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van den Heuvel M, Holdenrieder S, Schuurbiers M, Cigoianu D, Trulson I, van Rossum H, Lang D. Serum tumor markers for response prediction and monitoring of advanced lung cancer: A review focusing on immunotherapy and targeted therapies. Tumour Biol 2024; 46:S233-S268. [PMID: 37248927 DOI: 10.3233/tub-220039] [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: 05/31/2023] Open
Abstract
BACKGROUND The value of serum tumor markers (STMs) in the current therapeutic landscape of lung cancer is unclear. OBJECTIVE This scoping review gathered evidence of the predictive, prognostic, and monitoring value of STMs for patients with advanced lung cancer receiving immunotherapy (IT) or targeted therapy (TT). METHODS Literature searches were conducted (cut-off: May 2022) using PubMed and Cochrane CENTRAL databases. Medical professionals advised on the search strategies. RESULTS Study heterogeneity limited the evidence and inferences from the 36 publications reviewed. While increased baseline levels of serum cytokeratin 19 fragment antigen (CYFRA21-1) and carcinoembryonic antigen (CEA) may predict IT response, results for TT were less clear. For monitoring IT-treated patients, STM panels (including CYFRA21-1, CEA, and neuron-specific enolase) may surpass the power of single analyses to predict non-response. CYFRA21-1 measurement could aid in monitoring TT-treated patients, but the value of CEA in this context requires further investigation. Overall, baseline and dynamic changes in individual or combined STM levels have potential utility to predict treatment outcome and for monitoring of patients with advanced lung cancer. CONCLUSIONS In advanced lung cancer, STMs provide additional relevant clinical information by predicting treatment outcome, but further standardization and validation is warranted.
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Affiliation(s)
- Michel van den Heuvel
- Department of Pulmonology, Radboud University Medical Center - Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Stefan Holdenrieder
- Institute for Laboratory Medicine, German Heart Centre, Technical University of Munich, Munich, Germany
| | - Milou Schuurbiers
- Department of Pulmonology, Radboud University Medical Center - Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | | | - Inga Trulson
- Institute for Laboratory Medicine, German Heart Centre, Technical University of Munich, Munich, Germany
| | - Huub van Rossum
- Department of Laboratory Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - David Lang
- Department of Internal Medicine - Pulmonology, Johannes Kepler University Hospital, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
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Trulson I, Holdenrieder S. Prognostic value of blood-based protein biomarkers in non-small cell lung cancer: A critical review and 2008-2022 update. Tumour Biol 2024; 46:S111-S161. [PMID: 37927288 DOI: 10.3233/tub-230009] [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: 11/07/2023] Open
Abstract
BACKGROUND Therapeutic possibilities for non-small cell lung cancer (NSCLC) have considerably increased during recent decades. OBJECTIVE To summarize the prognostic relevance of serum tumor markers (STM) for early and late-stage NSCLC patients treated with classical chemotherapies, novel targeted and immune therapies. METHODS A PubMed database search was conducted for prognostic studies on carcinoembryonic antigen (CEA), cytokeratin-19 fragment (CYFRA 21-1), neuron-specific enolase, squamous-cell carcinoma antigen, progastrin-releasing-peptide, CA125, CA 19-9 and CA 15-3 STMs in NSCLC patients published from 2008 until June 2022. RESULTS Out of 1069 studies, 141 were identified as meeting the inclusion criteria. A considerable heterogeneity regarding design, patient number, analytical and statistical methods was observed. High pretherapeutic CYFRA 21-1 levels and insufficient decreases indicated unfavorable prognosis in many studies on NSCLC patients treated with chemo-, targeted and immunotherapies or their combinations in early and advanced stages. Similar results were seen for CEA in chemotherapy, however, high pretherapeutic levels were sometimes favorable in targeted therapies. CA125 is a promising prognostic marker in patients treated with immunotherapies. Combinations of STMs further increased the prognostic value over single markers. CONCLUSION Protein STMs, especially CYFRA 21-1, have prognostic potential in early and advanced stage NSCLC. For future STM investigations, better adherence to comparable study designs, analytical methods, outcome measures and statistical evaluation standards is recommended.
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Affiliation(s)
- Inga Trulson
- Munich Biomarker Research Center, Institute for Laboratory Medicine, German Heart Center, Technical University of Munich, Munich, Germany
| | - Stefan Holdenrieder
- Munich Biomarker Research Center, Institute for Laboratory Medicine, German Heart Center, Technical University of Munich, Munich, Germany
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Li J, Chi J, Yang Y, Song Z, Yang Y, Zhou X, Liu Y, Zhao Y. PHDs-seq: a large-scale phenotypic screening method for drug discovery through parallel multi-readout quantification. CELL REGENERATION (LONDON, ENGLAND) 2023; 12:22. [PMID: 37264282 DOI: 10.1186/s13619-023-00164-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 04/15/2023] [Indexed: 06/03/2023]
Abstract
High-throughput phenotypic screening is a cornerstone of drug development and the main technical approach for stem cell research. However, simultaneous detection of activated core factors responsible for cell fate determination and accurate assessment of directional cell transition are difficult using conventional screening methods that focus on changes in only a few biomarkers. The PHDs-seq (Probe Hybridization based Drug screening by sequencing) platform was developed to evaluate compound function based on their transcriptional effects in a wide range of signature biomarkers. In this proof-of-concept demonstration, several sets of markers related to cell fate determination were profiled in adipocyte reprogramming from dermal fibroblasts. After validating the accuracy, sensitivity and reproducibility of PHDs-seq data in molecular and cellular assays, a panel of 128 signalling-related compounds was screened for the ability to induce reprogramming of keloid fibroblasts (KF) into adipocytes. Notably, the potent ATP-competitive VEGFR/PDGFR inhibitor compound, ABT869, was found to promote the transition from fibroblasts to adipocytes. This study highlights the power and accuracy of the PHDs-seq platform for high-throughput drug screening in stem cell research, and supports its use in basic explorations of the molecular mechanisms underlying disease development.
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Affiliation(s)
- Jun Li
- State Key Laboratory of Natural and Biomimetic Drugs, MOE Key Laboratory of Cell Proliferation and Differentiation, Beijing Key Laboratory of Cardiometabolic Molecular Medicine, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, 100871, China
- Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, 100871, China
| | - Jun Chi
- Plastech Pharmaceutical Technology Ltd, Nanjing, 210031, China
| | - Yang Yang
- State Key Laboratory of Natural and Biomimetic Drugs, MOE Key Laboratory of Cell Proliferation and Differentiation, Beijing Key Laboratory of Cardiometabolic Molecular Medicine, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, 100871, China
- Plastech Pharmaceutical Technology Ltd, Nanjing, 210031, China
| | - Zhongya Song
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Yong Yang
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Xin Zhou
- Department of General Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Yang Liu
- State Key Laboratory of Natural and Biomimetic Drugs, MOE Key Laboratory of Cell Proliferation and Differentiation, Beijing Key Laboratory of Cardiometabolic Molecular Medicine, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, 100871, China.
- Plastech Pharmaceutical Technology Ltd, Nanjing, 210031, China.
| | - Yang Zhao
- State Key Laboratory of Natural and Biomimetic Drugs, MOE Key Laboratory of Cell Proliferation and Differentiation, Beijing Key Laboratory of Cardiometabolic Molecular Medicine, Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing, 100871, China.
- Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, 100871, China.
