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Massano D, Carraro E, Mussolin L, Buffardi S, Barat V, Zama D, Muggeo P, Vendemini F, Sau A, Moleti ML, Verzegnassi F, D'Amico S, Casini T, Garaventa A, Schiavello E, Cellini M, Vinti L, Farruggia P, Perruccio K, Cesaro S, De Santis R, Marinoni M, D'Alba I, Mura RM, Burnelli R, Mascarin M, Pillon M. Brentuximab vedotin in the treatment of paediatric patients with relapsed or refractory Hodgkin's lymphoma: Results of a real-life study. Pediatr Blood Cancer 2022; 69:e29801. [PMID: 35656841 DOI: 10.1002/pbc.29801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/22/2022] [Accepted: 05/06/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Brentuximab vedotin (BV) is an antibody drug-conjugated anti-CD30 approved for the treatment of adult classical Hodgkin's lymphoma (HL), whereas it is considered as off-label indication in paediatrics. The aim of the study was to evaluate the safety and efficacy of BV to treat patients aged less than 18 years with refractory/relapsed HL. MATERIALS AND METHODS In this multicentre, retrospective study, 68 paediatric patients who received at least one dose of BV between November 2011 and August 2020 were enrolled. A median of nine doses of BV were administered as monotherapy (n = 31) or combined with other therapies (n = 37). BV was administrated alone as consolidation therapy after stem cell transplantation (SCT) in 12 patients, before SCT in 18 patients, whereas in 15 patients it was used before and after SCT as consolidation therapy. Median follow-up was 2.8 years (range: 0.6-8.9 years). RESULTS The best response was observed in the 86% of patients; the overall response rate was 66%. The 3-year progression-free survival was 58%, whereas the overall survival was 75%. No statistically significant differences between patients treated with BV monotherapy or combination were highlighted. In multivariate analysis, patients with non-nodular sclerosis HL and not transplanted had an increased risk of failure. Overall, 46% of patients had grade 3-4 adverse events that led to BV discontinuation in five of them. CONCLUSION In conclusion, our study confirms that BV was a safe and effective drug, able to induce complete remission, either as monotherapy or in association with standard therapy.
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Affiliation(s)
- Davide Massano
- Paediatric Hematology, Oncology and Stem Cell Transplant Division, Padova University Hospital, Padua, Italy
| | - Elisa Carraro
- Paediatric Hematology, Oncology and Stem Cell Transplant Division, Padova University Hospital, Padua, Italy
| | - Lara Mussolin
- Maternal and Child Health Department, Padova University Hospital, Padua, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padua, Italy
| | - Salvatore Buffardi
- Paediatric Haemato-Oncology Department, Santobono-Pausilipon Children's Hospital, Napoli, Italy
| | - Veronica Barat
- Paediatric Onco-Hematology and Stem Cell Transplant Division, City of Health and Science, Regina Margherita Children's Hospital, Torino, Italy
| | - Daniele Zama
- Department of Paediatrics, Sant'Orsola Hospital, University of Bologna, Bologna, Italy
| | - Paola Muggeo
- Department of Paediatric Oncology and Hematology, University Hospital of Policlinico, Bari, Italy
| | - Francesca Vendemini
- Department of Paediatrics, Ospedale San Gerardo, University of Milano-Bicocca, Fondazione MBBM, Monza, Italy
| | - Antonella Sau
- Paediatric Hematology-Oncology Unit, Ospedale Civico, Pescara, Italy
| | - Maria Luisa Moleti
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | | | - Salvatore D'Amico
- Department of Clinical and Experimental Medicine, Paediatric Haemato-Oncology Unit, University of Catania, Catania, Italy
| | - Tommaso Casini
- Paediatric Haematology-Oncology Unit, Meyer Paediatric Hospital, Florence, Italy
| | - Alberto Garaventa
- Paediatric Oncology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Elisabetta Schiavello
- Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Paediatric Oncology Unit, Milan, Italy
| | - Monica Cellini
- Department of Paediatrics, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Luciana Vinti
- Department of Paediatric Hematology and Oncology, IRCSS Ospedale Bambino Gesù, Rome, Italy
| | - Piero Farruggia
- Paediatric Hematology and Oncology Unit, Oncology Department, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Katia Perruccio
- Paediatric Hematology-Oncology Unit, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Simone Cesaro
- Paediatric Hematology Oncology Unit, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Raffaela De Santis
- IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Maddalena Marinoni
- Paediatric Department, Hospital 'F. Del Ponte', University of Insubria, Varese, Italy
| | - Irene D'Alba
- Division of Paediatric Hematology and Oncology, Ospedale G. Salesi, Ancona, Italy
| | - Rosa Maria Mura
- Paediatric Hematology and Oncology Unit, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Roberta Burnelli
- Paediatric Hemato-Oncology Unit, Azienda Ospedaliero Universitaria Sant'Anna di Ferrara, Ferrara, Italy
| | - Maurizio Mascarin
- AYA Oncology and Paediatric Radiotherapy Unit, CRO-Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - Marta Pillon
- Paediatric Hematology, Oncology and Stem Cell Transplant Division, Padova University Hospital, Padua, Italy
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Wagner AD, Oertelt-Prigione S, Adjei A, Buclin T, Cristina V, Csajka C, Coukos G, Dafni U, Dotto GP, Ducreux M, Fellay J, Haanen J, Hocquelet A, Klinge I, Lemmens V, Letsch A, Mauer M, Moehler M, Peters S, Özdemir BC. Gender medicine and oncology: report and consensus of an ESMO workshop. Ann Oncol 2019; 30:1914-1924. [PMID: 31613312 DOI: 10.1093/annonc/mdz414] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The importance of sex and gender as modulators of disease biology and treatment outcomes is well known in other disciplines of medicine, such as cardiology, but remains an undervalued issue in oncology. Considering the increasing evidence for their relevance, European Society for Medical Oncology decided to address this topic and organized a multidisciplinary workshop in Lausanne, Switzerland, on 30 November and 1 December 2018. DESIGN Twenty invited faculty members and 40 selected physicians/scientists participated. Relevant content was presented by faculty members on the basis of a literature review conducted by each speaker. Following a moderated consensus session, the final consensus statements are reported here. RESULTS Clinically relevant sex differences include tumour biology, immune system activity, body composition and drug disposition and effects. The main differences between male and female cells are sex chromosomes and the level of sexual hormones they are exposed to. They influence both local and systemic determinants of carcinogenesis. Their effect on carcinogenesis in non-reproductive organs is largely unknown. Recent evidence also suggests differences in tumour biology and molecular markers. Regarding body composition, the difference in metabolically active, fat-free body mass is one of the most prominent: in a man and a woman of equal weight and height, it accounts for 80% of the man's and 65% of the woman's body mass, and is not taken into account in body-surface area based dosing of chemotherapy. CONCLUSION Sex differences in cancer biology and treatment deserve more attention and systematic investigation. Interventional clinical trials evaluating sex-specific dosing regimens are necessary to improve the balance between efficacy and toxicity for drugs with significant pharmacokinetic differences. Especially in diseases or disease subgroups with significant differences in epidemiology or outcomes, men and women with non-sex-related cancers should be considered as biologically distinct groups of patients, for whom specific treatment approaches merit consideration.
