51
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Yap TA, Smith AD, Ferraldeschi R, Al-Lazikani B, Workman P, de Bono JS. Drug discovery in advanced prostate cancer: translating biology into therapy. Nat Rev Drug Discov 2016; 15:699-718. [DOI: 10.1038/nrd.2016.120] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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52
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Lorion R, Bladou F, Spatz A, van Kempen L, Irani J. [Prostate cancer microenvironment: Its structure, functions and therapeutic applications]. Prog Urol 2016; 26:464-76. [PMID: 27423973 DOI: 10.1016/j.purol.2016.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 06/11/2016] [Accepted: 06/14/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION In the field of prostate cancer there is a growing tendency for more and more studies to emphasise the predominant role of the zone situated between the tumour and the host: the tumour microenvironment. The aim of this article is to describe the structure and the functions of the prostate cancer microenvironment as well as the principal treatments that are being applied to it. MATERIAL AND METHODS PubMed and ScienceDirect databases have been interrogated using the association of keywords "tumour microenvironment" and "neoplasm therapy" along with "microenvironnement tumoral" and "traitements". Of the 593 articles initially found, 50 were finally included. RESULTS The tumour microenvironment principally includes host elements that are diverted from their primary functions and encourage the development of the tumour. In it we find immunity cells, support tissue as well as vascular and lymphatic neovascularization. Highlighting the major role played by this microenvironment has led to the development of specific treatments, notably antiangiogenic therapy and immunotherapy. CONCLUSION The tumour microenvironment, the tumour and the host influence themselves mutually and create a variable situation over time. Improvement of the knowledge of the prostate cancer microenvironment gradually enables us to pass from an approach centred on the tumour to a broader approach to the whole tumoral ecosystem. This enabled the emergence of new treatments whose place in the therapeutic arsenal still need to be found.
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Affiliation(s)
- R Lorion
- Service d'urologie, centre hospitalo-universitaire la Milétrie, Poitiers, France; X chromosome and cancer laboratory, Lady Davis institute for medical research, Jewish general hospital, Montreal, Canada.
| | - F Bladou
- Department of urology, Jewish general hospital, Montreal, Canada; X chromosome and cancer laboratory, Lady Davis institute for medical research, Jewish general hospital, Montreal, Canada
| | - A Spatz
- Department of pathology, Jewish general hospital, Montreal, Canada; X chromosome and cancer laboratory, Lady Davis institute for medical research, Jewish general hospital, Montreal, Canada
| | - L van Kempen
- X chromosome and cancer laboratory, Lady Davis institute for medical research, Jewish general hospital, Montreal, Canada
| | - J Irani
- Service d'urologie, centre hospitalier universitaire de Bicêtre, Le Kremlin-Bicêtre, France
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53
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Ali N, Chandrakesan P, Nguyen CB, Husain S, Gillaspy AF, Huycke M, Berry WL, May R, Qu D, Weygant N, Sureban SM, Bronze MS, Dhanasekaran DN, Houchen CW. Inflammatory and oncogenic roles of a tumor stem cell marker doublecortin-like kinase (DCLK1) in virus-induced chronic liver diseases. Oncotarget 2016; 6:20327-44. [PMID: 25948779 PMCID: PMC4653008 DOI: 10.18632/oncotarget.3972] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 04/11/2015] [Indexed: 12/11/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related mortality worldwide. We previously showed that a tumor/cancer stem cell (CSC) marker, doublecortin-like kinase (DCLK1) positively regulates hepatitis C virus (HCV) replication, and promotes tumor growth in colon and pancreas. Here, we employed transcriptome analysis, RNA interference, tumor xenografts, patient's liver tissues and hepatospheroids to investigate DCLK1-regulated inflammation and tumorigenesis in the liver. Our studies unveiled novel DCLK1-controlled feed-forward signaling cascades involving calprotectin subunit S100A9 and NFκB activation as a driver of inflammation. Validation of transcriptome data suggests that DCLK1 co-expression with HCV induces BRM/SMARCA2 of SW1/SNF1 chromatin remodeling complexes. Frequently observed lymphoid aggregates including hepatic epithelial and stromal cells of internodular septa extensively express DCLK1 and S100A9. The DCLK1 overexpression also correlates with increased levels of S100A9, c-Myc, and BRM levels in HCV/HBV-positive patients with cirrhosis and HCC. DCLK1 silencing inhibits S100A9 expression and hepatoma cell migration. Normal human hepatocytes (NHH)-derived spheroids exhibit CSC properties. These results provide new insights into the molecular mechanism of the hepatitis B/C-virus induced liver inflammation and tumorigenesis via DCLK1-controlled networks. Thus, DCLK1 appears to be a novel therapeutic target for the treatment of inflammatory diseases and HCC.
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Affiliation(s)
- Naushad Ali
- Department of Internal Medicine, Section of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,Department of Veterans Affairs Medical Center, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Parthasarathy Chandrakesan
- Department of Internal Medicine, Section of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Charles B Nguyen
- Department of Internal Medicine, Section of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Sanam Husain
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Allison F Gillaspy
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Mark Huycke
- Infectious Diseases, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,Department of Veterans Affairs Medical Center, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - William L Berry
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Randal May
- Department of Internal Medicine, Section of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Dongfeng Qu
- Department of Internal Medicine, Section of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Nathaniel Weygant
- Department of Internal Medicine, Section of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Sripathi M Sureban
- Department of Internal Medicine, Section of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,Department of Veterans Affairs Medical Center, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Michael S Bronze
- Department of Internal Medicine, Section of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Danny N Dhanasekaran
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
| | - Courtney W Houchen
- Department of Internal Medicine, Section of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,Department of Veterans Affairs Medical Center, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA.,COARE Biotechnology, Oklahoma City, Oklahoma, OK, USA
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Deronic A, Tahvili S, Leanderson T, Ivars F. The anti-tumor effect of the quinoline-3-carboxamide tasquinimod: blockade of recruitment of CD11b(+) Ly6C(hi) cells to tumor tissue reduces tumor growth. BMC Cancer 2016; 16:440. [PMID: 27400708 PMCID: PMC4939705 DOI: 10.1186/s12885-016-2481-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 06/17/2016] [Accepted: 07/04/2016] [Indexed: 12/15/2022] Open
Abstract
Background Previous work has demonstrated immunomodulatory, anti-tumor, anti-metastatic and anti-angiogenic effects of the small molecule quinoline-3-carboxamide tasquinimod in pre-clinical cancer models. To better understand the anti-tumor effects of tasquinimod in transplantable tumor models, we have evaluated the impact of the compound both on recruitment of myeloid cells to tumor tissue and on tumor-induced myeloid cell expansion as these cells are known to promote tumor development. Methods Mice bearing subcutaneous 4 T1 mammary carcinoma tumors were treated with tasquinimod in the drinking water. A BrdU-based flow cytometry assay was utilized to assess the impact of short-term tasquinimod treatment on myeloid cell recruitment to tumors. Additionally, long-term treatment was performed to study the anti-tumor effect of tasquinimod as well as its effects on splenic myeloid cells and their progenitors. Myeloid cell populations were also immune-depleted by in vivo antibody treatment. Results Short-term tasquinimod treatment did not influence the proliferation of splenic Ly6Chi and Ly6Ghi cells, but instead reduced the influx of Ly6Chi cells to the tumor. Treatment with tasquinimod for various periods of time after tumor inoculation revealed that the anti-tumor effect of this compound mainly operated during the first few days of tumor growth. Similar to tasquinimod treatment, antibody-mediated depletion of Ly6Chi cells within that same time frame, caused reduced tumor growth, thereby confirming a significant role for these cells in tumor development. Additionally, long-term tasquinimod treatment reduced the splenomegaly and expansion of splenic myeloid cells during a later phase of tumor development. In this phase, tasquinimod normalized the tumor-induced alterations in myeloerythroid progenitor cells in the spleen but had only limited impact on the same populations in the bone marrow. Conclusions Our results indicate that tasquinimod treatment reduces tumor growth by operating early after tumor inoculation and that this effect is at least partially caused by reduced recruitment of Ly6Chi cells to tumor tissue. Long-term treatment also reduces the number of splenic myeloid cells and myeloerythroid progenitors, but these effects did not influence established rapidly growing tumors. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2481-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adnan Deronic
- Immunology group, Section for Immunology, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | | | - Tomas Leanderson
- Immunology group, Section for Immunology, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Fredrik Ivars
- Immunology group, Section for Immunology, Department of Experimental Medical Science, Lund University, Lund, Sweden.
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Silvestri I, Cattarino S, Giantulli S, Nazzari C, Collalti G, Sciarra A. A Perspective of Immunotherapy for Prostate Cancer. Cancers (Basel) 2016; 8:cancers8070064. [PMID: 27399780 PMCID: PMC4963806 DOI: 10.3390/cancers8070064] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/27/2016] [Accepted: 07/01/2016] [Indexed: 12/24/2022] Open
Abstract
In cancer patients, the immune system is often altered with an excess of inhibitory factors, such as immunosuppressive cytokines, produced by regulatory T cells (Treg) or myeloid-derived suppressor cells (MDSC). The manipulation of the immune system has emerged as one of new promising therapies for cancer treatment, and also represents an attractive strategy to control prostate cancer (PCa). Therapeutic cancer vaccines and immune checkpoint inhibitors have been the most investigated in clinical trials. Many trials are ongoing to define the effects of immune therapy with established treatments: androgen deprivation therapy (ADT) and chemotherapy (CT) or radiotherapy (RT). This article discusses some of these approaches in the context of future treatments for PCa.
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Affiliation(s)
- Ida Silvestri
- Department of Molecular Medicine, Sapienza University of Rome, Rome 00161, Italy.
| | - Susanna Cattarino
- Department of Urology, Sapienza University of Rome, Rome 00161, Italy.
| | - Sabrina Giantulli
- Department of Molecular Medicine, Sapienza University of Rome, Rome 00161, Italy.
| | - Cristina Nazzari
- Department of Public Health hand Infectious Diseases, "Sapienza" University of Rome, Rome 00185, Italy.
| | - Giulia Collalti
- Medicine of Systems, Rheumatology, Allergology and Clinical Immunology, Translational Medicine of the University Tor Vergata, Rome 00133, Italy.
