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Vergote I, González-Martín A, Fujiwara K, Kalbacher E, Bagaméri A, Ghamande S, Lee JY, Banerjee S, Maluf FC, Lorusso D, Yonemori K, Van Nieuwenhuysen E, Manso L, Woelber L, Westermann A, Covens A, Hasegawa K, Kim BG, Raimondo M, Bjurberg M, Cruz FM, Angelergues A, Cibula D, Barraclough L, Oaknin A, Gennigens C, Nicacio L, Teng MSL, Whalley E, Soumaoro I, Slomovitz BM. Tisotumab Vedotin as Second- or Third-Line Therapy for Recurrent Cervical Cancer. N Engl J Med 2024; 391:44-55. [PMID: 38959480 DOI: 10.1056/nejmoa2313811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
BACKGROUND Recurrent cervical cancer is a life-threatening disease, with limited treatment options available when disease progression occurs after first-line combination therapy. METHODS We conducted a phase 3, multinational, open-label trial of tisotumab vedotin as second- or third-line therapy in patients with recurrent or metastatic cervical cancer. Patients were randomly assigned, in a 1:1 ratio, to receive tisotumab vedotin monotherapy (2.0 mg per kilogram of body weight every 3 weeks) or the investigator's choice of chemotherapy (topotecan, vinorelbine, gemcitabine, irinotecan, or pemetrexed). The primary end point was overall survival. RESULTS A total of 502 patients underwent randomization (253 were assigned to the tisotumab vedotin group and 249 to the chemotherapy group); the groups were similar with respect to demographic and disease characteristics. The median overall survival was significantly longer in the tisotumab vedotin group than in the chemotherapy group (11.5 months [95% confidence interval {CI}, 9.8 to 14.9] vs. 9.5 months [95% CI, 7.9 to 10.7]), results that represented a 30% lower risk of death with tisotumab vedotin than with chemotherapy (hazard ratio, 0.70; 95% CI, 0.54 to 0.89; two-sided P = 0.004). The median progression-free survival was 4.2 months (95% CI, 4.0 to 4.4) with tisotumab vedotin and 2.9 months (95% CI, 2.6 to 3.1) with chemotherapy (hazard ratio, 0.67; 95% CI, 0.54 to 0.82; two-sided P<0.001). The confirmed objective response rate was 17.8% in the tisotumab vedotin group and 5.2% in the chemotherapy group (odds ratio, 4.0; 95% CI, 2.1 to 7.6; two-sided P<0.001). A total of 98.4% of patients in the tisotumab vedotin group and 99.2% in the chemotherapy group had at least one adverse event that occurred during the treatment period (defined as the period from day 1 of dose 1 until 30 days after the last dose); grade 3 or greater events occurred in 52.0% and 62.3%, respectively. A total of 14.8% of patients stopped tisotumab vedotin treatment because of toxic effects. CONCLUSIONS In patients with recurrent cervical cancer, second- or third-line treatment with tisotumab vedotin resulted in significantly greater efficacy than chemotherapy. (Funded by Genmab and Seagen [acquired by Pfizer]; innovaTV 301 ClinicalTrials.gov number, NCT04697628.).
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Affiliation(s)
- Ignace Vergote
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Antonio González-Martín
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Keiichi Fujiwara
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Elsa Kalbacher
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Andrea Bagaméri
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Sharad Ghamande
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Jung-Yun Lee
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Susana Banerjee
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Fernando Cotait Maluf
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Domenica Lorusso
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Kan Yonemori
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Els Van Nieuwenhuysen
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Luis Manso
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Linn Woelber
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Anneke Westermann
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Allan Covens
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Kosei Hasegawa
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Byoung-Gie Kim
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Miriam Raimondo
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Maria Bjurberg
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Felipe Melo Cruz
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Antoine Angelergues
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - David Cibula
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Lisa Barraclough
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Ana Oaknin
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Christine Gennigens
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Leo Nicacio
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Melinda Siew Leng Teng
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Elizabeth Whalley
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Ibrahima Soumaoro
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
| | - Brian M Slomovitz
- From Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, and the Belgium and Luxembourg Gynaecological Oncology Group, Leuven (I.V., E.V.N.), and Centre Hospitalier Universitaire de Liège, Liege (C.G.) - all in Belgium; Cancer Center Clínica Universidad de Navarra (A.G.-M.), Hospital Universitario 12 de Octubre (L.M.), and Grupo Español de Investigación en Cáncer de Ovario (GEICO) (A.G.-M.), Madrid, and Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona (A.O.) - all in Spain; Saitama Medical School International Medical Center, Saitama (K.F., K.H.), and the National Cancer Center Hospital, Tokyo (K.Y.) - both in Japan; Centre Hospitalier Universitaire de Besançon, Besançon (E.K.), and GINECO (E.K., A.A.) and Groupe Hospitalier Diaconesses Croix Saint-Simon (A.A.), Paris - all in France; Országos Onkológiai Intézet, Budapest, Hungary (A.B.); Georgia Cancer Center, Augusta University, Augusta (S.G.); Yonsei University College of Medicine (J.-Y.L.) and Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.) - both in Seoul, South Korea; the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and the Christie NHS Foundation Trust, Clinical Oncology, Manchester (L.B.) - both in the United Kingdom; Hospital Beneficencia Portuguesa de São Paulo (F.C.M.), Hospital Israelita Albert Einstein de São Paulo (F.C.M.), and Instituto Brasileiro de Controle do Câncer (F.M.C.) - all in Sao Paulo; Fondazione Policlinico Gemelli IRCCS and Catholic University of Sacred Heart, Rome (D.L.); Arbeitsgemeinschaft Gynäkologische Onkologie Study Group and University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.W.); Amsterdam University Medical Centers, Amsterdam (A.W.); Sunnybrook Research Institute, Toronto (A.C.); Medica Oncólogia Clinica en Grupo Gamma, Rosario, Argentina (M.R.); Skåne University Hospital and Lund University, Lund, Sweden (M.B.); First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic (D.C.); Pfizer, Bothell, WA (L.N., M.S.L.T., E.W.); Genmab US, Princeton, NJ (I.S.); and Mount Sinai Medical Center, Miami Beach, FL (B.M.S.)
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Khadela A, Megha K, Shah VB, Soni S, Shah AC, Mistry H, Bhatt S, Merja M. Exploring the Potential of Antibody-Drug Conjugates in Targeting Non-small Cell Lung Cancer Biomarkers. Clin Med Insights Oncol 2024; 18:11795549241260534. [PMID: 38911453 PMCID: PMC11193349 DOI: 10.1177/11795549241260534] [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: 10/16/2023] [Accepted: 05/17/2024] [Indexed: 06/25/2024] Open
Abstract
Antibody-drug conjugates (ADCs), combining the cytotoxicity of the drug payload with the specificity of monoclonal antibodies, are one of the rapidly evolving classes of anti-cancer agents. These agents have been successfully incorporated into the treatment paradigm of many malignancies, including non-small cell lung cancer (NSCLC). The NSCLC is the most prevalent subtype of lung cancer, having a considerable burden on the cancer-related mortality and morbidity rates globally. Several ADC molecules are currently approved by the Food and Drug Administration (FDA) to be used in patients with NSCLC. However, the successful management of NSCLC patients using these agents was met with several challenges, including the development of resistance and toxicities. These shortcomings resulted in the exploration of novel therapeutic targets that can be targeted by the ADCs. This review aims to explore the recently identified ADC targets along with their oncologic mechanisms. The ADC molecules targeting these biomarkers are further discussed along with the evidence from clinical trials.
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Affiliation(s)
- Avinash Khadela
- Department of Pharmacology, L. M. College of Pharmacy, Navrangpura, Ahmedabad, Gujarat, India
| | - Kaivalya Megha
- Department of Pharmacology, L. M. College of Pharmacy, Navrangpura, Ahmedabad, Gujarat, India
| | - Vraj B Shah
- Department of Pharmacology, L. M. College of Pharmacy, Navrangpura, Ahmedabad, Gujarat, India
| | - Shruti Soni
- Department of Pharmacology, L. M. College of Pharmacy, Navrangpura, Ahmedabad, Gujarat, India
| | - Aayushi C Shah
- Department of Pharmacology, L. M. College of Pharmacy, Navrangpura, Ahmedabad, Gujarat, India
| | - Hetvi Mistry
- Department of Pharmacology, L. M. College of Pharmacy, Navrangpura, Ahmedabad, Gujarat, India
| | - Shelly Bhatt
- Department of Pharmacology, L. M. College of Pharmacy, Navrangpura, Ahmedabad, Gujarat, India
| | - Manthan Merja
- Department of Clinical Oncology, Starlit Cancer Centre, Kothiya Hospital, Ahmedabad, Gujarat, India
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3
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Yu P, Zhu C, You X, Gu W, Wang X, Wang Y, Bu R, Wang K. The combination of immune checkpoint inhibitors and antibody-drug conjugates in the treatment of urogenital tumors: a review insights from phase 2 and 3 studies. Cell Death Dis 2024; 15:433. [PMID: 38898003 PMCID: PMC11186852 DOI: 10.1038/s41419-024-06837-w] [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: 01/20/2024] [Revised: 06/08/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024]
Abstract
With the high incidence of urogenital tumors worldwide, urinary system tumors are among the top 10 most common tumors in men, with prostate cancer ranking first and bladder cancer fourth. Patients with resistant urogenital tumors often have poor prognosis. In recent years, researchers have discovered numerous specific cancer antigens, which has led to the development of several new anti-cancer drugs. Using protein analysis techniques, researchers developed immune checkpoint inhibitors (ICIs) and antibody-conjugated drugs (ADCs) for the treatment of advanced urogenital tumors. However, tumor resistance often leads to the failure of monotherapy. Therefore, clinical trials of the combination of ICIs and ADCs have been carried out in numerous centers around the world. This article reviewed phase 2 and 3 clinical studies of ICIs, ADCs, and their combination in the treatment of urogenital tumors to highlight safe and effective methods for selecting individualized therapeutic strategies for patients. ICIs activate the immune system, whereas ADCs link monoclonal antibodies to toxins, which can achieve a synergistic effect when the two drugs are combined. This synergistic effect provides multiple advantages for the treatment of urogenital tumors.
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Affiliation(s)
- Puguang Yu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Chunming Zhu
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Xiangyun You
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
- Department of Urology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, 443002, China
- Department of Urology, Yichang Central People's Hospital, Yichang, 443002, China
| | - Wen Gu
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Xia Wang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Yuan Wang
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
| | - Renge Bu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
| | - Kefeng Wang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
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4
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Zhai C, Cui Y, Guo L, Chen C, Song Y, Zhong J, Wang Y. Progress in the study of antibody-drug conjugates for the treatment of cervical cancer. Front Oncol 2024; 14:1395784. [PMID: 38903711 PMCID: PMC11187480 DOI: 10.3389/fonc.2024.1395784] [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: 03/04/2024] [Accepted: 05/21/2024] [Indexed: 06/22/2024] Open
Abstract
Cervical cancer is the second most prevalent malignancy affecting women's health globally, and the number of morbidity and mortality from cervical cancer continues to rise worldwide. The 5-year survival rate of patients with recurrent or metastatic cervical cancer is significantly reduced, and existing treatment modalities have low efficacy and high adverse effects, so there is a strong need for new, effective, and well-tolerated therapies. Antibody-drug conjugates (ADCs) are a new targeted therapeutic modality that can efficiently kill tumor cells. This review aims to summarize the composition, research, and development history and mechanism of action of ADCs, to review the research progress of ADCs in the treatment of cervical cancer, and to summarize and prospect the application of ADCs.
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Affiliation(s)
- Congcong Zhai
- Department of Oncology, Gannan Medical University, Ganzhou, China
- Department of Oncology, First Affiliated Hospital, Gannan Medical University, Ganzhou, China
| | - Yan Cui
- Department of Oncology, Bengbu Medical University, Lu’an, China
| | - Ling Guo
- Department of Oncology, Gannan Medical University, Ganzhou, China
| | - Cixiang Chen
- Department of Oncology, Gannan Medical University, Ganzhou, China
| | - Yanfang Song
- Department of Oncology, First Affiliated Hospital, Gannan Medical University, Ganzhou, China
| | - Jinghua Zhong
- Department of Oncology, First Affiliated Hospital, Gannan Medical University, Ganzhou, China
- Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China
| | - Yili Wang
- Department of Oncology, First Affiliated Hospital, Gannan Medical University, Ganzhou, China
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5
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Lindgren ES, Yan R, Cil O, Verkman AS, Chan MF, Seitzman GD, Farooq AV, Huppert LA, Rugo HS, Pohlmann PR, Lu J, Esserman LJ, Pasricha ND. Incidence and Mitigation of Corneal Pseudomicrocysts Induced by Antibody-Drug Conjugates (ADCs). CURRENT OPHTHALMOLOGY REPORTS 2024; 12:13-22. [PMID: 38756824 PMCID: PMC11095972 DOI: 10.1007/s40135-024-00322-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 05/18/2024]
Abstract
Purpose of Review This study is to highlight the incidence of corneal pseudomicrocysts in FDA-approved antibody-drug conjugates (ADCs), and success of preventive therapies for pseudomicrocysts and related ocular surface adverse events (AEs). Recent Findings ADCs are an emerging class of selective cancer therapies that consist of a potent cytotoxin connected to a monoclonal antibody (mAb) that targets antigens expressed on malignant cells. Currently, there are 11 FDA-approved ADCs with over 164 in clinical trials. Various AEs have been attributed to ADCs, including ocular surface AEs (keratitis/keratopathy, dry eye, conjunctivitis, blurred vision, corneal pseudomicrocysts). While the severity and prevalence of ADC-induced ocular surface AEs are well reported, the reporting of corneal pseudomicrocysts is limited, complicating the development of therapies to prevent or treat ADC-related ocular surface toxicity. Summary Three of 11 FDA-approved ADCs have been implicated with corneal pseudomicrocysts, with incidence ranging from 41 to 100% of patients. Of the six ADCs that reported ocular surface AEs, only three had ocular substudies to investigate the benefit of preventive therapies including topical steroids, vasoconstrictors, and preservative-free lubricants. Current preventive therapies demonstrate limited efficacy at mitigating pseudomicrocysts and other ocular surface AEs.
