1
|
Turcios Escobar S, Yang R, Nelson KC, Gershenwald JE, Tawbi H, Aung PP, Patel SP, Torres-Cabala CA. Utility of next-generation sequencing in the diagnosis of metastatic melanoma: A case report. J Cutan Pathol 2024. [PMID: 38757469 DOI: 10.1111/cup.14660] [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] [Received: 11/13/2023] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024]
Abstract
During routine dermatologic examination, a 77-year-old male was noted to have a firm blue subcutaneous nodule on his right lateral upper back. His past medical history included metastatic melanoma of unknown primary involving right and left axillary lymph nodes, treated with ipilimumab/nivolumab with complete response, and subsequent primary uveal melanoma. The subcutaneous nodule was located near his previous right axillary scar for metastatic melanoma. Excision of the nodule showed a plexiform neoplasm involving mid and deep dermis composed of spindle and epithelioid atypical cells admixed with numerous melanophages. Central necrosis was present. Immunohistochemical studies revealed the tumor cells to be diffusely positive for HMB45, with retained expression of BAP1 and p16. The tumor cells were negative for PRAME, nuclear expression of β-catenin, LEF1, and BRAF V600E. Molecular studies demonstrated BAP1 and GNA11 somatic mutations, a profile different from that exhibited by his prior melanoma. Collectively, these data were interpreted as a metastasis from uveal melanoma and not a recurrence of his metastatic likely cutaneous melanoma after complete response to immunotherapy. This case emphasizes the importance of molecular studies for definitive diagnosis in challenging clinical situations, especially when there is discordance among histopathological, immunohistochemical, and molecular studies. Integration of clinical, histopathological, and molecular features is warranted.
Collapse
Affiliation(s)
- Saul Turcios Escobar
- Department of Pathology, University of Illinois Hospital & Health Sciences System, Chicago, Illinois, USA
| | - Richard Yang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kelly C Nelson
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Hussein Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Phyu P Aung
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carlos A Torres-Cabala
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
2
|
Glitza Oliva IC, Ferguson SD, Bassett R, Foster AP, John I, Hennegan TD, Rohlfs M, Richard J, Iqbal M, Dett T, Lacey C, Jackson N, Rodgers T, Phillips S, Duncan S, Haydu L, Lin R, Amaria RN, Wong MK, Diab A, Yee C, Patel SP, McQuade JL, Fischer GM, McCutcheon IE, O'Brien BJ, Tummala S, Debnam M, Guha-Thakurta N, Wargo JA, Carapeto FCL, Hudgens CW, Huse JT, Tetzlaff MT, Burton EM, Tawbi HA, Davies MA. Author Correction: Concurrent intrathecal and intravenous nivolumab in leptomeningeal disease: phase 1 trial interim results. Nat Med 2024:10.1038/s41591-024-02998-5. [PMID: 38649781 DOI: 10.1038/s41591-024-02998-5] [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: 04/25/2024]
Affiliation(s)
- Isabella C Glitza Oliva
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Sherise D Ferguson
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Roland Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alexandra P Foster
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ida John
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tarin D Hennegan
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michelle Rohlfs
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jessie Richard
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Masood Iqbal
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tina Dett
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carol Lacey
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Natalie Jackson
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Theresa Rodgers
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Suzanne Phillips
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sheila Duncan
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lauren Haydu
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ruitao Lin
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rodabe N Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael K Wong
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cassian Yee
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer L McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Grant M Fischer
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ian E McCutcheon
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Barbara J O'Brien
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sudhakar Tummala
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Matthew Debnam
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nandita Guha-Thakurta
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer A Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fernando C L Carapeto
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Courtney W Hudgens
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jason T Huse
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael T Tetzlaff
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Elizabeth M Burton
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael A Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
3
|
Chattopadhyay C, Roszik J, Bhattacharya R, Alauddin M, Mahmud I, Yadugiri S, Ali MM, Khan FS, Prabhu VV, Lorenzi P, Burton E, Morey RR, Lazcano R, Davies MA, Patel SP, Grimm EA. Imipridones inhibit tumor growth and improve survival in an orthotopic liver metastasis mouse model of human uveal melanoma. bioRxiv 2024:2024.01.12.575058. [PMID: 38293232 PMCID: PMC10827043 DOI: 10.1101/2024.01.12.575058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Purpose Uveal melanoma (UM) is a highly aggressive disease with very few treatment options. We previously demonstrated that mUM is characterized by high oxidative phosphorylation (OXPHOS). Here we tested the anti-tumor, signaling and metabolic effects of imipridones, CLPP activators which reduce OXPHOS indirectly and have demonstrated safety in patients. Experimental Design We assessed CLPP expression in UM patient samples. We tested the effects of imipridones (ONC201, ONC212) on the growth, survival, signaling and metabolism of UM cell lines in vitro, and for therapeutic effects in vivo in UM liver metastasis models. Results CLPP expression was confirmed in primary and mUM patient samples. ONC201/212 treatment of UM cell lines in vitro decreased OXPHOS effectors, inhibited cell growth and migration, and induced apoptosis. ONC212 increased metabolic stress and apoptotic pathways, inhibited amino acid metabolism, and induced cell death-related lipids. ONC212 also decreased tumor burden and increased survival in vivo in two UM liver metastasis models. Conclusion Imipridones are a promising strategy for further testing and development in mUM.
Collapse
|
4
|
Wei AZ, Chen LN, Orloff M, Ariyan CE, Asgari M, Barker CA, Buchbinder E, Chandra S, Couts K, Frumovitz MM, Futreal A, Gershenwald JE, Hanna EY, Izar B, LeBlanc AK, Leitao MM, Lipson EJ, Liu D, McCarter M, McQuade JL, Najjar Y, Rapisuwon S, Selig S, Shoushtari AN, Yeh I, Schwartz GK, Guo J, Patel SP, Carvajal RD. Proceedings from the Melanoma Research Foundation Mucosal Melanoma Meeting (December 16, 2022, New York, USA). Pigment Cell Melanoma Res 2023; 36:542-556. [PMID: 37804122 DOI: 10.1111/pcmr.13139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/01/2023] [Accepted: 09/23/2023] [Indexed: 10/08/2023]
Abstract
Mucosal melanoma remains a rare cancer with high mortality and a paucity of therapeutic options. This is due in significant part to its low incidence leading to limited patient access to expert care and downstream clinical/basic science data for research interrogation. Clinical challenges such as delayed and at times inaccurate diagnoses, and lack of consensus tumor staging have added to the suboptimal outcomes for these patients. Clinical trials, while promising, have been difficult to activate and accrue. While individual institutions and investigators have attempted to seek solutions to such problems, international, national, and local partnership may provide the keys to more efficient and innovative paths forward. Furthermore, a mucosal melanoma coalition would provide a potential network for patients and caregivers to seek expert opinion and advice. The Melanoma Research Foundation Mucosal Melanoma Meeting (December 16, 2022, New York, USA) highlighted the current clinical challenges faced by patients, providers, and scientists, identified current and future clinical trial investigations in this rare disease space, and aimed to increase national and international collaboration among the mucosal melanoma community in an effort to improve patient outcomes. The included proceedings highlight the clinical challenges of mucosal melanoma, global clinical trial experience, basic science advances in mucosal melanoma, and future directions, including the creation of shared rare tumor registries and enhanced collaborations.
Collapse
Affiliation(s)
- Alexander Z Wei
- Columbia University Irving Medical Center, New York, New York, USA
| | - Lanyi N Chen
- Columbia University Irving Medical Center, New York, New York, USA
| | - Marlana Orloff
- Thomas Jefferson University Sidney Kimmel Cancer Center, Philadelphia, Pennsylvania, USA
| | | | | | | | | | - Sunandana Chandra
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kasey Couts
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | - Andrew Futreal
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Ehab Y Hanna
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Benjamin Izar
- Columbia University Irving Medical Center, New York, New York, USA
| | - Amy K LeBlanc
- National Institute of Health, Bethesda, Maryland, USA
| | - Mario M Leitao
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York, USA
| | - Evan J Lipson
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David Liu
- Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, Massachusetts, USA
| | - Martin McCarter
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | - Yana Najjar
- University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | | | - Sara Selig
- Melanoma Research Foundation, CURE OM, Washington, DC, USA
| | | | - Iwei Yeh
- University of California, San Francisco, San Francisco, California, USA
| | | | - Jun Guo
- Peking University Cancer Hospital & Institute, Beijing, China
| | - Sapna P Patel
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | |
Collapse
|
5
|
Munoz EP, Patel SP, Leachman SA, Yu NY, Yu WY. Minority enrollment in melanoma clinical trials. J Am Acad Dermatol 2023; 89:1052-1054. [PMID: 37419186 DOI: 10.1016/j.jaad.2023.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/09/2023]
Affiliation(s)
- Elena Paz Munoz
- School of Medicine, Oregon Health and Science University, Portland, Oregon
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sancy A Leachman
- Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon; Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | - Nathan Y Yu
- Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona
| | - Wesley Y Yu
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon; Operative Care Division, VA Portland Health Care System, Portland, Oregon.
| |
Collapse
|
6
|
VanderWalde A, Bellasea SL, Kendra KL, Khushalani NI, Campbell KM, Scumpia PO, Kuklinski LF, Collichio F, Sosman JA, Ikeguchi A, Victor AI, Truong TG, Chmielowski B, Portnoy DC, Chen Y, Margolin K, Bane C, Dasanu CA, Johnson DB, Eroglu Z, Chandra S, Medina E, Gonzalez CR, Baselga-Carretero I, Vega-Crespo A, Garcilazo IP, Sharon E, Hu-Lieskovan S, Patel SP, Grossmann KF, Moon J, Wu MC, Ribas A. Ipilimumab with or without nivolumab in PD-1 or PD-L1 blockade refractory metastatic melanoma: a randomized phase 2 trial. Nat Med 2023; 29:2278-2285. [PMID: 37592104 PMCID: PMC10708907 DOI: 10.1038/s41591-023-02498-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [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: 02/23/2023] [Accepted: 07/12/2023] [Indexed: 08/19/2023]
Abstract
In this randomized phase 2 trial, blockade of cytotoxic T-lymphocyte protein 4 (CTLA-4) with continuation of programmed death protein 1 (PD-1) blockade in patients with metastatic melanoma who had received front-line anti-PD-1 or therapy against programmed cell death 1 ligand 1 and whose tumors progressed was tested in comparison with CTLA-4 blockade alone. Ninety-two eligible patients were randomly assigned in a 3:1 ratio to receive the combination of ipilimumab and nivolumab, or ipilimumab alone. The primary endpoint was progression-free survival. Secondary endpoints included the difference in CD8 T cell infiltrate among responding and nonresponding tumors, objective response rate, overall survival and toxicity. The combination of nivolumab and ipilimumab resulted in a statistically significant improvement in progression-free survival over ipilimumab (hazard ratio = 0.63, 90% confidence interval (CI) = 0.41-0.97, one-sided P = 0.04). Objective response rates were 28% (90% CI = 19-38%) and 9% (90% CI = 2-25%), respectively (one-sided P = 0.05). Grade 3 or higher treatment-related adverse events occurred in 57% and 35% of patients, respectively, which is consistent with the known toxicity profile of these regimens. The change in intratumoral CD8 T cell density observed in the present analysis did not reach statistical significance to support the formal hypothesis tested as a secondary endpoint. In conclusion, primary resistance to PD-1 blockade therapy can be reversed in some patients with the combination of CTLA-4 and PD-1 blockade. Clinicaltrials.gov identifier: NCT03033576 .
Collapse
Affiliation(s)
| | - Shay L Bellasea
- Southwest Oncology Group Statistics and Data Management Center, Seattle, WA, USA
- Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Kari L Kendra
- Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | - Katie M Campbell
- Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, CA, USA
| | - Philip O Scumpia
- Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, CA, USA
| | - Lawrence F Kuklinski
- Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, CA, USA
| | - Frances Collichio
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Jeffrey A Sosman
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | | | | | - Thach-Giao Truong
- Kaiser Permanente Northern California, Kaiser Permanente National Cancer Institute Community Oncology Research Program, Vallejo, CA, USA
| | - Bartosz Chmielowski
- Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, CA, USA
| | | | - Yuanbin Chen
- Cancer and Hematology Centers of Western Michigan-Cancer Research Consortium of West Michigan, Grand Rapids, MI, USA
| | - Kim Margolin
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
- St. John's Cancer Institute, Santa Monica, CA, USA
| | - Charles Bane
- Dayton Physicians LLC, Miami Valley Hospital North, Dayton, OH, USA
| | | | | | | | - Sunandana Chandra
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Egmidio Medina
- Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, CA, USA
| | - Cynthia R Gonzalez
- Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, CA, USA
| | | | - Agustin Vega-Crespo
- Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, CA, USA
| | - Ivan Perez Garcilazo
- Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, CA, USA
| | - Elad Sharon
- National Cancer Institute, Cancer Therapy Evaluation Program, Bethesda, MD, USA
| | | | - Sapna P Patel
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kenneth F Grossmann
- University of Utah, Huntsman Cancer Institute, Salt Lake City, UT, USA
- Merck & Co., Inc., Rahway, NJ, USA
| | - James Moon
- Southwest Oncology Group Statistics and Data Management Center, Seattle, WA, USA
- Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Michael C Wu
- Southwest Oncology Group Statistics and Data Management Center, Seattle, WA, USA
- Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Antoni Ribas
- Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, CA, USA.
| |
Collapse
|
7
|
Ugurel S, Patel SP. Editorial: Women in skin cancer vol II: 2022. Front Oncol 2023; 13:1253081. [PMID: 37614496 PMCID: PMC10443209 DOI: 10.3389/fonc.2023.1253081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/24/2023] [Indexed: 08/25/2023] Open
Affiliation(s)
- Selma Ugurel
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site Essen/Düsseldorf, Essen, Germany
| | - Sapna P. Patel
- MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| |
Collapse
|
8
|
Nardo M, Yilmaz B, Nelson BE, Torres HA, Wang LS, Granwehr BP, Song J, Dalla Pria HRF, Trinh VA, Glitza Oliva IC, Patel SP, Tannir NM, Kaseb AO, Altan M, Lee SS, Miller E, Zhang H, Stephen BA, Naing A. Safety and Efficacy of Immune Checkpoint Inhibitors in Patients with Cancer and Viral Hepatitis: The MD Anderson Cancer Center Experience. Oncologist 2023; 28:714-721. [PMID: 36952233 PMCID: PMC10400154 DOI: 10.1093/oncolo/oyad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/24/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Despite the clinical benefit of immune checkpoint inhibitors (ICIs), patients with a viral hepatitis have been excluded from clinical trials because of safety concerns. The purpose of this study was to determine the incidence rate of adverse events (AEs) in patients with viral hepatitis who received ICIs for cancer treatment. MATERIALS AND METHODS We conducted a retrospective study in patients with cancer and concurrent hepatitis B or C, who had undergone treatment with ICI at MD Anderson Cancer Center from January 1, 2010 to December 31, 2019. RESULTS Of the 1076 patients screened, we identified 33 with concurrent hepatitis. All 10 patients with HBV underwent concomitant antiviral therapy during ICI treatment. Sixteen of the 23 patients with HCV received it before the initiation of ICI. The median follow-up time was 33 months (95% CI, 23-45) and the median duration of ICI therapy was 3 months (IQR, 1.9-6.6). Of the 33 patients, 12 (39%) experienced irAEs (immune-related adverse events) of any grade, with 2 (6%) having grade 3 or higher. None of the patients developed hepatitis toxicities. CONCLUSION ICIs may be a therapeutic option with an acceptable safety profile in patients with cancer and advanced liver disease.
Collapse
Affiliation(s)
- Mirella Nardo
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bulent Yilmaz
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Blessie Elizabeth Nelson
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Harrys A Torres
- Department of Infectious Diseases Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lan Sun Wang
- Department of Genitourinary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bruno Palma Granwehr
- Department of Infectious Diseases Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Juhee Song
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hanna R F Dalla Pria
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Van A Trinh
- Department of Melanoma Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Isabella C Glitza Oliva
- Department of Melanoma Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sapna P Patel
- Department of Melanoma Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nizar M Tannir
- Department of Genitourinary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ahmed Omar Kaseb
- Department of Genitourinary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mehmet Altan
- Department of Genitourinary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston TX, USA
| | - Sunyoung S Lee
- Department of Gastrointestinal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ethan Miller
- Department of Gastrointestinal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hao Zhang
- Department of Gastrointestinal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bettzy A Stephen
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aung Naing
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
9
|
Stephen B, Hajjar J, Sarda S, Duose DY, Conroy JM, Morrison C, Alshawa A, Xu M, Zarifa A, Patel SP, Yuan Y, Kwiatkowski E, Wang L, Rodon Ahnert J, Fu S, Meric-Bernstam F, Lowman GM, Looney T, Naing A. T-cell receptor beta variable gene polymorphism predicts immune-related adverse events during checkpoint blockade immunotherapy. J Immunother Cancer 2023; 11:e007236. [PMID: 37604642 PMCID: PMC10445351 DOI: 10.1136/jitc-2023-007236] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors have revolutionized cancer treatment. However, they are associated with a unique spectrum of side effects, called immune-related adverse events (irAEs), which can cause significant morbidity and quickly progress to severe or life-threatening events if not treated promptly. Identifying predictive biomarkers for irAEs before immunotherapy initiation is therefore a critical area of research. Polymorphisms within the T-cell receptor beta (TCRB) variable (TRBV) gene have been implicated in autoimmune disease and may be mechanistically linked to irAEs. However, the repetitive nature of the TCRB locus and incomplete genome assembly has hampered the evaluation of TRBV polymorphisms in the past. PATIENTS AND METHODS We used a novel method for long-amplicon next generation sequencing of rearranged TCRB chains from peripheral blood total RNA to evaluate the link between TRBV polymorphisms and irAEs in patients treated with immunotherapy for cancer. We employed multiplex PCR to create amplicons spanning the three beta chain complementarity-determining regions (CDR) regions to enable detection of polymorphism within the germline-encoded framework and CDR1 and CDR2 regions in addition to CDR3 profiling. Resultant amplicons were sequenced via the Ion Torrent and TRBV allele profiles constructed for each individual was correlated with irAE annotations to identify haplotypes associated with severe irAEs (≥ grade 3). RESULTS Our study included 81 patients who had irAEs when treated with immunotherapy for cancer. By using principal component analysis of the 81 TRBV allele profiles followed by k-means clustering, we identified six major TRBV haplotypes. Strikingly, we found that one-third of this cohort possessed a TRBV allele haplotype that appeared to be protective against severe irAEs. CONCLUSION The data suggest that long-amplicon TCRB repertoire sequencing can potentially identify TRBV haplotype groups that correlate with the risk of severe irAEs. Germline-encoded TRBV polymorphisms may serve as a predictive biomarker of severe irAEs.
