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Marshall RF, Xu H, Berkenstock M. Ocular toxicities associated with antibody drug conjugates. Curr Opin Ophthalmol 2024; 35:494-498. [PMID: 38814581 DOI: 10.1097/icu.0000000000001063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
PURPOSE OF REVIEW To review the structure, mechanism of action, and pathophysiology of antibody-drug conjugates (ADCs) used to treat gynecological malignancies associated with ocular adverse effects. RECENT FINDINGS Recent research shows tisotumab vedotin causes ocular toxicity localized to the conjunctiva, with common adverse effects being conjunctivitis, dry eye, blepharitis, and keratitis. Toxicity is likely due to targeting tissue factor (TF) in the conjunctiva, leading to direct delivery of the cytotoxic payload resulting in apoptosis and bystander killing. Mirvetuximab soravtansine causes blurred vision, keratitis, or dry eye with toxicity often localized in the cornea. Off-target inflammation appears to cause ocular adverse effects, with nonreceptor mediated macropinocytosis by corneal stem cells. SUMMARY Collaboration between oncologists and ophthalmologists with adherence to mitigation protocols can decrease the risk of ocular adverse events.
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Affiliation(s)
- Rayna F Marshall
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Hannah Xu
- University of California San Diego, San Diego, California
| | - Meghan Berkenstock
- Division of Ocular Immunology, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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2
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Gupta A, O'Cearbhaill RE, Block MS, Hamilton E, Konner JA, Knutson KL, Potts J, Garrett G, Kenney RT, Wenham RM. Vaccination with folate receptor-alpha peptides in patients with ovarian cancer following response to platinum-based therapy: A randomized, multicenter clinical trial. Gynecol Oncol 2024; 189:90-97. [PMID: 39068739 DOI: 10.1016/j.ygyno.2024.07.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/16/2024] [Accepted: 07/18/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE Folate receptor alpha (FRα) is overexpressed on >90% of high-grade epithelial ovarian cancers (EOC). Targeting FRα with antibody-drug conjugates has proven utility in the platinum-resistant setting. It is also a potential therapeutic target for immuno-oncologic agents, such as peptide vaccines that work primarily via adaptive and humoral immunity. We tested the hypothesis that FRα peptide immunization could improve outcomes in patients with EOC following response to platinum-based therapy. METHODS We conducted a randomized, double-blind, multicenter, phase II study to evaluate the safety and efficacy of TPIV200 (a multi-epitope FRα peptide vaccine admixed with GM-CSF) versus GM-CSF alone in 120 women who did not have disease progression after at least 4 cycles of first-line platinum-based therapy. Patients were vaccinated intradermally once every 4 weeks up to 6 times, followed by a boosting period of 6 vaccinations at 12-week intervals. Primary endpoints included safety, tolerability, and progression free survival (PFS). RESULTS At study termination with a median follow-up of 15.2 months (range 1.2-28.4 months), 68 of 119 intention-to-treat patients had disease progression (55% in TPIV200 + GM-CSF arm and 59% in GM-CSF alone arm). The median PFS was 11.1 months (95% CI 8.3-16.6 months) with no significant difference between the treatment groups (10.9 months with TPIV200 + GM-CSF versus 11.1 months with GM-CSF, HR, 0.85; upper 90% CI 1.17]. No patient experienced a ≥ grade 3 drug-related adverse event. CONCLUSION TPIV200 was well tolerated but was not associated with improved PFS. Additional studies are required to uncover potential synergies using multiepitope vaccines targeting FRα. Trial Registration NLM/NCBI Registry, NCT02978222, https://clinicaltrials.gov/search?term=NCT02978222.
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Affiliation(s)
- Aditi Gupta
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Roisin E O'Cearbhaill
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, United States of America
| | | | - Erika Hamilton
- Sarah Cannon Research Institute, Nashville, TN, United States of America
| | - Jason A Konner
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, United States of America
| | | | - James Potts
- Veristat LLC, Southborough, MA, United States of America
| | - Gerald Garrett
- Marker Therapeutics, Inc., Houston, TX, United States of America
| | - Richard T Kenney
- Marker Therapeutics, Inc., Houston, TX, United States of America
| | - Robert M Wenham
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America.
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3
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Lin Q, Li J, Abudousalamu Z, Sun Y, Xue M, Yao L, Chen M. Advancing Ovarian Cancer Therapeutics: The Role of Targeted Drug Delivery Systems. Int J Nanomedicine 2024; 19:9351-9370. [PMID: 39282574 PMCID: PMC11401532 DOI: 10.2147/ijn.s478313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 08/06/2024] [Indexed: 09/19/2024] Open
Abstract
Ovarian cancer (OC) is the most lethal reproductive system cancer and a leading cause of cancer-related death. The high mortality rate and poor prognosis of OC are primarily due to its tendency for extensive abdominal metastasis, late diagnosis in advanced stages, an immunosuppressive tumor microenvironment, significant adverse reactions to first-line chemotherapy, and the development of chemoresistance. Current adjuvant chemotherapies face challenges such as poor targeting, low efficacy, and significant side effects. Targeted drug delivery systems (TDDSs) are designed to deliver drugs precisely to the tumor site to enhance efficacy and minimize side effects. This review highlights recent advancements in the use of TDDSs for OC therapies, including drug conjugate delivery systems, nanoparticle drug delivery systems, and hydrogel drug delivery systems. The focus is on employing TDDS to conduct direct, effective, and safer interventions in OC through methods such as targeted tumor recognition and controlled drug release, either independently or in combination. This review also discusses the prospects and challenges for further development of TDDSs. Undoubtedly, the use of TDDSs shows promise in the battle against OCs.
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Affiliation(s)
- Qianhan Lin
- Department of Gynecologic Oncology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jiajia Li
- Department of Gynecologic Oncology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Zulimire Abudousalamu
- Department of Gynecologic Oncology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yating Sun
- Department of Gynecologic Oncology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Mengyang Xue
- Department of Gynecologic Oncology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Liangqing Yao
- Department of Gynecologic Oncology, Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Mo Chen
- Department of Gynecologic Oncology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
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4
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Manning-Geist BL, Sullivan MW, Zhou Q, Iasonos A, Selenica P, Stallworth C, Liu YL, Long Roche K, Gordhandas S, Aghajanian C, Chi D, O'Cearbhaill R, Grisham RN, Chui MH. Folate receptor alpha expression in low-grade serous ovarian cancer: Exploring new therapeutic possibilities. Gynecol Oncol 2024; 188:52-57. [PMID: 38941962 PMCID: PMC11368654 DOI: 10.1016/j.ygyno.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/03/2024] [Accepted: 06/13/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE Mirvetuximab soravtansine may be a potentially effective therapeutic option for ovarian low-grade serous carcinoma (LGSC), but the prevalence of folate receptor alpha (FRα) overexpression in this tumor type is unknown. We sought to characterize FRα expression in LGSC and its association with clinical and molecular features. METHODS FRα immunohistochemistry was performed on a tissue microarray comprised of 89 LGSCs and 42 ovarian serous borderline tumors (SBTs). Clinical tumor-normal panel-based sequencing was performed on 78 LGSCs. Associations between FRα-high status and clinicopathologic characteristics and survival outcomes were examined. RESULTS Of 89 LGSCs, 36 (40%) were FRα-high (≥75% of viable tumor cells exhibiting moderate-to-strong membranous expression). Of 9 patients with LGSC and samples from different timepoints, 4 (44%) had discordant results, with conversion from FRα-negative to FRα-high in 3 (33%) cases. There was no association between FRα-high status with age, race, or progression-free/overall survival. A MAPK pathway genetic alteration, most commonly involving KRAS (n = 23), was present in 45 (58%) LGSCs. Those lacking MAPK pathway alterations were more likely to be FRα-high compared to MAPK-altered LGSCs (61% vs 20%, p < 0.001). In SBTs, FRα-high expression was associated with high-risk (micropapillary) histology and/or subsequent LGSC recurrence compared to conventional SBTs without malignant recurrence (53% vs 9%, p = 0.008). CONCLUSIONS Future studies of FRα-directed therapy in patients with LGSC are warranted. Discordant FRα status at recurrence suggests potential benefit for retesting. A biomarker-driven approach to direct treatment selection in LGSC is recommended. As high FRα expression is more common amongst tumors lacking MAPK pathway genetic alterations, FRα testing to determine eligibility for mirvetuximab soravtansine therapy is particularly recommended for this subgroup.
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Affiliation(s)
- Beryl L Manning-Geist
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mackenzie W Sullivan
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Qin Zhou
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexia Iasonos
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Pier Selenica
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chrystal Stallworth
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ying L Liu
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Kara Long Roche
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA
| | - Sushmita Gordhandas
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Carol Aghajanian
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Dennis Chi
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA
| | - Róisín O'Cearbhaill
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Rachel N Grisham
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
| | - M Herman Chui
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Zhang P, Tao C, Lu Y, Li P, Wang X, Dai Y, Xi Y, Shimura T, Li X, Fang J, Yang L, He D, Guo P. Epigenetic Reprogramming Potentiates ICAM1 Antibody Drug Conjugates in Preclinical Models of Melanoma. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2400203. [PMID: 38874532 PMCID: PMC11321650 DOI: 10.1002/advs.202400203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 05/15/2024] [Indexed: 06/15/2024]
Abstract
Therapeutic benefits and underlying biomechanism(s) of antibody drug conjugates (ADC) in combination with other targeted therapeutics are largely unknown. Here, the synergy between ADC and epigenetic drug decitabine (DAC), a clinically approved DNA methylation inhibitor, in multiple preclinical models of melanoma specifically investigated. Mechanistically, the underlying biomechanisms of how DAC cooperatively worked with ICAM1 antibody conjugated DNA topoisomerase I inhibitor DXd (I1-DXd) is elucidated. DAC treatment significantly enhanced anti-tumor efficacy of I1-DXd by upregulating antigen expression, enhancing antibody internalization and potentiating tumor sensitivity by epigenetically reprogramming of melanoma. Meanwhile, I1-DXd/DAC combination also exerted regulatory effects on tumor microenvironment (TME) by enhancing tumor infiltration of innate and adaptive immune cells and improving penetration of ADCs with a boosted antitumor immunity. This study provides a rational ADC combination strategy for solid tumor treatment.
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Affiliation(s)
- Peng Zhang
- Department of Medical OncologyZhejiang Provincial People's HospitalHangzhouZhejiang310022China
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang ProvinceZhejiang Provincial People's HospitalPeople's Hospital of Hangzhou Medical CollegeHangzhouZhejiang310014China
- Hangzhou Institute of Medicine (HIM)Chinese Academy of SciencesHangzhouZhejiang310022China
| | - Changjuan Tao
- Department of Radiation OncologyThe Cancer Hospital of the University of Chinese Academy of SciencesZhejiang Cancer HospitalHangzhouZhejiang310022China
- Key Laboratory of Head and Neck Cancer Translational Research of Zhejiang ProvinceZhejiang Cancer HospitalHangzhouZhejiang310022China
| | - Ye Lu
- Hangzhou Institute of Medicine (HIM)Chinese Academy of SciencesHangzhouZhejiang310022China
| | - Peijing Li
- Department of Radiation OncologyThe Cancer Hospital of the University of Chinese Academy of SciencesZhejiang Cancer HospitalHangzhouZhejiang310022China
- Key Laboratory of Head and Neck Cancer Translational Research of Zhejiang ProvinceZhejiang Cancer HospitalHangzhouZhejiang310022China
| | - Xing Wang
- Department of Head and Neck SurgeryThe Cancer Hospital of the University of Chinese Academy of SciencesZhejiang Cancer HospitalHangzhouZhejiang310022China
| | - Yujie Dai
- MabPlex InternationalYantaiShandong264006China
| | - Yun Xi
- Department of PathologyThe Cancer Hospital of the University of Chinese Academy of SciencesZhejiang Cancer HospitalHangzhouZhejiang310022China
| | - Takaya Shimura
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoya467–8601Japan
| | - Xinfang Li
- MabPlex InternationalYantaiShandong264006China
| | - Jianmin Fang
- School of Materials Science and EngineeringTianjin UniversityTianjin300072China
| | - Liu Yang
- Department of Medical OncologyZhejiang Provincial People's HospitalHangzhouZhejiang310022China
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang ProvinceZhejiang Provincial People's HospitalPeople's Hospital of Hangzhou Medical CollegeHangzhouZhejiang310014China
| | - Dawei He
- Department of UrologyChildren's Hospital of Chongqing Medical UniversityChongqingChina
| | - Peng Guo
- Hangzhou Institute of Medicine (HIM)Chinese Academy of SciencesHangzhouZhejiang310022China
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6
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Mathiot L, Baldini C, Letissier O, Hollebecque A, Bahleda R, Gazzah A, Smolenschi C, Sakkal M, Danlos FX, Henon C, Beshiri K, Goldschmidt V, Parisi C, Patrikidou A, Michot JM, Marabelle A, Postel-Vinay S, Bernard-Tessier A, Loriot Y, Ponce S, Champiat S, Ouali K. Exploring the Role of Target Expression in Treatment Efficacy of Antibody-Drug Conjugates (ADCs) in Solid Cancers: A Comprehensive Review. Curr Oncol Rep 2024:10.1007/s11912-024-01576-9. [PMID: 39066847 DOI: 10.1007/s11912-024-01576-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE OF REVIEW Antibody-drug conjugates (ADCs) offer a promising path for cancer therapy, leveraging the specificity of monoclonal antibodies and the cytotoxicity of linked drugs. The success of ADCs hinges on precise targeting of cancer cells based on protein expression levels. This review explores the relationship between target protein expression and ADC efficacy in solid tumours, focusing on results of clinical trials conducted between January 2019 and May 2023. RECENT FINDINGS We hereby highlight approved ADCs, revealing their effectiveness even in low-expressing target populations. Assessing target expression poses challenges, owing to variations in scoring systems and biopsy types. Emerging methods, like digital image analysis, aim to standardize assessment. The complexity of ADC pharmacokinetics, tumour dynamics, and off-target effects emphasises the need for a balanced approach. This review underscores the importance of understanding target protein dynamics and promoting standardized evaluation methods in shaping the future of ADC-based cancer therapies.
