification was observed in part of the region (3/7). The skull base canal structure was not affected (7/7). MRI showed a clear non-dilated lesion with an adipose signal, and none of the lesions showed medulla dilation or cortical destruction. Conclusions: Arrested pneumatization of the sphenoid sinus is a normal anatomic variation. When non-dilated lesions with clear bony boundaries and internal fatty components are encountered in the vaporizable region of the sphenoid sinus, the possibility of arrested pneumatization of the sphenoid sinus should be considered.
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Affiliation(s)
- Z K Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Y J Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J F Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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13
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Zhang RQ, Li YF, Wang YB, Zhao JH, Liu JF. [Clinical study on dysosmia associated with SARS-CoV-2 infection]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:1038-1044. [PMID: 37840173 DOI: 10.3760/cma.j.cn115330-20230117-00030] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Affiliation(s)
- R Q Zhang
- Beijing University of Chinese Medicine, Beijing 100029, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - Y F Li
- Beijing University of Chinese Medicine, Beijing 100029, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - Y B Wang
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - J H Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - J F Liu
- Beijing University of Chinese Medicine, Beijing 100029, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
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14
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Wright AA, Poort H, Tavormina A, Schmiege SJ, Matulonis UA, Campos SM, Liu JF, Slivjak ET, Gilmour AL, Salinger JM, Haggerty AF, Arch JJ. Pilot randomized trial of an acceptance-based telehealth intervention for women with ovarian cancer and PARP inhibitor-related fatigue. Gynecol Oncol 2023; 177:165-172. [PMID: 37708581 DOI: 10.1016/j.ygyno.2023.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVE Poly(ADP-ribose) polymerase inhibitors (PARPi) have dramatically changed treatment for advanced ovarian cancer, but nearly half of patients experience significant fatigue. We conducted a two-site pilot randomized trial to evaluate the feasibility, acceptability, and preliminary efficacy of a brief, acceptance-based telehealth intervention (REVITALIZE) designed to reduce fatigue interference in patients on PARPi. METHODS From June 2021 to April 2022, 44 participants were randomized 1:1 to REVITALIZE (6 weekly one-on-one sessions+booster) or enhanced usual care. Feasibility was defined as: ≥50% approach-to-consent among potentially eligible patients and ≥70% completion of 12-week follow-up assessment; acceptance was <20% participants reporting burden and <20% study withdrawal. Fatigue, anxiety, depression, and quality of life were assessed at baseline, 4-, 8- and 12-weeks. RESULTS Among 44 participants (mean age = 62.5 years, 81.8% stage III/IV disease), the study was feasible (56.4% approach-to-consent ratio, 86.3% completion of 12-week assessment) and acceptable (0% reporting burden, 11.3% study withdrawal). At 12-week follow-up, REVITALIZE significantly reduced fatigue interference (Cohen's d = 0.94, p = .008) and fatigue severity (d = 0.54, p = .049), and improved fatigue levels (d = 0.62, p = .04) relative to enhanced usual care. REVITALIZE also showed promise for improved fatigue self-efficacy, fatigue catastrophizing, anxiety, depression, and quality of life (ds = 0.60-0.86, p ≥ .05). Compared with enhanced usual care, REVITALIZE participants had fewer PARPi dose reductions (6.7% vs. 19.0%), and dose delays (6.7% vs. 23.8%). CONCLUSIONS Among fatigued adults with ovarian cancer on PARPi, a brief, acceptance-based telehealth intervention was feasible, acceptable, and demonstrated preliminary efficacy in improving fatigue interference, severity, and levels. REVITALIZE is a novel, scalable telehealth intervention worthy of further investigation.
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Affiliation(s)
- Alexi A Wright
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA; Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA.
| | - Hanneke Poort
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Anna Tavormina
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Sarah J Schmiege
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Center Campus, Aurora, CO, USA
| | - Ursula A Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Susana M Campos
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Joyce F Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | | | | | | | - Ashley F Haggerty
- PENN Medicine, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Joanna J Arch
- University of Colorado Boulder, Boulder, CO, USA; Cancer Prevention and Control Program, University of Colorado Cancer Center, Anschutz Medical Center Campus, School of Medicine, Aurora, CO, USA
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15
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Li YF, Zhang RQ, Wang YB, Zhao JH, Liu JF. [Research status in COVID-19-related taste dysfunction]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:817-822. [PMID: 37599248 DOI: 10.3760/cma.j.cn115330-20230106-00008] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Affiliation(s)
- Y F Li
- Beijing University of Chinese Medicine, Beijing 100029, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - R Q Zhang
- Beijing University of Chinese Medicine, Beijing 100029, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - Y B Wang
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - J H Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - J F Liu
- Beijing University of Chinese Medicine, Beijing 100029, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
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16
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Liu MF, Ma RX, Cao XB, Zhang H, Zhou SH, Jiang WH, Jiang Y, Sun JW, Yang QT, Li XZ, Sun YN, Shi L, Wang M, Song XC, Chen FQ, Zhang XS, Wei HQ, Yu SQ, Zhu DD, Ba L, Cao ZW, Xiao XP, Wei X, Lin ZH, Chen FH, Shan CG, Wang GK, Ye J, Qu SH, Zhao CQ, Wang ZL, Li HB, Liu F, Cui XB, Ye SN, Liu Z, Xu Y, Cai X, Hang W, Zhang RX, Zhao YL, Yu GD, Shi GG, Lu MP, Shen Y, Zhao YT, Pei JH, Xie SB, Yu LG, Liu YH, Gu SS, Yang YC, Cheng L, Liu JF. [Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:579-588. [PMID: 37339898 DOI: 10.3760/cma.j.cn115330-20230316-00117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.
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Affiliation(s)
- M F Liu
- Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - R X Ma
- Department of Otorhinolaryngology Head and Neck Surgery, the First People's Hospital of Yinchuan, Yinchuan 750001, China
| | - X B Cao
- Department of Otorhinolaryngology, the First People's Hospital of Yunnan Province, Kunming 650100, China
| | - H Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - S H Zhou
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China
| | - W H Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - Y Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - J W Sun
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of USTC, Hefei 230001, China
| | - Q T Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - X Z Li
- Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Y N Sun
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - L Shi
- Department of Rhinology and Allergy, Shandong Provincial ENT Hospital, Shandong University, Jinan 250299, China
| | - M Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Peking University People's Hospital, Beijing 100032, China
| | - X C Song
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China
| | - F Q Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an 710032, China
| | - X S Zhang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
| | - H Q Wei
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - S Q Yu
- Department of Otorhinolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical University, Shanghai 200065, China
| | - D D Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - L Ba
- Department of Otorhinolaryngology Head and Neck Surgery, Xizang Autonomous Region People's Hospital, Lasa 850000, China
| | - Z W Cao
- Department of Otorhinolaryngology Head and Neck Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - X P Xiao
- Department of Otorhinolaryngology Head and Neck Surgery, Hunan Provincial People's Hospital, Changsha 410005, China
| | - X Wei
- Department of Otorhinolaryngology Head and Neck Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, China
| | - Z H Lin
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China
| | - F H Chen
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - C G Shan
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - G K Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - J Ye
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - S H Qu
- Department of Otorhinolaryngology Head and Neck Surgery, Guangxi Zhuang Autonomous Region People's Hospital, Nanning 530021, China
| | - C Q Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, Shanxi Medical University Affiliated Second Hospital, Taiyuan 030001, China
| | - Z L Wang
- Department of Otorhinolaryngology Head and Neck Surgery, XuanWu Hospital, Capital Medical University, Beijing 100053, China
| | - H B Li
- Department of Otorhinolaryngology Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - F Liu
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - X B Cui
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010059, China
| | - S N Ye
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Z Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - X Cai
- Department of Otorhinolaryngology Head and Neck Surgery, Qinghai Provincial People's Hospital, Xining 810000, China
| | - W Hang
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin Huanhu Hospital, Tianjin 300350, China
| | - R X Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - Y L Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - G D Yu
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - G G Shi
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan 250021, China
| | - M P Lu
- Department of Otorhinolaryngology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Y Shen
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Y T Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, the First People's Hospital of Yinchuan, Yinchuan 750001, China
| | - J H Pei
- Department of Otorhinolaryngology, the First People's Hospital of Yunnan Province, Kunming 650100, China
| | - S B Xie
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - L G Yu
- Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Y H Liu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - S S Gu
- Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Y C Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - L Cheng
- Department of Otorhinolaryngology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - J F Liu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
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Lee JM, Liu JF. One fixed dosing of a poly(adenosine diphosphate ribose) polymerase inhibitor does not fit all. Cancer 2023; 129:1795-1796. [PMID: 37060235 DOI: 10.1002/cncr.34705] [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: 04/16/2023]
Affiliation(s)
- Jung-Min Lee
- Women's Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | - Joyce F Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Maryland, USA
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Meisenheimer B, Vo HV, McQueeney KE, Saldanha AL, Feeney C, Qi CH, Narayan S, Curtis JD, Nucci MR, Letai A, Paweletz CP, Liu JF, Matulonis UA, Ivanova E. Abstract 162: Individualizing treatment using patient derived organoids, BH3 profiling and microfluidics: A proof of concept in a patient with low-grade serous ovarian carcinoma. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-162] [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: 04/07/2023]
Abstract
Abstract
Background N of 1 treatment paradigms represent the pinnacle of personalized medicine in which a patient’s tumors are profiled to guide treatment. Low-grade serous ovarian cancer (LGSC) is a distinct subtype of ovarian cancer, comprising ~10% of serous carcinomas and typically characterized by a younger age of onset. Molecularly, these tumors are often characterized by alterations within the Ras signaling pathway, including KRAS mutations. Clinically, LGSC is often resistant to standard cytotoxic chemotherapy, but may have sensitivity to hormonal therapy or MEK inhibitors. Here we report on a platform and proof of concept in one LGSC patient to evaluate personalized tumor-directed therapy regimens using patient-derived organoids (PDOs), BH3 profiling and viability evaluation in 3D microfluidic devices.
Methods A patient with LGSC presented to the Dana Farber Cancer Institute and was treated with carboplatin and paclitaxel before a total abdominal hysterectomy with a bilateral salpingo-oophorectomy. Tissue was obtained under an IRB approved protocol and PDOs were established. Standard of care and non-standard of care treatments including doxorubicin, abemaciclib, letrozole, alpelisib, tamoxifen, trametinib, venetoclax, and navitoclax were evaluated by two orthogonal assays. First, they were tested for delta priming by BH3 profiling (Bhola et.al., Sci Signal. 2020 ) and second for cell viability using 3D microfluidic devices by TMRM/DRAQ7 dual-color fluorescent staining. Standard of care treatments carboplatin and paclitaxel were evaluated as individual treatments and in combination in 3D microfluidic devices.
Results We successfully established a PDO model from the patient’s tumor sample in 14 days. BH3 profiling at 24 hours and viability in 3D microfluidic devices after 6 days in treatment showed that from the eight tested drugs, the model was sensitive to navitoclax and venetoclax. Average percent change in viability was -91.5% and -89.9%, respectively, and the drugs had a dynamic BH3 profiling index of 551.4 AUC (+/- 76.63) and 488.9 AUC (+/- 21.46) with the threshold of response being >175 for BH3 profiling. Trametinib showed a clear response in 3D, with an average percent change of -72.6% compared to the control but no significant response in BH3 profiling. Neither carboplatin and paclitaxel alone, nor in combination, elicited a significant change in viability. This observation was consistent with the patient’s history prior to surgery, where the tumor did not demonstrate significant clinical response to neoadjuvant carboplatin and paclitaxel therapy.