Collapse
Affiliation(s)
- Bettzy Stephen
- Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Joud Hajjar
- Adult Allergy and Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | | | - Dzifa Yawa Duose
- Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Carl Morrison
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Anas Alshawa
- Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mingxuan Xu
- Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Abdulrazzak Zarifa
- Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sapna P Patel
- Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ying Yuan
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Evan Kwiatkowski
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Linghua Wang
- Genomic Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jordi Rodon Ahnert
- Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Siqing Fu
- Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Funda Meric-Bernstam
- Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Timothy Looney
- Thermo Fisher Scientific, Clinical Next-Generation Sequencing, Austin, Texas, USA
| | - Aung Naing
- Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
10
|
Lucci A, Addanki S, Chiang YJ, Meas S, Sarli VN, Upshaw JR, Manchem M, Patel SP, Wargo JA, Gershenwald JE, Ross MI. Presence of Circulating Tumor Cells Predates Imaging Detection of Relapse in Patients with Stage III Melanoma. Cancers (Basel) 2023; 15:3630. [PMID: 37509290 PMCID: PMC10377914 DOI: 10.3390/cancers15143630] [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: 06/14/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Stage III melanoma includes nodal metastasis or in-transit disease. Five-year survival rates vary between 32% and 93%. The identification of high-risk patients is important for clinical decision making. We demonstrated previously that ≥1 circulating tumor cells (CTCs) at baseline was associated with recurrence. In this study, we investigated how frequently CTCs were identified prior to radiologically detected recurrence. Stage III patients (n = 325) had imaging at baseline and q 3 months. Baseline and q 6-12 months blood draws (7.5 mL) were performed to identify CTCs up to 3.5 years from diagnosis. CTC assessment was performed using the immunomagnetic capture of CD146-positive cells and anti-MEL-PE. The presence of one or more CTCs was considered positive. We analyzed the cohort of patients with relapse confirmed by radiologic imaging. CTC collection dates were assessed to determine the lead time for CTC detection. CTC-negative patients were significantly less likely to relapse compared to patients positive for CTCs (p-value < 0.001). Within the 325-patient cohort, 143 patients (44%) had recurrence, with a median follow-up of 52 months from diagnosis. The cohort (n = 143) with positive imaging and CTC results revealed 76% of patients (108/143) had CTC+ results before the radiological identification of relapse. The median time between positive CTC and positive imaging was 9 months. CTCs were positive in >75% of patients prior to relapse at a median of 9 months before radiologic detection.
Collapse
Affiliation(s)
- Anthony Lucci
- Departments of Breast Surgical Oncology and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sridevi Addanki
- Departments of Breast Surgical Oncology and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Yi-Ju Chiang
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Salyna Meas
- Departments of Breast Surgical Oncology and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Vanessa N Sarli
- Departments of Breast Surgical Oncology and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Joshua R Upshaw
- Departments of Breast Surgical Oncology and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mayank Manchem
- Departments of Breast Surgical Oncology and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jennifer A Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Merrick I Ross
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| |
Collapse
|
11
|
Garbe C, Dummer R, Amaral T, Amaria RN, Ascierto PA, Burton EM, Dreno B, Eggermont AMM, Hauschild A, Hoeller C, Kaufmann R, Lebbe C, Mandala M, Menzies AM, Moreno D, Michielin O, Nathan P, Patel SP, Robert C, Schadendorf D, Lorigan PC, Scolyer RA, Tawbi HA, van de Wiel BA, Blank C, Long GV. Neoadjuvant immunotherapy for melanoma is now ready for clinical practice. Nat Med 2023:10.1038/s41591-023-02336-1. [PMID: 37193799 DOI: 10.1038/s41591-023-02336-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Affiliation(s)
- Claus Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zürich (USZ), Zürich, Switzerland.
- Faculty of Medicine, University of Zürich (UZH), Zürich, Switzerland.
| | - Teresa Amaral
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Rodabe N Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Paolo A Ascierto
- Department of Skin Cancer, Cancer Immunotherapy and Development Therapeutics, Instituto Nazionale Tumouri IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Elizabeth M Burton
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Alexander M M Eggermont
- Faculty of Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
- Comprehensive Cancer Centre Munich of the Technical University Munich and the Ludwig Maximilians University, Munich, Germany
| | - Axel Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Christoph Hoeller
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Roland Kaufmann
- Department of Dermatology, Venerology and Allergology, Frankfurt University Hospital, Frankfurt, Germany
| | - Celeste Lebbe
- Université Paris Cite, AP-HP Department of Dermatology, Hôpital Saint-Louis Paris, Paris, France
| | - Mario Mandala
- Department of Surgery and Medicine, Unit of Medical Oncology, University of Perugia, Perugia, Italy
| | - Alexander M Menzies
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia
- Faculty of Medicine & Health, The University of Sydney, Sydney, NSW, Australia
| | - David Moreno
- Medical & Surgical Dermatology Service, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Olivier Michielin
- Department of Medical Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Caroline Robert
- Department of Medical Oncology, Gustave Roussy and Paris-Saclay University, Villejuif, France
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen, Essen, Germany
- German Cancer Consortium, Heidelberg Partner Site Essen, Essen, Germany
| | | | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia
- Faculty of Medicine & Health, The University of Sydney, Sydney, NSW, Australia
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bart A van de Wiel
- Department of Pathology, Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
| | - Christian Blank
- Department of Medical Oncology, Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
- Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia
- Faculty of Medicine & Health, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
12
|
Hu-Lieskovan S, Moon J, Hyngstrom J, Campbell KM, In GK, Logan TF, Kendra KL, Wang DM, Johnson DB, Doolittle GC, Tan A, Silk AW, Grossmann KF, Ryan CW, Patel SP, Bellasea S, Wu MC, Kirkwood JM, Chen HX, Ribas A. Abstract 3275: Combination of talimogene laherparepvec (T-VEC) with pembrolizumab (pembro) in advanced melanoma patients following progression on a prior PD-1 inhibitor: SWOG S1607. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-3275] [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
We hypothesize that a significant number of patients do not respond to PD-1/L1 blockade because there are no pre-existing tumor antigen-specific T-cells, and this can be addressed by combination therapy with an oncolytic virus such as T-VEC. S1607 is a single arm Phase 2 study of T-VEC plus pembro in patients with advanced melanoma after PD-1/L1 inhibitor progression. The primary endpoint is ORR by modified RECIST (progression at the first follow-up disease assessment had to be confirmed). Secondary endpoints include durable response rate (response ≥ 6 months), ORR in injected, non-visceral non-injected, and visceral lesions, PFS, OS and toxicity. In Cohort A patients must have at least one measurable visceral lesion; in Cohort B patients must not have any visceral lesions. Each cohort had an independent accrual goal with a 2-stage design. All received intratumoral T-VEC and pembro 200mg IV every 21 days. Tumor biopsy and research blood are taken at baseline and on Day 28 (both injected and non-injected lesions). Tumor assessments are performed every 12 weeks for up to 2 years. 38 evaluable patients were enrolled. As of July 26, 2022, the median follow up was 28 months. Treatment was well tolerated, with 5/38 (13%) grade 3 AE (no grade 4/5) including injection site reactions, lymphocyte count decrease, and hypoxia. Cohort A was closed after stage I (n=11) with no confirmed responses. In Cohort B (n=27), there were 7 confirmed responses (26%; 2 CR, 5 PR; this rejected H0: ORR = 10%, p=0.01). Clinical outcomes are summarized in Table 1. Baseline tumor mutational burden from 17 patients in Cohort B were not different between responder vs non-responders (p=0.96). Translational study is ongoing for pharmacodynamic confirmation. T-VEC plus pembro in melanoma patients who have progressed on prior anti-PD1/L1 therapy has efficacy in the subset of melanoma patients who have non-visceral metastases.
Table 1 Cohort A (Visceral) Cohort B(Non-Visceral) N (%; 95% CI) 11 27 Confirmed PR + CR 0 (0%; 0%-28%) 7 (26%; 11%-46%) Confirmed + Unconfirmed 1 (9%; 0%-41%) 9 (33%; 17%-54%) Durable response 0 (0%; 0%-28%) 4 (15%; 4%-34%) Median PFS in months 2.1 (0.7-5.5) 2.3 (1.9-6.2) INJECTED LESIONS 11 27 Confirmed PR + CR 0 (0%; 0%-28%) 6 (22%; 9%-42%) Confirmed + Unconfirmed, PR + CR 1 (9%; 0%-41%) 8 (30%; 14%-50%) NON-INJECTED, NON-VISCERAL LESIONS 8 19 Confirmed PR + CR 0 (0%; 0%-37%) 3 (16%; 3%-40%) Confirmed + Unconfirmed, PR + CR 0 (0%; 0%-37%) 5 (26%; 9%-51%) VISCERAL LESIONS 11 Confirmed PR + CR 0 (0%; 0%-28%) Confirmed + Unconfirmed, PR + CR 1 (9%; 0%-41%) ACQUIRED RESISTANCE 3 2 Confirmed PR + CR 0 (0%; 0%-71%) 2 (100%; 16%-100%) Confirmed + Unconfirmed, PR + CR 0 (0%; 0%-71%) 2 (100%; 16%-100%) Median PFS in months 2.1 (2.0-4.1) NR (8.0-∞) PRIMARY RESISTANCE 8 25 Confirmed PR + CR 0 (0%; 0%-37%) 5 (20%; 7%-41%) Confirmed + Unconfirmed, PR + CR 1 (13%; 0%-53%) 7 (28%; 12%-49%) Median PFS in months 1.8 (0.3-6.2) 2.1 (1.9-3.3)
Citation Format: Siwen Hu-Lieskovan, James Moon, John Hyngstrom, Katie M. Campbell, Gino K. In, Theodore F. Logan, Kari L. Kendra, Ding M. Wang, Douglas B. Johnson, Gary C. Doolittle, Alan Tan, Ann W. Silk, Kenneth F. Grossmann, Christopher W. Ryan, Sapna P. Patel, Shay Bellasea, Michael C. Wu, John M. Kirkwood, Helen X. Chen, Antoni Ribas. Combination of talimogene laherparepvec (T-VEC) with pembrolizumab (pembro) in advanced melanoma patients following progression on a prior PD-1 inhibitor: SWOG S1607 [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 3275.
Collapse
Affiliation(s)
| | - James Moon
- 2SWOG Statistics and Data Management Center, Seattle, WA
| | - John Hyngstrom
- 1University of Utah Huntsman Cancer Institute, Salt Lake City, UT
| | | | - Gino K. In
- 4University of Southern California (USC) Norris Comprehensive Cancer Center, Los Angeles, CA
| | - Theodore F. Logan
- 5Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN
| | | | | | | | | | - Alan Tan
- 10Cancer Treatment Centers of America, Phoenix, AZ
| | | | | | | | | | - Shay Bellasea
- 2SWOG Statistics and Data Management Center, Seattle, WA
| | - Michael C. Wu
- 2SWOG Statistics and Data Management Center, Seattle, WA
| | - John M. Kirkwood
- 14University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, PA
| | - Helen X. Chen
- 15National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD
| | - Antoni Ribas
- 3UCLA Johnson Comprehensive Cancer Center, Los Angeles, CA
| |
Collapse
|
13
|
Patel SP, Haymaker C, Sheth RA, Kuban JD, Weintraub J, Wehrenberg-Klee E, Novelli P, Gonsalves C, Adamo R, Honaker V, Timciuc L, Hennegan T, Molina JCA, Duose D, Cuenta ERP, Lucci A, Meas S, Sarli V, Prieto VG, LaPorte J, Hulstine AM, Moody A, Cox B, Geller D, Davar D, Montazeri K, Orloff M, Katz SC, Carvajal R. Abstract 5881: PERIO-01: Initial safety experience and immunologic effects of a Class C TLR9 agonist using pressure- enabled drug delivery in a phase 1 trial of hepatic arterial infusion of SD-101 +/- checkpoint inhibition in metastatic uveal melanoma. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-5881] [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
Immune checkpoint inhibitors (ICI) have demonstrated limited success in patients with metastatic uveal melanoma (MUM) with liver involvement due to an immunosuppressive tumor microenvironment (TME) driven in part by myeloid-derived suppressor cells (MDSCs). Toll-like receptor-9 agonists (TLR-9A) have improved ICI response rates in cutaneous melanoma, but delivery challenges have limited their application for MUM. Hepatic arterial infusion (HAI) of TLR-9A using a pressure-enabled drug deliveryTM (PEDDTM) device has the potential to enhance responsiveness to ICI by optimizing delivery to intrahepatic tumors and reprogramming the TME, including elimination of MDSCs.PERIO-01 is an open-label first-in-human Phase 1 trial of SD-101 given by HAI using a PEDDTM in MUM (NCT04935229). The study consists of dose-escalation cohorts of single agent SD-101 alone and with ICI. SD-101 is delivered over 2 cycles, with 3 weekly doses per cycle. Research blood, tumor and normal liver biopsies are collected serially for correlative studies. At data cutoff, a total of 20 patients were enrolled, with 13 in the single agent dose escalation cohort (2, 4, and 8 mg) and 7 patients with SD-101 (2 mg) + nivolumab. The median age was 65.5 years with an equal gender distribution. Only 2 patients were treatment-naïve and the median number of liver metastases was 5.1. The average number of SD-101 infusions was 5.2. One patient in the combination cohort experienced a serious adverse event related to treatment - asymptomatic Grade 3 increase in liver enzymes. PEDDTM resulted in high drug levels in the liver (up to 2,340 ng/ml at 8mg) with only transient exposure in the periphery (<4 hours) with one Grade 2 cytokine related syndrome adverse event. Dose-dependent increases in canonical TLR9-associated cytokines (IL-18, IFNγ, IP-10, and soluble CD25) was observed across the 2mg, 4mg, and 8mg single-agent dose levels. Concordant with predicted mechanism of action, PEDDTM HAI administered SD-101 resulted in decreases in liver monocytic MDSCs in 4 of 4 patients with available multiplex immunofluorescence data. NanoString analysis from three patients revealed increases in ISG15, IL-9, IFNα, and IL-2 transcripts and decreases in ARG1 and IDO transcripts, with increased scores for macrophages, activated CD8 T cells, Th1 cells, and Th1 activation. For patients who received 2mg SD-101 + ICI with available liquid biopsy data, 4 of 7 demonstrated decreases in circulating tumor cells and 3 of 5 showing ctDNA decreases after the first cycle. In this first-in-human experience, HAI of SD-101 via PEDDTM was well tolerated and associated with encouraging immunologic activity. Evidence of biologic activity with 2 mg of SD-101 with nivolumab is encouraging and patients are currently enrolling at higher SD-101 dose levels + ICI.
Citation Format: Sapna P. Patel, Cara Haymaker, Rahul A. Sheth, Joshua D. Kuban, Joshua Weintraub, Eric Wehrenberg-Klee, Paula Novelli, Carin Gonsalves, Robert Adamo, Virgina Honaker, Laura Timciuc, Tarin Hennegan, Juan C. Amador Molina, Dzifa Duose, Edwin R. Parras Cuenta, Anthony Lucci, Salyna Meas, Vanessa Sarli, Victor G. Prieto, Jason LaPorte, Ann-Marie Hulstine, Ashley Moody, Bryan Cox, David Geller, Diwakar Davar, Kamaneh Montazeri, Marlana Orloff, Steven C. Katz, Richard Carvajal. PERIO-01: Initial safety experience and immunologic effects of a Class C TLR9 agonist using pressure- enabled drug delivery in a phase 1 trial of hepatic arterial infusion of SD-101 +/- checkpoint inhibition in metastatic uveal melanoma [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 5881.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Paula Novelli
- 4University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Bryan Cox
- 6TriSalus Life Sciences, Westminster, CO
| | - David Geller
- 4University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Diwakar Davar
- 4University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | | | | | | |
Collapse
|
14
|
Glitza Oliva IC, Ferguson SD, Bassett R, Foster AP, John I, Hennegan TD, Rohlfs M, Richard J, Iqbal M, Dett T, Lacey C, Jackson N, Rodgers T, Phillips S, Duncan S, Haydu L, Lin R, Amaria RN, Wong MK, Diab A, Yee C, Patel SP, McQuade JL, Fischer GM, McCutcheon IE, O'Brien BJ, Tummala S, Debnam M, Guha-Thakurta N, Wargo JA, Carapeto FCL, Hudgens CW, Huse JT, Tetzlaff MT, Burton EM, Tawbi HA, Davies MA. Concurrent intrathecal and intravenous nivolumab in leptomeningeal disease: phase 1 trial interim results. Nat Med 2023; 29:898-905. [PMID: 36997799 PMCID: PMC10115650 DOI: 10.1038/s41591-022-02170-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 12/02/2022] [Indexed: 04/01/2023]
Abstract
There is a critical need for effective treatments for leptomeningeal disease (LMD). Here, we report the interim analysis results of an ongoing single-arm, first-in-human phase 1/1b study of concurrent intrathecal (IT) and intravenous (IV) nivolumab in patients with melanoma and LMD. The primary endpoints are determination of safety and the recommended IT nivolumab dose. The secondary endpoint is overall survival (OS). Patients are treated with IT nivolumab alone in cycle 1 and IV nivolumab is included in subsequent cycles. We treated 25 patients with metastatic melanoma using 5, 10, 20 and 50 mg of IT nivolumab. There were no dose-limiting toxicities at any dose level. The recommended IT dose of nivolumab is 50 mg (with IV nivolumab 240 mg) every 2 weeks. Median OS was 4.9 months, with 44% and 26% OS rates at 26 and 52 weeks, respectively. These initial results suggest that concurrent IT and IV nivolumab is safe and feasible with potential efficacy in patients with melanoma LMD, including in patients who had previously received anti-PD1 therapy. Accrual to the study continues, including in patients with lung cancer. ClinicalTrials.gov registration: NCT03025256 .