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Ratta R, Zappasodi R, Raggi D, Grassi P, Verzoni E, Necchi A, Di Nicola M, Salvioni R, de Braud F, Procopio G. Immunotherapy advances in uro-genital malignancies. Crit Rev Oncol Hematol 2016; 105:52-64. [PMID: 27372200 DOI: 10.1016/j.critrevonc.2016.06.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/27/2016] [Accepted: 06/16/2016] [Indexed: 12/27/2022] Open
Abstract
Immunotherapy for the treatment of cancer has made significant progresses over the last 20 years. Multiple efforts have been attempted to restore immune-mediated tumor elimination, leading to the development of several targeted immunotherapies. Data from recent clinical trials suggest that these agents might improve the prognosis of patients with advanced genito-urinary (GU) malignancies. Nivolumab has been the first immune checkpoint-inhibitor approved for pre-treated patients with metastatic renal cell carcinoma. Pembrolizumab and atezolizumab have shown promising results in both phase I and II trials in urothelial carcinoma. Brentuximab vedotin has demonstrated early signals of clinical activity and immunomodulatory effects in highly pre-treated patients with testicular germ cell tumors. In this review, we have summarized the major clinical achievements of immunotherapy in GU cancers, focusing on immune checkpoint blockade as well as the new immunomodulatory monoclonal antibodies (mAbs) under clinical evaluation for these malignancies.
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Affiliation(s)
- Raffaele Ratta
- Department of Medical Oncology, Fondazione IRCSS Istituto Nazionale Tumori, Milan, Italy
| | - Roberta Zappasodi
- Ludwig Collaborative and Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Daniele Raggi
- Department of Medical Oncology, Fondazione IRCSS Istituto Nazionale Tumori, Milan, Italy
| | - Paolo Grassi
- Department of Medical Oncology, Fondazione IRCSS Istituto Nazionale Tumori, Milan, Italy
| | - Elena Verzoni
- Department of Medical Oncology, Fondazione IRCSS Istituto Nazionale Tumori, Milan, Italy
| | - Andrea Necchi
- Department of Medical Oncology, Fondazione IRCSS Istituto Nazionale Tumori, Milan, Italy
| | - Massimo Di Nicola
- Unit of Immunotherapy and Anticancer Innovative Therapeutics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberto Salvioni
- Department of Surgery, Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Filippo de Braud
- Department of Medical Oncology, Fondazione IRCSS Istituto Nazionale Tumori, Milan, Italy
| | - Giuseppe Procopio
- Department of Medical Oncology, Fondazione IRCSS Istituto Nazionale Tumori, Milan, Italy.
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Sternberg C, Armstrong A, Pili R, Ng S, Huddart R, Agarwal N, Khvorostenko D, Lyulko O, Brize A, Vogelzang N, Delva R, Harza M, Thanos A, James N, Werbrouck P, Bögemann M, Hutson T, Milecki P, Chowdhury S, Gallardo E, Schwartsmann G, Pouget JC, Baton F, Nederman T, Tuvesson H, Carducci M. Randomized, Double-Blind, Placebo-Controlled Phase III Study of Tasquinimod in Men With Metastatic Castration-Resistant Prostate Cancer. J Clin Oncol 2016; 34:2636-43. [PMID: 27298414 DOI: 10.1200/jco.2016.66.9697] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Tasquinimod, a novel oral therapy targeting the tumor microenvironment, significantly improved progression-free survival (PFS) in a randomized, placebo-controlled phase II trial in men with metastatic castration-resistant prostate cancer (mCRPC). This phase III study was conducted to confirm the phase II results and to detect an overall survival (OS) benefit. PATIENTS AND METHODS Men with chemotherapy-naïve mCRPC and evidence of bone metastases were assigned (2:1) to receive tasquinimod once per day or placebo until progression or toxicity. The primary end point was radiographic PFS (rPFS; time from random assignment to radiologic progression or death) per Prostate Cancer Working Group 2 criteria and RECIST 1.1. The study had 99.9% power to detect an rPFS hazard ratio (HR) of 0.6 with a two-sided alpha error of .05 and 80% power to detect a target HR of 0.8 for OS, the key secondary end point. RESULTS In all, 1,245 patients were randomly assigned to either tasquinimod (n = 832) or placebo (n = 413) between March 2011 and December 2012 at 241 sites in 37 countries. Baseline characteristics were balanced between groups: median age, 71 years; Karnofsky performance status ≥ 90%, 77.3%; and visceral metastases, 21.1%. Estimated median rPFS by central review was 7.0 months (95% CI, 5.8 to 8.2 months) with tasquinimod and 4.4 months (95% CI, 3.5 to 5.5 months) with placebo (HR, 0.64; 95% CI, 0.54 to 0.75; P < .001). Median OS was 21.3 months (95% CI, 19.5 to 23.0 months) with tasquinimod and 24.0 months (95% CI, 21.4 to 26.9 months) with placebo (HR, 1.10; 95% CI, 0.94 to 1.28; P = .25). Grade ≥ 3 adverse events were more frequent with tasquinimod (42.8% v 33.6%), the most common being anemia, fatigue, and cancer pain. CONCLUSION In chemotherapy-naïve men with mCRPC, tasquinimod significantly improved rPFS compared with placebo. However, no OS benefit was observed.
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Affiliation(s)
- Cora Sternberg
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Andrew Armstrong
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Roberto Pili
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Siobhan Ng
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Robert Huddart
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Neeraj Agarwal
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Denis Khvorostenko
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Olexiy Lyulko
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Arija Brize
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Nicholas Vogelzang
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Rémy Delva
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Mihai Harza
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Anastasios Thanos
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Nicholas James
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Patrick Werbrouck
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Martin Bögemann
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Thomas Hutson
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Piotr Milecki
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Simon Chowdhury
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Enrique Gallardo
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Gilberto Schwartsmann
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Jean-Christophe Pouget
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Frédérique Baton
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Thore Nederman
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Helen Tuvesson
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Michael Carducci
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD.
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Yoo S, Choi SY, You D, Kim CS. New drugs in prostate cancer. Prostate Int 2016; 4:37-42. [PMID: 27358841 PMCID: PMC4916061 DOI: 10.1016/j.prnil.2016.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 05/09/2016] [Indexed: 01/21/2023] Open
Abstract
The standard primary treatment for advanced prostate cancer has been hormonal therapy since the 1940s. However, prostate cancer inevitably progresses to castration-resistant prostate cancer (CRPC) after a median duration of 18 months of androgen deprivation therapy. In patients with CRPC, docetaxel has been regarded as the standard treatment. However, survival advantages of docetaxel over other treatments are slim, and the need for new agents persists. In recent years, novel agents, including abiraterone, enzalutamide, cabazitaxel, radium-223, and sipuleucel-T, have been approved for the treatment of CRPC, and more such agents based on diverse mechanisms are under investigation or evaluation. In this article, the authors reviewed the current literature on recent advances in medical treatment of prostate cancer, especially CRPC. In addition, the authors elaborated on novel drugs for prostate cancer currently undergoing investigation and their mechanisms.
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Affiliation(s)
| | | | | | - Choung-Soo Kim
- Corresponding author. Department of Urology, Asan Medical Center, 388-1 Pungnap 2 dong, Songpa-gu, Seoul 138-736, South Korea.Department of UrologyAsan Medical Center388-1 Pungnap 2 dongSongpa-guSeoul138-736South Korea
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59
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Progress in the mechanism and drug development of castration-resistant prostate cancer. Future Med Chem 2016; 8:765-88. [PMID: 27149562 DOI: 10.4155/fmc.16.12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Although prostate cancer can initially respond to androgen deprivation therapy, it will inevitably relapse and switch to a castration-resistant state. The progress in understanding the mechanism of castration-resistant prostate cancer (CRPC) has led to the evolution of novel agents, including sipuleucel-T as an immunomodulant agent, enzalutamide as an androgen receptor antagonist, docetaxel as a chemotherapeutic agent and radium-223 as a radiopharmaceutical agent. In this review, we discuss the main mechanisms of CRPC and the development of promising agents along with the novel therapies in the clinic. New therapeutic challenges remain, such as the identification of predictive biomarkers and the optimal combinations of agents. Future investigation is still needed for a better understanding of CRPC.
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Fontaine M, Lepape A, Piriou V, Venet F, Friggeri A. Innate danger signals in acute injury: From bench to bedside. Anaesth Crit Care Pain Med 2016; 35:283-92. [PMID: 26987739 DOI: 10.1016/j.accpm.2015.10.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/08/2015] [Accepted: 10/08/2015] [Indexed: 11/24/2022]
Abstract
The description of the systemic inflammatory response syndrome (SIRS) as a reaction to numerous insults marked a turning point in the understanding of acute critical states, which are intensive care basic cases. This concept highlighted the final inflammatory response features whichever the injury mechanism is: infectious, or non-infectious such as extensive burns, traumas, major surgery or acute pancreatitis. In these cases of severe non-infectious insult, many endogenous mediators are released. Like infectious agents components, they can activate the immune system (via common signaling pathways) and initiate an inflammatory response. They are danger signals or alarmins. These molecules generally play an intracellular physiological role and acquire new functions when released in extracellular space. Many progresses brought new information on these molecules and on their function in infectious and non-infectious inflammation. These danger signals can be used as biomarkers and provide new pathophysiological and therapeutic approaches, particularly for immune dysfunctions occurring after an acute injury. We present herein the danger model, the main danger signals and the clinical consequences.