Conclusions We describe a proof of concept of a N of 1 response assessment platform for LGSC using PDOs, BH3 profiling and live/dead fluorescent staining in microfluidic devices and demonstrate that BH3 profiling and 3D viability assessment assays show good congruity.
Citation Format: Brittany Meisenheimer, Ha V. Vo, Kelley E. McQueeney, Aisha L. Saldanha, Carina Feeney, Courtney H. Qi, Swati Narayan, Jennifer D. Curtis, Marisa R. Nucci, Anthony Letai, Cloud P. Paweletz, Joyce F. Liu, Ursula A. Matulonis, Elena Ivanova. Individualizing treatment using patient derived organoids, BH3 profiling and microfluidics: A proof of concept in a patient with low-grade serous ovarian carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 162.
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Affiliation(s)
| | - Ha V. Vo
- 1Dana-Farber Cancer Institute, Boston, MA
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19
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Zhang Y, Liu JF, Guo M. [Progress on diagnosis and treatment of nasal valve dysfunction]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:380-384. [PMID: 37005775 DOI: 10.3760/cma.j.cn115330-20221122-00701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- Y Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J F Liu
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China
| | - M Guo
- Department of Orthopedic, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Konstantinopoulos PA, Lee EK, Xiong N, Krasner C, Campos S, Kolin DL, Liu JF, Horowitz N, Wright AA, Bouberhan S, Penson RT, Yeku O, Bowes B, Needham H, Hayes M, Sawyer H, Polak M, Shea M, Cheng SC, Castro C, Matulonis UA. A Phase II, Two-Stage Study of Letrozole and Abemaciclib in Estrogen Receptor-Positive Recurrent Endometrial Cancer. J Clin Oncol 2023; 41:599-608. [PMID: 36174113 DOI: 10.1200/jco.22.00628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Estrogen receptor (ER)-positive endometrial cancers (ECs) are characterized by phosphatidylinositol 3-kinase (PI3K) and receptor tyrosine kinase (RTK)/RAS/β-catenin (CTNNB1) pathway alterations in approximately 90% and 80% of cases, respectively. Extensive cross-talk between ER, PI3K, and RTK/RAS/CTNNB1 pathways leads to both ligand-dependent and ligand-independent ER transcriptional activity as well as upregulation of cyclin D1 which, in complex with cyclin-dependent kinases 4 and 6 (CDK4 and CDK6), is a critical regulator of cell cycle progression and a key mediator of resistance to hormonal therapy. We hypothesized that the combination of the aromatase inhibitor letrozole and CDK4/6 inhibitor abemaciclib would demonstrate promising activity in this setting. METHODS We conducted a phase II, two-stage study of letrozole/abemaciclib in recurrent ER-positive EC. Eligibility criteria included measurable disease, no limit on prior therapies, and all EC histologies; prior hormonal therapy was allowed. Primary end points were objective response rate by RECIST 1.1 and progression-free survival (PFS) rate at 6 months. RESULTS At the data cutoff date (December 03, 2021), 30 patients (28 with endometrioid EC) initiated protocol therapy; 15 (50%) patients had prior hormonal therapy. There were nine total responses (eight confirmed), for an objective response rate of 30% (95% CI, 14.7 to 49.4), all in endometrioid adenocarcinomas. Median PFS was 9.1 months, PFS at 6 months was 55.6% (95% CI, 35.1 to 72), and median duration of response was 7.4 months. Most common ≥ grade 3 treatment-related adverse events were neutropenia (20%) and anemia (17%). Responses were observed regardless of grade, prior hormonal therapy, mismatch repair, and progesterone receptor status. Exploratory tumor profiling revealed several mechanistically relevant candidate predictors of response (CTNNB1, KRAS, and CDKN2A mutations) or absence of response (TP53 mutations), which require independent validation. CONCLUSION Letrozole/abemaciclib demonstrated encouraging and durable evidence of activity in recurrent ER positive endometrioid EC.
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Affiliation(s)
| | | | - Niya Xiong
- Dana-Farber Cancer Institute, Boston, MA
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- Beth Israel Deaconess Medical Center, Boston, MA
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21
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Ding L, Wang Q, Martincuks A, Kearns MJ, Jiang T, Lin Z, Cheng X, Qian C, Xie S, Kim HJ, Launonen IM, Färkkilä A, Roberts TM, Freeman GJ, Liu JF, Konstantinopoulos PA, Matulonis U, Yu H, Zhao JJ. STING agonism overcomes STAT3-mediated immunosuppression and adaptive resistance to PARP inhibition in ovarian cancer. J Immunother Cancer 2023; 11:e005627. [PMID: 36609487 PMCID: PMC9827255 DOI: 10.1136/jitc-2022-005627] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Poly (ADP-ribose) polymerase (PARP) inhibition (PARPi) has demonstrated potent therapeutic efficacy in patients with BRCA-mutant ovarian cancer. However, acquired resistance to PARPi remains a major challenge in the clinic. METHODS PARPi-resistant ovarian cancer mouse models were generated by long-term treatment of olaparib in syngeneic Brca1-deficient ovarian tumors. Signal transducer and activator of transcription 3 (STAT3)-mediated immunosuppression was investigated in vitro by co-culture experiments and in vivo by analysis of immune cells in the tumor microenvironment (TME) of human and mouse PARPi-resistant tumors. Whole genome transcriptome analysis was performed to assess the antitumor immunomodulatory effect of STING (stimulator of interferon genes) agonists on myeloid cells in the TME of PARPi-resistant ovarian tumors. A STING agonist was used to overcome STAT3-mediated immunosuppression and acquired PARPi resistance in syngeneic and patient-derived xenografts models of ovarian cancer. RESULTS In this study, we uncover an adaptive resistance mechanism to PARP inhibition mediated by tumor-associated macrophages (TAMs) in the TME. Markedly increased populations of protumor macrophages are found in BRCA-deficient ovarian tumors that rendered resistance to PARPi in both murine models and patients. Mechanistically, PARP inhibition elevates the STAT3 signaling pathway in tumor cells, which in turn promotes protumor polarization of TAMs. STAT3 ablation in tumor cells mitigates polarization of protumor macrophages and increases tumor-infiltrating T cells on PARP inhibition. These findings are corroborated in patient-derived, PARPi-resistant BRCA1-mutant ovarian tumors. Importantly, STING agonists reshape the immunosuppressive TME by reprogramming myeloid cells and overcome the TME-dependent adaptive resistance to PARPi in ovarian cancer. This effect is further enhanced by addition of the programmed cell death protein-1 blockade. CONCLUSIONS We elucidate an adaptive immunosuppression mechanism rendering resistance to PARPi in BRCA1-mutant ovarian tumors. This is mediated by enrichment of protumor TAMs propelled by PARPi-induced STAT3 activation in tumor cells. We also provide a new strategy to reshape the immunosuppressive TME with STING agonists and overcome PARPi resistance in ovarian cancer.
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Affiliation(s)
- Liya Ding
- Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Biological Chemistry & Molecular Pharmacology, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Qiwei Wang
- Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Biological Chemistry & Molecular Pharmacology, Harvard Medical School, Boston, Massachusetts, USA
| | - Antons Martincuks
- Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Michael J Kearns
- Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Tao Jiang
- Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ziying Lin
- Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Respiratory and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xin Cheng
- Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Biological Chemistry & Molecular Pharmacology, Harvard Medical School, Boston, Massachusetts, USA
| | - Changli Qian
- Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Shaozhen Xie
- Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Hye-Jung Kim
- Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Anniina Färkkilä
- Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
| | - Thomas M Roberts
- Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Biological Chemistry & Molecular Pharmacology, Harvard Medical School, Boston, Massachusetts, USA
| | - Gordon J Freeman
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Joyce F Liu
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Ursula Matulonis
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Hua Yu
- Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Jean J Zhao
- Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Biological Chemistry & Molecular Pharmacology, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Harvard Program in Therapeutic Science, Harvard Medical School, Boston, MA, USA
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Lee EK, Liu JF. Rational Combinations of PARP Inhibitors with HRD-Inducing Molecularly Targeted Agents. Cancer Treat Res 2023; 186:171-188. [PMID: 37978136 DOI: 10.1007/978-3-031-30065-3_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Cancers with wild-type BRCA, homologous recombination proficiency, or de novo or acquired resistance to PARP inhibition represent a growing population of patients who may benefit from combinatorial PARP inhibitor strategies. We review targeted inhibitors of angiogenesis, epigenetic regulators, and PI3K, MAPK, and other cellular signaling pathways as inducers of homologous recombination deficiency, providing support for the use of PARP inhibitors in contexts not previously considered susceptible to PARP inhibition.
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23
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Liu JF. [Role of surgery in the treatment of nasopharyngeal carcinoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:1347-1353. [PMID: 36404664 DOI: 10.3760/cma.j.cn115330-20220614-00350] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- J F Liu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
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Han HL, Lyu QP, Liu JF, Zhao JH. [Evaluation of reliability and validity of the Chinese version of a new symptom score of laryngopharyngeal reflux disease]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:1185-1190. [PMID: 36319123 DOI: 10.3760/cma.j.cn115330-20220531-00322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To produce the Chinese version of a new reflux symptom score (RSS) of laryngopharyngeal reflux disease (LPRD) and to evaluate its reliability, validity and clinical value. Methods: This was a retrospective study which contained 42 healthy volunteers and 135 possible LPRD patients. RSI,RFS,oropharyngeal pH monitoring (Dx-pH monitoring) and RSS of each patient were performed. RSS was performed again after 1 week. Confirmed LPRD patients were treated with proton pump inhibitor for 8 week. And RSS was performed again after treatment. Reliability and validity of RSS were evaluated. Results: The Cronbach's α coefficient of RSS was 0.77, which indicated good internal reliability of the new score. The results of test-retest found all P values were less than 0.05, which supported good external reliability. Comparing RSS with laryngopharyngeal reflux test results, the diagnostic coincidence rate was 84.44% (114/135), and the positive predictive value was 85.71% (114/133), which showed good criterion validity. After 8 weeks treatment of PPI, RSS decreased significantly (pretreatment 84.79±42.50,posttreatment 20.11±22.82,t=-10.54, P<0.001), indicating good reactivity of RSS. The score of quality of life impact (Qol) in possible LPRD patients was obviously higher than that of healthy volunteers (t=7.15,P<0.001). All patients and volunteers believed that RSS was a good way to evaluate their symptoms. Conclusions: The new score RSS have good internal and external reliability, criterion validity and reactivity. RSS can be one of the important reference indexes to evaluate LPRD.