Collapse
Affiliation(s)
- Isabella C Glitza Oliva
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Sherise D Ferguson
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Roland Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alexandra P Foster
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ida John
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tarin D Hennegan
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michelle Rohlfs
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jessie Richard
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Masood Iqbal
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tina Dett
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carol Lacey
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Natalie Jackson
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Theresa Rodgers
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Suzanne Phillips
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sheila Duncan
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lauren Haydu
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ruitao Lin
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rodabe N Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael K Wong
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cassian Yee
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer L McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Grant M Fischer
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ian E McCutcheon
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Barbara J O'Brien
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sudhakar Tummala
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Matthew Debnam
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nandita Guha-Thakurta
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer A Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fernando C L Carapeto
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Courtney W Hudgens
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jason T Huse
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael T Tetzlaff
- Department of Pathology, The University of California San Francisco, San Francisco, CA, USA
| | - Elizabeth M Burton
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael A Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
15
|
Patel SP, Othus M, Chen Y, Wright GP, Yost KJ, Hyngstrom JR, Hu-Lieskovan S, Lao CD, Fecher LA, Truong TG, Eisenstein JL, Chandra S, Sosman JA, Kendra KL, Wu RC, Devoe CE, Deutsch GB, Hegde A, Khalil M, Mangla A, Reese AM, Ross MI, Poklepovic AS, Phan GQ, Onitilo AA, Yasar DG, Powers BC, Doolittle GC, In GK, Kokot N, Gibney GT, Atkins MB, Shaheen M, Warneke JA, Ikeguchi A, Najera JE, Chmielowski B, Crompton JG, Floyd JD, Hsueh E, Margolin KA, Chow WA, Grossmann KF, Dietrich E, Prieto VG, Lowe MC, Buchbinder EI, Kirkwood JM, Korde L, Moon J, Sharon E, Sondak VK, Ribas A. Neoadjuvant-Adjuvant or Adjuvant-Only Pembrolizumab in Advanced Melanoma. N Engl J Med 2023; 388:813-823. [PMID: 36856617 PMCID: PMC10410527 DOI: 10.1056/nejmoa2211437] [Citation(s) in RCA: 174] [Impact Index Per Article: 174.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND Whether pembrolizumab given both before surgery (neoadjuvant therapy) and after surgery (adjuvant therapy), as compared with pembrolizumab given as adjuvant therapy alone, would increase event-free survival among patients with resectable stage III or IV melanoma is unknown. METHODS In a phase 2 trial, we randomly assigned patients with clinically detectable, measurable stage IIIB to IVC melanoma that was amenable to surgical resection to three doses of neoadjuvant pembrolizumab, surgery, and 15 doses of adjuvant pembrolizumab (neoadjuvant-adjuvant group) or to surgery followed by pembrolizumab (200 mg intravenously every 3 weeks for a total of 18 doses) for approximately 1 year or until disease recurred or unacceptable toxic effects developed (adjuvant-only group). The primary end point was event-free survival in the intention-to-treat population. Events were defined as disease progression or toxic effects that precluded surgery; the inability to resect all gross disease; disease progression, surgical complications, or toxic effects of treatment that precluded the initiation of adjuvant therapy within 84 days after surgery; recurrence of melanoma after surgery; or death from any cause. Safety was also evaluated. RESULTS At a median follow-up of 14.7 months, the neoadjuvant-adjuvant group (154 patients) had significantly longer event-free survival than the adjuvant-only group (159 patients) (P = 0.004 by the log-rank test). In a landmark analysis, event-free survival at 2 years was 72% (95% confidence interval [CI], 64 to 80) in the neoadjuvant-adjuvant group and 49% (95% CI, 41 to 59) in the adjuvant-only group. The percentage of patients with treatment-related adverse events of grades 3 or higher during therapy was 12% in the neoadjuvant-adjuvant group and 14% in the adjuvant-only group. CONCLUSIONS Among patients with resectable stage III or IV melanoma, event-free survival was significantly longer among those who received pembrolizumab both before and after surgery than among those who received adjuvant pembrolizumab alone. No new toxic effects were identified. (Funded by the National Cancer Institute and Merck Sharp and Dohme; S1801 ClinicalTrials.gov number, NCT03698019.).
Collapse
Affiliation(s)
- Sapna P Patel
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Megan Othus
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Yuanbin Chen
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - G Paul Wright
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Kathleen J Yost
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - John R Hyngstrom
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Siwen Hu-Lieskovan
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Christopher D Lao
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Leslie A Fecher
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Thach-Giao Truong
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Jennifer L Eisenstein
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Sunandana Chandra
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Jeffrey A Sosman
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Kari L Kendra
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Richard C Wu
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Craig E Devoe
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Gary B Deutsch
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Aparna Hegde
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Maya Khalil
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Ankit Mangla
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Amy M Reese
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Merrick I Ross
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Andrew S Poklepovic
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Giao Q Phan
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Adedayo A Onitilo
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Demet G Yasar
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Benjamin C Powers
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Gary C Doolittle
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Gino K In
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Niels Kokot
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Geoffrey T Gibney
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Michael B Atkins
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Montaser Shaheen
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - James A Warneke
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Alexandra Ikeguchi
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Jose E Najera
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Bartosz Chmielowski
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Joseph G Crompton
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Justin D Floyd
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Eddy Hsueh
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Kim A Margolin
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Warren A Chow
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Kenneth F Grossmann
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Eliana Dietrich
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Victor G Prieto
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Michael C Lowe
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Elizabeth I Buchbinder
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - John M Kirkwood
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Larissa Korde
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - James Moon
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Elad Sharon
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Vernon K Sondak
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| | - Antoni Ribas
- From the University of Texas M.D. Anderson Cancer Center, Houston (S.P.P., M.I.R., V.G.P.), and the University of Texas Health Science Center at San Antonio, San Antonio (M.S.); Southwest Oncology Group Statistics and Data Management Center (M.O., J.M.) and the Fred Hutchinson Cancer Center (M.O., E.D., J.M.) - both in Seattle; the Cancer Research Consortium of West Michigan National Cancer Institute Community Oncology Research Program (NCORP)-Cancer and Hematology Centers of Western Michigan (Y.C.), the Cancer Research Consortium of West Michigan NCORP-Spectrum Health (G.P.W.), and the Cancer Research Consortium of West Michigan NCORP (K.J.Y.), Grand Rapids, and the University of Michigan Rogel Cancer Center, Ann Arbor (C.D.L., L.A.F.); the University of Utah Huntsman Cancer Institute, Salt Lake City (J.R.H., S.H.-L.); Kaiser Permanente Northern California, Vallejo (T.-G.T.), University of Southern California Norris Comprehensive Cancer Center (G.K.I., N.K.) and University of California Los Angeles Jonsson Comprehensive Cancer Center (B.C., J.G.C., A.R.), Los Angeles, City of Hope Comprehensive Cancer Center-Saint John's Cancer Institute, Santa Monica (K.A.M.), and City of Hope Comprehensive Cancer Center-University of California, Irvine, Irvine (W.A.C.) - all in California; Kaiser Permanente Colorado, Lafayette (J.L.E.); Northwestern University, Chicago (S.C., J.A.S.), and the Cancer Care Specialists of Illinois-Heartland NCORP, O'Fallon (J.D.F.) - both in Illinois; Ohio State University Wexner Medical Center, Columbus (K.L.K., R.C.W.), and University Hospitals Seidman Cancer Center-Case Western Reserve University Case Comprehensive Cancer Center, Cleveland (A.M., A.M.R.); Northwell Health Cancer Institute, Lake Success, NY (C.E.D., G.B.D.); the University of Alabama at Birmingham, Birmingham (A.H., M.K.); Virginia Commonwealth University-Massey Cancer Center-VCU Massey Cancer Center Minority Underserved NCORP, Richmond (A.S.P., G.Q.P.); Marshfield Medical Center Wisconsin NCORP, Weston (A.A.O.), and Marshfield Medical Center Wisconsin NCORP, Minocqua (D.G.Y.); the University of Kansas Cancer Center, Overland Park (B.C.P.), and the University of Kansas Hospital-Westwood Cancer Center, Westwood (G.C.D.); MedStar Georgetown University Hospital, Washington, DC (G.T.G., M.B.A.); Banner University Medical Center-University of Arizona Cancer Center, Tucson (M.S., J.A.W.); the University of Oklahoma, Oklahoma City (A.I.), and the University of Oklahoma-Cancer Centers of Southwest Oklahoma, Lawton (J.E.N.); Saint Louis University School of Medicine, St. Louis (E.H.); Merck, Rahway, NJ (K.F.G.); Emory University, Atlanta (M.C.L.); Dana-Farber Cancer Institute-Harvard Cancer Center, Boston (E.I.B.); the University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh (J.M.K.); the National Cancer Institute Cancer Therapy Evaluation Program, Bethesda, MD (L.K., E.S.); and Moffitt Cancer Center, Tampa, FL (V.K.S.)
| |
Collapse
|
16
|
Amaria RN, Postow M, Burton EM, Tetzlaff MT, Ross MI, Torres-Cabala C, Glitza IC, Duan F, Milton DR, Busam K, Simpson L, McQuade JL, Wong MK, Gershenwald JE, Lee JE, Goepfert RP, Keung EZ, Fisher SB, Betof-Warner A, Shoushtari AN, Callahan M, Coit D, Bartlett EK, Bello D, Momtaz P, Nicholas C, Gu A, Zhang X, Korivi BR, Patnana M, Patel SP, Diab A, Lucci A, Prieto VG, Davies MA, Allison JP, Sharma P, Wargo JA, Ariyan C, Tawbi HA. Author Correction: Neoadjuvant relatlimab and nivolumab in resectable melanoma. Nature 2023; 615:E23. [PMID: 36894629 PMCID: PMC10033416 DOI: 10.1038/s41586-023-05892-1] [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: 03/11/2023]
Affiliation(s)
- Rodabe N Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Michael Postow
- Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Elizabeth M Burton
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael T Tetzlaff
- Department of Pathology, The University of California San Francisco, San Francisco, CA, USA
| | - Merrick I Ross
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Carlos Torres-Cabala
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Isabella C Glitza
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fei Duan
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Denái R Milton
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Klaus Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lauren Simpson
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer L McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael K Wong
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Jeffrey E Lee
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Emily Z Keung
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Sarah B Fisher
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Allison Betof-Warner
- Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Alexander N Shoushtari
- Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Margaret Callahan
- Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Daniel Coit
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Edmund K Bartlett
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Danielle Bello
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Parisa Momtaz
- Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Courtney Nicholas
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aidi Gu
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xuejun Zhang
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brinda Rao Korivi
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Madhavi Patnana
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Anthony Lucci
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Victor G Prieto
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael A Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - James P Allison
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Padmanee Sharma
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer A Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Charlotte Ariyan
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
17
|
Patel SP. New evidence for neoadjuvant therapy in advanced melanoma. Clin Adv Hematol Oncol 2023; 21:128-130. [PMID: 36867555] [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: 03/04/2023]
Affiliation(s)
- Sapna P Patel
- The University of Texas, MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
18
|
Carvajal RD, Sacco JJ, Jager MJ, Eschelman DJ, Olofsson Bagge R, Harbour JW, Chieng ND, Patel SP, Joshua AM, Piperno-Neumann S. Advances in the clinical management of uveal melanoma. Nat Rev Clin Oncol 2023; 20:99-115. [PMID: 36600005 DOI: 10.1038/s41571-022-00714-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/05/2023]
Abstract
Melanomas arising in the uveal tract of the eye are a rare form of the disease with a biology and clinical phenotype distinct from their more common cutaneous counterparts. Treatment of primary uveal melanoma with radiotherapy, enucleation or other modalities achieves local control in more than 90% of patients, although 40% or more ultimately develop distant metastases, most commonly in the liver. Until January 2022, no systemic therapy had received regulatory approval for patients with metastatic uveal melanoma, and these patients have historically had a dismal prognosis owing to the limited efficacy of the available treatments. A series of seminal studies over the past two decades have identified highly prevalent early, tumour-initiating oncogenic genomic aberrations, later recurring prognostic alterations and immunological features that characterize uveal melanoma. These advances have driven the development of a number of novel emerging treatments, including tebentafusp, the first systemic therapy to achieve regulatory approval for this disease. In this Review, our multidisciplinary and international group of authors summarize the biology of uveal melanoma, management of primary disease and surveillance strategies to detect recurrent disease, and then focus on the current standard and emerging regional and systemic treatment approaches for metastatic uveal melanoma.
Collapse
Affiliation(s)
- Richard D Carvajal
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
| | - Joseph J Sacco
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Martine J Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - David J Eschelman
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - J William Harbour
- Department of Ophthalmology and Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Nicholas D Chieng
- Medical Imaging Services, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Anthony M Joshua
- Department of Medical Oncology, Kinghorn Cancer Centre, St Vincent's Hospital Sydney and Garvan Institute of Medical Research, Sydney, New South Wales, Australia.,School of Clinical Medicine, UNSW Medicine & Health, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW, Sydney, New South Wales, Australia
| | | |
Collapse
|
19
|
Unger JM, Darke A, Othus M, Truong TG, Khushalani N, Kendra K, Lewis KD, Faller B, Funchain P, Buchbinder EI, Tarhini AA, Kirkwood JM, Sharon E, Sondak V, Guild SR, Grossmann K, Ribas A, Patel SP. Effectiveness of Adjuvant Pembrolizumab vs High-Dose Interferon or Ipilimumab for Quality-of-Life Outcomes in Patients With Resected Melanoma: A Secondary Analysis of the SWOG S1404 Randomized Clinical Trial. JAMA Oncol 2023; 9:251-260. [PMID: 36416836 PMCID: PMC9685550 DOI: 10.1001/jamaoncol.2022.5486] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/19/2022] [Indexed: 11/24/2022]
Abstract
Importance A key issue for the adjuvant treatment of patients with melanoma is the assessment of the effect of treatment on relapse, survival, and quality of life (QOL). Objective To compare QOL in patients with resected melanoma at high risk for relapse who were treated with adjuvant pembrolizumab vs standard of care with either ipilimumab or high-dose interferon α 2b (HDI). Design, Setting, and Participants The S1404 phase 3 randomized clinical trial was conducted by the SWOG Cancer Research Network at 211 community/academic sites in the US, Canada, and Ireland. Patients were enrolled from December 2015 to October 2017. Data analysis for this QOL substudy was completed in March 2022. Overall, 832 patients were evaluable for the primary QOL end point. Interventions Patients were randomized (1:1) to treatment with adjuvant pembrolizumab vs standard of care with ipilimumab/HDI. Main Outcomes and Measures Quality of life was assessed for patients at baseline and cycles 1, 3, 5, 7, and 9 after randomization using the Functional Assessment of Cancer Therapy (FACT) Biological Response Modifiers (FACT-BRM), FACT-General, Functional Assessment of Chronic Illness Therapy-Diarrhea, and European QOL 5-Dimension 3-Level scales. The primary end point was the comparison by arm of cycle 3 FACT-BRM trial outcome index (TOI) scores using linear regression. Linear-mixed models were used to evaluate QOL scores over time. Regression analyses included adjustments for the baseline score, disease stage, and programmed cell death ligand 1 status. A clinically meaningful difference of 5 points was targeted. Results Among 1303 eligible patients (median [range] age, 56.7 [18.3-86.0] years; 524 women [40.2%]; 779 men [59.8%]; 10 Asian [0.8%], 7 Black [0.5%], 44 Hispanic [3.4%], and 1243 White [95.4%] individuals), 1188 (91.1%) had baseline FACT-BRM TOI scores, and 832 were evaluable at cycle 3 (ipilimumab/HDI = 267 [32.1%]; pembrolizumab = 565 [67.9%]). Evaluable patients were predominantly younger than 65 years (623 [74.9%]) and male (779 [58.9%]). Estimates of FACT-BRM TOI cycle 3 compliance did not differ by arm (ipilimumab/HDI, 96.0% vs pembrolizumab, 98.3%; P = .25). The adjusted cycle 3 FACT-BRM TOI score was 9.6 points (95% CI, 7.9-11.3; P < .001) higher (better QOL) for pembrolizumab compared with ipilimumab/HDI, exceeding the prespecified clinically meaningful difference. In linear-mixed models, differences by arm exceeded 5 points in favor of pembrolizumab through cycle 7. In post hoc analyses, FACT-BRM TOI scores favored the pembrolizumab arm compared with the subset of patients receiving ipilimumab (difference, 6.0 points; 95% CI, 4.1-7.8; P < .001) or HDI (difference, 17.0 points; 95% CI, 14.6-19.4; P < .001). Conclusions and Relevance This secondary analysis of a phase 3 randomized clinical trial found that adjuvant pembrolizumab improved QOL vs treatment with adjuvant ipilimumab or HDI in patients with high-risk resected melanoma. Trial Registration ClinicalTrials.gov identifier: NCT02506153.
Collapse
Affiliation(s)
- Joseph M. Unger
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Amy Darke
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Megan Othus
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Center, Seattle, Washington
| | | | | | | | | | - Bryan Faller
- Heartland NCORP/Missouri Baptist Medical Center, St Louis
| | | | | | | | - John M. Kirkwood
- The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Elad Sharon
- National Cancer Institute, Bethesda, Maryland
| | - Vernon Sondak
- H. Moffitt Cancer Center and Research Institute, Tampa, Florida
| | | | | | - Antoni Ribas
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, California
| | - Sapna P. Patel
- The University of Texas MD Anderson Cancer Center, Houston
| |
Collapse
|
20
|
Amaria RN, Postow M, Burton EM, Tetzlaff MT, Ross MI, Torres-Cabala C, Glitza IC, Duan F, Milton DR, Busam K, Simpson L, McQuade JL, Wong MK, Gershenwald JE, Lee JE, Goepfert RP, Keung EZ, Fisher SB, Betof-Warner A, Shoushtari AN, Callahan M, Coit D, Bartlett EK, Bello D, Momtaz P, Nicholas C, Gu A, Zhang X, Korivi BR, Patnana M, Patel SP, Diab A, Lucci A, Prieto VG, Davies MA, Allison JP, Sharma P, Wargo JA, Ariyan C, Tawbi HA. Neoadjuvant relatlimab and nivolumab in resectable melanoma. Nature 2022; 611:155-160. [PMID: 36289334 PMCID: PMC9607737 DOI: 10.1038/s41586-022-05368-8] [Citation(s) in RCA: 106] [Impact Index Per Article: 53.0] [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: 04/01/2022] [Accepted: 09/20/2022] [Indexed: 01/26/2023]
Abstract
Relatlimab and nivolumab combination immunotherapy improves progression-free survival over nivolumab monotherapy in patients with unresectable advanced melanoma1. We investigated this regimen in patients with resectable clinical stage III or oligometastatic stage IV melanoma (NCT02519322). Patients received two neoadjuvant doses (nivolumab 480 mg and relatlimab 160 mg intravenously every 4 weeks) followed by surgery, and then ten doses of adjuvant combination therapy. The primary end point was pathologic complete response (pCR) rate2. The combination resulted in 57% pCR rate and 70% overall pathologic response rate among 30 patients treated. The radiographic response rate using Response Evaluation Criteria in Solid Tumors 1.1 was 57%. No grade 3-4 immune-related adverse events were observed in the neoadjuvant setting. The 1- and 2-year recurrence-free survival rate was 100% and 92% for patients with any pathologic response, compared to 88% and 55% for patients who did not have a pathologic response (P = 0.005). Increased immune cell infiltration at baseline, and decrease in M2 macrophages during treatment, were associated with pathologic response. Our results indicate that neoadjuvant relatlimab and nivolumab induces a high pCR rate. Safety during neoadjuvant therapy is favourable compared to other combination immunotherapy regimens. These data, in combination with the results of the RELATIVITY-047 trial1, provide further confirmation of the efficacy and safety of this new immunotherapy regimen.
