26
|
Driessen C, Kraus M, Joerger M, Rosing H, Bader J, Hitz F, Berset C, Xyrafas A, Hawle H, Berthod G, Overkleeft HS, Sessa C, Huitema A, Pabst T, von Moos R, Hess D, Mey UJM. Treatment with the HIV protease inhibitor nelfinavir triggers the unfolded protein response and may overcome proteasome inhibitor resistance of multiple myeloma in combination with bortezomib: a phase I trial (SAKK 65/08). Haematologica 2015; 101:346-55. [PMID: 26659919 DOI: 10.3324/haematol.2015.135780] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/04/2015] [Indexed: 12/29/2022] Open
Abstract
Downregulation of the unfolded protein response mediates proteasome inhibitor resistance in multiple myeloma. The Human Immunodeficieny Virus protease inhibitor nelfinavir activates the unfolded protein response in vitro. We determined dose-limiting toxicity and recommended dose for phase II of nelfinavir in combination with the proteasome inhibitor bortezomib. Twelve patients with advanced hematologic malignancies were treated with nelfinavir (2500-5000 mg/day p.o., days 1-14, 3+3 dose escalation) and bortezomib (1.3 mg/m(2), days 1, 4, 8, 11; 21-day cycles). A run in phase with nelfinavir monotherapy allowed pharmakokinetic/pharmakodynamic assessment of nelfinavir in the presence or absence of concomittant bortezomib. End points included dose-limiting toxicity, activation of the unfolded protein response, proteasome activity, toxicity and response to trial treatment. Nelfinavir 2×2500 mg was the recommended phase II dose identified. Nelfinavir alone significantly up-regulated expression of proteins related to the unfolded protein response in peripheral blood mononuclear cells and inhibited proteasome activity. Of 10 evaluable patients in the dose escalation cohort, 3 achieved a partial response, 4 stable disease for 2 cycles or more, while 3 had progressive disease as best response. In an exploratory extension cohort with 6 relapsed, bortezomib-refractory, lenalidomide-resistant myeloma patients treated at the recommended phase II dose, 3 reached a partial response, 2 a minor response, and one progressive disease. The combination of nelfinavir with bortezomib is safe and shows promising activity in advanced, bortezomib-refractory multiple myeloma. Induction of the unfolded protein response by nelfinavir may overcome the biological features of proteasome inhibitor resistance. (clinicaltrials.gov identifier: 01164709).
Collapse
|
27
|
Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J, Marth C, Nout R, Querleu D, Mirza MR, Sessa C, Altundag O, Amant F, van Leeuwenhoek A, Banerjee S, Bosse T, Casado A, de Agustín L, Cibula D, Colombo N, Creutzberg C, del Campo JM, Emons G, Goffin F, González-Martín A, Greggi S, Haie-Meder C, Katsaros D, Kesic V, Kurzeder C, Lax S, Lécuru F, Ledermann J, Levy T, Lorusso D, Mäenpää J, Marth C, Matias-Guiu X, Morice P, Nijman H, Nout R, Powell M, Querleu D, Mirza M, Reed N, Rodolakis A, Salvesen H, Sehouli J, Sessa C, Taylor A, Westermann A, Zeimet A. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up. Ann Oncol 2015; 27:16-41. [PMID: 26634381 DOI: 10.1093/annonc/mdv484] [Citation(s) in RCA: 685] [Impact Index Per Article: 76.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/05/2015] [Indexed: 12/27/2022] Open
Abstract
The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically relevant questions about endometrial cancer relating to the following four areas: prevention and screening, surgery, adjuvant treatment and advanced and recurrent disease. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. Results of this consensus conference, together with a summary of evidence supporting each recommendation, are detailed in this article. All participants have approved this final article.
Collapse
|
28
|
Pentheroudakis G, Cardoso F, Arnold D, Sessa C, Peters S, Horwich A, Pavlidis N, Stahel R, Cervantes A. The ESMO guideline strategy: an identity statement and reflections on improvement. Ann Oncol 2015; 26 Suppl 5:v1-7. [PMID: 26314771 DOI: 10.1093/annonc/mdv299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Guidelines should provide recommendations on the optimal management of a patient in specific clinical circumstances based on the scientific evidence. ESMO, as Europe's leading society in medical oncology produces a range of guideline products in order to assist the cancer specialist towards implementation of quality cancer care, as well as in order to provide information to patients establishing standards for up-to-date optimal management. The ESMO 'guideline products' include the Clinical Practice Guidelines, the complementing Consensus Conferences on focused clinical scenarios, as well as memory tools such as print and e-Pocket Guidelines and Patient Guides. In this manuscript, methodology, design and characteristics of the ESMO guideline products are explained and discussed by their strengths and weaknesses, opportunities and threats in order to stimulate reflections on room for improvement and future strategy.