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Affiliation(s)
- Ethan S. Lindgren
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Rongshan Yan
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Onur Cil
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Alan S. Verkman
- Departments of Medicine and Physiology, University of California San Francisco, San Francisco, CA, USA
| | - Matilda F. Chan
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, USA
| | - Gerami D. Seitzman
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, USA
| | - Asim V. Farooq
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL, USA
| | - Laura A. Huppert
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Hope S. Rugo
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Paula R. Pohlmann
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Janice Lu
- Department of Medical Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Laura J. Esserman
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Neel D. Pasricha
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, USA
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Cheng T, Xie J, Yuan X, Guo M, Wu J, Wang M, Huang Z, Zhang J. Site-specific Antibody-Nitric Oxide Conjugate HN02 Possesses Improved Antineoplastic and Safety Properties. J Immunother 2024; 47:149-159. [PMID: 38557756 DOI: 10.1097/cji.0000000000000507] [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] [Accepted: 01/11/2024] [Indexed: 04/04/2024]
Abstract
Antibody-drug conjugates (ADCs) combine the high specificity of antibodies with the cytotoxicity of payloads and have great potential in pan-cancer immunotherapy. However, the current payloads for clinical uses have limited the therapeutic window due to their uncontrollable off-site toxicity. There is unmet needs to develop more potent ADC payloads with better safety and efficacy profiles. Nitric oxide (NO) is a special molecule that has low toxicity itself, which can kill tumor cells effectively when highly concentrated, has broad application prospects. Previously, we prepared for the first time an antibody-nitric oxide conjugate (ANC)-HN01, which showed inhibitory activity against hepatocellular carcinoma. However, the random conjugation method made HN01 highly heterogeneous and unstable. Here, we used site-specific conjugation-based engineered cysteine sites (CL-V211C) of anti-CD24 antibody to prepare a second-generation ANC with a drug-to-antibody ratio of 2. The homogeneous ANC, HN02 was stable in human plasma, shown in vitro bystander effect to neighboring cells and antiproliferative activity to CD24-targeted tumor cells. Compared with HN01, HN02 significantly prolonged the survival of tumor-bearing mice. In summary, we developed a stable and homogeneous site-specific conjugated ANC, which showed good antitumor activity and improved safety profile both in vitro and in vivo. This study provides new insight into the development of next generation of ADC candidates.
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Affiliation(s)
- Tianyue Cheng
- Antibody Engineering Laboratory, School of Life Science & Technology, China Pharmaceutical University, Nanjing, China
| | - Jiajun Xie
- Antibody Engineering Laboratory, School of Life Science & Technology, China Pharmaceutical University, Nanjing, China
| | - Xun Yuan
- State Key Laboratory of Natural Medicines, Nanjing, China
- Jiangsu Key Laboratory of Drug Discovery for Metabolic Diseases, Center of Drug Discovery, China Pharmaceutical University, Nanjing, China
| | - Minji Guo
- Antibody Engineering Laboratory, School of Life Science & Technology, China Pharmaceutical University, Nanjing, China
| | - Jianbing Wu
- State Key Laboratory of Natural Medicines, Nanjing, China
- Jiangsu Key Laboratory of Drug Discovery for Metabolic Diseases, Center of Drug Discovery, China Pharmaceutical University, Nanjing, China
| | - Min Wang
- School Infirmary, China Pharmaceutical University, Nanjing, China
| | - Zhangjian Huang
- State Key Laboratory of Natural Medicines, Nanjing, China
- Jiangsu Key Laboratory of Drug Discovery for Metabolic Diseases, Center of Drug Discovery, China Pharmaceutical University, Nanjing, China
| | - Juan Zhang
- Antibody Engineering Laboratory, School of Life Science & Technology, China Pharmaceutical University, Nanjing, China
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7
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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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8
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Marshall RF, Xu H, Berkenstock M. Ocular toxicities associated with antibody drug conjugates. Curr Opin Ophthalmol 2024:00055735-990000000-00172. [PMID: 38814581 DOI: 10.1097/icu.0000000000001063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [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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9
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Somme LB, Chouaid C, Moinard-Butot F, Barbe-Richaud JB, Greillier L, Schott R. Antibody-Drug Conjugates as Novel Therapeutic Agents for Non-Small Cell Lung Carcinoma with or without Alterations in Oncogenic Drivers. BioDrugs 2024:10.1007/s40259-024-00660-7. [PMID: 38767823 DOI: 10.1007/s40259-024-00660-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/22/2024]
Abstract
Antibody-drug conjugates (ADCs) are an emerging class of therapeutics for lung cancer, and several are currently in development for this malignancy. The structure of these molecules is based on an antibody that targets a protein on the lung cancer cell surface and a cytotoxic payload attached by a linker. Many protein targets, including TROP2, c-MET, CEACAM5, HER2, and HER3 have been identified. In metastatic non-small cell lung carcinoma (NSCLC) without alterations in oncogenic drivers, platinum-based chemotherapy and immune checkpoint inhibitors (ICIs) targeting the programmed death-1/programmed death-ligand 1 (PD1/PDL1) interaction are the standard first-line treatments. In patients with EGFR-mutated or ALK-rearranged NSCLC, tyrosine kinase inhibitors (TKIs) are recommended. However, although the prognosis of patients with metastatic NSCLC differs between such with and without alterations in oncogenic drivers, most patients eventually experience disease progression. A novel therapeutic class is needed in routine practice to overcome the mechanisms of resistance to ICIs and EGFR/ALK TKIs. Several ADCs have already been approved for other cancers, such as breast cancer and urothelial carcinoma. This review summarizes the knowledge about the efficacy and tolerance profiles of ADCs targeting TROP2, HER2, HER3, CEACAM5 and c-MET in metastatic NSCLC with and without alterations in oncogenic drivers.
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Affiliation(s)
- Laura Bender Somme
- Oncology Department, Institut de Cancérologie Strasbourg, 17 avenue Albert Calmette, 67200, Strasbourg, France.
| | - Christos Chouaid
- Pneumology Department, Hôpital Intercommunal de Créteil, 40 avenue de Verdun, 94010, Creteil, France
| | - Fabien Moinard-Butot
- Oncology Department, Institut de Cancérologie Strasbourg, 17 avenue Albert Calmette, 67200, Strasbourg, France
| | - Jean-Baptiste Barbe-Richaud
- Oncology Department, Institut de Cancérologie Strasbourg, 17 avenue Albert Calmette, 67200, Strasbourg, France
| | - Laurent Greillier
- Multidisciplinary Oncology and Therapeutic Innovations Department, Assistance Publique-Hôpitaux de Marseille, Aix Marseille University, Chemin des Bourrely, 13915, Marseille, France
| | - Roland Schott
- Oncology Department, Institut de Cancérologie Strasbourg, 17 avenue Albert Calmette, 67200, Strasbourg, France
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10
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Gitto SB, Whicker M, Davies G, Kumar S, Kinneer K, Xu H, Lewis A, Mamidi S, Medvedev S, Kim H, Anderton J, Tang EJ, Ferman B, Coats S, Wilkinson RW, Brown E, Powell DJ, Simpkins F. A B7-H4-Targeting Antibody-Drug Conjugate Shows Antitumor Activity in PARPi and Platinum-Resistant Cancers with B7-H4 Expression. Clin Cancer Res 2024; 30:1567-1581. [PMID: 37882675 PMCID: PMC11034955 DOI: 10.1158/1078-0432.ccr-23-1079] [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: 05/01/2023] [Revised: 08/21/2023] [Accepted: 10/24/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE Platinum and PARP inhibitors (PARPi) demonstrate activity in breast and ovarian cancers, but drug resistance ultimately emerges. Here, we examine B7-H4 expression in primary and recurrent high-grade serous ovarian carcinoma (HGSOC) and the activity of a B7-H4-directed antibody-drug conjugate (B7-H4-ADC), using a pyrrolobenzodiazepine-dimer payload, in PARPi- and platinum-resistant HGSOC patient-derived xenograft (PDX) models. EXPERIMENTAL DESIGN B7-H4 expression was quantified by flow cytometry and IHC. B7-H4-ADC efficacy was tested against multiple cell lines in vitro and PDX in vivo. The effect of B7-H4-ADC on cell cycle, DNA damage, and apoptosis was measured using flow cytometry. RESULTS B7-H4 is overexpressed in 92% of HGSOC tumors at diagnosis (n = 12), persisted in recurrent matched samples after platinum treatment, and was expressed at similar levels across metastatic sites after acquired multi-drug resistance (n = 4). Treatment with B7-H4-ADC resulted in target-specific growth inhibition of multiple ovarian and breast cancer cell lines. In platinum- or PARPi-resistant ovarian cancer cells, B7-H4-ADC significantly decreased viability and colony formation while increasing cell-cycle arrest and DNA damage, ultimately leading to apoptosis. Single-dose B7-H4-ADC led to tumor regression in 65.5% of breast and ovarian PDX models (n = 29), with reduced activity in B7-H4 low or negative models. In PARPi and platinum-resistant HGSOC PDX models, scheduled B7-H4-ADC dosing led to sustained tumor regression and increased survival. CONCLUSIONS These data support B7-H4 as an attractive ADC target for treatment of drug-resistant HGSOC and provide evidence for activity of an ADC with a DNA-damaging payload in this population. See related commentary by Veneziani et al., p. 1434.
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Affiliation(s)
- Sarah B. Gitto
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Margaret Whicker
- Penn Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104 USA
| | | | - Sushil Kumar
- Penn Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104 USA
| | | | - Haineng Xu
- Penn Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104 USA
| | | | | | - Sergey Medvedev
- Penn Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Hyoung Kim
- Penn Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104 USA
| | | | - E. Jessica Tang
- Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Benjamin Ferman
- Penn Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104 USA
| | | | | | - Eric Brown
- Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Daniel J. Powell
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
- Penn Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Fiona Simpkins
- Penn Ovarian Cancer Research Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104 USA
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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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Babayan LM, Bouts C, Guntupalli S, Marjon NA. Exploring tisotumab vedotin in recurrent cervical cancer: A case series including an HPV-independent gastric type adenocarcinoma. Gynecol Oncol Rep 2024; 52:101356. [PMID: 38523623 PMCID: PMC10958683 DOI: 10.1016/j.gore.2024.101356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/26/2024] Open
Abstract
Metastatic and recurrent cervical cancer is difficult to treat with limited options following platinum-based chemotherapy. Tisotumab vedotin (TV) is an antibody drug conjugate (ADC) targeted at a tissue factor (TF), which is a cell surface protein that is upregulated in the majority of cervical cancers. Prior clinical trials have demonstrated efficacy of TV in metastatic and recurrent cervical cancer with an objective response rate of 24-26 % with an 8.3 month duration of response. In this case series, we present 3 patients with recurrent or progressive cervical cancer of three different histologies (squamous cell, adenocarcinoma, and human papillomavirus (HPV)-independent gastric type carcinomas). We demonstrate a 100 % complete response rate with average time of complete response of 4.33 months. The duration of response was not reached as none of our patients had a confirmed progression at the time of writing this manuscript, but the mean time since the initiation of treatment was 6.1 months. In concordance with the clinical trials, our patients tolerated TV well although the grade 3 ocular toxicities were higher in our patients compared to prior data. This case series presents data confirming the efficacy and tolerability of TV in patients with recurrent cervical cancer, including an HPV-independent gastric type cervical cancer.
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Affiliation(s)
- Lisa Marie Babayan
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Catherine Bouts
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Saketh Guntupalli
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Nicole A. Marjon
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Colorado School of Medicine, Aurora, CO, USA
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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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Soberanis Pina P, Lheureux S. Novel Molecular Targets in Endometrial Cancer: Mechanisms and Perspectives for Therapy. Biologics 2024; 18:79-93. [PMID: 38529411 PMCID: PMC10962462 DOI: 10.2147/btt.s369783] [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: 12/01/2023] [Accepted: 02/22/2024] [Indexed: 03/27/2024]
Abstract
Endometrial cancer (EC) has a high epidemiological impact with incidence and mortality rising worldwide. In recent years, the integration of the pathologic and molecular classification has provided relevant information to understand the heterogeneity in the biology of EC, which led to the evolution in the management of patients. Currently, therapeutic breakthroughs have been made in advanced EC to improve oncologic outcomes, with efforts to include patient reported outcomes. Precision and personalized medicine are under way in EC exploring different combination approaches to target cross-talk pathways, cancer cell microenvironment, and metabolic vulnerabilities and improve drug delivery. Yet, collaborative efforts are needed to face the challenges in practice by refining patient selection, ideal biomarker identification, and de-escalation of therapies according to emerging molecular and genomic features of EC.