Collapse
Affiliation(s)
- Rodabe N Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Michael Postow
- Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Elizabeth M Burton
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael T Tetzlaff
- Department of Pathology, The University of California San Francisco, San Francisco, CA, USA
| | - Merrick I Ross
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Carlos Torres-Cabala
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Isabella C Glitza
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fei Duan
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Denái R Milton
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Klaus Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lauren Simpson
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer L McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael K Wong
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Jeffrey E Lee
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Emily Z Keung
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Sarah B Fisher
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Allison Betof-Warner
- Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Alexander N Shoushtari
- Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Margaret Callahan
- Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Daniel Coit
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Edmund K Bartlett
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Danielle Bello
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Parisa Momtaz
- Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Courtney Nicholas
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aidi Gu
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xuejun Zhang
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brinda Rao Korivi
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Madhavi Patnana
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Anthony Lucci
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Victor G Prieto
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael A Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - James P Allison
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Padmanee Sharma
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer A Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, US
| | - Charlotte Ariyan
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
21
|
Ho J, Mattei J, Tetzlaff M, Williams MD, Davies MA, Diab A, Oliva ICG, McQuade J, Patel SP, Tawbi H, Wong MK, Fisher SB, Hanna E, Keung EZ, Ross M, Weiser R, Su SY, Frumovitz M, Meyer LA, Jazaeri A, Pettaway CA, Guadagnolo BA, Bishop AJ, Mitra D, Farooqi A, Bassett R, Faria S, Nagarajan P, Amaria RN. Neoadjuvant checkpoint inhibitor immunotherapy for resectable mucosal melanoma. Front Oncol 2022; 12:1001150. [PMID: 36324592 PMCID: PMC9618687 DOI: 10.3389/fonc.2022.1001150] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022] Open
Abstract
Background Neoadjuvant checkpoint inhibition (CPI) has recently demonstrated impressive outcomes in patients with stage 3 cutaneous melanoma. However, the safety, efficacy, and outcome of neoadjuvant CPI in patients with mucosal melanoma (MM) are not well studied as MM is a rare melanoma subtype. CPI such as combination nivolumab and ipilimumab achieves response rates of 37-43% in unresectable or metastatic MM but there is limited data regarding the efficacy of these agents in the preoperative setting. We hypothesize that neoadjuvant CPI is a safe and feasible approach for patients with resectable MM. Method Under an institutionally approved protocol, we identified adult MM patients with resectable disease who received neoadjuvant anti-PD1 +/- anti-CTLA4 between 2015 to 2019 at our institution. Clinical information include age, gender, presence of nodal involvement or satellitosis, functional status, pre-treatment LDH, tumor mutation status, and treatment data was collected. Outcomes include event free survival (EFS), overall survival (OS), objective response rate (ORR), pathologic response rate (PRR), and grade ≥3 toxicities. Results We identified 36 patients. Median age was 62; 58% were female. Seventy-eight percent of patients received anti-PD1 + anti-CTLA4. Node positive disease or satellite lesions was present at the time of treatment initiation in 47% of patients. Primary sites of disease were anorectal (53%), urogenital (25%), head and neck (17%), and esophageal (6%). A minority of patients did not undergo surgery due to complete response (n=3, 8%) and disease progression (n=6, 17%), respectively. With a median follow up of 37.9 months, the median EFS was 9.2 months with 3-year EFS rate of 29%. Median OS had not been reached and 3-year OS rate was 55%. ORR was 47% and PRR was 35%. EFS was significantly higher for patients with objective response and for patients with pathologic response. OS was significantly higher for patients with pathologic response. Grade 3 toxicities were reported in 39% of patients. Conclusion Neoadjuvant CPI for resectable MM is a feasible approach with signs of efficacy and an acceptable safety profile. As there is currently no standard approach for resectable MM, this study supports further investigations using neoadjuvant therapy for these patients.
Collapse
Affiliation(s)
- Joel Ho
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States,*Correspondence: Joel Ho,
| | - Jane Mattei
- Oncology Department, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Michael Tetzlaff
- Division of Dermatopathology, University of California San Francisco (UCSF), San Francisco, CA, United States
| | - Michelle D. Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Michael A. Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Isabella C. Glitza Oliva
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jennifer McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sapna P. Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Hussein Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Michael K. Wong
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sarah B. Fisher
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ehab Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Emily Z. Keung
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Merrick Ross
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Roi Weiser
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Shirley Y. Su
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Michael Frumovitz
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Larissa A. Meyer
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Amir Jazaeri
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Curtis A. Pettaway
- Department of Urologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - B. Ashleigh Guadagnolo
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Andrew J. Bishop
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Devarati Mitra
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ahsan Farooqi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Roland Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Silvana Faria
- Department of Abdominal Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Priyadharsini Nagarajan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Rodabe N. Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| |
Collapse
|
22
|
Khan S, Patel SP, Shoushtari AN, Ambrosini G, Cremers S, Lee S, Franks L, Singh-Kandah S, Hernandez S, Sender N, Vuolo K, Nesson A, Mundi P, Izar B, Schwartz GK, Carvajal RD. Intermittent MEK inhibition for the treatment of metastatic uveal melanoma. Front Oncol 2022; 12:975643. [PMID: 36249046 PMCID: PMC9557946 DOI: 10.3389/fonc.2022.975643] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 06/22/2022] [Accepted: 08/30/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Uveal melanoma (UM) is associated with poor outcomes in the metastatic setting and harbors activating mutations resulting in upregulation of MAPK signaling in almost all cases. The efficacy of selumetinib, an oral allosteric inhibitor of MEK1/2, was limited when administered at a continual dosing schedule of 75 mg BID. Preclinical studies demonstrate that intermittent MEK inhibition reduces compensatory pathway activation and promotes T cell activation. We hypothesized that intermittent dosing of selumetinib would reduce toxicity, allow for the administration of increased doses, and achieve more complete pathway inhibition, thus resulting in improved antitumor activity. Methods We conducted a phase Ib trial of selumetinib using an intermittent dosing schedule in patients with metastatic UM. The primary objective was to estimate the maximum tolerated dose (MTD) and assess safety and tolerability. Secondary objectives included assessment of the overall response rate (RR), progression-free survival (PFS) and overall survival (OS). Tumor biopsies were collected at baseline, on day 3 (on treatment), and between days 11-14 (off treatment) from 9 patients for pharmacodynamic (PD) assessments. Results 29 patients were enrolled and received at least one dose of selumetinib across 4 dose levels (DL; DL1: 100 mg BID; DL2: 125 mg BID; DL3: 150 mg BID; DL4: 175 mg BID). All patients experienced a treatment-related adverse event (TRAE), with 5/29 (17%) developing a grade 3 or higher TRAE. Five dose limiting toxicities (DLT) were observed: 2/20 in DL2, 2/5 in DL3, 1/1 in DL4. The estimated MTD was 150 mg BID (DL3), with an estimated probability of toxicity of 29% (90% probability interval 16%-44%). No responses were observed; 11/29 patients achieved a best response of stable disease (SD). The median PFS and OS were 1.8 months (95% CI 1.7, 4.5) and 7.1 months (95% CI 5.3, 11.5). PD analysis demonstrated at least partial pathway inhibition in all samples at day 3, with reactivation between days 11-14 in 7 of those cases. Conclusions We identified 150 mg BID as the MTD of intermittent selumetinib, representing a 100% increase over the continuous dose MTD (75 mg BID). However, no significant clinical efficacy was observed using this dosing schedule.
Collapse
Affiliation(s)
- Shaheer Khan
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
- *Correspondence: Shaheer Khan,
| | - Sapna P. Patel
- Department of Melanoma Medical Oncology University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | - Grazia Ambrosini
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
| | - Serge Cremers
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
| | - Shing Lee
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Lauren Franks
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Shahnaz Singh-Kandah
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
| | - Susana Hernandez
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
| | - Naomi Sender
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
| | - Kristina Vuolo
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
| | - Alexandra Nesson
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
| | - Prabhjot Mundi
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
| | - Benjamin Izar
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
| | - Gary K. Schwartz
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
| | - Richard D. Carvajal
- Department of Medicine Columbia University Irving Medical Center, New York, NY, United States
| |
Collapse
|
23
|
Creasy CA, Meng YJ, Forget MA, Karpinets T, Tomczak K, Stewart C, Torres-Cabala CA, Pilon-Thomas S, Sarnaik AA, Mulé JJ, Garraway L, Bustos M, Zhang J, Patel SP, Diab A, Glitza IC, Yee C, Tawbi H, Wong MK, McQuade J, Hoon DSB, Davies MA, Hwu P, Amaria RN, Haymaker C, Beroukhim R, Bernatchez C. Genomic Correlates of Outcome in Tumor-Infiltrating Lymphocyte Therapy for Metastatic Melanoma. Clin Cancer Res 2022; 28:1911-1924. [PMID: 35190823 DOI: 10.1158/1078-0432.ccr-21-1060] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/01/2021] [Accepted: 02/16/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Adoptive cell therapy (ACT) of tumor-infiltrating lymphocytes (TIL) historically yields a 40%-50% response rate in metastatic melanoma. However, the determinants of outcome are largely unknown. EXPERIMENTAL DESIGN We investigated tumor-based genomic correlates of overall survival (OS), progression-free survival (PFS), and response to therapy by interrogating tumor samples initially collected to generate TIL infusion products. RESULTS Whole-exome sequencing (WES) data from 64 samples indicated a positive correlation between neoantigen load and OS, but not PFS or response to therapy. RNA sequencing analysis of 34 samples showed that expression of PDE1C, RTKN2, and NGFR was enriched in responders who had improved PFS and OS. In contrast, the expression of ELFN1 was enriched in patients with unfavorable response, poor PFS and OS, whereas enhanced methylation of ELFN1 was observed in patients with favorable outcomes. Expression of ELFN1, NGFR, and PDE1C was mainly found in cancer-associated fibroblasts and endothelial cells in tumor tissues across different cancer types in publicly available single-cell RNA sequencing datasets, suggesting a role for elements of the tumor microenvironment in defining the outcome of TIL therapy. CONCLUSIONS Our findings suggest that transcriptional features of melanomas correlate with outcomes after TIL therapy and may provide candidates to guide patient selection.
Collapse
Affiliation(s)
- Caitlin A Creasy
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Yuzhong Jeff Meng
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Marie-Andrée Forget
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Tatiana Karpinets
- Department of Genomic Medicine, The University of Texas MDACC, Houston, Texas
| | - Katarzyna Tomczak
- Department of Translational Molecular Pathology, The University of Texas MDACC, Houston, Texas
| | - Chip Stewart
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | | | - Shari Pilon-Thomas
- Department of Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Amod A Sarnaik
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - James J Mulé
- Department of Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Levi Garraway
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Matias Bustos
- Department of Translational Molecular Medicine, Saint John's Cancer Institute, Saint John's Health Center, Santa Monica, California
| | - Jianhua Zhang
- Department of Genomic Medicine, The University of Texas MDACC, Houston, Texas
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Isabella C Glitza
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Cassian Yee
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Hussein Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Michael K Wong
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Jennifer McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Dave S B Hoon
- Department of Translational Molecular Medicine, Saint John's Cancer Institute, Saint John's Health Center, Santa Monica, California
| | - Michael A Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Patrick Hwu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Rodabe N Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas
| | - Cara Haymaker
- Department of Translational Molecular Pathology, The University of Texas MDACC, Houston, Texas
| | - Rameen Beroukhim
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Chantale Bernatchez
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center (MDACC), Houston, Texas.,Department of Translational Molecular Pathology, The University of Texas MDACC, Houston, Texas
| |
Collapse
|
24
|
Khimani K, Patel SP, Whyte A, Al-Zubidi N. Case Report: Neuromyelitis Optica After Treatment of Uveal Melanoma With Nivolumab and Ipilimumab. Front Oncol 2022; 12:806501. [PMID: 35402220 PMCID: PMC8984112 DOI: 10.3389/fonc.2022.806501] [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: 10/31/2021] [Accepted: 02/24/2022] [Indexed: 11/23/2022] Open
Abstract
The development of immune checkpoint inhibitors (ICIs) has greatly improved survival of patients with advanced malignancies. ICIs can cause immune-related adverse effects (irAEs) involving any organ. Neurological irAEs are infrequent and have mostly been reported in patients with melanoma. We describe the case of a 57-year-old male with right eye uveal melanoma, gene expression profile (class 2), and PRAME (preferentially expressed antigen in melanoma) positivity, who received plaque brachytherapy with Iodine-125 for 4 days with subsequent adjuvant ICIs (immune checkpoint inhibitors), nivolumab and ipilimumab. 18 weeks after discontinuation of immunotherapy, the patient presented with acute onset of left-sided headaches, pain with eye movements, and vision loss. The patient was tested positive for serum anti-aquaporin-4 antibody (AQP4-Ab) and was diagnosed with neuromyelitis optica spectrum disorder (NMOSD). Subsequently, he was treated with 5 days of intravenous methylprednisolone followed by an oral prednisone taper over 10 weeks, with improvement in symptoms. We report a unique case of neuromyelitis optica spectrum disorder (NMOSD) following treatment with ICIs. To our best knowledge, this is the third reported case in English literature of NMOSD following ICI therapy and the first reported case of NMOSD caused by ICI treatment in uveal melanoma.
Collapse
Affiliation(s)
- Karima Khimani
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, United States
| | - Sapna P. Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Andrew Whyte
- Department of Head and Neck Surgery, Section of Ophthalmology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Nagham Al-Zubidi
- Department of Head and Neck Surgery, Section of Ophthalmology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, United States
- Department of Ophthalmology, Weill Cornell Medicine, New York, NY, United States
- *Correspondence: Nagham Al-Zubidi,
| |
Collapse
|
25
|
Loya A, Gombos DS, Patel SP. Second Primary Malignancies in Patients With Melanoma Subtypes: Analysis of 120,299 Patients From the SEER Database (2000-2016). Front Oncol 2022; 12:853076. [PMID: 35372013 PMCID: PMC8972193 DOI: 10.3389/fonc.2022.853076] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeEvaluate incidence of second primary malignancies (SPM) after non-acral cutaneous melanoma (NACM), acral lentiginous melanoma (ALM), mucosal melanoma (MM), and uveal melanoma (UM).Patients and MethodsFirst primary NACM, ALM, MM, and UM cases diagnosed 2000-2016 were extracted from SEER. Seer*Stat was used to calculate excess absolute risks (EAR) and standardized incidence ratios (SIR) of SPMs relative to a matched cohort from the general population. P-value of 0.05 determined significance.ResultsInclusion criteria was met by 109,385 patients with NACM, 2166 with ALM, 2498 with MM, and 6250 with UM. Increased incidence of malignancies occurred after NACM (SIR 1.51; 95%CI, 1.49-1.54), ALM (SIR 1.59; 95%CI, 1.40-1.81), MM (SIR 2.14; 95%CI, 1.85-2.45), and UM (SIR 1.24; 95%CI, 1.14-1.34) relative to the general population. Cutaneous melanoma occurred more frequently after NACM (SIR 9.54; 95%CI, 9.27-9.83), ALM (SIR 12.19; 95%CI, 9.70-15.14), MM (SIR 10.05; 95%CI, 7.18-13.68), and UM (SIR 2.91; 95%CI, 2.27-3.66). Patients with initial NACM (SIR 2.44; 95%CI, 1.64-3.51) and UM (SIR 44.34; 95%CI, 29.91-63.29) demonstrated increased incidence of eye and orbit melanoma. Renal malignancies occurred more frequently after NACM (SIR 1.24; 95%CI, 1.11-1.38), MM (SIR 3.54; 95%CI, 1.62-6.72) and UM (SIR 1.68; 95%CI, 1.09-2.48). Increased incidence of thyroid malignancies was observed after NACM (SIR 1.83; 95%CI, 1.61-2.06), ALM (SIR 3.74; 95%CI, 1.71-7.11), MM (SIR 4.40; 95%CI, 1.77-9.06), and UM (SIR 3.79; 95%CI, 2.52-5.47). Increased incidence of lymphoma was observed after NACM (SIR 1.20; 95%CI, 1.09-1.31) and ALM (SIR 2.06; 95%CI, 1.13-3.46).ConclusionPatients with NACM, ALM, MM, and UM have increased incidence of SPMs compared to that expected from the general population. Each of these melanoma subtypes had increased occurrence of cutaneous melanoma and thyroid cancer; some, but not all, had increased occurrence of renal malignancies, eye and orbit melanoma, and lymphoma.
Collapse
Affiliation(s)
- Asad Loya
- School of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Dan S. Gombos
- Section of Ophthalmology, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Pediatrics, Division of Cancer Medicine, Baylor College of Medicine, Houston, TX, United States
- Department of Ophthalmology & Visual Sciences, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Sapna P. Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- *Correspondence: Sapna P. Patel,
| |
Collapse
|
26
|
Meneveau MO, Kumar P, Lynch KT, Patel SP, Slingluff CL. The vaccine-site microenvironment: impacts of antigen, adjuvant, and same-site vaccination on antigen presentation and immune signaling. J Immunother Cancer 2022; 10:jitc-2021-003533. [PMID: 35277457 PMCID: PMC8919469 DOI: 10.1136/jitc-2021-003533] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2022] [Indexed: 12/17/2022] Open
Abstract
Background A goal of cancer vaccines is to induce strong T cell responses to tumor antigens, but the delivery method, schedule, and formulation of cancer vaccines have not yet been optimized. Adjuvants serve to increase the immune response against vaccine antigens. However, little is known about the impact of adjuvants plus antigen and their delivery schedule on the immunologic milieu in the vaccine-site microenvironment (VSME). We hypothesized that antigen processing and presentation may occur directly in the VSME, that adding the toll-like receptor 3 (TLR3) agonist polyICLC (pICLC) would enhance markers of immune activation, and that the immune signatures would be enhanced further by repeated vaccination in the same skin site rather than after multiple vaccines in different skin locations. Methods Using RNA sequencing, we evaluated VSME biopsies from patients undergoing subcutaneous/intradermal peptide vaccination against melanoma, with incomplete Freund’s adjuvant (IFA) with or without pICLC. Differential gene expression analyses and gene set enrichment analyses were performed using R. False discovery rate corrected p values <0.05 were considered significant. Results We found that addition of peptide antigens to IFA enhanced antigen presentation pathways and a tertiary lymphoid structure gene-signature locally at the VSME. Addition of pICLC to IFA + peptide induced an immunologically favorable VSME 1 week after injection but had little impact on the VSME after three injections, compared with IFA + peptide alone. Repeated same-site injection of IFA + peptide antigens induced a VSME with more dendritic cell activation, Th1 dominance, and TLR adaptor protein gene expression than that induced by injections at different, rotating skin locations. Conclusions These data suggest that the vaccine-site itself may be a critically important location contributing to vaccine immunity rather than just the draining lymph node, that IFA induces a favorable VSME with TLR agonist being most beneficial early in the vaccine course, and that same-site injections lead to persistent stimulation of immune pathways that may be beneficial in eliciting antigen specific T cell expansion.