- Plastech Pharmaceutical Technology Ltd, Nanjing, 210031, China.
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Pérez-López AM, Belsom A, Fiedler L, Xin X, Rappsilber J. Dual-Bioorthogonal Catalysis by a Palladium Peptide Complex. J Med Chem 2023; 66:3301-3311. [PMID: 36820649 PMCID: PMC10009749 DOI: 10.1021/acs.jmedchem.2c01689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Artificial metalloenzymes (ArMs) enrich bioorthogonal chemistry with new-to-nature reactions while limiting metal deactivation and toxicity. This enables biomedical applications such as activating therapeutics in situ. However, while combination therapies are becoming widespread anticancer treatments, dual catalysis by ArMs has not yet been shown. We present a heptapeptidic ArM with a novel peptide ligand carrying a methyl salicylate palladium complex. We observed that the peptide scaffold reduces metal toxicity while protecting the metal from deactivation by cellular components. Importantly, the peptide also improves catalysis, suggesting involvement in the catalytic reaction mechanism. Our work shows how a palladium-peptide homogeneous catalyst can simultaneously mediate two types of chemistry to synthesize anticancer drugs in human cells. Methyl salicylate palladium LLEYLKR peptide (2-Pd) succeeded to simultaneously produce paclitaxel by depropargylation, and linifanib by Suzuki-Miyaura cross-coupling in cell culture, thereby achieving combination therapy on non-small-cell lung cancer (NSCLC) A549 cells.
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Affiliation(s)
- Ana M Pérez-López
- Chair of Bioanalytics, Technische Universität Berlin, 10623 Berlin, Germany.,Si-M/"Der Simulierte Mensch", a Science Framework of Technische Universität Berlin and Charité─Universitätsmedizin Berlin, 10623 Berlin, Germany
| | - Adam Belsom
- Chair of Bioanalytics, Technische Universität Berlin, 10623 Berlin, Germany.,Si-M/"Der Simulierte Mensch", a Science Framework of Technische Universität Berlin and Charité─Universitätsmedizin Berlin, 10623 Berlin, Germany
| | - Linus Fiedler
- Chair of Bioanalytics, Technische Universität Berlin, 10623 Berlin, Germany.,Si-M/"Der Simulierte Mensch", a Science Framework of Technische Universität Berlin and Charité─Universitätsmedizin Berlin, 10623 Berlin, Germany
| | - Xiaoyi Xin
- Chair of Bioanalytics, Technische Universität Berlin, 10623 Berlin, Germany.,Si-M/"Der Simulierte Mensch", a Science Framework of Technische Universität Berlin and Charité─Universitätsmedizin Berlin, 10623 Berlin, Germany
| | - Juri Rappsilber
- Chair of Bioanalytics, Technische Universität Berlin, 10623 Berlin, Germany.,Si-M/"Der Simulierte Mensch", a Science Framework of Technische Universität Berlin and Charité─Universitätsmedizin Berlin, 10623 Berlin, Germany.,Wellcome Centre for Cell Biology, University of Edinburgh, Edinburgh EH9 3BF, U.K
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Anti-Angiogenic Therapy in ALK Rearranged Non-Small Cell Lung Cancer (NSCLC). Int J Mol Sci 2022; 23:ijms23168863. [PMID: 36012123 PMCID: PMC9407780 DOI: 10.3390/ijms23168863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022] Open
Abstract
The management of advanced lung cancer has been transformed with the identification of targetable oncogenic driver alterations. This includes anaplastic lymphoma kinase (ALK) gene rearrangements. ALK tyrosine kinase inhibitors (TKI) are established first-line treatment options in advanced ALK rearranged non-small cell lung cancer (NSCLC), with several next-generation ALK TKIs (alectinib, brigatinib, ensartinib and lorlatinib) demonstrating survival benefit compared with the first-generation ALK TKI crizotinib. Still, despite high objective response rates and durable progression-free survival, drug resistance inevitably ensues, and treatment options beyond ALK TKI are predominantly limited to cytotoxic chemotherapy. Anti-angiogenic therapy targeting the vascular endothelial growth factor (VEGF) signaling pathway has shown efficacy in combination with platinum-doublet chemotherapy in advanced NSCLC without a driver alteration, and with EGFR TKI in advanced EGFR mutated NSCLC. The role for anti-angiogenic therapy in ALK rearranged NSCLC, however, remains to be elucidated. This review will discuss the pre-clinical rationale, clinical trial evidence to date, and future directions to evaluate anti-angiogenic therapy in ALK rearranged NSCLC.
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Zhou S, Zhang H. Synergies of Targeting Angiogenesis and Immune Checkpoints in Cancer: From Mechanism to Clinical Applications. Anticancer Agents Med Chem 2021; 20:768-776. [PMID: 32031076 DOI: 10.2174/1871520620666200207091653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/23/2019] [Accepted: 01/12/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Angiogenesis marks key progress in the growth, recurrence, and metastasis of various cancers. Antiangiogenic drugs can improve the blood supply and oxygen content of tumors and enhance the effects of chemotherapy and radiotherapy by normalizing tumor blood vessels and microenvironment. The further recent developments of Immune Checkpoint Inhibitors (ICIs) provide significant progress in cancer immunotherapy. The study focused on programmed cell death protein 1 (PD-1) and Cytotoxic T Lymphocyte Antigen 4 (CTLA-4) blockade, reflecting on the evidence of durable responses among various tumor types. The aim of this review was to sum up present evidence and clarify the rationale behind supporting the benefits of combining antiangiogenic drugs with immunotherapy for cancer treatment as well as list the ongoing clinical trials that are being conducted. METHODS Using PubMed and Web of Science, published articles have been searched and comprehensively reviewed. RESULTS Antiangiogenic agents can trigger antitumor and immunity, and they can also be induced by the immune system. Combining antiangiogenic drugs with immunotherapy may be effective for the treatment of human cancers. CONCLUSION It is evidenced that combining angiogenesis inhibitors with immunotherapy has a synergistic effect thus improving the curative effect of both agents.