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Affiliation(s)
- Pamela Soberanis Pina
- Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Stephanie Lheureux
- Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
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15
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Zhang M, Zuo Y, Chen S, Li Y, Xing Y, Yang L, Wang H, Guo R. Antibody-drug conjugates in urothelial carcinoma: scientometric analysis and clinical trials analysis. Front Oncol 2024; 14:1323366. [PMID: 38665947 PMCID: PMC11044263 DOI: 10.3389/fonc.2024.1323366] [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: 10/17/2023] [Accepted: 02/12/2024] [Indexed: 04/28/2024] Open
Abstract
In 2020, bladder cancer, which commonly presents as urothelial carcinoma, became the 10th most common malignancy. For patients with metastatic urothelial carcinoma, the standard first-line treatment remains platinum-based chemotherapy, with immunotherapy serving as an alternative in cases of programmed death ligand 1 expression. However, treatment options become limited upon resistance to platinum and programmed death 1 or programmed death ligand 1 agents. Since the FDA's approval of Enfortumab Vedotin and Sacituzumab Govitecan, the therapeutic landscape has expanded, heralding a shift towards antibody-drug conjugates as potential first-line therapies. Our review employed a robust scientometric approach to assess 475 publications on antibody-drug conjugates in urothelial carcinoma, revealing a surge in related studies since 2018, predominantly led by U.S. institutions. Moreover, 89 clinical trials were examined, with 36 in Phase II and 13 in Phase III, exploring antibody-drug conjugates as both monotherapies and in combination with other agents. Promisingly, novel targets like HER-2 and EpCAM exhibit substantial therapeutic potential. These findings affirm the increasing significance of antibody-drug conjugates in urothelial carcinoma treatment, transitioning them from posterior-line to frontline therapies. Future research is poised to focus on new therapeutic targets, combination therapy optimization, treatment personalization, exploration of double antibody-coupled drugs, and strategies to overcome drug resistance.
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Affiliation(s)
- Meng Zhang
- Department of Clinical Laboratory, First Affiliated Hospital of Jilin University, Changchun, China
| | - Yuanye Zuo
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Siyi Chen
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Yaonan Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Yang Xing
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Lei Yang
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Hong Wang
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Rui Guo
- Department of Clinical Laboratory, First Affiliated Hospital of Jilin University, Changchun, China
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16
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Lewis CS, Backman C, Ahsan S, Cliff A, Hariharan A, Yeh JJ, Zhang X, Xie C, Sohal DPS, Bogdanov VY. First-in-Class Humanized Antibody against Alternatively Spliced Tissue Factor Augments Anti-Metastatic Efficacy of Chemotherapy in a Preclinical Model of Pancreatic Ductal Adenocarcinoma. Int J Mol Sci 2024; 25:2580. [PMID: 38473827 PMCID: PMC10932375 DOI: 10.3390/ijms25052580] [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: 01/01/2024] [Revised: 02/05/2024] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
Alternatively spliced tissue factor (asTF) promotes the progression of pancreatic ductal adenocarcinoma (PDAC) by activating β1-integrins on PDAC cell surfaces. hRabMab1, a first-in-class humanized inhibitory anti-asTF antibody we recently developed, can suppress PDAC primary tumor growth as a single agent. Whether hRabMab1 has the potential to suppress metastases in PDAC is unknown. Following in vivo screening of three asTF-proficient human PDAC cell lines, we chose to make use of KRAS G12V-mutant human PDAC cell line PaCa-44, which yields aggressive primary orthotopic tumors with spontaneous spread to PDAC-relevant anatomical sites, along with concomitant severe leukocytosis. The experimental design featured orthotopic tumors formed by luciferase labeled PaCa-44 cells; administration of hRabMab1 alone or in combination with gemcitabine/paclitaxel (gem/PTX); and the assessment of the treatment outcomes on the primary tumor tissue as well as systemic spread. When administered alone, hRabMab1 exhibited poor penetration of tumor tissue; however, hRabMab1 was abundant in tumor tissue when co-administered with gem/PTX, which resulted in a significant decrease in tumor cell proliferation; leukocyte infiltration; and neovascularization. Gem/PTX alone reduced primary tumor volume, but not metastatic spread; only the combination of hRabMab1 and gem/PTX significantly reduced metastatic spread. RNA-seq analysis of primary tumors showed that the addition of hRabMab1 to gem/PTX enhanced the downregulation of tubulin binding and microtubule motor activity. In the liver, hRabMab1 reduced liver metastasis as a single agent. Only the combination of hRabMab1 and gem/PTX eliminated tumor cell-induced leukocytosis. We here demonstrate for the first time that hRabMab1 may help suppress metastasis in PDAC. hRabMab1's ability to improve the efficacy of chemotherapy is significant and warrants further investigation.
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Affiliation(s)
- Clayton S. Lewis
- Division of Hematology/Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA; (C.S.L.); (C.B.); (S.A.); (D.P.S.S.)
| | - Charles Backman
- Division of Hematology/Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA; (C.S.L.); (C.B.); (S.A.); (D.P.S.S.)
| | - Sabahat Ahsan
- Division of Hematology/Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA; (C.S.L.); (C.B.); (S.A.); (D.P.S.S.)
| | - Ashley Cliff
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.C.); (A.H.); (J.J.Y.)
| | - Arthi Hariharan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.C.); (A.H.); (J.J.Y.)
| | - Jen Jen Yeh
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.C.); (A.H.); (J.J.Y.)
- Departments of Surgery and Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Xiang Zhang
- Division of Environmental Genetics and Molecular Toxicology, Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA;
| | - Changchun Xie
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA;
| | - Davendra P. S. Sohal
- Division of Hematology/Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA; (C.S.L.); (C.B.); (S.A.); (D.P.S.S.)
| | - Vladimir Y. Bogdanov
- Division of Hematology/Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA; (C.S.L.); (C.B.); (S.A.); (D.P.S.S.)
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17
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Liu Z, Jing C, Kong F. From clinical management to personalized medicine: novel therapeutic approaches for ovarian clear cell cancer. J Ovarian Res 2024; 17:39. [PMID: 38347608 PMCID: PMC10860311 DOI: 10.1186/s13048-024-01359-7] [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: 07/05/2023] [Accepted: 01/26/2024] [Indexed: 02/15/2024] Open
Abstract
Ovarian clear-cell cancer is a rare subtype of epithelial ovarian cancer with unique clinical and biological features. Despite optimal cytoreductive surgery and platinum-based chemotherapy being the standard of care, most patients experience drug resistance and a poor prognosis. Therefore, novel therapeutic approaches have been developed, including immune checkpoint blockade, angiogenesis-targeted therapy, ARID1A synthetic lethal interactions, targeting hepatocyte nuclear factor 1β, and ferroptosis. Refining predictive biomarkers can lead to more personalized medicine, identifying patients who would benefit from chemotherapy, targeted therapy, or immunotherapy. Collaboration between academic research groups is crucial for developing prognostic outcomes and conducting clinical trials to advance treatment for ovarian clear-cell cancer. Immediate progress is essential, and research efforts should prioritize the development of more effective therapeutic strategies to benefit all patients.
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Affiliation(s)
- Zesi Liu
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Dalian Medical University, Dalian, 116000, Liaoning Province, China
| | - Chunli Jing
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116000, Liaoning Province, China
| | - Fandou Kong
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Dalian Medical University, Dalian, 116000, Liaoning Province, China.
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18
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Tavares V, Marques IS, Melo IGD, Assis J, Pereira D, Medeiros R. Paradigm Shift: A Comprehensive Review of Ovarian Cancer Management in an Era of Advancements. Int J Mol Sci 2024; 25:1845. [PMID: 38339123 PMCID: PMC10856127 DOI: 10.3390/ijms25031845] [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: 12/31/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
Ovarian cancer (OC) is the female genital malignancy with the highest lethality. Patients present a poor prognosis mainly due to the late clinical presentation allied with the common acquisition of chemoresistance and a high rate of tumour recurrence. Effective screening, accurate diagnosis, and personalised multidisciplinary treatments are crucial for improving patients' survival and quality of life. This comprehensive narrative review aims to describe the current knowledge on the aetiology, prevention, diagnosis, and treatment of OC, highlighting the latest significant advancements and future directions. Traditionally, OC treatment involves the combination of cytoreductive surgery and platinum-based chemotherapy. Although more therapeutical approaches have been developed, the lack of established predictive biomarkers to guide disease management has led to only marginal improvements in progression-free survival (PFS) while patients face an increasing level of toxicity. Fortunately, because of a better overall understanding of ovarian tumourigenesis and advancements in the disease's (epi)genetic and molecular profiling, a paradigm shift has emerged with the identification of new disease biomarkers and the proposal of targeted therapeutic approaches to postpone disease recurrence and decrease side effects, while increasing patients' survival. Despite this progress, several challenges in disease management, including disease heterogeneity and drug resistance, still need to be overcome.
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Affiliation(s)
- Valéria Tavares
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP), Pathology and Laboratory Medicine Department, Clinical Pathology SV/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Porto Comprehensive Cancer Centre (Porto.CCC), 4200-072 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-072 Porto, Portugal
- ICBAS-Instituto de Ciências Biomédicas Abel Salazar, University of Porto, 4050-313 Porto, Portugal
| | - Inês Soares Marques
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP), Pathology and Laboratory Medicine Department, Clinical Pathology SV/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Porto Comprehensive Cancer Centre (Porto.CCC), 4200-072 Porto, Portugal
- Faculty of Sciences, University of Porto, 4169-007 Porto, Portugal
| | - Inês Guerra de Melo
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP), Pathology and Laboratory Medicine Department, Clinical Pathology SV/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Porto Comprehensive Cancer Centre (Porto.CCC), 4200-072 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-072 Porto, Portugal
| | - Joana Assis
- Clinical Research Unit, Research Center of IPO Porto (CI-IPOP), RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
| | - Deolinda Pereira
- Oncology Department, Portuguese Institute of Oncology of Porto (IPOP), 4200-072 Porto, Portugal
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP), Pathology and Laboratory Medicine Department, Clinical Pathology SV/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Porto Comprehensive Cancer Centre (Porto.CCC), 4200-072 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-072 Porto, Portugal
- ICBAS-Instituto de Ciências Biomédicas Abel Salazar, University of Porto, 4050-313 Porto, Portugal
- Faculty of Health Sciences, Fernando Pessoa University, 4200-150 Porto, Portugal
- Research Department, Portuguese League Against Cancer (NRNorte), 4200-172 Porto, Portugal
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Bakema JE, Stigter-van Walsum M, Harris JR, Ganzevles SH, Muthuswamy A, Houtkamp M, Plantinga TS, Bloemena E, Brakenhoff RH, Breij ECW, van de Ven R. An Antibody-Drug Conjugate Directed to Tissue Factor Shows Preclinical Antitumor Activity in Head and Neck Cancer as a Single Agent and in Combination with Chemoradiotherapy. Mol Cancer Ther 2024; 23:187-198. [PMID: 37828725 DOI: 10.1158/1535-7163.mct-23-0298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/21/2023] [Accepted: 10/10/2023] [Indexed: 10/14/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a solid tumor type that arises in the squamous epithelial cells lining the mucosal surfaces of the upper aerodigestive tract. Long-term survival of patients with advanced disease stage remains disappointing with current treatment options. We show that tissue factor is abundantly expressed on patient-derived HNSCC cell lines, xenograft tumor material, and tumor biopsies from patients with HNSCC. Tisotumab vedotin (TV) is an antibody-drug conjugate (ADC) directed to tissue factor, a protein expressed in many solid tumors. HNSCC cells and xenograft tumors were efficiently eliminated in vitro and in vivo with TV-monotherapy compared with treatment with a control antibody conjugated to monomethyl auristatin E (MMAE). Antitumor activity of TV was also tested in vivo in combination with chemoradiotherapy, standard of care for patients with advanced stage HNSCC tumors outside the oral cavity. Preclinical studies showed that by adding TV to chemoradiotherapy, survival was markedly improved, and TV, not radiotherapy or chemotherapy, was the main driver of antitumor activity. Interestingly, TV-induced cell death in xenograft tumors showed an influx of macrophages indicative of a potential immune-mediated mode-of-action. In conclusion, on the basis of these preclinical data, TV may be a novel treatment modality for patients suffering from head and neck cancer and is hypothesized to improve efficacy of chemoradiotherapy. SIGNIFICANCE This work shows preclinical in vitro and in vivo antitumor activity of the antibody-drug conjugate Tisotumab vedotin in head and neck cancer models, and enhanced activity in combination with chemoradiotherapy, supporting further clinical development for this cancer type.