Collapse
Affiliation(s)
- Max O Meneveau
- Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Pankaj Kumar
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, Virginia, USA
| | - Kevin T Lynch
- Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Sapna P Patel
- Department of Melanoma/Medical Oncology, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Craig L Slingluff
- Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
- University of Virginia Cancer Center, Charlottesville, Virginia, USA
| |
Collapse
|
27
|
Grossmann KF, Othus M, Patel SP, Tarhini AA, Sondak VK, Knopp MV, Petrella TM, Truong TG, Khushalani NI, Cohen JV, Buchbinder EI, Kendra K, Funchain P, Lewis KD, Conry RM, Chmielowski B, Kudchadkar RR, Johnson DB, Li H, Moon J, Eroglu Z, Gastman B, Kovacsovics-Bankowski M, Gunturu KS, Ebbinghaus SW, Ahsan S, Ibrahim N, Sharon E, Korde LA, Kirkwood JM, Ribas A. Adjuvant Pembrolizumab versus IFNα2b or Ipilimumab in Resected High-Risk Melanoma. Cancer Discov 2022; 12:644-653. [PMID: 34764195 PMCID: PMC8904282 DOI: 10.1158/2159-8290.cd-21-1141] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/19/2021] [Accepted: 11/08/2021] [Indexed: 12/14/2022]
Abstract
We conducted a randomized phase III trial to evaluate whether adjuvant pembrolizumab for one year (647 patients) improved recurrence-free survival (RFS) or overall survival (OS) in comparison with high-dose IFNα-2b for one year or ipilimumab for up to three years (654 patients), the approved standard-of-care adjuvant immunotherapies at the time of enrollment for patients with high-risk resected melanoma. At a median follow-up of 47.5 months, pembrolizumab was associated with significantly longer RFS than prior standard-of-care adjuvant immunotherapies [HR, 0.77; 99.62% confidence interval (CI), 0.59-0.99; P = 0.002]. There was no statistically significant association with OS among all patients (HR, 0.82; 96.3% CI, 0.61-1.09; P = 0.15). Proportions of treatment-related adverse events of grades 3 to 5 were 19.5% with pembrolizumab, 71.2% with IFNα-2b, and 49.2% with ipilimumab. Therefore, adjuvant pembrolizumab significantly improved RFS but not OS compared with the prior standard-of-care immunotherapies for patients with high-risk resected melanoma. SIGNIFICANCE Adjuvant PD-1 blockade therapy decreases the rates of recurrence, but not survival, in patients with surgically resectable melanoma, substituting the prior standard-of-care immunotherapies for this cancer. See related commentary by Smithy and Shoushtari, p. 599. This article is highlighted in the In This Issue feature, p. 587.
Collapse
Affiliation(s)
| | - Megan Othus
- SWOG Statistics and Data Management Center, Seattle
| | - Sapna P. Patel
- The University of Texas MD Anderson Cancer Center, Houston
| | | | | | | | | | | | | | - Justine V. Cohen
- Massachusetts General Hospital, Boston (during conduct of trial), University of Pennsylvania, Philadelphia (current)
| | | | | | | | | | - Robert M. Conry
- University of Alabama at Birmingham Cancer Center, Birmingham (during conduct of trial), Clearview Cancer Institute, Anniston (current)
| | - Bartosz Chmielowski
- University of California Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles
| | | | | | - Hongli Li
- SWOG Statistics and Data Management Center, Seattle
| | - James Moon
- SWOG Statistics and Data Management Center, Seattle
| | - Zeynep Eroglu
- H. Lee Moffitt Cancer Center and Research Institute, Tampa
| | | | | | | | | | | | | | - Elad Sharon
- National Cancer Institute, Cancer Therapy Evaluation Program, Bethesda
| | - Larissa A. Korde
- National Cancer Institute, Cancer Therapy Evaluation Program, Bethesda
| | | | - Antoni Ribas
- University of California Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles
| |
Collapse
|
28
|
Patel AB, Farooq S, Welborn M, Amaria RN, Chon SY, Diab A, Glitza Oliva IC, Huen AO, Li SQ, Nelson KC, Pacha O, Patel SP, Rapini RP, Tawbi HA, Wong MK, McQuade J, Davies MA, Haydu LE. Cutaneous adverse events in 155 patients with metastatic melanoma consecutively treated with anti-CTLA4 and anti-PD1 combination immunotherapy: Incidence, management, and clinical benefit. Cancer 2022; 128:975-983. [PMID: 34724197 DOI: 10.1002/cncr.34004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/01/2021] [Accepted: 09/28/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND In response to the increased use of combination checkpoint inhibitors (CPIs) and the resulting increased cutaneous adverse events (CAEs), this study reviewed patients with melanoma treated with combination CPIs to characterize CAE features and their clinical impact, correlation to adverse events in other organs, and correlation to tumor response. METHODS Patients from the authors' institutional database who received at least 1 dose of ipilimumab in combination with either nivolumab or pembrolizumab between January 1, 2012, and December 31, 2017, for stage IV or unresectable stage III melanoma were identified. The time to next treatment (TTNT) was calculated from the start of CPI therapy to the start of the next treatment or death, and the development of CAEs was tested in a time-dependent Cox regression to identify associations with TTNT. RESULTS Eighty-one patients (52.3%) experienced a total of 92 CAEs, including eczematous dermatitis (25.0%), morbilliform eruption (22.8%), vitiligo (12.0%), and pruritus without rash (8.7%). The median times to the onset and resolution of CAEs were 21 days (range, 0-341 days) and 50 days (range, 1-352 days), respectively. Most CAEs resolved after patients entered the CPI maintenance phase and treatment with oral antihistamines with or without topical steroids. CPI discontinuation occurred in 4 patients (2.6%) because of CAEs, in 49 (31.6%) because of other immune-related adverse events, and in 20 (12.9%) because of melanoma progression or death. For patients definitively treated with CPIs (n = 134; 86.5%), TTNT was significantly longer with CAEs than without CAEs (hazard ratio, 0.567; 95% CI, 0.331-0.972; P = .039). CONCLUSIONS CAEs were mostly reversible and rarely required therapy discontinuation. The development of CAEs was associated with a longer TTNT, and this suggested a possible clinical benefit.
Collapse
Affiliation(s)
- Anisha B Patel
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,McGovern Medical School, The University of Texas Health Science Center, Houston, Texas
| | - Sahira Farooq
- McGovern Medical School, The University of Texas Health Science Center, Houston, Texas
| | - Macartney Welborn
- Department of Dermatology, University of Florida, Gainesville, Florida
| | - Rodabe N Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan Y Chon
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Isabella C Glitza Oliva
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Auris O Huen
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Kelly C Nelson
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,McGovern Medical School, The University of Texas Health Science Center, Houston, Texas
| | - Omar Pacha
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ronald P Rapini
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,McGovern Medical School, The University of Texas Health Science Center, Houston, Texas
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael K Wong
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jennifer McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael A Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lauren E Haydu
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
29
|
Truong TG, Kennedy LB, Patel SP. 25 Years of Adjuvant Therapy in Melanoma: A Perspective on Current Approvals and Insights into Future Directions. Curr Oncol Rep 2022; 24:533-542. [PMID: 35192117 DOI: 10.1007/s11912-022-01232-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Thach-Giao Truong
- Kaiser Permanente Northern California, 975 Sereno Drive, Vallejo, CA, 94589, USA
| | - Lucy Boyce Kennedy
- The Cleveland Clinic Foundation, 9500 Euclid Ave CA-60, Cleveland, OH, 44195, USA
| | - Sapna P Patel
- The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 0430, Houston, TX, 77030, USA.
| |
Collapse
|
30
|
Spencer CN, McQuade JL, Gopalakrishnan V, McCulloch JA, Vetizou M, Cogdill AP, Khan AW, Zhang X, White MG, Peterson CB, Wong MC, Morad G, Rodgers T, Badger JH, Helmink BA, Andrews MC, Rodrigues RR, Morgun A, Kim YS, Roszik J, Hoffman KL, Zheng J, Zhou Y, Medik YB, Kahn LM, Johnson S, Hudgens CW, Wani K, Gaudreau PO, Harris AL, Jamal MA, Baruch EN, Perez-Guijarro E, Day CP, Merlino G, Pazdrak B, Lochmann BS, Szczepaniak-Sloane RA, Arora R, Anderson J, Zobniw CM, Posada E, Sirmans E, Simon J, Haydu LE, Burton EM, Wang L, Dang M, Clise-Dwyer K, Schneider S, Chapman T, Anang NAAS, Duncan S, Toker J, Malke JC, Glitza IC, Amaria RN, Tawbi HA, Diab A, Wong MK, Patel SP, Woodman SE, Davies MA, Ross MI, Gershenwald JE, Lee JE, Hwu P, Jensen V, Samuels Y, Straussman R, Ajami NJ, Nelson KC, Nezi L, Petrosino JF, Futreal PA, Lazar AJ, Hu J, Jenq RR, Tetzlaff MT, Yan Y, Garrett WS, Huttenhower C, Sharma P, Watowich SS, Allison JP, Cohen L, Trinchieri G, Daniel CR, Wargo JA. Dietary fiber and probiotics influence the gut microbiome and melanoma immunotherapy response. Science 2021; 374:1632-1640. [PMID: 34941392 PMCID: PMC8970537 DOI: 10.1126/science.aaz7015] [Citation(s) in RCA: 318] [Impact Index Per Article: 106.0] [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] [Indexed: 07/20/2023]
Abstract
Gut bacteria modulate the response to immune checkpoint blockade (ICB) treatment in cancer, but the effect of diet and supplements on this interaction is not well studied. We assessed fecal microbiota profiles, dietary habits, and commercially available probiotic supplement use in melanoma patients and performed parallel preclinical studies. Higher dietary fiber was associated with significantly improved progression-free survival in 128 patients on ICB, with the most pronounced benefit observed in patients with sufficient dietary fiber intake and no probiotic use. Findings were recapitulated in preclinical models, which demonstrated impaired treatment response to anti–programmed cell death 1 (anti–PD-1)–based therapy in mice receiving a low-fiber diet or probiotics, with a lower frequency of interferon-γ–positive cytotoxic T cells in the tumor microenvironment. Together, these data have clinical implications for patients receiving ICB for cancer.
Collapse
Affiliation(s)
- Christine N. Spencer
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jennifer L. McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | - John A. McCulloch
- Laboratory of Integrative Cancer Immunology, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Marie Vetizou
- Laboratory of Integrative Cancer Immunology, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Alexandria P. Cogdill
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - A. Wadud Khan
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xiaotao Zhang
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Michael G. White
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Christine B. Peterson
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Matthew C. Wong
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Golnaz Morad
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Theresa Rodgers
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jonathan H. Badger
- Laboratory of Integrative Cancer Immunology, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Beth A. Helmink
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Miles C. Andrews
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Richard R. Rodrigues
- Frederick National Laboratory for Cancer Research, and Microbiome and Genetics Core, Laboratory of Integrative Cancer Immunology, CCR, NCI, NIH, Bethesda, MD 20852, USA
| | - Andrey Morgun
- Department of Pharmaceutical Science, Oregon State University, Corvallis, OR 97331, USA
| | - Young S. Kim
- Nutritional Science Research Group, Division of Cancer Prevention, NCI, NIH, Rockville, MD 20850, USA
| | - Jason Roszik
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Kristi L. Hoffman
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jiali Zheng
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Yifan Zhou
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Yusra B. Medik
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Laura M. Kahn
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- MD Anderson University of Texas Health Graduate School, Houston, TX 77030, USA
| | - Sarah Johnson
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Courtney W. Hudgens
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Khalida Wani
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Pierre-Olivier Gaudreau
- Canadian Cancer Trials Group and Department of Oncology, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Angela L. Harris
- Center for Co-Clinical Trials, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mohamed A. Jamal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Erez N. Baruch
- Department of Internal Medicine, The University of Texas Health Science Center, Houston, TX 77030, USA
| | - Eva Perez-Guijarro
- Laboratory of Cancer Biology and Genetics, CCR, NCI, NIH, Bethesda, MD 20892, USA
| | - Chi-Ping Day
- Laboratory of Cancer Biology and Genetics, CCR, NCI, NIH, Bethesda, MD 20892, USA
| | - Glenn Merlino
- Laboratory of Cancer Biology and Genetics, CCR, NCI, NIH, Bethesda, MD 20892, USA
| | - Barbara Pazdrak
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Brooke S. Lochmann
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | - Reetakshi Arora
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jaime Anderson
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Chrystia M. Zobniw
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Eliza Posada
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Elizabeth Sirmans
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Julie Simon
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Lauren E. Haydu
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Elizabeth M. Burton
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Linghua Wang
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Minghao Dang
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Karen Clise-Dwyer
- Advanced Cytometry and Sorting Facility at South Campus, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Hematopoietic Biology and Malignancy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sarah Schneider
- Advanced Cytometry and Sorting Facility at South Campus, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Thomas Chapman
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Nana-Ama A. S. Anang
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sheila Duncan
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Joseph Toker
- Department of Neurosurgery, Harvard University, Cambridge, MA 02138, USA
- Department of Oncology, University of Cambridge, Cambridge CB2 1TN, UK
| | - Jared C. Malke
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Isabella C. Glitza
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Rodabe N. Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hussein A. Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Michael K. Wong
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sapna P. Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Scott E. Woodman
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Michael A. Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Merrick I. Ross
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jeffrey E. Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jeffrey E. Lee
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Patrick Hwu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Vanessa Jensen
- Department of Veterinary Medicine and Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Yardena Samuels
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, 76100, Israel
| | - Ravid Straussman
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, 76100, Israel
| | - Nadim J. Ajami
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Kelly C. Nelson
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Luigi Nezi
- Dipartimento di Oncologia Sperimentale, Instituto Europeo di Oncologia, Milan, P.I. 08691440153, Italy
| | - Joseph F. Petrosino
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - P. Andrew Futreal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Alexander J. Lazar
- MD Anderson University of Texas Health Graduate School, Houston, TX 77030, USA
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jianhua Hu
- Department of Biostatistics, Columbia University, New York, NY 10032, USA
| | - Robert R. Jenq
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Stem Cell Transplant, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Michael T. Tetzlaff
- Departments of Pathology and Dermatology, Dermatopathology and Oral Pathology Unit, University of California San Francisco, San Francisco, CA 94115, USA
| | - Yan Yan
- Department of Biostatistics and the Harvard T.H. Chan Microbiome in Public Health Center, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Wendy S. Garrett
- Department of Molecular Metabolism, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Curtis Huttenhower
- Department of Biostatistics and the Harvard T.H. Chan Microbiome in Public Health Center, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Harvard Chan Microbiome in Public Health Center, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Padmanee Sharma
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Parker Institute for Cancer Immunotherapy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Stephanie S. Watowich
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - James P. Allison
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Parker Institute for Cancer Immunotherapy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Giorgio Trinchieri
- Laboratory of Integrative Cancer Immunology, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Carrie R. Daniel
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jennifer A. Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| |
Collapse
|
31
|
Patel SP, Petroni GR, Roszik J, Olson WC, Wages NA, Chianese-Bullock KA, Smolkin M, Varhegyi N, Gaughan E, Smith KT, Haden K, Hall EH, Gnjatic S, Hwu P, Slingluff CL. Phase I/II trial of a long peptide vaccine (LPV7) plus toll-like receptor (TLR) agonists with or without incomplete Freund's adjuvant (IFA) for resected high-risk melanoma. J Immunother Cancer 2021; 9:e003220. [PMID: 34413169 PMCID: PMC8378357 DOI: 10.1136/jitc-2021-003220] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 06/29/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND We performed a clinical trial to evaluate safety and immunogenicity of a novel long peptide vaccine administered in combinations of incomplete Freund's adjuvant (IFA) and agonists for TLR3 (polyICLC) and TLR7/8 (resiquimod). We hypothesized that T cell responses to minimal epitope peptides (MEPs) within the long peptides would be enhanced compared with prior vaccines with MEP themselves and that T cell responses would be enhanced with TLR agonists, compared with IFA alone. METHODS Participants with resected stage IIB-IV melanoma were vaccinated with seven long melanoma peptides (LPV7) from tyrosinase, gp100, MAGE-A1, MAGE-A10, and NY-ESO-1, each containing a known MEP for CD8+ T cells, plus a tetanus helper peptide (Tet) restricted by Class II MHC. Enrollment was guided by an adaptive design to one of seven adjuvant combinations. Vaccines were administered at weeks 1, 2, 3, 6, 9, 12 at rotating injection sites. T cell and IgG antibody (Ab) responses were measured with IFN-gamma ELIspot assay ex vivo and ELISA, respectively. RESULTS Fifty eligible participants were assigned to seven study groups, with highest enrollment on arm E (LPV7+Tet+IFA+polyICLC). There was one dose-limiting toxicity (DLT) in Group E (grade 3 injection site reaction, 6% DLT rate). All other treatment-related adverse events were grades 1-2. The CD8+ T cell immune response rate (IRR) to MEPs was 18%, less than in prior studies using MEP vaccines in IFA. The CD8+ T cell IRR trended higher for IFA-containing adjuvants (24%) than adjuvants containing only TLR agonists (6%). Overall T cell IRR to full-length LPV7 was 30%; CD4+ T cell IRR to Tet was 40%, and serum Ab IRR to LPV7 was 84%. These IRRs also trended higher for IFA-containing adjuvants (36% vs 18%, 48% vs 24%, and 97% vs 60%, respectively). CONCLUSIONS The LPV7 vaccine is safe with each of seven adjuvant strategies and induced T cell responses to CD8 MEPs ex vivo in a subset of patients but did not enhance IRRs compared with prior vaccines using short peptides. Immunogenicity was supported more by IFA than by TLR agonists alone and may be enhanced by polyICLC plus IFA. TRIAL REGISTRATION NUMBER NCT02126579.