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Affiliation(s)
- Mathieu Fontaine
- Burn Intensive Care Unit, centre hospitalier Saint-Joseph-Saint-Luc, 20, quai Claude-Bernard, 69007 Lyon, France; EAM 4174 « Hemostasis, inflammation and sepsis », hospices civils de Lyon, université Claude-Bernard Lyon I, 69008 Lyon, France.
| | - Alain Lepape
- EAM 4174 « Hemostasis, inflammation and sepsis », hospices civils de Lyon, université Claude-Bernard Lyon I, 69008 Lyon, France; Intensive Care Unit, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - Vincent Piriou
- EAM 4174 « Hemostasis, inflammation and sepsis », hospices civils de Lyon, université Claude-Bernard Lyon I, 69008 Lyon, France; Intensive Care Unit, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - Fabienne Venet
- EAM 4174 « Hemostasis, inflammation and sepsis », hospices civils de Lyon, université Claude-Bernard Lyon I, 69008 Lyon, France; Immunology Laboratory, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69437 Lyon cedex 03, France
| | - Arnaud Friggeri
- Intensive Care Unit, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
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61
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Magnusson LU, Hagberg Thulin M, Plas P, Olsson A, Damber JE, Welén K. Tasquinimod inhibits prostate cancer growth in bone through alterations in the bone microenvironment. Prostate 2016; 76:383-93. [PMID: 26660725 DOI: 10.1002/pros.23133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 11/13/2015] [Indexed: 11/06/2022]
Abstract
BACKGROUND Tasquinimod (ABR-215050) is an orally active quinoline-3-carboxamide analog that inhibits occurrence of experimental metastasis and delays disease progression of castration resistant prostate cancer in humans. Its mechanism of action is not fully elucidated, but previous studies show immunomodulatory and anti-angiogenic effects. The aim of the present study was to investigate the tumor inhibiting effect of tasquinimod in bone of castrated mice as well as to elucidate its working mechanism related to bone microenvironment. METHODS Effects of tasquinimod on prostate cancer metastasis to bone was studied in an intratibial xenograft model. Animals were treated with tasquinimod and tumor establishment and growth, immunological status, as well as markers for bone remodeling were analyzed. Direct effects of tasquinimod on osteoblasts were studied in vitro. RESULTS Establishment and growth of tumors in the bone after intratibial implantation in castrated mice was suppressed by tasquinimod treatment. The treatment effect was linked to decreased potential for immunosuppression in the pre-metastatic niche in bone (lower levels of CD206 and Arg1 expression in combination with increased iNOS expression) as well as in the tumor microenvironment (less Gr1 and CD206 staining). The shift to a pro-inflammatory, anti-tumorigenic milieu was also reflected in serum by increased levels of IFN-γ, CCL4, IL-5, LIX, IP-10, and MCP-1 as well as decreased TGF-β. Tasquinimod treatment also affected expression of factors involved in the pre-metastatic niche in the bone microenvironment (Lox, Cdh2, Cdh11, and Cxcl12). In addition, tasquinimod treatment caused a decreased osteogenic response indicated by decreased expression of Ocn, Runx2, and Col1a2 and increased expression of osteoclast stimulating CSF2. In vitro studies on mouse osteoblasts showed impaired osteoblast mineralization upon tasquinimod treatment. CONCLUSIONS The present study shows that tasquinimod reduces establishment and progression of tumor growth in bone likely through a combination of effects on the pre-metastatic niche, homing, immunological status, and osteogenesis. It was concluded that tasquinimod interferes with the metastatic process, presumably by inhibition of tumor establishment. Hence, our data suggest that tasquinimod might be most effective in inhibiting the occurrence of new metastatic lesions.
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Affiliation(s)
- Lisa U Magnusson
- Sahlgrenska Cancer Center, Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Malin Hagberg Thulin
- Sahlgrenska Cancer Center, Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | | | | | - Jan-Erik Damber
- Sahlgrenska Cancer Center, Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Karin Welén
- Sahlgrenska Cancer Center, Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Nakhlé J, Pierron V, Bauchet AL, Plas P, Thiongane A, Meyer-Losic F, Schmidlin F. Tasquinimod modulates tumor-infiltrating myeloid cells and improves the antitumor immune response to PD-L1 blockade in bladder cancer. Oncoimmunology 2016; 5:e1145333. [PMID: 27471612 PMCID: PMC4955379 DOI: 10.1080/2162402x.2016.1145333] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/06/2016] [Accepted: 01/16/2016] [Indexed: 01/25/2023] Open
Abstract
The infiltration of myeloid cells helps tumors to overcome immune surveillance and imparts resistance to cancer immunotherapy. Thus, strategies to modulate the effects of these immune cells may offer a potential therapeutic benefit. We report here that tasquinimod, a novel immunotherapy which targets S100A9 signaling, reduces the immunosuppressive properties of myeloid cells in preclinical models of bladder cancer (BCa). As single anticancer agent, tasquinimod treatment was effective in preventing early stage tumor growth, but did not achieve a clear antitumor effect in advanced tumors. Investigations of this response revealed that tasquinimod induces an increase in the expression of a negative regulator of T cell activation, Programmed-death-ligand 1 (PD-L1). This markedly weakens its antitumor immunity, yet provokes an "inflamed" milieu rendering tumors more prone to T cell-mediated immune attack by PD-L1 blockade. Interestingly, the combination of tasquinimod with an Anti-PD-L1 antibody enhanced the antitumor immune response in bladder tumors. This combination synergistically modulated tumor-infiltrating myeloid cells, thereby strongly affecting proliferation and activation of effector T cells. Together, our data provide insight into the rational combination of therapies that activate both innate and adaptive immune system, such as the association of S100A9-targeting agents with immune checkpoints inhibitors, to improve the response to cancer immunotherapeutic agents in BCa.
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Affiliation(s)
- Jessica Nakhlé
- IPSEN Innovation, Global Drug Discovery department , Les Ulis, France
| | - Valérie Pierron
- IPSEN Innovation, Global Drug Discovery department , Les Ulis, France
| | | | - Pascale Plas
- IPSEN Innovation, Global Drug Discovery department , Les Ulis, France
| | - Amath Thiongane
- IPSEN Innovation, Global Drug Discovery department , Les Ulis, France
| | | | - Fabien Schmidlin
- IPSEN Innovation, Global Drug Discovery department , Les Ulis, France
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Modena A, Massari F, Ciccarese C, Brunelli M, Santoni M, Montironi R, Martignoni G, Tortora G. Targeting Met and VEGFR Axis in Metastatic Castration-Resistant Prostate Cancer: ‘Game Over’? Target Oncol 2016; 11:431-46. [DOI: 10.1007/s11523-015-0412-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Mehta AR, Armstrong AJ. Tasquinimod in the treatment of castrate-resistant prostate cancer - current status and future prospects. Ther Adv Urol 2016; 8:9-18. [PMID: 26834836 DOI: 10.1177/1756287215603558] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Treatment options have significantly expanded in recent years for men with metastatic castration-resistant prostate cancer (mCRPC), with the routine use of immunotherapy (sipuleucel-T) and novel hormonal agents such as enzalutamide and abiraterone acetate prior to taxane-based chemotherapy or radium-223 radiotherapy. A number of immune checkpoints limit the immune response of the host to metastatic tumor progression in prostate cancer, one of which is an immunosuppressive and pro-angiogenic cell called the myeloid-derived suppressor cell (MDSC). Tasquinimod is a small molecular oral inhibitor of S100A9, a key cell surface regulator of MDSC function, and has shown anti-angiogenic, antitumor and immune-modulatory properties in preclinical models of prostate cancer and other solid tumors. A large randomized phase II trial of tasquinimod in men with chemotherapy-naïve mCRPC demonstrated a significant prolongation in radiographic and symptomatic progression-free survival compared with placebo, which was also associated with improvements in overall survival. Tasquinimod was studied in a global phase III randomized trial in men with bone mCRPC and, while it significantly improved radiographic progression-free survival, this did not result in an overall survival benefit. However, tasquinimod is under evaluation as well as a combination therapy with other systemic agents in prostate cancer and as a single agent in other solid tumors. This review encompasses the preclinical and clinical development of tasquinimod as a therapy for men with prostate cancer.
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Affiliation(s)
- Amit R Mehta
- Duke Cancer Institute Genitourinary Program, Cary, NC, USA
| | - Andrew J Armstrong
- Associate Professor of Medicine and Surgery, Associate Director for Clinical Research in Genitourinary Oncology, Duke Cancer Institute, Divisions of Medical Oncology and Urology, Duke University, DUMC Box 103861, Durham, NC 27710, USA
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Abstract
Castrate resistant prostate cancer (CRPC) remains a disease with significant morbidity and mortality. The recent approval of abiraterone and enzalutamide highlight the improvements which can be made targeting the androgen receptor (AR) axis. Nonetheless, resistance inevitably develops and there is continued interest in targeting alternate pathways which cause disease resistance and progression. Here, we review non-AR targets in CRPC, with an emphasis on novel agents now in development. This includes therapeutics which target the tumour microenvironment, the bone metastatic environment, microtubules, cellular energetics, angiogenesis, the stress response, survival proteins, intracellular signal transduction, DNA damage repair and dendritic cells. Understanding the hallmarks of prostate cancer resistance in CRPC has led to the identification and development of these new targets. We review the molecular rationale, as well at the clinical experience for each of these different classes of agents which are in clinical development.