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Affiliation(s)
- Shi Zhou
- Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, Jiangsu, China
| | - Haijun Zhang
- Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, Jiangsu, China
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Dou Y, Jiang D. [Research Progress of Small Molecule Anti-angiogenic Drugs
in Non-small Cell Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2021; 24:56-62. [PMID: 33478192 PMCID: PMC7849040 DOI: 10.3779/j.issn.1009-3419.2021.102.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
肺癌是世界上发病率最高的癌症之一,且尚无二线进展后的标准治疗方案,而肿瘤血管生成目前已被确定为恶性肿瘤的重要治疗靶点,小分子多靶点血管激酶抑制剂可通过抑制血管生成相关信号通路,抑制肿瘤血管的生成。目前已开展多项小分子抗血管生成药物治疗非小细胞肺癌的临床试验,且已有部分血管内皮生长因子受体酪氨酸激酶抑制剂(vascular endothelial growth factor receptor-tyrosine kinase inhibitors, VEGFR-TKIs)获批治疗晚期非小细胞肺癌,本文基于国内外多项小分子抗血管生成药物治疗非小细胞肺癌的发展现状,归纳了多个VEGFR-TKIs及成纤维细胞生长因子受体(fibroblast growth factor receptor, FGFR)-TKI单药或联合[包括分别与化疗、表皮生长因子受体(epidermal growth factor receptor, EGFR)-TKIs、免疫治疗、放疗等联合)]治疗非小细胞肺癌的疗效与安全性研究,同时探讨了VEGFR-TKIs可能存在的耐药机制及疗效预测指标等,并对未来抗血管治疗非小细胞肺癌的发展趋势以及存在的潜在问题进行展望,同时为肺癌后续的精准治疗及个体化治疗提供新的思路。
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Affiliation(s)
- Yan Dou
- Department of Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Da Jiang
- Department of Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
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Zhang HM, Li H, Wang GX, Wang J, Xiang Y, Huang Y, Shen C, Dai ZT, Li JP, Zhang TC, Liao XH. MKL1/miR-5100/CAAP1 loop regulates autophagy and apoptosis in gastric cancer cells. Neoplasia 2020; 22:220-230. [PMID: 32315812 PMCID: PMC7167518 DOI: 10.1016/j.neo.2020.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE miR-5100 participates in the proliferation of lung cancer and pancreatic cancer cells, and participates in the differentiation of osteoblasts. However, the regulation of gastric cancer cells in gastric cancer cells remains unclear. EXPERIMENTAL DESIGN The blood of patients was collected to detect the expression level of miR-5100, and the apoptosis and autophagy levels of cells were detected using western blot, flow cytometry, and confocal. At the same time, in vitro tumor formation experiments in nude mice were used to verify the results of in vitro experiments. RESULTS The expression of miR-5100 is related to the prognosis of gastric cancer, miR-5100 can enhance the apoptosis level of gastric cancer cells and inhibit the occurrence of autophagy by targeting CAAP1. MKL1 can inhibit the apoptosis of gastric cancer cells and promote the occurrence of autophagy by targeting CAAP1. At the same time, MKL1 can also increase the expression of miR-5100. CONCLUSIONS Our research reveals the mechanism by which the MKL1/miR-5100/CAAP1 loop regulates apoptosis and autophagy levels in gastric cancer cells, and miR-5100 is expected to become a new potential target for gastric cancer treatment.
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Affiliation(s)
- Hui-Min Zhang
- Institute of Biology and Medicine, College of Life and Health Sciences, Wuhan University of Science and Technology, 430000, PR China
| | - Hui Li
- Institute of Biology and Medicine, College of Life and Health Sciences, Wuhan University of Science and Technology, 430000, PR China
| | - Gen-Xin Wang
- Institute of Biology and Medicine, College of Life and Health Sciences, Wuhan University of Science and Technology, 430000, PR China.
| | - Jun Wang
- Institute of Biology and Medicine, College of Life and Health Sciences, Wuhan University of Science and Technology, 430000, PR China
| | - Yuan Xiang
- Institute of Biology and Medicine, College of Life and Health Sciences, Wuhan University of Science and Technology, 430000, PR China
| | - You Huang
- Institute of Biology and Medicine, College of Life and Health Sciences, Wuhan University of Science and Technology, 430000, PR China
| | - Chao Shen
- Institute of Biology and Medicine, College of Life and Health Sciences, Wuhan University of Science and Technology, 430000, PR China
| | - Zhou-Tong Dai
- Institute of Biology and Medicine, College of Life and Health Sciences, Wuhan University of Science and Technology, 430000, PR China
| | - Jia-Peng Li
- Institute of Biology and Medicine, College of Life and Health Sciences, Wuhan University of Science and Technology, 430000, PR China
| | - Tong-Cun Zhang
- Institute of Biology and Medicine, College of Life and Health Sciences, Wuhan University of Science and Technology, 430000, PR China.
| | - Xing-Hua Liao
- Institute of Biology and Medicine, College of Life and Health Sciences, Wuhan University of Science and Technology, 430000, PR China.
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Zhang Z, Zou H, Yuan A, Jiang F, Zhao B, Liu Y, Chen J, Zuo M, Gong L. A Single Enhanced Dual-Energy CT Scan May Distinguish Lung Squamous Cell Carcinoma From Adenocarcinoma During the Venous phase. Acad Radiol 2020; 27:624-629. [PMID: 31447258 DOI: 10.1016/j.acra.2019.07.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 07/11/2019] [Accepted: 07/22/2019] [Indexed: 01/03/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate whether iodine quantification extracted from enhanced dual energy-computed tomography (DE-CT) is useful for distinguishing lung squamous cell carcinoma from adenocarcinoma and to evaluate whether a single scan evaluated during the venous phase (VP) can be substituted for scans evaluated during other phases. MATERIALS AND METHODS Sixty-two patients with lung cancer (32 squamous cell carcinomas; 30 adenocarcinomas) underwent enhanced dual-phase DE-CT scans, including an arterial phase and VP. The iodine concentration (IC), normalized iodine concentration (NIC), and slope of the curve (K) in lesions were measured during two scanning phases in two different pathological types of lung cancers. The differences in parameters (IC, NIC, and K) between these two types of lung cancers were statistically analyzed. In addition, the receiver operating characteristic curves of these parameters were performed to discriminate squamous cell carcinoma from adenocarcinoma. RESULTS The mean IC, NIC, and K in adenocarcinomas were all higher than those in squamous cell carcinomas during the two scanning phases. However, the differences in these parameters between the two types of cancers were significant only during the VP, not during the arterial phase. Receiver operating characteristic analysis demonstrated that the optimal thresholds of the IC, NIC, and K for discriminating squamous cell carcinoma from adenocarcinoma were 1.550, 0.227, and 1.608, respectively. In addition, the sensitivity, specificity, and area under the curve were 81.2%, 83.3%, and 0.871 for the IC; 56.2%, 93.3%, and 0.800 for the NIC; and 65.6%, 80%, and 0.720 for the K; 81.3%, 83.3%, and 0.874 for the IC + NIC; 68.8%, 93.3%, and 0.891 for the IC + NIC + K, respectively. The "IC + NIC + K" had the highest diagnostic efficiency for discriminating two types of lung cancers, but with low sensitivity. Whereas, "IC"and "IC + NIC" had the similar lower diagnostic efficiency, but with high sensitivity and specificity. CONCLUSION The iodine quantification parameters derived from enhanced DE-CT during the VP may be useful for distinguishing lung squamous cell carcinoma from adenocarcinoma.