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Affiliation(s)
- A D Wagner
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - S Oertelt-Prigione
- Department of Primary and Community Care, Radboud Institute of Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Adjei
- Department of Oncology, Mayo Clinic, Rochester, USA
| | - T Buclin
- Service of Clinical Pharmacology, Lausanne University, Lausanne
| | - V Cristina
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - C Csajka
- Service of Clinical Pharmacology, Lausanne University, Lausanne; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Lausanne
| | - G Coukos
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Ludwig Lausanne Branch and Swiss Cancer Center, Lausanne, Switzerland
| | - U Dafni
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; National and Kapodistrian University of Athens, Athens, Greece
| | - G-P Dotto
- Department of Biochemistry, Lausanne University, Lausanne, Switzerland; Massachusetts General Hospital, Boston, USA; International Cancer Prevention Institute, Epalinges, Switzerland
| | - M Ducreux
- Gastrointestinal Cancer Unit, Gustave Roussy, Paris Saclay University, Villejuif, France
| | - J Fellay
- Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne; EPFL School of Life Sciences, Lausanne, Switzerland
| | - J Haanen
- Division of Medical Oncology and Immunology, Department of Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A Hocquelet
- Department of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - I Klinge
- Dutch Society for Gender and Health
| | - V Lemmens
- Department of Research and Development, Comprehensive Cancer Organisation the Netherlands, Utrecht; Department of Public Health, Erasmus Medical Centre University, Rotterdam, The Netherlands
| | - A Letsch
- Department of Hematology and Oncology, Charity CBF, Berlin; Charity Comprehensive Cancer Center CCCC, Berlin; Palliative Care Unit, Campus Benjamin Franklin, Berlin, Germany
| | | | - M Moehler
- Department of Internal Medicine 1/Gastrointestinal Oncology, Johannes-Gutenberg-University Clinic, Mainz, Germany
| | - S Peters
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - B C Özdemir
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; International Cancer Prevention Institute, Epalinges, Switzerland
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6
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Collins M, Wilhelm M, Conyers R, Herschtal A, Whelan J, Bielack S, Kager L, Kühne T, Sydes M, Gelderblom H, Ferrari S, Picci P, Smeland S, Eriksson M, Petrilli AS, Bleyer A, Thomas DM. Benefits and Adverse Events in Younger Versus Older Patients Receiving Neoadjuvant Chemotherapy for Osteosarcoma: Findings From a Meta-Analysis. J Clin Oncol 2013; 31:2303-12. [DOI: 10.1200/jco.2012.43.8598] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The LIVESTRONG Young Adult Alliance has conducted a meta-analysis of individual patient data from prospective neoadjuvant chemotherapy osteosarcoma studies and registries to examine the relationships of sex, age, and toxicity on survival. Patients and Methods Suitable data sets were identified by a survey of published data reported in PubMed. The final pooled data set comprised 4,838 patients from five international cooperative groups. Results After accounting for important variables known at study entry such as tumor location and histology, females experienced higher overall survival rates than males (P = .005) and children fared better than adolescents and adults (P = .002). Multivariate landmark analysis following surgery indicated that a higher rate of chemotherapy-induced tumor necrosis was associated with longer survival (P < .001), as was female sex (P = .004) and the incidence of grade 3 or 4 mucositis (P = .03). Age group was not statistically significant in this landmark analysis (P = .12). Females reported higher rates of grade 3 or 4 thrombocytopenia relative to males (P < .001). Children reported the highest rates of grade 3 or 4 neutropenia (P < .001) and thrombocytopenia (P < .001). The achievement of good tumor necrosis was higher for females than for males (P = .002) and for children than for adults (P < .001). Conclusion These results suggest fundamental differences in the way chemotherapy is handled by females compared with males and by children compared with older populations. These differences may influence survival in a disease in which chemotherapy is critical to overall outcomes.
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Affiliation(s)
- Marnie Collins
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Miriam Wilhelm
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Rachel Conyers
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Alan Herschtal
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Jeremy Whelan
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Stefan Bielack
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Leo Kager
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Thomas Kühne
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Matthew Sydes
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Hans Gelderblom
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Stefano Ferrari
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Piero Picci
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Sigbjørn Smeland
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Mikael Eriksson
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Antonio Sérgio Petrilli
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - Archie Bleyer
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
| | - David M. Thomas
- Marnie Collins, Rachel Conyers, Alan Herschtal, and David M. Thomas, Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group, Melbourne, Australia; Jeremy Whelan, University College London Hospitals; Matthew Sydes, Medical Research Council Clinical Trials Unit, London, United Kingdom; Hans Gelderblom, European Osteosarcoma Intergroup and University Medical Centre, Leiden, the Netherlands; Miriam Wilhelm and Stefan Bielack, Cooperative Osteosarcoma Study Group and Klinikum Stuttgart,
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