Collapse
Affiliation(s)
- Sapna P Patel
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gina R Petroni
- University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Jason Roszik
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Walter C Olson
- University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Nolan A Wages
- Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | | | - Mark Smolkin
- Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Nikole Varhegyi
- Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Elizabeth Gaughan
- University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Kelly T Smith
- University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Kathleen Haden
- University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Emily H Hall
- University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Sacha Gnjatic
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Craig L Slingluff
- Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
| |
Collapse
|
32
|
Andrews MC, Duong CPM, Gopalakrishnan V, Iebba V, Chen WS, Derosa L, Khan MAW, Cogdill AP, White MG, Wong MC, Ferrere G, Fluckiger A, Roberti MP, Opolon P, Alou MT, Yonekura S, Roh W, Spencer CN, Curbelo IF, Vence L, Reuben A, Johnson S, Arora R, Morad G, Lastrapes M, Baruch EN, Little L, Gumbs C, Cooper ZA, Prieto PA, Wani K, Lazar AJ, Tetzlaff MT, Hudgens CW, Callahan MK, Adamow M, Postow MA, Ariyan CE, Gaudreau PO, Nezi L, Raoult D, Mihalcioiu C, Elkrief A, Pezo RC, Haydu LE, Simon JM, Tawbi HA, McQuade J, Hwu P, Hwu WJ, Amaria RN, Burton EM, Woodman SE, Watowich S, Diab A, Patel SP, Glitza IC, Wong MK, Zhao L, Zhang J, Ajami NJ, Petrosino J, Jenq RR, Davies MA, Gershenwald JE, Futreal PA, Sharma P, Allison JP, Routy B, Zitvogel L, Wargo JA. Gut microbiota signatures are associated with toxicity to combined CTLA-4 and PD-1 blockade. Nat Med 2021; 27:1432-1441. [PMID: 34239137 PMCID: PMC11107795 DOI: 10.1038/s41591-021-01406-6] [Citation(s) in RCA: 199] [Impact Index Per Article: 66.3] [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: 12/01/2020] [Accepted: 05/25/2021] [Indexed: 02/06/2023]
Abstract
Treatment with combined immune checkpoint blockade (CICB) targeting CTLA-4 and PD-1 is associated with clinical benefit across tumor types, but also a high rate of immune-related adverse events. Insights into biomarkers and mechanisms of response and toxicity to CICB are needed. To address this, we profiled the blood, tumor and gut microbiome of 77 patients with advanced melanoma treated with CICB, with a high rate of any ≥grade 3 immune-related adverse events (49%) with parallel studies in pre-clinical models. Tumor-associated immune and genomic biomarkers of response to CICB were similar to those identified for ICB monotherapy, and toxicity from CICB was associated with a more diverse peripheral T-cell repertoire. Profiling of gut microbiota demonstrated a significantly higher abundance of Bacteroides intestinalis in patients with toxicity, with upregulation of mucosal IL-1β in patient samples of colitis and in pre-clinical models. Together, these data offer potential new therapeutic angles for targeting toxicity to CICB.
Collapse
Affiliation(s)
- Miles C Andrews
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Olivia Newton-John Cancer Research Institute and La Trobe University School of Cancer Medicine, Heidelberg, Victoria, Australia
- Deparment of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Connie P M Duong
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France
- Institut National de la Santé Et de la Recherche Medicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
- Université Paris-Saclay, Faculté de Médecine Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
| | | | - Valerio Iebba
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France
- Institut National de la Santé Et de la Recherche Medicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
| | - Wei-Shen Chen
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Dermatology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Lisa Derosa
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France
- Institut National de la Santé Et de la Recherche Medicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
- Université Paris-Saclay, Faculté de Médecine Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
| | - Md Abdul Wadud Khan
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alexandria P Cogdill
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France
- Institut National de la Santé Et de la Recherche Medicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
- Université Paris-Saclay, Faculté de Médecine Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael G White
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Matthew C Wong
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gladys Ferrere
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France
- Institut National de la Santé Et de la Recherche Medicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
- Université Paris-Saclay, Faculté de Médecine Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
| | - Aurélie Fluckiger
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France
- Institut National de la Santé Et de la Recherche Medicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
- Université Paris-Saclay, Faculté de Médecine Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
| | - Maria P Roberti
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France
- Institut National de la Santé Et de la Recherche Medicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
- Université Paris-Saclay, Faculté de Médecine Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
| | - Paule Opolon
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France
| | - Maryam Tidjani Alou
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France
- Institut National de la Santé Et de la Recherche Medicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
- Université Paris-Saclay, Faculté de Médecine Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
| | - Satoru Yonekura
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France
- Institut National de la Santé Et de la Recherche Medicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
- Université Paris-Saclay, Faculté de Médecine Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
| | - Whijae Roh
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Christine N Spencer
- Department of Informatics, Parker Institute for Cancer Immunotherapy, San Francisco, CA, USA
| | - Irina Fernandez Curbelo
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Luis Vence
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alexandre Reuben
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sarah Johnson
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Reetakshi Arora
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Golnaz Morad
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Matthew Lastrapes
- MD Anderson Cancer Center University of Texas Health Graduate School of Biomedical Sciences (GSBS), Houston, TX, USA
| | - Erez N Baruch
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Latasha Little
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Curtis Gumbs
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Peter A Prieto
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Khalida Wani
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alexander J Lazar
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael T Tetzlaff
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Courtney W Hudgens
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Margaret K Callahan
- Department of Informatics, Parker Institute for Cancer Immunotherapy, San Francisco, CA, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Matthew Adamow
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Division of Immunology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michael A Postow
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Division of Immunology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Charlotte E Ariyan
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Pierre-Olivier Gaudreau
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Luigi Nezi
- Istituto Europeo di Oncologia, Milan, Italy
| | - Didier Raoult
- Aix-Marseille Université, MEPHI, IRD, IHU Méditerranée Infection, Marseille, France
| | - Catalin Mihalcioiu
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University Health Centre, Montreal, Quebec, Canada
| | - Arielle Elkrief
- Cedars Cancer Center, McGill University Health Centre, Montreal, Quebec, Canada
| | - Rossanna C Pezo
- Division of Medical Oncology, University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | - Lauren E Haydu
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Julie M Simon
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Patrick Hwu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wen-Jen Hwu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rodabe N Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Elizabeth M Burton
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Scott E Woodman
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephanie Watowich
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Isabella C Glitza
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael K Wong
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Li Zhao
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jianhua Zhang
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nadim J Ajami
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph Petrosino
- Department of Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Robert R Jenq
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael A Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P Andrew Futreal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Padmanee Sharma
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - James P Allison
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bertrand Routy
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France
- Institut National de la Santé Et de la Recherche Medicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
- Université Paris-Saclay, Faculté de Médecine Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
| | - Laurence Zitvogel
- Gustave Roussy Cancer Campus (GRCC), Villejuif, France.
- Institut National de la Santé Et de la Recherche Medicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France.
- Université Paris-Saclay, Faculté de Médecine Kremlin-Bicêtre, Le Kremlin-Bicêtre, France.
| | - Jennifer A Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| |
Collapse
|
33
|
Sezen D, Patel RR, Tang C, Onstad M, Nagarajan P, Patel SP, Welsh JW, Lin LL. Immunotherapy combined with high- and low-dose radiation to all sites leads to complete clearance of disease in a patient with metastatic vaginal melanoma. Gynecol Oncol 2021; 161:645-652. [PMID: 33795130 DOI: 10.1016/j.ygyno.2021.03.017] [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] [Indexed: 10/21/2022]
Abstract
A 73-year-old woman with metastatic vaginal mucosal melanoma that had progressed on ipilimumab and nivolumab experienced clinical and radiographic complete response to dual checkpoint inhibitor immunotherapy given in combination with high-dose plus low-dose radiation. General characteristics and treatment options in this disease are highlighted.
Collapse
Affiliation(s)
- Duygu Sezen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Radiation Oncology, Koc University School of Medicine, Istanbul, Turkey
| | - Roshal R Patel
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Albany Medical College, Albany, NY, USA
| | - Christine Tang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Baylor College of Medicine, Houston, TX, USA
| | - Michaela Onstad
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Priyadharsini Nagarajan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sapna P Patel
- Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - James W Welsh
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lilie L Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| |
Collapse
|
34
|
Ogata D, Haydu LE, Glitza IC, Patel SP, Tawbi HA, McQuade JL, Diab A, Ekmekcioglu S, Wong MK, Davies MA, Amaria RN. The efficacy of anti-programmed cell death protein 1 therapy among patients with metastatic acral and metastatic mucosal melanoma. Cancer Med 2021; 10:2293-2299. [PMID: 33686688 PMCID: PMC7982611 DOI: 10.1002/cam4.3781] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/26/2020] [Accepted: 01/28/2021] [Indexed: 12/18/2022] Open
Abstract
Background Anti‐programmed cell death protein 1 (PD‐1) antibodies are a standard treatment for metastatic melanoma patients. However, the understanding of the efficacy of anti‐PD‐1 for acral melanoma (AM) and mucosal melanoma (MM) is limited as these subtypes are relatively rare compared to cutaneous melanoma (CM). Methods This single institution, retrospective cohort study included patients with advanced AM and MM who underwent anti‐PD‐1 therapy for metastatic melanoma between 2012 and 2018. Objective responses were determined using the investigator‐assessed Response Evaluation Criteria in Solid Tumors version 1.1. Progression‐free survival (PFS) and overall survival (OS) were assessed using the Kaplan–Meier method. A Cox regression analysis was performed to identify the factors associated with survival outcomes. Results Ninety‐seven patients were identified, 38 (39%) with AM and 59 (61%) with MM. The objective response rates (ORRs) were 21.0% and 15.2% in patients with AM and MM, respectively. The median PFS and OS were 3.6 and 25.7 months for AM patients, and 3.0 and 20.1 months for MM patients, respectively. Elevated serum lactate dehydrogenase (LDH) (AM: hazard ratio [HR], 0.22; 95% confidence interval [CI], 0.06–0.87; p = 0.03, MM: HR, 0.20; 95% CI, 0.08–0.53; p = 0.001) was significantly associated with shorter OS for both subtypes. Conclusions The ORR, PFS, and OS with anti‐PD‐1 therapy were poor in patients with AM and MM compared to those previously reported clinical trials for nonacral CM. High serum LDH was associated with significantly shorter OS.
Collapse
Affiliation(s)
- Dai Ogata
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA.,Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Lauren E Haydu
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Isabella C Glitza
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer L McQuade
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Adi Diab
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Suhendan Ekmekcioglu
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Michael K Wong
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Michael A Davies
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Rodabe N Amaria
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
35
|
Muñoz NM, Williams M, Dixon K, Dupuis C, McWatters A, Avritscher R, Manrique SZ, McHugh K, Murthy R, Tam A, Naing A, Patel SP, Leach D, Hartgerink JD, Young S, Prakash P, Hwu P, Sheth RA. Influence of injection technique, drug formulation and tumor microenvironment on intratumoral immunotherapy delivery and efficacy. J Immunother Cancer 2021; 9:e001800. [PMID: 33589526 PMCID: PMC7887346 DOI: 10.1136/jitc-2020-001800] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [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: 01/10/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Intratumoral delivery of immunotherapeutics represents a compelling solution to directly address local barriers to tumor immunity. However, we have previously shown that off-target delivery is a substantial problem during intratumoral injections; this can lead to diminished drug efficacy and systemic toxicities. We have identified three variables that influence intratumoral drug delivery: injection technique, drug formulation and tumor microenvironment. The purpose of this study was to characterize the impact of modifications in each variable on intratumoral drug delivery and immunotherapy efficacy. METHODS Intratumoral injections were performed in a hybrid image-guided intervention suite with ultrasound, fluoroscopy and CT scanning capabilities in both rat and mouse syngeneic tumor models. Intratumoral drug distribution was quantified by CT volumetric imaging. The influence of varying needle design and hydrogel-based drug delivery on the immune response to a stimulator of interferon genes (STING) agonist was evaluated using flow cytometry and single cell RNA sequencing. We also evaluated the influence of tumor stiffness on drug injection distribution. RESULTS Variations in needle design, specifically with the use of a multiside hole needle, led to approximately threefold improvements in intratumoral drug deposition relative to conventional end-hole needles. Likewise, delivery of a STING agonist through a multiside hole needle led to significantly increased expression of type I interferon-associated genes and 'inflammatory' dendritic cell gene signatures relative to end-hole STING agonist delivery. A multidomain peptide-based hydrogel embedded with a STING agonist led to substantial improvements in intratumoral deposition; however, the hydrogel was noted to generate a strong immune response against itself within the target tumor. Evaluation of tumor stroma on intratumoral drug delivery revealed that there was a greater than twofold improvement in intratumoral distribution in soft tumors (B16 melanoma) compared with firm tumors (MC38 colorectal). CONCLUSIONS Injection technique, drug formulation and tumor stiffness play key roles in the accurate delivery of intratumoral immunotherapeutics.
Collapse
MESH Headings
- Adaptor Proteins, Signal Transducing/agonists
- Adaptor Proteins, Signal Transducing/immunology
- Animals
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/chemistry
- Carcinoma, Hepatocellular/drug therapy
- Carcinoma, Hepatocellular/immunology
- Carcinoma, Hepatocellular/pathology
- Cell Line, Tumor
- Colorectal Neoplasms/drug therapy
- Colorectal Neoplasms/immunology
- Colorectal Neoplasms/pathology
- Drug Carriers
- Drug Compounding
- Female
- Hydrogels
- Immunotherapy
- Injections, Intralesional
- Liver Neoplasms/drug therapy
- Liver Neoplasms/immunology
- Liver Neoplasms/pathology
- Melanoma, Experimental/drug therapy
- Melanoma, Experimental/immunology
- Melanoma, Experimental/pathology
- Membrane Proteins/agonists
- Membrane Proteins/immunology
- Mice, Inbred C57BL
- Peptides/administration & dosage
- Peptides/chemistry
- Rats, Inbred BUF
- Skin Neoplasms/drug therapy
- Skin Neoplasms/immunology
- Skin Neoplasms/pathology
- Tumor Microenvironment
- Mice
- Rats
Collapse
Affiliation(s)
- Nina M Muñoz
- Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Malea Williams
- Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Katherine Dixon
- Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Crystal Dupuis
- Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Amanda McWatters
- Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Rony Avritscher
- Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Soraya Zorro Manrique
- Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kevin McHugh
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Ravi Murthy
- Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alda Tam
- Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Aung Naing
- Department of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sapna P Patel
- Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - David Leach
- Department of Chemistry, Rice University, Houston, Texas, USA
| | | | - Simon Young
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Punit Prakash
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas, USA
| | - Patrick Hwu
- Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Rahul A Sheth
- Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
36
|
Qin Y, Bollin K, de Macedo MP, Carapeto F, Kim KB, Roszik J, Wani KM, Reuben A, Reddy ST, Williams MD, Tetzlaff MT, Wang WL, Gombos DS, Esmaeli B, Lazar AJ, Hwu P, Patel SP. Immune profiling of uveal melanoma identifies a potential signature associated with response to immunotherapy. J Immunother Cancer 2020; 8:jitc-2020-000960. [PMID: 33203661 PMCID: PMC7674090 DOI: 10.1136/jitc-2020-000960] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 12/14/2022] Open
Abstract
Background To date, no systemic therapy, including immunotherapy, exists to improve clinical outcomes in metastatic uveal melanoma (UM) patients. To understand the role of immune infiltrates in the genesis, metastasis, and response to treatment for UM, we systematically characterized immune profiles of UM primary and metastatic tumors, as well as samples from UM patients treated with immunotherapies. Methods Relevant immune markers (CD3, CD8, FoxP3, CD68, PD-1, and PD-L1) were analyzed by immunohistochemistry on 27 primary and 31 metastatic tumors from 47 patients with UM. Immune gene expression profiling was conducted by NanoString analysis on pre-treatment and post-treatment tumors from patients (n=6) receiving immune checkpoint blockade or 4-1BB and OX40 dual costimulation. The immune signature of UM tumors responding to immunotherapy was further characterized by Ingenuity Pathways Analysis and validated in The Cancer Genome Atlas data set. Results Both primary and metastatic UM tumors showed detectable infiltrating lymphocytes. Compared with primary tumors, treatment-naïve metastatic UM showed significantly higher levels of CD3+, CD8+, FoxP3+ T cells, and CD68+ macrophages. Notably, levels of PD-1+ infiltrates and PD-L1+ tumor cells were low to absent in primary and metastatic UM tumors. No metastatic organ-specific differences were seen in immune infiltrates. Our NanoString analysis revealed significant differences in a set of immune markers between responders and non-responders. A group of genes relevant to the interferon-γ signature was differentially up-expressed in the pre-treatment tumors of responders. Among these genes, suppressor of cytokine signaling 1 was identified as a marker potentially contributing to the response to immunotherapy. A panel of genes that encoded pro-inflammatory cytokines and molecules were expressed significantly higher in pre-treatment tumors of non-responders compared with responders. Conclusion Our study provides critical insight into immune profiles of UM primary and metastatic tumors, which suggests a baseline tumor immune signature predictive of response and resistance to immunotherapy in UM.
Collapse
Affiliation(s)
- Yong Qin
- Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, USA
| | - Kathryn Bollin
- Medical Oncology, Scripps MD Anderson Cancer Center, San Diego, California, USA
| | | | - Fernando Carapeto
- Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kevin B Kim
- Center for Melanoma Research and Treatment, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Jason Roszik
- Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Khalida M Wani
- Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alexandre Reuben
- Thoracic/Head & Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sujan T Reddy
- Neurology, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Michelle D Williams
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael T Tetzlaff
- Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Wei-Lien Wang
- Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Dan S Gombos
- Department of Head and Neck Surgery, Section of Ophthalmology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Bita Esmaeli
- Orbital Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alexander J Lazar
- Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Patrick Hwu
- Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sapna P Patel
- Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
37
|
Pelster MS, Gruschkus SK, Bassett R, Gombos DS, Shephard M, Posada L, Glover MS, Simien R, Diab A, Hwu P, Carter BW, Patel SP. Nivolumab and Ipilimumab in Metastatic Uveal Melanoma: Results From a Single-Arm Phase II Study. J Clin Oncol 2020; 39:599-607. [PMID: 33125309 DOI: 10.1200/jco.20.00605] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Metastatic uveal melanoma has poor overall survival (OS) and no approved systemic therapy options. Studies of single-agent immunotherapy regimens have shown minimal benefit. There is the potential for improved responses with the use of combination immunotherapy. PATIENTS AND METHODS We conducted a phase II study of nivolumab with ipilimumab in patients with metastatic uveal melanoma. Any number of prior treatments was permitted. Patients received nivolumab 1 mg/kg and ipilimumab 3 mg/kg for four cycles, followed by nivolumab maintenance therapy for up to 2 years. The primary outcome of the study was overall response rate (ORR) as determined by RECIST 1.1 criteria. Progression-free survival (PFS), OS, and adverse events were also assessed. RESULTS Thirty-five patients were enrolled, and 33 patients were evaluable for efficacy. The ORR was 18%, including one confirmed complete response and five confirmed partial responses. The median PFS was 5.5 months (95% CI, 3.4 to 9.5 months), and the median OS was 19.1 months (95% CI, 9.6 months to NR). Forty percent of patients experienced a grade 3-4 treatment-related adverse event. CONCLUSION The combination regimen of nivolumab plus ipilimumab demonstrates activity in metastatic uveal melanoma, with deep and sustained confirmed responses.