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Spagnuolo A, Palazzolo G, Sementa C, Gridelli C. Vascular endothelial growth factor receptor tyrosine kinase inhibitors for the treatment of advanced non-small cell lung cancer. Expert Opin Pharmacother 2020; 21:491-506. [DOI: 10.1080/14656566.2020.1713092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- A Spagnuolo
- Division of Medical Oncology, ‘S. G. Moscati’ Hospital, Avellino, Italy
| | - G Palazzolo
- Division of Medical Oncology, “ULSS 15 Cittadella”, Cittadella, Padova, Italy
| | - C Sementa
- Division of Legal Medicine, ‘S. G. Moscati’ Hospital, Avellino, Italy
| | - C Gridelli
- Division of Medical Oncology, ‘S. G. Moscati’ Hospital, Avellino, Italy
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Lv WW, Zhang JJ, Zhou XL, Song Z, Wei CM. Safety of combining vascular endothelial growth factor receptor tyrosine-kinase inhibitors with chemotherapy in patients with advanced non-small-cell lung cancer: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2019; 98:e15806. [PMID: 31169681 PMCID: PMC6571213 DOI: 10.1097/md.0000000000015806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) have been developed for targeted therapies in non-small-cell lung cancer (NSCLC); moreover, some drug-related toxic reactions among cancer patients have been reported. A meta-analysis of randomized controlled trials (RCTs) to definite the incidence and the risk of grade ≥3 adverse events (AEs), serious and fatal AEs (SAEs and FAEs), with VEGFR-TKIs in advanced/metastatic NSCLC patients was performed. METHODS A comprehensive literature search was conducted for the clinical trials published up to December 2017. Qualified studies allotted patients with advanced/metastatic NSCLC to receive either chemotherapy alone or in combination with VEGFR-TKIs. Data were extracted by 2 authors. RESULTS Eighteen RCTs of VEGFR-TKIs plus chemotherapy, involving 8461 advanced NSCLC patients were included. The proportion of patients with grade ≥3 AEs was increased with the addition of VEGFR-TKIs (relative risk, 1.35; 95% confidence interval [CI] 1.19-1.52; incidence, 68.1% vs 50.1%; P < .001). The most common grade ≥3 AEs was neutropenia (24.9% vs 15.4%, P < .001). Addition of VEGFR-TKIs was also related to the increased risk of SAEs (relative risk, 1.34; 95% CI 1.14-1.56; incidence, 37.8% vs 27.9%; P < .001) and FAEs (relative risk, 2.16, 95% CI 1.47-3.19; incidence, 3.4% vs 1.8%). Subgroup analysis suggested there was no difference in the rates of SAEs and FAEs in the second-line settings. No evidence of bias was found between the literatures. The study was registered with PROSPERO (CRD42018099654). CONCLUSIONS In comparison with chemotherapy alone, the addition of VEGFR-TKIs in advanced NSCLC patients was related to the increased risk of grades ≥3 AEs, SAEs, and FAEs, especially in the first-line settings. Physicians should be aware of some specific grade ≥3 adverse effect, especially haematologic adverse events, and it is also necessary to monitor cancer patients receiving VEGFR-TKIs.
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Liu L, Zhang Y, Wei J, Chen Z, Yu J. VEGFR-TKIs combined with chemotherapy for advanced non-small cell lung cancer: A systematic review. J Cancer 2019; 10:799-809. [PMID: 30854085 PMCID: PMC6400799 DOI: 10.7150/jca.29643] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 01/09/2019] [Indexed: 12/18/2022] Open
Abstract
Introduction: To estimate the efficacy and safety of vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) in combination with chemotherapy for patients with advanced non-small cell lung cancer (NSCLC). Methods: We searched PubMed, PMC database, EMBASE, EBSCO-Medline, Cochrane Central Register of Controlled Trials (CENTRAL), American Society of Clinical Oncology (ASCO), International Association for the Study of Lung Cancer (IASLC) and the European Society of Medical Oncology (ESMO), http://www.clinicaltrials.gov/, CNKI, and Wanfang databases to identify primary research reporting the survival outcomes and safety of VEGFR-TKIs in patients with advanced NSCLC. A meta-analysis was conducted to generate combined hazard ratios (HRs) with 95% confidence intervals (CI) for overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and risk ratios (RRs) with 95% CI for adverse events (AEs). Results: A total of 20 RCTs (8,366 participants) were included. The VEGFR-TKIs resulted in improved PFS (HR 0.82, 95% CI 0.78-0.87), ORR (HR 1.72, 95% CI 1.34-2.22), and DCR (1.45, 1.26-1.67) in patients with advanced NSCLC, but had no impact on OS (HR 0.94, 95% CI 0.89-1.00). The incidence of some high grade (≥ 3) AEs increased, such as hemorrhage, hypertension and neutropenia. Conclusions: Our study demonstrated that regimens with VEGFR-TKIs combined with chemotherapy improved PFS, ORR and DCR in patients with advanced NSCLC, but had no impact on OS. VEGFR-TKIs induced more frequent and serious AEs compared with control therapies.
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Affiliation(s)
- Lian Liu
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xi Cheng District, Beijing, 100050, China
| | - Yue Zhang
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xi Cheng District, Beijing, 100050, China
| | - Jia Wei
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xi Cheng District, Beijing, 100050, China
| | - Zhaoxin Chen
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xi Cheng District, Beijing, 100050, China
| | - Jing Yu
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xi Cheng District, Beijing, 100050, China
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13
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Li J, Gu J. Cardiovascular Toxicities with Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitors in Cancer Patients: A Meta-Analysis of 77 Randomized Controlled Trials. Clin Drug Investig 2018; 38:1109-1123. [DOI: 10.1007/s40261-018-0709-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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14
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Spigel DR, Burris HA, Greco FA, Shih KC, Gian VG, Lipman AJ, Daniel DB, Waterhouse DM, Finney L, Heymach JV, Hainsworth JD. Erlotinib plus either pazopanib or placebo in patients with previously treated advanced non-small cell lung cancer: A randomized, placebo-controlled phase 2 trial with correlated serum proteomic signatures. Cancer 2018; 124:2355-2364. [PMID: 29645086 DOI: 10.1002/cncr.31290] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/06/2017] [Accepted: 11/14/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND This study compared the efficacy and safety of treatment with erlotinib plus pazopanib versus erlotinib plus placebo in patients with previously treated advanced non-small cell lung cancer (NSCLC). METHODS Patients with progressive-stage IV NSCLC after either 1 or 2 previous chemotherapy regimens were randomized to receive erlotinib (150 mg by mouth daily) with either pazopanib (600 mg by mouth daily) or placebo. During treatment, patients were evaluated every 8 weeks until disease progression or unacceptable toxicity. After a study amendment, pretreatment serum specimens for the VeriStrat assay were collected. The predictive value of the VeriStrat score (good vs poor) for progression-free survival (PFS) and overall survival (OS) was assessed in the overall population and in each treatment group. RESULTS One hundred ninety-two eligible patients were randomized between February 2010 and February 2011. PFS was prolonged with erlotinib plus pazopanib versus erlotinib plus placebo (median, 2.6 vs 1.8 months; hazard ratio, 0.58; P = .001). There was no difference in the OS of the 2 groups. A good VeriStrat score predicted longer PFS and OS in the entire group and predicted longer PFS in the subgroup receiving erlotinib plus pazopanib. The addition of pazopanib increased toxicity, and this was consistent with the known toxicity profile. CONCLUSIONS The addition of pazopanib to erlotinib in an unselected group of patients with previously treated NSCLC improved PFS and increased treatment-related toxicity, but it had no influence on OS. The efficacy of both regimens was modest. Patients receiving erlotinib plus pazopanib had longer PFS if they had a good VeriStrat score versus a poor one. Cancer 2018;124:2355-64. © 2018 American Cancer Society.