Collapse
|
29
|
Forster M, Sessa C, Von Moos R, Brown N, Metaxas Y, Griguolo G, Lardelli P, Coronado C, Juan L, Fernandez-Teruel C, Soto-Matos A, Stathis A. 316 Phase I study of lurbinectedin (PM01183) in combination with cisplatin (C) with or without aprepitant (Ap) in patients (pts) with advanced solid tumors. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30181-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
30
|
Garralda E, Stathis A, Drilon A, Boni V, Hyman D, Calvo E, Griguolo G, Makker V, Doger B, Canziani L, Varghese A, Jimenez E, Luque J, Soto-Matos A, Szyldergemajn S, Sessa C. 335 Lurbinectedin (PM01183) in combination with paclitaxel (P) in patients (pts) with advanced solid tumors. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
31
|
Joerger M, Hess D, Delmonte A, Gallerani E, Fasolo A, Gianni L, Cresta S, Barbieri P, Pace S, Sessa C. Integrative population pharmacokinetic and pharmacodynamic dose finding approach of the new camptothecin compound namitecan (ST1968). Br J Clin Pharmacol 2015; 80:128-38. [PMID: 25580946 DOI: 10.1111/bcp.12583] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 12/08/2014] [Accepted: 12/31/2014] [Indexed: 11/30/2022] Open
Abstract
AIMS Namitecan is a new camptothecan compound undergoing early clinical development. This study was initiated to build an integrated pharmacokinetic (PK) and pharmacodynamic (PD) population model of namitecan to guide future clinical development. METHODS Plasma concentration-time data, neutrophils and thrombocytes were pooled from two phase 1 studies in 90 patients with advanced solid tumours, receiving namitecan as a 2 h infusion on days 1 and 8 every 3 weeks (D1,8) (n = 34), once every 3 weeks (D1) (n = 29) and on 3 consecutive days (D1-3) (n = 27). A linear three compartment PK model was coupled to a semiphysiological PD-model for neutrophils and thrombocytes. Data simulations were used to interrogate various dosing regimens and give dosing recommendations. RESULTS Clearance was estimated to be 0.15 l h(-1), with a long terminal half-life of 48 h. Body surface area was not associated with clearance, supporting flat-dosing of namitecan. A significant and clinically relevant association was found between namitecan area under the concentration-time curve (AUC) and the percentage drop of neutrophils (r(2) = 0.51, P < 10(-4)) or thrombocytes (r(2) = 0.49, P < 10(-4)). With a target for haematological dose-limiting toxicity of <20%, the recommended dose was defined as 12.5 mg for the D1,8 regimen, 23 mg for the once every 3 week regimen and 7 mg for the D1-3 regimen. CONCLUSION This is the first integrated population PK-PD analysis of the new hydrophilic topoisomerase I inhibitor namitecan, that is currently undergoing early clinical development. A distinct relationship was found between drug exposure and haematological toxicity, supporting flat-dosing once every 3 weeks as the most adequate dosing regimen.