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Affiliation(s)
- H L Han
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - Q P Lyu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - J F Liu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - J H Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China
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Lee JM, Moore RG, Ghamande S, Park MS, Diaz JP, Chapman J, Kendrick J, Slomovitz BM, Tewari KS, Lowe ES, Milenkova T, Kumar S, Dymond M, Brown J, Liu JF. Cediranib in Combination with Olaparib in Patients without a Germline BRCA1/2 Mutation and with Recurrent Platinum-Resistant Ovarian Cancer: Phase IIb CONCERTO Trial. Clin Cancer Res 2022; 28:4186-4193. [PMID: 35917514 PMCID: PMC9527502 DOI: 10.1158/1078-0432.ccr-21-1733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 05/11/2022] [Accepted: 07/29/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE The efficacy, safety, and tolerability of cediranib plus olaparib (cedi/ola) were investigated in patients with nongermline-BRCA-mutated (non-gBRCAm) platinum-resistant recurrent ovarian cancer. PATIENTS AND METHODS PARP inhibitor-naïve women aged ≥18 years with platinum-resistant non-gBRCAm ovarian cancer, ECOG performance status of 0-2, and ≥3 prior lines of therapy received cediranib 30 mg once daily plus olaparib 200 mg twice daily in this single-arm, multicenter, phase IIb trial. The primary endpoint was objective response rate (ORR) by independent central review (ICR) using RECIST 1.1. Progression-free survival (PFS), overall survival (OS), and safety and tolerability were also examined. RESULTS Sixty patients received cedi/ola, all of whom had confirmed non-gBRCAm status. Patients had received a median of four lines of chemotherapy; most (88.3%) had received prior bevacizumab. ORR by ICR was 15.3%, median PFS was 5.1 months, and median OS was 13.2 months. Forty-four (73.3%) patients reported a grade ≥3 adverse event (AE), with one patient experiencing a grade 5 AE (sepsis), considered unrelated to the study treatment. Dose interruptions, reductions, and discontinuations due to AEs occurred in 55.0%, 18.3%, and 18.3% of patients, respectively. Patients with high global loss of heterozygosity (gLOH) had ORR of 26.7% [4/15; 95% confidence interval (CI), 7.8-55.1], while ORR was 12.5% (4/32; 95% CI, 3.5-29.0) in the low gLOH group. CONCLUSIONS Clinical activity was shown for the cedi/ola combination in heavily pretreated, non-gBRCAm, platinum-resistant patients with ovarian cancer despite failing to meet the target ORR of 20%, highlighting a need for further biomarker studies.
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Affiliation(s)
- Jung-Min Lee
- Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.,Corresponding Author: Jung-Min Lee, Center for Cancer Research, National Cancer Institute, 10 Center Drive, Building 10, Room 4B54, Bethesda, MD 20892-1906. Phone: 240-760-6128; E-mail:
| | - Richard G. Moore
- Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York
| | - Sharad Ghamande
- Cancer Center, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Min S. Park
- Swedish Cancer Institute, Swedish Medical Center, Seattle, Washington
| | - John P. Diaz
- Miami Cancer Institute, Baptist Health South Florida, Miami, Florida
| | - Julia Chapman
- Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, Kansas
| | | | - Brian M. Slomovitz
- Broward Health, Fort Lauderdale, Florida, and Department of Obstetrics and Gynecology, Florida International University, Miami, Florida
| | | | | | | | | | | | | | - Joyce F. Liu
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
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Wang J, Yan TT, Feng YL, He YL, Yang Y, Liu JF, Yao NJ, Zhu YG, Zhao YR, Chen TY. [The effect of maternal HBV DNA levels on HBV intrauterine transmission and fetal distress]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:873-878. [PMID: 36207944 DOI: 10.3760/cma.j.cn501113-20190610-00207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Aim: To identify the key risk factors of intrauterine hepatitis B virus transmission (HBV) and its effect on the placenta and fetus. Methods: 425 infants born to hepatitis B surface antigen (HBsAg)-positive pregnant women who received combined immunization with hepatitis B immunoglobulin and hepatitis B vaccine between 2009 to 2015 were prospectively enrolled in this study. The intrauterine transmission situation was assessed by dynamic monitoring of infants HBV DNA load and quantitative HBsAg. Univariate and multivariate regression analysis was used to determine the high risk factors for intrauterine transmission. Stratified analysis was used to determine the relationship between maternal HBV DNA load and fetal distress. Transmission electron microscopy was used to observe HBV Effects on placental tissue. Results: HBV intrauterine infection rate was 2.6% (11/425). Multivariate analysis result showed that the maternal HBV DNA load was an independent risk factor for intrauterine infection among infants (P=0.011). Intrauterine infection and distress rate was significantly higher in infants with with maternal HBV DNA>106 IU/ml than those with HBV DNA <106 IU/ml (12.2% vs. 1.8%; χ2=11.275, P=0.006), and (24.4% vs. 16.0%, χ2=3.993, P=0.046). Transmission electron microscopy showed that mitochondrial edema, endoplasmic reticulum expansion and thicker basement membrane were apparent when the maternal HBV DNA>106 IU/ml than that of maternal HBV DNA<106 IU/ml (960 nm vs. 214 nm, Z=-2.782, P=0.005) in the placental tissue. Conclusion: Maternal HBV DNA>106 IU/ml is associated not only with intrauterine infection, but also with increased incidence of intrauterine distress and placental sub-microstructural changes, providing strong clinical and histological evidence for pregnancy avoidance and treatment in this population.
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Affiliation(s)
- J Wang
- The Department of Rheumatology, First Affiliated Hospital of Medicine College, Xi'an Jiaotong University, Xi'an 710061,China
| | - T T Yan
- The Department of Infectious Disease, First Affiliated Hospital of Medicine College, Xi'an Jiaotong University, Xi'an 710061,China
| | - Y L Feng
- The Department of Infectious Disease, First Affiliated Hospital of Medicine College, Xi'an Jiaotong University, Xi'an 710061,China
| | - Y L He
- The Department of Infectious Disease, First Affiliated Hospital of Medicine College, Xi'an Jiaotong University, Xi'an 710061,China
| | - Y Yang
- The Department of Infectious Disease, First Affiliated Hospital of Medicine College, Xi'an Jiaotong University, Xi'an 710061,China
| | - J F Liu
- The Department of Infectious Disease, First Affiliated Hospital of Medicine College, Xi'an Jiaotong University, Xi'an 710061,China
| | - N J Yao
- The Department of Infectious Disease, First Affiliated Hospital of Medicine College, Xi'an Jiaotong University, Xi'an 710061,China
| | - Y G Zhu
- The Department of Infectious Disease, First Affiliated Hospital of Medicine College, Xi'an Jiaotong University, Xi'an 710061,China
| | - Y R Zhao
- The Department of Infectious Disease, First Affiliated Hospital of Medicine College, Xi'an Jiaotong University, Xi'an 710061,China
| | - T Y Chen
- The Department of Infectious Disease, First Affiliated Hospital of Medicine College, Xi'an Jiaotong University, Xi'an 710061,China
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Patterson-Fortin J, Bose A, Tsai WC, Grochala CJ, Nguyen H, Zhou J, Parmar K, Lazaro JB, Liu JF, McQueen K, Shapiro GI, Kozono D, D'Andrea AD. Targeting DNA repair with combined inhibition of NHEJ and MMEJ induces synthetic lethality in TP53-mutant cancers. Cancer Res 2022; 82:3815-3829. [PMID: 35972384 PMCID: PMC9588747 DOI: 10.1158/0008-5472.can-22-1124] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/16/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022]
Abstract
DNA repair pathway inhibitors are a new class of anti-cancer drugs that are advancing in clinical trials. Peposertib is an inhibitor of DNA-dependent protein kinase (DNA-PK), which is a key driver of non-homologous end-joining (NHEJ). To identify regulators of response to peposertib, we performed a genome-wide CRISPR knockout screen and found that loss of POLQ (Polymerase Theta, POLθ) and other genes in the microhomology-mediated end-joining (MMEJ) pathway as key predictors of sensitivity to DNA-PK inhibition. Simultaneous disruption of two DNA repair pathways via combined treatment with peposertib plus a POLθ inhibitor novobiocin exhibited synergistic synthetic lethality resulting from accumulation of toxic levels of DNA double-strand break end resection. TP53-mutant tumor cells were resistant to peposertib but maintained elevated expression of POLQ and increased sensitivity to novobiocin. Consequently, the combination of peposertib plus novobiocin resulted in synthetic lethality in TP53-deficient tumor cell lines, organoid cultures, and patient-derived xenograft models. Thus, the combination of a targeted DNA-PK/NHEJ inhibitor with a targeted POLθ/MMEJ inhibitor may provide a rational treatment strategy for TP53-mutant solid tumors.
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Affiliation(s)
| | - Arindam Bose
- Dana-Farber Cancer Institute, Boston, MA, United States
| | - Wei-Chih Tsai
- Dana-Farber Cancer Institute, Boston, MA, United States
| | | | - Huy Nguyen
- Dana-Farber Cancer Institute, Boston, MA, United States
| | - Jia Zhou
- Dana-Farber Cancer Institute, Boston, MA, United States
| | - Kalindi Parmar
- Dana-Farber Cancer Institute, Boston, Massachusetts, United States
| | | | - Joyce F Liu
- Dana-Farber Cancer Institute, Boston, United States
| | | | | | - David Kozono
- Dana-Farber Cancer Institute, Boston, MA, United States
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Porter RL, Sun S, Flores MN, Berzolla E, You E, Phillips IE, KC N, Desai N, Tai EC, Szabolcs A, Lang ER, Pankaj A, Raabe MJ, Thapar V, Xu KH, Nieman LT, Rabe DC, Kolin DL, Stover EH, Pepin D, Stott SL, Deshpande V, Liu JF, Solovyov A, Matulonis UA, Greenbaum BD, Ting DT. Satellite repeat RNA expression in epithelial ovarian cancer associates with a tumor-immunosuppressive phenotype. J Clin Invest 2022; 132:e155931. [PMID: 35708912 PMCID: PMC9374379 DOI: 10.1172/jci155931] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 06/14/2022] [Indexed: 11/17/2022] Open
Abstract
Aberrant expression of viral-like repeat elements is a common feature of epithelial cancers, and the substantial diversity of repeat species provides a distinct view of the cancer transcriptome. Repeatome profiling across ovarian, pancreatic, and colorectal cell lines identifies distinct clustering independent of tissue origin that is seen with coding gene analysis. Deeper analysis of ovarian cancer cell lines demonstrated that human satellite II (HSATII) satellite repeat expression was highly associated with epithelial-mesenchymal transition (EMT) and anticorrelated with IFN-response genes indicative of a more aggressive phenotype. SATII expression - and its correlation with EMT and anticorrelation with IFN-response genes - was also found in ovarian cancer RNA-Seq data and was associated with significantly shorter survival in a second independent cohort of patients with ovarian cancer. Repeat RNAs were enriched in tumor-derived extracellular vesicles capable of stimulating monocyte-derived macrophages, demonstrating a mechanism that alters the tumor microenvironment with these viral-like sequences. Targeting of HSATII with antisense locked nucleic acids stimulated IFN response and induced MHC I expression in ovarian cancer cell lines, highlighting a potential strategy of modulating the repeatome to reestablish antitumor cell immune surveillance.