Collapse
Affiliation(s)
- Meredith S Pelster
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Stephen K Gruschkus
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Roland Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Dan S Gombos
- Department of Head and Neck Surgery, Section of Ophthalmology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Shephard
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Liberty Posada
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Maura S Glover
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rinata Simien
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Patrick Hwu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Brett W Carter
- Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
38
|
Janku F, Sakamuri D, Kato S, Huang HJ, Call SG, Naing A, Holley VR, Patel SP, Amaria RN, Falchook GS, Piha-Paul SA, Zinner RG, Tsimberidou AM, Hong DS, Meric-Bernstam F. Dose-escalation study of vemurafenib with sorafenib or crizotinib in patients with BRAF-mutated advanced cancers. Cancer 2020; 127:391-402. [PMID: 33119140 DOI: 10.1002/cncr.33242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/09/2020] [Accepted: 08/28/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND BRAF inhibitors are effective in melanoma and other cancers with BRAF mutations; however, patients ultimately develop therapeutic resistance through the activation of alternative signaling pathways such as RAF/RAS or MET. The authors hypothesized that combining the BRAF inhibitor vemurafenib with either the multikinase inhibitor sorafenib or the MET inhibitor crizotinib could overcome therapeutic resistance. METHODS Patients with advanced cancers and BRAF mutations were enrolled in a dose-escalation study (3 + 3 design) to determine the maximum tolerated dose (MTD) and the dose-limiting toxicities (DLTs) of vemurafenib with sorafenib (VS) or vemurafenib with crizotinib (VC). RESULTS In total, 38 patients (VS, n = 24; VC, n = 14) were enrolled, and melanoma was the most represented tumor type (VS, 38%; VC, 64%). In the VS arm, vemurafenib 720 mg twice daily and sorafenib 400 mg am/200 mg pm were identified as the MTDs, DLTs included grade 3 rash (n = 2) and grade 3 hypertension, and partial responses were reported in 5 patients (21%), including 2 with ovarian cancer who had received previous treatment with BRAF, MEK, or ERK inhibitors. In the VC arm, vemurafenib 720 mg twice daily and crizotinib 250 mg daily were identified as the MTDs, DLTs included grade 3 rash (n = 2), and partial responses were reported in 4 patients (29%; melanoma, n = 3; lung adenocarcinoma, n = 1) who had received previous treatment with BRAF, MEK, and/or ERK inhibitors. Optional longitudinal collection of plasma to assess dynamic changes in circulating tumor DNA demonstrated the elimination of BRAF-mutant DNA from plasma during therapy (P = .005). CONCLUSIONS Vemurafenib combined with sorafenib or crizotinib was well tolerated with encouraging activity, including among patients who previously received treatment with BRAF, MEK, or ERK inhibitors.
Collapse
Affiliation(s)
- Filip Janku
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Divya Sakamuri
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shumei Kato
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Helen J Huang
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - S Greg Call
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Aung Naing
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Veronica R Holley
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Rodabe N Amaria
- Department of Melanoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gerald S Falchook
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Sarah Cannon Research Institute at HealthONE, Presbyterian/St Luke's Medical Center, Denver, Colorado
| | - Sarina A Piha-Paul
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ralph G Zinner
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.,University of Kentucky Markey Cancer Center, Lexington, Kentucky
| | - Apostolia M Tsimberidou
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David S Hong
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
39
|
Chua V, Mattei J, Han A, Johnston L, LiPira K, Selig SM, Carvajal RD, Aplin AE, Patel SP. The Latest on Uveal Melanoma Research and Clinical Trials: Updates from the Cure Ocular Melanoma (CURE OM) Science Meeting (2019). Clin Cancer Res 2020; 27:28-33. [PMID: 33060121 DOI: 10.1158/1078-0432.ccr-20-2536] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/11/2020] [Accepted: 10/08/2020] [Indexed: 12/12/2022]
Abstract
Uveal melanoma is a rare cancer in adults, but its treatment is one of the clinical unmet needs in the melanoma field. Metastatic disease develops in approximately 50% of patients and is associated with poor survival due to the lack of effective treatment options. It provides a paradigm for cancers that show evidence of aberrant G protein-coupled receptor signaling, tumor dormancy, and liver-selective metastatic tropism and are associated with the loss of the BAP1 tumor suppressor. At the Melanoma Research Foundation CURE OM Science Meeting at the Society for Melanoma Research Meeting held in Utah on November 20, 2019, clinicians and researchers presented findings from their studies according to three themes within uveal melanoma: (i) ongoing clinical trials, (ii) molecular determinants, and (iii) novel targets that could be translated into clinical trials. This meeting underscored the high interest in the uveal melanoma research field and the unmet need for effective treatment strategies for late-stage disease. Findings from ongoing clinical trials are promising, and multiple studies show how novel combinatorial strategies increase response rates. Novel targets and tumor vulnerabilities identified bioinformatically or through high-throughput screens also reveal new opportunities to target uveal melanoma. The future directions pursued by the uveal melanoma research field will likely have an impact on other cancer types that harbor similar genetic alterations and/or show similar biological properties.
Collapse
Affiliation(s)
- Vivian Chua
- Department of Cancer Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jane Mattei
- Department of Melanoma Medical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Anna Han
- Department of Cancer Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | | | | | - Richard D Carvajal
- Division of Hematology/Oncology, Department of Medicine, Columbia University Herbert Irving Comprehensive Cancer Center, New York, New York
| | - Andrew E Aplin
- Department of Cancer Biology, Thomas Jefferson University, Philadelphia, Pennsylvania.,Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
| |
Collapse
|
40
|
Patel SP, Hwu P, Davies M, Wong M, Tawbi H, Amaria R, Diab A, Gombos D, Glitza IC. Abstract A09: Characteristics of uveal melanoma patients with central nervous system metastases. Cancer Res 2020. [DOI: 10.1158/1538-7445.mel2019-a09] [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
In contrast to cutaneous melanoma, central nervous system (CNS) metastasis from uveal melanoma are uncommon, occurring in less than 5% of uveal patients. There is no published literature describing the features or survival of this unique population. Here we describe the clinical characteristics and outcomes of uveal melanoma CNS metastasis patients. We performed an MD Anderson Cancer Center institutional database review from 1999–2017 for consecutive uveal melanoma patients with CNS metastasis. Excluding dural-based metastases, 19 patients were identified. Ethnic makeup was 84% White, 11% Hispanic, 5% other, and median age at diagnosis was 52.4 years. The gender distribution was 12 (63%) female and 7 (37%) male. Primary tumor location in the uveal tract was 26% choroid, 11% iridociliary, 5% chiliochoroidal, and 58% not otherwise specified. Seven of 19 (37%) patients were treated with enucleation; 63% received radiation therapy for primary uveal melanoma. Median interval from diagnosis of uveal melanoma to diagnosis of CNS metastasis was 5 years. Only 7 patients had molecular testing for mutations. Of these, all had G-alpha mutations: 4 (57%) with GNAQ, and 3 (43%) with GNA11 hotspot mutations in Q209. At the time of data cutoff, 14 of 19 (74%) patients were deceased. Additional clinical information regarding treatment for CNS metastasis, histopathologic evaluation, and overall survival will be presented at the meeting.
Citation Format: Sapna P. Patel, Patrick Hwu, Michael Davies, Michael Wong, Hussein Tawbi, Rodabe Amaria, Adi Diab, Dan Gombos, Isabella C. Glitza. Characteristics of uveal melanoma patients with central nervous system metastases [abstract]. In: Proceedings of the AACR Special Conference on Melanoma: From Biology to Target; 2019 Jan 15-18; Houston, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(19 Suppl):Abstract nr A09.
Collapse
Affiliation(s)
- Sapna P. Patel
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Patrick Hwu
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Davies
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Wong
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Hussein Tawbi
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rodabe Amaria
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Adi Diab
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Dan Gombos
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | |
Collapse
|
41
|
Owen CN, Shoushtari AN, Chauhan D, Palmieri DJ, Lee B, Rohaan MW, Mangana J, Atkinson V, Zaman F, Young A, Hoeller C, Hersey P, Dummer R, Khattak MA, Millward M, Patel SP, Haydon A, Johnson DB, Lo S, Blank CU, Sandhu S, Carlino MS, Larkin JMG, Menzies AM, Long GV. Management of early melanoma recurrence despite adjuvant anti-PD-1 antibody therapy ☆. Ann Oncol 2020; 31:1075-1082. [PMID: 32387454 PMCID: PMC9211001 DOI: 10.1016/j.annonc.2020.04.471] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/13/2020] [Accepted: 04/23/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Anti-programmed cell death protein 1 (PD-1) antibodies (PD1) prolong recurrence-free survival in high-risk resected melanoma; however, approximately 25%-30% of patients recur within 1 year. This study describes the pattern of recurrence, management and outcomes of patients who recur with adjuvant PD1 therapy. PATIENTS AND METHODS Consecutive patients from 16 centres who recurred having received adjuvant PD1 therapy for resected stage III/IV melanoma were studied. Recurrence characteristics, management and outcomes were examined; patients with mucosal melanoma were analysed separately. RESULTS Melanoma recurrence occurred in 147 (17%) of ∼850 patients treated with adjuvant PD1. In those with cutaneous melanoma (n = 136), median time to recurrence was 4.6 months (range 0.3-35.7); 104 (76%) recurred during (ON) adjuvant PD1 after a median 3.2 months and 32 (24%) following (OFF) treatment cessation after a median 12.5 months, including in 21 (15%) who ceased early for toxicity. Fifty-nine (43%) recurred with locoregional disease only and 77 (57%) with distant disease. Of those who recurred locally, 22/59 (37%) subsequently recurred distantly. Eighty-nine (65%) patients received systemic therapy after recurrence. Of those who recurred ON adjuvant PD1, none (0/6) responded to PD1 alone; 8/33 assessable patients (24%) responded to ipilimumab (alone or in combination with PD1) and 18/23 (78%) responded to BRAF/MEK inhibitors. Of those who recurred OFF adjuvant PD1, two out of five (40%) responded to PD1 monotherapy, two out of five (40%) responded to ipilimumab-based therapy and 9/10 (90%) responded to BRAF/MEK inhibitors. CONCLUSIONS Most patients who recur early despite adjuvant PD1 develop distant metastases. In those who recur ON adjuvant PD1, there is minimal activity of further PD1 monotherapy, but ipilimumab (alone or in combination with PD1) and BRAF/MEK inhibitors have clinical utility. Retreatment with PD1 may have activity in select patients who recur OFF PD1.
Collapse
Affiliation(s)
- C N Owen
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | | | - D Chauhan
- The Royal Marsden NHS Foundation Trust, London, UK
| | - D J Palmieri
- Westmead Hospital and Blacktown Hospitals, Sydney, Australia
| | - B Lee
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - M W Rohaan
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | - J Mangana
- University Hospital Zurich, Zürich, Switzerland
| | - V Atkinson
- Greenslopes Private Hospital, Princess Alexandra Hospital and The University of Queensland, Brisbane, Australia
| | - F Zaman
- The Alfred Hospital, Melbourne, Australia
| | - A Young
- Vanderbilt University Medical Center, Nashville, USA
| | - C Hoeller
- Medical University of Vienna, Vienna, Austria
| | - P Hersey
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - R Dummer
- University Hospital Zurich, Zürich, Switzerland
| | - M A Khattak
- Fiona Stanley Hospital, The University of Western Australia, Perth, Australia
| | - M Millward
- School of Medicine and Pharmacology, Nedlands, Australia
| | - S P Patel
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Haydon
- The Alfred Hospital, Melbourne, Australia
| | - D B Johnson
- Vanderbilt University Medical Center, Nashville, USA
| | - S Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - C U Blank
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | - S Sandhu
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - M S Carlino
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Westmead Hospital and Blacktown Hospitals, Sydney, Australia
| | - J M G Larkin
- The Royal Marsden NHS Foundation Trust, London, UK
| | - A M Menzies
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Royal North Shore and Mater Hospitals, Sydney, Australia
| | - G V Long
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Royal North Shore and Mater Hospitals, Sydney, Australia.
| |
Collapse
|
42
|
Haydu LE, Lo SN, McQuade JL, Amaria RN, Wargo J, Ross MI, Cormier JN, Lucci A, Lee JE, Ferguson SD, Saw RP, Spillane AJ, Shannon KF, Stretch JR, Hwu P, Patel SP, Diab A, Wong MK, Glitza Oliva IC, Tawbi H, Carlino MS, Menzies AM, Long GV, Lazar AJ, Tetzlaff MT, Scolyer RA, Gershenwald JE, Thompson JF, Davies MA. Cumulative Incidence and Predictors of CNS Metastasis for Patients With American Joint Committee on Cancer 8th Edition Stage III Melanoma. J Clin Oncol 2020; 38:1429-1441. [PMID: 31990608 PMCID: PMC7193747 DOI: 10.1200/jco.19.01508] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2019] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Improved understanding of the incidence, risk factors, and timing of CNS metastasis is needed to inform surveillance strategies for patients with melanoma. PATIENTS AND METHODS Clinical data were extracted from the databases of 2 major melanoma centers in the United States and Australia for 1,918 patients with American Joint Committee on Cancer (AJCC) 8th edition stage III melanoma, diagnosed from 1998-2014, who had (negative) baseline CNS imaging within 4 months of diagnosis. The cumulative incidence of CNS metastasis was calculated in the presence of the competing risk of death, from stage III presentation and at benchmark time points 1, 2, and 5 years postdiagnosis. RESULTS At a median follow-up of 70.2 months, distant recurrence occurred in 711 patients (37.1%). The first site of distant metastasis was CNS only for 3.9% of patients, CNS and extracranial (EC) for 1.8%, and EC only for 31.4%. Overall, 16.7% of patients were diagnosed with CNS metastasis during follow-up. The cumulative incidence of CNS metastasis was 3.6% (95% CI, 2.9% to 4.6%) at 1 year, 9.6% (95% CI, 8.3% to 11.0%) at 2 years, and 15.8% (95% CI, 14.1% to 17.6%) at 5 years. The risk of CNS metastasis was significantly influenced by patient sex, age, AJCC stage, primary tumor site, and primary tumor mitotic rate in multivariable and conditional analyses. High primary tumor mitotic rate was significantly associated with increased risk of CNS metastasis at diagnosis and all subsequent time points examined. CONCLUSION Similar rates of CNS metastasis were observed in 2 large, geographically distinct cohorts of patients with stage III melanoma. The results highlight the importance of primary tumor mitotic rate. Furthermore, they provide a framework for developing evidence-based surveillance strategies and evaluating the impact of contemporary adjuvant therapies on the risk of CNS metastasis development.
Collapse
Affiliation(s)
- Lauren E. Haydu
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Serigne N. Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jennifer L. McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rodabe N. Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jennifer Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Merrick I. Ross
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Janice N. Cormier
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Anthony Lucci
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jeffrey E. Lee
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sherise D. Ferguson
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Robyn P.M. Saw
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Andrew J. Spillane
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Kerwin F. Shannon
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Jonathan R. Stretch
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Patrick Hwu
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sapna P. Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael K.K. Wong
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Isabella C. Glitza Oliva
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Hussein Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Matteo S. Carlino
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Medical Oncology, Westmead and Blacktown Hospitals, Sydney, New South Wales, Australia
| | - Alexander M. Menzies
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Georgina V. Long
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Alexander J. Lazar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Department of Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael T. Tetzlaff
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Department of Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Richard A. Scolyer
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Jeffrey E. Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - John F. Thompson
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Michael A. Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
43
|
Lucci A, Hall CS, Patel SP, Narendran B, Bauldry JB, Royal RE, Karhade M, Upshaw JR, Wargo JA, Glitza IC, Wong MKK, Amaria RN, Tawbi HA, Diab A, Davies MA, Gershenwald JE, Lee JE, Hwu P, Ross MI. Circulating Tumor Cells and Early Relapse in Node-positive Melanoma. Clin Cancer Res 2020; 26:1886-1895. [PMID: 32015020 DOI: 10.1158/1078-0432.ccr-19-2670] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/09/2019] [Accepted: 01/29/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE There is a need for sensitive, reproducible biomarkers for patients with stage III melanoma to guide clinical decision making. Circulating tumor cells (CTCs) can be detected in patients with melanoma; however, there are limited data regarding their significance in stage III disease. The aim of this study was to determine whether CTCs are associated with early relapse in stage III melanoma. EXPERIMENTAL DESIGN We prospectively assessed CTCs at first presentation in clinic (baseline) for 243 patients with stage III melanoma. CTCs were measured using the CellSearch System. Relapse-free survival (RFS) was compared between patients with one or more baseline CTC versus those with no CTCs. Log-rank test and Cox regression analysis were applied to establish associations of CTCs with RFS. RESULTS At least one baseline CTC was identified in 90 of 243 (37%) patients. Forty-five (19%), 67 (28%), 118 (49%), and 13 (5%) patients were stage IIIA, IIIB, IIIC, or IIID, respectively. CTC detection was not associated with substage, or primary tumor characteristics. Multivariable analysis demonstrated that the detection of ≥1 baseline CTC was significantly associated with decreased 6-month RFS [log-rank, P < 0.0001; HR, 3.62, 95% confidence interval (CI), 1.78-7.36; P < 0.0001] and 54-month RFS (log-rank, P = 0.01; HR, 1.69; 95% CI, 1.13-2.54; P = 0.01). CONCLUSIONS ≥1 CTC was independently associated with melanoma relapse, suggesting that CTC assessment may be useful to identify patients at risk for relapse who could derive benefit from adjuvant therapy.
Collapse
Affiliation(s)
- Anthony Lucci
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Carolyn S Hall
- Department of Breast Surgery-Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Boomadevi Narendran
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jessica B Bauldry
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard E Royal
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mandar Karhade
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Joshua R Upshaw
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jennifer A Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Isabella C Glitza
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael K K Wong
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Rodabe N Amaria
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adi Diab
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael A Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey E Lee
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Patrick Hwu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Merrick I Ross
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
44
|
Holbrook K, Lutzky J, Davies MA, Davis JM, Glitza IC, Amaria RN, Diab A, Patel SP, Amin A, Tawbi H. Intracranial antitumor activity with encorafenib plus binimetinib in patients with melanoma brain metastases: A case series. Cancer 2019; 126:523-530. [PMID: 31658370 PMCID: PMC7004095 DOI: 10.1002/cncr.32547] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 12/15/2022]
Abstract
Background Sixty percent of patients with stage IV melanoma may develop brain metastases, which result in significantly increased morbidity and a poor overall prognosis. Phase 3 studies of melanoma usually exclude patients with untreated brain metastases; therefore, clinical data for intracranial responses to treatments are limited. Methods A multicenter, retrospective case series investigation of consecutive BRAF‐mutant patients with melanoma brain metastases (MBMs) treated with a combination of BRAF inhibitor encorafenib and MEK inhibitor binimetinib was conducted to evaluate the antitumor response. Assessments included the intracranial, extracranial, and global objective response rates (according to the modified Response Evaluation Criteria in Solid Tumors, version 1.1); the clinical benefit rate; the time to response; the duration of response; and safety. Results A total of 24 patients with stage IV BRAF‐mutant MBMs treated with encorafenib plus binimetinib in 3 centers in the United States were included. Patients had received a median of 2.5 prior lines of treatment, and 88% had prior treatment with BRAF/MEK inhibitors. The intracranial objective response rate was 33%, and the clinical benefit rate was 63%. The median time to a response was 6 weeks, and the median duration of response was 22 weeks. Among the 21 patients with MBMs and prior BRAF/MEK inhibitor treatment, the intracranial objective response rate was 24%, and the clinical benefit rate was 57%. Similar outcomes were observed for extracranial and global responses. The safety profile for encorafenib plus binimetinib was similar to that observed in patients with melanoma without brain metastases. Conclusions Combination therapy with encorafenib plus binimetinib elicited intracranial activity in patients with BRAF‐mutant MBMs, including patients previously treated with BRAF/MEK inhibitors. Further prospective studies are warranted and ongoing. All clinical trials to date with encorafenib and binimetinib (US Food and Drug Administration–approved in June 2018 for BRAF‐mutated metastatic melanoma) have excluded untreated melanoma brain metastases. This case series provides the first clinical evidence of intracranial activity of the combination of encorafenib plus binimetinib in patients with BRAF‐mutant melanoma with active brain metastases. Intracranial clinical activity is observed for the first time in patients previously treated with BRAF/MEK inhibitors, a population that has not been previously investigated.