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Affiliation(s)
- Jantine E Bakema
- Department of Otolaryngology | Head & Neck Surgery, Amsterdam UMC, location VU University Medical Center, Amsterdam, The Netherlands
- Genmab, Utrecht, The Netherlands
| | - Marijke Stigter-van Walsum
- Department of Otolaryngology | Head & Neck Surgery, Amsterdam UMC, location VU University Medical Center, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands
| | | | - Sonja H Ganzevles
- Department of Otolaryngology | Head & Neck Surgery, Amsterdam UMC, location VU University Medical Center, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Cancer Immunology, Amsterdam, The Netherlands
| | | | | | | | - Elisabeth Bloemena
- Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands
- Department of Pathology, Amsterdam UMC, location VU University Medical Center, Amsterdam, The Netherlands
| | - Ruud H Brakenhoff
- Department of Otolaryngology | Head & Neck Surgery, Amsterdam UMC, location VU University Medical Center, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands
| | | | - Rieneke van de Ven
- Department of Otolaryngology | Head & Neck Surgery, Amsterdam UMC, location VU University Medical Center, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Cancer Immunology, Amsterdam, The Netherlands
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20
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Yadav G, Srinivasan G, Jain A. Cervical cancer: Novel treatment strategies offer renewed optimism. Pathol Res Pract 2024; 254:155136. [PMID: 38271784 DOI: 10.1016/j.prp.2024.155136] [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: 12/12/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/27/2024]
Abstract
Cervical cancer poses a significant global public health issue, primarily affecting women, and stands as one of the four most prevalent cancers affecting woman globally, which includes breast cancer, colorectal cancer, lung cancer and cervical cancer. Almost every instance of cervical cancer is associated with infections caused by the human papillomavirus (HPV). Prevention of this disease hinges on screening and immunization of the patients, yet disparities in cervical cancer occurrence exist between developed and developing nations. Multiple factors contribute to cervical cancer, including sexually transmitted diseases (STDs), reproductive and hormonal influences, genetics, and host-related factors. Preventive programs, lifestyle improvements, smoking cessation, and prompt precancerous lesion treatment can reduce the occurrence of cervical cancer. The persistency and recurrence of the cases are inherited even after the innovative treatments available for cervical cancer. For patient's ineligible for curative surgery or radiotherapy, palliative chemotherapy remains the standard treatment. Novel treatment strategies are emerging to combat the limited effectiveness of chemotherapy. Nanocarriers offer the promise of concurrent chemotherapeutic drug delivery as a beacon of hope in cervical cancer research. The primary aim of this review study is to contribute to a thorough understanding of cervical cancer, fostering awareness and informed decision-making and exploring novel treatment methods such as nanocarriers for the treatment of cervical cancer. This manuscript delves into cutting-edge approaches, exploring the potential of nanocarriers and other innovative treatments. Our study underscores the critical need for global awareness, early intervention, and enhanced treatment options. Novel strategies, such as nanocarriers, offer renewed optimism in the battle against cervical cancer. This research provides compelling evidence for the investigation of these novel therapeutic approaches within the medical field. Cervical cancer remains a formidable adversary, but with ongoing advancements and unwavering commitment, we move closer to a future where it is a preventable and treatable disease, even in the most underserved regions.
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Affiliation(s)
- Gangotri Yadav
- Vivekanand Education Society college of Pharmacy, Chembur, Maharashtra 400074, India; Principal, Shri D. D. Vispute college of Pharmacy and Research Centre, New Panvel, Maharashtra 410221, India.
| | - Ganga Srinivasan
- Vivekanand Education Society college of Pharmacy, Chembur, Maharashtra 400074, India; Principal, Shri D. D. Vispute college of Pharmacy and Research Centre, New Panvel, Maharashtra 410221, India
| | - Ashish Jain
- Vivekanand Education Society college of Pharmacy, Chembur, Maharashtra 400074, India; Principal, Shri D. D. Vispute college of Pharmacy and Research Centre, New Panvel, Maharashtra 410221, India
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21
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Tavares V, Neto BV, Marques IS, Assis J, Pereira D, Medeiros R. Cancer-associated thrombosis: What about microRNAs targeting the tissue factor coagulation pathway? Biochim Biophys Acta Rev Cancer 2024; 1879:189053. [PMID: 38092078 DOI: 10.1016/j.bbcan.2023.189053] [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: 08/04/2023] [Revised: 12/03/2023] [Accepted: 12/08/2023] [Indexed: 12/18/2023]
Abstract
Cancer patients are often diagnosed with venous thromboembolism (VTE), a cardiovascular disease that substantially decreases their quality of life and survival rate. Haemostasis in these patients is deregulated, which is reflected in the common presentation of a blood hypercoagulation state. Despite the inconsistent results, existing evidence suggests that the expression of microRNAs (miRNAs) is deregulated in the context of venous thrombogenesis in the general population. However, few miRNAs are known to be linked to cancer-associated VTE due to the lack of studies with oncological patients. Parallelly, coagulation factor III, also known as tissue factor (TF), tissue factor pathway inhibitor 1 (TFPI1) and tissue factor pathway inhibitor 2 (TFPI2) have been proposed to have a central role in cancer-associated VTE and tumour progression. Yet, contrary to what was expected, the role of miRNAs targeting the TF coagulation pathway (or extrinsic coagulation pathway) is poorly explored in cancer-induced thrombogenesis. In this review, in addition to miRNAs implicated in VTE, TF and TFPI1/2-targeting miRNAs were revised. Future studies should clarify the implications of these non-coding RNAs in tumour coagulome.
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Affiliation(s)
- Valéria Tavares
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP)/ Pathology and Laboratory Medicine Dep., Clinical Pathology SV/ RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Centre (Porto.CCC), 4200-072 Porto, Portugal; Faculty of Medicine of University of Porto (FMUP), 4200-072 Porto, Portugal; Abel Salazar Institute for the Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal
| | - Beatriz Vieira Neto
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP)/ Pathology and Laboratory Medicine Dep., Clinical Pathology SV/ RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Centre (Porto.CCC), 4200-072 Porto, Portugal; Research Department, Portuguese League Against Cancer (NRNorte), 4200-172 Porto, Portugal
| | - Inês Soares Marques
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP)/ Pathology and Laboratory Medicine Dep., Clinical Pathology SV/ RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Centre (Porto.CCC), 4200-072 Porto, Portugal; Faculty of Sciences of University of Porto (FCUP), 4169-007 Porto, Portugal
| | - Joana Assis
- Clinical Research Unit, Research Center of IPO Porto (CI-IPOP) / RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
| | - Deolinda Pereira
- Oncology Department, Portuguese Institute of Oncology of Porto (IPO Porto), 4200-072 Porto, Portugal
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP)/ Pathology and Laboratory Medicine Dep., Clinical Pathology SV/ RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Centre (Porto.CCC), 4200-072 Porto, Portugal; Faculty of Medicine of University of Porto (FMUP), 4200-072 Porto, Portugal; Abel Salazar Institute for the Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal; Research Department, Portuguese League Against Cancer (NRNorte), 4200-172 Porto, Portugal; Faculty of Health Sciences, Fernando Pessoa University, 4200-150 Porto, Portugal.
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22
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Liu X, Deng J, Zhang R, Xing J, Wu Y, Chen W, Liang B, Xing D, Xu J, Zhang M. The clinical development of antibody-drug conjugates for non-small cell lung cancer therapy. Front Immunol 2023; 14:1335252. [PMID: 38162667 PMCID: PMC10755013 DOI: 10.3389/fimmu.2023.1335252] [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: 11/08/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Despite the emergence of molecular targeted therapy and immune checkpoint inhibitors as standard first-line treatments for non-small cell lung cancer (NSCLC), their efficacy in some patients is limited by intrinsic and acquired resistance. Antibody-drug conjugates (ADCs), a revolutionary class of antitumor drugs, have displayed promising clinical outcomes in cancer treatment. In 2022, trastuzumab deruxtecan (Enhertu) was approved for treating HER2-mutated NSCLC, thereby underscoring the clinical value of ADCs in NSCLC treatment strategies. An increasing number of ADCs, focusing on NSCLC, are undergoing clinical trials, potentially positioning them as future treatment options. In this review, we encapsulate recent advancements in the clinical research of novel ADCs for treating NSCLC. Subsequently, we discuss the mechanisms of action, clinical efficacy, and associated limitations of these ADCs.
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Affiliation(s)
- Xinlin Liu
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- Qingdao Cancer Institute, Qingdao, China
| | - Junwen Deng
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- Qingdao Cancer Institute, Qingdao, China
| | - Renshuai Zhang
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- Qingdao Cancer Institute, Qingdao, China
| | - Jiyao Xing
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- Qingdao Cancer Institute, Qingdao, China
| | - Yudong Wu
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- Qingdao Cancer Institute, Qingdao, China
| | - Wujun Chen
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- Qingdao Cancer Institute, Qingdao, China
| | - Bing Liang
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- Qingdao Cancer Institute, Qingdao, China
| | - Dongming Xing
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- Qingdao Cancer Institute, Qingdao, China
- School of Life Sciences, Tsinghua University, Beijing, China
| | - Jiazhen Xu
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- Qingdao Cancer Institute, Qingdao, China
| | - Miao Zhang
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- Qingdao Cancer Institute, Qingdao, China
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Filis P, Zerdes I, Soumala T, Matikas A, Foukakis T. The ever-expanding landscape of antibody-drug conjugates (ADCs) in solid tumors: A systematic review. Crit Rev Oncol Hematol 2023; 192:104189. [PMID: 37866413 DOI: 10.1016/j.critrevonc.2023.104189] [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: 06/10/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND The advent of targeted therapies signaled novel avenues for more optimal oncological outcomes. Antibody-drug conjugates (ADCs) have risen as a cornerstone of the ever-expanding targeted therapy era. The purpose of this systematic review is to delineate the rapidly evolving clinical landscape of ADCs for solid tumors. METHODS A literature search was performed in Medline, Embase and Cochrane databases for phase II and III clinical trials. Outcomes of interest were the objective response rate, overall survival, progression-free survival and adverse events. RESULTS A total of 92 clinical trials (76 phase II and 16 phase III) evaluated the efficacy and safety of ADCs for a plethora of solid tumors. Out of the 30 investigated ADCs, 8 have received approval by regulatory organizations for solid tumors. Currently, 52 phase III clinical trials for ADCs are ongoing. CONCLUSION ADCs have shown promising results for several solid tumors and various cancer settings.
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Affiliation(s)
- Panagiotis Filis
- Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
| | - Ioannis Zerdes
- Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden; Breast Center, Karolinska Comprehensive Cancer Center and Karolinska University Hospital, Stockholm, Sweden
| | - Theodora Soumala
- Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Alexios Matikas
- Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden; Breast Center, Karolinska Comprehensive Cancer Center and Karolinska University Hospital, Stockholm, Sweden
| | - Theodoros Foukakis
- Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden; Breast Center, Karolinska Comprehensive Cancer Center and Karolinska University Hospital, Stockholm, Sweden.
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24
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Peng M, Chu X, Peng Y, Li D, Zhang Z, Wang W, Zhou X, Xiao D, Yang X. Targeted therapies in bladder cancer: signaling pathways, applications, and challenges. MedComm (Beijing) 2023; 4:e455. [PMID: 38107059 PMCID: PMC10724512 DOI: 10.1002/mco2.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023] Open
Abstract
Bladder cancer (BC) is one of the most prevalent malignancies in men. Understanding molecular characteristics via studying signaling pathways has made tremendous breakthroughs in BC therapies. Thus, targeted therapies including immune checkpoint inhibitors (ICIs), antibody-drug conjugates (ADCs), and tyrosine kinase inhibitor (TKI) have markedly improved advanced BC outcomes over the last few years. However, the considerable patients still progress after a period of treatment with current therapeutic regimens. Therefore, it is crucial to guide future drug development to improve BC survival, based on the molecular characteristics of BC and clinical outcomes of existing drugs. In this perspective, we summarize the applications and benefits of these targeted drugs and highlight our understanding of mechanisms of low response rates and immune escape of ICIs, ADCs toxicity, and TKI resistance. We also discuss potential solutions to these problems. In addition, we underscore the future drug development of targeting metabolic reprogramming and cancer stem cells (CSCs) with a deep understanding of their signaling pathways features. We expect that finding biomarkers, developing novo drugs and designing clinical trials with precisely selected patients and rationalized drugs will dramatically improve the quality of life and survival of patients with advanced BC.
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Affiliation(s)
- Mei Peng
- Department of PharmacyXiangya HospitalCentral South UniversityChangshaHunanChina
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan ProvinceThe Research Center of Reproduction and Translational Medicine of Hunan ProvinceKey Laboratory of Chemical Biology & Traditional Chinese Medicine Research of Ministry of EducationDepartment of PharmacySchool of MedicineHunan Normal UniversityChangshaHunanChina
| | - Xuetong Chu
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan ProvinceThe Research Center of Reproduction and Translational Medicine of Hunan ProvinceKey Laboratory of Chemical Biology & Traditional Chinese Medicine Research of Ministry of EducationDepartment of PharmacySchool of MedicineHunan Normal UniversityChangshaHunanChina
| | - Yan Peng
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan ProvinceThe Research Center of Reproduction and Translational Medicine of Hunan ProvinceKey Laboratory of Chemical Biology & Traditional Chinese Medicine Research of Ministry of EducationDepartment of PharmacySchool of MedicineHunan Normal UniversityChangshaHunanChina
| | - Duo Li
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan ProvinceThe Research Center of Reproduction and Translational Medicine of Hunan ProvinceKey Laboratory of Chemical Biology & Traditional Chinese Medicine Research of Ministry of EducationDepartment of PharmacySchool of MedicineHunan Normal UniversityChangshaHunanChina
| | - Zhirong Zhang
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan ProvinceThe Research Center of Reproduction and Translational Medicine of Hunan ProvinceKey Laboratory of Chemical Biology & Traditional Chinese Medicine Research of Ministry of EducationDepartment of PharmacySchool of MedicineHunan Normal UniversityChangshaHunanChina
| | - Weifan Wang
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan ProvinceThe Research Center of Reproduction and Translational Medicine of Hunan ProvinceKey Laboratory of Chemical Biology & Traditional Chinese Medicine Research of Ministry of EducationDepartment of PharmacySchool of MedicineHunan Normal UniversityChangshaHunanChina
| | - Xiaochen Zhou
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan ProvinceThe Research Center of Reproduction and Translational Medicine of Hunan ProvinceKey Laboratory of Chemical Biology & Traditional Chinese Medicine Research of Ministry of EducationDepartment of PharmacySchool of MedicineHunan Normal UniversityChangshaHunanChina
| | - Di Xiao
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan ProvinceThe Research Center of Reproduction and Translational Medicine of Hunan ProvinceKey Laboratory of Chemical Biology & Traditional Chinese Medicine Research of Ministry of EducationDepartment of PharmacySchool of MedicineHunan Normal UniversityChangshaHunanChina
| | - Xiaoping Yang
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan ProvinceThe Research Center of Reproduction and Translational Medicine of Hunan ProvinceKey Laboratory of Chemical Biology & Traditional Chinese Medicine Research of Ministry of EducationDepartment of PharmacySchool of MedicineHunan Normal UniversityChangshaHunanChina
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25
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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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26
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Giudice E, Mirza MR, Lorusso D. Advances in the Management of Recurrent Cervical Cancer: State of the Art and Future Perspectives. Curr Oncol Rep 2023; 25:1307-1326. [PMID: 37870697 PMCID: PMC10640496 DOI: 10.1007/s11912-023-01463-9] [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] [Accepted: 09/19/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE OF REVIEW This review aims to give an insight into the currently available options for recurrent/metastatic (R/M) cervical cancer (CC), along with the main future, potentially practice-changing perspectives in this field. RECENT FINDINGS Improvements in terms of tumor responses were observed with the use of immune checkpoints inhibitors (ICIs) in the previously treated CC population, followed by emerging striking data in terms of both antitumor activity and survival rates with the addition of the ICIs to platinum-based chemotherapy with or without bevacizumab in the first-line setting. Furthermore, the CC treatment landscape took another step forward in 2021 with the introduction of antibody-drug conjugates (ADCs) in the second-line setting, a highly targeted therapeutic strategy, which demonstrated to be a valid alternative option in the recurrent setting. R/M CC is a hard-to-treat disease. However, after several years of limited systemic therapeutic options for the recurrent setting, the year 2018 marked a turning point for R/M CC patients, with the introduction of immunotherapy in the treatment paradigm, which completely reshaped the therapeutic armamentarium of the disease. Besides, another valuable treatment option represented by ADCs demonstrated its efficacy in the recurrent setting, thus further widening the treatment landscape for those patients. Yet, the introduction of immunotherapy in the upfront setting brought along new issues to be addressed such as the emerging ICIs resistance and the following need for alternative options in the post-ICIs setting. Several innovative therapeutic strategies are under investigation in ongoing clinical trials, with the aim of overcoming ICIs resistance with the addition of immunomodulatory agents or bypassing the ICIs resistance with novel alternative drugs.