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Affiliation(s)
- Laurent Mathiot
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Capucine Baldini
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Octave Letissier
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Antoine Hollebecque
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Rastislav Bahleda
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Anas Gazzah
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Cristina Smolenschi
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Madona Sakkal
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - François-Xavier Danlos
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
- Institut National de La Santé Et de La Recherche Médicale (INSERM) U1015, Villejuif, France
- Centre d'Investigations Cliniques Biothérapies Pour Une Immunisation in Situ (BIOTHERIS), INSERM, CIC1428, Villejuif, France
| | - Clémence Henon
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Kristi Beshiri
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Vincent Goldschmidt
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Claudia Parisi
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Anna Patrikidou
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Jean-Marie Michot
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Aurélien Marabelle
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Sophie Postel-Vinay
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | | | - Yohann Loriot
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
- Institut National de La Santé Et de La Recherche Médicale (INSERM) U981, Villejuif, France
| | - Santiago Ponce
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - Stéphane Champiat
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France
- Institut National de La Santé Et de La Recherche Médicale (INSERM) U1015, Villejuif, France
- Centre d'Investigations Cliniques Biothérapies Pour Une Immunisation in Situ (BIOTHERIS), INSERM, CIC1428, Villejuif, France
| | - Kaïssa Ouali
- Drug Development Department, Gustave Roussy Cancer Campus, Villejuif Cedex, France.
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7
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Lawson BC, Marques-Piubelli ML, Westin SN, Malpica A. Folate Receptor Immunohistochemical Staining and Gynecologic Tumors: Initial Experience With 216 Cases. Int J Gynecol Pathol 2024:00004347-990000000-00173. [PMID: 38914019 DOI: 10.1097/pgp.0000000000001053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Folate receptor alpha has been shown to have possible mechanisms of tumorigenesis in malignancies, becoming a potential target for therapy. Mirvetuximab soravtansine is an antifolate receptor alpha monoclonal antibody, with an approved FOLR1-2.1 immunohistochemical biomarker. After IRB approval, a retrospective review of gynecologic pathology cases was performed to identify cases in which FOLR1 immunohistochemistry (IHC) was performed at our institution over a period of 9 months as part of clinical care for therapy eligibility. Clinical data collected included patients' age, tumor histotype, tumor grade, primary tumor site, FIGO stage, dates of recurrence/progression, and use of mirvetuximab therapy. FOLR1 IHC data were recorded, including the date specimen obtained, date IHC was performed, site tested, case type, percentage tumor staining, and intensity. Cases were deemed positive or negative according to current recommendations (75%, 2-3+intensity). Two hundred sixteen cases were identified. Patient ages ranged from 25 to 83 years old (median: 59 yr). Staining intensity was reported as 0 in 15 (6.9%) cases, weak (1+) in 8 (3.7%), moderate (2+) in 27 (12.5%), strong (3+) in 27 (12.5%), weak-to-moderate (1-2+) in 15 (6.9%), and moderate-to-strong (2-3+) in 99 (45.8%); intensity was not provided in 25 (11.6%). Percentage of tumor staining ranged from 0 to 100, with a median of 60. The IHC was overall deemed positive in 98 (45.4%) cases and negative in 118 (54.6%). By histotype, 5 of 17 (29.4%) low-grade serous carcinomas, 88 of 162 (54.3%) high-grade serous carcinomas, 3 of 5 (60%) of carcinosarcomas, and 2 of 6 (33.3%) of mixed carcinomas were positive. No case of clear cell CA, endometrioid CA, Mullerian CA NOS, serous borderline, mucinous CA, or granulosa cell tumor was positive. The primary site of disease was tubo-ovarian in 192 (88.9%) cases, peritoneal in 8 (3.7%) cases, uterine in 3 (1.4%) cases, and unknown in 13 (6%) cases. By site on which immunohistochemical stain was performed: primary site positive in 53 of 96 (55.2%) cases, metastatic site at time of diagnosis/debulking positive in 23 of 41 (52.1%) cases, and metastatic/recurrent cases positive in 22 of 79 (27.8%) cases. There was a statistically significant correlation when comparing the positivity rates between these sites (P = 0.0004). Survival data were examined with high-grade serous carcinoma, with no statistically significant difference between positive and negative cases in overall survival (P = 0.622) or progression-free survival (P = 0.711). Biopsy specimens were positive in 17 (25%) cases, while negative in 51 (75%), whereas resection specimens were positive in 81 (54.7%) and negative in 67 (45.3%), a statistically significant difference (P < 0.0001). Cases that were <19 months old had 38 (36.2%) positive and 67 (63.8%) negative, compared with cases ≥19 months old that had 60 (54.1%) positive and 51 (45.9%) negative, a statistically significant difference (P = 0.0084). Significant differences in FOLR1 staining were noted between histotypes, age of the specimen, type of case tested, and site of disease tested. Further testing is needed to help determine the best tissue to be utilized for this new biomarker.
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Affiliation(s)
- Barrett C Lawson
- Departments of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas
| | - Mario L Marques-Piubelli
- Departments of Translational Molecular Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas
| | - Shannon N Westin
- Departments of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, The University of Texas, Houston, Texas
| | - Anais Malpica
- Departments of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas
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8
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Richardson DL, Moore KN, Vergote I, Gilbert L, Martin LP, Mantia-Smaldone GM, Castro CM, Provencher D, Matulonis UA, Stec J, Wang Y, Method M, O'Malley DM. Phase 1b study of mirvetuximab soravtansine, a folate receptor alpha (FRα)-targeting antibody-drug conjugate, in combination with carboplatin and bevacizumab in patients with platinum-sensitive ovarian cancer. Gynecol Oncol 2024; 185:186-193. [PMID: 38447347 DOI: 10.1016/j.ygyno.2024.01.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Evaluate the antitumor activity and safety profile of the triplet combination of mirvetuximab soravtansine (MIRV), carboplatin, and bevacizumab in recurrent, platinum-sensitive ovarian cancer. METHODS Participants with recurrent, platinum-sensitive epithelial ovarian, fallopian tube, or primary peritoneal cancer (1-2 prior lines of therapy) received MIRV (6 mg/kg adjusted ideal body weight), carboplatin (AUC5), and bevacizumab (15 mg/kg) once every 3 weeks. Carboplatin could be discontinued after 6 cycles per investigator discretion; continuation of MIRV+bevacizumab as maintenance therapy was permitted. Eligibility included folate receptor alpha (FRα) expression by immunohistochemistry (≥50% of cells with ≥2+ intensity; PS2+ scoring); prior bevacizumab was allowed. Tumor response, duration of response (DOR), progression-free survival (PFS), and adverse events (AEs) were assessed. RESULTS Forty-one participants received triplet therapy, with a median of 6, 12, and 13 cycles of carboplatin, MIRV, and bevacizumab, respectively. The confirmed objective response rate was 83% (9 complete and 25 partial responses). The median DOR was 10.9 months; median PFS was 13.5 months. AEs (any grade) occurred as expected, based on each agent's safety profile; most common were diarrhea (83%), nausea (76%), fatigue (73%), thrombocytopenia (71%), and blurred vision (68%). Most cases were mild to moderate (grade ≤2), except for thrombocytopenia, for which most drug-related discontinuations occurred, and neutropenia. CONCLUSIONS This triplet regimen (MIRV+carboplatin+bevacizumab) was highly active, with a tolerable AE profile in participants with recurrent, platinum-sensitive, FRα-expressing ovarian cancer. Thrombocytopenia was the primary cause of dose modifications. These outcomes compare favorably to historical data reported for platinum-based chemotherapy plus bevacizumab regimens in similar patient populations.
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MESH Headings
- Humans
- Female
- Bevacizumab/administration & dosage
- Bevacizumab/adverse effects
- Carboplatin/administration & dosage
- Carboplatin/adverse effects
- Middle Aged
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Aged
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/pathology
- Folate Receptor 1
- Adult
- Maytansine/analogs & derivatives
- Maytansine/adverse effects
- Maytansine/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/therapeutic use
- Immunoconjugates/administration & dosage
- Immunoconjugates/adverse effects
- Carcinoma, Ovarian Epithelial/drug therapy
- Progression-Free Survival
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/pathology
- Fallopian Tube Neoplasms/drug therapy
- Aged, 80 and over
- Peritoneal Neoplasms/drug therapy
- Thrombocytopenia/chemically induced
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Affiliation(s)
- Debra L Richardson
- Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Sarah Cannon Research Institute, Nashville, TN, United States.
| | - Kathleen N Moore
- Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Sarah Cannon Research Institute, Nashville, TN, United States.
| | - Ignace Vergote
- University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium.
| | - Lucy Gilbert
- McGill University Health Center-Research Institute, Montréal, Québec, Canada.
| | - Lainie P Martin
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
| | | | - Cesar M Castro
- Massachusetts General Hospital, Boston, MA, United States.
| | - Diane Provencher
- Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
| | | | - James Stec
- ImmunoGen, Inc., Waltham, MA, United States.
| | - Yuemei Wang
- ImmunoGen, Inc., Waltham, MA, United States.
| | | | - David M O'Malley
- The Ohio State University, James Comprehensive Cancer Center, Columbus, OH, United States. david.o'
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9
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Ascione L, Guidi L, Prakash A, Trapani D, LoRusso P, Lou E, Curigliano G. Unlocking the Potential: Biomarkers of Response to Antibody-Drug Conjugates. Am Soc Clin Oncol Educ Book 2024; 44:e431766. [PMID: 38828973 DOI: 10.1200/edbk_431766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Antibody-drug conjugates (ADCs) have reshaped the cancer treatment landscape across a variety of different tumor types. ADCs' peculiar pharmacologic design combines the cytotoxic properties of chemotherapeutic agents with the selectivity of targeted therapies. At present, the approval of many ADCs used in clinical practice has not always been biomarker-driven. Indeed, predicting ADCs' activity and toxicity through the demonstration of specific biomarkers is still a great unmet need, and the identification of patients who can derive significant benefit from treatment with ADCs may often be uncertain. With the lack of robust predictive biomarkers to anticipate primary, intrinsic resistance to ADCs and no consolidated biomarkers to aid in the early identification of treatment resistance (ie, acquired resistance), the determination of precise biologic mechanisms of ADC activity and safety becomes priority in the quest for better patient-centric outcomes. Of great relevance, whether the target antigen expression is a determinant of ADCs' primary activity is still to be clarified, and available data remain quite controversial. Antigen expression assessment is typically performed on tissue biopsy, hence only providing information on a specific tumor site, therefore unable to capture heterogeneous patterns of tumor antigen expression. Quantifying the expression of the target antigen across all tumor sites would help better understand tumor heterogeneity, whereas molecularly characterizing tumor-intrinsic features over time might provide information on resistance mechanisms. In addition, toxicity can represent a critical concern, since most ADCs have a safety profile that resembles that of chemotherapies, with often unique adverse events requiring special management, possibly because of the differential in pharmacokinetics between the small-molecule agent versus payload of a similar class (eg, deruxtecan conjugate-related interstitial lung disease). As such, the identification of robust predictive biomarkers of safety and activity of ADCs has the potential to improve patient selection and enrich the population of patients most likely to derive a substantial clinical benefit, especially in those disease settings where different ADCs happen to be approved in competing clinical indications, with undefined biomarkers to make precise decision making and unclear data on how to sequence ADCs. At this point, the identification of clinically actionable biomarkers in the space of ADCs remains a top research priority.
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Affiliation(s)
- Liliana Ascione
- Division of Early Drug Development, IEO, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hematology (DIPO), University of Milan, Milan, Italy
| | - Lorenzo Guidi
- Division of Early Drug Development, IEO, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hematology (DIPO), University of Milan, Milan, Italy
| | - Ajay Prakash
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Dario Trapani
- Division of Early Drug Development, IEO, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hematology (DIPO), University of Milan, Milan, Italy
| | - Patricia LoRusso
- Yale University School of Medicine, Yale Cancer Center, New Haven, CT
| | - Emil Lou
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Giuseppe Curigliano
- Division of Early Drug Development, IEO, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hematology (DIPO), University of Milan, Milan, Italy
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10
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Kokori E, Olatunji G, Komolafe R, Abraham IC, Ukoaka B, Samuel O, Ayodeji A, Ogunbowale I, Ezenwoba C, Aderinto N. Mirvetuximab soravtansine: A breakthrough in targeted therapy for platinum-resistant ovarian cancer. Medicine (Baltimore) 2024; 103:e38132. [PMID: 38758856 PMCID: PMC11098247 DOI: 10.1097/md.0000000000038132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/12/2024] [Indexed: 05/19/2024] Open
Abstract
Ovarian cancer, ranked as the second leading cause of gynecologic malignancy-related deaths globally, poses a formidable challenge despite advances in early detection and treatment modalities. This paper explores the efficacy and safety of mirvetuximab soravtansine, the first folate receptor alpha (FRα)-targeting antibody-drug conjugate, in platinum-resistant ovarian cancer expressing FRα. A review of 4 key studies involving 453 participants consistently demonstrates mirvetuximab soravtansine's clinically meaningful antitumor activity and favorable safety profile. Clinical implications emphasize mirvetuximab soravtansine's pivotal role in targeted therapy, especially for high FRα-expressing tumors, potentially reshaping platinum-resistant ovarian cancer management. The combination therapy approach introduces a novel dimension, suggesting enhanced therapeutic outcomes. Even in heavily pretreated patients, mirvetuximab soravtansine's favorable tolerability positions it as a viable option. The reliability of archival tissue for FRα assessment simplifies patient selection, streamlining accessibility to targeted therapies. However, identified gaps, including limited diversity in patient populations, sparse quality of life data, and the need for long-term safety information, indicate areas for future research. Exploration of additional biomarkers predicting mirvetuximab soravtansine responsiveness is essential for personalized treatment.