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Affiliation(s)
- Rebecca L. Porter
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Gynecologic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Siyu Sun
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Micayla N. Flores
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Emily Berzolla
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Eunae You
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Ildiko E. Phillips
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Neelima KC
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Niyati Desai
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Eric C. Tai
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Annamaria Szabolcs
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Evan R. Lang
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Amaya Pankaj
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
- Department of Surgery, Massachusetts General Hospital
| | - Michael J. Raabe
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Vishal Thapar
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Katherine H. Xu
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Linda T. Nieman
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Daniel C. Rabe
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - David L. Kolin
- Department of Pathology, Brigham and Women’s Hospital, and
| | - Elizabeth H. Stover
- Division of Gynecologic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - David Pepin
- Department of Surgery, Massachusetts General Hospital
| | - Shannon L. Stott
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Vikram Deshpande
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joyce F. Liu
- Division of Gynecologic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Alexander Solovyov
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ursula A. Matulonis
- Division of Gynecologic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Benjamin D. Greenbaum
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - David T. Ting
- Mass General Cancer Center, Harvard Medical School, Charlestown, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Zhou L, Chen X, Wang J, Liu ZY, You J, Lan S, Liu JF. [Predictive value of mismatch negativity and P3a combined with electroencephalogram reactivity for the prognosis of comatose patients after severe brain injury]. Zhonghua Yi Xue Za Zhi 2022; 102:2265-2271. [PMID: 35927057 DOI: 10.3760/cma.j.cn112137-20220413-00799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the clinical value of mismatch negativity and P3a combined with electroencephalogram (EEG) reactivity to predict the prognosis of patients after severe brain injury. Methods: The clinical data of patients with severe brain injury who were admitted to the neurosurgical intensive care unit of Xiangya Hospital of Central South University from October 2019 to July 2020 were retrospectively analyzed. All patients underwent evaluation of auditory mismatch negativity (MMN), P3a, and EEG reactivity (EEG-R) within 28 days after the onset of coma. Patients were divided into two groups using the 3-month Glasgow Outcome Scale (GOS) after coma onset, a GOS score of 3-5 was defined as a favorable outcome, and GOS grades 1-2 were defined as an unfavorable outcome. The correlation between clinical indicators and prognosis was analyzed, and the predictive values of statistically significant indicators and the cut-off values were determined using the receiver operating characteristic (ROC) curve. Results: A total of 48 patients were enrolled in the study, including 35 males and 13 females (age range:18-68 years old). Twenty-nine of the patients had a favorable outcome and 19 had an unfavorable outcome. The Glasgow Coma Scale (GCS), EEG-R, absolute amplitude of MMN at Fz (FzMMNA), and amplitude of P3a at Cz (CzP3aA) were significantly correlated with the prognosis of comatose patients (P<0.001). Multivariate logistic regression analysis revealed that only EEG-R, FzMMNA, and CzP3aA were independent predictors for the prognosis of comatose patients after severe brain injury (all P<0.05), with the area under the curve (AUC) of 0.757 (0.613-0.900), 0.912 (0.830-0.994) and 0.887 (0.793-0.981), respectively. The combination of FzMMNA and CzP3aA and the combinationof EEG-R, FzMMNA and CzP3aA increased the value of AUC to 0.942 (0.879-1.000) and 0.964 (0.920-1.000), respectively. Moreover, a cut-off value of 1.27 μV and 2.64 μV for FzMMNA and CzP3aA, respectively, yielded the best sensitivity and specificity for the prognosis prediction of patients with severe brain injury [FzMMNA: 89.66%(26/29) and 84.21%(16/19); CzP3aA:82.76%(24/29) and 84.21%(16/19)]. Conclusion: This study indicates that the combination of EEG-R, FzMMNA, and CzP3aA may serve as a favorable prognostic indicator for comatose patients after severe brain injury.
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Affiliation(s)
- L Zhou
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - X Chen
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - J Wang
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - Z Y Liu
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - J You
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - S Lan
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - J F Liu
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
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Liu M, Tayob N, Penter L, Sellars M, Tarren A, Chea V, Carulli I, Huang T, Li S, Cheng SC, Le P, Frackiewicz L, Fasse J, Qi C, Liu JF, Stover EH, Curtis J, Livak KJ, Neuberg D, Zhang G, Matulonis UA, Wu CJ, Keskin DB, Konstantinopoulos PA. Improved T-cell Immunity Following Neoadjuvant Chemotherapy in Ovarian Cancer. Clin Cancer Res 2022; 28:3356-3366. [PMID: 35443043 PMCID: PMC9357177 DOI: 10.1158/1078-0432.ccr-21-2834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/20/2021] [Accepted: 04/13/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Although local tissue-based immune responses are critical for elucidating direct tumor-immune cell interactions, peripheral immune responses are increasingly recognized as occupying an important role in anticancer immunity. We evaluated serial blood samples from patients with advanced epithelial ovarian cancer (EOC) undergoing standard-of-care neoadjuvant carboplatin and paclitaxel chemotherapy (including dexamethasone for prophylaxis of paclitaxel-associated hypersensitivity reactions) to characterize the evolution of the peripheral immune cell function and composition across the course of therapy. EXPERIMENTAL DESIGN Serial blood samples from 10 patients with advanced high-grade serous ovarian cancer treated with neoadjuvant chemotherapy (NACT) were collected before the initiation of chemotherapy, after the third and sixth cycles, and approximately 2 months after completion of chemotherapy. T-cell function was evaluated using ex vivo IFNγ ELISpot assays, and the dynamics of T-cell repertoire and immune cell composition were assessed using bulk and single-cell RNA sequencing (RNAseq). RESULTS T cells exhibited an improved response to viral antigens after NACT, which paralleled the decrease in CA125 levels. Single-cell analysis revealed increased numbers of memory T-cell receptor (TCR) clonotypes and increased central memory CD8+ and regulatory T cells throughout chemotherapy. Finally, administration of NACT was associated with increased monocyte frequency and expression of HLA class II and antigen presentation genes; single-cell RNAseq analyses showed that although driven largely by classical monocytes, increased class II gene expression was a feature observed across monocyte subpopulations after chemotherapy. CONCLUSIONS NACT may alleviate tumor-associated immunosuppression by reducing tumor burden and may enhance antigen processing and presentation. These findings have implications for the successful combinatorial applications of immune checkpoint blockade and therapeutic vaccine approaches in EOC.
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Affiliation(s)
- Min Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Nabihah Tayob
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Livius Penter
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow Klinikum, Berlin, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - MacLean Sellars
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Anna Tarren
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Translational Immunogenomics Laboratory, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Vipheaviny Chea
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Translational Immunogenomics Laboratory, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Isabel Carulli
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Translational Immunogenomics Laboratory, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Teddy Huang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Translational Immunogenomics Laboratory, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Shuqiang Li
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Translational Immunogenomics Laboratory, Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of MIT and Harvard, Cambridge, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Su-Chun Cheng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Phuong Le
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Translational Immunogenomics Laboratory, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Laura Frackiewicz
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Julia Fasse
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Courtney Qi
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Joyce F. Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Elizabeth H. Stover
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Jennifer Curtis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Kenneth J. Livak
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Translational Immunogenomics Laboratory, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Donna Neuberg
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Guanglan Zhang
- Department of Computer Science, Metropolitan College, Boston University, Boston, Massachusetts
| | - Ursula A. Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Catherine J. Wu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Derin B. Keskin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Translational Immunogenomics Laboratory, Dana-Farber Cancer Institute, Boston, Massachusetts.,Broad Institute of MIT and Harvard, Cambridge, Massachusetts.,Department of Computer Science, Metropolitan College, Boston University, Boston, Massachusetts.,Department of Health Technology, Section for Bioinformatics, Technical University of Denmark, Lyngby, Denmark.,Corresponding Authors: Panagiotis A. Konstantinopoulos, Dana-Farber Cancer Institute, 450 Brookline Avenue, YC-1424, Boston, MA 02215. E-mail: ; and Derin B. Keskin,
| | - Panagiotis A. Konstantinopoulos
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Corresponding Authors: Panagiotis A. Konstantinopoulos, Dana-Farber Cancer Institute, 450 Brookline Avenue, YC-1424, Boston, MA 02215. E-mail: ; and Derin B. Keskin,
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Konstantinopoulos PA, Gockley AA, Xiong N, Krasner C, Horowitz N, Campos S, Wright AA, Liu JF, Shea M, Yeku O, Castro C, Polak M, Lee EK, Sawyer H, Bowes B, Moroney J, Cheng SC, Tayob N, Bouberhan S, Spriggs D, Penson RT, Fleming GF, Nucci MR, Matulonis UA. Evaluation of Treatment With Talazoparib and Avelumab in Patients With Recurrent Mismatch Repair Proficient Endometrial Cancer. JAMA Oncol 2022; 8:1317-1322. [PMID: 35900726 PMCID: PMC9335244 DOI: 10.1001/jamaoncol.2022.2181] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Question Is treatment with combined polyadenosine diphosphate-ribose polymerase and immune checkpoint inhibition active and safe in patients with recurrent mismatch repair proficient endometrial cancer (MMRP EC)? Findings In this single-arm, phase 2, 2-stage, nonrandomized clinical trial of treatment with avelumab and talazoparib in recurrent MMRP EC that included 35 patients, the confirmed objective response rate was 11.4%, and the progression-free survival at 6 months rate was 22.9%. No patients discontinued therapy because of toxic effects, and immunogenomic profiling provided insights into subsets of patients who may derive benefit from this combination. Meaning These study findings suggest that treatment with avelumab and talazoparib has a favorable toxic effects profile and support further investigation in certain subsets of patients with recurrent MMRP EC. Importance Although the activity of pembrolizumab and lenvatinib (the only US Food and Drug Administration–approved immunotherapy for mismatch repair proficient endometrial cancer [MMRP EC]) is compelling, there are no biomarkers of response and most patients do not tolerate, do not respond to, or develop resistance to this regimen, highlighting the need for additional, potentially biomarker-driven therapeutic approaches for patients with recurrent MMRP EC. Objective To assess the potential positive outcomes and safety of the combination of the polyadenosine diphosphate-ribose polymerase inhibitor talazoparib and the programmed cell death ligand 1 (PD-L1) inhibitor avelumab in recurrent MMRP EC. Design, Settings, and Participants This investigator-initiated, open-label, single-arm, 2-stage, phase 2 study nonrandomized controlled trial patients at 4 institutions in the US. Key eligibility criteria included measurable disease, unlimited prior therapies, and all endometrial cancer histologies. Interventions Talazoparib, 1 mg, orally, daily, and avelumab, 10 mg/kg, intravenously, every 2 weeks, were administered until disease progression or unacceptable toxic effects. Main Outcomes and Measures Statistical considerations were developed for 2 coprimary objectives of objective response rate and rate of progression-free survival at 6 months, with a 2-stage design that allowed for early discontinuation for futility. Prespecified exploratory objectives included the association of immunogenomic features (determined by targeted-panel next-generation sequencing and immunohistochemistry) with activity. Results Thirty-five female patients (mean [SD] age, 67.9 [8.41] years) received protocol therapy; 9 (25.7%) derived clinical benefit after meeting at least 1 of the 2 coprimary end points. Four patients (11.4%) exhibited confirmed objective response rates (4 partial responses), and 8 (22.9%) survived progression free at 6 months. The most common grade 3 and 4 treatment-related toxic effects were anemia (16 [46%]), thrombocytopenia (10 [29%]), and neutropenia (4 [11%]); no patient discontinued receipt of therapy because of toxic effects. Tumors with homologous recombination repair alterations were associated with clinical benefit from treatment with avelumab and talazoparib. Tumor mutational burden, tumor-infiltrating lymphocytes, and PD-L1 status were not associated with clinical benefit. Conclusions and Relevance The results of this nonrandomized controlled trial suggest that treatment with avelumab and talazoparib demonstrated a favorable toxic effect profile and met the predetermined criteria to be considered worthy of further evaluation in MMRP EC. Immunogenomic profiling provided insights that may inform ongoing and future studies of polyadenosine diphosphate-ribose polymerase and PD-L1 inhibitor combinations in endometrial cancer. Trial Registration ClinicalTrials.gov Identifier: NCT02912572
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Affiliation(s)
| | | | - Niya Xiong
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | | | | | | | - Joyce F Liu
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Meghan Shea
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Saldanha AL, Vo HV, Vasquez K, Ngo K, Roychoudhury S, Feeney C, Qi CH, Narayan S, Curtis JD, Gokhale PC, Chowdhury D, Paweletz CP, Nucci MR, Matulonis UA, Ivanova E, Liu JF. Abstract 3065: Establishment and characterization of a platform of endometrial cancer organoids. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Endometrial cancer is the most commonly diagnosed gynecologic cancer in the US; the incidence is rising, and survival rates for this cancer are decreasing. There is a paucity of effective treatment for recurrent endometrial cancer, especially high grade endometrial cancers (HGEC) which include serous, carcinosarcoma, endometrioid, and clear cell histologies. Models that mimic the clinical and molecular characteristics of HGEC are lacking. To support the development of next generation therapeutics for endometrial cancer, we report on the establishment of 3D endometrial patient-derived organoids (PDOs) from HGEC.