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Affiliation(s)
- Elena Giudice
- Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mansoor Raza Mirza
- Department of Cancer Treatment, Copenhagen University Hospital, Copenhagen, Denmark
| | - Domenica Lorusso
- Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
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27
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Babbar R, Vanya, Bassi A, Arora R, Aggarwal A, Wal P, Dwivedi SK, Alolayan S, Gulati M, Vargas-De-La-Cruz C, Behl T, Ojha S. Understanding the promising role of antibody drug conjugates in breast and ovarian cancer. Heliyon 2023; 9:e21425. [PMID: 38027672 PMCID: PMC10660083 DOI: 10.1016/j.heliyon.2023.e21425] [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: 07/25/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
A nascent category of anticancer therapeutic drugs called antibody-drug conjugates (ADCs) relate selectivity of aimed therapy using chemotherapeutic medicines with high cytotoxic power. Progressive linker technology led to the advancement of more efficacious and safer treatments. It offers neoteric as well as encouraging therapeutic strategies for treating cancer. ADCs selectively administer a medication by targeting antigens which are abundantly articulated on the membrane surface of tumor cells. Tumor-specific antigens are differently expressed in breast and ovarian cancers and can be utilized to direct ADCs. Compared to conventional chemotherapeutic drugs, this approach enables optimal tumor targeting while minimizing systemic damage. A cleavable linker improves the ADCs because it allows the toxic payload to be distributed to nearby cells that do not express the target protein, operating on assorted tumors with dissimilar cell aggregation. Presently fifteen ADCs are being studied in breast and ovarian carcinoma preclinically, and assortment of few have already undergone promising early-phase clinical trial testing. Furthermore, Phase I and II studies are investigating a wide variety of ADCs, and preliminary findings are encouraging. An expanding sum of ADCs will probably become feasible therapeutic choices as solo agents or in conjunction with chemotherapeutic agents. This review accentuates the most recent preclinical findings, pharmacodynamics, and upcoming applications of ADCs in breast and ovarian carcinoma.
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Affiliation(s)
- Ritchu Babbar
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, 140401, India
| | - Vanya
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, 140401, India
| | - Aarti Bassi
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, 140401, India
| | - Rashmi Arora
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, 140401, India
| | - Ankur Aggarwal
- Institute of Pharmaceutical Sciences and Research, Gwalior, Madhya Pradesh, India
| | - Pranay Wal
- Pranveer Singh Institute of Technology, Pharmacy, NH-19 Bhauti, Kanpur, Uttar Pradesh, India
| | | | - Salma Alolayan
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, 51452, Kingdom of Saudi Arabia
| | - Monica Gulati
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 1444411, India
- ARCCIM, Faculty of Health, University of Technology Sydney, Ultimo, NSW, 20227, Australia
| | - Celia Vargas-De-La-Cruz
- Department of Pharmacology, Faculty of Pharmacy and Biochemistry, Bromatology and Toxicology, Universidad Nacional Mayor de San Marcos, Lima, 150001, Peru
- E-Health Research Center, Universidad de Ciencias y Humanidades, Lima, 15001, Peru
| | - Tapan Behl
- Amity School of Pharmaceutical Sciences, Amity University, Punjab, 140306, India
| | - Shreesh Ojha
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, P.O. Box 15551, United Arab Emirates
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28
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Fu Z, Gao C, Wu T, Wang L, Li S, Zhang Y, Shi C. Peripheral neuropathy associated with monomethyl auristatin E-based antibody-drug conjugates. iScience 2023; 26:107778. [PMID: 37727735 PMCID: PMC10505985 DOI: 10.1016/j.isci.2023.107778] [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] [Indexed: 09/21/2023] Open
Abstract
Since the successful approval of gemtuzumab ozogamicin, antibody-drug conjugates (ADCs) have emerged as a pivotal category of targeted therapies for cancer. Among these ADCs, the use of monomethyl auristatin E (MMAE) as a payload is prevalent in the development of ADC drugs, which has significantly improved overall therapeutic efficacy against various malignancies. However, increasing clinical observations have raised concerns regarding the potential nervous system toxicity associated with MMAE-based ADCs. Specifically, a higher incidence of peripheral neuropathy has been reported in ADCs incorporating MMAE as payloads. Considering the increasing global use of MMAE-based ADCs, it is imperative to provide an inclusive overview of diagnostic and management strategies for this adverse event. In this review, we examine current information and what future research directions are required to better understand and manage this type of clinical challenge.
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Affiliation(s)
- Zhiwen Fu
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430000, China
| | - Chen Gao
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430000, China
| | - Tingting Wu
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430000, China
| | - Lulu Wang
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430000, China
| | - Shijun Li
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430000, China
| | - Yu Zhang
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430000, China
| | - Chen Shi
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430000, China
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29
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Boucher R, Haigh O, Barreau E, Champiat S, Lambotte O, Adam C, Labetoulle M, Rousseau A. Ocular surface toxicities associated with modern anticancer therapies. Surv Ophthalmol 2023:S0039-6257(23)00134-0. [PMID: 37806566 DOI: 10.1016/j.survophthal.2023.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023]
Abstract
Cancer treatments have recently shifted from broad-spectrum cytotoxic therapies to more focused treatments, maximizing anti-cancerous activity while reducing toxicity to healthy cells. These modern anticancer therapies (MATs) encompass a wide range of innovative molecules that mainly include immune checkpoint inhibitors (ICIs) and targeted anticancer therapies (TATs), comprising antibody drug conjugates (ADCs) and inhibitors of signal transduction (IST). Some MATs are associated with ocular surface (OS) adverse events (AEs) that can cause severe discomfort and even lead to loss of vision. While these complications remain rare, they're probably underreported. It is likely that both oncologists and ophthalmologists will come across MATs-associated OS-AEs in their practices, due to the increasing number of patients being treated with MATs. Rapid identification of OS-AEs is crucial, as early intervention can manage these conditions to avoid vision loss and reduce negative impacts on quality of life (QoL). We discuss characteristics of OS pathologies attributed to MATs, describe the suspected underlying pathophysiological mechanisms, and outline the main lines of treatment.
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Affiliation(s)
- Rafael Boucher
- Service d'Ophtalmologie, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Saclay. Centre de Référence pour les maladies rares en ophtalmologie (OPHTARA), Le Kremlin-Bicêtre, France; Department of Immunology of viral and auto-immune disease (IMVA DSV/iMETI / IDMIT), UMR1184, CEA, Le Kremlin-Bicêtre & Fontenay-aux-Roses, France
| | - Oscar Haigh
- Department of Immunology of viral and auto-immune disease (IMVA DSV/iMETI / IDMIT), UMR1184, CEA, Le Kremlin-Bicêtre & Fontenay-aux-Roses, France
| | - Emmanuel Barreau
- Service d'Ophtalmologie, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Saclay. Centre de Référence pour les maladies rares en ophtalmologie (OPHTARA), Le Kremlin-Bicêtre, France
| | - Stéphane Champiat
- Département d'Innovation Thérapeutique et d'Essais Précoces (DITEP), Gustave Roussy, Villejuif, France
| | - Olivier Lambotte
- Department of Immunology of viral and auto-immune disease (IMVA DSV/iMETI / IDMIT), UMR1184, CEA, Le Kremlin-Bicêtre & Fontenay-aux-Roses, France; Department of Internal Medicine and Immunology, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Saclay
| | - Clovis Adam
- Department of Pathology, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Saclay
| | - Marc Labetoulle
- Service d'Ophtalmologie, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Saclay. Centre de Référence pour les maladies rares en ophtalmologie (OPHTARA), Le Kremlin-Bicêtre, France; Department of Immunology of viral and auto-immune disease (IMVA DSV/iMETI / IDMIT), UMR1184, CEA, Le Kremlin-Bicêtre & Fontenay-aux-Roses, France
| | - Antoine Rousseau
- Service d'Ophtalmologie, Assistance Publique Hôpitaux de Paris (AP-HP), Université Paris-Saclay. Centre de Référence pour les maladies rares en ophtalmologie (OPHTARA), Le Kremlin-Bicêtre, France; Department of Immunology of viral and auto-immune disease (IMVA DSV/iMETI / IDMIT), UMR1184, CEA, Le Kremlin-Bicêtre & Fontenay-aux-Roses, France.
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30
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Garg V, Oza AM. Treatment of Ovarian Cancer Beyond PARP Inhibition: Current and Future Options. Drugs 2023; 83:1365-1385. [PMID: 37737434 PMCID: PMC10581945 DOI: 10.1007/s40265-023-01934-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/23/2023]
Abstract
Ovarian cancer is the leading cause of gynecological cancer death. Improved understanding of the biologic pathways and introduction of poly (ADP-ribose) polymerase inhibitors (PARPi) during the last decade have changed the treatment landscape. This has improved outcomes, but unfortunately half the women with ovarian cancer still succumb to the disease within 5 years of diagnosis. Pathways of resistance to PARPi and chemotherapy have been studied extensively, but there is an unmet need to overcome treatment failure and improve outcome. Major mechanisms of PARPi resistance include restoration of homologous recombination repair activity, alteration of PARP function, stabilization of the replication fork, drug efflux, and activation of alternate pathways. These resistant mechanisms can be targeted to sensitize the resistant ovarian cancer cells either by rechallenging with PARPi, overcoming resistance mechanism or bypassing resistance pathways. Augmenting the PARPi activity by combining it with other targets in the DNA damage response pathway, antiangiogenic agents and immune checkpoint inhibitors can potentially overcome the resistance mechanisms. Methods to bypass resistance include targeting non-cross-resistant pathways acting independent of homologous recombination repair (HRR), modulating tumour microenvironment, and enhancing drug delivery systems such as antibody drug conjugates. In this review, we will discuss the first-line management of ovarian cancer, resistance mechanisms and potential strategies to overcome these.
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Affiliation(s)
- Vikas Garg
- 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.
- , 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
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31
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Thomas J, Sun M, Getz T, Ho B, Nauseef JT, Tagawa ST. Antibody-drug conjugates for urothelial carcinoma. Urol Oncol 2023; 41:420-428. [PMID: 37419845 DOI: 10.1016/j.urolonc.2023.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/18/2023] [Indexed: 07/09/2023]
Abstract
The standard of care for advanced urothelial carcinoma includes platinum chemotherapy and immunotherapy. Antibody-drug conjugates (ADCs), originally developed for hematologic malignancies, involve potent cytotoxic agents linked to antibodies that recognize tumor-specific antigens; this rational drug design allows for more on-target efficacy, while mitigating systemic toxicity. Herein, we review the emerging landscape of ADCs in urothelial carcinoma. The anti-Nectin-4 ADC enfortumab vedotin has demonstrated efficacy in prospective studies in patients with advanced urothelial carcinoma in several settings either alone or in combination with pembrolizumab. The anti-Trop-2 ADC sacituzumab govitecan has also shown efficacy in single-armed studies. Both conjugates have full or accelerated approval from the Food and Drug Administration. Common adverse events include rash and neuropathy for enfortumab vedotin and myelosuppression and diarrhea for sacituzumab govitecan. Several anti-human epidermal growth factor receptor 2 ADCs are in clinical trials, and in localized bladder cancer, the anti-epithelial cell adhesion molecule ADC oportuzumab monatox is being studied in patients refractory to intravesical bacillus calmette-guerin therapy. Antibody-drug conjugates for urothelial carcinoma are approved and emerging as therapies for patients with advanced urothelial carcinoma, filling a prior void for treatment of progressive disease. Ongoing studies are also evaluating these agents in the neoadjuvant and adjuvant settings.