Collapse
|
32
|
Proebstle TM, Alm BJ, Göckeritz O, Wenzel C, Noppeney T, Lebard C, Sessa C, Creton D, Pichot O. Five-year results from the prospective European multicentre cohort study on radiofrequency segmental thermal ablation for incompetent great saphenous veins. Br J Surg 2015; 102:212-8. [PMID: 25627262 PMCID: PMC4328454 DOI: 10.1002/bjs.9679] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 06/25/2014] [Accepted: 09/19/2014] [Indexed: 12/18/2022]
Abstract
Background This was a prospective study of radiofrequency segmental thermal ablation (RFA) for the treatment of incompetent varicose great saphenous veins (GSVs). The present report describes long-term follow-up at 5 years. Methods The 5-year follow-up of this multicentre European study included assessment of the Venous Clinical Severity Score (VCSS), and GSV occlusion and reflux on duplex imaging. Results A total of 225 patients had 295 GSVs treated by RFA, achieving an initial vein occlusion rate of 100 per cent. With 80·0 per cent compliance, Kaplan–Meier analyses showed a GSV occlusion rate of 91·9 per cent and a reflux-free rate of 94·9 per cent at 5 years. Among the 15 GSVs noted with reflux during follow-up, only three showed full recanalization of the GSV at 1 week, 6 months and 3 years. Of the 12 legs with partial recanalization, reflux originated at the saphenofemoral junction in ten, with a mean length of the patent segment of 5·8 (range 3·2–10) cm; only six patients were symptomatic. Mean(s.d.) VCSS scores improved from 3·9(2·1) at baseline to 0·6(1·2), 0·9(1·3) and 1·3(1·7) at 1, 3 and 5 years. Conclusion At 5 years RFA proved to be an efficient endovenous treatment for incompetent GSVs in terms of sustained clinical and anatomical success for the vast majority of treated patients.
Collapse
|
33
|
Reni M, Belli C, Balzano G, Cereda S, Nicoletti R, Pepe G, Sessa C, Cappio S, Doglioni C, Palazzo V, Ceraulo D, Gianni L. Phase Ib Trial of Nab-Paclitaxel Plus Gemcitabine, Capecitabine, and Cisplatin (Paxg Regimen) in Patients with Stage III Pancreatic Adenocarcinoma. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
34
|
Colombo N, Preti E, Landoni F, Carinelli S, Colombo A, Marini C, Sessa C. Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2014; 24 Suppl 6:vi33-8. [PMID: 24078661 DOI: 10.1093/annonc/mdt353] [Citation(s) in RCA: 377] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
|
35
|
Rosset E, Ben Ahmed S, Galvaing G, Favre J, Sessa C, Lermusiaux P, Hassen-Khodja R, Coggia M, Haulon S, Rinckenbach S, Enon B, Feugier P, Steinmetz E, Becquemin J. Hybrid Treatment of Thoracic, Thoracoabdominal, and Abdominal Aortic Aneurysms: A Multicenter Retrospective Study. J Vasc Surg 2014. [DOI: 10.1016/j.jvs.2014.03.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
36
|
Rosset E, Ben Ahmed S, Galvaing G, Favre JP, Sessa C, Lermusiaux P, Hassen-Khodja R, Coggia M, Haulon S, Rinckenbach S, Enon B, Feugier P, Steinmetz E, Becquemin JP. Editor's choice--hybrid treatment of thoracic, thoracoabdominal, and abdominal aortic aneurysms: a multicenter retrospective study. Eur J Vasc Endovasc Surg 2014; 47:470-8. [PMID: 24656593 DOI: 10.1016/j.ejvs.2014.02.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The aim of this study was to assess the results of hybrid techniques for the treatment of thoracic, thoracoabdominal, and abdominal aortic aneurysms based on multicenter results and the various series regarding hybrid procedures reported in the literature. METHODS The results of 76 hybrid procedures performed in 19 French university hospital centers between November 2001 and October 2011 were collected. There were 50 men and 26 women, mean age 68.2 (35-86) years. All patients were considered at high risk (ASA≥3) for conventional surgery. Aneurysms involved the thoracic, abdominal, and thoracoabdominal aorta in five, 14, and 57 cases respectively. There were 11 emergent repairs. The revascularization of four visceral arteries was performed in 38 cases. Between one and three visceral arteries were revascularized in the other cases. Visceral artery debranching and stent graft deployment were performed in a one-stage procedure in 53 cases and in a two-stage procedure in 23 cases. RESULTS There were 26 (34.2%) postoperative deaths. Nine of the survivors developed paraplegia, of which one resolved completely. Bowel ischemia occurred in 13 cases (17.1%), and one patient was treated by a superior mesenteric artery bypass. Four patients required long-term hemodialysis. Postoperative computed tomography scan showed a type II endoleak in two patients. CONCLUSIONS Morbidity and mortality in this study were greater than previously reported. Candidates for hybrid aortic repair should be carefully selected.