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Affiliation(s)
- Paul J Toren
- Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
| | - Martin E Gleave
- Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada
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Olsson A, Nakhlé J, Sundstedt A, Plas P, Bauchet AL, Pierron V, Bruetschy L, Deronic A, Törngren M, Liberg D, Schmidlin F, Leanderson T. Tasquinimod triggers an early change in the polarization of tumor associated macrophages in the tumor microenvironment. J Immunother Cancer 2015; 3:53. [PMID: 26673090 PMCID: PMC4678646 DOI: 10.1186/s40425-015-0098-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/23/2015] [Indexed: 12/19/2022] Open
Abstract
Background Tasquinimod (a quinoline-3-carboxyamide) is a small molecule immunotherapy with demonstrated effects on the tumor microenvironment (TME) involving immunomodulation, anti-angiogenesis and inhibition of metastasis. A target molecule of tasquinimod is the inflammatory protein S100A9 which has been shown to affect the accumulation and function of suppressive myeloid cell subsets in tumors. Given the major impact of myeloid cells to the tumor microenvironment, manipulation of this cell compartment is a desirable goal in cancer therapeutics. Methods To understand the consequences of tasquinimod treatment on the TME, we evaluated early treatment effects in tumor infiltrating myeloid cells. Cellular phenotypes were studied by flow cytometry while gene expression both in tumor tissue and in isolated CD11b+ cells or tumor cells were measured by real time-PCR. Effects on angiogenesis were monitored by changes in CD31 levels and by gene expression in tumor tissue. Effects on cytokine levels in tumor tissue and serum were determined by multiplex analysis. Results The MC38-C215 colon carcinoma tumors showed a substantial infiltration of primarily myeloid cells that were dominated by Ly6ClowF4/80+CD206+ M2-polarized tumor associated macrophages (TAMs), an immuno-suppressive and pro-angiogenic cell population. Here, we show that tasquinimod treatment induces an anti-tumor effect which is subsequent to a reduction in tumor infiltrating CD206+ M2 macrophages and a simultaneous increase in M1 macrophages expressing MHC class II and CD86. The tasquinimod-induced changes in TAM polarization were evident within 24 h of exposure, emphasizing the ability of tasquinimod to rapidly reprogram the tumor microenvironment. This change in the tumor associated myeloid compartment preceded an increased IL12-production within the tumor and a decrease in tumor neovascularization. The switch in TAM polarization by tasquinimod was confirmed in the 4T1 breast cancer model where tasquinimod also reduce lung metastasis development. Conclusion Our data show that tasquinimod affects tumor infiltrating myeloid cells early after exposure, leading to a change in phenotype from pro-angiogenic and immunosuppressive M2-like TAMs to pro-inflammatory M1-like macrophages. These changes are consistent with the effects of tasquinimod seen on tumor vascularization, immune suppression and metastasis giving further insights to the anti-tumor mechanism of action of tasquinimod. Electronic supplementary material The online version of this article (doi:10.1186/s40425-015-0098-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Jessica Nakhlé
- Global Drug Discovery Department, IPSEN Innovation, 91966 Les Ulis, France
| | | | - Pascale Plas
- Global Drug Discovery Department, IPSEN Innovation, 91966 Les Ulis, France
| | - Anne-Laure Bauchet
- Global Drug Discovery Department, IPSEN Innovation, 91966 Les Ulis, France
| | - Valérie Pierron
- Global Drug Discovery Department, IPSEN Innovation, 91966 Les Ulis, France
| | - Luce Bruetschy
- Global Drug Discovery Department, IPSEN Innovation, 91966 Les Ulis, France
| | | | | | | | - Fabien Schmidlin
- Global Drug Discovery Department, IPSEN Innovation, 91966 Les Ulis, France
| | - Tomas Leanderson
- Active Biotech AB, Lund, Sweden.,Immunology Group, Lund University, Lund, Sweden
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Ghatalia P, Morgan CJ, Sonpavde G. Meta-analysis of regression of advanced solid tumors in patients receiving placebo or no anti-cancer therapy in prospective trials. Crit Rev Oncol Hematol 2015; 98:122-36. [PMID: 26597016 DOI: 10.1016/j.critrevonc.2015.10.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 10/05/2015] [Accepted: 10/28/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A meta-analysis of prospective trials systematically investigated regression of advanced solid tumors in patients receiving placebo or no anticancer therapy to inform on spontaneous regressions. PATIENT AND METHODS Arms of randomized controlled trials (RCTs) of metastatic solid tumors receiving placebo or no anti-cancer therapy were used. Statistical analyses were conducted to calculate the overall response rate (ORR) and to detect differentials based on histology, progression at baseline and prior therapies. RESULTS A total of 7676 patients were evaluable from 61 RCTs evaluating 18 solid tumors. The ORR was 1.95% (95% CI: 1.52-2.48%). There was no significant effect of histology (p=0.110), baseline progressive disease (p>0.20) or the line of therapy (p>0.20) on ORR. CONCLUSIONS Spontaneous regressions are seen across all advanced solid tumors. Some malignancies demonstrated higher rates of spontaneous regressions and may be relatively immunotherapy responsive.
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Affiliation(s)
- Pooja Ghatalia
- Department of Internal Medicine, University of Alabama at Birmingham (UAB), AL, United States
| | - Charity J Morgan
- Department of Biostatistics, UAB School of Medicine, United States
| | - Guru Sonpavde
- Department of Internal Medicine, Section of Medical Oncology, UAB Medical Center, United States.
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Oesterle A, Bowman MAH. S100A12 and the S100/Calgranulins: Emerging Biomarkers for Atherosclerosis and Possibly Therapeutic Targets. Arterioscler Thromb Vasc Biol 2015; 35:2496-507. [PMID: 26515415 DOI: 10.1161/atvbaha.115.302072] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 10/14/2015] [Indexed: 11/16/2022]
Abstract
Atherosclerosis is mediated by local and systematic inflammation. The multiligand receptor for advanced glycation end products (RAGE) has been studied in animals and humans and is an important mediator of inflammation and atherosclerosis. This review focuses on S100/calgranulin proteins (S100A8, S100A9, and S100A12) and their receptor RAGE in mediating vascular inflammation. Mice lack the gene for S100A12, which in humans is located on chromosome 3 between S100A8 and S100A9. Transgenic mice with smooth muscle cell-targeted expression of S100A12 demonstrate increased coronary and aortic calcification, as well as increased plaque vulnerability. Serum S100A12 has recently been shown to predict future cardiovascular events in a longitudinal population study, underscoring a role for S100A12 as a potential biomarker for coronary artery disease. Genetic ablation of S100A9 or RAGE in atherosclerosis-susceptible apolipoprotein E null mice results in reduced atherosclerosis. Importantly, S100A12 and the RAGE axis can be modified pharmacologically. For example, soluble RAGE reduces murine atherosclerosis and vascular inflammation. Additionally, a class of compounds currently in phase III clinical trials for multiple sclerosis and rheumatologic conditions, the quinoline-3-carboxamides, reduce atherosclerotic plaque burden and complexity in transgenic S100A12 apolipoprotein E null mice, but have not been tested with regards to human atherosclerosis. The RAGE axis is an important mediator for inflammation-induced atherosclerosis, and S100A12 has emerged as biomarker for human atherosclerosis. Decreasing inflammation by inhibiting S100/calgranulin-mediated activation of RAGE attenuates murine atherosclerosis, and future studies in patients with coronary artery disease are warranted to confirm S100/RAGE as therapeutic target for atherosclerosis.
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Affiliation(s)
- Adam Oesterle
- From the Department of Medicine, The University of Chicago, IL
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69
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Abstract
Tumour-promoting inflammation is considered one of the enabling characteristics of cancer development. Chronic inflammatory disease increases the risk of some cancers, and strong epidemiological evidence exists that NSAIDs, particularly aspirin, are powerful chemopreventive agents. Tumour microenvironments contain many different inflammatory cells and mediators; targeting these factors in genetic, transplantable and inducible murine models of cancer substantially reduces the development, growth and spread of disease. Thus, this complex network of inflammation offers targets for prevention and treatment of malignant disease. Much potential exists in this area for novel cancer prevention and treatment strategies, although clinical research to support targeting of cancer-related inflammation and innate immunity in patients with advanced-stage cancer remains in its infancy. Following the initial successes of immunotherapies that modulate the adaptive immune system, we assert that inflammation and innate immunity are important targets in patients with cancer on the basis of extensive preclinical and epidemiological data. The adaptive immune response is heavily dependent on innate immunity, therefore, inhibiting some of the tumour-promoting immunosuppressive actions of the innate immune system might enhance the potential of immunotherapies that activate a nascent antitumour response.
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Affiliation(s)
- Shanthini M Crusz
- Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, Charterhouse Square, London EC1M 6BQ, UK
| | - Frances R Balkwill
- Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, Charterhouse Square, London EC1M 6BQ, UK
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70
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Hathaway AR, Baker MK, Sonpavde G. Emerging agents for the therapy of advanced prostate cancer. Future Oncol 2015; 11:2775-87. [DOI: 10.2217/fon.15.224] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Since 2010, multiple advances have been made in the field of metastatic castration-resistant prostate cancer including regulatory approvals for five new agents including androgen pathway inhibitors (enzalutamide, abiraterone acetate), immunotherapy (sipuleucel-T), cytotoxic chemotherapy (cabazitaxel) and radiopharmaceuticals (radium-223) that have improved overall survival in this patient population. Despite these advances, each therapy has only extended median survival by 3–5 months and data suggest substantial cross-resistance among them. Given these modest increments, there is a major role for the vigorous investigation of new drugs and predictive biomarkers to select suitable patients who will benefit from them. This review describes emerging promising agents and their ongoing clinical development.
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Affiliation(s)
- Amanda R Hathaway
- University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL, USA
| | - Mary Katherine Baker
- University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL, USA
| | - Guru Sonpavde
- University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL, USA
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71
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Tucci M, Scagliotti GV, Vignani F. Metastatic castration-resistant prostate cancer: time for innovation. Future Oncol 2015; 11:91-106. [PMID: 25572785 DOI: 10.2217/fon.14.145] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Androgen deprivation is the mainstay of advanced prostate cancer treatment. Despite initial responses, almost all patients progress to castration-resistant prostate cancer (CRPC). The understanding of the biology of CRPC and the evidence that CRPC still remains driven by androgen receptor signaling led to the discovery of new therapeutic targets. In the last few years, large Phase III trials showed improvements in survival and outcomes and led to the approval of a CYP17 inhibitor (abiraterone), an androgen receptor antagonist (enzalutamide), the taxane cabazitaxel, an α-emitter (radium-223), the bone resorption-targeting drug denosumab and an immunotherapy (sipuleucel-T). This article describes the molecular mechanisms underlying castration resistance, discusses recent and ongoing trials and offers some insights into identifying the best sequence of new drugs.
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Affiliation(s)
- Marcello Tucci
- University of Turin, Department of Oncology, S Luigi Hospital, Division of Medical Oncology, Regione Gonzole, 10, 10043 - Orbassano (Torino), Italy
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72
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Boccellino M, Alaia C, Misso G, Cossu AM, Facchini G, Piscitelli R, Quagliuolo L, Caraglia M. Gene interference strategies as a new tool for the treatment of prostate cancer. Endocrine 2015; 49:588-605. [PMID: 26049369 DOI: 10.1007/s12020-015-0629-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 05/11/2015] [Indexed: 12/14/2022]
Abstract
Prostate cancer (PCa) is one of the most common cancer in men. It affects older men and the incidence increases with age; the median age at diagnosis is 67 years. The diagnosis of PCa is essentially based on three tools: digital rectal exam, serum concentration of prostate specific antigen, and transrectal ultrasound-guided biopsy. Currently, the therapeutic treatments of this cancer are different and range from the prostatectomy to hormonal therapy, to radiation therapy, to immunotherapy, and to chemotherapy. However, additional efforts are required in order to find new weapons for the treatment of metastatic setting of disease. The purpose of this review is to highlight new therapeutic strategies based on gene interference; in fact, numerous siRNA and miRNA in the therapeutic treatment of PCa are reported below.