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Affiliation(s)
- Emmanuel Kokori
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Gbolahan Olatunji
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Rosemary Komolafe
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | | | - Bonaventure Ukoaka
- Department of Internal Medicine, Asokoro District Hospital, Abuja, Nigeria
| | - Owolabi Samuel
- Department of Medicine and Surgery, Lagos State Health Service Commission, Lagos, Nigeria
| | - Akinmeji Ayodeji
- Department of Medicine and Surgery, Olabisi Onabanjo University, Ogun, Nigeria
| | | | - Chidiogo Ezenwoba
- Department of Medicine and Surgery, Afe Babalola University, Ado-ekiti, Ekiti, Nigeria
| | - Nicholas Aderinto
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
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11
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Katrini J, Boldrini L, Santoro C, Valenza C, Trapani D, Curigliano G. Biomarkers for Antibody-Drug Conjugates in Solid Tumors. Mol Cancer Ther 2024; 23:436-446. [PMID: 38363729 DOI: 10.1158/1535-7163.mct-23-0482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/10/2024] [Accepted: 01/30/2024] [Indexed: 02/18/2024]
Abstract
The clinical development and then the progressive entry in clinical practice of antibody-drug conjugates (ADC) have marked a transformative advancement in the overall cancer treatment. ADCs have been extensively tested for a large number of tumors, reporting heterogeneous clinical efficacy and safety results. In some diseases, the advent of ADCs has yielded significant changes in the prognostic trajectory, portending an improvement of the survival and/or quality of life. ADCs are targeted agents, capable of delivering highly cytotoxic payloads selectively to antigen-expressing cancer cells. As such, they have been intended as perfect "bullets" to enable the promise of precision medicine, toward high-efficacy and limited-toxicity treatment options. However, only some approved ADCs are intended for the use in biomarker-selected patient populations, restricting potentially the opportunity to be more precise. Yet, key characteristics of modern ADCs might allow the activity of ADCs in tumors with heterogeneous or low expression of cancer antigens, resulting in a clinical activity that could sublimate the classic paradigm of a drug-to-target perfect match. In our review, we portrayed the current landscape of approved ADCs, reporting data of activity as related to the expression of the cancer antigens, and elucidating possible determinants of the safety and efficacy, including when used in a therapeutic sequence.
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Affiliation(s)
- Jalissa Katrini
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Laura Boldrini
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Celeste Santoro
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Carmine Valenza
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Dario Trapani
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Giuseppe Curigliano
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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12
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García-Illescas D, Mazzeo R, García-Durán C, Oaknin A. The evolving landscape of antibody-drug conjugates in ovarian cancer: new drugs for a new era. Curr Opin Obstet Gynecol 2024; 36:104-111. [PMID: 38170620 DOI: 10.1097/gco.0000000000000934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW This review addresses the emerging role of antibody-drug conjugates (ADCs) in the treatment of ovarian cancer, a field marked by a high need for more effective and targeted therapies. Given the recent advancements in ADC technology and the ongoing challenges in treating ovarian cancer, particularly in late-stage and recurrent cases, this review is both timely and relevant. It synthesizes current research findings and clinical trial data, highlighting the potential of ADCs to revolutionize ovarian cancer treatment. RECENT FINDINGS The review covers key themes including the mechanism of action of ADCs, their specificity in targeting ovarian cancer cells, recent clinical trial outcomes, advancements in ADC design for improved efficacy and reduced toxicity, and strategies to overcome drug resistance in ovarian cancer. It also addresses the heterogeneity of ovarian cancer and the implications for personalized ADC therapies. SUMMARY The review underscores the potential of ADCs to significantly impact clinical practice, offering a more effective and personalized treatment approach for ovarian cancer patients. The review suggests a paradigm shift in the treatment of this malignancy, emphasizing the need for further research and development in this area.
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Affiliation(s)
- David García-Illescas
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Roberta Mazzeo
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Carmen García-Durán
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Ana Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
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13
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Liu K, Li M, Li Y, Li Y, Chen Z, Tang Y, Yang M, Deng G, Liu H. A review of the clinical efficacy of FDA-approved antibody‒drug conjugates in human cancers. Mol Cancer 2024; 23:62. [PMID: 38519953 PMCID: PMC10960395 DOI: 10.1186/s12943-024-01963-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/21/2024] [Indexed: 03/25/2024] Open
Abstract
While strategies such as chemotherapy and immunotherapy have become the first-line standard therapies for patients with advanced or metastatic cancer, acquired resistance is still inevitable in most cases. The introduction of antibody‒drug conjugates (ADCs) provides a novel alternative. ADCs are a new class of anticancer drugs comprising the coupling of antitumor mAbs with cytotoxic drugs. Compared with chemotherapeutic drugs, ADCs have the advantages of good tolerance, accurate target recognition, and small effects on noncancerous cells. ADCs occupy an increasingly important position in the therapeutic field. Currently, there are 13 Food and Drug Administration (FDA)‒approved ADCs and more than 100 ADC drugs at different stages of clinical trials. This review briefly describes the efficacy and safety of FDA-approved ADCs, and discusses the related problems and challenges to provide a reference for clinical work.
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Affiliation(s)
- Kaifeng Liu
- Laboratory of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Meijia Li
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Yudong Li
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Yutong Li
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Zixin Chen
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Yiqi Tang
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Meitian Yang
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Guoquan Deng
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Hongwei Liu
- Laboratory of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China.
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China.
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14
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Lumish MA, Kohn EC, Tew WP. Top advances of the year: Ovarian cancer. Cancer 2024; 130:837-845. [PMID: 38100616 DOI: 10.1002/cncr.35135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Although cure rates remain low and effective screening strategies are elusive, the recent advances in systemic therapies over the past year highlighted in this review have prolonged survival for women with ovarian cancer. In 2022, the first antibody-drug conjugate for platinum-resistant ovarian cancer received accelerated US Food and Drug Administration (FDA) approval. Confirmatory studies examining the efficacy of mirvetuximab and other antibody-drug conjugates are underway. In the upfront setting, the first data establishing an overall survival benefit from poly(ADP-ribose) polymerase inhibitor maintenance was demonstrated after a 7-year follow-up period. In contrast, long-term updates from poly(ADP-ribose) polymerase inhibitor trials in the noncurative setting reported survival detriments, and the FDA withdrew the respective indications. Several trials attempted to improve upon the standard of care for platinum-sensitive ovarian carcinoma and those with rare ovarian cancer histologies (carcinosarcoma, clear cell carcinoma) but failed to demonstrate a clinically or statistically meaningful benefit. This leaves the open question of how to further optimize systemic therapy for advanced ovarian carcinoma to improve long-term survival and cure rates.
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Affiliation(s)
- Melissa A Lumish
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Elise C Kohn
- National Cancer Institute, Bethesda, Maryland, USA
| | - William P Tew
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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15
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Wilson EM, Eskander RN, Binder PS. Recent Therapeutic Advances in Gynecologic Oncology: A Review. Cancers (Basel) 2024; 16:770. [PMID: 38398161 PMCID: PMC10887183 DOI: 10.3390/cancers16040770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
Gynecologic malignancies have high incidence rates both nationally and internationally, and cervical, endometrial, and ovarian cancers account for high mortality rates worldwide. Significant research is ongoing to develop targeted therapies to address unmet needs in the field and improve patient outcomes. As tumors mutate and progress through traditional lines of treatment, new therapies must be developed to overcome resistance and target cancer-specific receptors and mutations. Recent advances in the development of immunotherapy and antibody-drug conjugates have resulted in compelling and clinically meaningful results in cervical, endometrial, and ovarian cancers. In the last decade, several immunotherapy agents have received FDA approval or NCCN guideline recommendation for the treatment of gynecologic malignancies, including dostarlimab for advanced or recurrent endometrial cancer and pembrolizumab for advanced or recurrent cervical and endometrial cancers. Several other immunotherapeutic agents are under active investigation. Development of antibody-drug conjugates including tisotumab vedotin in cervical cancer, mirvetuximab soravtansine in ovarian cancer, and trastuzumab deruxtecan in multiple gynecologic cancers has translated into exciting efficacy signals, prompting full drug approvals and additional investigation. This article aims to review recent novel advances in targeted treatments for gynecologic malignancies, highlighting the trials and data underlying these novel interventions.
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Affiliation(s)
| | | | - Pratibha S. Binder
- Moores Cancer Center, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, San Diego, CA 92037, USA; (E.M.W.); (R.N.E.)
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16
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Nwabufo CK. Mirvetuximab soravtansine in ovarian cancer therapy: expert opinion on pharmacological considerations. Cancer Chemother Pharmacol 2024; 93:89-105. [PMID: 37594572 DOI: 10.1007/s00280-023-04575-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/03/2023] [Indexed: 08/19/2023]
Abstract
ImmunoGen developed mirvetuximab soravtansine as an antibody-drug conjugate comprising of a humanized anti-folate receptor-α (FRα) monoclonal antibody of IgG1k subtype, a cleavable linker, and a cytotoxic payload, DM4. Mirvetuximab soravtansine was granted accelerated approval by the US FDA on November 14, 2022, for the treatment of adult patients with FRα positive, platinum-resistant epithelial ovarian, fallopian tube or primary peritoneal cancer who have received 1-3 prior systemic treatment regimens. The approval of mirvetuximab soravtansine represents a breakthrough for addressing the unmet medical needs of ovarian cancer, especially for up to 80% of patients who relapse and become resistant to platinum-based chemotherapy, resulting in poor prognosis and limited treatment options. However, it is my impression that addressing several pharmacological factors could improve the safety and efficacy of mirvetuximab soravtansine. This article summarizes the current pharmacological profile of mirvetuximab soravtansine and provides an expert opinion on pharmacological strategies for optimizing its safety and efficacy profile for the treatment of platinum-resistant ovarian cancer.
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Affiliation(s)
- Chukwunonso K Nwabufo
- OneDrug, Toronto, ON, Canada.
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON, M5S 3M2, Canada.
- Program in Translational Medicine, Hospital for Sick Children, Toronto, ON, Canada.
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17
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Wang Y, Liu L, Jin X, Yu Y. Efficacy and safety of mirvetuximab soravtansine in recurrent ovarian cancer with FRa positive expression: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2024; 194:104230. [PMID: 38122916 DOI: 10.1016/j.critrevonc.2023.104230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/18/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of mirvetuximab soravtansine in treating recurrent ovarian cancer with folate receptor alpha (FRa) expression. METHODS A comprehensive search was conducted on online databases, including PubMed, Cochrane Library, and EMBASE, to identify relevant literature about the efficacy and safety of mirvetuximab soravtansine in recurrent ovarian cancer with FRa-positive expression. The keywords were the following: recurrent ovarian cancer, mirvetuximab soravtansine, FRa, and antibody-drug conjugate. Furthermore, studies that satisfied the necessary qualifications were carefully evaluated for further meta-analysis. RESULTS This meta-analysis involved the examination of seven trials with a total of 631 patients. According to the pooled data, the objective response rate (ORR) was 36% (95%CI: 27%-45%). Similarly, the disease control rate (DCR) was 88% (95% CI: 84-91%). Furthermore, the median progression-free survival (PFS) was determined to be 6.1 months (95% CI: 4.27-7.47). The overall response rate and PFS for platinum-resistant ovarian cancer were found to be 29% (95% CI: 25-32%) and 6.26 months (95% CI: 4.67-7.85), respectively. The most often observed adverse events (AEs) in patients with recurrent ovarian cancer (OC) receiving mirvetuximab soravtansine were blurred vision (all grades: 45%, Grade III: 2%), nausea (all grades: 42%, Grade III: 1%), and diarrhea (all grades: 42%, Grade III: 2%). These AEs were specifically associated with the safety profile of mirvetuximab soravtansine in this patient population. CONCLUSION The efficacy of mirvetuximab soravtansine in treating recurrent ovarian cancer with FRa-positive expression is satisfactory, and the safety is tolerable.
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Affiliation(s)
- Yicong Wang
- Department of Obstetrics and Gynecology,Central Hospital of Dalian University of Technology, Dalian, China
| | - Lifeng Liu
- Department of Obstetrics and Gynecology,Central Hospital of Dalian University of Technology, Dalian, China
| | - Xianyu Jin
- Department of Obstetrics and Gynecology,Central Hospital of Dalian University of Technology, Dalian, China
| | - Yongai Yu
- Department of Obstetrics and Gynecology,Central Hospital of Dalian University of Technology, Dalian, China.
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18
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Moore KN, Angelergues A, Konecny GE, García Y, Banerjee S, Lorusso D, Lee JY, Moroney JW, Colombo N, Roszak A, Tromp J, Myers T, Lee JW, Beiner M, Cosgrove CM, Cibula D, Martin LP, Sabatier R, Buscema J, Estévez-García P, Coffman L, Nicum S, Duska LR, Pignata S, Gálvez F, Wang Y, Method M, Berkenblit A, Bello Roufai D, Van Gorp T. Mirvetuximab Soravtansine in FRα-Positive, Platinum-Resistant Ovarian Cancer. N Engl J Med 2023; 389:2162-2174. [PMID: 38055253 DOI: 10.1056/nejmoa2309169] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
BACKGROUND Mirvetuximab soravtansine-gynx (MIRV), a first-in-class antibody-drug conjugate targeting folate receptor α (FRα), is approved for the treatment of platinum-resistant ovarian cancer in the United States. METHODS We conducted a phase 3, global, confirmatory, open-label, randomized, controlled trial to compare the efficacy and safety of MIRV with the investigator's choice of chemotherapy in the treatment of platinum-resistant, high-grade serous ovarian cancer. Participants who had previously received one to three lines of therapy and had high FRα tumor expression (≥75% of cells with ≥2+ staining intensity) were randomly assigned in a 1:1 ratio to receive MIRV (6 mg per kilogram of adjusted ideal body weight every 3 weeks) or chemotherapy (paclitaxel, pegylated liposomal doxorubicin, or topotecan). The primary end point was investigator-assessed progression-free survival; key secondary analytic end points included objective response, overall survival, and participant-reported outcomes. RESULTS A total of 453 participants underwent randomization; 227 were assigned to the MIRV group and 226 to the chemotherapy group. The median progression-free survival was 5.62 months (95% confidence interval [CI], 4.34 to 5.95) with MIRV and 3.98 months (95% CI, 2.86 to 4.47) with chemotherapy (P<0.001). An objective response occurred in 42.3% of the participants in the MIRV group and in 15.9% of those in the chemotherapy group (odds ratio, 3.81; 95% CI, 2.44 to 5.94; P<0.001). Overall survival was significantly longer with MIRV than with chemotherapy (median, 16.46 months vs. 12.75 months; hazard ratio for death, 0.67; 95% CI, 0.50 to 0.89; P = 0.005). During the treatment period, fewer adverse events of grade 3 or higher occurred with MIRV than with chemotherapy (41.7% vs. 54.1%), as did serious adverse events of any grade (23.9% vs. 32.9%) and events leading to discontinuation (9.2% vs. 15.9%). CONCLUSIONS Among participants with platinum-resistant, FRα-positive ovarian cancer, treatment with MIRV showed a significant benefit over chemotherapy with respect to progression-free and overall survival and objective response. (Funded by ImmunoGen; MIRASOL ClinicalTrials.gov number, NCT04209855.).