Collapse
|
37
|
Fatuzzo PM, Sessa C, Patanè G, Reina A, Ventura V, Santangelo P, Marchese R, Aliotta R, Rapisarda F, Zanoli L, Castellino P. [Nephrological paradox]. GIORNALE ITALIANO DI NEFROLOGIA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI NEFROLOGIA 2014; 31:gin/00105.12. [PMID: 24777925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Patients that are followed by nephrologists from the beginning of the illness, they show a deceleration in the progression of the Chronic Kidney Disease towards dialysis and a better quality of life (less osteodystrophy, anaemia and fluids overload, better pressure management). However, in 2013 it still exists a great lack of knowledge about the professional figure of nephrologist. Residents of Nephrological School of Catania decided to conduct a survey to evaluate common knowledge of renal diseases and their treatments. The survey was conducted in two cities of Sicily. The results show that people are generally uninformed and disoriented about renal illness and their risks.
Collapse
|
38
|
Popescu R, Schäfer R, Califano R, Eckert R, Coleman R, Douillard JY, Cervantes A, Casali P, Sessa C, Van Cutsem E, de Vries E, Pavlidis N, Fumasoli K, Wörmann B, Samonigg H, Cascinu S, Cruz Hernández J, Howard A, Ciardiello F, Stahel R, Piccart M. The current and future role of the medical oncologist in the professional care for cancer patients: a position paper by the European Society for Medical Oncology (ESMO). Ann Oncol 2014; 25:9-15. [DOI: 10.1093/annonc/mdt522] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
39
|
Britten C, Wainberg Z, Tabernero J, Maqueda M, Leong S, Sessa C, Millham R, Hirohashi T, Siu L, Brana I. PH 1 Study of PI3KMTOR Inhibitors PF-04691502 or PF-05212384 + MEK Inhibitor PD-0325901 or Irinotecan in Advanced Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt459.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
40
|
Ledermann J, Raja F, Fotopoulou C, Gonzalez-Martin A, Colombo N, Sessa C. Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24 Suppl 6:vi24-32. [DOI: 10.1093/annonc/mdt333] [Citation(s) in RCA: 531] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
41
|
Seckl MJ, Sebire NJ, Fisher RA, Golfier F, Massuger L, Sessa C. Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24 Suppl 6:vi39-50. [PMID: 23999759 DOI: 10.1093/annonc/mdt345] [Citation(s) in RCA: 206] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
|
42
|
Chen DS, Feltquate DM, Smothers F, Hoos A, Langermann S, Marshall S, May R, Fleming M, Hodi FS, Senderowicz A, Wiman KG, de Dosso S, Fiedler W, Gianni L, Cresta S, Schulze-Bergkamen HB, Gurrieri L, Salzberg M, Dietrich B, Danielczyk A, Baumeister H, Goletz S, Sessa C, Strumberg D, Schultheis B, Santel A, Gebhardt F, Meyer-Sabellek W, Keil O, Giese K, Kaufmann J, Maio M, Choy G, Covre A, Parisi G, Nicolay H, Fratta E, Fonsatti E, Sigalotti L, Coral S, Taverna P, Azab M, Deutsch E, Lepechoux C, Pignon JP, Tao YT, Rivera S, Bourgier BC, Angokai M, Bahleda R, Slimane K, Angevin E, Besse BB, Soria JC, Dragnev K, Beumer JH, Anyang B, Ma T, Galimberti F, Erkmen CP, Nugent W, Rigas J, Abraham K, Johnstone D, Memoli V, Dmitrovsky E, Voest EE, Siu L, Janku F, Soria JC, Tsimberidou A, Kurzrock R, Tabernero J, Rodon J, Berger R, Onn A, Batist G, Bresson C, Lazar V, Molenaar JJ, Koster J, Ebus M, Zwijnenburg DA, van Sluis P, Lamers F, Schild L, van der Ploeg I, Caron HN, Versteeg R, Pouyssegur J, Marchiq I, Chiche J, Roux D, Le Floch R, Critchlow SE, Wooster RF, Agresta S, Yen KE, Janne PA, Plummer ER, Trinchieri G, Ellis L, Chan SL, Yeo W, Chan AT, Mouliere F, El Messaoudi S, Gongora C, Lamy PJ, del Rio M, Lopez-Crapez E, Gillet