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Affiliation(s)
- Joseph Thomas
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, NY; Department of Internal Medicine, Weill Cornell Medical Center, New York, NY
| | - Michael Sun
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, NY; Department of Internal Medicine, Weill Cornell Medical Center, New York, NY
| | - Ted Getz
- Department of Internal Medicine, Weill Cornell Medical Center, New York, NY
| | - Benedict Ho
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, NY; Department of Internal Medicine, Weill Cornell Medical Center, New York, NY
| | - Jones T Nauseef
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, NY; Department of Internal Medicine, Weill Cornell Medical Center, New York, NY; Meyer Cancer Center, Weill Cornell Medical Center, New York, NY
| | - Scott T Tagawa
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, NY; Department of Internal Medicine, Weill Cornell Medical Center, New York, NY; Meyer Cancer Center, Weill Cornell Medical Center, New York, NY; Department of Urology, Weill Cornell Medical Center, New York, NY.
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Faltas B. A new era in the treatment of urothelial carcinoma. Urol Oncol 2023; 41:395-397. [PMID: 37833099 DOI: 10.1016/j.urolonc.2023.08.020] [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: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 10/15/2023]
Abstract
The advances in targeted therapies, immunotherapy, and the recent emergence of antibody-drug conjugates (ADCs) herald a potential paradigm shift in treating patients with metastatic urothelial cancer. Yet, there are inherent challenges in utilizing these therapies, including the management of treatment-related toxicities. In this special Urologic Oncology: Seminars and Original Investigations issue, we review the latest developments and discuss insights into future research needs.
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Affiliation(s)
- Bishoy Faltas
- Department of Hematology and Oncology, Weill Cornell Medicine, New York, NY; Department of Cell and Developmental Biology, Weill Cornell Medicine, New York, NY.
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Agostinelli V, Musacchio L, Camarda F, Salutari V, Carbone MV, Ghizzoni V, Nero C, Ricci C, Perri MT, Giudice E, Lardino S, Berardi R, Scambia G, Lorusso D. Therapeutic Potential of Tisotumab Vedotin in the Treatment of Recurrent or Metastatic Cervical Cancer: A Short Report on the Emerging Data. Cancer Manag Res 2023; 15:1063-1072. [PMID: 37790898 PMCID: PMC10543937 DOI: 10.2147/cmar.s294080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/05/2023] [Indexed: 10/05/2023] Open
Abstract
Cervical cancer is the fourth most common type of cancer in women worldwide. It is associated with a high death rate, despite the fact that it is a nearly 100% preventable disease because of very effective primary and secondary preventive strategies. Advanced and recurrent disease is uncurable with a high relapse risk and the second-line therapies are limited with modest response rates and short durability. Investigating alternative mechanisms of action is crucial because of the high request for effective new therapies. Tisotumab vedotin (TV) is the first antibody-drug conjugated to target a cell surface-expressed tissue factor, and preliminary data in patients with metastatic and recurrent cervical cancer have been promising. In addition, the trials showed a favorable tolerability profile, with limited incidence of grade 3 or worse adverse events. According to the data of ENGOT-cx6/GOG-3023/innovaTV 204, the US Food and Drug Administration granted expedited approval of TV on September 20, 2021, for women with recurrent or metastatic cervical cancer. Actually, two other trials testing TV alone or in combination with other agents are ongoing. ENGOT-cx8/GOG-3024/innovaTV 205 is a Phase Ib/II trial of TV in combination with platinum or bevacizumab or pembrolizumab, in patients with recurrent or metastatic cervical cancer who have not received prior systemic therapy or who have progressed after no more than two prior systemic therapies. ENGOT-cx12/GOG-3057/InnovaTV 301 is a Phase 3 trial of TV vs investigator's choice chemotherapy in patients with advanced or recurrent cervical cancer who had received no more than 2 prior chemotherapy lines. The outcomes of these two trials will potentially confirm and reinforce the use of TV as a new standard of care in advanced or recurrent cervical cancer.
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Affiliation(s)
| | - Lucia Musacchio
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Floriana Camarda
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Vanda Salutari
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Maria Vittoria Carbone
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Viola Ghizzoni
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Camilla Nero
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Caterina Ricci
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Maria Teresa Perri
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Elena Giudice
- Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sara Lardino
- Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rossana Berardi
- Oncologic Clinic, Università Politecnica delle Marche, Ancona, Italy
| | - Giovanni Scambia
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenica Lorusso
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy
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Passey C, Voellinger J, Gibiansky L, Gunawan R, Nicacio L, Soumaoro I, Hanley WD, Winter H, Gupta M. Exposure-safety and exposure-efficacy analyses for tisotumab vedotin for patients with locally advanced or metastatic solid tumors. CPT Pharmacometrics Syst Pharmacol 2023; 12:1262-1273. [PMID: 37496366 PMCID: PMC10508544 DOI: 10.1002/psp4.13007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 07/28/2023] Open
Abstract
The antibody-drug conjugate (ADC) tisotumab vedotin (TV) received accelerated approval from the US Food and Drug Administration for treatment of adults with recurrent or metastatic cervical cancer (r/mCC) with disease progression on or after chemotherapy. A population pharmacokinetic (PK) model, developed using dosing data from four clinical TV studies, was used to estimate individual exposure and explore safety and efficacy exposure-response (ER) relationships. Because PK analysis showed no appreciable accumulation of TV and monomethyl auristatin E (MMAE) with repeated dosing, cycle 1 exposure metrics and predicted average concentrations from time zero until end of the cycle in which an event occurred (CavgLast ) were used for ER analyses. The probability of achieving objective response increased significantly as the ADC cycle 1 maximum serum concentration (Cmax ) increased. The probability of treatment-related adverse events (AEs) leading to dose modification increased significantly as ADC cycle 1 area under the concentration-time curve (AUC) increased. Number of grade 2+ ocular AEs increased significantly as ADC cycle 1 AUC, Cmax , and ADC CavgLast increased. MMAE cycle 1 AUC predicted risk of serious treatment-related AEs. The relationship between ADC exposure and efficacy end points suggests ADC treatment was associated with clinically meaningful response across the observed exposures; greater exposure was associated with increased efficacy. The relationship between ADC and MMAE exposure and safety end points suggests increased exposure was associated with increased AE risk. These results align with clinical findings showing TV 2 mg/kg (≤200 mg for patients ≥100 kg) every 3 weeks is efficacious and tolerable for patients with r/mCC.
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Sausen DG, Shechter O, Gallo ES, Dahari H, Borenstein R. Herpes Simplex Virus, Human Papillomavirus, and Cervical Cancer: Overview, Relationship, and Treatment Implications. Cancers (Basel) 2023; 15:3692. [PMID: 37509353 PMCID: PMC10378257 DOI: 10.3390/cancers15143692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
There is a significant body of research examining the role of human papillomavirus (HPV) in the pathogenesis of cervical cancer, with a particular emphasis on the oncogenic proteins E5, E6, and E7. What is less well explored, however, is the relationship between cervical cancer and herpes simplex virus (HSV). To date, studies examining the role of HSV in cervical cancer pathogenesis have yielded mixed results. While several experiments have determined that HPV/HSV-2 coinfection results in a higher risk of developing cervical cancer, others have questioned the validity of this association. However, clarifying the potential role of HSV in the pathogenesis of cervical cancer may have significant implications for both the prevention and treatment of this disease. Should this relationship be clarified, treating and preventing HSV could open another avenue with which to prevent cervical cancer. The importance of this is highlighted by the fact that, despite the creation of an effective vaccine against HPV, cervical cancer still impacts 604,000 women and is responsible for 342,000 deaths annually. This review provides an overview of HSV and HPV infections and then delves into the possible links between HPV, HSV, and cervical cancer. It concludes with a summary of preventive measures against and recent treatment advances in cervical cancer.
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Affiliation(s)
- Daniel G. Sausen
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, VA 23501, USA; (D.G.S.); (O.S.)
| | - Oren Shechter
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, VA 23501, USA; (D.G.S.); (O.S.)
| | - Elisa S. Gallo
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel
| | - Harel Dahari
- The Program for Experimental and Theoretical Modeling, Division of Hepatology, Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA;
| | - Ronen Borenstein
- The Program for Experimental and Theoretical Modeling, Division of Hepatology, Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA;
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Reyes A, Pharaon R, Mohanty A, Massarelli E. Arising Novel Agents in Lung Cancer: Are Bispecifics and ADCs the New Paradigm? Cancers (Basel) 2023; 15:3162. [PMID: 37370772 DOI: 10.3390/cancers15123162] [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: 05/18/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Lung cancer is one of the most common cancers with the highest mortality. Non-small cell lung cancer (NSCLC) contributes to around 85% of lung cancer diagnoses (vs. 15% for small cell lung cancer). The treatment of NSCLC has vastly changed in the last two decades since the development of immunotherapy and targeted therapy against driver mutations. As is the nature of malignancy, cancer cells have acquired resistance to these treatments prompting an investigation into novel treatments and new targets. Bispecific antibodies, capable of targeting multiple substrates at once, and antibody-drug conjugates that can preferentially deliver chemotherapy to tumor cells are examples of this innovation. From our initial evaluation, both treatment modalities appear promising.
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Affiliation(s)
- Amanda Reyes
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA 910102, USA
| | - Rebecca Pharaon
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA 910102, USA
| | - Atish Mohanty
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA 910102, USA
| | - Erminia Massarelli
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA 910102, USA
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Ahmadi SE, Shabannezhad A, Kahrizi A, Akbar A, Safdari SM, Hoseinnezhad T, Zahedi M, Sadeghi S, Mojarrad MG, Safa M. Tissue factor (coagulation factor III): a potential double-edge molecule to be targeted and re-targeted toward cancer. Biomark Res 2023; 11:60. [PMID: 37280670 DOI: 10.1186/s40364-023-00504-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/19/2023] [Indexed: 06/08/2023] Open
Abstract
Tissue factor (TF) is a protein that plays a critical role in blood clotting, but recent research has also shown its involvement in cancer development and progression. Herein, we provide an overview of the structure of TF and its involvement in signaling pathways that promote cancer cell proliferation and survival, such as the PI3K/AKT and MAPK pathways. TF overexpression is associated with increased tumor aggressiveness and poor prognosis in various cancers. The review also explores TF's role in promoting cancer cell metastasis, angiogenesis, and venous thromboembolism (VTE). Of note, various TF-targeted therapies, including monoclonal antibodies, small molecule inhibitors, and immunotherapies have been developed, and preclinical and clinical studies demonstrating the efficacy of these therapies in various cancer types are now being evaluated. The potential for re-targeting TF toward cancer cells using TF-conjugated nanoparticles, which have shown promising results in preclinical studies is another intriguing approach in the path of cancer treatment. Although there are still many challenges, TF could possibly be a potential molecule to be used for further cancer therapy as some TF-targeted therapies like Seagen and Genmab's tisotumab vedotin have gained FDA approval for treatment of cervical cancer. Overall, based on the overviewed studies, this review article provides an in-depth overview of the crucial role that TF plays in cancer development and progression, and emphasizes the potential of TF-targeted and re-targeted therapies as potential approaches for the treatment of cancer.
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Affiliation(s)
- Seyed Esmaeil Ahmadi
- Departments of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ashkan Shabannezhad
- Departments of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Kahrizi
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Armin Akbar
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Mehrab Safdari
- Departments of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Taraneh Hoseinnezhad
- Department of Hematolog, Faculty of Allied Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammad Zahedi
- Department of Medical Biotechnology, School of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Soroush Sadeghi
- Faculty of Science, Engineering and Computing, Kingston University, London, UK
| | - Mahsa Golizadeh Mojarrad
- Shahid Beheshti Educational and Medical Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Majid Safa
- Departments of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.
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McDermott MS, O'Brien NA, Hoffstrom B, Gong K, Lu M, Zhang J, Luo T, Liang M, Jia W, Hong JJ, Chau K, Davenport S, Xie B, Press MF, Panayiotou R, Handly-Santana A, Brugge JS, Presta L, Glaspy J, Slamon DJ. Preclinical Efficacy of the Antibody-Drug Conjugate CLDN6-23-ADC for the Treatment of CLDN6-Positive Solid Tumors. Clin Cancer Res 2023; 29:2131-2143. [PMID: 36884217 PMCID: PMC10233360 DOI: 10.1158/1078-0432.ccr-22-2981] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/05/2022] [Accepted: 03/02/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE Claudin-6 (CLDN6) is expressed at elevated levels in multiple human cancers including ovarian and endometrial malignancies, with little or no detectable expression in normal adult tissue. This expression profile makes CLDN6 an ideal target for development of a potential therapeutic antibody-drug conjugate (ADC). This study describes the generation and preclinical characterization of CLDN6-23-ADC, an ADC consisting of a humanized anti-CLDN6 monoclonal antibody coupled to monomethyl auristatin E (MMAE) via a cleavable linker. EXPERIMENTAL DESIGN A fully humanized anti-CLDN6 antibody was conjugated to MMAE resulting in the potential therapeutic ADC, CLDN6-23-ADC. The antitumor efficacy of CLDN6-23-ADC was assessed for antitumor efficacy in CLDN6-positive (CLDN6+) and -negative (CLDN6-) xenografts and patient-derived xenograft (PDX) models of human cancers. RESULTS CLDN6-23-ADC selectively binds to CLDN6, versus other CLDN family members, inhibits the proliferation of CLDN6+ cancer cells in vitro, and is rapidly internalized in CLDN6+ cells. Robust tumor regressions were observed in multiple CLDN6+ xenograft models and tumor inhibition led to markedly enhanced survival of CLDN6+ PDX tumors following treatment with CLDN6-23-ADC. IHC assessment of cancer tissue microarrays demonstrate elevated levels of CLDN6 in 29% of ovarian epithelial carcinomas. Approximately 45% of high-grade serous ovarian carcinomas and 11% of endometrial carcinomas are positive for the target. CONCLUSIONS We report the development of a novel ADC, CLDN6-23-ADC, that selectively targets CLDN6, a potential onco-fetal-antigen which is highly expressed in ovarian and endometrial cancers. CLDN6-23-ADC exhibits robust tumor regressions in mouse models of human ovarian and endometrial cancers and is currently undergoing phase I study.