Methods: 26 Tumors from 21 different patients with HGEC (Serous, Carcinosarcoma, Clear Cell and High-grade Endometrioid subtypes) who underwent surgical resection (n= 13), biopsy (n = 7), paracentesis (n = 3) or thoracentesis (n = 3) were passaged as 3D organoid cultures in Matrigel in an optimized media. Robust models (defined by average days to passage <14 days) were viably banked. 3 frozen models were also thawed and re-cultured to assess the viability post freezing. PDOs were collected for H&E staining and their histology was compared to the original diagnosis. DNA replication rate and the effect of replication stress on organoid growth were assessed by the DNA Fiber Assay and immunofluorescence (IF). Finally, an established clear cell endometrial cancer organoid model was engrafted in mice to generate a Patient-Derived Xenograft (PDX) model.
Results: Endometrial PDOs were successfully developed from 19 of 26 original samples for an overall success rate of 73.1%. Successful PDOs were developed from multiple histologies, including 8 carcinosarcoma, 6 uterine serous, 2 endometrioid, 2 clear cell and 1 mixed uterine serous and endometrioid. Though biopsy samples had initially fewer viable cells, our overall success rate was similar at 85.7% compared to 84.6% for surgical resections and higher than 66.7% for paracenteses. Samples obtained via thoracentesis did not form PDOs. Endometrial PDOs were histologically validated to match the primary patient tumor. Freeze thawing had no effect on morphology and growth characteristics. DNA fiber assays could be successfully conducted in PDOs, with a reduction in replication rate observed in PDO models treated with ATR or WEE1 inhibitors, with concurrent increase in y-H2AX and decrease in pRPA2 observed by IF. We also successfully generated a validated PDX model from organoids. Studies to determine molecular fidelity between the original patient tumor and established organoids are ongoing.
Conclusions: We describe the successful establishment of 19 endometrial PDO models which retain original tumor morphology and demonstrate sensitivity to drug-induced DNA damage. 3D endometrial organoids can therefore be used for further target discovery and validation as well as biomarker studies to advance targeted therapies for high-grade endometrial cancer.
Citation Format: Aisha L. Saldanha, Ha V. Vo, Kevin Vasquez, Kenneth Ngo, Shrabasti Roychoudhury, Carina Feeney, Courtney H. Qi, Swati Narayan, Jennifer D. Curtis, Prafulla C. Gokhale, Dipanjan Chowdhury, Cloud P. Paweletz, Marisa R. Nucci, Ursula A. Matulonis, Elena Ivanova, Joyce F. Liu. Establishment and characterization of a platform of endometrial cancer organoids [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3065.
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Affiliation(s)
- Aisha L. Saldanha
- 1Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA
| | - Ha V. Vo
- 1Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA
| | - Kevin Vasquez
- 1Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA
| | - Kenneth Ngo
- 1Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | | | - Prafulla C. Gokhale
- 1Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA
| | | | - Cloud P. Paweletz
- 1Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA
| | - Marisa R. Nucci
- 3Brigham and Women's Hospital, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA
| | | | - Elena Ivanova
- 1Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA
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Shapiro GI, Basu B, El-Khoueiry A, Postel-Vinay S, Im SA, Rha SY, Friedman CF, Italiano A, Kim YM, Lim MC, Roux R, Liu JF, Sanai E, Smith SA, Smith C, Farhi SE, Lau A, Lukashchuk N, Dean E, Krebs MG. Abstract CT201: Ceralasertib and olaparib in the treatment of homologous recombination repair (HRR)-deficient platinum-sensitive ovarian cancer after progression on PARP inhibitors. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-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
Background: The majority of BRCA-mutant or HRR-deficient ovarian cancers are initially sensitive to PARP inhibitors (PARPis) but eventually develop resistance. The most commonly reported PARPi resistance mechanisms are (1) reversal of HRR deficiency through (a) reversion mutations in BRCA or other HRR genes (eg, RAD51C/D) or (b) DNA end resection rewiring with loss of 53BP1, REV7, or Shieldin complex components; or (2) stabilization of stalled replication forks through loss of PTIP or EZH2, preventing nuclease recruitment. The only confirmed PARPi resistance mechanism in the clinic to date is reversion mutations.
Combined ATR and PARP inhibition is an attractive strategy that may overcome PARPi resistance, as has been shown in PARPi-resistant cell lines and patient-derived xenograft models (Yazinski et al Genes Dev 2017; Murai et al Oncotarget 2016; Kim et al Nat Commun 2020; data on file, AstraZeneca). The PARPi olaparib 300 mg twice daily (BID) continuously in combination with the ATR inhibitor ceralasertib 160 mg daily on days 1-7 of a 28-day cycle has demonstrated promising activity in the CAPRI study in patients with ovarian cancer who had progressed on PARPis (Wethington et al J Clin Oncol 2021). However, preclinical models of PARPi resistance suggest that a higher dose or duration of ceralasertib with a lower dose of olaparib may be more beneficial (data on file, AstraZeneca).
Methods: D5330C00004 (NCT02264678) is a multicenter, modular, phase 1 study assessing ceralasertib in combination with other anti-cancer agents in adults with advanced solid malignancies. In Module 2, a lower dose of olaparib (150 mg BID continuous) and a longer duration of ceralasertib (80 mg BID, days 1-14 of a 28-day cycle) is now being explored in 2 expansion cohorts in patients with platinum-sensitive, high-grade, serous or endometrioid ovarian, fallopian tube, or primary peritoneal cancer with deleterious or suspected deleterious germline or somatic BRCA or RAD51C/D mutations, or HRR deficiency by Myriad MyChoice® or FoundationOne® CDx (F1CDx) assays. Patients will have progressed on prior PARPis after ≥6 months in the maintenance or treatment setting (≥12 months after first-line maintenance). Cohort 1 is enrolling ~30 patients immediately after progression on a PARPi; Cohort 2 is recruiting ~30 PARPi-treated patients after intervening platinum-based chemotherapy. Study endpoints include safety, tumor response by RECIST 1.1, and duration of response. Exploratory analyses include genomic and functional analysis of HRR restoration in tumor and circulating tumor DNA, and analysis of replication fork stability in organoid cultures established from mandatory fresh tumor biopsy samples. Recruitment began in July 2021 with the first patient dosed in August 2021.
Citation Format: Geoffrey I. Shapiro, Bristi Basu, Anthony El-Khoueiry, Sophie Postel-Vinay, Seock-Ah Im, Sun Young Rha, Claire F. Friedman, Antoine Italiano, Yong Man Kim, Myong Cheol Lim, Rene Roux, Joyce F. Liu, Elhan Sanai, Simon A. Smith, Claire Smith, Sarah El Farhi, Alan Lau, Natalia Lukashchuk, Emma Dean, Matthew G. Krebs. Ceralasertib and olaparib in the treatment of homologous recombination repair (HRR)-deficient platinum-sensitive ovarian cancer after progression on PARP inhibitors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT201.
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Affiliation(s)
| | - Bristi Basu
- 2University of Cambridge, Cambridge, United Kingdom
| | - Anthony El-Khoueiry
- 3USC Norris Comprehensive Cancer Center and Hoag Memorial Hospital Presbyterian, Los Angeles, CA
| | | | - Seock-Ah Im
- 5Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun Young Rha
- 6Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea
| | | | | | | | | | - Rene Roux
- 11Churchill Hospital Oxford, Oxford, United Kingdom
| | | | | | | | | | | | - Alan Lau
- 12AstraZeneca, Cambridge, United Kingdom
| | | | - Emma Dean
- 12AstraZeneca, Cambridge, United Kingdom
| | - Matthew G. Krebs
- 13The University of Manchester and the Christie NHS Foundation Trust, Manchester, United Kingdom
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Landen CN, Buckanovich RJ, Sill M, Mannel RS, Walker JL, Disilvestro P, Mathews CA, Mutch DG, Hernandez M, Martin LP, Bishop E, Gill S, Gordinier ME, Burger RA, Aghajanian C, Liu JF, Moore KN, Bookman MA. A phase I/II study of ruxolitinib with frontline neoadjuvant and post-surgical therapy in patients with advanced epithelial ovarian, Fallopian tube, or primary peritoneal cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.5501] [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
5501 Background: The Interleukin-6/JAK/STAT3 axis, via an increase in cancer stem-like cell (CSC) survival, is a reported driver of chemotherapy resistance. We hypothesized that addition of the JAK1/2 inhibitor ruxolitinib to standard chemotherapy would be tolerable and, by targeting therapy-resistant cells, improve the progression-free survival (PFS) of ovarian/fallopian tube/primary peritoneal carcinoma (OV/FT/PPC) patients treated in the up-front setting. Methods: Patients with OV/FT/PPC dispositioned to neoadjuvant chemotherapy were eligible for NRG-GY007 (NCT #02713386). In phase I, treatment was with dose-dense paclitaxel (P) 70 or 80 mg/m2 days 1, 8, and 15; carboplatin (C) AUC 5 or 6 day 1; and ruxolitinib (R) 15mg PO BID, every 21 days. In the absence of tumor progression or an inability to tolerate surgery, interval tumor reductive surgery (TRS) was required after cycle 3. After TRS, 3 additional cycles were administered, followed by maintenance ruxolitinib until progression, unacceptable toxicity, or voluntary withdrawal. In phase II, patients were randomized to dose-dense PC (arm 1) or dose-dense PC plus ruxolitinib (arm 2) at the phase I-defined dose of 15mg PO BID. After 3 cycles, TRS was performed, followed by another 3 cycles of the randomized regimen, without maintenance ruxolitinib. The primary phase II endpoint was progression-free survival (PFS). Results: 17 patients were enrolled in phase I. The MTD was P at 70, C at 5, and R at 15, which was chosen as the phase II dose. 130 patients were enrolled in phase II with a median follow-up of 24 months. There were five Grade 5 events in phase II, 2 in arm 1 and 3 in arm 2, with all except one being unrelated to therapy; a G5 febrile neutropenia in arm 2 was considered possibly related. In arm 2 there was potential trend towards higher grade 3-4 anemia (64% v 27% control), grade 3-4 neutropenia (53% v 37%), thromboembolic events (12.6% v 2.4%), and febrile neutropenia (6% v 0%). The HR for PFS was 0.702 (90% 1-sided CI = 0-0.89, log-rank p = 0.059). The median PFS in arm 1 was 11.6 versus 14.6 in arm 2. The overall survival HR = 0.785 (90% CI = 0.44 to 1.39, p = 0.70). There were no differences between rates of total gross resection. Conclusions: Ruxolitinib 15mg PO BID was well-tolerated with acceptable toxicity in combination with dose-dense PC. The primary endpoint of prolongation of PFS was achieved in the experimental arm. Further study of this combination can be considered. This trial also demonstrates the feasibility of early-phase randomized studies with novel agents and biospecimen collection in front line neoadjuvant treatment of ovarian cancer. Clinical trial information: 02713386.
