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Kesari S, Wagle N, Carrillo JA, Sharma A, Nguyen M, Truong J, Gill JM, Nersesian R, Nomura N, Rahbarlayegh E, Barkhoudarian G, Sivakumar W, Kelly DF, Krauss H, Bustos MA, Hoon DSB, Anker L, Singh AS, Sankhala KK, Juarez TM. Pilot Study of High-Dose Pemetrexed in Patients with Progressive Chordoma. Clin Cancer Res 2024; 30:323-333. [PMID: 38047868 DOI: 10.1158/1078-0432.ccr-23-2317] [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: 08/18/2023] [Revised: 10/26/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023]
Abstract
PURPOSE Chordomas are ultrarare tumors of the axial spine and skull-base without approved systemic therapy. Most chordomas have negative expression of thymidylate synthase (TS), suggesting a potential for responding to the antifolate agent pemetrexed, which inhibits TS and other enzymes involved in nucleotide biosynthesis. We evaluated the therapeutic activity and safety of high-dose pemetrexed in progressive chordoma. PATIENTS AND METHODS Adult patients with previously treated, progressive chordoma participated in an open-label, single-institution, single-arm, pilot clinical trial of intravenous pemetrexed 900 mg/m2 every 3 weeks and supportive medications of folic acid, vitamin B12, and dexamethasone. The primary endpoint was objective response rate according to RECIST v1.1. Secondary endpoints included adverse events, progression-free survival (PFS), tumor molecular profiles, and alterations in tissue and blood-based biomarkers. RESULTS Fifteen patients were enrolled and the median number of doses administered was 15 (range, 4-31). One patient discontinued treatment due to psychosocial issues after four cycles and one contracted COVID-19 after 13 cycles. Of the 14 response-evaluable patients, 2 (14%) achieved a partial response and 10 (71%) demonstrated stable disease. Median PFS was 10.5 months (95% confidence interval: 9 months-undetermined) and 6-month PFS was 67%. Adverse events were expected and relatively mild, with one grade 3 creatinine increased, and one each of grade 3 and 4 lymphopenia. No grade 5 adverse events, unexpected toxicities, or dose-limiting toxicities were observed. Several patients reported clinical improvement in disease-related symptoms. CONCLUSIONS High-dose pemetrexed appears tolerable and shows objective antitumor activity in patients with chordoma. Phase II studies of high-dose pemetrexed are warranted.
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Affiliation(s)
- Santosh Kesari
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Naveed Wagle
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Jose A Carrillo
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Akanksha Sharma
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Minhdan Nguyen
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Judy Truong
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Jaya M Gill
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Raffi Nersesian
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Natsuko Nomura
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Elnaz Rahbarlayegh
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Garni Barkhoudarian
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | | | - Daniel F Kelly
- Pacific Neuroscience Institute, Santa Monica, California
| | - Howard Krauss
- Pacific Neuroscience Institute, Santa Monica, California
| | - Matias A Bustos
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Dave S B Hoon
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
| | - Lars Anker
- Providence St. Joseph Hospital Orange, Orange, California
| | - Arun S Singh
- UCLA Health, Santa Monica Cancer Care, Santa Monica, California
| | - Kamalesh K Sankhala
- Cedars-Sinai Medical Center, Samuel Oschin Cancer Center, Los Angeles, California
| | - Tiffany M Juarez
- Pacific Neuroscience Institute, Santa Monica, California
- Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, California
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Lee S, Sankhala KK, Bose S, Gallemore RP. Combined Central Retinal Artery and Vein Occlusion with Ischemic Optic Neuropathy After COVID-19 Vaccination. Int Med Case Rep J 2022; 15:7-14. [PMID: 35079224 PMCID: PMC8778623 DOI: 10.2147/imcrj.s328931] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 11/30/2021] [Indexed: 11/27/2022] Open
Abstract
Purpose To report a case of combined central retinal vein and artery occlusion that evolved into ischemic optic neuropathy following the Pfizer COVID-19 vaccination. Methods Patient was followed with optical coherence tomography (OCT), fluorescein angiography, and Humphrey visual field. Results Patient was able to recover vision from count fingers to 20/30 on a combination of aflibercept, steroidal and non-steroidal anti-inflammatories, a diuretic (acetazolamide), antiplatelet agents (aspirin and pentoxifylline), and an anticoagulant (apixaban). Conclusion COVID-19 vaccination may be associated with a myriad of sight-threatening ocular thrombotic conditions, which may respond to a combination of anti-inflammatory and anticoagulant therapies.