B, Mathonnet M, Pezet D, Ychou M, Thierry AR, Ribrag V, Vainchenker W, Constantinescu S, Keilhack H, Umelo IA, Noeparast A, Chen G, Renard M, Geers C, Vansteenkiste J, Teugels E, de Greve J, Rixe O, Qi X, Chu Z, Celerier J, Leconte L, Minet N, Pakradouni J, Kaur B, Cuttitta F, Wagner AJ, Zhang YX, Sicinska E, Czaplinski JT, Remillard SP, Demetri GD, Weng S, Debussche L, Agoni L, Reddy EP, Guha C, Silence K, Thibault A, de Haard H, Dreier T, Ulrichts P, Moshir M, Gabriels S, Luo J, Carter C, Rajan A, Khozin S, Thomas A, Lopez-Chavez A, Brzezniak C, Doyle L, Keen C, Manu M, Raffeld M, Giaccone G, Lutzker S, Melief JM, Eckhardt SG, Trusolino L, Migliardi G, Zanella ER, Cottino F, Galimi F, Sassi F, Marsoni S, Comoglio PM, Bertotti A, Hidalgo M, Weroha SJ, Haluska P, Becker MA, Harrington SC, Goodman KM, Gonzalez SE, al Hilli M, Butler KA, Kalli KR, Oberg AL, Huijbers IJ, Bin Ali R, Pritchard C, Cozijnsen M, Proost N, Song JY, Krimpenfort P, Michalak E, Jonkers J, Berns A, Banerji U, Stewart A, Thavasu P, Banerjee S, Kaye SB. Lectures. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
43
|
de Dosso S, Fiedler W, Gianni L, Cresta S, Schulze-Bergkamen H, Gurrieri L, Salzberg M, Dietrich B, Danielczyk A, Baumeister H, Goletz S, Sessa C. Phase I Clinical and Pharmacological Study of Cetugex, a Novel Anti-EGFR Monoclonal Antibody with an Optimized Antibody Dependent Cellular Cytotoxicity. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt042.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
44
|
Macaulay VM, Middleton MR, Protheroe AS, Tolcher A, Dieras V, Sessa C, Bahleda R, Blay JY, LoRusso P, Mery-Mignard D, Soria JC. Phase I study of humanized monoclonal antibody AVE1642 directed against the type 1 insulin-like growth factor receptor (IGF-1R), administered in combination with anticancer therapies to patients with advanced solid tumors. Ann Oncol 2013; 24:784-91. [PMID: 23104723 PMCID: PMC3574548 DOI: 10.1093/annonc/mds511] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Revised: 07/23/2012] [Accepted: 08/27/2012] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Type 1 insulin-like growth factor receptor (IGF-1R) mediates resistance to chemotherapy and targeted agents. This study assessed the safety, pharmacokinetics (PK), and tolerability of humanized IGF-1R antibody AVE1642 with other cancer treatments. PATIENTS Patients with advanced solid tumors received three weekly AVE1642 dosed at 6 mg/kg, chosen following previous study, with 75 (cohort A) or 100 mg/m(2) (B) docetaxel, 1250 mg/m(2) gemcitabine/100 mg erlotinib (C1), or 60 mg/m(2) doxorubicin (D1). Blood samples were assayed for PK, IGFs, and IGF-BP3. RESULTS Fifty-eight patients received 317 AVE1642 infusions. The commonest adverse events were diarrhea (37/58 patients), asthenia (34/58), nausea (30/58), and stomatitis (21/58). Dose-limiting toxic effects in cohorts C1 (diarrhea) and D1 (neutropenia) prompted addition of cohorts C2 (1000 mg/m(2) gemcitabine/75 mg erlotinib) and D2 (50 mg/m(2) doxorubicin). Grade 3-4 hyperglycemia (three cases) accompanied steroid premedication for docetaxel administration. No PK interactions were detected. There were three partial responses in cohorts B (melanoma) and C (leiomyosarcoma, two cases) and 22 stabilizations ≥12 weeks, giving a control rate of 25/57 (44%). On treatment IGF-II rose by 68 ± 25 ng/ml in patients discontinuing treatment <12 weeks, and fell by 55.5 ± 21 ng/ml with disease control (P < 0.001). CONCLUSION AVE1642 was tolerable with 75-100 mg/m(2) docetaxel and 1000 mg/m(2) gemcitabine/75 mg erlotinib, achieving durable disease control in 44%, with an association between IGF-II and response.