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Affiliation(s)
- Mariarosaria Boccellino
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Via L. De Crecchio, 7, 80138, Naples, Italy
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73
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Macciò A, Gramignano G, Madeddu C. A Multitargeted Treatment Approach for Anemia and Cachexia in Metastatic Castration-Resistant Prostate Cancer. J Pain Symptom Manage 2015; 50:e1-4. [PMID: 26004402 DOI: 10.1016/j.jpainsymman.2015.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 04/09/2015] [Accepted: 04/23/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Antonio Macciò
- Department of Gynecologic Oncology, A. Businco Hospital, Regional Referral Center for Cancer Diseases, Cagliari, Italy.
| | - Giulia Gramignano
- Division of Medical Oncology, N.S. di Bonaria Hospital, San Gavino, Italy
| | - Clelia Madeddu
- Department of Medical Sciences "Mario Aresu", University of Cagliari, Cagliari, Italy
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van Dodewaard-de Jong JM, Verheul HM, Bloemendal HJ, de Klerk JM, Carducci MA, van den Eertwegh AJ. New Treatment Options for Patients With Metastatic Prostate Cancer: What Is The Optimal Sequence? Clin Genitourin Cancer 2015; 13:271-279. [DOI: 10.1016/j.clgc.2015.01.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 01/04/2015] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
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Pharmacotherapeutic management of metastatic, castration-resistant prostate cancer in the elderly: focus on non-chemotherapy agents. Drugs Aging 2015; 31:873-82. [PMID: 25387443 DOI: 10.1007/s40266-014-0224-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In the past 4 years, five new agents have been approved for metastatic, castration-resistant prostate cancer. Four of them are non-chemotherapeutic and generally well tolerated. However, each has toxicities that can negatively impact patients, particularly the elderly. This review covers the epidemiology of prostate cancer in elderly men. It discusses the efficacy data for sipuleucel-T, abiraterone in chemotherapy-naïve patients, enzalutamide in chemotherapy-naïve patients and radium-223 and presents any additional studies done for those over 75 years of age. Disease burden, such as the presence or absence of visceral disease, and comorbid conditions weigh into the selection of therapy and are discussed here. Drug-drug interactions between these agents and other drugs commonly used in the elderly population are also considered. The emerging therapies tasquinimod and ipilimumab are reviewed. With the arrival of so many agents for prostate cancer, selection of the most appropriate agent can be perplexing, particularly because these agents were tested against placebo, not one another. Furthermore, the study population differs significantly from those seen in clinical practice. This review addresses these issues.
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76
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Isaacs JT, Dalrymple SL, Rosen DM, Hammers H, Olsson A, Leanderson T. Anti-cancer potency of tasquinimod is enhanced via albumin-binding facilitating increased uptake in the tumor microenvironment. Oncotarget 2015; 5:8093-106. [PMID: 25193858 PMCID: PMC4226669 DOI: 10.18632/oncotarget.2378] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Tasquinimod, an orally active quinoline-3-carboxamide, binds with high affinity to HDAC4 and S100A9 in cancer and infiltrating host cells within compromised tumor microenvironment inhibiting adaptive survival pathways needed for an angiogenic response. Clinical trials document that as low as 0.5-1mg tasquinimod/day is therapeutic against castrate resistant metastatic prostate cancer. Tasquinimod is metabolized via cytochrome P4503A4, but ketoconazole at a dose which completely inhibits CYP3A metabolism does not affect tasquinimod's ability to inhibit endothelial “sprouting” in vitro or anti-cancer efficacy against human prostate cancer xenografts in vivo. Tasquinimod's potency is facilitated by its reversible binding (Kd < 35 μM) to the IIA subdomain of albumin (Sudlow's site I). As blood vessels within the compromised cancer microenvironment are characterized by a higher degree of leakiness than those in normal tissues, this results in an enhanced uptake of tasquinimod bound to albumin in cancer tissue via a tumor specific process known as the “enhanced permeability and retention” (i.e., EPR) effect. Thus, despite plasma levels of < 1 μM, the EPR effect results in intracellular drug concentrations of 2-3 μM, levels several-fold higher than needed for inhibition of endothelial sprouting (IC50 ~ 0.5 μM) or for inhibition of HDAC4 and S100A9 mediated tumor growth.
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Affiliation(s)
- John T Isaacs
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins ,Baltimore, MD; The Brady Urological Institute-Department of Urology, The Johns Hopkins University School of Medicine ,Baltimore, MD
| | - Susan L Dalrymple
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins ,Baltimore, MD
| | - D Marc Rosen
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins ,Baltimore, MD
| | - Hans Hammers
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins ,Baltimore, MD
| | | | - Tomas Leanderson
- Active Biotech, AB Lund, Sweden; Immunology group, Lund University, Sweden
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77
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Beyond the Immune Suppression: The Immunotherapy in Prostate Cancer. BIOMED RESEARCH INTERNATIONAL 2015; 2015:794968. [PMID: 26161414 PMCID: PMC4486485 DOI: 10.1155/2015/794968] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 11/18/2022]
Abstract
Prostate cancer (PCa) is the second most common cancer in men. As well in many other human cancers, inflammation and immune suppression have an important role in their development. We briefly describe the host components that interact with the tumor to generate an immune suppressive environment involved in PCa promotion and progression. Different tools provide to overcome the mechanisms of immunosuppression including vaccines and immune checkpoint blockades. With regard to this, we report results of most recent clinical trials investigating immunotherapy in metastatic PCa (Sipuleucel-T, ipilimumab, tasquinimod, Prostvac-VF, and GVAX) and provide possible future perspectives combining the immunotherapy to the traditional therapies.
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78
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[New therapies in metastatic castration resistant prostate cancer]. Bull Cancer 2015; 102:501-8. [PMID: 26022286 DOI: 10.1016/j.bulcan.2015.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 04/02/2015] [Indexed: 02/07/2023]
Abstract
Therapeutic arsenal in prostate cancer widens for several years. New hormonal therapies such as acetate abiraterone or enzalutamide were the first molecules to revolutionize the treatment of metastatic castration resistant prostate cancer. Several other treatments are on trial targeting different pathways: androgene pathway (TAK-007, ARN-509, ODM-201, TOK-001), immune system (sipuleucel, ipilimumab, PROSTVAC-V/F, tasquinimod), but also tumor cell (PARP inhibitor, cabozantinib). The treatment sequencing will therefore soon be problematic, raising the necessity to identify predictive markers of response to the new therapies.
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79
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Beltran H, Kaur G, de España CG, Tagawa ST. Exploring the role of anti-angiogenic therapies in prostate cancer: results from the phase 3 trial of sunitinib. Asian J Androl 2015; 16:568-9. [PMID: 24875818 PMCID: PMC4104084 DOI: 10.4103/1008-682x.127822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Prostate cancer is a leading cause of cancer death in men. Despite recent advances in our understanding and treatment of advanced disease, no systemic therapy is curative and new therapies are needed. Targeting angiogenesis is an attractive therapeutic strategy, as angiogenic pathways are upregulated in prostate tumors similar to other malignancies due to imbalance of pro- and anti-angiogenic factors secreted by tumor, endothelial and stromal cells and increased neovasculature.1 Vascular endothelial growth factor (VEGF) is the most well-characterized pro-angiogenenic factor, with several small molecule inhibitors (sunitinib, sorafenib, pazopanib, axitinib, others), antibodies (bevacizumab) and other drugs that target the VEGF pathway approved and/or in development for the treatment of a wide range of tumor types.
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Affiliation(s)
- Himisha Beltran
- Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, USA
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80
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Petrioli R, Francini E, Fiaschi AI, Laera L, Roviello G. Targeted Therapies for Prostate Cancer. Cancer Invest 2015; 33:276-85. [DOI: 10.3109/07357907.2015.1033105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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81
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Current and Emerging Immunotherapies for Castration-resistant Prostate Cancer. Urology 2015; 85:976-986. [DOI: 10.1016/j.urology.2014.12.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/16/2014] [Accepted: 12/19/2014] [Indexed: 11/17/2022]
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82
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Droz JP, Medioni J, Chevreau C, De Mont-Serrat H, Merger M, Stopfer P, Kaiser R, Oudard S. Randomized phase II study of nintedanib in metastatic castration-resistant prostate cancer postdocetaxel. Anticancer Drugs 2015; 25:1081-8. [PMID: 24849708 DOI: 10.1097/cad.0000000000000131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This open-label, phase II trial assessed the efficacy and safety of two doses of nintedanib, a triple angiokinase inhibitor targeting vascular endothelial growth factor, fibroblast growth factor, and platelet-derived growth factor signaling, in patients with metastatic castration-resistant prostate cancer (mCRPC) following progression on docetaxel-based regimens. Patients were randomized to nintedanib 150 mg (arm A, n=40) or 250 mg (arm B, n=41) twice daily for 6 months unless disease progression or adverse events (AEs) led to discontinuation. The primary endpoint was the prostate-specific antigen (PSA) response rate (confirmed PSA decline of ≥20% from baseline). Eighty-one patients were enrolled. The PSA response rate was 0% (0/32) in arm A versus 11.1% (4/36) in arm B (P=0.12); 5.6% of patients (2/36) in arm B showed a PSA reduction of at least 50%. In arm B, the rate of PSA increase was significantly decelerated on treatment versus before treatment (P=0.002). The median progression-free survival was 73.5 and 76.0 days for arm A and arm B, respectively (P=0.3). AEs included gastrointestinal disorders, asthenia, hypertension, and reversible elevated transaminases. The incidence of drug-related serious AEs (no drug-related deaths) was 20.0% (arm A) and 24.4% (arm B). The primary endpoint was not met. Nintedanib (250 mg) showed only modest activity with manageable AEs in patients with mCRPC post-docetaxel.