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Affiliation(s)
- Sol Lee
- Department of Clinical Research, Retina Macula Institute, Torrance, CA, USA
| | | | - Swaraj Bose
- NeuroOphthalmology & Orbital Surgery, Cedars-Sinai Medical Towers, NeuroEyeOrbit Institute, Los Angeles, CA, USA
| | - Ron P Gallemore
- Department of Clinical Research, Retina Macula Institute, Torrance, CA, USA
- Correspondence: Ron P Gallemore Department of Clinical Research, Retina Macula Institute, 4201 Torrance Blvd, Suite 220, Torrance, CA, 90503, USATel +1 310-413-7020 Email
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Wick A, Bähr O, Schuler M, Rohrberg K, Chawla SP, Janku F, Schiff D, Heinemann V, Narita Y, Lenz HJ, Ikeda M, Ando Y, Wick W, Steinbach JP, Burger MC, Wenger K, Lassen U, Sankhala KK, Roggia C, Genvresse I, Munhoz C, Rentzsch C, Reschke S, Langer S, Wagner M, Kaulfuss S, Cai C, Lagkadinou E, Jeffers M, Peña C, Tabatabai G. Phase I Assessment of Safety and Therapeutic Activity of BAY1436032 in Patients with IDH1-Mutant Solid Tumors. Clin Cancer Res 2021; 27:2723-2733. [PMID: 33622704 DOI: 10.1158/1078-0432.ccr-20-4256] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/15/2020] [Accepted: 02/18/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE BAY1436032, an inhibitor of mutant isocitrate dehydrogenase 1 (mIDH1), was active against multiple IDH1-R132X solid tumors in preclinical models. This first-in-human study was designed to determine the safety and pharmacokinetics of BAY1436032, and to evaluate its potential pharmacodynamics and antitumor effects. PATIENTS AND METHODS The study comprised of dose escalation and dose expansion cohorts. BAY1436032 tablets were orally administered twice daily on a continuous basis in subjects with mIDH1 solid tumors. RESULTS In dose escalation, 29 subjects with various tumor types were administered BAY1436032 across five doses (150-1,500 mg twice daily). BAY1432032 exhibited a relatively short half-life. Most evaluable subjects experienced target inhibition as indicated by a median maximal reduction of plasma R-2-hydroxyglutarate levels of 76%. BAY1436032 was well tolerated and an MTD was not identified. A dose of 1,500 mg twice daily was selected for dose expansion, where 52 subjects were treated in cohorts representing four different tumor types [lower grade glioma (LGG), glioblastoma, intrahepatic cholangiocarcinoma, and a basket cohort of other tumor types]. The best clinical outcomes were in subjects with LGG (n = 35), with an objective response rate of 11% (one complete response and three partial responses) and stable disease in 43%. As of August 2020, four of these subjects were in treatment for >2 years and still ongoing. Objective responses were observed only in LGG. CONCLUSIONS BAY1436032 was well tolerated and showed evidence of target inhibition and durable objective responses in a small subset of subjects with LGG.
