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Naidoo J, Wang X, Woo KM, Iyriboz T, Halpenny D, Cunningham J, Chaft JE, Segal NH, Callahan MK, Lesokhin AM, Rosenberg J, Voss MH, Rudin CM, Rizvi H, Hou X, Rodriguez K, Albano M, Gordon RA, Leduc C, Rekhtman N, Harris B, Menzies AM, Guminski AD, Carlino MS, Kong BY, Wolchok JD, Postow MA, Long GV, Hellmann MD. Pneumonitis in Patients Treated With Anti-Programmed Death-1/Programmed Death Ligand 1 Therapy. J Clin Oncol 2016; 35:709-717. [PMID: 27646942 DOI: 10.1200/jco.2016.68.2005] [Citation(s) in RCA: 739] [Impact Index Per Article: 92.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose Pneumonitis is an uncommon but potentially fatal toxicity of anti-programmed death-1 (PD-1)/programmed death ligand 1 (PD-L1) monoclonal antibodies (mAbs). Clinical, radiologic, and pathologic features are poorly described. Methods Patients who received anti-PD-1/PD-L1 monotherapy or in combination with anti-cytotoxic T-cell lymphocyte-4 mAb were identified at two institutions (Memorial Sloan Kettering Cancer Center: advanced solid cancers, 2009 to 2014, and Melanoma Institute of Australia: melanomas only, 2013 to 2015). Pneumonitis was diagnosed by the treating investigator; cases with confirmed malignant lung infiltration or infection were excluded. Clinical, radiologic, and pathologic features of pneumonitis were collected. Associations among pneumonitis incidence, therapy received, and underlying malignancy were examined with Fisher's exact test as were associations between pneumonitis features and outcomes. Results Of 915 patients who received anti-PD-1/PD-L1 mAbs, pneumonitis developed in 43 (5%; 95% CI, 3% to 6%; Memorial Sloan Kettering Cancer Center, 27 of 578 [5%]; Melanoma Institute of Australia, 16 of 337 [5%]). Time to onset of pneumonitis ranged from 9 days to 19.2 months. The incidence of pneumonitis was higher with combination immunotherapy versus monotherapy (19 of 199 [10%] v 24 of 716 [3%]; P < .01). Incidence was similar in patients with melanoma and non-small-cell lung cancer (overall, 26 of 532 [5%] v nine of 209 [4%]; monotherapy, 15 of 417 v five of 152 [ P = 1.0]; combination, 11 of 115 v four of 57 [ P = .78]). Seventy-two percent (31 of 43) of cases were grade 1 to 2, and 86% (37 of 43) improved/resolved with drug holding/immunosuppression. Five patients worsened clinically and died during the course of pneumonitis treatment; proximal cause of death was pneumonitis (n = 1), infection related to immunosuppression (n = 3), or progressive cancer (n = 1). Radiologic and pathologic features of pneumonitis were diverse. Conclusion Pneumonitis associated with anti-PD-1/PD-L1 mAbs is a toxicity of variable onset and clinical, radiologic, and pathologic appearances. It is more common when anti-PD-1/PD-L1 mAbs are combined with anti-cytotoxic T-cell lymphocyte-4 mAb. Most events are low grade and improve/resolve with drug holding/immunosuppression. Rarely, pneumonitis worsens despite immunosuppression, and may result in infection and/or death.
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Affiliation(s)
- Jarushka Naidoo
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Xuan Wang
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Kaitlin M Woo
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Tunc Iyriboz
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Darragh Halpenny
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Jane Cunningham
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Jamie E Chaft
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Neil H Segal
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Margaret K Callahan
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Alexander M Lesokhin
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Jonathan Rosenberg
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Martin H Voss
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Charles M Rudin
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Hira Rizvi
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Xue Hou
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Katherine Rodriguez
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Melanie Albano
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Ruth-Ann Gordon
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Charles Leduc
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Natasha Rekhtman
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Bianca Harris
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Alexander M Menzies
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Alexander D Guminski
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Matteo S Carlino
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Benjamin Y Kong
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Jedd D Wolchok
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Michael A Postow
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Georgina V Long
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
| | - Matthew D Hellmann
- Jarushka Naidoo, Kaitlin M. Woo, Tunc Iyriboz, Darragh Halpenny, Jane Cunningham, Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Hira Rizvi, Xue Hou, Katherine Rodriguez, Melanie Albano, Ruth-Ann Gordon, Charles Leduc, Natasha Rekhtman, Bianca Harris, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Jamie E. Chaft, Neil H. Segal, Margaret K. Callahan, Alexander M. Lesokhin, Jonathan Rosenberg, Martin H. Voss, Charles M. Rudin, Jedd D. Wolchok, Michael A. Postow, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Jarushka Naidoo, Sidney Kimmel Cancer Center at Johns Hopkins University, Baltimore, MD; Xuan Wang, Peking University Cancer Hospital and Institute, Beijing; Xue Hou, Sun Yat-sen University Cancer Center, Guangdong Province, People's Republic of China; Xuan Wang, Matteo S. Carlino, Benjamin Y. Kong, and Georgina V. Long, The University of Sydney; Alexander M. Menzies and Alexander D. Guminski, Royal North Shore and Mater Hospital; and Matteo S. Carlino and Benjamin Y. Kong, Westmead and Blacktown Hospitals, Sydney, Australia
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