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Affiliation(s)
- Kathleen N Moore
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Antoine Angelergues
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Gottfried E Konecny
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Yolanda García
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Susana Banerjee
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Domenica Lorusso
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Jung-Yun Lee
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - John W Moroney
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Nicoletta Colombo
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Andrzej Roszak
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Jacqueline Tromp
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Tashanna Myers
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Jeong-Won Lee
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Mario Beiner
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Casey M Cosgrove
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - David Cibula
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Lainie P Martin
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Renaud Sabatier
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Joseph Buscema
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Purificación Estévez-García
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Lan Coffman
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Shibani Nicum
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Linda R Duska
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Sandro Pignata
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Fernando Gálvez
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Yuemei Wang
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Michael Method
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Anna Berkenblit
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Diana Bello Roufai
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
| | - Toon Van Gorp
- From the Stephenson Cancer Center Section of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City (K.N.M.); Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris (A.A.), Aix-Marseille Université, INSERM, National Center for Scientific Research, Institut Paoli-Calmettes, Department of Medical Oncology, Marseille (R.S.), and Institut Curie, Saint-Cloud (D.B.R.) - all in France; the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles (G.E.K.); Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell (Y.G.), Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla, Seville (P.E.-G.), and Hospital Universitario de Jaén, Jaen (F.G.) - all in Spain; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research (S.B.) and University College London Cancer Institute (S.N.) - both in London; Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.), the Gynecologic Oncology Program, European Institute of Oncology IRCCS, and the Department of Medicine and Surgery, University Milan-Bicocca, Milan (N.C.), and Dipartimento Uro-Ginecologico, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G. Pascale, Naples (S.P.) - all in Italy; Yonsei University College of Medicine (J.-Y.L.) and the Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine (J.-W.L.) - both in Seoul, South Korea; the University of Chicago, Chicago (J.W.M.); Wielkopolskie Centrum Onkologii and Poznań University of Medical Sciences, Poznań, Poland (A.R.); Amsterdam University Medical Centers, Amsterdam (J.T.); Baystate Medical Center, Division of Gynecologic Oncology, University of Massachusetts-Chan Baystate, Springfield (T.M.), and ImmunoGen, Waltham (Y.W., M.M., A.B.) - both in Massachusetts; Meir Medical Center, Kfar Saba, Israel (M.B.); Ohio State University, Columbus (C.M.C.); the Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); the Division of Hematology-Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.P.M.), and Hillman Cancer Center, University of Pittsburgh, Pittsburgh (L.C.) - both in Pennsylvania; Arizona Oncology Associates, PC-HOPE, Tucson (J.B.); the University of Virginia School of Medicine, Charlottesville (L.R.D.); and University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium (T.V.G.)
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Bodriagova O, Previs RA, Gaba L, Shankar A, Vidal L, Saini KS. Recent Advances in Gynecological Malignancies: Focus on ASCO 2023. Oncol Ther 2023; 11:397-409. [PMID: 37715082 PMCID: PMC10673792 DOI: 10.1007/s40487-023-00244-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/30/2023] [Indexed: 09/17/2023] Open
Affiliation(s)
| | - Rebecca Ann Previs
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, USA
- Labcorp Oncology, Durham, USA
| | - Lydia Gaba
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - Abhishek Shankar
- Department of Radiation Oncology, Dr. BRAIRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Laura Vidal
- Fortrea Inc., 8, Moore Drive, Durham, NC, 27709, USA
| | - Kamal S Saini
- Fortrea Inc., 8, Moore Drive, Durham, NC, 27709, USA.
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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Jaffry M, Choudhry H, Aftab OM, Dastjerdi MH. Antibody-Drug Conjugates and Ocular Toxicity. J Ocul Pharmacol Ther 2023; 39:675-691. [PMID: 37615544 DOI: 10.1089/jop.2023.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Antibody-drug conjugates (ADCs) are a growing class of chemotherapeutic agents for the purpose of treating cancers that often have relapsed or failed first- and second-line treatments. ADCs are composed of extremely potent cytotoxins with a variety of side effects, one of the most significant being ocular toxicity. The available literature describes these toxicities as varying in severity and in incidence, although with disparate methods of evaluation and management. Some of the most common toxicities include microcyst-like epithelial keratopathy and dry eye. We discuss proposed mechanisms of ocular toxicity and describe the reports that mention these toxicities. We focus on ADCs with the most published literature and the most significant effects on ocular tissue. We propose areas for further investigation and possible ideas of future management. We provide a comprehensive look at the reports of ADCs in current literature to better inform clinicians on an expanding drug class.
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Affiliation(s)
- Mustafa Jaffry
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Hassaam Choudhry
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Owais M Aftab
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Mohammad H Dastjerdi
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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21
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Veneziani AC, Gonzalez-Ochoa E, Alqaisi H, Madariaga A, Bhat G, Rouzbahman M, Sneha S, Oza AM. Heterogeneity and treatment landscape of ovarian carcinoma. Nat Rev Clin Oncol 2023; 20:820-842. [PMID: 37783747 DOI: 10.1038/s41571-023-00819-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/04/2023]
Abstract
Ovarian carcinoma is characterized by heterogeneity at the molecular, cellular and anatomical levels, both spatially and temporally. This heterogeneity affects response to surgery and/or systemic therapy, and also facilitates inherent and acquired drug resistance. As a consequence, this tumour type is often aggressive and frequently lethal. Ovarian carcinoma is not a single disease entity and comprises various subtypes, each with distinct complex molecular landscapes that change during progression and therapy. The interactions of cancer and stromal cells within the tumour microenvironment further affects disease evolution and response to therapy. In past decades, researchers have characterized the cellular, molecular, microenvironmental and immunological heterogeneity of ovarian carcinoma. Traditional treatment approaches have considered ovarian carcinoma as a single entity. This landscape is slowly changing with the increasing appreciation of heterogeneity and the recognition that delivering ineffective therapies can delay the development of effective personalized approaches as well as potentially change the molecular and cellular characteristics of the tumour, which might lead to additional resistance to subsequent therapy. In this Review we discuss the heterogeneity of ovarian carcinoma, outline the current treatment landscape for this malignancy and highlight potentially effective therapeutic strategies in development.
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Affiliation(s)
- Ana C Veneziani
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Eduardo Gonzalez-Ochoa
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Husam Alqaisi
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Ainhoa Madariaga
- Medical Oncology Department, 12 De Octubre University Hospital, Madrid, Spain
| | - Gita Bhat
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Marjan Rouzbahman
- Department of Laboratory Medicine and Pathobiology, Toronto General Hospital, Toronto, Ontario, Canada
| | - Suku Sneha
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Amit M Oza
- Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
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22
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Mai J, Wu L, Yang L, Sun T, Liu X, Yin R, Jiang Y, Li J, Li Q. Therapeutic strategies targeting folate receptor α for ovarian cancer. Front Immunol 2023; 14:1254532. [PMID: 37711615 PMCID: PMC10499382 DOI: 10.3389/fimmu.2023.1254532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/11/2023] [Indexed: 09/16/2023] Open
Abstract
Epithelial ovarian cancer (EOC) is the deadliest gynecological cancer, and presents a major clinical challenge due to limited treatment options. Folate receptor alpha (FRα), encoded by the FOLR1 gene, is an attractive therapeutically target due to its prevalent and high expression in EOC cells. Recent basic and translational studies have explored several modalities, such as antibody-drug conjugate (ADC), monoclonal antibodies, small molecules, and folate-drug conjugate, to exploit FRα for EOC treatment. In this review, we summarize the function of FRα, and clinical efficacies of various FRα-based therapeutics. We highlight mirvetuximab soravtansine (MIRV), or Elahere (ImmunoGen), the first FRα-targeting ADC approved by the FDA to treat platinum-resistant ovarian cancer. We discuss potential mechanisms and management of ocular adverse events associated with MIRV administration.
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Affiliation(s)
- Jia Mai
- Department of Laboratory Medicine, Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Center of Growth, Metabolism and Aging, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, Sichuan, China
| | - Limei Wu
- Department of Laboratory Medicine, Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Center of Growth, Metabolism and Aging, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, Sichuan, China
- Department of Obstetrics and Gynecology, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Ling Yang
- Department of Laboratory Medicine, Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Center of Growth, Metabolism and Aging, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, Sichuan, China
| | - Ting Sun
- Department of Clinical Laboratory, The first Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaojuan Liu
- Department of Laboratory Medicine, Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Center of Growth, Metabolism and Aging, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, Sichuan, China
| | - Rutie Yin
- Department of Laboratory Medicine, Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Center of Growth, Metabolism and Aging, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, Sichuan, China
| | - Yongmei Jiang
- Department of Laboratory Medicine, Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Center of Growth, Metabolism and Aging, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, Sichuan, China
| | - Jinke Li
- Department of Laboratory Medicine, Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Center of Growth, Metabolism and Aging, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, Sichuan, China
| | - Qintong Li
- Department of Laboratory Medicine, Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Center of Growth, Metabolism and Aging, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, Sichuan, China
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23
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Zhao M, DiPeri TP, Raso MG, Zheng X, Rizvi YQ, Evans KW, Yang F, Akcakanat A, Roberto Estecio M, Tripathy D, Dumbrava EE, Damodaran S, Meric-Bernstam F. Epigenetically upregulating TROP2 and SLFN11 enhances therapeutic efficacy of TROP2 antibody drug conjugate sacitizumab govitecan. NPJ Breast Cancer 2023; 9:66. [PMID: 37567892 PMCID: PMC10421911 DOI: 10.1038/s41523-023-00573-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
TROP2 antibody drug conjugates (ADCs) are under active development. We seek to determine whether we can enhance activity of TROP2 ADCs by increasing TROP2 expression. In metaplastic breast cancers (MpBC), there is limited expression of TROP2, and downregulating transcription factor ZEB1 upregulates E-cad and TROP2, thus sensitizing cancers to TROP2 ADC sacituzumab govitecan (SG). Demethylating agent decitabine decreases DNA methyltransferase expression and TROP2 promoter methylation and subsequently increases TROP2 expression. Decitabine treatment as well as overexpression of TROP2 significantly enhance SG antitumor activity. Decitabine also increases SLFN11, a biomarker of topoisomerase 1 inhibitor (TOP1) sensitivity and is synergistic with SG which has a TOP1 payload, in TROP2-expressing SLFN11-low BC cells. In conclusion, TROP2 and SLFN11 expression can be epigenetically modulated and the combination of demethylating agent decitabine with TROP2 ADCs may represent a novel therapeutic approach for tumors with low TROP2 or SLFN11 expression.
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Affiliation(s)
- Ming Zhao
- Department of Investigational Cancer Therapeutics, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Timothy P DiPeri
- Department of Surgical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Maria Gabriela Raso
- Department of Translational Molecular Pathology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Xiaofeng Zheng
- Department of Bioinformatics and Computational Biology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Yasmeen Qamar Rizvi
- Department of Investigational Cancer Therapeutics, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Kurt W Evans
- Department of Investigational Cancer Therapeutics, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Fei Yang
- Department of Translational Molecular Pathology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Argun Akcakanat
- Department of Investigational Cancer Therapeutics, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Marco Roberto Estecio
- Department of Epigenetic and Molecular Carcinogenesis, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Debu Tripathy
- Department of Breast Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Ecaterina E Dumbrava
- Department of Investigational Cancer Therapeutics, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Senthil Damodaran
- Department of Breast Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
- Department of Breast Surgical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
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24
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Gonzalez-Ochoa E, Veneziani AC, Oza AM. Mirvetuximab Soravtansine in Platinum-Resistant Ovarian Cancer. Clin Med Insights Oncol 2023; 17:11795549231187264. [PMID: 37528890 PMCID: PMC10387675 DOI: 10.1177/11795549231187264] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/25/2023] [Indexed: 08/03/2023] Open
Abstract
Ovarian cancer is the second leading cause of death from gynecologic malignancies worldwide. Management of platinum-resistant disease is challenging and clinical outcomes with standard chemotherapy are poor. Over the past decades, significant efforts have been made to understand drug resistance and develop strategies to overcome treatment failure. Antibody drug conjugates (ADCs) are a rapidly growing class of oncologic therapeutics, which combine the ability to target tumor-specific antigens with the cytotoxic effects of chemotherapy. Mirvetuximab soravtansine is an ADC comprising an IgG1 monoclonal antibody against the folate receptor alpha (FRα) conjugated to the cytotoxic maytansinoid effector molecule DM4 that has shown promising clinical activity in patients with FR-α-positive ovarian cancer. This review summarizes current evidence of mirvetuximab soravtansine in platinum-resistant ovarian cancer, focusing on clinical activity, toxicity, and future directions.