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Affiliation(s)
- Jean-Pierre Droz
- aDepartment of Medical Oncology, Centre Léon-Bérard, Claude Bernard Lyon-1 University, Lyon bMedical Oncology Department, Georges Pompidou European Hospital (HEGP), Paris cDepartment of Medical Oncology, Institut Claudius Regaud, Toulouse dBoehringer Ingelheim France S.A.S, Reims, France eBoehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
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83
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Mooney D, Paluri R, Mehta A, Goyal J, Sonpavde G. Update in Systemic Therapy of Urologic Malignancies. Postgrad Med 2015; 126:44-54. [DOI: 10.3810/pgm.2014.01.2724] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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84
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Houédé N, Irani J. [Tasquinimod: How to act on microenvironment in metastatic prostate cancer]. Prog Urol 2015; 25:298-305. [PMID: 25684391 DOI: 10.1016/j.purol.2015.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 01/12/2015] [Accepted: 01/14/2015] [Indexed: 10/24/2022]
Abstract
Despite the recent introduction of new drugs, castration-resistant metastatic prostate cancer, (mCRPC) remains a poor prognosis disease, with a crucial need for new therapeutic approaches. Tasquinimod is a newly developed molecule, orally administered, currently evaluated in phase III studies. Tasquinimod targets the tumor microenvironment, focusing on the angiogenic and immune components. Its specific action on the S100A9 protein restores immunity and reduces angiogenesis. A phase II double-blind randomized study against placebo showed an improvement of more than 50% of progression free survival in the group of mCRPC patients treated with tasquinimod, as compared to the placebo group. At a dose of 1mg/day, the tolerance of tasquinimod appeared acceptable. This review presents the available preclinical and clinical results of tasquinimod, with a particular focus on the originality of its mode of action.
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Affiliation(s)
- N Houédé
- Oncologie médicale, CHU Caremeau, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France.
| | - J Irani
- Service d'urologie, hôpital de Milétrie, avenue Jacques-Cœur, 86000 Poitiers, France
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85
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Abstract
In humans, the S100 protein family is composed of 21 members that exhibit a high degree of structural similarity, but are not functionally interchangeable. This family of proteins modulates cellular responses by functioning both as intracellular Ca(2+) sensors and as extracellular factors. Dysregulated expression of multiple members of the S100 family is a common feature of human cancers, with each type of cancer showing a unique S100 protein profile or signature. Emerging in vivo evidence indicates that the biology of most S100 proteins is complex and multifactorial, and that these proteins actively contribute to tumorigenic processes such as cell proliferation, metastasis, angiogenesis and immune evasion. Drug discovery efforts have identified leads for inhibiting several S100 family members, and two of the identified inhibitors have progressed to clinical trials in patients with cancer. This Review highlights new findings regarding the role of S100 family members in cancer diagnosis and treatment, the contribution of S100 signalling to tumour biology, and the discovery and development of S100 inhibitors for treating cancer.
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Affiliation(s)
- Anne R. Bresnick
- Department of Biochemistry, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York 10461, USA
| | - David J. Weber
- Center for Biomolecular Therapeutics and Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, 108 North Greene Street, Baltimore, Maryland 20102, USA
| | - Danna B. Zimmer
- Center for Biomolecular Therapeutics and Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, 108 North Greene Street, Baltimore, Maryland 20102, USA
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86
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Diakos CI, Charles KA, McMillan DC, Clarke SJ. Cancer-related inflammation and treatment effectiveness. Lancet Oncol 2015; 15:e493-503. [PMID: 25281468 DOI: 10.1016/s1470-2045(14)70263-3] [Citation(s) in RCA: 1397] [Impact Index Per Article: 155.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Inflammation is a recognised hallmark of cancer that substantially contributes to the development and progression of malignancies. In established cancers, there is increasing evidence for the roles that local immune response and systemic inflammation have in progression of tumours and survival of patients with cancer. This knowledge provides an opportunity to target these inflammatory responses to improve patient outcomes. In this Review, we examine the complex interplay between local immune responses and systemic inflammation, and their influence on clinical outcomes, and propose potential anti-inflammatory interventions for patients with cancer.
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Affiliation(s)
- Connie I Diakos
- Kolling Institute of Medical Research, University of Sydney, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Kellie A Charles
- School of Medical Sciences (Pharmacology), Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Royal Infirmary, Glasgow, UK
| | - Stephen J Clarke
- Kolling Institute of Medical Research, University of Sydney, Royal North Shore Hospital, Sydney, NSW, Australia.
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87
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Immunotherapy for castration-resistant prostate cancer: Progress and new paradigms. Urol Oncol 2015; 33:245-60. [PMID: 25575714 DOI: 10.1016/j.urolonc.2014.10.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 10/10/2014] [Accepted: 10/15/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND The approval of sipuleucel-T in conjunction with data from other immunotherapeutic trials for prostate cancer and other solid tumors demonstrates the potential of harnessing the patients' immune system for long-term survival. Thus, a range of therapeutic approaches are under evaluation. This review describes the rationale for immunotherapy for prostate cancer, summarizes the approaches under evaluation, and discusses sequencing options for immunotherapy in the current treatment paradigm. DESIGN References for this review were identified through searches of PubMed with the search terms "prostate cancer," "immune system," "vaccine," "immunotherapy," and "T cells." Articles were also identified through searches of the authors' own files. The final reference list was generated based on originality and relevance. RESULTS The immune system can recognize and respond to prostate tumor antigens, effected through tumor-associated antigens and tumor infiltration of immune effector cells. However, evidence also suggests that prostate tumors are adept at escaping immunological recognition, thus hypothesizing multiple therapeutic strategies. Therapeutic approaches could include vaccination and modulation of T-cell function via the blockade of checkpoint receptors such as cytotoxic T-lymphocyte antigen-4 and programmed death 1. In phase III trials, sipuleucel-T improved overall survival for an M1 patient population with castration-resistant prostate cancer and ipilimumab also did so when given after radiotherapy in a subset of better risk patients. In randomized phase II trials, prostate-specific antigen-TRICOM improved overall survival and tasquinimod improved progression-free survival. CONCLUSION Although immunotherapy has the potential to affect advanced prostate cancer, additional research is needed to (1) identify predictive or surrogate markers of activity, (2) understand which agents are clinically effective alone or in combination with other therapies, and (3) define the optimal timing for an immunotherapy to achieve maximal benefit.
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88
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Frieling JS, Basanta D, Lynch CC. Current and emerging therapies for bone metastatic castration-resistant prostate cancer. Cancer Control 2015; 22:109-20. [PMID: 25504285 PMCID: PMC4673894 DOI: 10.1177/107327481502200114] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND A paucity of therapeutic options is available to treat men with metastatic castration-resistant prostate cancer (mCRPC). However, recent developments in our understanding of the disease have resulted in several new therapies that show promise in improving overall survival rates in this patient population. METHODS Agents approved for use in the United States and those undergoing clinical trials for the treatment of mCRPC are reviewed. Recent contributions to the understanding of prostate biology and bone metastasis are discussed as well as how the underlying mechanisms may represent opportunities for therapeutic intervention. New challenges to delivering effective mCRPC treatment will also be examined. RESULTS New and emerging treatments that target androgen synthesis and utilization or the microenvironment may improve overall survival rates for men diagnosed with mCRPC. Determining how factors derived from the primary tumor can promote the development of premetastatic niches and how prostate cancer cells parasitize niches in the bone microenvironment, thus remaining dormant and protected from systemic therapy, could yield new therapies to treat mCRPC. Challenges such as intratumoral heterogeneity and patient selection can potentially be circumvented via computational biology approaches. CONCLUSIONS The emergence of novel treatments for mCRPC, combined with improved patient stratification and optimized therapy sequencing, suggests that significant gains may be made in terms of overall survival rates for men diagnosed with this form of cancer.
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Affiliation(s)
- Jeremy S Frieling
- Department of Tumor Biology, Moffitt Cancer Center, Tampa, FL 33612, USA.
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89
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Abstract
Angiogenesis is a very complex physiological process, which involves multiple pathways that are dependent on the homeostatic balance between the growth factors (stimulators and inhibitors). This tightly controlled process is stimulated by angiogenic factors, which are present within the tumor and surrounding tumor-associated stromal cells. The dependence of tumor propagation, invasion and metastasis on angiogenesis makes the inhibitors of new blood vessel formation attractive drugs for treating the malignancies. Angiogenesis can be disrupted by several distinct mechanisms: by inhibiting endothelial cells, by interrupting the signaling pathways or by inhibiting other activators of angiogenesis. This strategy has shown therapeutic benefit in several types of solid tumors, leading to Food and Drug Administration (FDA) approval of anti-angiogenic agents in the treatment of kidney, non-small cell lung, colon and brain cancers. Although no angiogenesis inhibitors have been approved for patients with metastatic prostate cancer, therapies that target new blood vessel formation are still an emerging and promising area of prostate cancer research.
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Affiliation(s)
| | - Yu-Ning Wong
- Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
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Shen L, Sundstedt A, Ciesielski M, Miles KM, Celander M, Adelaiye R, Orillion A, Ciamporcero E, Ramakrishnan S, Ellis L, Fenstermaker R, Abrams SI, Eriksson H, Leanderson T, Olsson A, Pili R. Tasquinimod modulates suppressive myeloid cells and enhances cancer immunotherapies in murine models. Cancer Immunol Res 2014; 3:136-48. [PMID: 25370534 DOI: 10.1158/2326-6066.cir-14-0036] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A major barrier for cancer immunotherapy is the presence of suppressive cell populations in patients with cancer, such as myeloid-derived suppressor cells (MDSC) and tumor-associated macrophages (TAM), which contribute to the immunosuppressive microenvironment that promotes tumor growth and metastasis. Tasquinimod is a novel antitumor agent that is currently at an advanced stage of clinical development for treatment of castration-resistant prostate cancer. A target of tasquinimod is the inflammatory protein S100A9, which has been demonstrated to affect the accumulation and function of tumor-suppressive myeloid cells. Here, we report that tasquinimod provided a significant enhancement to the antitumor effects of two different immunotherapeutics in mouse models of cancer: a tumor vaccine (SurVaxM) for prostate cancer and a tumor-targeted superantigen (TTS) for melanoma. In the combination strategies, tasquinimod inhibited distinct MDSC populations and TAMs of the M2-polarized phenotype (CD206(+)). CD11b(+) myeloid cells isolated from tumors of treated mice expressed lower levels of arginase-1 and higher levels of inducible nitric oxide synthase (iNOS), and were less immunosuppressive ex vivo, which translated into a significantly reduced tumor-promoting capacity in vivo when these cells were coinjected with tumor cells. Tumor-specific CD8(+) T cells were increased markedly in the circulation and in tumors. Furthermore, T-cell effector functions, including cell-mediated cytotoxicity and IFNγ production, were potentiated. Taken together, these data suggest that pharmacologic targeting of suppressive myeloid cells by tasquinimod induces therapeutic benefit and provide the rationale for clinical testing of tasquinimod in combination with cancer immunotherapies.