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Affiliation(s)
- Antje Wick
- Department of Neurology and Neurooncology Program of the National Center for Tumor Diseases, Heidelberg University Hospital & Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Oliver Bähr
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Martin Schuler
- West German Cancer Center, Department of Medical Oncology, University Hospital Essen and German Cancer Consortium (DKTK), Partner site University Hospital Essen, Essen, Germany
| | - Kristoffer Rohrberg
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sant P Chawla
- Department of Medicine, Sarcoma Oncology Center, Santa Monica, California
| | - Filip Janku
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Center, Houston, Texas
| | - David Schiff
- Department of Neurology, University of Virginia, Charlottesville, Virginia
| | - Volker Heinemann
- Department of Medical Oncology and Hematology, LMU University Hospital Munich, Munich, Germany
| | - Yoshitaka Narita
- Department of Neurosurgery and Neurooncology, National Cancer Center Hospital, Tokyo, Japan
| | - Heinz-Josef Lenz
- Adult Oncology, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Masafumi Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuichi Ando
- Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Wolfgang Wick
- Department of Neurology and Neurooncology Program of the National Center for Tumor Diseases, Heidelberg University Hospital & Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Joachim P Steinbach
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Michael C Burger
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Katharina Wenger
- Dr. Senckenberg Institute of Neurooncology, Department of Neuroradiology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Ulrik Lassen
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Cristiana Roggia
- Department of Neurology & Interdisciplinary Neurooncology, University Hospital of Tübingen, Hertie Institute for Clinical Brain Research, Center for Neuro-Oncology at Comprehensive Cancer Center Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
| | | | | | | | | | - Simon Langer
- Early Development Statistics - Oncology, Chrestos Concept GmbH & Co. KG, Essen, Germany
| | | | | | - Charles Cai
- Pharmaceuticals Division, Bayer HealthCare Pharmaceuticals, Inc., Whippany, New Jersey
| | | | - Michael Jeffers
- Pharmaceuticals Division, Bayer HealthCare Pharmaceuticals, Inc., Whippany, New Jersey
| | - Carol Peña
- Pharmaceuticals Division, Bayer HealthCare Pharmaceuticals, Inc., Whippany, New Jersey
| | - Ghazaleh Tabatabai
- Department of Neurology & Interdisciplinary Neurooncology, University Hospital of Tübingen, Hertie Institute for Clinical Brain Research, Center for Neuro-Oncology at Comprehensive Cancer Center Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
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Somaiah N, Chawla SP, Block MS, Morris JC, Do K, Kim JW, Druta M, Sankhala KK, Hwu P, Jones RL, Gnjatic S, Kim-Schulze S, Tuballes K, Yishak M, Lu H, Yakovich A, Ter Meulen J, Chen M, Kenney RT, Bohac C, Pollack SM. A Phase 1b Study Evaluating the Safety, Tolerability, and Immunogenicity of CMB305, a Lentiviral-Based Prime-Boost Vaccine Regimen, in Patients with Locally Advanced, Relapsed, or Metastatic Cancer Expressing NY-ESO-1. Oncoimmunology 2020; 9:1847846. [PMID: 33312760 PMCID: PMC7714520 DOI: 10.1080/2162402x.2020.1847846] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023] Open
Abstract
Preclinical data suggest that a "prime-boost" vaccine regimen using a target-expressing lentiviral vector for priming, followed by a recombinant protein boost, may be effective against cancer; however, this strategy has not been evaluated in a clinical setting. CMB305 is a prime-boost vaccine designed to induce a broad anti-NY-ESO-1 immune response. It is composed of LV305, which is an NY-ESO-1 expressing lentiviral vector, and G305, a recombinant adjuvanted NY-ESO-1 protein. This multicenter phase 1b, first-in-human trial evaluated CMB305 in patients with NY-ESO-1 expressing solid tumors. Safety was examined in a 3 + 3 dose-escalation design, followed by an expansion with CMB305 alone or in a combination with either oral metronomic cyclophosphamide or intratumoral injections of a toll-like receptor agonist (glucopyranosyl lipid A). Of the 79 patients who enrolled, 81.0% had sarcomas, 86.1% had metastatic disease, and 57.0% had progressive disease at study entry. The most common adverse events were fatigue (34.2%), nausea (26.6%), and injection-site pain (24.1%). In patients with soft tissue sarcomas, a disease control rate of 61.9% and an overall survival of 26.2 months (95% CI, 22.1-NA) were observed. CMB305 induced anti-NY-ESO-1 antibody and T-cell responses in 62.9% and 47.4% of patients, respectively. This is the first trial to test a prime-boost vaccine regimen in patients with advanced cancer. This approach is feasible, can be delivered safely, and with evidence of immune response as well as suggestion of clinical benefit.