Collapse
|
45
|
Colombo N, Carinelli S, Colombo A, Marini C, Rollo D, Sessa C. Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 23 Suppl 7:vii27-32. [PMID: 22997451 DOI: 10.1093/annonc/mds268] [Citation(s) in RCA: 187] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
|
46
|
Britten C, Wainberg Z, Tabernero J, Alsina Maqueda M, Leong S, Sessa C, Millham R, Gallo J, Siu L, Brana I. 358 A Multi-arm Phase 1 Dose Escalation Study of Safety, Pharmacokinetics, and Pharmacodynamics of the Dual PI3K/mTOR Inhibitors PF-04691502 (oral) and PF-05212384 (IV) in Combination with the MEK Inhibitor PD-0325901 or Irinotecan in Patients with Advanced Cancer. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72156-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
47
|
Fasolo A, Sessa C, Gianni L, Broggini M. Seminars in clinical pharmacology: an introduction to MET inhibitors for the medical oncologist. Ann Oncol 2012; 24:14-20. [PMID: 23110808 DOI: 10.1093/annonc/mds520] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
MET is a tyrosine kinase receptor for hepatocyte growth factor (HGF), primarily expressed on epithelial cells; the activation of MET induces several biological responses relevant for the development and growth of many human cancers. Several human malignancies present altered expression of MET and this is usually associated with poor prognosis and aggressive phenotype. The majority of MET inhibitors in clinical development target directly the receptor through the use of monoclonal antibodies (MAbs) or through small molecule inhibitors of MET kinase activity; small molecule inhibitors are very potent but less specific than MAbs. MET inhibitors are of great clinical interest because of the extensive crosstalk of the HGF/MET axis with many other signaling pathways, including growth factor-dependent pathways (like PI3K/AKT/mTOR,RAS/RAF/ERK) and vascular endothelial growth factor (VEGF) axis. In preclinical studies, the treatment with MET inhibitors could prevent or reverse resistance to inhibitors of growth factor-dependent signaling; this hypothesis is currently tested in phase III trials with anti-epidermal growth factor receptor (EGFR) inhibitors in non-small-cell lung cancer (NSCLC). Based on preclinical and preliminary clinical results, a rational strategy for the clinical development of MET antagonists should include a selection of the tumors with MET overexpression, the identification of prognostic/predictive biomarkers, the evaluation of combinations with anti-VEGF compounds.
Collapse
|
48
|
Colombo N, Peiretti M, Garbi A, Carinelli S, Marini C, Sessa C. Non-epithelial ovarian cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2012; 23 Suppl 7:vii20-6. [DOI: 10.1093/annonc/mds223] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
49
|
Abstract
The clinical development of PARP inhibitors for the treatment of tumors deficient in BRCA1 or BRCA2 is based on the concept of synthetic lethality. From the initial proof of concept study with the PARP1 inhibitor olaparib (AZD2281) in BRCA mutation carriers, in which 28% of ovarian cancer patients achieved an objective response, the target population of ovarian patients potentially sensitive to treatment with PARP inhibitors has greatly increased. Objective responses have been observed in both platinum-sensitive and platinum-resistant BRCA mutation carriers but, more recently, also in BRCA negative 'BRCAness' patients, those with no BRCA mutations but with a dysfunction of the homologous recombination (HR) system, which makes them more sensitive to the antitumor agents which cause double strand breaks of DNA. The recent results achieved with olaparib, given as maintenance in platinum sensitive recurrent high grade serous ovarian cancer, in response after reinduction with platinum, confirm the antitumor effect of single agent olaparib in BRCAness patients. Main topics of investigations in this field are the identification of BRCAness phenotype and the definition of tests to identify BRCAness patients. More in general, additional preclinical studies are needed to further improve clinical results in order to define the optimal regimen of combination with PARP1 inhibitor and cytotoxics or molecular targeted agents (sequence of administration, interval between dosing of the agents, duration of treatment).
Collapse
|
50
|
Magne J, Pirvu A, Sessa C, Cochet E, Blaise H, Ducos C. Carotid Artery Revascularisation Following Neck Irradiation: Immediate and Long-Term Results. Eur J Vasc Endovasc Surg 2012; 43:4-7. [DOI: 10.1016/j.ejvs.2011.09.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 09/06/2011] [Indexed: 11/17/2022]
|