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Affiliation(s)
| | | | - Michael Sill
- Gynecologic Oncology Group Statistical and Data Center, Buffalo, NY
| | | | - Joan L. Walker
- The University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | | | - Cara Amanda Mathews
- Program in Women’s Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, RI
| | | | | | - Lainie P. Martin
- University of Pennsylvania, Abramson Cancer Center, Philadelphia, PA
| | - Erin Bishop
- Froedtert and the Medical College of Wisconsin, Milwaukee, WI
| | - Sarah Gill
- Nancy N. and J.C. Lewis Cancer and Research Pavilion, Savannah, GA
| | | | - Robert Allen Burger
- Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA
| | | | | | - Kathleen N. Moore
- Division of Obstetrics and Gynecology, Department of Gynecologic Oncology, University of Oklahoma Health Science Center, Stephenson Cancer Center, Oklahoma City, OK
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Patel MR, Makker V, Oaknin A, Pignata S, Backes FJ, Gonzalez Martin A, Eskander RN, Pothuri B, Richardson DL, Secord AA, Van Nieuwenhuysen E, Liu JF, Musa F, Penson RT, Wride K, Lepley DM, Dusek R, Cameron T, Hamilton EP, Concin N. Efficacy and safety of lucitanib + nivolumab in patients with advanced gynecologic malignancies: Phase 2 results from the LIO-1 study (NCT04042116; ENGOT-GYN3/AGO/LIO). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.5517] [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
5517 Background: LIO-1 is assessing the oral antiangiogenic, multikinase inhibitor lucitanib in combination with the programmed cell death receptor 1 (PD-1) inhibitor nivolumab. Individualized lucitanib dose titration is being explored to maximize lucitanib exposure and potential clinical benefit of the combination. Here, we present data from stage 1 of a Simon 2-stage design across 4 different types of advanced gynecologic cancers from the phase 2 part of LIO-1. Methods: Patients (pts) with advanced, recurrent, or metastatic endometrial cancer (EC, who received ≥1 prior platinum-based chemotherapy); cervical cancer (CC, who received ≥1 prior platinum-based chemotherapy ± bevacizumab); high-grade ovarian cancer (OC, who received ≥2 prior chemotherapies); or EC/OC with clear-cell histology (EOCC, who received ≥1 prior platinum-based chemotherapy + taxane) were enrolled. Prior PD-1 or programmed cell death ligand 1 (PD-L1) inhibitor treatment was excluded, except for up to 10 pts in the EC cohort. Pts received lucitanib at a starting dose of 6 mg once daily (QD), escalating to 8 mg QD and then 10 mg QD if safety-based titration criteria were met, plus intravenous nivolumab 480 mg every 28 days. The data cutoff was Jan 10, 2022. Results: Across cohorts, 100 pts were enrolled to stage 1; 27 (27%) remain on treatment. To date, 28 (28%) have escalated to lucitanib 8 mg, and 17 (17%) have escalated to the maximum dose of 10 mg. Confirmed responses per RECIST v1.1 have been reported in 5/22 (22.7%; 5 partial responses [PRs]) EC pts, 7/22 (31.8%; 2 complete responses [CRs], 5 PRs) CC pts, 4/33 (12.1%; 4 PRs) OC pts, and 5/23 (21.7%; 1 CR, 4 PRs) EOCC pts. Response duration ranges from 1.9+ to 13.1+ months. Of 5 pts with EC who received prior PD-1 inhibitor, there were 2 PRs, and 1 pt with ongoing stable disease of 7+ months. Grade ≥3 treatment-emergent adverse events (TEAEs) considered related to study treatment were reported in 43 (43%) pts, with hypertension the most frequent (n = 25 [25%]). Forty-six (46%) pts had a lucitanib-related TEAE that led to lucitanib interruption and 12 (12%) had one that led to lucitanib dose reduction. Eleven (11%) and 8 (8%) pts discontinued lucitanib and nivolumab, respectively, due to a treatment-related TEAE. Safety results were generally consistent across tumor cohorts. Conclusions: The combination of lucitanib + nivolumab is active in the treatment of advanced gynecological malignancies and has a manageable safety profile through effective dose titration. Stage 2 enrollment has continued in the CC cohort. Biomarker analysis is ongoing, and more mature efficacy and safety data will be presented at the meeting. Clinical trial information: NCT04042116.
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Affiliation(s)
- Manish R. Patel
- Drug Development Unit, Florida Cancer Specialists/Sarah Cannon Research Institute, Sarasota, FL
| | - Vicky Makker
- Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical Center, New York, NY
| | - Ana Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Sandro Pignata
- Department Uro-Ginecologico, Istituto Nazionale Tumori-Fondazione “G. Pascale”, Naples, Italy
| | - Floor Jenniskens Backes
- Division of Gynecologic Oncology, Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH
| | | | - Ramez Nassef Eskander
- Department of Obstetrics, Gynecology, and Reproductive Sciences, UC San Diego Moores Cancer Center, La Jolla, CA
| | - Bhavana Pothuri
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Laura and Isaac Perlmutter Cancer Center at NYU Langone, New York, NY
| | - Debra L. Richardson
- Division of Gynecologic Oncology, Stephenson Cancer Center/Sarah Cannon Research Institute, The University of Oklahoma, Oklahoma City, OK
| | - Angeles Alvarez Secord
- Department of Obstetrics & Gynecology, Gynecologic Oncology Division, Duke Cancer Institute, Duke University School of Medicine, Durham, NC
| | - Els Van Nieuwenhuysen
- Department of Gynecological Oncology, Campus Gasthuisberg, University Hospitals Leuven, Leuven, Belgium
| | - Joyce F. Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Fernanda Musa
- Department of Gynecologic Oncology, Swedish Cancer Institute, Seattle, WA
| | - Richard T. Penson
- Medical Gynecologic Oncology, Massachusetts General Hospital, Boston, MA
| | - Kenton Wride
- Biostatistics, Clovis Oncology, Inc., Boulder, CO
| | | | - Rachel Dusek
- Translational Medicine, Clovis Oncology, Inc., Boulder, CO
| | - Teresa Cameron
- Clinical Science, Clovis Oncology UK Ltd., Cambridge, United Kingdom
| | - Erika P. Hamilton
- Medical Oncology, Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN
| | - Nicole Concin
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, Innsbruck, Austria and Department of Gynecology and Gynecologic Oncology, Evang. Kliniken Essen-Mitte, Essen, Germany
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Boni V, Fidler MJ, Arkenau HT, Spira A, Meric-Bernstam F, Uboha N, Sanborn RE, Sweis RF, LoRusso P, Nagasaka M, Garcia-Corbacho J, Jalal S, Harding JJ, Kim SK, Miedema IH, Vugts DJ, Huisman MC, Zwezerijnen GJ, van Dongen GA, Menke van der Houven van Oordt CW, Wang S, Dang T, Zein IA, Vasiljeva O, Lyman SK, Paton V, Hannah A, Liu JF. Praluzatamab Ravtansine, a CD166-Targeting Antibody-Drug Conjugate, in Patients with Advanced Solid Tumors: An Open-Label Phase I/II Trial. Clin Cancer Res 2022; 28:2020-2029. [PMID: 35165101 PMCID: PMC9365353 DOI: 10.1158/1078-0432.ccr-21-3656] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/11/2021] [Accepted: 02/07/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Praluzatamab ravtansine (CX-2009) is a conditionally activated Probody drug conjugate (PDC) comprising an anti-CD166 mAb conjugated to DM4, with a protease-cleavable linker and a peptide mask that limits target engagement in normal tissue and circulation. The tumor microenvironment is enriched for proteases capable of cleaving the linker, thereby releasing the mask, allowing for localized binding of CX-2009 to CD166. CX-2009 was evaluated in a phase I/II clinical trial for patients with advanced solid tumors. PATIENTS AND METHODS Eligible patients had metastatic cancer receiving ≥2 prior treatments. CX-2009 was administered at escalating doses every 3 weeks (0.25-10 mg/kg) or every 2 weeks (4-6 mg/kg). Primary objective was to determine the safety profile and recommended phase II dose (RP2D). RESULTS Of 99 patients enrolled, the most prevalent subtype was breast cancer (n = 45). Median number of prior therapies was 5 (range, 1-19). Dose-limiting toxicities were observed at 8 mg/kg every 3 weeks and 6 mg/kg every 2 weeks. On the basis of tolerability, the RP2D was 7 mg/kg every 3 weeks. Tumor regressions were observed at doses ≥4 mg/kg. In the hormone receptor-positive/HER2-nonamplified breast cancer subset (n = 22), 2 patients (9%) had confirmed partial responses, and 10 patients (45%) had stable disease. Imaging with zirconium-labeled CX-2009 confirmed uptake in tumor lesions and shielding of major organs. Activated, unmasked CX-2009 was measurable in 18 of 22 posttreatment biopsies. CONCLUSIONS CD166 is a novel, ubiquitously expressed target. CX-2009 is the first conditionally activated antibody-drug conjugate to CD166 to demonstrate both translational and clinical activity in a variety of tumor types.