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Affiliation(s)
- Neeta Somaiah
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sant P. Chawla
- Sarcoma Oncology Center, Santa Monica, CA, United States
| | - Matthew S. Block
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, United States
| | - John C. Morris
- Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Khanh Do
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Joseph W. Kim
- Department of Medical Oncology, Yale School of Medicine, New Haven, CT, United States
| | - Mihaela Druta
- Medical Oncology, Moffitt Cancer Center, Tampa, FL, United States
| | - Kamalesh K. Sankhala
- Hematology/Oncology, Cedars-Sinai Medical Center, Beverly Hills, CA, United States
| | - Patrick Hwu
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Robin L. Jones
- Seattle Cancer Care Alliance, Seattle, WA
- Sarcoma Unit, Royal Marsden Hospital, London, UK
- Sarcoma Clinical Trials, Institute of Cancer Research, London, UK
| | - Sacha Gnjatic
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Seunghee Kim-Schulze
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kevin Tuballes
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Mahlet Yishak
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Hailing Lu
- Immune Design Corp., South San Francisco, CA, United States
- Biomarkers and Diagnostics, Seattle Genetics, Inc, Bothell, WA, United States
| | - Adam Yakovich
- Immune Design Corp., South San Francisco, CA, United States
- Medical Affairs, Replimune Group, Inc, Woburn, MA, United States
| | - Jan Ter Meulen
- Immune Design Corp., South San Francisco, CA, United States
| | - Michael Chen
- Immune Design Corp., South San Francisco, CA, United States
- *Sangamo Therapeutics, Inc., Brisbane, CA, United States
| | - Richard T. Kenney
- Immune Design Corp., South San Francisco, CA, United States
- Clin Reg Biologics, LLC, Potomac, MD, United States
| | - Chet Bohac
- Immune Design Corp., South San Francisco, CA, United States
- Macrogenics, Inc, Rockville, MD, United States
| | - Seth M. Pollack
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
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5
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Palmerini E, Chawla NS, Ferrari S, Sudan M, Picci P, Marchesi E, Leopardi MP, Syed I, Sankhala KK, Parthasarathy P, Mendanha WE, Pierini M, Paioli A, Chawla SP. Denosumab in advanced/unresectable giant-cell tumour of bone (GCTB): For how long? Eur J Cancer 2017; 76:118-124. [PMID: 28324746 DOI: 10.1016/j.ejca.2017.01.028] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 01/27/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Giant-cell tumours of bone (GCTB) are RANK/RANK-ligand (RANKL) positive, aggressive and progressive osteolytic tumours. Denosumab, a RANKL inhibitor, was FDA-approved for adults and skeletally mature adolescents with unresectable GCTB or when surgical resection is likely to result in severe morbidity. Data on long-term toxicity and activity of denosumab monthly 'GCTB-schedule' (120 mg per 12/year, 1440 mg total dose/year) are lacking. METHODS Patients with GCTB receiving denosumab, 120 mg on days 1, 8, 15, 29 and every 4 weeks thereafter, from 2006 to 2015 treated in two centres were included. Long-term toxicity was evaluated. RESULTS Ninety-seven patients were identified. 43 patients underwent resection of the tumour with a median time on denosumab treatment of 12 months (range 6-45 months). Fifty-four patients had unresectable GCTB's (male/female 23/31, median age 35 years [range: 13-76 years], 26% presented with lung metastases, 31% had primary tumor located to the spine, 63% were relapsed after previous surgery) with a median time on denosumab of 54 months (9-115 months). In the unresectable GCTB group, tumour control and clinical benefits were observed in all patients undergoing denosumab, whereas 40% of patients discontinuing denosumab had tumour progression after a median of 8 months (range 7-15 months). ADVERSE EVENTS Overall, six (6%) patients developed osteonecrosis of jaw (ONJ): 1/43 (2%) in the resectable group, 5/54 (9%) in the unresectable group, with a 5-year ONJ-free survival of 92% (95% CI 84-100). Only patients with prolonged treatment experienced mild peripheral neuropathy (6/54, 11%), skin rash (5/54, 9%), hypophosphataemia (2/54, 4%) and atypical femoral fracture (2/54, 4%). CONCLUSIONS Prolonged treatment with denosumab has sustained activity in GCTB, with a mild toxicity profile. The dose-dependent toxicity observed recommends a careful and strict monitoring of patients who need prolonged treatment. Decreased dose-intensity schedules should be further explored in unresectable GCTB.