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Affiliation(s)
- David R Spigel
- Sarah Cannon Research Institute, Nashville, Tennessee.,Tennessee Oncology, Nashville, Tennessee
| | - Howard A Burris
- Sarah Cannon Research Institute, Nashville, Tennessee.,Tennessee Oncology, Nashville, Tennessee
| | - F Anthony Greco
- Sarah Cannon Research Institute, Nashville, Tennessee.,Tennessee Oncology, Nashville, Tennessee
| | - Kent C Shih
- Sarah Cannon Research Institute, Nashville, Tennessee.,Tennessee Oncology, Nashville, Tennessee
| | - Victor G Gian
- Sarah Cannon Research Institute, Nashville, Tennessee.,Tennessee Oncology, Nashville, Tennessee
| | - Andrew J Lipman
- Sarah Cannon Research Institute, Nashville, Tennessee.,Florida Cancer Specialists, Naples, Florida
| | - Davey B Daniel
- Sarah Cannon Research Institute, Nashville, Tennessee.,Tennessee Oncology, Chattanooga, Tennessee
| | | | | | - John V Heymach
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - John D Hainsworth
- Sarah Cannon Research Institute, Nashville, Tennessee.,Tennessee Oncology, Nashville, Tennessee
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15
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Qu J, Zhang Y, Chen X, Yang H, Zhou C, Yang N. Newly developed anti-angiogenic therapy in non-small cell lung cancer. Oncotarget 2017. [PMID: 29515799 PMCID: PMC5839380 DOI: 10.18632/oncotarget.23755] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Angiogenesis and its role in the growth and development of non-small cell lung cancer (NSCLC) metastases has become an increasing clinical problem. Vascular endothelial growth factor (VEGF) plays a key role in advanced NSCLC. To some extent, anti-angiogenic therapies acquired some efficacy in combination with chemotherapy, target therapy and immunotherapy. However, the reliable clinical benefit obtained with these drugs is still questionable and often quantitatively limited. In this review, the authors highlight the data obtained from first-line, second-line, epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI) target therapy and immunotherapy in NSCLC patients who are treated with anti-angiogenic molecules in advanced NSCLC. The purpose of this study is to help us truly understand how to best use angiogenesis therapy in advanced NSCLC.
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Affiliation(s)
- Jingjing Qu
- Department of Lung Cancer and Gastrointestinal Oncology Medicine, Hunan Cancer Hospital, Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, 410013, China
| | - Yongchang Zhang
- Department of Lung Cancer and Gastrointestinal Oncology Medicine, Hunan Cancer Hospital, Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, 410013, China
| | - Xue Chen
- Department of Lung Cancer and Gastrointestinal Oncology Medicine, Hunan Cancer Hospital, Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, 410013, China
| | - Haiyan Yang
- Department of Lung Cancer and Gastrointestinal Oncology Medicine, Hunan Cancer Hospital, Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, 410013, China
| | - Chunhua Zhou
- Department of Lung Cancer and Gastrointestinal Oncology Medicine, Hunan Cancer Hospital, Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, 410013, China
| | - Nong Yang
- Department of Lung Cancer and Gastrointestinal Oncology Medicine, Hunan Cancer Hospital, Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, 410013, China
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16
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Kanaan R, Strange C. Use of multitarget tyrosine kinase inhibitors to attenuate platelet-derived growth factor signalling in lung disease. Eur Respir Rev 2017; 26:26/146/170061. [PMID: 29070579 PMCID: PMC9488848 DOI: 10.1183/16000617.0061-2017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/05/2017] [Indexed: 02/07/2023] Open
Abstract
Platelet-derived growth factors (PDGFs) and their receptors (PDGFRs) play a fundamental role in the embryonic development of the lung. Aberrant PDGF signalling has been documented convincingly in a large variety of pulmonary diseases, including idiopathic pulmonary arterial hypertension, lung cancer and lung fibrosis. Targeting PDGF signalling has been proven to be effective in these diseases. In clinical practice, the most effective way to block PDGF signalling is to inhibit the activity of the intracellular PDGFR kinases. Although the mechanism of action of such drugs is not specific for PDGF signalling, the medications have a broad therapeutic index that allows clinical use. The safety profile and therapeutic opportunities of these and future medications that target PDGFs and PDGFRs are reviewed. An increasing role for PDGF signalling inhibitors in clinical trials for the treatment of various pulmonary diseaseshttp://ow.ly/buaI30f9HcN
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Affiliation(s)
- Rana Kanaan
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Dept of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Charlie Strange
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Dept of Medicine, Medical University of South Carolina, Charleston, SC, USA
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17
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Assoun S, Brosseau S, Steinmetz C, Gounant V, Zalcman G. Bevacizumab in advanced lung cancer: state of the art. Future Oncol 2017; 13:2515-2535. [PMID: 28812378 DOI: 10.2217/fon-2017-0302] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Despite recent advances in metastatic lung cancer treatment with the advent of immune checkpoint inhibitors and molecules targeting addictive genomic abnormalities, prognosis of most of the patients remains unfavorable. Combination approaches with older drugs, such as bevacizumab, should be thus envisioned. Bevacizumab is a monoclonal anti-VEGF antibody, approved by the US FDA and the EMA in first-line and maintenance settings of advanced nonsquamous non-small-cell lung cancer (NSCLC) treatment, in association with platinum-based chemotherapy. In the years to come, bevacizumab might be associated with new molecular therapies or immuno-oncology drugs, in order to optimize response rates and overcome resistances. This review summarizes the pharmacologic properties, clinical efficacy and safety of bevacizumab in advanced lung cancer treatment, with a focus on NSCLC, EGFR-mutant NSCLC and small-cell lung cancer.
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Affiliation(s)
- Sandra Assoun
- Department of Thoracic Oncology & CIC 1425/CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - Solenn Brosseau
- Department of Thoracic Oncology & CIC 1425/CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France.,University Paris-Diderot, Paris, France
| | - Christelle Steinmetz
- Pharmacy Department, Bichat-Claude Bernard Hospital, APHP, 46, rue Henri Huchard, 75877 Paris Cedex 18, Paris, France
| | - Valérie Gounant
- Department of Thoracic Oncology & CIC 1425/CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - Gérard Zalcman
- Department of Thoracic Oncology & CIC 1425/CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France.,University Paris-Diderot, Paris, France
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18
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Strategies targeting angiogenesis in advanced non-small cell lung cancer. Oncotarget 2017; 8:53854-53872. [PMID: 28881856 PMCID: PMC5581155 DOI: 10.18632/oncotarget.17957] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 04/27/2017] [Indexed: 12/26/2022] Open
Abstract
Tumor angiogenesis is a frequent event in the development and progression of non-small cell lung cancer (NSCLC) and has been identified as a promising therapeutic target. The vascular endothelial growth factor (VEGF) family and other angiogenic factors, including fibroblast growth factor and platelet-derived growth factor, promote the growth of newly formed vessels from preexisting vessels and change the tumor microenvironment. To date, two antiangiogenic monoclonal antibodies, bevacizumab and ramucirumab, which target VEGF-A and its receptor VEGF receptor-2, respectively, have been approved for the treatment of locally advanced or metastatic NSCLC when added to first-line standard chemotherapy. Numerous oral multitargeting angiogenic small molecule tyrosine kinase inhibitors (TKIs) have been widely evaluated in advanced NSCLC, but only nintedanib in combination with platinum-based doublet chemotherapy has demonstrated a survival benefit in the second-line setting. Additionally, small-molecule TKIs remain the standard of care for patients with mutated EGFR, ALK or ROS1. Moreover, immune checkpoint inhibitors that target the programmed cell death protein 1 (PD-1) and programmed cell death protein ligand 1 (PD-L1) are changing the current strategy in the treatment of advanced NSCLC without driver gene mutations. The potential synergistic activity of antiangiogenic agents and TKIs or immunotherapy is an interesting topic of research. This review will summarize the novel antiangiogenic agents, antiangiogenic monotherapy, as well as potential combination therapeutic strategies for the clinical management of advanced NSCLC.