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Affiliation(s)
- Valentina Boni
- START Madrid HM CIOCC (Centro Integral Oncológico Clara Campal), Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | | | | | | | | | - Nataliya Uboha
- University of Wisconsin-Carbone Cancer Center, Madison, Wisconsin
| | - Rachel E. Sanborn
- Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, Oregon
| | | | | | | | | | - Shadia Jalal
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana
| | - James J. Harding
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | | | - Iris H.C. Miedema
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Danielle J. Vugts
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marc C. Huisman
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Gerben J.C. Zwezerijnen
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Guus A.M.S. van Dongen
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | | | - Song Wang
- CytomX Therapeutics, Inc., South San Francisco, California
| | - Tam Dang
- CytomX Therapeutics, Inc., South San Francisco, California
| | - Ivan A. Zein
- CytomX Therapeutics, Inc., South San Francisco, California
| | - Olga Vasiljeva
- CytomX Therapeutics, Inc., South San Francisco, California
| | - Susan K. Lyman
- CytomX Therapeutics, Inc., South San Francisco, California
| | - Virginia Paton
- CytomX Therapeutics, Inc., South San Francisco, California
| | - Alison Hannah
- CytomX Therapeutics, Inc., South San Francisco, California
| | - Joyce F. Liu
- Dana-Farber Cancer Institute, Boston, Massachusetts
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Konstantinopoulos PA, Cheng SC, Supko JG, Polak M, Wahner-Hendrickson AE, Ivy SP, Bowes B, Sawyer H, Basada P, Hayes M, Curtis J, Horowitz N, Wright AA, Campos SM, Ivanova EV, Paweletz CP, Palakurthi S, Liu JF, D'Andrea AD, Gokhale PC, Chowdhury D, Matulonis UA, Shapiro GI. Combined PARP and HSP90 inhibition: preclinical and Phase 1 evaluation in patients with advanced solid tumours. Br J Cancer 2022; 126:1027-1036. [PMID: 34887522 PMCID: PMC8980096 DOI: 10.1038/s41416-021-01664-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/20/2021] [Accepted: 12/01/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE PARP inhibitor resistance may be overcome by combinatorial strategies with agents that disrupt homologous recombination repair (HRR). Multiple HRR pathway components are HSP90 clients, so that HSP90 inhibition leads to abrogation of HRR and sensitisation to PARP inhibition. We performed in vivo preclinical studies of the HSP90 inhibitor onalespib with olaparib and conducted a Phase 1 combination study. PATIENTS AND METHODS Tolerability and efficacy studies were performed in patient-derived xenograft(PDX) models of ovarian cancer. Clinical safety, tolerability, steady-state pharmacokinetics and preliminary efficacy of olaparib and onalespib were evaluated using a standard 3 + 3 dose-escalation design. RESULTS Olaparib/onalespib exhibited anti-tumour activity against BRCA1-mutated PDX models with acquired PARPi resistance and PDX models with RB-pathway alterations(CDKN2A loss and CCNE1 overexpression). Phase 1 evaluation revealed that dose levels up to olaparib 300 mg/onalespib 40 mg and olaparib 200 mg/onalespib 80 mg were safe without dose-limiting toxicities. Coadministration of olaparib and onalespib did not appear to affect the steady-state pharmacokinetics of either agent. There were no objective responses, but disease stabilisation ≥24 weeks was observed in 7/22 (32%) evaluable patients including patients with BRCA-mutated ovarian cancers and acquired PARPi resistance and patients with tumours harbouring RB-pathway alterations. CONCLUSIONS Combining onalespib and olaparib was feasible and demonstrated preliminary evidence of anti-tumour activity.
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Affiliation(s)
| | | | | | | | | | - S Percy Ivy
- National Cancer Institute, Bethesda, MD, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Joyce F Liu
- Dana-Farber Cancer Institute, Boston, MA, USA
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Liu JF, Brady MF, Matulonis UA, Miller A, Kohn EC, Swisher EM, Cella D, Tew WP, Cloven NG, Muller CY, Bender DP, Moore RG, Michelin DP, Waggoner SE, Geller MA, Fujiwara K, D'Andre SD, Carney M, Alvarez Secord A, Moxley KM, Bookman MA. Olaparib With or Without Cediranib Versus Platinum-Based Chemotherapy in Recurrent Platinum-Sensitive Ovarian Cancer (NRG-GY004): A Randomized, Open-Label, Phase III Trial. J Clin Oncol 2022; 40:2138-2147. [PMID: 35290101 DOI: 10.1200/jco.21.02011] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Platinum-based chemotherapy is the standard of care for platinum-sensitive ovarian cancer, but complications from repeated platinum therapy occur. We assessed the activity of two all-oral nonplatinum alternatives, olaparib or olaparib/cediranib, versus platinum-based chemotherapy. PATIENTS AND METHODS NRG-GY004 is an open-label, randomized, phase III trial conducted in the United States and Canada. Eligible patients had high-grade serous or endometrioid platinum-sensitive ovarian cancer. Patients were randomly assigned 1:1:1 to platinum-based chemotherapy, olaparib, or olaparib/cediranib. The primary end point was progression-free survival (PFS) in the intention-to-treat population. Secondary end points included activity within germline BRCA-mutated or wild-type subgroups and patient-reported outcomes (PROs). RESULTS Between February 04, 2016, and November 13, 2017, 565 eligible patients were randomly assigned. Median PFS was 10.3 (95% CI, 8.7 to 11.2), 8.2 (95% CI, 6.6 to 8.7), and 10.4 (95% CI, 8.5 to 12.5) months with chemotherapy, olaparib, and olaparib/cediranib, respectively. Olaparib/cediranib did not improve PFS versus chemotherapy (hazard ratio [HR] 0.86; 95% CI, 0.66 to 1.10; P = .077). In women with germline BRCA mutation, the PFS HR versus chemotherapy was 0.55 (95% CI, 0.32 to 0.94) for olaparib/cediranib and 0.63 (95% CI, 0.37 to 1.07) for olaparib. In women without a germline BRCA mutation, the PFS HR versus chemotherapy was 0.97 (95% CI, 0.73 to 1.30) for olaparib/cediranib and 1.41 (95% CI, 1.07 to 1.86) for olaparib. Hematologic adverse events occurred more commonly with chemotherapy; however, nonhematologic adverse events were higher with olaparib/cediranib. In 489 patients evaluable for PROs, patients receiving olaparib/cediranib scored on average 1.1 points worse on the NFOSI-DRS-P subscale (97.5% CI, -2.0 to -0.2, P = .0063) versus chemotherapy; no difference between olaparib and chemotherapy was observed. CONCLUSION Combination olaparib/cediranib did not improve PFS compared with chemotherapy and resulted in reduced PROs. Notably, in patients with a germline BRCA mutation, both olaparib and olaparib/cediranib had significant clinical activity.
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Affiliation(s)
- Joyce F Liu
- Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA
| | - Mark F Brady
- NRG Oncology; Clinical Trial Development Division; Biostatistics & Bioinformatics; Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Ursula A Matulonis
- Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA
| | - Austin Miller
- NRG Oncology; Clinical Trial Development Division; Biostatistics & Bioinformatics; Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Elise C Kohn
- Gynecologic Cancer Therapeutics, National Cancer Institute, Rockville, MD
| | | | - David Cella
- Department of Medical Social Sciences, Northwestern University Health System, Chicago, IL
| | - William P Tew
- Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - David P Bender
- Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Richard G Moore
- Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester, Rochester, NY
| | - David P Michelin
- Gynecologic Oncology, Cancer Research Consortium of West Michigan, Munson Medical Center, Traverse City, MI
| | | | - Melissa A Geller
- Ob/Gyn & Women's Health, University of Minnesota, Minneapolis, MN
| | - Keiichi Fujiwara
- Gynecologic Oncology, Saitama Medical University International Medical Center; Hidaka-Shi, Japan
| | - Stacy D D'Andre
- Executive Chair, Sutter Cancer Research Consortium, Sutter Health Research Enterprise, Sacramento, CA
| | - Michael Carney
- Kapialoni Medical Center for Women & Children, University of Hawaii, Honolulu, HI
| | | | - Katherine M Moxley
- Stephenson Cancer Center Gynecologic Cancers Clinic, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Michael A Bookman
- Director, Gynecologic Oncology Therapeutics, Kaiser Permanente Northern California, San Francisco, CA
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39
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Yuan HS, Liu JF. [Pay attention to the imaging research in marathon-related musculoskeletal injuries]. Zhonghua Yi Xue Za Zhi 2022; 102:611-614. [PMID: 35249304 DOI: 10.3760/cma.j.cn112137-20220106-00036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Marathon-related musculoskeletal injuries are very common. The imaging research of musculoskeletal injuries may provide scientific support for the health protection of marathon athletes. Unfortunately, imaging studies on musculoskeletal system injury are relatively lacking, large sample studies are almost blank, and neither imaging methods nor study populations are comprehensive enough. The imaging study of marathon-related musculoskeletal injuries remains to be further studied. As a country with a large number of marathon participants, China should strengthen relevant imaging studies to provide more health protection for marathon enthusiasts and professional athletes.
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Affiliation(s)
- H S Yuan
- Department of Radiology, the Third Hospital of Peking University, Beijing 100091, China
| | - J F Liu
- Department of Radiology, the Third Hospital of Peking University, Beijing 100091, China
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40
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Zhao JH, Liu JF, Han DZ, Yang Y, Zhao YB, Wang FJ, You F. [Endoscopic posterior nasal neurectomy for the treatment of allergic rhinitis: anatomy and analysis of clinical efficacy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:295-300. [PMID: 35325941 DOI: 10.3760/cma.j.cn115330-20210710-00447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To propose total posterior nasal neurectomy with transection of sphenopalatine neurovascular bundle from anatomy for the treatment of allergic rhinitis, and to explore its clinical application. Methods: Two fresh cadaveric heads (4 sides) were dissected through endoscopic transnasal middle meatus approach at Otorhinolaryngology Anatomy Laboratory of China-Japan Friendship Hospital. The structures of the craniofacial bone related to the surgical approach were observed. Twelve patients with allergic rhinitis who treated in Department of Otorhinolaryngology, China-Japan Friendship Hospital from Feb. 1 2019 to Jun. 10 2021 were selected. All the patients were treated by posterior nasal neurotomy with the technique of complete transection of sphenopalatine neurovascular bundle and followed up for 1 year after sugery. During the follow-up, 2 patients were lost. The other 10 patients included 4 males and 6 females, aging from 29 to 69 years. Visual Analogue Scale (VAS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were used to evaluate the effect of the surgery. SPSS 25.0 software was used for statistical analysis. Results: Important anatomic landmarks of transnasal middle meatus approach were obtained during anatomy, such as ethmoid crest, sphenopalatine foramen/notch, palatine orbital process and sphenopalatine process. The postoperative VAS scores of nose, eye, pharynx, ear and whole body and total VAS scores were significantly lower than those before operation, with statistically significant difference (nose 2.50±1.70 vs 6.47±2.17, eyes 1.15±0.89 vs 3.60±2.57, pharynx 1.30±1.36 vs 4.25±3.64, ear 1.10±1.03 vs 2.67±2.00, whole body 1.08±1.24 vs 3.60±1.17, total 7.13±4.31 vs 20.58±9.05, all P<0.05). The postoperative RQLQ scores of sleep, nose, eyes, practical problems, emotion, activity and the total RQLQ scores of patients were significantly lower than those before operation, with statistically significant difference (sleep 0.80±0.69 vs 2.93±1.33, nose 1.38±1.18 vs 3.93±1.50, eyes 0.58±0.66 vs 1.80±1.25, practical problems 1.10±1.22 vs 3.03±1.84, emotion 1.00±1.81 vs 2.58±2.00, activity 2.77±2.93 vs 6.00±1.85, total 8.99±8.92 vs 22.42±8.69, all P<0.05). There was no significant difference in preoperative and postoperative scores of non-nasal/ocular symptoms (1.37±1.60 vs 2.16±1.12, P=0.166). There was no other complication except 2 cases with short-term postoperative numbness. Conclusions: Total posterior nasal neurectomy with transection of sphenopalatine neurovascular bundle is a safe, effective and feasible method for the treatment of intractable allergic rhinitis, and its long-term efficacy needs further observation.