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Affiliation(s)
- Li Shen
- Genitourinary Program, Roswell Park Cancer Institute, Buffalo, New York
| | | | - Michael Ciesielski
- Department of Neurosurgery, Roswell Park Cancer Institute, Buffalo, New York
| | | | | | - Remi Adelaiye
- Genitourinary Program, Roswell Park Cancer Institute, Buffalo, New York
| | - Ashley Orillion
- Genitourinary Program, Roswell Park Cancer Institute, Buffalo, New York
| | - Eric Ciamporcero
- Genitourinary Program, Roswell Park Cancer Institute, Buffalo, New York
| | | | - Leigh Ellis
- Genitourinary Program, Roswell Park Cancer Institute, Buffalo, New York
| | - Robert Fenstermaker
- Department of Neurosurgery, Roswell Park Cancer Institute, Buffalo, New York
| | - Scott I Abrams
- Department of Tumor Immunology, Roswell Park Cancer Institute, Buffalo, New York
| | | | - Tomas Leanderson
- Active Biotech AB, Lund, Sweden. Immunology Group, Lund University, Lund, Sweden
| | | | - Roberto Pili
- Genitourinary Program, Roswell Park Cancer Institute, Buffalo, New York.
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91
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Basch E, Loblaw DA, Oliver TK, Carducci M, Chen RC, Frame JN, Garrels K, Hotte S, Kattan MW, Raghavan D, Saad F, Taplin ME, Walker-Dilks C, Williams J, Winquist E, Bennett CL, Wootton T, Rumble RB, Dusetzina SB, Virgo KS. Systemic therapy in men with metastatic castration-resistant prostate cancer:American Society of Clinical Oncology and Cancer Care Ontario clinical practice guideline. J Clin Oncol 2014; 32:3436-48. [PMID: 25199761 PMCID: PMC4876355 DOI: 10.1200/jco.2013.54.8404] [Citation(s) in RCA: 179] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To provide treatment recommendations for men with metastatic castration-resistant prostate cancer (CRPC). METHODS The American Society of Clinical Oncology and Cancer Care Ontario convened an expert panel to develop evidence-based recommendations informed by a systematic review of the literature. RESULTS When added to androgen deprivation, therapies demonstrating improved survival, improved quality of life (QOL), and favorable benefit-harm balance include abiraterone acetate/prednisone, enzalutamide, and radium-223 ((223)Ra; for men with predominantly bone metastases). Improved survival and QOL with moderate toxicity risk are associated with docetaxel/prednisone. For asymptomatic/minimally symptomatic men, improved survival with unclear QOL impact and low toxicity are associated with sipuleucel-T. For men who previously received docetaxel, improved survival, unclear QOL impact, and moderate to high toxicity risk are associated with cabazitaxel/prednisone. Modest QOL benefit (without survival benefit) and high toxicity risk are associated with mitoxantrone/prednisone after docetaxel. No benefit and excess toxicity are observed with bevacizumab, estramustine, and sunitinib. RECOMMENDATIONS Continue androgen deprivation (pharmaceutical or surgical) indefinitely. Abiraterone acetate/prednisone, enzalutamide, or (223)Ra should be offered; docetaxel/prednisone should also be offered, accompanied by discussion of toxicity risk. Sipuleucel-T may be offered to asymptomatic/minimally symptomatic men. For men who have experienced progression with docetaxel, cabazitaxel may be offered, accompanied by discussion of toxicity risk. Mitoxantrone may be offered, accompanied by discussion of limited clinical benefit and toxicity risk. Ketoconazole or antiandrogens (eg, bicalutamide, flutamide, nilutamide) may be offered, accompanied by discussion of limited known clinical benefit. Bevacizumab, estramustine, and sunitinib should not be offered. There is insufficient evidence to evaluate optimal sequences or combinations of therapies. Palliative care should be offered to all patients.
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Affiliation(s)
- Ethan Basch
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - D Andrew Loblaw
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Thomas K Oliver
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Michael Carducci
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Ronald C Chen
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - James N Frame
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Kristina Garrels
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Sebastien Hotte
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Michael W Kattan
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Derek Raghavan
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Fred Saad
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Mary-Ellen Taplin
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Cindy Walker-Dilks
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - James Williams
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Eric Winquist
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Charles L Bennett
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Ted Wootton
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - R Bryan Rumble
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Stacie B Dusetzina
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
| | - Katherine S Virgo
- Ethan Basch, Ronald C. Chen, and Stacie B. Dusetzina, University of North Carolina, Chapel Hill; Derek Raghavan, Carolinas Health Care/Levine Cancer Institute, Charlotte, NC; D. Andrew Loblaw, Odette Cancer Centre, Sunnybrook Health Sciences Centre; Ted Wootton, Patient Representatives, Toronto; Sebastian Hotte and Cindy Walker-Dilks, McMaster University; Cindy Walker-Dilks, Cancer Care Ontario, Hamilton; Eric Winquist, London Health Sciences Centre, London, Ontario; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Thomas K. Oliver and R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Michael Carducci, Johns Hopkins University, Baltimore, MD; James N. Frame, Charleston Area Medical Center Health Systems, Charleston, WV; Kristina Garrels, Private Practice, Fargo, ND; Michael W. Kattan, Cleveland Clinic, Cleveland, OH; Mary-Ellen Taplin, Dana-Farber Cancer Institute, Boston, MA; James Williams, Pennsylvania Prostate Cancer Coalition, Camp Hill, PA; Charles L. Bennett, South Carolina College of Pharmacy, Columbia, SC; and Katherine S. Virgo, Emory University, Atlanta, GA
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Armstrong AJ, Kaboteh R, Carducci MA, Damber JE, Stadler WM, Hansen M, Edenbrandt L, Forsberg G, Nordle Ö, Pili R, Morris MJ. Assessment of the bone scan index in a randomized placebo-controlled trial of tasquinimod in men with metastatic castration-resistant prostate cancer (mCRPC). Urol Oncol 2014; 32:1308-16. [PMID: 25240761 DOI: 10.1016/j.urolonc.2014.08.006] [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: 06/30/2014] [Revised: 08/11/2014] [Accepted: 08/13/2014] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Drug development and clinical decision making for patients with metastatic prostate cancer (PC) have been hindered by a lack of quantitative methods of assessing changes in bony disease burden that are associated with overall survival (OS). Bone scan index (BSI), a quantitative imaging biomarker of bone tumor burden, is prognostic in men with metastatic PC. We evaluated an automated method for BSI calculation for the association between BSI over time with clinical outcomes in a randomized double-blind trial of tasquinimod (TASQ) in men with metastatic castration-resistant PC (mCRPC). METHODS Bone scans collected during central review from the TASQ trial were analyzed retrospectively using EXINIbone(BSI), an automated software package for BSI calculation. Associations between BSI and other prognostic biomarkers, progression-free survival, OS, and treatment were evaluated over time. RESULTS Of 201 men (57 TASQ and 28 placebo), 85 contributed scans at baseline and week 12 of sufficient quality. Baseline BSI correlated with prostate-specific antigen and alkaline phosphatase levels and was associated with OS in univariate (hazard ratio [HR] = 1.42, P = 0.013) and multivariate (HR = 1.64, P<0.001) analyses. BSI worsening at 12 weeks was prognostic for progression-free survival (HR = 2.14 per BSI doubling, P<0.001) and OS (HR = 1.58, P = 0.033) in multivariate analyses including baseline BSI and TASQ treatment. TASQ delayed BSI progression. CONCLUSIONS BSI and BSI changes over time were independently associated with OS in men with mCRPC. A delay in objective radiographic bone scan progression with TASQ is suggested; prospective evaluation of BSI progression and response criteria in phase 3 trials of men with mCRPC is warranted.
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Affiliation(s)
- Andrew J Armstrong
- Duke Cancer Institute and the Duke Prostate Center, Duke University, Durham, NC.
| | - Reza Kaboteh
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Michael A Carducci
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD
| | - Jan-Erik Damber
- Department of Urology, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden
| | | | | | - Lars Edenbrandt
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Department of Clinical Sciences, Lund University, Malmö, Sweden; EXINI Diagnostics AB, Lund, Sweden
| | | | | | - Roberto Pili
- Roswell Park Cancer Institute Genitourinary Program, Buffalo, NY
| | - Michael J Morris
- Genitourinary Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY
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93
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Quinn DI, Vaishampayan U, Higano CS, Lin DW, Shore ND, Beer TM. Sequencing therapy in advanced prostate cancer: focus on sipuleucel-T. Expert Rev Anticancer Ther 2014; 14:51-61. [PMID: 24224900 DOI: 10.1586/14737140.2014.848065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Immunotherapies such as sipuleucel-T present new and unique challenges for the optimal timing and sequencing of therapies for metastatic castration-resistant prostate cancer (mCRPC). Key considerations for the sequencing of sipuleucel-T are its unique proposed mechanism of action, the time required to generate a clinically relevant immune response, and the observed efficacy in Phase III trials in 'early' or asymptomatic or minimally symptomatic mCRPC. There are three broad timing and sequencing options for sipuleucel-T in patients with rising prostate-specific antigen and radiologic evidence of disease: immediately after androgen-deprivation therapy failure, after failure of secondary hormonal maneuvers, or after chemotherapy. There are several other agents in Phase III development in mCRPC and any future approvals will impact on the current treatment algorithm, and raise further questions regarding how to optimize sequencing and timing of therapies for better clinical outcomes.
