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Abraham G, Noronha V, Rajappa S, Agarwal A, Batra U, Somani N, Raja T, Patil S, Kaushal AM, Joshi A, Radhakrishnan V, Singh N, Babu G, Tewani R, Baghmar S, Dodagoudar C, Ananthakrishnan R, Haragadde Poppareddy S, Sharma V, Menon N, M Patil V, Joshi A, Gupta S, Prabhash K, Bajpai J. The clinical utility and safety of short-course immune checkpoint inhibitors in multiple tumours-A real-world multicentric study from India. Int J Cancer 2021; 150:1045-1052. [PMID: 34751432 DOI: 10.1002/ijc.33868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/14/2021] [Accepted: 09/09/2021] [Indexed: 11/10/2022]
Abstract
The real-world data on short course of immune checkpoint inhibitor (ICI) use are sparse and merit exploration. A multicentric observational study on the safety and efficacy of ICI in oncology patients between August 2014 and October 2020 involves 1011 patients across 13 centers in India. The median age was 59 (min 16-max 98) years with male preponderance (77.9%). The predominant cohort received short-course ICI therapy; the median number of cycles was 5 (95% confidence interval [CI] 1-27), and the median duration of therapy was 3 (95% CI 0.5-13) months. ICIs were used commonly in the second and third line setting in our study (66.4%, n = 671). Objective response rate (complete or partial response) was documented in 254 (25.1%) of the patients, 202 (20.0%) had stable disease, and 374 (37.0%) had progressive disease. The clinical benefit rate was present in 456 (45.1%). Among the patients whom ICI was stopped (n = 906), the most common reason for cessation of ICI was disease progression (616, 68.0%) followed by logistic reasons like financial constraints (234, 25.82%). With a median follow-up of 14.1 (95% CI 12.9-15.3) months, there were 616 events of progression and 443 events of death, and the median progression free survival and overall survival were 6.4 (95% CI 5.5-7.3) and 13.6 (95% CI 11.6-15.7) months, respectively, in the overall cohort. Among the immune-related adverse events, autoimmune pneumonitis (29, 3.8%) and thyroiditis (24, 2.4%) were common. Real-world multicentric Indian data predominantly with short-course ICI therapy have comparable efficacy/safety to international literature with standard ICI therapy.
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Affiliation(s)
- George Abraham
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Senthil Rajappa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Amit Agarwal
- Department of Medical Oncology, BLK Superspeciality Hospital, Delhi, India
| | - Ullas Batra
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Naresh Somani
- Department of Medical Oncology, HCG Cancer Centre, Jaipur, India
| | | | - Shekhar Patil
- Department of Medical Oncology, HCG Cancer Centre, Bengaluru, India
| | - Ashish M Kaushal
- Department of Medical Oncology, HCG Cancer Centre, Ahmedabad, India
| | - Ashish Joshi
- Department of Medical Oncology, Mumbai Oncocare Centre, Mumbai, India
| | | | - Navneet Singh
- Department of Medical Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Govind Babu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, India
| | - Rohan Tewani
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - Saphalta Baghmar
- Department of Medical Oncology, BLK Superspeciality Hospital, Delhi, India
| | | | | | | | - Vibhor Sharma
- Department of Medical Oncology, Paras Hospitals, Gurgaon, India
| | - Nandini Menon
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Vijay M Patil
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - Jyoti Bajpai
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
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Ghosh M, Naik R, Lingaraju SM, Susheela SP, Patil S, Srinivasachar GK, Thungappa SC, Murugan K, Jayappa SB, Bhattacharjee S, Rao N, Bandimegal M, Krishnappa R, Poppareddy SH, Raghavendrachar KC, Shivakumar Y, Nagesh S, Kodandapani R, Rajan A, Bahadur U, Agrawal P, Ramaswamy V, Nanjaiah TB, Kunigal S, Katragadda S, Manjunath A, Ram A, Ajaikumar BS. Landscape of clinically actionable mutations in breast cancer 'A cohort study'. Transl Oncol 2021; 14:100877. [PMID: 33099186 PMCID: PMC7581976 DOI: 10.1016/j.tranon.2020.100877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 01/16/2023] Open
Abstract
Breast cancer (BC) is a heterogeneous disease. Numerous chemotherapeutic agents are available for early stage or advanced/metastatic breast cancer to provide maximum benefit with minimum side effects. However, the clinical outcome of patients with the same clinical and pathological characteristics and treated with similar treatments may show major differences and a vast majority of patients still develop treatment resistance and eventually succumb to disease. It remains an unmet need to identify specific molecular defects, new biomarkers to enable clinicians to adopt individualized treatment for every patient in terms of endocrine, chemotherapy or targeted therapy which will improve clinical outcomes in BC. Our study aimed to identify frequent hotspot mutation profile in BC by targeted deep sequencing in cancer-related genes using Illumina Truseq amplicon/Swift Accel-Amplicon panel and MiSeq technology in an IRB-approved prospective study in a CLIA compliant laboratory. All the cases had pathology review for stage, histological type, hormonal status and Ki-67. Data was processed using Strand NGS™. Mutations identified in the tumor were assessed for 'actionability' i.e. response to therapy and impact on prognosis.
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Affiliation(s)
| | - Radheshyam Naik
- HealthCare Global Enterprises Limited, Bangalore, Karnataka 560027, India
| | | | | | - Shekar Patil
- HealthCare Global Enterprises Limited, Bangalore, Karnataka 560027, India
| | | | | | - Krithika Murugan
- HealthCare Global Enterprises Limited, Bangalore, Karnataka 560027, India
| | | | | | - Nalini Rao
- HealthCare Global Enterprises Limited, Bangalore, Karnataka 560027, India
| | - Mahesh Bandimegal
- HealthCare Global Enterprises Limited, Bangalore, Karnataka 560027, India
| | - Roopesh Krishnappa
- HealthCare Global Enterprises Limited, Bangalore, Karnataka 560027, India
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Amritanshu Ram
- HealthCare Global Enterprises Limited, Bangalore, Karnataka 560027, India
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