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Affiliation(s)
- Eduardo Gonzalez-Ochoa
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Ana C Veneziani
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Amit M Oza
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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25
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Porter RL, Matulonis UA. Mirvetuximab soravtansine for platinum-resistant epithelial ovarian cancer. Expert Rev Anticancer Ther 2023; 23:783-796. [PMID: 37458180 DOI: 10.1080/14737140.2023.2236793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/20/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
INTRODUCTION Mirvetuximab soravtansine (mirvetuximab) is an antibody drug conjugate (ADC) comprised of a humanized folate receptor alpha (FRα)-binding monoclonal antibody attached via a cleavable linker to the cytotoxic maytansinoid molecule, DM4. FRα is expressed in several epithelial cancers, including high grade serous ovarian cancer (HGSOC). Mirvetuximab received accelerated approval by the United States Food and Drug Administration (FDA) in November 2022 based on the results of the SORAYA trial, which tested mirvetuximab for the treatment of patients with recurrent platinum resistant HGSOC with high FRα expression and showed an overall response rate (ORR) of 32.4% and a median duration of response of 6.9 months. Mirvetuximab toxicities included low grade ocular and gastrointestinal toxicities. The National Comprehensive Cancer Network (NCCN) ovarian cancer 2023 guidelines adopted mirvetuximab as 2A, and mirvetuximab combined with bevacizumab as 2B, recommendations. AREAS COVERED This manuscript will review the preclinical and clinical development of mirvetuximab, the toxicities associated with mirvetuximab and mitigation strategies, and future applications of mirvetuximab. EXPERT OPINION Mirvetuximab represents the first biomarker-directed therapy with an indication specifically for the treatment of PROC. The efficacy and favorable safety profile support further development of mirvetuximab and mirvetuximab combinations in platinum sensitive and newly diagnosed ovarian cancer.
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Affiliation(s)
- Rebecca L Porter
- Division of Gynecologic Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, United States of America
| | - Ursula A Matulonis
- Division of Gynecologic Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, United States of America
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26
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Xu K, Wang T, Pan S, He J. The efficacy and toxicity of mirvetuximab soravtansine, a novel antibody-drug conjugate, in the treatment of advanced or recurrent ovarian cancer: a meta-analysis. Expert Rev Clin Pharmacol 2023; 16:1141-1152. [PMID: 37771164 DOI: 10.1080/17512433.2023.2262673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023]
Abstract
INTRODUCTION This meta-analysis aims to systematically analyze the efficacy and toxicity of mirvetuximab soravtansine (MIRV) as second-line and above treatment for advanced or recurrent ovarian cancer. METHODS Candidate studies were identified in PubMed, Embase, Cochrane Library, CNKI, and Wanfang databases up to 1 May 2023. Objective response rate (ORR), progression-free survival (PFS), the incidence of adverse events (AEs), and incidence of grade ≥ 3 AEs were extracted and calculated by meta-analysis of merging ratios or mean to describe the efficacy and toxicity of MIRV. RESULTS Seven eligible prospective studies were included in this meta-analysis, including 605 patients with advanced ovarian cancer who received second-line or higher therapy. ORR of MIRV was 34.2% (95% confidence interval [CI] 25.0-43.5), and PFS was 5.82 months (95%CI 4.47-7.18). The overall incidence of AEs was 87.4% (95%CI 52.9-100.0) and the incidence of grade ≥ 3 AEs was 27.1% (95%CI 18.9-36.1). The most common AEs were vision blurring, nausea, and diarrhea, with incidence of 46.7% (39.6-53.8), 41.8% (34.0-49.9), and 41.3% (30.4-52.5), respectively. CONCLUSIONS MIRV has definite efficacy and good safety as a novel choice for second-line and above treatment of advanced or recurrent FRα positive ovarian cancer. This may have promising application in patients with platinum-resistant diseases. PROSPERO REGISTRATION NUMBER CRD42023428599.
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Affiliation(s)
- Ke Xu
- Clinical Medical College, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Oncology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Tianlei Wang
- Clinical Medical College, Chengdu Medical College, Chengdu, Sichuan, China
| | - Shenbin Pan
- Clinical Medical College, Chengdu Medical College, Chengdu, Sichuan, China
| | - Jie He
- Clinical Medical College, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
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Duan Y, Zhang P, Zhang T, Zhou L, Yin R. Characterization of global research trends and prospects on platinum-resistant ovarian cancer: a bibliometric analysis. Front Oncol 2023; 13:1151871. [PMID: 37342181 PMCID: PMC10277726 DOI: 10.3389/fonc.2023.1151871] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/22/2023] [Indexed: 06/22/2023] Open
Abstract
Background In the last decades, growing attention has been focused on identifying effective therapeutic strategies in the orphan clinical setting of women with platinum-resistant ovarian cancer (PROC), generating thousands of original articles. However, the literature involving bibliometric analysis of PROC has not been published yet. Objective This study hopes to gain a better understanding of the hot spots and trends in PROC by conducting a bibliometric analysis, as well as identify potential new research directions. Methods We searched the Web of Science Core Collection (WOSCC) for PROC-related articles published between 1990 and 2022. CiteSpace 6.1.R2 and VOS viewer 1.6.18.0 were primarily utilized to evaluate the contribution and co-occurrence relationships of various countries and regions, institutes, and journals and to identify research hotspots and promising future trends in this research field. Results A total of 3,462 Web of Science publications were retrieved that were published in 671 academic journals by 1135 authors from 844 organizations in 75 countries and regions. The United States was the leading contributor in this field, and the University of Texas MD Anderson Cancer Center was the most productive institution. Gynecologic Oncology was the most productive journal, while the Journal of Clinical Oncology was the most cited and influential. Co-citation cluster labels revealed the characteristics of seven major clusters, including synthetic lethality, salvage treatment, human ovarian-carcinoma cell line, PARP inhibitor resistance, antitumor complexes, folate receptor, and targeting platinum-resistant disease. Keywords and references burst detection indicated that biomarkers, genetic and phenotypic changes, immunotherapy, and targeted therapy were the most recent and most significant aspects of PROC research. Conclusion This study conducted a comprehensive review of PROC research using bibliometric and visual techniques. Understanding the immunological landscape of PROC and identifying the population that can benefit from immunotherapy, especially in combination with other therapeutic options (such as chemotherapy and targeted therapy), will continue to be the focal point of research.
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Affiliation(s)
- Yuanqiong Duan
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Peixuan Zhang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Tianyue Zhang
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Lu Zhou
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Rutie Yin
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
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Huynh U, Wu P, Qiu J, Prachyathipsakul T, Singh K, Jerry DJ, Gao J, Thayumanavan S. Targeted Drug Delivery Using a Plug-to-Direct Antibody-Nanogel Conjugate. Biomacromolecules 2023; 24:849-857. [PMID: 36639133 PMCID: PMC9928872 DOI: 10.1021/acs.biomac.2c01269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Targeted drug delivery using antibody-drug conjugates has attracted great attention due to its enhanced therapeutic efficacy compared to traditional chemotherapy. However, the development has been limited due to a low drug-to-antibody ratio and laborious linker-payload optimization. Herein, we present a simple and efficient strategy to combine the favorable features of polymeric nanocarriers with antibodies to generate an antibody-nanogel conjugate (ANC) platform for targeted delivery of cytotoxic agents. Our nanogels stably encapsulate several chemotherapeutic agents with a wide range of mechanisms of action and solubility. We showcase the targetability of ANCs and their selective killing of cancer cells over-expressing disease-relevant antigens such as human epidermal growth factor receptor 2, epidermal growth factor receptor, and tumor-specific mucin 1, which cover a broad range of breast cancer cell types while maintaining low to no toxicity to non-targeted cells. Overall, our system represents a versatile approach that could impact next-generation nanomedicine in antibody-targeted therapeutics.
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Affiliation(s)
- Uyen Huynh
- Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003, United States
| | - Peidong Wu
- Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003, United States
| | - Jingyi Qiu
- Department of Biomedical Engineering, University of Massachusetts, Amherst, Massachusetts 01003, United States
| | | | - Khushboo Singh
- Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003, United States
| | - D. Joseph Jerry
- Center for Bioactive Delivery, Institute for Applied Life Sciences, University of Massachusetts, Amherst, Massachusetts 01003, United States
- Department of Veterinary and Animal Sciences, University of Massachusetts, Amherst, Massachusetts 01003, United States
| | - Jingjing Gao
- Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003, United States
| | - S. Thayumanavan
- Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003, United States
- Department of Biomedical Engineering, University of Massachusetts, Amherst, Massachusetts 01003, United States
- Center for Bioactive Delivery, Institute for Applied Life Sciences, University of Massachusetts, Amherst, Massachusetts 01003, United States
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Abstract
Mirvetuximab soravtansine (mirvetuximab soravtansine-gynx; Elahere™) is an antibody-drug conjugate (ADC), which is comprised of a folate receptor α (FRα) directed antibody conjugated to a microtubule inhibitor via a cleavable linker. The ADC is being developed by ImmunoGen for the treatment of FRα expressing cancers. In November 2022, mirvetuximab soravtansine was approved in the USA for the treatment of adult patients with FRα positive, platinum-resistant epithelial ovarian, fallopian tube or primary peritoneal cancer who have received 1-3 prior systemic treatment regimens. This article summarizes the milestones in the development of mirvetuximab soravtansine leading to this first approval.
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Affiliation(s)
- Young-A Heo
- Springer Nature, Mairangi Bay, Private Bag 65901, Auckland, 0754, New Zealand.
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30
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Matulonis UA, Lorusso D, Oaknin A, Pignata S, Dean A, Denys H, Colombo N, Van Gorp T, Konner JA, Marin MR, Harter P, Murphy CG, Wang J, Noble E, Esteves B, Method M, Coleman RL. Efficacy and Safety of Mirvetuximab Soravtansine in Patients With Platinum-Resistant Ovarian Cancer With High Folate Receptor Alpha Expression: Results From the SORAYA Study. J Clin Oncol 2023; 41:2436-2445. [PMID: 36716407 PMCID: PMC10150846 DOI: 10.1200/jco.22.01900] [Citation(s) in RCA: 103] [Impact Index Per Article: 103.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Single-agent chemotherapies have limited activity and considerable toxicity in patients with platinum-resistant epithelial ovarian cancer (PROC). Mirvetuximab soravtansine (MIRV) is an antibody-drug conjugate targeting folate receptor α (FRα). SORAYA is a single-arm, phase II study evaluating efficacy and safety of MIRV in patients with PROC. METHODS SORAYA enrolled FRα-high patients with PROC who had received one to three prior therapies, including required bevacizumab. The primary end point was confirmed objective response rate (ORR) by investigator; duration of response was the key secondary end point. RESULTS One hundred six patients were enrolled; 105 were evaluable for efficacy. All patients had received prior bevacizumab, 51% had three prior lines of therapy, and 48% received a prior poly ADP-ribose polymerase inhibitor. Median follow-up was 13.4 months. ORR was 32.4% (95% CI, 23.6 to 42.2), including five complete and 29 partial responses. The median duration of response was 6.9 months (95% CI, 5.6 to 9.7). In patients with one to two priors, the ORR by investigator was 35.3% (95% CI, 22.4 to 49.9) and in patients with three priors was 30.2% (95% CI, 18.3 to 44.3). The ORR by investigator was 38.0% (95% CI, 24.7 to 52.8) in patients with prior poly ADP-ribose polymerase inhibitor exposure and 27.5% (95% CI, 15.9 to 41.7) in those without. The most common treatment-related adverse events (all grade and grade 3-4) were blurred vision (41% and 6%), keratopathy (29% and 9%), and nausea (29% and 0%). Treatment-related adverse events led to dose delays, reductions, and discontinuations in 33%, 20%, and 9% of patients, respectively. CONCLUSION MIRV demonstrated consistent clinically meaningful antitumor activity and favorable tolerability and safety in patients with FRα-high PROC who had received up to three prior therapies, including bevacizumab, representing an important advance for this biomarker-selected population.
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Affiliation(s)
| | - Domenica Lorusso
- Fondazione Policlinico Universitario A. Gemelli, IRCCS and Catholic University of Sacred Heart, Rome, Italy
| | - Ana Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Sandro Pignata
- Istituto Nazionale Tumori di Napoli Fondazione G Pascale IRCCS, Naples, Italy
| | - Andrew Dean
- WA Medical Oncology St John of God Subiaco Hospital, Subiaco, WA, Australia
| | | | - Nicoletta Colombo
- European Institute of Oncology IRCCS, Milan, Italy.,University of Milan-Bicocca, Milan, Italy
| | - Toon Van Gorp
- University Hospital of Leuven, Leuven Cancer Institute, Leuven, Belgium
| | | | - Margarita Romeo Marin
- Institut Català d'Oncologia/Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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31
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Patra A, Satpathy S, Naik PK, Kazi M, Hussain MD. Folate receptor-targeted PLGA-PEG nanoparticles for enhancing the activity of genistein in ovarian cancer. ARTIFICIAL CELLS, NANOMEDICINE, AND BIOTECHNOLOGY 2022; 50:228-239. [DOI: 10.1080/21691401.2022.2118758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Arjun Patra
- Department of Pharmaceutical & Biomedical Sciences, College of Pharmacy, California Health Sciences University, Clovis, CA, USA
- Department of Pharmacy, Guru Ghasidas University, Bilaspur, India
| | - Swaha Satpathy
- Department of Pharmaceutical & Biomedical Sciences, College of Pharmacy, California Health Sciences University, Clovis, CA, USA
- Department of Biotechnology and Bioinformatics, Sambalpur University, Sambalpur, India
| | - Pradeep K. Naik
- Department of Biotechnology and Bioinformatics, Sambalpur University, Sambalpur, India
| | - Mohsin Kazi
- Department of Pharmaceutics, College of Pharmacy, POBOX-2457, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad Delwar Hussain
- Department of Pharmaceutical & Biomedical Sciences, College of Pharmacy, California Health Sciences University, Clovis, CA, USA
- Department of Pharmaceutical Sciences, School of Pharmacy, College of Health and Pharmacy, Husson University, Bangor, ME, USA
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Wang AJ, Gao Y, Shi YY, Dai MY, Cai HB. A review of recent advances on single use of antibody-drug conjugates or combination with tumor immunology therapy for gynecologic cancer. Front Pharmacol 2022; 13:1093666. [PMID: 36618922 PMCID: PMC9813853 DOI: 10.3389/fphar.2022.1093666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Immune checkpoint inhibitors have made significant progress in the treatment of various cancers. However, due to the low ICI responsive rate for the gynecologic cancer, ICI two-drug combination therapy tends to be a predominant way for clinical treatment. Antibody-drug conjugates, a promising therapeutic modality for cancer, have been approved by the FDA for breast cancer, lymphoma, multiple myeloma and gastric cancer. On September 2021, the FDA granted accelerated approval to tisotumab vedotin for patients with recurrent or metastatic cervical cancer. Currently, the role of therapy of ADCs on gynecologic tumors was also included in medication regimens. Now more than 30 ADCs targeting for 20 biomarkers are under clinical trials in the field, including monotherapy or combination with others for multiple lines of therapy. Some ADCs have been proved to enhance the antitumor immunity effect on both pre-clinical models and clinical trials. Therefore, combination of ADCs and ICIs are expected in clinical trials. In this review, we discuss current development of ADCs in gynecologic oncology and the combination effects of ICIs and ADCs.