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19
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Arrieta O, Zatarain-Barrón ZL, Cardona AF, Carmona A, Lopez-Mejia M. Ramucirumab in the treatment of non-small cell lung cancer. Expert Opin Drug Saf 2017; 16:637-644. [PMID: 28395526 DOI: 10.1080/14740338.2017.1313226] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 03/27/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Therapeutic options for treating Non-Small Cell Lung Cancer (NSCLC) have recently increased. Ramucirumab (Cyramza), an anti-angionenic agent was approved in 2014 for treatment of several malignancies, including second-line treatment of patients with NSCLC with disease progression on or after platinum-based chemotherapy. Areas covered: We performed a comprehensive search of the literature focused on clinical trials with use of ramucirumab, targeting its evolution in the treatment of NSCLC. This review summarizes the results regarding its safety and efficacy. Expert opinion: Angiogenesis has been widely recognized as a quintessential feature in cancer, intrinsically mediating tumor survival and progression. Ramucirumab, an anti-VEGFR2 agent, combined with docetaxel, was FDA-approved for NSCLC patients. Results from a phase III trial have demonstrated the usefulness of this combination, with benefits in progression free survival and overall survival for NSCLC patients. A greater magnitude of benefit is seen in patients with aggressive tumor behavior. Treatment with ramucirumab is generally tolerable, however, there is potential for severe toxicity. Adverse events reported with this combination include neutropenia, febrile neutropenia and hypertension. Also, there is the intrinsic risk of bleeding resulting from the mechanism of action. As such, adverse events should be identified timely, so drug-related complications can be prevented.
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MESH Headings
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/pharmacology
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Carcinoma, Non-Small-Cell Lung/blood supply
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/pathology
- Disease Progression
- Disease-Free Survival
- Humans
- Lung Neoplasms/blood supply
- Lung Neoplasms/drug therapy
- Lung Neoplasms/pathology
- Neovascularization, Pathologic/drug therapy
- Neovascularization, Pathologic/pathology
- Survival Rate
- Ramucirumab
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Affiliation(s)
- Oscar Arrieta
- a Thoracic Oncology Unit , Instituto Nacional de Cancerologia
| | | | - Andrés F Cardona
- b Clinical and Traslational Oncology Group , Clínica del Country , Bogotá , Colombia
- c Foundation for Clinical and Applied Cancer Research - FICMAC , Bogotá , Colombia
| | - Amir Carmona
- a Thoracic Oncology Unit , Instituto Nacional de Cancerologia
- d Comprehensive Cancer Center , Médica Sur Clinic and Foundation , Mexico
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20
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Huang X, Sun Y, Trow P, Chatterjee S, Chakravartty A, Tian L, Devanarayan V. Patient subgroup identification for clinical drug development. Stat Med 2017; 36:1414-1428. [PMID: 28147447 DOI: 10.1002/sim.7236] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 11/22/2016] [Accepted: 01/05/2017] [Indexed: 12/26/2022]
Abstract
Causal mechanism of relationship between the clinical outcome (efficacy or safety endpoints) and putative biomarkers, clinical baseline, and related predictors is usually unknown and must be deduced empirically from experimental data. Such relationships enable the development of tailored therapeutics and implementation of a precision medicine strategy in clinical trials to help stratify patients in terms of disease progression, clinical response, treatment differentiation, and so on. These relationships often require complex modeling to develop the prognostic and predictive signatures. For the purpose of easier interpretation and implementation in clinical practice, defining a multivariate biomarker signature in terms of thresholds (cutoffs/cut points) on individual biomarkers is preferable. In this paper, we propose some methods for developing such signatures in the context of continuous, binary and time-to-event endpoints. Results from simulations and case study illustration are also provided. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Xin Huang
- AbbVie, Inc., North Chicago, IL, U.S.A
| | - Yan Sun
- AbbVie, Inc., North Chicago, IL, U.S.A
| | - Paul Trow
- AbbVie, Inc., North Chicago, IL, U.S.A
| | | | | | - Lu Tian
- Stanford University School of Medicine, Palo Alto, CA, U.S.A
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21
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Targeting Neovasculature with Multitargeted Antiangiogenesis Tyrosine Kinase Inhibitors in Non-small Cell Lung Cancer. BioDrugs 2017; 30:421-439. [PMID: 27670779 DOI: 10.1007/s40259-016-0194-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Chemotherapy has reached a plateau in the efforts for survival improvement in non-small cell lung cancer (NSCLC). The growing knowledge of NSCLC molecular pathobiology has led to the development of new treatments that target specific tumor functions. Angiogenesis is a tumor function leading to the formation of new tumor vessels that are crucial for its survival. Although vascular endothelial growth factor (VEGF) plays a primary role in angiogenesis, the inhibition of the VEGF pathway with VEGF-receptor (VEGFR) tyrosine kinase inhibitors (TKIs) is associated with a modest survival benefit due to the development of resistance by the tumor that has been mainly attributed to the up-regulation of other stimulators of angiogenesis. Thus, the use of multitargeted antiangiogenesis TKIs (MATKIs) for simultaneous inhibition of multiple angiogenic pathways has been proposed. This review summarizes data about novel treatment strategies incorporating the inhibition of angiogenesis with MATKIs in NSCLC. The data from all relevant studies shows that MATKIs do not offer additional survival benefit to currently available chemotherapeutic options in unselected NSCLC patients. However, the diversity in disease response to MATKI-containing regimens implies that specific patient subgroups may benefit from or be harmed by these agents. In this context, most studies agree that the VEGFR-targeting MATKIs are harmful in squamous NSCLC while specific MATKIs (i.e., motesanib, vandetanib and nintedanib) are associated with improved progression free survival in non-squamous NSCLC. However, overall survival benefit was found only in adenocarcinoma and Asian non-squamous NSCLC patients with the use of nintedanib and motesanib, respectively.
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22
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Buttigliero C, Bertaglia V, Novello S. Anti-angiogenetic therapies for central nervous system metastases from non-small cell lung cancer. Transl Lung Cancer Res 2016; 5:610-627. [PMID: 28149756 DOI: 10.21037/tlcr.2016.09.03] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Central nervous system (CNS) metastases are common in patients with advanced non-small cell lung cancer (NSCLC), occurring in 24% to 44% of patients in the course of their disease and confer significant morbidity and mortality. Systemic therapies have been deemed ineffective in brain metastases (BM) under the hypothesis that the blood-brain barrier (BBB) limits their delivery to the brain. Angiogenesis, which is mainly mediated by vascular endothelial growth factor (VEGF) pathway, is crucial for tumor survival, growth and invasion both in primary and metastatic brain lesions. Two major categories of agents have been developed to target this pathway: antibody-based agents and VEGF receptor tyrosine kinase inhibitors (TKIs). Clinical benefits have been shown with anti-angiogenetic therapies in the treatment of metastatic NSCLC. However, patients with CNS metastases were often excluded from trials with these agents, due to concerns about a potentially greater risk of cerebral haemorrhage and thromboembolic disease. Therefore, the overall efficacy and safety of angiogenetic agents in patients with BM from NSCLC are yet to be clarified. This paper aims to review available data about the efficacy and safety of anti-angiogenetic therapies for CNS metastases in NSCLC patients.
