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Selby PJ, Banks RE, Gregory W, Hewison J, Rosenberg W, Altman DG, Deeks JJ, McCabe C, Parkes J, Sturgeon C, Thompson D, Twiddy M, Bestall J, Bedlington J, Hale T, Dinnes J, Jones M, Lewington A, Messenger MP, Napp V, Sitch A, Tanwar S, Vasudev NS, Baxter P, Bell S, Cairns DA, Calder N, Corrigan N, Del Galdo F, Heudtlass P, Hornigold N, Hulme C, Hutchinson M, Lippiatt C, Livingstone T, Longo R, Potton M, Roberts S, Sim S, Trainor S, Welberry Smith M, Neuberger J, Thorburn D, Richardson P, Christie J, Sheerin N, McKane W, Gibbs P, Edwards A, Soomro N, Adeyoju A, Stewart GD, Hrouda D. Methods for the evaluation of biomarkers in patients with kidney and liver diseases: multicentre research programme including ELUCIDATE RCT. PROGRAMME GRANTS FOR APPLIED RESEARCH 2018. [DOI: 10.3310/pgfar06030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BackgroundProtein biomarkers with associations with the activity and outcomes of diseases are being identified by modern proteomic technologies. They may be simple, accessible, cheap and safe tests that can inform diagnosis, prognosis, treatment selection, monitoring of disease activity and therapy and may substitute for complex, invasive and expensive tests. However, their potential is not yet being realised.Design and methodsThe study consisted of three workstreams to create a framework for research: workstream 1, methodology – to define current practice and explore methodology innovations for biomarkers for monitoring disease; workstream 2, clinical translation – to create a framework of research practice, high-quality samples and related clinical data to evaluate the validity and clinical utility of protein biomarkers; and workstream 3, the ELF to Uncover Cirrhosis as an Indication for Diagnosis and Action for Treatable Event (ELUCIDATE) randomised controlled trial (RCT) – an exemplar RCT of an established test, the ADVIA Centaur® Enhanced Liver Fibrosis (ELF) test (Siemens Healthcare Diagnostics Ltd, Camberley, UK) [consisting of a panel of three markers – (1) serum hyaluronic acid, (2) amino-terminal propeptide of type III procollagen and (3) tissue inhibitor of metalloproteinase 1], for liver cirrhosis to determine its impact on diagnostic timing and the management of cirrhosis and the process of care and improving outcomes.ResultsThe methodology workstream evaluated the quality of recommendations for using prostate-specific antigen to monitor patients, systematically reviewed RCTs of monitoring strategies and reviewed the monitoring biomarker literature and how monitoring can have an impact on outcomes. Simulation studies were conducted to evaluate monitoring and improve the merits of health care. The monitoring biomarker literature is modest and robust conclusions are infrequent. We recommend improvements in research practice. Patients strongly endorsed the need for robust and conclusive research in this area. The clinical translation workstream focused on analytical and clinical validity. Cohorts were established for renal cell carcinoma (RCC) and renal transplantation (RT), with samples and patient data from multiple centres, as a rapid-access resource to evaluate the validity of biomarkers. Candidate biomarkers for RCC and RT were identified from the literature and their quality was evaluated and selected biomarkers were prioritised. The duration of follow-up was a limitation but biomarkers were identified that may be taken forward for clinical utility. In the third workstream, the ELUCIDATE trial registered 1303 patients and randomised 878 patients out of a target of 1000. The trial started late and recruited slowly initially but ultimately recruited with good statistical power to answer the key questions. ELF monitoring altered the patient process of care and may show benefits from the early introduction of interventions with further follow-up. The ELUCIDATE trial was an ‘exemplar’ trial that has demonstrated the challenges of evaluating biomarker strategies in ‘end-to-end’ RCTs and will inform future study designs.ConclusionsThe limitations in the programme were principally that, during the collection and curation of the cohorts of patients with RCC and RT, the pace of discovery of new biomarkers in commercial and non-commercial research was slower than anticipated and so conclusive evaluations using the cohorts are few; however, access to the cohorts will be sustained for future new biomarkers. The ELUCIDATE trial was slow to start and recruit to, with a late surge of recruitment, and so final conclusions about the impact of the ELF test on long-term outcomes await further follow-up. The findings from the three workstreams were used to synthesise a strategy and framework for future biomarker evaluations incorporating innovations in study design, health economics and health informatics.Trial registrationCurrent Controlled Trials ISRCTN74815110, UKCRN ID 9954 and UKCRN ID 11930.FundingThis project was funded by the NIHR Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 6, No. 3. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Peter J Selby
- Clinical and Biomedical Proteomics Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Rosamonde E Banks
- Clinical and Biomedical Proteomics Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Walter Gregory
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Jenny Hewison
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - William Rosenberg
- Institute for Liver and Digestive Health, Division of Medicine, University College London, London, UK
| | - Douglas G Altman
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Jonathan J Deeks
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Christopher McCabe
- Department of Emergency Medicine, University of Alberta Hospital, Edmonton, AB, Canada
| | - Julie Parkes
- Primary Care and Population Sciences Academic Unit, University of Southampton, Southampton, UK
| | | | | | - Maureen Twiddy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Janine Bestall
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Tilly Hale
- LIVErNORTH Liver Patient Support, Newcastle upon Tyne, UK
| | - Jacqueline Dinnes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Marc Jones
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | | | | | - Vicky Napp
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Alice Sitch
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sudeep Tanwar
- Institute for Liver and Digestive Health, Division of Medicine, University College London, London, UK
| | - Naveen S Vasudev
- Clinical and Biomedical Proteomics Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Paul Baxter