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Affiliation(s)
- An-Jin Wang
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China,Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, Hubei, China,Hubei Cancer Clinical Study Center, Wuhan, Hubei, China
| | - Yang Gao
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China,Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, Hubei, China,Hubei Cancer Clinical Study Center, Wuhan, Hubei, China
| | - Yu-Ying Shi
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China,Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, Hubei, China,Hubei Cancer Clinical Study Center, Wuhan, Hubei, China
| | - Meng-Yuan Dai
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China,Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, Hubei, China,Hubei Cancer Clinical Study Center, Wuhan, Hubei, China,*Correspondence: Meng-Yuan Dai, ; Hong-Bing Cai,
| | - Hong-Bing Cai
- Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China,Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, Hubei, China,Hubei Cancer Clinical Study Center, Wuhan, Hubei, China,*Correspondence: Meng-Yuan Dai, ; Hong-Bing Cai,
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Alves RC, Perosa Fernandes R, Lira de Farias R, da Silva PB, Santos Faria R, Quijia CR, Galvão Frem RC, Azevedo RB, Chorilli M. Fabrication of Functional bioMOF-100 Prototype as Drug Delivery System for Breast Cancer Therapy. Pharmaceutics 2022; 14:pharmaceutics14112458. [PMID: 36432650 PMCID: PMC9699488 DOI: 10.3390/pharmaceutics14112458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/04/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Breast cancer is the most frequent cause of cancer death in women, representing the fifth leading cause of cancer death overall. Therefore, the growing search for the development of new treatments for breast cancer has been developed lately as well as drug delivery systems such as biocompatible metal-organic Frameworks (bio-MOFs). These may be promising and attractive for drug incorporation and release. The present study aims to develop a drug carrier system RCA (bioMOF-100 submitted to the activation process) containing incorporated curcumin (CCM), whose material surface is coated with folic acid molecules (FA) to promote the targeting of drug carrier systems to the tumor region. They were synthesized and characterized using several characterization techniques. The materials were submitted to drug encapsulation tests, whose encapsulation efficiency was 32.80% for CCM@RCA-1D. Using the 1H nuclear magnetic resonance (NMR) spectroscopy technique, it was possible to verify the appearance of signals referring to folic acid, suggesting success in the functionalization of these matrices. In vitro tests such as cell viability and type of cell death were evaluated in both series of compounds (CCM@RCA-1D, CCM@RCA-1D/FA) in breast tumor lines. The results revealed low toxicity of the materials and cell death by late apoptosis. Thus, these results indicate that the matrices studied can be promising carriers in the treatment of breast cancer.
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Affiliation(s)
- Renata Carolina Alves
- Department of Drugs and Medicines, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara Jau, Km 01—s/n—Campos Ville, Araraquara 14800-903, Brazil
- Correspondence: (R.C.A.); (M.C.)
| | | | - Renan Lira de Farias
- Departament of Chemical, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro 22451-900, Brazil
| | - Patricia Bento da Silva
- Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasilia (UnB), Campus Universitario Darcy Ribeiro—Asa Norte, Brasilia 70910-900, Brazil
| | - Raquel Santos Faria
- Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasilia (UnB), Campus Universitario Darcy Ribeiro—Asa Norte, Brasilia 70910-900, Brazil
| | - Christian Rafael Quijia
- Department of Drugs and Medicines, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara Jau, Km 01—s/n—Campos Ville, Araraquara 14800-903, Brazil
| | - Regina Célia Galvão Frem
- Chemistry Institute, São Paulo State University (UNESP), Campus Araraquara, Araraquara 14800-060, Brazil
| | - Ricardo Bentes Azevedo
- Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasilia (UnB), Campus Universitario Darcy Ribeiro—Asa Norte, Brasilia 70910-900, Brazil
| | - Marlus Chorilli
- Department of Drugs and Medicines, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara Jau, Km 01—s/n—Campos Ville, Araraquara 14800-903, Brazil
- Correspondence: (R.C.A.); (M.C.)
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Banerjee S, Michalarea V, Ang JE, Ingles Garces A, Biondo A, Funingana IG, Little M, Ruddle R, Raynaud F, Riisnaes R, Gurel B, Chua S, Tunariu N, Porter JC, Prout T, Parmar M, Zachariou A, Turner A, Jenkins B, McIntosh S, Ainscow E, Minchom A, Lopez J, de Bono J, Jones R, Hall E, Cook N, Basu B, Banerji U. A Phase I Trial of CT900, a Novel α-Folate Receptor-Mediated Thymidylate Synthase Inhibitor, in Patients with Solid Tumors with Expansion Cohorts in Patients with High-Grade Serous Ovarian Cancer. Clin Cancer Res 2022; 28:4634-4641. [PMID: 35984704 PMCID: PMC9623233 DOI: 10.1158/1078-0432.ccr-22-1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/07/2022] [Accepted: 08/17/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE CT900 is a novel small molecule thymidylate synthase inhibitor that binds to α-folate receptor (α-FR) and thus is selectively taken up by α-FR-overexpressing tumors. PATIENTS AND METHODS A 3+3 dose escalation design was used. During dose escalation, CT900 doses of 1-6 mg/m2 weekly and 2-12 mg/m2 every 2 weeks (q2Wk) intravenously were evaluated. Patients with high-grade serous ovarian cancer were enrolled in the expansion cohorts. RESULTS 109 patients were enrolled: 42 patients in the dose escalation and 67 patients in the expansion cohorts. At the dose/schedule of 12 mg/m2/q2Wk (with and without dexamethasone, n = 40), the most common treatment-related adverse events were fatigue, nausea, diarrhea, cough, anemia, and pneumonitis, which were predominantly grade 1 and grade 2. Levels of CT900 more than 600 nmol/L needed for growth inhibition in preclinical models were achieved for >65 hours at a dose of 12 mg/m2. In the expansion cohorts, the overall response rate (ORR), was 14/64 (21.9%). Thirty-eight response-evaluable patients in the expansion cohorts receiving 12 mg/m2/q2Wk had tumor evaluable for quantification of α-FR. Patients with high or medium expression had an objective response rate of 9/25 (36%) compared with 1/13 (7.7%) in patients with negative/very low or low expression of α-FR. CONCLUSIONS The dose of 12 mg/m2/q2Wk was declared the recommended phase II dose/schedule. At this dose/schedule, CT900 exhibited an acceptable side effect profile with clinical benefit in patients with high/medium α-FR expression and warrants further investigation.
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Affiliation(s)
- Susana Banerjee
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Vasiliki Michalarea
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Joo Ern Ang
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Alvaro Ingles Garces
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Andrea Biondo
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Ionut-Gabriel Funingana
- Cambridge University Hospitals NHS Foundation Trust and University of Cambridge, Cambridge, United Kingdom
| | - Martin Little
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Ruth Ruddle
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Florence Raynaud
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Ruth Riisnaes
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Bora Gurel
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Sue Chua
- Radiology and Nuclear Medicine Department, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Nina Tunariu
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Radiology and Nuclear Medicine Department, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Joanna C. Porter
- UCL Respiratory, University College London and Interstitial Lung Disease Service, University College London NHS Foundation Trust, London, United Kingdom
| | - Toby Prout
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Mona Parmar
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Anna Zachariou
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Alison Turner
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Ben Jenkins
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | | | | | - Anna Minchom
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Juanita Lopez
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Johann de Bono
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Robert Jones
- Cardiff University, School of Medicine, Velindre University NHS Trust, Cardiff, United Kingdom
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | - Natalie Cook
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, United Kingdom
- Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
| | - Bristi Basu
- Cambridge University Hospitals NHS Foundation Trust and University of Cambridge, Cambridge, United Kingdom
| | - Udai Banerji
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
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Yazaki S, Kojima Y, Yoshida H, Takamizawa S, Kitadai R, Nishikawa T, Shimoi T, Sudo K, Saito A, Okuma HS, Tanioka M, Noguchi E, Uno M, Ishikawa M, Kato T, Fujiwara Y, Ohe Y, Yonemori K. High expression of folate receptor alpha is associated with poor prognosis in patients with cervical cancer. J Gynecol Oncol 2022; 33:e82. [PMID: 36245230 PMCID: PMC9634091 DOI: 10.3802/jgo.2022.33.e82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/03/2021] [Accepted: 08/11/2022] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Folate receptor α (FRα) is a membrane protein expressed in various solid tumors but has limited expression in normal cells. Therefore, FRα is an attractive target for cancer treatment. This study aimed to investigate the relationship between FRα expression and the clinicopathological characteristics and survivals of cervical cancer. METHODS This retrospective study included patients with cervical cancer who underwent primary surgery between 2000 and 2020 at our institution. Immunohistochemical staining of FRα was performed using an anti-folate-binding protein/FBP antibody. FRα-positive staining was defined as ≥5% of tumor staining and FRα-high as ≥50% tumor staining with ≥2+ intensity. The association between FRα expression and survival was assessed using multivariate Cox regression analysis, adjusting for established prognostic factors. RESULTS Overall, 123 patients were identified, and 140 tumor samples, including 17 paired primary and metastatic samples, were evaluated. As histological types, 67 patients had squamous cell carcinoma (SCC), and 56 patients had non-SCC. All primary tumors were FRα-positive. High FRα expression was observed in 25% of the cases and differed according to histology (SCC vs. non-SCC, 14.9% vs. 37.5%, p=0.004). FRα expression was significantly higher in metastatic tumors than in primary (170 [IQR, 140-205] vs. 125 [IQR, 110-150], p=0.0006). High FRα expression was significantly associated with worse overall survival (hazard ratio, 6.73; 95% confidence interval, 2.21-20.53; p=0.001). CONCLUSION In cervical cancer, FRα expression was elevated in metastatic tumors and high expression was associated with a worse prognosis. Our study supports the development of FRα-targeted therapy for advanced cervical cancer.
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Affiliation(s)
- Shu Yazaki
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.,Department of Cancer Medicine, Jikei University Graduate School of Medicine, Tokyo, Japan
| | - Yuki Kojima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Rui Kitadai
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tadaaki Nishikawa
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsunori Shimoi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Sudo
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ayumi Saito
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Maki Tanioka
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Emi Noguchi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masaya Uno
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Mitsuya Ishikawa
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Tomoyasu Kato
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Cancer Medicine, Jikei University Graduate School of Medicine, Tokyo, Japan
| | - Kan Yonemori
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
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Dodda JM, Remiš T, Rotimi S, Yeh YC. Progress in the drug encapsulation of poly(lactic- co-glycolic acid) and folate-decorated poly(ethylene glycol)-poly(lactic- co-glycolic acid) conjugates for selective cancer treatment. J Mater Chem B 2022; 10:4127-4141. [PMID: 35593381 DOI: 10.1039/d2tb00469k] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Poly(lactic-co-glycolic acid) (PLGA) is a US Food and Drug Administration (FDA)-approved polymer used in humans in the forms of resorbable sutures, drug carriers, and bone regeneration materials. Recently, PLGA-based conjugates have been extensively investigated for cancer, which is the second leading cause of death globally. This article presents an account of the literature on PLGA-based conjugates, focusing on their chemistries, biological activity, and functions as targeted drug carriers or sustained drug controllers for common cancers (e.g., breast, prostate, and lung cancers). The preparation and drug encapsulation of PLGA nanoparticles and folate-decorated poly(ethylene glycol)-poly(lactic-co-glycolic acid) (FA-PEG-PLGA) conjugates are discussed, along with several representative examples. Particularly, the reactions used for preparing drug-conjugated PLGA and FA-PEG-PLGA are emphasized, with the associated chemistries involved in the formation of structures and their biocompatibility with internal organs. This review provides a deeper understanding of the constituents and interactions of PLGA-conjugated materials to ensure successful conjugation in PLGA material design and the subsequent biomedical applications.
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Affiliation(s)
- Jagan Mohan Dodda
- New Technologies-Research Centre (NTC), University of West Bohemia, Univerzitní 8, 301 00 Pilsen, Czech Republic.
| | - Tomáš Remiš
- New Technologies-Research Centre (NTC), University of West Bohemia, Univerzitní 8, 301 00 Pilsen, Czech Republic.
| | - Sadiku Rotimi
- Institute of NanoEngineering Research (INER) and Department of Chemical, Metallurgical and Materials Engineering, Tshwane University of Technology, Staatsartillerie Rd, 0183, Pretoria West Campus, South Africa
| | - Yi-Cheun Yeh
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei, Taiwan
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Canestraro J, Hultcrantz M, Modi S, Hamlin PA, Shoushtari AN, Konner JA, Tew WP, Iyengar NM, Heinemann M, Abramson DH, Francis JH. Refractive Shifts and Changes in Corneal Curvature Associated With Antibody-Drug Conjugates. Cornea 2022; 41:792-801. [PMID: 34839332 PMCID: PMC9106803 DOI: 10.1097/ico.0000000000002934] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/28/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Antibody-drug conjugates (ADCs) are a class of cancer drug wherein some are associated with corneal abnormalities, but there is a dearth of published information on refractive shifts in patients receiving ADCs. Here, we evaluated the dynamics of refractive error and keratometry readings in patients with ADC-related keratopathy and microcyst-like epithelial changes (MECs). METHODS This study is a retrospective case series including 58 eyes of 29 patients with ADC-related keratopathy from a single tertiary care cancer referral center (MSKCC). One eye (29 total) was randomly assigned for statistical analysis. In addition, a subset analysis of MEC location-refractive error correlation was performed on 20 eyes. Clinical records including slitlamp examination, indirect ophthalmoscopy, calculated spherical equivalence (SE), keratometry, and visual acuity were recorded at baseline, during, and off treatment. RESULTS A subset analysis of MEC location-refractive error correlation of 20 eyes revealed the following: Peripheral MECs were significantly associated with hyperopic shifts (P value < 0.001) and paracentral/central associated with myopic shifts (P value < 0.001). In the full cohort and on drug, the greatest change in SE from baseline was myopic (68%, as high as -4.75 D) and hyperopic (32%, as much as +3.75 D). Eighty-nine percent had a change in vision from baseline while on drug, but at the 3-month follow-up off drug, SE and vision returned to baseline in 33% and 82% of eyes. CONCLUSIONS Peripheral MECs were significantly associated with hyperopic shifts, and paracentral/central MECs were associated with myopic shifts. While on drug, most eyes had a myopic refractive shift, which corresponded with corneal steepening.