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Affiliation(s)
- Martina S.J. McDermott
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Neil A. O'Brien
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Benjamin Hoffstrom
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - KeWei Gong
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Ming Lu
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Jun Zhang
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Tong Luo
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Min Liang
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Weiping Jia
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Jenny J. Hong
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Kevin Chau
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Simon Davenport
- Pathology, University of Southern California, Los Angeles, California
| | - Bin Xie
- Pathology, University of Southern California, Los Angeles, California
| | - Michael F. Press
- Pathology, University of Southern California, Los Angeles, California
| | - Richard Panayiotou
- Department of Cell Biology and Ludwig Center at Harvard, Harvard Medical School, Boston, Massachusetts
| | - Abram Handly-Santana
- Department of Cell Biology and Ludwig Center at Harvard, Harvard Medical School, Boston, Massachusetts
| | - Joan S. Brugge
- Department of Cell Biology and Ludwig Center at Harvard, Harvard Medical School, Boston, Massachusetts
| | - Leonard Presta
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - John Glaspy
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Dennis J. Slamon
- Department of Medicine, Division of Hematology/Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
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Singh AM, Guevara-Patino JA, Wang X, Li R, Sonpavde G, Jain RK. Antibody-Drug Conjugates in the Treatment of Urothelial Cancer. BioDrugs 2023:10.1007/s40259-023-00606-5. [PMID: 37256534 DOI: 10.1007/s40259-023-00606-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/01/2023]
Abstract
Antibody-drug conjugates (ADCs) have transformed the treatment landscape in oncology and become an essential therapeutic modality. In urothelial carcinoma (UC), the two ADCs that have been especially successful in clinical practice are enfortumab vedotin and sacituzumab govitecan. These drugs are currently approved as monotherapy for later lines of treatment in locally advanced or metastatic UC and have had a significant impact for patients with limited treatment options. Combinational trials, as well as additional ADCs, are currently being investigated in the treatment of UC for subsequent lines of therapy as overall survival rates remain dismal.
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Affiliation(s)
- Avani M Singh
- Department of Hematology and Oncology, University of South Florida/Moffitt Cancer Center, Tampa, FL, USA
| | | | - Xuefeng Wang
- Department of Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Roger Li
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33647, USA
| | - Guru Sonpavde
- Division of Medical Oncology, Advent Health Cancer Institute, Orlando, FL, USA
| | - Rohit K Jain
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33647, USA.
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40
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Passaro A, Jänne PA, Peters S. Antibody-Drug Conjugates in Lung Cancer: Recent Advances and Implementing Strategies. J Clin Oncol 2023:JCO2300013. [PMID: 37224424 DOI: 10.1200/jco.23.00013] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/17/2023] [Accepted: 04/06/2023] [Indexed: 05/26/2023] Open
Abstract
Antibody-drug conjugates (ADCs) are one of the fastest-growing oncology therapeutics, merging the cytotoxic effect of conjugated payload with the high specific ability and selectivity of monoclonal antibody targeted on a specific cancer cell membrane antigen. The main targets for ADC development are antigens commonly expressed by lung cancer cells, but not in normal tissues. They include human epidermal growth factor receptor 2, human epidermal growth factor receptor 3, trophoblast cell surface antigen 2, c-MET, carcinoembryonic antigen-related cell adhesion molecule 5, and B7-H3, each with one or more specific ADCs that showed encouraging results in the lung cancer field, more in non-small-cell lung cancer than in small-cell lung cancer histology. To date, multiple ADCs are under evaluation, alone or in combination with different molecules (eg, chemotherapy agents or immune checkpoint inhibitors), and the optimal strategy for selecting patients who may benefit from the treatment is evolving, including an improvement of biomarker understanding, involving markers of resistance or response to the payload, besides the antibody target. In this review, we discuss the available evidence and future perspectives on ADCs for lung cancer treatment, including a comprehensive discussion on structure-based drug design, mechanism of action, and resistance concepts. Data were summarized by specific target antigen, biology, efficacy, and safety, differing among ADCs according to the ADC payload and their pharmacokinetics and pharmacodynamics properties.
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Affiliation(s)
- Antonio Passaro
- Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Pasi A Jänne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | - Solange Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University, Lausanne, Switzerland
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Al-Jazrawe M, Xu S, Poon R, Wei Q, Przybyl J, Varma S, van de Rijn M, Alman BA. CD142 Identifies Neoplastic Desmoid Tumor Cells, Uncovering Interactions Between Neoplastic and Stromal Cells That Drive Proliferation. CANCER RESEARCH COMMUNICATIONS 2023; 3:697-708. [PMID: 37377751 PMCID: PMC10128091 DOI: 10.1158/2767-9764.crc-22-0403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/03/2023] [Accepted: 03/27/2023] [Indexed: 06/29/2023]
Abstract
The interaction between neoplastic and stromal cells within a tumor mass plays an important role in cancer biology. However, it is challenging to distinguish between tumor and stromal cells in mesenchymal tumors because lineage-specific cell surface markers typically used in other cancers do not distinguish between the different cell subpopulations. Desmoid tumors consist of mesenchymal fibroblast-like cells driven by mutations stabilizing beta-catenin. Here we aimed to identify surface markers that can distinguish mutant cells from stromal cells to study tumor-stroma interactions. We analyzed colonies derived from single cells from human desmoid tumors using a high-throughput surface antigen screen, to characterize the mutant and nonmutant cells. We found that CD142 is highly expressed by the mutant cell populations and correlates with beta-catenin activity. CD142-based cell sorting isolated the mutant population from heterogeneous samples, including one where no mutation was previously detected by traditional Sanger sequencing. We then studied the secretome of mutant and nonmutant fibroblastic cells. PTX3 is one stroma-derived secreted factor that increases mutant cell proliferation via STAT6 activation. These data demonstrate a sensitive method to quantify and distinguish neoplastic from stromal cells in mesenchymal tumors. It identifies proteins secreted by nonmutant cells that regulate mutant cell proliferation that could be therapeutically. Significance Distinguishing between neoplastic (tumor) and non-neoplastic (stromal) cells within mesenchymal tumors is particularly challenging, because lineage-specific cell surface markers typically used in other cancers do not differentiate between the different cell subpopulations. Here, we developed a strategy combining clonal expansion with surface proteome profiling to identify markers for quantifying and isolating mutant and nonmutant cell subpopulations in desmoid tumors, and to study their interactions via soluble factors.
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Affiliation(s)
- Mushriq Al-Jazrawe
- Hospital for Sick Children, Program in Developmental & Stem Cell Biology, Toronto, Ontario, Canada
- Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Steven Xu
- Hospital for Sick Children, Program in Developmental & Stem Cell Biology, Toronto, Ontario, Canada
| | - Raymond Poon
- Hospital for Sick Children, Program in Developmental & Stem Cell Biology, Toronto, Ontario, Canada
| | - Qingxia Wei
- Hospital for Sick Children, Program in Developmental & Stem Cell Biology, Toronto, Ontario, Canada
| | - Joanna Przybyl
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Sushama Varma
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Matt van de Rijn
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Benjamin A. Alman
- Hospital for Sick Children, Program in Developmental & Stem Cell Biology, Toronto, Ontario, Canada
- Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Department of Orthopedic Surgery, Duke University, Durham, North Carolina
- Regeneration Next Initiative, Duke University, Durham, North Carolina
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42
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Vergote I, Ray-Coquard I, Lorusso D, Oaknin A, Cibula D, Van Gorp T. Investigational drugs for recurrent or primary advanced metastatic cervical cancer: what is in the clinical development pipeline? Expert Opin Investig Drugs 2023; 32:201-211. [PMID: 36803278 DOI: 10.1080/13543784.2023.2179483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
INTRODUCTION Recurrent or primary advanced metastatic cervical cancer (R/M CC) has a poor prognosis with a 5-year-survival rate of 16.5%, demanding novel and improved therapies for the treatment of these patients. The first-line standard of care for R/M CC now benefits from the addition of the immune checkpoint inhibitor, pembrolizumab, to platinum-based chemotherapy with paclitaxel and bevacizumab. Additionally, new options for second-line treatment have become available in recent years. AREAS COVERED Here, we review current investigational drugs and discuss their relative targets, efficacies, and potential within the R/M CC treatment landscape. This review will focus on recently published data and key ongoing clinical trials in patients with R/M CC, covering multiple modes of action, including immunotherapies, antibody-drug conjugates, and tyrosine kinase inhibitors. We searched clinicaltrials.gov for ongoing trials and pubmed.ncbi.nih.gov for recently published trial data, as well as recent years' proceedings from the annual conferences of the American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), European Society of Gynaecological Oncology (ESGO), and the International Gynecologic Cancer Society (IGCS). EXPERT OPINION Therapeutics currently attracting attention include novel immune checkpoint inhibitors, therapeutic vaccinations, antibody-drug conjugates, such as tisotumab vedotin, tyrosine kinase inhibitors targeting HER2, and multitarget synergistic combinations.
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Affiliation(s)
- Ignace Vergote
- Department of Gynecology and Obstetrics, Gynecologic Oncology, Leuven Cancer Institute, Catholic University Leuven, Leuven, Belgium; Belgium and Luxembourg Gynaecological Oncology Group (BGOG), Leuven, Belgium, European Union
| | - Isabelle Ray-Coquard
- Medical Oncology Department, Centre Léon Bérard and University Claude Bernard Lyon 1, GINECO, Lyon, France
| | - Domenica Lorusso
- Gynecologic Oncology Unit, Catholic University of Sacred Heart and Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Ana Oaknin
- Gynecologic Cancer Program, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - David Cibula
- Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic; Central and Eastern European Gynecologic Oncology Group (CEEGOG), Prague, Czech Republic
| | - Toon Van Gorp
- Department of Gynecology and Obstetrics, Gynecologic Oncology, Leuven Cancer Institute, Catholic University Leuven, Leuven, Belgium; Belgium and Luxembourg Gynaecological Oncology Group (BGOG), Leuven, Belgium, European Union
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Luu K, Chu A, Chang B. A review of the novel tissue factor antibody-drug conjugate: Tisotumab vedotin. J Oncol Pharm Pract 2023; 29:441-449. [PMID: 36415085 DOI: 10.1177/10781552221139775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To review and compare the pharmacology, efficacy, and safety of the novel tissue factor antibody-drug conjugate, tisotumab vedotin. DATA SOURCES Literature search was performed through PubMed MEDLINE, Google Scholar, ClinicalTrials.gov, and the Food and Drug Administration. DATA SUMMARY Tisotumab vedotin, a novel tissue factor antibody-drug conjugate, was granted accelerated approval by the US FDA on 20 September 2021 for adult patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy. Tisotumab vedotin demonstrated clinical efficacy in a number of solid tumors in innovaTV 201 and more specifically in cervical cancer in the pivotal phase 2 innovaTV 204. In the single-arm innovaTV 204 study, 101 patients with recurrent or metastatic cervical cancer received intravenous tisotumab vedotin at the recommended dose of 2 mg/kg every 3 weeks until disease progression or unacceptable toxicity. The independent review committee confirmed an objective response rate of 24% with 7% complete responses and 17% partial responses. Tisotumab vedotin is associated with several notable adverse events with data from innovaTV 204 including ocular toxicity, hemorrhage, and peripheral neuropathy. Ninety-two percent of patients experienced treatment-related adverse events with 28% experiencing an adverse event of grade 3 or higher. CONCLUSIONS Metastatic cervical cancer has a high risk of relapse with few effective second-line therapeutic options. Current guidelines recommend single agent tisotumab vedotin as a possible option. Ongoing trials will further define its place in therapy.