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Affiliation(s)
- E Palmerini
- Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - N S Chawla
- Sarcoma Oncology Center, Santa Monica, CA, USA
| | - S Ferrari
- Istituto Ortopedico Rizzoli, Bologna, Italy
| | - M Sudan
- Sarcoma Oncology Center, Santa Monica, CA, USA
| | - P Picci
- Istituto Ortopedico Rizzoli, Bologna, Italy
| | - E Marchesi
- Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - I Syed
- Sarcoma Oncology Center, Santa Monica, CA, USA
| | | | | | | | - M Pierini
- Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Paioli
- Istituto Ortopedico Rizzoli, Bologna, Italy
| | - S P Chawla
- Sarcoma Oncology Center, Santa Monica, CA, USA
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Sankhala KK. Clinical development landscape in GIST: from novel agents that target accessory pathways to revisiting non-targeted therapies. Expert Opin Investig Drugs 2017; 26:427-443. [PMID: 28267385 DOI: 10.1080/13543784.2017.1303045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Activating mutations in the genes encoding the tyrosine receptor kinases KIT and platelet-derived growth factor receptor occur in 85%-90% of patients with gastrointestinal stromal tumors (GIST). Although imatinib and other tyrosine kinase inhibitors have revolutionized the treatment of GIST, most patients progress within a few years. Areas covered: Monoclonal antibodies and small-molecule inhibitors targeting specific signaling pathways or proteins associated with resistance to existing treatments are being explored as alternative treatment approaches for GIST. Other alternative approaches include inhibiting more general regulators of protein folding, chromatin packaging, and cell-cycle regulation; nontargeted approaches are also being evaluated in select patient populations. This review summarizes preclinical and clinical data from agents using these accessory pathways. Expert opinion: As we learn more about GIST biology, it is becoming clear that treatment strategies will become more personalized, as reflected by the fact that several trials are enrolling specific subpopulations of patients with GIST. Going forward, researchers should evaluate these new drugs alone or in combination with other types of drugs to better meet patient needs.