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Sue Bell
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - David A Cairns
- Clinical and Biomedical Proteomics Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | | | - Neil Corrigan
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Francesco Del Galdo
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Peter Heudtlass
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Nick Hornigold
- Clinical and Biomedical Proteomics Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Claire Hulme
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Michelle Hutchinson
- Clinical and Biomedical Proteomics Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Carys Lippiatt
- Department of Specialist Laboratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Roberta Longo
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Matthew Potton
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Stephanie Roberts
- Clinical and Biomedical Proteomics Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Sheryl Sim
- Clinical and Biomedical Proteomics Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Sebastian Trainor
- Clinical and Biomedical Proteomics Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Matthew Welberry Smith
- Clinical and Biomedical Proteomics Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - James Neuberger
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Paul Richardson
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - John Christie
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Neil Sheerin
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - William McKane
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Paul Gibbs
- Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | | | - Naeem Soomro
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Grant D Stewart
- NHS Lothian, Edinburgh, UK
- Academic Urology Group, University of Cambridge, Cambridge, UK
| | - David Hrouda
- Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
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McDermott DF, Drake CG, Sznol M, Choueiri TK, Powderly JD, Smith DC, Brahmer JR, Carvajal RD, Hammers HJ, Puzanov I, Hodi FS, Kluger HM, Topalian SL, Pardoll DM, Wigginton JM, Kollia GD, Gupta A, McDonald D, Sankar V, Sosman JA, Atkins MB. Survival, Durable Response, and Long-Term Safety in Patients With Previously Treated Advanced Renal Cell Carcinoma Receiving Nivolumab. J Clin Oncol 2015; 33:2013-20. [PMID: 25800770 DOI: 10.1200/jco.2014.58.1041] [Citation(s) in RCA: 354] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Blockade of the programmed death-1 inhibitory cell-surface molecule on immune cells using the fully human immunoglobulin G4 antibody nivolumab mediates tumor regression in a portion of patients with advanced treatment-refractory solid tumors. We report clinical activity, survival, and long-term safety in patients with advanced renal cell carcinoma (RCC) treated with nivolumab in a phase I study with expansion cohorts. PATIENTS AND METHODS A total of 34 patients with previously treated advanced RCC, enrolled between 2008 and 2012, received intravenous nivolumab (1 or 10 mg/kg) in an outpatient setting once every two weeks for up to 96 weeks and were observed for survival and duration of response after treatment discontinuation. RESULTS Ten patients (29%) achieved objective responses (according to RECIST [version 1.0]), with median response duration of 12.9 months; nine additional patients (27%) demonstrated stable disease lasting > 24 weeks. Three of five patients who stopped treatment while in response continued to respond for ≥ 45 weeks. Median overall survival in all patients (71% with two to five prior systemic therapies) was 22.4 months; 1-, 2-, and 3-year survival rates were 71%, 48%, and 44%, respectively. Grade 3 to 4 treatment-related adverse events occurred in 18% of patients; all were reversible. CONCLUSION Patients with advanced treatment-refractory RCC treated with nivolumab demonstrated durable responses that in some responders persisted after drug discontinuation. Overall survival is encouraging, and toxicities were generally manageable. Ongoing randomized clinical trials will further assess the impact of nivolumab on overall survival in patients with advanced RCC.
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Affiliation(s)
- David F McDermott
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC.
| | - Charles G Drake
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Mario Sznol
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Toni K Choueiri
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - John D Powderly
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - David C Smith
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Julie R Brahmer
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Richard D Carvajal
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Hans J Hammers
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Igor Puzanov
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - F Stephen Hodi
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Harriet M Kluger
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Suzanne L Topalian
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Drew M Pardoll
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Jon M Wigginton
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Georgia D Kollia
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Ashok Gupta
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Dan McDonald
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Vindira Sankar
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Jeffrey A Sosman
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Michael B Atkins
- David F. McDermott, Beth Israel Deaconess Medical Center; Toni K. Choueiri, Dana-Farber Cancer Institute/Brigham and Women's Hospital; Igor Puzanov and F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; Charles G. Drake, Julie R. Brahmer, Hans J. Hammers, Suzanne L. Topalian, and Drew M. Pardoll, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; John D. Powderly, Carolina BioOncology Institute, Huntersville, NC; David C. Smith, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Richard D. Carvajal, Memorial Sloan-Kettering Cancer Center, New York, NY; Jon M. Wigginton, Georgia D. Kollia, Ashok Gupta, Dan McDonald, and Vindira Sankar, Bristol-Myers Squibb, Princeton, NJ; Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Nashville, TN; and Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
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