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Affiliation(s)
- J H Zhao
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China
| | - J F Liu
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China China Japan Friendship Clinical College, Beijing University of Traditional Chinese Medicine, Beijing 100029, China
| | - D Z Han
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China China Japan Friendship Clinical College, Beijing University of Traditional Chinese Medicine, Beijing 100029, China
| | - Y Yang
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Y B Zhao
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China
| | - F J Wang
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Fangjia You
- China Japan Friendship Clinical College, Beijing University of Traditional Chinese Medicine, Beijing 100029, China
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41
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Che XY, Liu JF. [Assessment of folate status among women of childbearing age from 2000 to 2020]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:377-385. [PMID: 35381663 DOI: 10.3760/cma.j.cn112150-20211215-01161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To analyze the folate status among women of childbearing age worldwide from 2000 to 2020, and explore the impact of socioeconomic factors on folate status, so as to provide support for the formulation of relevant supplementary policies in China in the future. Methods: The "folate" "folic acid" "deficiency" "status" "women" "childbearing" and "reproductive" were used as Chinese and English keywords to systematically search CNKI and PubMed database. Global Health Data Exchange database (GDHx), Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia datasets (BRINDA) and Ground Work publications were systematically searched with "micronutrients" and "nutrition" as keywords. The retrieval time was from January 1, 2000 to August 31, 2020, and the language was restricted to English and Chinese. After title, abstract and full-text screening, a total of 45 literatures were included. The folate status of women of childbearing age in the eligible literature was analyzed, and the income and folate status were tested by Kruskal Wallis H test and Nemenyi test. Results: The M (Q1, Q3) of serum folate deficiency rate and erythrocyte folate insufficiency rate in women of childbearing age were 15.0% (3.5%, 37.0%) and 49.0% (22.0%, 83.0%). There were great differences in serum folate status and serum folate deficiency rate among women of childbearing age in different income countries. The serum folate deficiency rate of women of childbearing age in low-income countries was significantly higher than that in middle and high-income countries. Conclusion: The folate status of women of childbearing age in most countries has not reached the ideal state from 2000 to 2020. More studies on folate supplementation programs should be carried out.
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Affiliation(s)
- X Y Che
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China,Beijing 100191, China Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - J F Liu
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China,Beijing 100191, China Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
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Stover EH, Xiong N, Myers AP, Tayob N, Engvold V, Polak M, Broaddus RR, Makker V, Drapkin R, Liu JF, Horowitz NS, Meric-Bernstam F, Aghajanian C, Coleman RL, Mills GB, Cantley LC, Matulonis UA, Westin SN, Konstantinopoulos PA. A phase II study of MK-2206, an AKT inhibitor, in uterine serous carcinoma. Gynecol Oncol Rep 2022; 40:100974. [PMID: 35434236 PMCID: PMC9011027 DOI: 10.1016/j.gore.2022.100974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 11/24/2022] Open
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43
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Guo ZY, Liu JF, Zhou CH, Qian MB, Chen YD, Zhou XN, Li SZ. [Current status and challenges for taeniasis and cysticercosis control in China]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2021; 33:563-569. [PMID: 35128885 DOI: 10.16250/j.32.1374.2021170] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In the WHO new road map for neglected tropical diseases 2021-2030, the disease-specific targets are classified into control, elimination as a public health problem, elimination and eradication, and taeniasis and cysticercosis are targeted for control. The overall prevalence of taeniasis and cysticercosis is low in China, and varies remarkably in regions and populations; however, there are many challenges for elimination of taeniasis and cysticercosis in China. Based on previous taeniasis and cysticercosis control programs, developing a sensitive taeniasis and cysticercosis surveillance-response system, updating criteria for diagnosis of taeniasis and cysticercosis, proposing a national guideline for treatment of taeniasis and cysticercosis, and strengthening interdisciplinary and intersectoral communications and collaborations are urgently needed under the One Health concept.
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Affiliation(s)
- Z Y Guo
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, National Research Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, National Health Commission, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - J F Liu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, National Research Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, National Health Commission, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - C H Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, National Research Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, National Health Commission, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - M B Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, National Research Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, National Health Commission, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Y D Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, National Research Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, National Health Commission, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - X N Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, National Research Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, National Health Commission, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - S Z Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, National Research Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, National Health Commission, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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44
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Wang YJ, Ren YY, Tang CY, Li XT, Liu JF. [Clinical characteristics analysis of two cases of nosebleed with acute cerebral hemorrhage]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:1336-1337. [PMID: 34963223 DOI: 10.3760/cma.j.cn115330-20210304-00108] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Y J Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Y Y Ren
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - C Y Tang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - X T Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J F Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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45
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Zhou M, Liu JF, Yuan JJ, Yan ZF, Dai JS, Ge XY, Wang NY. [The research progress of excitatory and inhibitory inputs of lateral superior olive]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:1008-1012. [PMID: 34666458 DOI: 10.3760/cma.j.cn115330-20210825-00571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- M Zhou
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - J F Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - J J Yuan
- Department of Otorhinolaryngology Head and Neck Surgery, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100020, China
| | - Z F Yan
- Department of Otorhinolaryngology Head and Neck Surgery, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100020, China
| | - J S Dai
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - X Y Ge
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - N Y Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
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Fuh KC, Bookman MA, Liu JF, Coleman RL, Herzog TJ, Thaker PH, Monk BJ, Anderson R, McIntyre G, Rangwala R, Moore KN. Phase 1b study of AVB-500 in combination with paclitaxel or pegylated liposomal doxorubicin platinum-resistant recurrent ovarian cancer. Gynecol Oncol 2021; 163:254-261. [PMID: 34474927 DOI: 10.1016/j.ygyno.2021.08.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE GAS6 and AXL are expressed in high-grade serous ovarian cancer but not in normal ovarian tissue. AVB-500, a novel high affinity Fc-sAXL fusion protein, binds GAS6 preventing AXL signaling. This Phase 1b study (NCT03639246) evaluated safety, efficacy, and exploratory predictive markers of AVB-500 combined with paclitaxel (PAC) or pegylated liposomal doxorubicin (PLD) in patients with platinum-resistant ovarian cancer (PROC), and used a model informed drug development (MIDD) approach for identification of the recommended phase 2 dose (RP2D). METHODS Eligible patients received AVB-500 at 10, 15, or 20 mg/kg IV q2wk combined with PAC (n = 23) or PLD (n = 30). Patients were treated until progression or unacceptable toxicity. All were followed for survival. RESULTS No dose limiting toxicities were observed and serum GAS6 was completely suppressed across the three dose levels evaluated. AVB-500 + PAC yielded better clinical activity than AVB-500 + PLD with an ORR of 34.8% (8/23, 2 complete responses) and median DoR, PFS, and OS of 7.0, 3.1, and 10.3 months, respectively. Subgroup analyses showed AVB-500 + PAC patients who had no prior bevacizumab or whose AVB-500 trough levels were >13.8 mg/L exhibited the best clinical response. The ORR and median PFS and OS in patients with these characteristics were ≥50%, ≥7.5 months, and ≥19 months, respectively. Given AVB-500 nor the combination with chemotherapy was expected to cause DLTs, the RP2D of AVB-500 was 15 mg/kg identified using an MIDD approach. CONCLUSION AVB-500 was well-tolerated in combination with PAC or PLD and contributed to the clinical activity of PAC in PROC patients. Subgroup analyses identified a population of PROC patients who may benefit the most from AVB-500 treatment, which will be further assessed in an ongoing Phase 3 PROC trial.
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Affiliation(s)
- Katherine C Fuh
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, United States of America.
| | | | - Joyce F Liu
- Dana-Farber Cancer Institute, Boston, MA, United States of America
| | - Robert L Coleman
- US Oncology Network, The Woodlands, TX, United States of America
| | - Thomas J Herzog
- University of Cincinnati Cancer Center, Cincinnati, OH, United States of America
| | - Premal H Thaker
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Bradley J Monk
- Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix, AZ, United States of America
| | | | - Gail McIntyre
- Aravive, Inc., Houston, TX, United States of America
| | | | - Kathleen N Moore
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States of America
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47
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Liu JF, Brigitta XL, Wang YJ, Dai JS, Ren YY, Zhang Y, Li W, Wang NY. [Clinical characteristics of patients with odontogenic sinusitis underwent endoscopic sinus surgery]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:848-853. [PMID: 34521170 DOI: 10.3760/cma.j.cn115330-20201217-00928] [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] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the clinical features of patients with odontogenic sinusitis (OS) treated by endoscopic sinus surgery (ESS). Methods: A retrospective investigation was carried out in our 27 (16 males and 11 females) cases with OS aged (49.74±14.42) years old. Subjects were hospitalized between January 2018 and November 2020 from Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital. The medical history, symptoms, result of nasal endoscopy and paranasal sinus computed tomography (CT) were analyzed statistically by SPSS 19.0. Results: OS mainly occured on unilateral sinuses, with a duration of (8.56±11.79) months. Seventy point four percent (19/27) of the patients had a course within six-month, only 11% was over 12 months (3/27). Symptoms mostly showed as nasal obstruction (88.9%; 24/27), runny nose (81.5%; 22/27), nasal stinks (16/19) and postnasal drip (10/10). Sixty-three percent (17/27) of the OS patients had a dental history. Nasal endoscopic examination revealed a swelling of the ostiomeatal complex (77.8%; 21/27), medial wall interhal displacement of maxillary sinus (55.6%; 15/27), white emulsion-like purulent secretion in the middle meatus (70.4%; 19/27) and nasal polyps (59.3%; 16/27). Etiology of OS included implant-related problems (14.8%; 4/27) and periodontal disease (85.2%; 23/27). Conclusions: OS is usually unilateral sinusitis with a short history. Its clinical features show nasal stinks, white emulsion-like purulent secretion in the middle meatus and imaging findings of unilateral maxillary sinusitis with tooth-related lesions.
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Affiliation(s)
- J F Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - X L Brigitta
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Y J Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J S Dai
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Y Y Ren
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Y Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - W Li
- Department of Oral and Maxillofacial Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - N Y Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Lin J, Ji XJ, Wang AY, Liu JF, Liu P, Zhang M, Qi ZL, Guo DC, Bellomo R, Bagshaw SM, Wald R, Gallagher M, Duan ML. Corrigendum to "Timing of continuous renal replacement therapy in severe acute kidney injury patients with fluid overload: A retrospective cohort study" [J Crit Care. 2021 Aug; 64: 226-236]. J Crit Care 2021; 66:191. [PMID: 34274206 DOI: 10.1016/j.jcrc.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J Lin
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - X J Ji
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - A Y Wang
- The George Institute for Global Health, Newtown, UNSW, Australia; Concord Clinical School, The University of Sydney, Australia; Department of Renal Medicine, Concord Repatriation General Hospital, Australia.
| | - J F Liu
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - P Liu
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - M Zhang
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - Z L Qi
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - D C Guo
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - R Bellomo
- The George Institute for Global Health, Newtown, UNSW, Australia; Department of Intensive Care, Austin Hospital, Australia
| | - S M Bagshaw
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - R Wald
- Division of Nephrology, St. Michael's Hospital, University of Toronto, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - M Gallagher
- The George Institute for Global Health, Newtown, UNSW, Australia; Concord Clinical School, The University of Sydney, Australia; Department of Renal Medicine, Concord Repatriation General Hospital, Australia
| | - M L Duan
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China.
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49
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Zhao Y, Cheng JN, Yang DZ, Liu JF. [Endoscopic resection of recurrent nasal inverted papilloma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:797. [PMID: 34344114 DOI: 10.3760/cma.j.cn115330-20210303-00104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Y Zhao
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China
| | - J N Cheng
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China
| | - D Z Yang
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China
| | - J F Liu
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China
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50
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Salani R, Liu JF. The American Society of Clinical Oncology 2021 annual (virtual) meeting: A review and summary of selected abstracts. Gynecol Oncol 2021; 162:245-248. [PMID: 34210516 DOI: 10.1016/j.ygyno.2021.06.021] [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: 11/25/2022]
Affiliation(s)
- Ritu Salani
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of California Los Angeles, Los Angeles, CA, United States of America.
| | - Joyce F Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States of America
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