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Affiliation(s)
- Julia Canestraro
- Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Malin Hultcrantz
- Myeloma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Shanu Modi
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paul A Hamlin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Jason A Konner
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - William P Tew
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Neil M Iyengar
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Murk Heinemann
- Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical Center, New York, NY, USA
| | - David H Abramson
- Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical Center, New York, NY, USA
| | - Jasmine H Francis
- Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical Center, New York, NY, USA
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Nerone M, Del Grande M, Sessa C, Colombo I. Advancing antibody-drug conjugates in gynecological malignancies: myth or reality? EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2022; 3:149-171. [PMID: 36046840 PMCID: PMC9400759 DOI: 10.37349/etat.2022.00077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/11/2022] [Indexed: 11/30/2022] Open
Abstract
Antibody-drug conjugates (ADCs) represent a new class of therapeutic agents designed to target specific antigens on tumor cells, combining the specificity of monoclonal antibodies to the cytotoxicity of classic chemotherapy agents. These drugs have been extensively studied both in solid and hematologic malignancies, leading to substantial improvement in the therapeutic landscape for several tumors. Despite no ADC have been yet approved for the treatment of gynecological malignancies, some agents have shown promising results and might have the potential to become part of the standard of care. Among them, mirvetuximab soravtansine has shown activity in platinum-resistant ovarian cancer with high folate-α receptor expression, as a single agent and in combination. Tisotumab vedotin is active in patients with pre-treated cervical cancer, and further investigation is ongoing. The purpose of this review is to summarize the structural and functional characteristics of ADCs and analyze the most recent and promising data regarding the clinical development of ADCs in gynecological malignancies. The available data on the efficacy of the more studied ADCs in ovarian, endometrial, and cervical cancers will be discussed along with toxicities of special interest, the mechanisms of resistance, and future possible drugs combination.
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Affiliation(s)
- Marta Nerone
- Service of Medical Oncology, Oncology Institute of Southern Switzerland (IOSI), EOC, 6500 Bellinzona, Switzerland
| | - Maria Del Grande
- Service of Medical Oncology, Oncology Institute of Southern Switzerland (IOSI), EOC, 6500 Bellinzona, Switzerland
| | - Cristiana Sessa
- Service of Medical Oncology, Oncology Institute of Southern Switzerland (IOSI), EOC, 6500 Bellinzona, Switzerland
| | - Ilaria Colombo
- Service of Medical Oncology, Oncology Institute of Southern Switzerland (IOSI), EOC, 6500 Bellinzona, Switzerland
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Nanomaterial-based biosensor developing as a route toward in vitro diagnosis of early ovarian cancer. Mater Today Bio 2022; 13:100218. [PMID: 35243293 PMCID: PMC8861407 DOI: 10.1016/j.mtbio.2022.100218] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 12/13/2022] Open
Abstract
The grand challenges of ovarian cancer early diagnosis have led to an alarmingly high mortality rate from ovarian cancer (OC) in the past half century. In vitro diagnosis (IVD) has great potential in the early diagnosis of OC through non-invasive and dynamic analysis of biomarkers. However, common IVDs often fail to provide reliable test results due to lack of sensitivity, specificity, and convenience. In recent years, the discovery of new biomarkers and the progress of nanomaterials can solve the shortcomings of traditional IVD for early OC. These emerging biosensors based on nanomaterials offer great improvements in convenience, speed, selectivity, and sensitivity of IVD. In this review, we firstly systematically summarized the limits of commercial IVD biosensors of OC and the latest discovery of new biomarkers for OC. The representative optimization strategies for six potential ovarian cancer biomarkers are systematically discussed with emphasis on nanomaterial selection and the design of detection principles. Then, various strategies adopted by emerging biosensors based on nanomaterials are also introduced in detail, including optical, electrochemical, microfluidic, and surface plasmon sensors. Finally, current challenges of early OC IVD are proposed, and future research directions on this promising field are also discussed. Failure to diagnose OC early will lead to high mortality. The detection of OC-related biomarkers by IVD method will achieve early diagnosis of OC. The development of nanomaterials-based biosensors is expected to enhance efficiency of detection. Strategies and progress for nanomaterials-based biosensors are systematically reviewed.
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40
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Wang Z, Zhao S, shi J, Meng F, Yuan J, Zhong Z. Folate-mediated targeted PLK1 inhibition therapy for ovarian cancer: A comparative study of molecular inhibitors and siRNA therapeutics. Acta Biomater 2022; 138:443-452. [PMID: 34757229 DOI: 10.1016/j.actbio.2021.10.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/29/2021] [Accepted: 10/25/2021] [Indexed: 12/15/2022]
Abstract
PLK1 is a promising target for clinical treatment of diverse malignancies including ovarian cancer (OC), in which PLK1 over-expression is often correlated with poor prognosis and short survival. PLK1 can be blocked with small molecular inhibitors like volasertib (Vol) or silenced with PLK1-specific siRNA (siPLK1), hence effectively suppressing tumor growth. Surprisingly, despite intensive work on molecular inhibitor and siRNA therapeutics, there is no direct comparison between them reported for targeted tumor therapy. Herein, we employing folate as a ligand and polymersomes as a nanovehicle performed a comparative study on Vol and siPLK1 in inhibiting OC in vitro and in vivo. Folate-targeted polymersomal Vol and siPLK1 (termed as FA-Ps-Vol and FA-Ps-siPLK1, respectively) were both nano-sized and stable, and displayed an optimal FA density of 20% for SKOV-3 cells. Notably, FA-Ps-Vol and FA-Ps-siPLK1 exhibited an IC50 of 193 and 770 nM, respectively, to SKOV-3 cells, indicating a greater potency of Vol than siPLK1. The markedly increased uptake for FA-Ps-Vol and FA-Ps-siPLK1 compared with respective non-targeted controls by SKOV-3 tumor xenografts in mice confirmed that FA mediates strong OC-targeting in vivo. Intriguingly, FA-Ps-Vol while greatly lessening toxic effects of Vol potently repressed tumor growth with a remarkable tumor inhibition rate (TIR) of 97% at 20 mg (i.e. 32.4 µmol) Vol equiv./kg. FA-Ps-siPLK1 achieved effective tumor inhibition (TIR = ca. 87% or 90%) at 2 or 4 mg (i.e. 0.15 or 0.3 µmol) siPLK1 equiv./kg without causing adverse effects. This comparative study highlights that molecular inhibitor has the advantage of easy dose escalation and potent protein inhibition at the expense of certain adverse effects while siRNA therapeutics has low toxicity with moderate protein inhibition in vivo. STATEMENT OF SIGNIFICANCE: PLK1 is a promising target for the development of innovative and specific treatments against diverse malignancies. Interestingly, despite intensive work on molecular inhibitors and siRNA against PLK1, little work has been directed to compare their efficacy in targeted tumor therapy. Here, we employed folate as a ligand and polymersomes as a nanovehicle and have performed a comparative study on volasertib and siPLK1 in inhibiting ovarian cancer in vitro and in vivo. Our data show that the dose of volasertib can be easily escalated to induce prominent antitumor efficacy at the expense of certain adverse effects, while siPLK1 brings about moderate protein inhibition and antitumor therapy without causing toxicity at two-orders-of-magnitude lower dose.
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Jin Y, Schladetsch MA, Huang X, Balunas MJ, Wiemer AJ. Stepping forward in antibody-drug conjugate development. Pharmacol Ther 2022; 229:107917. [PMID: 34171334 PMCID: PMC8702582 DOI: 10.1016/j.pharmthera.2021.107917] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 01/03/2023]
Abstract
Antibody-drug conjugates (ADCs) are cancer therapeutic agents comprised of an antibody, a linker and a small-molecule payload. ADCs use the specificity of the antibody to target the toxic payload to tumor cells. After intravenous administration, ADCs enter circulation, distribute to tumor tissues and bind to the tumor surface antigen. The antigen then undergoes endocytosis to internalize the ADC into tumor cells, where it is transported to lysosomes to release the payload. The released toxic payloads can induce apoptosis through DNA damage or microtubule inhibition and can kill surrounding cancer cells through the bystander effect. The first ADC drug was approved by the United States Food and Drug Administration (FDA) in 2000, but the following decade saw no new approved ADC drugs. From 2011 to 2018, four ADC drugs were approved, while in 2019 and 2020 five more ADCs entered the market. This demonstrates an increasing trend for the clinical development of ADCs. This review summarizes the recent clinical research, with a specific focus on how the in vivo processing of ADCs influences their design. We aim to provide comprehensive information about current ADCs to facilitate future development.
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Affiliation(s)
- Yiming Jin
- Division of Medicinal Chemistry, Department of Pharmaceutical Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Megan A Schladetsch
- Division of Medicinal Chemistry, Department of Pharmaceutical Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Xueting Huang
- Division of Medicinal Chemistry, Department of Pharmaceutical Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Marcy J Balunas
- Division of Medicinal Chemistry, Department of Pharmaceutical Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Andrew J Wiemer
- Division of Medicinal Chemistry, Department of Pharmaceutical Sciences, University of Connecticut, Storrs, CT 06269, USA; Institute for Systems Genomics, University of Connecticut, Storrs, CT 06269, USA.
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El Bairi K, Al Jarroudi O, Afqir S. Revisiting antibody-drug conjugates and their predictive biomarkers in platinum-resistant ovarian cancer. Semin Cancer Biol 2021; 77:42-55. [PMID: 33812984 DOI: 10.1016/j.semcancer.2021.03.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/07/2021] [Accepted: 03/27/2021] [Indexed: 02/05/2023]
Abstract
Until to date, platinum derived drugs are still the backbone of treating ovarian cancer (OC). Most patients treated with platinum-based chemotherapy develop resistance during the course of their management. The treatment of platinum-resistant ovarian cancer (PROC) is challenging. Few therapeutic options are available for patients with this aggressive disease. Besides, there are liminal advances regarding new anticancer drugs as well as validated predictive biomarkers of clinical outcomes in this setting. The enrollment of PROC patients in interventional studies is limited as compared to newly launched clinical trials for platinum-sensitive OC. Enthusiastically, the emergence of antibody-drug conjugates (ADCs) has provided promising findings for further clinical development in PROC. ADCs have the advantage to selectively deliver cytotoxic drugs to cancer cells expressing several of antigens using specific monoclonal antibodies based on the concept of immune bioconjugation. This innovative class of therapeutics showed encouraging early signs of clinical efficacy in PROC particularly mirvetuximab soravtansine that has been successfully introduced into three randomized and controlled phase III studies. In this review, the evidence from clinical trials supporting the development of ADCs targeting folate receptor alpha, sodium-dependent phosphate transporter 2B, dipeptidase 3, mesothelin, mucin 16, and tissue factor using various cytotoxic payloads in PROC is reviewed.
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Affiliation(s)
- Khalid El Bairi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco; Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco.
| | - Ouissam Al Jarroudi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco; Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
| | - Said Afqir
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco; Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
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Wang Z, Meng F, Zhong Z. Emerging targeted drug delivery strategies toward ovarian cancer. Adv Drug Deliv Rev 2021; 178:113969. [PMID: 34509574 DOI: 10.1016/j.addr.2021.113969] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 12/11/2022]
Abstract
Ovarian cancer is a high-mortality malignancy in women. The contemporary clinical chemotherapy with classic cytotoxic drugs, targeted molecular inhibitors would mostly fail when ovarian cancer cells become drug-resistant or metastasize through the body or when patients bare no more toleration because of strong adverse effects. The past decade has spotted varying targeted delivery systems including antibody-drug conjugates (ADCs), peptide/folate/aptamer-drug conjugates, polymer-drug conjugates, ligand-functionalized nanomedicines, and dual-targeted nanomedicines that upgrade ovarian cancer chemo- and molecular therapy effectively in preclinical/clinical settings via endowing therapeutic agents selectivity and bypassing drug resistance as well as lessening systemic toxicity. The targeted delivery approaches further provide means to potentiate emergent treatment modalities such as molecular therapy, gene therapy, protein therapy, photodynamic therapy, dual-targeting therapy and combination therapy for ovarian cancer. This review highlights up-to-date development of targeted drug delivery strategies toward advanced, metastatic, relapsed, and drug resistant ovarian cancers.
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Martín-Sabroso C, Lozza I, Torres-Suárez AI, Fraguas-Sánchez AI. Antibody-Antineoplastic Conjugates in Gynecological Malignancies: Current Status and Future Perspectives. Pharmaceutics 2021; 13:1705. [PMID: 34683998 PMCID: PMC8541375 DOI: 10.3390/pharmaceutics13101705] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/08/2021] [Accepted: 10/12/2021] [Indexed: 12/18/2022] Open
Abstract
In the last decade, antibody-drug conjugates (ADCs), normally formed by a humanized antibody and a small drug via a chemical cleavable or non-cleavable linker, have emerged as a potential treatment strategy in cancer disease. They allow to get a selective delivery of the chemotherapeutic agents at the tumor level, and, consequently, to improve the antitumor efficacy and, especially to decrease chemotherapy-related toxicity. Currently, nine antibody-drug conjugate-based formulations have been already approved and more than 80 are under clinical trials for the treatment of several tumors, especially breast cancer, lymphomas, and multiple myeloma. To date, no ADCs have been approved for the treatment of gynecological formulations, but many formulations have been developed and have reached the clinical stage, especially for the treatment of ovarian cancer, an aggressive disease with a low five-year survival rate. This manuscript analyzes the ADCs formulations that are under clinical research in the treatment of gynecological carcinomas, specifically ovarian, endometrial, and cervical tumors.