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Affiliation(s)
- David I Quinn
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
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94
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Wozney JL, Antonarakis ES. Growth factor and signaling pathways and their relevance to prostate cancer therapeutics. Cancer Metastasis Rev 2014; 33:581-94. [PMID: 24402967 PMCID: PMC4090293 DOI: 10.1007/s10555-013-9475-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Treatments that target the androgen axis represent an effective strategy for patients with advanced prostate cancer, but the disease remains incurable and new therapeutic approaches are necessary. Significant advances have recently occurred in our understanding of the growth factor and signaling pathways that are active in prostate cancer. In conjunction with this, many new targeted therapies with sound preclinical rationale have entered clinical development and are being tested in men with castration-resistant prostate cancer. Some of the most relevant pathways currently being exploited for therapeutic gain are HGF/c-Met signaling, the PI3K/AKT/mTOR pathway, Hedgehog signaling, the endothelin axis, Src kinase signaling, the IGF pathway, and angiogenesis. Here, we summarize the biological basis for the use of selected targeted agents and the results from available clinical trials of these drugs in men with prostate cancer.
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Affiliation(s)
- Jocelyn L. Wozney
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Emmanuel S. Antonarakis
- Prostate Cancer Research Program, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, CRB1-1 M45, 1650 Orleans St., Baltimore, MD 21231, USA
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95
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Abstract
The therapeutic landscape of metastatic castration-resistant prostate cancer (mCRPC) has been revolutionized by the arrival of multiple novel agents in the past 2 years. Immunotherapy in the form of sipuleucel-T, androgen axis inhibitors, including abiraterone acetate and enzalutamide, a chemotherapeutic agent, cabazitaxel, and a radiopharmaceutical, radium-223, have all yielded incremental extensions of survival and have been recently approved. A number of other agents appear promising in early studies, suggesting that the armamentarium against castrate-resistant prostate cancer is likely to continue to expand. Emerging androgen pathway inhibitors include androgen synthesis inhibitors (TAK700), androgen receptor inhibitors (ARN-509, ODM-201), AR DNA binding domain inhibitors (EPI-001), selective AR downregulators or SARDs (AZD-3514), and agents that inhibit both androgen synthesis and receptor binding (TOK-001/galeterone). Promising immunotherapeutic agents include poxvirus vaccines and CTLA-4 inhibitor (ipilimumab). Biologic agents targeting the molecular drivers of disease are also being investigated as single agents, including cabozantinib (Met and VEGFR2 inhibitor) and tasquinimod (angiogenesis and immune modulatory agent). Despite the disappointing results seen from studies evaluating docetaxel in combination with other agents, including GVAX, anti-angiogentic agents (bevacizumab, aflibercept, lenalinomide), a SRC kinase inhibitor (dasatinib), endothelin receptor antagonists (atrasentan, zibotentan), and high-dose calcitriol (DN-101), the results from the trial evaluating docetaxel in combination with the clusterin antagonist, custirsen, are eagerly awaited. New therapeutic hurdles consist of discovering new targets, understanding resistance mechanisms, the optimal sequencing and combinations of available agents, as well as biomarkers predictive for benefit. Novel agents targeting bone metastases are being developed following the success of zoledronic acid and denosumab. Finally, all of these modalities do not appear curative, suggesting that clinical trial enrollment and a better understanding of biology remain of paramount importance.
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Affiliation(s)
- N Agarwal
- Division of Medical Oncology, University of Utah Huntsman Cancer Institute, Salt Lake City, USA
| | - G Di Lorenzo
- Department of Endocrinology and Medical Oncology, Genitourinary Cancer Section, University Federico II, Napoli, Italy
| | - G Sonpavde
- Department of Medicine, Division of Hematology Oncology, University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham
| | - J Bellmunt
- Department of Medical Oncology, Dana Farber Cancer Institute and Harvard Medical School, Boston, USA and; University Hospital del Mar-IMIM, Barcelona, Spain.
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96
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Abstract
Bone metastases are present in the vast majority of men with advanced prostate cancer, representing the main cause for morbidity and mortality. Recurrent or metastatic disease is managed initially with androgen deprivation but the majority of the patients eventually will progress to castration-resistant prostate cancer, with patients developing bone metastases in most of the cases. Survival and growth of the metastatic prostate cancer cells is dependent on a complex microenvironment (onco-niche) that includes the osteoblasts, the osteoclasts, the endothelium, and the stroma. This review summarizes agents that target the pathways involved in this complex interaction between prostate cancer and bone microenvironment and aim to transform lethal metastatic prostate cancer into a chronic disease.
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Affiliation(s)
- Daniel L Suzman
- Prostate Cancer Research Program, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1650 Orleans Street, CRB1-1 M45, Baltimore, MD, 21231-1000, USA
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97
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Patel NK, Finianos A, Whitaker KD, Aragon-Ching JB. Advanced prostate cancer - patient survival and potential impact of enzalutamide and other emerging therapies. Ther Clin Risk Manag 2014; 10:651-64. [PMID: 25170270 PMCID: PMC4144843 DOI: 10.2147/tcrm.s57509] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The advent of exponential growth of novel agents tested and approved for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) has brought about a need for understanding of the mechanism of action, side-effects, and clinical efficacy of these drugs as they relate to these patients. This review will provide a synopsis of the treatment landscape in mCRPC as varying agents such as abiraterone acetate, cabazitaxel, sipuleucel-T, radium, and selected emerging agents are presented. A distinct focus on the utilization of enzalutamide, its mechanism of action, key pivotal trials that brought about its US Food and Drug Administration approval, as well as patient-focused perspectives and clinical implications are discussed herein.
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Affiliation(s)
- Nihar K Patel
- Department of Medicine, Division of Hematology and Oncology, George Washington University Medical Center, Washington, DC, USA
| | - Antoine Finianos
- Department of Medicine, Division of Hematology and Oncology, George Washington University Medical Center, Washington, DC, USA
| | - Kristen D Whitaker
- Department of Medicine, Division of Hematology and Oncology, George Washington University Medical Center, Washington, DC, USA
| | - Jeanny B Aragon-Ching
- Department of Medicine, Division of Hematology and Oncology, George Washington University Medical Center, Washington, DC, USA
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98
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Tidehag V, Hammarsten P, Egevad L, Granfors T, Stattin P, Leanderson T, Wikström P, Josefsson A, Hägglöf C, Bergh A. High density of S100A9 positive inflammatory cells in prostate cancer stroma is associated with poor outcome. Eur J Cancer 2014; 50:1829-1835. [DOI: 10.1016/j.ejca.2014.03.278] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 03/18/2014] [Accepted: 03/20/2014] [Indexed: 01/28/2023]
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99
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Suzman DL, Antonarakis ES. Castration-resistant prostate cancer: latest evidence and therapeutic implications. Ther Adv Med Oncol 2014; 6:167-79. [PMID: 25057303 PMCID: PMC4107711 DOI: 10.1177/1758834014529176] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Medical oncologists who treat men with castration-resistant prostate cancer (CRPC) have seen an abundance of new agents approved by the United States Food and Drug Administration in the last decade for a disease that was previously difficult to treat after becoming resistant to androgen-deprivation therapy. Advances in understanding of the mechanisms of castration-resistance and prostate cancer progression have highlighted several pathways and targets that appear promising to better treat CRPC. As the majority of CRPC appears to continue to rely on the androgen receptor for growth and progression, several of these agents directly or indirectly target the androgen receptor. A novel microtubule-targeted agent, cabazitaxel, has demonstrated an overall survival benefit following progression on docetaxel. Other agents target tumor immunogenicity and immune checkpoint pathways to attempt to harness the host immune system. The recently approved radiopharmaceutical, radium-223 dichloride, has demonstrated impressive results in patients with extensive bony metastases with minimal toxicity. Lastly, further understanding of the pathways underlying CRPC progression has led to late-phase clinical trials with the novel agents: custirsen, tasquinimod and cabozantinib. This article reviews the approved therapies for CRPC, the agents currently in late-phase clinical trials, and notable early-phase trials of novel therapies and their combinations, with particular attention to trials incorporating novel biomarkers and intermediate endpoints to better identify those men who may or may not benefit from specific therapies.
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Affiliation(s)
- Daniel L Suzman
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Emmanuel S Antonarakis
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, 1650 Orleans Street, CRB1-1M45, Baltimore, MD 21287, USA
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100
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Quantitative determination of the anti-tumor agent tasquinimod in human urine by liquid chromatography-tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2014; 961:42-8. [PMID: 24858264 DOI: 10.1016/j.jchromb.2014.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 04/29/2014] [Accepted: 05/04/2014] [Indexed: 11/23/2022]
Abstract
Tasquinimod is an anti-tumor drug that is currently in clinical development for the treatment of solid cancers. After oral administration, tasquinimod and a number of its metabolites are excreted in the urine. The quantitative determination of tasquinimod in urine is challenging because of the required sensitivity (down to 0.1nM or 40pg/mL), the highly variable nature of this biological matrix and the presence of potentially unstable metabolites, which may convert back to the parent drug. In this article, an LC-MS/MS method is described for the determination of tasquinimod in human urine in the concentration range 0.1-200nM. Liquid-liquid extraction with n-chlorobutane was used to extract tasquinimod from 100μL human urine and to remove interfering endogenous urinary constituents. Reversed-phase liquid chromatography coupled to a triple quadrupole mass spectrometer equipped with an ESI source was used for quantification of tasquinimod in a 2.5-min run. A stable-isotope labeled internal standard was used for response normalization. The intra- and inter-day coefficients of variation (precision) as well as the bias (accuracy) of the method were below 7%. Although considerable conversion of conjugated tasquinimod metabolites back to parent drug was observed when incurred samples were stored at 37°C for a prolonged time, tasquinimod as well as its metabolites were sufficiently stable under all relevant sampling, storage and analysis conditions. The method was successfully applied to determine the urinary excretion of tasquinimod in healthy volunteers and patients with renal impairment after a 0.5-mg oral dose.
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