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Affiliation(s)
- Consuelo Buttigliero
- Department of Oncology, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Valentina Bertaglia
- Department of Oncology, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Silvia Novello
- Department of Oncology, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
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23
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Genova C, Rijavec E, Biello F, Rossi G, Barletta G, Dal Bello MG, Vanni I, Coco S, Alama A, Grossi F. New systemic strategies for overcoming resistance to targeted therapies in non-small cell lung cancer. Expert Opin Pharmacother 2016; 18:19-33. [DOI: 10.1080/14656566.2016.1261109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Carlo Genova
- Lung Cancer Unit, San Martino Hospital – National Institute for Cancer Research, Genova, Italy
| | - Erika Rijavec
- Lung Cancer Unit, San Martino Hospital – National Institute for Cancer Research, Genova, Italy
| | - Federica Biello
- Lung Cancer Unit, San Martino Hospital – National Institute for Cancer Research, Genova, Italy
| | - Giovanni Rossi
- Lung Cancer Unit, San Martino Hospital – National Institute for Cancer Research, Genova, Italy
| | - Giulia Barletta
- Lung Cancer Unit, San Martino Hospital – National Institute for Cancer Research, Genova, Italy
| | | | - Irene Vanni
- Lung Cancer Unit, San Martino Hospital – National Institute for Cancer Research, Genova, Italy
| | - Simona Coco
- Lung Cancer Unit, San Martino Hospital – National Institute for Cancer Research, Genova, Italy
| | - Angela Alama
- Lung Cancer Unit, San Martino Hospital – National Institute for Cancer Research, Genova, Italy
| | - Francesco Grossi
- Lung Cancer Unit, San Martino Hospital – National Institute for Cancer Research, Genova, Italy
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24
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Li BT, Barnes TA, Chan DL, Naidoo J, Lee A, Khasraw M, Marx GM, Kris MG, Clarke SJ, Drilon A, Rudin CM, Pavlakis N. The addition of anti-angiogenic tyrosine kinase inhibitors to chemotherapy for patients with advanced non-small-cell lung cancers: A meta-analysis of randomized trials. Lung Cancer 2016; 102:21-27. [PMID: 27987583 DOI: 10.1016/j.lungcan.2016.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/16/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The role of anti-angiogenic tyrosine kinase inhibitors (AATKI) for patients with non-small-cell lung cancers (NSCLC) is uncertain. We conducted a comprehensive meta-analysis to assess the overall utility of adding AATKI to chemotherapy. MATERIALS AND METHODS We included 15 randomized controlled trials (RCTs) of AATKI plus chemotherapy versus chemotherapy involving 7997 patients with advanced NSCLC. Meta-analysis was performed to obtain pooled hazard ratios (HR) for OS and PFS, and pooled odds ratios (OR) for objective response rate (ORR) and grade 3 or greater toxicity. Pre-specified subgroup analyses were performed according to line of chemotherapy, chemotherapeutic regimen and histology. RESULTS The addition of AATKI to chemotherapy significantly increased progression-free survival (PFS) (HR 0.83, 95% CI 0.79, 0.87; P<0.00001) and ORR [OR 1.63, 95% CI 1.45, 1.84; P<0.00001], but not overall survival (OS) (HR 0.96, 95% CI 0.91, 1.01; P=0.14). OS benefit was seen in the subset of patients with adenocarcinomas (HR 0.86; 95% CI 0.79, 0.95; P=0.002), especially in the second line setting (HR 0.85; 95% CI 0.76, 0.96; P=0.008). However, both grade ≥3 toxicity (HR 2.08, 95% CI 1.59, 2.73; P<0.00001) and treatment-related deaths (OR 2.37, 95% CI 1.58, 3.56; P<0.0001) were significantly higher with the addition of AATKI. CONCLUSION The addition of AATKI to chemotherapy in patients with advanced NSCLC significantly increased PFS and ORR but not OS, and did so at the expense of increased toxicity and treatment-related deaths. Preclinical and translational research in predictive biomarkers are essential for the clinical development of this class of drugs.
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Affiliation(s)
- Bob T Li
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, 300 East 66th Street, New York, NY 10065, USA; Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia
| | - Tristan A Barnes
- Department of Medical Oncology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - David L Chan
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; Department of Medical Oncology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Jarushka Naidoo
- Department of Medical Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, 301 Building Suite 4500, Baltimore, MD 21224, USA
| | - Adrian Lee
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; Department of Medical Oncology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Mustafa Khasraw
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; Department of Medical Oncology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Gavin M Marx
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; SAN Integrated Cancer Centre, Sydney Adventist Hospital, 185 Fox Valley Rd, Wahroonga, NSW 2076, Australia
| | - Mark G Kris
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, 300 East 66th Street, New York, NY 10065, USA
| | - Stephen J Clarke
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; Department of Medical Oncology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Alexander Drilon
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, 300 East 66th Street, New York, NY 10065, USA
| | - Charles M Rudin
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, 300 East 66th Street, New York, NY 10065, USA
| | - Nick Pavlakis
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; Department of Medical Oncology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
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25
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Manegold C, Dingemans AMC, Gray JE, Nakagawa K, Nicolson M, Peters S, Reck M, Wu YL, Brustugun OT, Crinò L, Felip E, Fennell D, Garrido P, Huber RM, Marabelle A, Moniuszko M, Mornex F, Novello S, Papotti M, Pérol M, Smit EF, Syrigos K, van Meerbeeck JP, van Zandwijk N, Yang JCH, Zhou C, Vokes E. The Potential of Combined Immunotherapy and Antiangiogenesis for the Synergistic Treatment of Advanced NSCLC. J Thorac Oncol 2016; 12:194-207. [PMID: 27729297 DOI: 10.1016/j.jtho.2016.10.003] [Citation(s) in RCA: 167] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/30/2016] [Accepted: 10/02/2016] [Indexed: 01/05/2023]
Abstract
Over the past few years, there have been considerable advances in the treatments available to patients with metastatic or locally advanced NSCLC, particularly those who have progressed during first-line treatment. Some of the treatment options available to patients are discussed here, with a focus on checkpoint inhibitor immunotherapies (nivolumab and pembrolizumab) and antiangiogenic agents (bevacizumab, ramucirumab, and nintedanib). It is hypothesized that combining immunotherapy with antiangiogenic treatment may have a synergistic effect and enhance the efficacy of both treatments. In this review, we explore the theory and potential of this novel treatment option for patients with advanced NSCLC. We discuss the growing body of evidence that proangiogenic factors can modulate the immune response (both by reducing T-cell infiltration into the tumor microenvironment and through systemic effects on immune-regulatory cell function), and we examine the preclinical evidence for combining these treatments. Potential challenges are also considered, and we review the preliminary evidence of clinical efficacy and safety with this novel combination in a variety of solid tumor types.