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Affiliation(s)
- Kevin Luu
- Clinical Pharmacy Services, Kaiser Permanente, Fontana, CA, USA
| | - Angelyne Chu
- Clinical Pharmacy Services, Kaiser Permanente, Fontana, CA, USA
| | - Brandon Chang
- Clinical Pharmacy Services, Kaiser Permanente, Fontana, CA, USA
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Tisotumab vedotin in recurrent or metastatic cervical cancer. Curr Probl Cancer 2023; 47:100952. [PMID: 36842202 DOI: 10.1016/j.currproblcancer.2023.100952] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/01/2023] [Accepted: 01/17/2023] [Indexed: 02/12/2023]
Abstract
Tisotumab vedotin (TV) is an antibody-drug conjugate used for the treatment of adult patients with recurrent or metastatic cervical cancer. TV comprised of a monoclonal antibody against tissue factor and monomethyl auristatin E (MMAE), a potent inhibitor of cell division. The innovaTV-201 and innovaTV-204/GO30xx/ENGOT-cx6 trials showed that TV has clinically meaningful and durable antitumor activity in pretreated patients with recurrent or metastatic cervical cancer. The innovaTV-204 trial showed that TV monotherapy resulted in an objective response rate of 24% (including 7% and 17% complete and partial responses, respectively). In September 2021, the US Food and Drugs Administration (FDA) granted accelerated approval to TV for the treatment of recurrent or metastatic cervical cancer patients with disease progression on or after chemotherapy. The ongoing randomized, open-label Phase 3 innovaTV-301/ENGOTcx12/GOG-30xx trial will assess the effect of TV in pre-treated recurrent or metastatic cervical cancer. Meanwhile, the phase 1b/2 trial ENGOT Cx8/GOG 3024/innovaTV-205 is testing other possible combination between TV and other treatments. TV is characterized by a promising antitumor activity and an acceptable safety profile. Moreover, the preliminary data highlighted the feasibility of using TV in first line. In the first line, TV in combination with carboplatin or pembrolizumab provides an ORR of 55% and 41%, respectively Although the effect of adding TV to the current standard of care in first-line (carboplatin plus pembrolizumab) is still under evaluation, we expected to observe impressive results in the cervical cancer population.
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Sardinha M, Palma Dos Reis AF, Barreira JV, Fontes Sousa M, Pacey S, Luz R. Antibody-Drug Conjugates in Prostate Cancer: A Systematic Review. Cureus 2023; 15:e34490. [PMID: 36874351 PMCID: PMC9983052 DOI: 10.7759/cureus.34490] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
The prognosis in the setting of metastatic castration-resistant prostate cancer patients (mCRPC) remains limited. Therefore, novel treatment strategies remain an unmet need. Antibody-drug conjugates (ADC) emerged as a new drug concept with the potential to deliver a cytotoxic payload with limited off-target toxicity and potentially bystander effect. Following the success of ADCs in breast cancer and urothelial tumours, their activity in prostate cancer is now under investigation. Thus, the aim of this systematic review was to identify published and ongoing prospective clinical trials regarding ADC treatment in prostate cancer. A systematic search of PubMed, MEDLINE, and Web of Science was conducted as per PRISMA guidelines to identify prospective clinical trials of ADCin prostate cancer. Trials are currently ongoing on ClinicalTrials.gov and in the EU. The Clinical Trials Register was also identified. Abstracts, publications in languages other than English, review articles, retrospective analyses, and phase I trials were excluded. A total of six phase I/II prospective clinical trials already published were included. Seven ongoing trials were also identified. All studies were in the refractory/advanced tumour setting, and two included only mCRPC patients. The ADC targets were prostate-specific membrane antigen (PSMA), trophoblast cell surface antigen-2 (TROP-2), six-transmembrane epithelial antigen of prostate-1 (STEAP-1), tissue factor (TF), delta-like protein 3 (DLL-3), B7-H3 family of proteins (B7-H3), and human epidermal growth factor receptor 2 (HER2). Regarding the efficacy of PSMA ADC treatment in the second-line or beyond mCRPC setting, a PSA ≥ 50% decline rate in 14% of all treated patients was reported. One patient achieved a complete response with TROP-2 ADC. Overall, a wide range of safety issues were raised, particularly in connection with neuropathy and hematologic toxicity. Novel therapies have been changing the scope of treatment in mCRPC. ADCs seem to provide efficacy benefits, even with potential toxicity. The results of most prospective ongoing studies are still awaited, and a longer follow-up time is warranted to evaluate the real impact of ADCs in PCa.
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Affiliation(s)
- Mariana Sardinha
- Medical Oncology, Centro Hospitalar Universitário Central Lisboa, Lisbon, PRT
| | - Ana Filipa Palma Dos Reis
- Medical Oncology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, GBR
| | - João Vasco Barreira
- Medical Oncology, Hospital dos Serviços de Assistência Médico-Social, Lisbon, PRT
| | | | - Simon Pacey
- Medical Oncology, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, GBR
| | - Ricardo Luz
- Medical Oncology, Centro Hospitalar Universitário Central Lisboa, Lisbon, PRT
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Bianchi A, von Deimling M, Pallauf M, Yanagisawa T, Kawada T, Mostafaei H, Quhal F, Laukhtina E, Rajwa P, Majdoub M, Motlagh RS, Pradere B, Karakiewicz PI, Cerruto MA, Antonelli A, Shariat SF. Perspectives on the future of urothelial carcinoma therapy: chemotherapy and beyond. Expert Opin Pharmacother 2023; 24:177-195. [PMID: 36440477 DOI: 10.1080/14656566.2022.2150966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Despite recent developments in the landscape of urothelial carcinoma (UC) treatment, platinum combination chemotherapy still remains a milestone. Recently immunotherapeutic agents have gained ever-growing attractivity, particularly in the metastatic setting. Novel chemotherapeutic strategies and agents, such as antibody-drug conjugates (ADCs), and powerful combination regimens have been developed to overcome the resistance of most UC to current therapies. AREAS COVERED Herein, we review the current standard-of-care chemotherapy, the development of ADCs, the rationale for combining therapy regimens with chemotherapy in current trials, and future directions in UC management. EXPERT OPINION Immunotherapy has prompted a revolution in the treatment paradigm of UC. However, only a few patients experience a long-term response when treated with single-agent immunotherapies. Combination treatments are necessary to bypass resistance mechanisms and broaden the clinical utility of current options. Current evidence supports the intensification of standard-of-care chemotherapy with maintenance immunotherapy. However, the optimal sequence, combination, and duration must be determined to achieve individual longevity with acceptable health-related quality of life. In that regard, ADCs appear as a promising alternative for single and combination strategies in UC, as they specifically target the tumor cells, thereby, theoretically improving treatment efficacy and avoiding extensive off-target toxicities.
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Affiliation(s)
- Alberto Bianchi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Markus von Deimling
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Pallauf
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, Paracelsus Medical University Salzburg, University Hospital Salzburg, Salzburg, Austria
| | - Takafumi Yanagisawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tatsushi Kawada
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hadi Mostafaei
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fahad Quhal
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Pawel Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Muhammad Majdoub
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Reza Sari Motlagh
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, La Croix Du Sud Hospital, Quint Fonsegrives, France
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Québec, Canada
| | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan.,Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
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Nguyen TD, Bordeau BM, Balthasar JP. Mechanisms of ADC Toxicity and Strategies to Increase ADC Tolerability. Cancers (Basel) 2023; 15:713. [PMID: 36765668 PMCID: PMC9913659 DOI: 10.3390/cancers15030713] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
Anti-cancer antibody-drug conjugates (ADCs) aim to expand the therapeutic index of traditional chemotherapy by employing the targeting specificity of monoclonal antibodies (mAbs) to increase the efficiency of the delivery of potent cytotoxic agents to malignant cells. In the past three years, the number of ADCs approved by the Food and Drug Administration (FDA) has tripled. Although several ADCs have demonstrated sufficient efficacy and safety to warrant FDA approval, the clinical use of all ADCs leads to substantial toxicity in treated patients, and many ADCs have failed during clinical development due to their unacceptable toxicity profiles. Analysis of the clinical data has demonstrated that dose-limiting toxicities (DLTs) are often shared by different ADCs that deliver the same cytotoxic payload, independent of the antigen that is targeted and/or the type of cancer that is treated. DLTs are commonly associated with cells and tissues that do not express the targeted antigen (i.e., off-target toxicity), and often limit ADC dosage to levels below those required for optimal anti-cancer effects. In this manuscript, we review the fundamental mechanisms contributing to ADC toxicity, we summarize common ADC treatment-related adverse events, and we discuss several approaches to mitigating ADC toxicity.
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Affiliation(s)
- Toan D Nguyen
- Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Brandon M Bordeau
- Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Joseph P Balthasar
- Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14214, USA
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Duenas-Gonzalez A. Combinational therapies for the treatment of advanced cervical cancer. Expert Opin Pharmacother 2023; 24:73-81. [PMID: 35653267 DOI: 10.1080/14656566.2022.2084689] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION From a therapeutic standpoint, invasive cervical cancer can be designated as early, locally advanced, and advanced stages. Systemic treatment remains the primary therapeutical modality for advanced cervical cancer patients who are not candidates for local curative treatments (surgery and radiation). AREAS COVERED In this review, the author discusses recent clinical studies published in PubMed on the treatment of advanced cervical carcinoma. The author also provides his expert perspectives on the current state of play. EXPERT OPINION Survival outcomes for advanced cervical cancer patients have been steadily improving since 1981, when single-agent cisplatin was adopted as the standard of care. In 2014, bevacizumab increased median overall survival (MOS) to 17 months when combined with standard chemotherapy (platinum-paclitaxel). In 2021, the checkpoint inhibitor (CPI) pembrolizumab, when used in the first line added to platinum-paclitaxel-bevacizumab, increased mOS to 24 months. Two other CPIs are in phase III trials as first-line treatments. As for second-line therapy, cemiplimab has shown increased survival compared to single-agent chemotherapy, and a phase III trial with tisotumab vedotin is currently ongoing. Nevertheless, there is still an unmet need for new more effective treatments and significant efforts are needed in the discovery of drugs for advanced cervical cancer beyond the current 'me-too' drugs.
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Affiliation(s)
- Alfonso Duenas-Gonzalez
- Departamento de Medicina Genómica y Toxicologia Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autonoma de Mexico/Instituto Nacional de Cancerologia, Mexico City, Mexico
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49
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Polten R, Kutle I, Hachenberg J, Klapdor R, Morgan M, Schambach A. Towards Novel Gene and Cell Therapy Approaches for Cervical Cancer. Cancers (Basel) 2022; 15:cancers15010263. [PMID: 36612258 PMCID: PMC9818159 DOI: 10.3390/cancers15010263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Cervical cancer is one of the most common malignancies in women, and the majority of cases are caused by infection with high-risk human papilloma virus (HPV) subtypes. Despite effective preventative measures, such as vaccinations against HPV, over 300,000 women die world-wide from cervical cancer each year. Once cervical cancer is diagnosed, treatment may consist of radial hysterectomy, or chemotherapy and radiotherapy, or a combination of therapies dependent upon the disease stage. Unfortunately, overall prognosis for patients with metastatic or recurrent disease remains poor. In these cases, immunotherapies may be useful based on promising preclinical work, some of which has been successfully translated to the clinic. For example, approaches using monoclonal antibodies directed against surface proteins important for control of immune checkpoints (i.e., immune checkpoint inhibitors) were shown to improve outcome in many cancer settings, including cervical cancer. Additionally, initial clinical studies showed that application of cytotoxic immune cells modified to express chimeric antigen receptors (CAR) or T cell receptors (TCR) for better recognition and elimination of tumor cells may be useful to control cervical cancer. This review explores these important topics, including strengths and limitations of standard and developing approaches, and how some novel treatment strategies may be optimally used to offer the best possible treatment for cervical cancer patients.
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Affiliation(s)
- Robert Polten
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
| | - Ivana Kutle
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
| | - Jens Hachenberg
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
- Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany
| | - Rüdiger Klapdor
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
- Department of Obstetrics and Gynecology, Hannover Medical School, 30625 Hannover, Germany
| | - Michael Morgan
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
- Correspondence: (M.M.); (A.S.); Tel.: +49-511-532-6067 (A.S.)
| | - Axel Schambach
- Institute of Experimental Hematology, Hannover Medical School, 30625 Hannover, Germany
- Division of Hematology/Oncology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Correspondence: (M.M.); (A.S.); Tel.: +49-511-532-6067 (A.S.)
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50
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Santaniello G, Nebbioso A, Altucci L, Conte M. Recent Advancement in Anticancer Compounds from Marine Organisms: Approval, Use and Bioinformatic Approaches to Predict New Targets. Mar Drugs 2022; 21:md21010024. [PMID: 36662197 PMCID: PMC9862894 DOI: 10.3390/md21010024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/23/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
In recent years, the study of anticancer bioactive compounds from marine sources has received wide interest. Contextually, world regulatory authorities have approved several marine molecules, and new synthetic derivatives have also been synthesized and structurally improved for the treatment of numerous forms of cancer. However, the administration of drugs in cancer patients requires careful evaluation since their interaction with individual biological macromolecules, such as proteins or nucleic acids, determines variable downstream effects. This is reflected in a constant search for personalized therapies that lay the foundations of modern medicine. The new knowledge acquired on cancer mechanisms has certainly allowed advancements in tumor prevention, but unfortunately, due to the huge complexity and heterogeneity of cancer, we are still looking for a definitive therapy and clinical approaches. In this review, we discuss the significance of recently approved molecules originating from the marine environment, starting from their organism of origin to their structure and mechanism of action. Subsequently, these bio-compounds are used as models to illustrate possible bioinformatics approaches for the search of new targets that are useful for improving the knowledge on anticancer therapies.
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Affiliation(s)
- Giovanna Santaniello
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Vico L. De Crecchio 7, 80138 Naples, Italy
| | - Angela Nebbioso
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Vico L. De Crecchio 7, 80138 Naples, Italy
| | - Lucia Altucci
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Vico L. De Crecchio 7, 80138 Naples, Italy
- BIOGEM, Institute of Molecular Biology and Genetics, Via Camporeale, 83031 Ariano Irpino, Italy
- IEOS, Institute for Endocrinology and Experimental Oncology, CNR, Via Pansini 5, 80131 Napoli, Italy
- Correspondence: (L.A.); (M.C.); Tel.: +39-081-5667564 (M.C.)
| | - Mariarosaria Conte
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Vico L. De Crecchio 7, 80138 Naples, Italy
- Correspondence: (L.A.); (M.C.); Tel.: +39-081-5667564 (M.C.)
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