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Affiliation(s)
- Kamalesh K Sankhala
- a Translational and Clinical Research , Sarcoma Oncology Center , Santa Monica , CA , USA
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Sankhala KK, Chawla NS, Chawla SP. Aldoxorubicin for the treatment of advanced soft tissue sarcoma. Expert Opin Orphan Drugs 2015. [DOI: 10.1517/21678707.2015.1018179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Chawla SP, Chua VS, Hendifar AF, Quon DV, Soman N, Sankhala KK, Wieland DS, Levitt DJ. A phase 1B/2 study of aldoxorubicin in patients with soft tissue sarcoma. Cancer 2014; 121:570-9. [DOI: 10.1002/cncr.29081] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 07/14/2014] [Accepted: 07/16/2014] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | | | | | - Kamalesh K. Sankhala
- Institute for Drug DevelopmentCancer Therapy and Research CenterUniversity of Texas Health Science CenterSan Antonio Texas
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K. Sankhala K, M. Mita M, C. Mita A, H. Takimoto C. Heat Shock Proteins: A Potential Anticancer Target. Curr Drug Targets 2011; 12:2001-8. [DOI: 10.2174/138945011798829339] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Revised: 09/23/2010] [Accepted: 10/01/2010] [Indexed: 11/22/2022]
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10
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Chawla SP, Staddon AP, Baker LH, Schuetze SM, Tolcher AW, D'Amato GZ, Blay JY, Mita MM, Sankhala KK, Berk L, Rivera VM, Clackson T, Loewy JW, Haluska FG, Demetri GD. Phase II study of the mammalian target of rapamycin inhibitor ridaforolimus in patients with advanced bone and soft tissue sarcomas. J Clin Oncol 2011; 30:78-84. [PMID: 22067397 DOI: 10.1200/jco.2011.35.6329] [Citation(s) in RCA: 194] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Ridaforolimus is an inhibitor of mammalian target of rapamycin, an integral component of the phosphatidyl 3-kinase/AKT signaling pathway, with early evidence of activity in sarcomas. This multicenter, open-label, single-arm, phase II trial was conducted to assess the antitumor activity of ridaforolimus in patients with distinct subtypes of advanced sarcomas. PATIENTS AND METHODS Patients with metastatic or unresectable soft tissue or bone sarcomas received ridaforolimus 12.5 mg administered as a 30-minute intravenous infusion once daily for 5 days every 2 weeks. The primary end point was clinical benefit response (CBR) rate (complete response or partial response [PR] or stable disease ≥ 16 weeks). Safety, progression-free survival (PFS), overall survival (OS), time to progression, and duration of response were also evaluated. RESULTS A total of 212 patients were treated in four separate histologic cohorts. In this heavily pretreated population, 61 patients (28.8%) achieved CBR. Median PFS was 15.3 weeks; median OS was 40 weeks. Response Evaluation Criteria in Solid Tumors (RECIST) confirmed response rate was 1.9%, with four patients achieving confirmed PR (two with osteosarcoma, one with spindle cell sarcoma, and one with malignant fibrous histiocytoma). Archival tumor protein markers analyzed were not correlated with CBR. Related adverse events were generally mild or moderate and consisted primarily of stomatitis, mucosal inflammation, mouth ulceration, rash, and fatigue. CONCLUSION Single-agent ridaforolimus in patients with advanced and pretreated sarcomas led to PFS results that compare favorably with historical metrics. A phase III trial based on these data will further define ridaforolimus activity in sarcomas.
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Affiliation(s)
- Sant P Chawla
- International Institute of Clinical Studies, Sarcoma Oncology Center, Santa Monica, CA, USA
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Sankhala KK, Pandya DM, Sarantopoulos J, Soefje SA, Giles FJ, Chawla SP. Prevention of chemotherapy induced nausea and vomiting: a focus on aprepitant. Expert Opin Drug Metab Toxicol 2009; 5:1607-14. [DOI: 10.1517/17425250903451675] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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12
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Sankhala KK, Chawla SP. Review: desmoplastic small round cell tumor: current treatment approach and role of targeted therapy. Clin Adv Hematol Oncol 2009; 7:476-478. [PMID: 19701156] [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: 05/28/2023]
MESH Headings
- Abdominal Neoplasms/drug therapy
- Abdominal Neoplasms/genetics
- Abdominal Neoplasms/pathology
- Adolescent
- Antibodies, Monoclonal/therapeutic use
- Antineoplastic Agents, Alkylating/therapeutic use
- Child
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 22/genetics
- Genes, Wilms Tumor
- Humans
- Neoplasms, Connective and Soft Tissue/drug therapy
- Neoplasms, Connective and Soft Tissue/genetics
- Neoplasms, Connective and Soft Tissue/pathology
- RNA-Binding Protein EWS/genetics
- Receptor, ErbB-2/metabolism
- Translocation, Genetic
- Young Adult
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Affiliation(s)
- Kamalesh K Sankhala
- Institute for Drug Development, Cancer Therapy and Research Center, The University of Texas Health Science Center, San Antonio, TX 78229, USA.
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