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Affiliation(s)
- Cristina Martín-Sabroso
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (C.M.-S.); (I.L.); (A.I.T.-S.)
- Institute of Industrial Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Irene Lozza
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (C.M.-S.); (I.L.); (A.I.T.-S.)
| | - Ana Isabel Torres-Suárez
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (C.M.-S.); (I.L.); (A.I.T.-S.)
- Institute of Industrial Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Ana Isabel Fraguas-Sánchez
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (C.M.-S.); (I.L.); (A.I.T.-S.)
- Institute of Industrial Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
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45
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Lucas AT, Moody A, Schorzman AN, Zamboni WC. Importance and Considerations of Antibody Engineering in Antibody-Drug Conjugates Development from a Clinical Pharmacologist's Perspective. Antibodies (Basel) 2021; 10:30. [PMID: 34449544 PMCID: PMC8395454 DOI: 10.3390/antib10030030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/04/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022] Open
Abstract
Antibody-drug conjugates (ADCs) appear to be in a developmental boom, with five FDA approvals in the last two years and a projected market value of over $4 billion by 2024. Major advancements in the engineering of these novel cytotoxic drug carriers have provided a few early success stories. Although the use of these immunoconjugate agents are still in their infancy, valuable lessons in the engineering of these agents have been learned from both preclinical and clinical failures. It is essential to appreciate how the various mechanisms used to engineer changes in ADCs can alter the complex pharmacology of these agents and allow the ADCs to navigate the modern-day therapeutic challenges within oncology. This review provides a global overview of ADC characteristics which can be engineered to alter the interaction with the immune system, pharmacokinetic and pharmacodynamic profiles, and therapeutic index of ADCs. In addition, this review will highlight some of the engineering approaches being explored in the creation of the next generation of ADCs.
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Affiliation(s)
- Andrew T. Lucas
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.T.L.); (A.N.S.)
- Carolina Center of Cancer Nanotechnology Excellence, UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
| | - Amber Moody
- Carolina Center of Cancer Nanotechnology Excellence, UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
| | - Allison N. Schorzman
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.T.L.); (A.N.S.)
| | - William C. Zamboni
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.T.L.); (A.N.S.)
- Carolina Center of Cancer Nanotechnology Excellence, UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
- Glolytics, LLC, Chapel Hill, NC 27517, USA
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46
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Liang D, Tuo X, Wang Q, Zhao L, Zhang K, Wang Y, Feng X, Yin P, Guo L, Liu Y, Wang L, Han L, An R, Li Q. Near-Infrared Fluorescent Agent for In Vitro Screening of Endometrial Cancer and Precancerous Lesions. Front Oncol 2021; 11:713583. [PMID: 34277456 PMCID: PMC8281888 DOI: 10.3389/fonc.2021.713583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/22/2021] [Indexed: 11/30/2022] Open
Abstract
The lack of cytopathologists delays the advancement of screening for endometrial cancer. It was urgent to develop a new dye for rapid diagnosis. Our study aimed to synthesize a targeted folate receptor-α near-infrared (NIR) fluorescent agent, folic acid-zwitterionic NIR fluorophore (ZW-FA), and explore the feasibility for screening of endometrial cancer and precancerous change. Folic acid was conjugated with zwitterionic NIR fluorophore. The preparation of ZW-FA was validated by 1H NMR, mass spectrometric, ultraviolet spectra and fluorescence spectra. ZW-FA was incubated with endometrial cytology samples obtained from patients who underwent dilation and curettage or total hysterectomy. Diagnostic utility was calculated by applying laser confocal microscope, Image-J and statistical models, such as enumeration, receiver operating characteristic curve, logistic regression, support vector machine and decision tree were used. The purity of ZW-FA was > 95% determined by 1H NMR. ZW-FA had the strongest absorption peak at 633 nm in ultraviolet spectra. Photostability of ZW-FA was over 8 hours. In clinical validation, a total of 92 patients were enrolled. The cut-off value of ZW-FA was 49 in enumeration, which was used to distinguish the type of samples. Indicators about diagnostic utility are as follows: sensitivity 90.77%, specificity 62.96%, false-positive rate 37.04%, false-negative rate 9.23%, positive predictive value 85.51% and negative predictive value 73.91%. The samples processed by ZW-FA did not affect further Hematoxylin-Eosin staining and pathological diagnosis. It was an effective cytologic strategy for in vitro diagnosis of endometrial cancer and precancerous change by using ZW-FA.
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Affiliation(s)
- Dongxin Liang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xiaoqian Tuo
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qing Wang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lanbo Zhao
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Kailu Zhang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Yiran Wang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xue Feng
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Panyue Yin
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lin Guo
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Yu Liu
- Department of Pathology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lei Wang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lu Han
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Ruifang An
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qiling Li
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
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Moore K, Oza A, Colombo N, Oaknin A, Scambia G, Lorusso D, Konecny G, Banerjee S, Murphy C, Tanyi J, Hirte H, Konner J, Lim P, Prasad-Hayes M, Monk B, Pautier P, Wang J, Berkenblit A, Vergote I, Birrer M. Phase III, randomized trial of mirvetuximab soravtansine versus chemotherapy in patients with platinum-resistant ovarian cancer: primary analysis of FORWARD I. Ann Oncol 2021; 32:757-765. [DOI: 10.1016/j.annonc.2021.02.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 11/26/2022] Open
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Roy AG, Robinson JM, Sharma P, Rodriguez-Garcia A, Poussin MA, Nickerson-Nutter C, Powell DJ. Folate Receptor Beta as a Direct and Indirect Target for Antibody-Based Cancer Immunotherapy. Int J Mol Sci 2021; 22:5572. [PMID: 34070369 PMCID: PMC8197521 DOI: 10.3390/ijms22115572] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/12/2021] [Accepted: 05/15/2021] [Indexed: 01/08/2023] Open
Abstract
Folate receptor beta (FRβ) is a folate binding receptor expressed on myeloid lineage hematopoietic cells. FRβ is commonly expressed at high levels on malignant blasts in patients with acute myeloid leukemia (AML), as well as on M2 polarized tumor-associated macrophages (TAMs) in the tumor microenvironment of many solid tumors. Therefore, FRβ is a potential target for both direct and indirect cancer therapy. We demonstrate that FRβ is expressed in both AML cell lines and patient-derived AML samples and that a high-affinity monoclonal antibody against FRβ (m909) has the ability to cause dose- and expression-dependent ADCC against these cells in vitro. Importantly, we find that administration of m909 has a significant impact on tumor growth in a humanized mouse model of AML. Surprisingly, m909 functions in vivo with and without the infusion of human NK cells as mediators of ADCC, suggesting potential involvement of mouse macrophages as effector cells. We also found that TAMs from primary ovarian ascites samples expressed appreciable levels of FRβ and that m909 has the ability to cause ADCC in these samples. These results indicate that the targeting of FRβ using m909 has the potential to limit the outgrowth of AML in vitro and in vivo. Additionally, m909 causes cytotoxicity to TAMs in the tumor microenvironment of ovarian cancer warranting further investigation of m909 and its derivatives as therapeutic agents in patients with FRβ-expressing cancers.
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MESH Headings
- Animals
- Antineoplastic Agents, Immunological/pharmacology
- CHO Cells
- Cricetulus
- Female
- Folate Receptor 2/antagonists & inhibitors
- Folate Receptor 2/immunology
- HL-60 Cells
- Humans
- Immunotherapy
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Mice
- Mice, Inbred NOD
- Mice, Knockout
- Mice, SCID
- Neoplasm Proteins/antagonists & inhibitors
- Neoplasm Proteins/immunology
- Ovarian Neoplasms/immunology
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/therapy
- THP-1 Cells
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Allison G. Roy
- Ovarian Cancer Research Center, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.G.R.); (P.S.); (A.R.-G.); (M.A.P.)
- Center for Cellular Immunotherapies, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - J. Michael Robinson
- Department of Gynecologic Oncology, Zimmer Cancer Center, New Hanover Regional Medical Center, Wilmington, NC 28401, USA;
| | - Prannda Sharma
- Ovarian Cancer Research Center, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.G.R.); (P.S.); (A.R.-G.); (M.A.P.)
- Center for Cellular Immunotherapies, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Alba Rodriguez-Garcia
- Ovarian Cancer Research Center, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.G.R.); (P.S.); (A.R.-G.); (M.A.P.)
- Center for Cellular Immunotherapies, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mathilde A. Poussin
- Ovarian Cancer Research Center, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.G.R.); (P.S.); (A.R.-G.); (M.A.P.)
- Center for Cellular Immunotherapies, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | - Daniel J. Powell
- Ovarian Cancer Research Center, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.G.R.); (P.S.); (A.R.-G.); (M.A.P.)
- Center for Cellular Immunotherapies, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA
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Bussing D, Sharma S, Li Z, Meyer LF, Shah DK. Quantitative Evaluation of the Effect of Antigen Expression Level on Antibody-Drug Conjugate Exposure in Solid Tumor. AAPS JOURNAL 2021; 23:56. [PMID: 33856579 DOI: 10.1208/s12248-021-00584-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/17/2021] [Indexed: 12/22/2022]
Abstract
Antibody-drug conjugates (ADCs) rely on high expression of target antigens on cancer cells to effectively enter the cell and release a cytotoxic payload. Previous studies have shown that ADC efficacy is not always tied to antigen expression. However, our recent in vitro study suggests a linear relationship between antigen expression and the intracellular levels of the ADC payload. In this study, we have explored the relationship between antigen expression and intratumoral ADC exposure in vivo. Using trastuzumab-vc-MMAE (T-vc-MMAE) and four cell lines with varying expression of human epithelial growth factor receptor 2 (HER2), the pharmacokinetics of total trastuzumab, released ("free") MMAE, and total MMAE were evaluated in a tumor xenograft model. Nude mice were implanted with tumors originating from BT-474, MDA-MB-453, MCF-7, and MDA-MB-468 cell lines and dosed with 10 mg/kg or 1 mg/kg of ADC. Observed data were mathematically characterized using a mechanism-based PK model. A strong positive correlation was observed between antigen expression levels and free/total MMAE exposure (R2 ≥ 0.91) (total MMAE being the sum of released and conjugated MMAE) within the tumor, but not for total trastuzumab exposure. The PK model was able to recapitulate plasma PK through simulation; however, the tumor PK was overpredicted or underpredicted in some cases potentially due to differences in tumor vasculature or extracellular matrix conditions. Our results indicate a linear relationship between antigen expression and tumor exposure of free/total ADC payload in vivo, validating our previous finding in vitro, while also revealing the need to understand complex physiology of the tumor to predict tumor PK of ADC and its components. Our findings also support the concept of antigen expression screening in patients for targeted therapies like ADCs to achieve the maximum therapeutic benefit of the treatment.
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Affiliation(s)
- David Bussing
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, Buffalo, New York, USA
| | - Sharad Sharma
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, Buffalo, New York, USA. .,NBE-PK, Research and Development, Boehringer Ingelheim Pharmaceuticals Inc, 900 Ridgebury Rd., P.O. Box 368, Ridgefield, Connecticut, 06877-0368, USA.
| | - Zhe Li
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, Buffalo, New York, USA
| | - Lyndsey F Meyer
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, Buffalo, New York, USA
| | - Dhaval K Shah
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, Buffalo, New York, USA.
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50
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Yam C, Rauch GM, Rahman T, Karuturi M, Ravenberg E, White J, Clayborn A, McCarthy P, Abouharb S, Lim B, Litton JK, Ramirez DL, Saleem S, Stec J, Symmans WF, Huo L, Damodaran S, Sun R, Moulder SL. A phase II study of Mirvetuximab Soravtansine in triple-negative breast cancer. Invest New Drugs 2020; 39:509-515. [PMID: 32984932 DOI: 10.1007/s10637-020-00995-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/26/2020] [Indexed: 12/31/2022]
Abstract
Folate receptor alpha (FRα) has been reported to be expressed in up to 80% of triple-negative breast cancers (TNBC) with limited expression in normal tissues, making it a promising therapeutic target. Mirvetuximab soravtansine (mirvetuximab-s) is an antibody drug conjugate which has shown promise in the treatment of FRα-positive solid tumors in early phase clinical trials. Herein, are the results of the first prospective phase II trial evaluating mirvetuximab-s in metastatic TNBC. Patients with advanced, FRα-positive TNBC were enrolled on this study. Mirvetuximab-s was administered at a dose of 6.0 mg/kg every 3 weeks. 96 patients with advanced TNBC consented for screening. FRα staining was performed on tumor tissue obtained from 80 patients. The rate of FRα positivity by immunohistochemistry was 10.0% (8/80). Two patients were treated on study, with best overall responses of stable disease in one and progressive disease in the other. Adverse events were consistent with earlier studies. The study was terminated early due to the low rate of FRα positivity in the screened patient population and lack of disease response in the two patients treated. The observed rate of FRα positivity was considerably lower than previously reported and none of the patients had a partial or complete response. Treatment with mirvetuximab-s should only be further explored in TNBC if an alternate biomarker strategy is developed for patient selection on the basis of additional preclinical data.
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Affiliation(s)
- Clinton Yam
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | - Gaiane M Rauch
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tanbin Rahman
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Meghan Karuturi
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | - Elizabeth Ravenberg
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | - Jason White
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | - Alyson Clayborn
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | - Pamela McCarthy
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | - Sausan Abouharb
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | - Bora Lim
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | - Jennifer K Litton
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | - David L Ramirez
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | - Sadia Saleem
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | | | - W Fraser Symmans
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lei Huo
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Senthil Damodaran
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA
| | - Ryan Sun
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stacy L Moulder
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Dan L. Duncan Building CPB5.3542, 1515 Holcombe Blvd. Unit 1354, Houston, TX, 77030, USA.
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