Collapse
Affiliation(s)
| | - Jose Lutzky
- Mount Sinai Comprehensive Cancer Center, Miami Beach, Florida
| | - Michael A Davies
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | | | - Rodabe N Amaria
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adi Diab
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sapna P Patel
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Asim Amin
- Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Hussein Tawbi
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
45
|
Lonek L, Puhova A, Griecsova-Kindernay L, Patel SP, Zohdi V, Jezova D, Ravingerova T. Voluntary exercise may activate components of pro-survival risk pathway in the rat heart and potentially modify cell proliferation in the myocardium. Physiol Res 2019; 68:581-588. [PMID: 31177799 DOI: 10.33549/physiolres.934182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Although physical exercise is known to reduce size of infarction, incidence of ventricular arrhythmias, and to improve heart function, molecular mechanisms of this protection are not fully elucidated. We explored the hypothesis that voluntary running, similar to adaptive interventions, such as ischemic or remote preconditioning, may activate components of pro-survival (RISK) pathway and potentially modify cell proliferation. Sprague-Dawley adult male rats freely exercised for 23 days in cages equipped with running wheels, while sedentary controls were housed in standard cages. After 23 days, left ventricular (LV) myocardial tissue samples were collected for the detection of expression and activation of RISK proteins (WB). The day before, a marker of cell proliferation 5-bromo-2'-deoxyuridine (BrdU) was given to all animals to detect its incorporation into DNA of the LV cells (ELISA). Running increased phosphorylation (activation) of Akt, as well as the levels of PKC? and phospho-ERK1/2, whereas BrdU incorporation into DNA was unchanged. In contrast, exercise promoted pro-apoptotic signaling - enhanced Bax/Bcl-2 ratio and activation of GSK-3ß kinase. Results suggest that in the rat myocardium adapted to physical load, natural cardioprotective processes associated with physiological hypertrophy are stimulated, while cell proliferation is not modified. Up-regulation of pro-apoptotic markers indicates potential induction of cell death mechanisms that might lead to maladaptation in the long-term.
Collapse
Affiliation(s)
- L Lonek
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovak Republic.
| | | | | | | | | | | | | |
Collapse
|
46
|
Buchbinder EI, Dutcher JP, Daniels GA, Curti BD, Patel SP, Holtan SG, Miletello GP, Fishman MN, Gonzalez R, Clark JI, Richart JM, Lao CD, Tykodi SS, Silk AW, McDermott DF. Therapy with high-dose Interleukin-2 (HD IL-2) in metastatic melanoma and renal cell carcinoma following PD1 or PDL1 inhibition. J Immunother Cancer 2019; 7:49. [PMID: 30777131 PMCID: PMC6380045 DOI: 10.1186/s40425-019-0522-3] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [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: 10/31/2018] [Accepted: 01/31/2019] [Indexed: 01/04/2023] Open
Abstract
Background Metastatic melanoma (mM) and renal cell carcinoma (mRCC) are often treated with anti-PD-1 based therapy, however not all patients respond and further therapies are needed. High dose interleukin-2 (HD IL-2) can lead to durable responses in a subset of mM and mRCC patients. The efficacy and toxicity of HD IL-2 therapy following anti-PD-1 or anti-PD-L1 therapy have not yet been explored. Methods Reports on mM and mRCC patients who had received HD IL-2 after PD-1 or PD-L1 inhibition were queried from the PROCLAIMSM database. Patient characteristics, toxicity and efficacy were analyzed. Results A total of 57 patients (40 mM, 17 mRCC) were treated with high dose IL-2 after PD-1 or PD-L1 inhibition and had data recorded in the PROCLAIM database. The best overall response rate to HD IL-2 was 22.5% for mM (4 complete response (CR), 5 partial responses (PRs)) and 24% for mRCC (2 CRs, 2 PRs). The toxicity related to HD IL-2 observed in these patients was similar to that observed in patients treated with HD IL-2 without prior checkpoint blockade. One patient who had received prior PD-L1 blockade developed drug induced pneumonitis with HD IL-2 requiring steroid therapy. Conclusion In this retrospective analysis, HD IL-2 therapy displayed durable antitumor activity in mM and mRCC patients who progressed following treatment with PD-1 and PD-L1 inhibition. The toxicities were generally manageable and consistent with expectations from HD IL-2 but physicians should watch for immune related toxicities such as pneumonitis. This analysis supports the development of randomized prospective trials to assess the proper sequencing and combination of immune checkpoint blockade and cytokine therapy. Electronic supplementary material The online version of this article (10.1186/s40425-019-0522-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | | | | | | | - Sapna P Patel
- The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | | | | | | | | | - Joseph I Clark
- Loyola University Stritch School of Medicine, Maywood, IL, USA
| | | | | | - Scott S Tykodi
- University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ann W Silk
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | |
Collapse
|
47
|
Bhatty M, Kato S, Piha-Paul SA, Naing A, Subbiah V, Huang HJ, Karp DD, Tsimberidou AM, Zinner RG, Hwu WJ, Javle M, Patel SP, Hu MI, Varadhachary GR, Conley AP, Ramzanali NM, Holley VR, Kurzrock R, Meric-Bernstam F, Chae YK, Kim KB, Falchook GS, Janku F. Phase 1 study of the combination of vemurafenib, carboplatin, and paclitaxel in patients with BRAF-mutated melanoma and other advanced malignancies. Cancer 2019; 125:463-472. [PMID: 30383888 PMCID: PMC6340722 DOI: 10.1002/cncr.31812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/22/2018] [Accepted: 08/28/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND BRAF inhibitors are effective against selected BRAFV600 -mutated tumors. Preclinical data suggest that BRAF inhibition in conjunction with chemotherapy has increased therapeutic activity. METHODS Patients with advanced cancers and BRAF mutations were enrolled into a dose-escalation study (3+3 design) to determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs). RESULTS Nineteen patients with advanced cancers and BRAF mutations were enrolled and received vemurafenib (480-720 mg orally twice a day), carboplatin (area under the curve [AUC] 5-6 intravenously every 3 weeks), and paclitaxel (100-135 mg/m2 intravenously every 3 weeks). The MTD was not reached, and vemurafenib at 720 mg twice a day, carboplatin at AUC 5, and paclitaxel at 135 mg/m2 were the last safe dose levels. DLTs included a persistent grade 2 creatinine elevation (n = 1), grade 3 transaminitis (n = 1), and grade 4 thrombocytopenia (n = 1). Non-dose-limiting toxicities that were grade 3 or higher and occurred in more than 2 patients included grade 3/4 neutropenia (n = 5), grade 3/4 thrombocytopenia (n = 5), grade 3 fatigue (n = 4), and grade 3 anemia (n = 3). Of the 19 patients, 5 (26%; all with melanoma) had a partial response (PR; n = 4) or complete response (CR; n = 1); these responses were mostly durable and lasted 3.1 to 54.1 months. Of the 13 patients previously treated with BRAF and/or mitogen-activated protein kinase kinase (MEK) inhibitors, 4 (31%) had a CR (n = 1) or PR (n = 3). Patients not treated with prior platinum therapy had a higher response rate than those who did (45% vs 0%; P = .045). CONCLUSIONS The combination of vemurafenib, carboplatin, and paclitaxel is well tolerated and demonstrates encouraging activity, predominantly in patients with advanced melanoma and BRAFV600 mutations, regardless of prior treatment with BRAF and/or MEK inhibitors.
Collapse
Affiliation(s)
- Minny Bhatty
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shumei Kato
- Division of Hematology & Oncology and Center for Personalized Cancer Therapy, University of California San Diego Moores Cancer Center, San Diego, California
| | - Sarina A. Piha-Paul
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Aung Naing
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Vivek Subbiah
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Helen J. Huang
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Daniel D. Karp
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Apostolia M. Tsimberidou
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Wen-Jen Hwu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Milind Javle
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sapna P. Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mimi I. Hu
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gauri R. Varadhachary
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Anthony P. Conley
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Nishma M. Ramzanali
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Veronica R. Holley
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Razelle Kurzrock
- Division of Hematology & Oncology and Center for Personalized Cancer Therapy, University of California San Diego Moores Cancer Center, San Diego, California
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Young Kwang Chae
- Developmental Therapeutics Lurie Cancer Center and Division of Hematology Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kevin B. Kim
- California Pacific Medical Center Research Institute, San Francisco, California
| | | | - Filip Janku
- Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program), Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
48
|
Curry JL, Tetzlaff MT, Wang SA, Landon G, Alouch N, Patel SP, Nagarajan P, Gupta S, Aung PP, Devine CE, Khoury JD, Loghavi S, Prieto VG, DiNardo CD, Gershenwald JE. Case Report of Myeloid Sarcoma Masquerading as In-Transit Metastasis at a Previous Melanoma Site: Avoiding a Diagnostic Pitfall. Am J Dermatopathol 2018; 40:831-835. [PMID: 29863571 DOI: 10.1097/dad.0000000000001150] [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] [Indexed: 02/03/2023]
Abstract
Myeloid sarcoma is a rare extramedullary hematologic malignancy. Accurate and timely diagnosis may be challenging because myeloid sarcoma is known to mimic solid tumors, including hepatobiliary, nasopharyngeal, and breast carcinomas. We report a case of myeloid sarcoma that developed in the primary tumor lymphatic drainage field of a previously treated intermediate-thickness cutaneous melanoma, clinically and radiographically mimicking an in-transit metastasis, in a patient with myelodysplastic syndrome. The diagnosis of myeloid sarcoma was achieved after surgical excision of the mass and pathological examination that included extensive immunohistochemical studies. Awareness of such an unusual clinical presentation can help reduce diagnostic delay and ensure that adequate tissue is obtained for pathological examination and ancillary studies that are critical for accurate diagnosis and appropriate patient management.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jeffrey E Gershenwald
- Surgical Oncology, and
- Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
49
|
Amaria RN, Reddy SM, Tawbi HA, Davies MA, Ross MI, Glitza IC, Cormier JN, Lewis C, Hwu WJ, Hanna E, Diab A, Wong MK, Royal R, Gross N, Weber R, Lai SY, Ehlers R, Blando J, Milton DR, Woodman S, Kageyama R, Wells DK, Hwu P, Patel SP, Lucci A, Hessel A, Lee JE, Gershenwald J, Simpson L, Burton EM, Posada L, Haydu L, Wang L, Zhang S, Lazar AJ, Hudgens CW, Gopalakrishnan V, Reuben A, Andrews MC, Spencer CN, Prieto V, Sharma P, Allison J, Tetzlaff MT, Wargo JA. Neoadjuvant immune checkpoint blockade in high-risk resectable melanoma. Nat Med 2018; 24:1649-1654. [PMID: 30297909 PMCID: PMC6481682 DOI: 10.1038/s41591-018-0197-1] [Citation(s) in RCA: 520] [Impact Index Per Article: 86.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/21/2018] [Indexed: 12/17/2022]
Abstract
Preclinical studies suggest that treatment with neoadjuvant immune checkpoint blockade is associated with enhanced survival and antigen-specific T cell responses compared with adjuvant treatment1; however, optimal regimens have not been defined. Here we report results from a randomized phase 2 study of neoadjuvant nivolumab versus combined ipilimumab with nivolumab in 23 patients with high-risk resectable melanoma ( NCT02519322 ). RECIST overall response rates (ORR), pathologic complete response rates (pCR), treatment-related adverse events (trAEs) and immune correlates of response were assessed. Treatment with combined ipilimumab and nivolumab yielded high response rates (RECIST ORR 73%, pCR 45%) but substantial toxicity (73% grade 3 trAEs), whereas treatment with nivolumab monotherapy yielded modest responses (ORR 25%, pCR 25%) and low toxicity (8% grade 3 trAEs). Immune correlates of response were identified, demonstrating higher lymphoid infiltrates in responders to both therapies and a more clonal and diverse T cell infiltrate in responders to nivolumab monotherapy. These results describe the feasibility of neoadjuvant immune checkpoint blockade in melanoma and emphasize the need for additional studies to optimize treatment regimens and to validate putative biomarkers.
Collapse
Affiliation(s)
- Rodabe N Amaria
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Sangeetha M Reddy
- Department of Breast Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Michael A Davies
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Merrick I Ross
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Isabella C Glitza
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Janice N Cormier
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Carol Lewis
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA
| | - Wen-Jen Hwu
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Ehab Hanna
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA
| | - Adi Diab
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Michael K Wong
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Richard Royal
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Neil Gross
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA
| | - Randal Weber
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen Y Lai
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA
| | - Richard Ehlers
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Jorge Blando
- Department of Immunology, MD Anderson Cancer Center, Houston, TX, USA
| | - Denái R Milton
- Department of Biostatistics, MD Anderson Cancer Center, Houston, TX, USA
| | - Scott Woodman
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Robin Kageyama
- Parker Institute for Cancer Immunotherapy, San Francisco, CA, USA
| | - Daniel K Wells
- Parker Institute for Cancer Immunotherapy, San Francisco, CA, USA
| | - Patrick Hwu
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Anthony Lucci
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Amy Hessel
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey E Lee
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey Gershenwald
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Lauren Simpson
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Elizabeth M Burton
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Liberty Posada
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Lauren Haydu
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Linghua Wang
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA
| | - Shaojun Zhang
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA
| | - Alexander J Lazar
- Department of Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | | | | | - Alexandre Reuben
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Miles C Andrews
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Victor Prieto
- Department of Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | - Padmanee Sharma
- Department of Immunology, MD Anderson Cancer Center, Houston, TX, USA.,Department of Genitourinary Cancers, MD Anderson Cancer Center, Houston, TX, USA
| | - James Allison
- Department of Immunology, MD Anderson Cancer Center, Houston, TX, USA
| | - Michael T Tetzlaff
- Department of Pathology, MD Anderson Cancer Center, Houston, TX, USA.,Department of Translational and Molecular Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer A Wargo
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA. .,Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA.
| |
Collapse
|
50
|
Amaria RN, Trinh VA, Gu J, McIntyre S, Cabala CT, Simien R, Diab A, Tawbi HA, Davies MA, Wong MK, Hwu P, Glitza IC, Patel SP, Hwu WJ. Abstract 3640: Treatment strategies using anti-PD1/PD-L1 (anti-PD) and BRAF/MEK inhibitor (BRAFi) therapy: a retrospective study comparing sequential vs. concurrent administration in BRAF-mutated metastatic melanoma (BMMM). Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-3640] [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: It is unclear whether anti-PD and BRAFi therapy should be administered sequentially or concurrently in patients (pts) with BMMM, although clinical trials using varying strategies are ongoing. We performed a retrospective, single-center analysis of BMMM pts who received anti-PD therapy either sequentially or concurrent with BRAFi therapy. Methods: A total of 457 metastatic melanoma pts (excluding uveal) were treated with anti-PD therapy at MD Anderson Cancer Center from 11/2009-12/2015. Of those, 148 pts had BMMM and were categorized into 4 treatment groups: BRAFi-naïve treated with anti-PD alone (group 1) N=39 (26%); BRAFi-naive treated with combination therapy (group 2) N=30 (20%); BRAFi-refractory treated with anti-PD alone (group 3) N=45 (31%); and BRAFi-refractory treated with combination therapy (group 4) N=34 (23%). Clinical outcomes were analyzed and tabulated for each group. Pretreatment tissue samples were obtained for correlative biomarker immunohistochemistry (IHC) analyses. Results: BMMM pts with elevated LDH are more likely to receive upfront combination therapy. BRAFi-refractory pts have a higher incidence of brain metastases than BRAFi-naïve pts. The clinical outcomes of overall responses, median PFS and OS are provided in the table. Preliminary biomarker IHC analyses in 11 pts showed PD-L1 expression on the tumor cells correlated with median PFS and OS : 15 mo and 22 mo, respectively in 7 pts with PD-L1 >1%, vs. 6.5 mo and 12 mo in 4 pts with PD-L1 <1%. Conclusions: Single-agent anti-PD therapy is an effective strategy in BMMM pts who are either BRAFi-naïve or refractory. Combination therapy of anti-PD and BRAFi in either BRAFi-naïve or refractory BMMM did not appear to improve clinical outcomes. Confirmation data are needed from ongoing prospective randomized clinical trials.
GroupLDH > upper limit normal (%)Prior CNS metastases (%)Prior anti CLTA-4 exposure (%)Number of anti PD-1 doses (#)Overall Responses CRs + PRs (%)Median PFS (mo)Median OS (mo)Group 1 BRAFi-naïve; anti-PD alone23.72317.912.530.8 + 25.6= 56.41021Group 2 BRAFi-naïve; combination37.9206.710.523.3 + 43.3 = 66.6 812.5Group 3 BRAFi- refractory; anti-PD alone254073.31637.8 + 17.8= 55.6925Group 4 BRAFi- refractory; combination17.644.172.711.529.4 + 5.9 = 35.3519
Citation Format: Rodabe N. Amaria, Van A. Trinh, Jun Gu, Susan McIntyre, Carlos Torres Cabala, Rinata Simien, Adi Diab, Hussein A. Tawbi, Michael A. Davies, Michael K. Wong, Patrick Hwu, Isabella C. Glitza, Sapna P. Patel, Wen Jen Hwu. Treatment strategies using anti-PD1/PD-L1 (anti-PD) and BRAF/MEK inhibitor (BRAFi) therapy: a retrospective study comparing sequential vs. concurrent administration in BRAF-mutated metastatic melanoma (BMMM) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3640.
Collapse
Affiliation(s)
| | | | - Jun Gu
- MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Adi Diab
- MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | | | |
Collapse
|