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Affiliation(s)
- Christian Manegold
- Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
| | - Anne-Marie C Dingemans
- Department of Pulmonary Diseases, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jhanelle E Gray
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Marianne Nicolson
- Oncology Department, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - Solange Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Martin Reck
- Department of Thoracic Oncology, Lung Clinic Grosshansdorf, Airway Research Center North, Grosshansdorf, Germany
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Odd Terje Brustugun
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
| | - Lucio Crinò
- Medical Oncology Department, Perugia University Medical School, Perugia, Italy
| | - Enriqueta Felip
- Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Dean Fennell
- Department of Oncology, University of Leicester and Leicester University Hospitals, Leicester, United Kingdom
| | - Pilar Garrido
- Servicio de Oncología Médica, IRYCIS Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Rudolf M Huber
- Ludwig-Maximilians-Universität München, University Hospital, Division of Respiratory Medicine and Thoracic Oncology, Münich, Germany
| | - Aurélien Marabelle
- Gustave Roussy, Université Paris-Saclay, Département d'Innovation Thérapeutique et d'Essais Précoces, INSERM U1015, Villejuif, France
| | - Marcin Moniuszko
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystok, Poland
| | - Françoise Mornex
- Department of Radiation Oncology, Centre Hospitalier Lyon Sud, Université Claude Bernard, Lyon, France
| | - Silvia Novello
- Department of Oncology, University of Turin, Turin, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Maurice Pérol
- Département de Cancérologie, Médicale Centre Léon Bérard, Lyon, France
| | - Egbert F Smit
- Department of Pulmonary Diseases and Department of Thoracic Oncology, VU University Medical Centre, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Kostas Syrigos
- Oncology Unit GPP, Sotiria General Hospital, Athens University School of Medicine, Athens, Greece
| | - Jan P van Meerbeeck
- Thoracic Oncology, Antwerp University Hospital and Ghent University, Edegem, Belgium
| | - Nico van Zandwijk
- Asbestos Diseases Research Institute, University of Sydney, New South Wales, Australia
| | - James Chih-Hsin Yang
- Department of Oncology, National Taiwan University Hospital and National Taiwan University Cancer Center, Taipei, Taiwan
| | - Caicun Zhou
- Department of Oncology, Shanghai Pulmonary Hospital, Shanghai, People's Republic of China
| | - Everett Vokes
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
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de Marinis F, Bria E, Ciardiello F, Crinò L, Douillard JY, Griesinger F, Lambrechts D, Perol M, Ramalingam SS, Smit EF, Gridelli C. International Experts Panel Meeting of the Italian Association of Thoracic Oncology on Antiangiogenetic Drugs for Non-Small Cell Lung Cancer: Realities and Hopes. J Thorac Oncol 2016; 11:1153-69. [PMID: 27063293 DOI: 10.1016/j.jtho.2016.03.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/07/2016] [Accepted: 03/26/2016] [Indexed: 12/21/2022]
Abstract
Angiogenesis, one of the hallmarks of cancer, occurs when new blood vessels feed malignant cells, providing oxygen and nutrients, promoting tumor growth, and allowing tumor cells to escape into the circulation, thus leading to metastases. To date, a series of antiangiogenic drugs (either monoclonal antibodies or small molecules) have been approved by regulatory agencies for the treatment of advanced non-small cell lung cancer, and they are currently available for both first- and second-line therapy. The overall benefit of these drugs seems modest (although clearly significant), especially when administered as a single agent, and there is no clear consensus with regard to which patients should be candidates to receive these drugs across the different disease settings. From the biological perspective, angiogenesis represents a difficult and complex process to explore, given the interference with other key pathways and the dynamic evolution during the disease's history. Indeed, this process is complicated by the presence of multiple targets to hit, polymorphisms, hypoxia-dependent modifications, and epigenetics. These difficulties do not allow capture of which specific key pathways can be identified as biomarkers of efficacy so as to maximize to overall benefit of such drugs. An International Experts Panel Meeting was inspired by the absence of clear recommendations to address which patients should receive antiangiogenic drugs in the context of advanced non-small cell lung cancer so as to support decisions for clinical practice on a daily basis and determine priorities for future research. After a literature review and panelists consensus, a series of recommendations were defined to support decisions for the daily clinical practice and to indicate a potential road map for translational research.
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Affiliation(s)
- Filippo de Marinis
- Thoracic Oncology Division, European Institute of Oncology, Milan, Italy
| | - Emilio Bria
- Medical Oncology, Department of Medicine, University Hospital of Verona, Verona, Italy
| | - Fortunato Ciardiello
- Medical Oncology, Department of Clinical and Experimental Medicine 'F. Magrassi e A. Lanzara, Second University of Naples, Naples, Italy
| | - Lucio Crinò
- Medical Oncology Division, S. Maria della Misericordia Hospital, Perugia, Italy
| | | | - Frank Griesinger
- Department of Hematology and Oncology, University Division, Internal Medicine-Oncology, Pius-Hospital Oldenburg, University of Oldenburg, Germany
| | - Diether Lambrechts
- VIB Vesalius Research Center, Department of Oncology, University of Leuven, Belgium
| | - Maurice Perol
- Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
| | | | - Egbert F Smit
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Cesare Gridelli
- Medical Oncology, A.O. 'S.G. Moscati' Hospital, Avellino, Italy.
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27
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Cheng H, Nair SK, Murray BW. Recent progress on third generation covalent EGFR inhibitors. Bioorg Med Chem Lett 2016; 26:1861-8. [DOI: 10.1016/j.bmcl.2016.02.067] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 02/18/2016] [Accepted: 02/22/2016] [Indexed: 11/24/2022]
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Tampellini M, Sonetto C, Scagliotti GV. Novel anti-angiogenic therapeutic strategies in colorectal cancer. Expert Opin Investig Drugs 2016; 25:507-20. [PMID: 26938715 DOI: 10.1517/13543784.2016.1161754] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Anti-angiogenetic agents are currently the standard of care in metastatic CRC patients. Bevacizumab, aflibercept, regorafenib and recently ramucirumab have significantly improved both progression-free and overall survival in different lines of treatment. Since bevacizumab's approval, a number of novel anti-VEGF agents have been tested in preclinical and clinical models. AREAS COVERED This review is focused on the most recent clinical results of novel agents targeting VEGF and its receptors with a major focus on those investigated recently in clinical trials. EXPERT OPINION In the last 15 years, a number of new anti-angiogenetic agents have been tested. Unfortunately, most of them have demonstrated unacceptable toxicities or failed to show activity. When tested as single agents, encouraging preliminary results were reported with fruquintinib, famitinib, and nintedanib. Interesting novel mechanisms of action are also being explored: VGX-100 is a monoclonal antibody (mAb) which binds to VEGF-C, inhibiting activation of VEGFR-2 and VEGFR-3 when combined with bevacizumab; tanibirumab is a mAb which binds to VEGFR-2 and vanucizumab is a bispecific mAb binding both to VEGF-A and Angiopoietin-2. Data about the combination of these agents with chemotherapy are very encouraging, even though preliminary. However, the definition of specific predictive biomarkers remains a priority.
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Affiliation(s)
- M Tampellini
- a University of Turin , Department of Oncology, AOU San Luigi di Orbassano , Torino , Italy
| | - C Sonetto
- a University of Turin , Department of Oncology, AOU San Luigi di Orbassano , Torino , Italy
| | - G V Scagliotti
- a University of Turin , Department of Oncology, AOU San Luigi di Orbassano , Torino , Italy
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Horinouchi H. Anti-vascular endothelial growth factor therapies at the crossroads: linifanib for non-small cell lung cancer. Transl Lung Cancer Res 2016; 5:78-81. [PMID: 26958495 DOI: 10.3978/j.issn.2218-6751.2015.06.08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Activated vascular endothelial growth factor receptors (VEGFR) 1, 2 and 3, and platelet-derived growth factor receptor (PDGFR) work together to guide the microvasculature into tumor lesions, and have been shown to be involved in tumor growth, invasion and metastasis. In non-small cell lung cancer (NSCLC), tumor angiogenesis mediated by vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) is known to be associated with a poor disease free survival and poor overall survival. A randomized phase II trial was carried out to compare the efficacy/safety of three doses of linifanib with that of CBDCD + paclitaxel (PTX), as the largest and first placebo-controlled trial of linifanib for NSCLC. The result revealed modest, but not robust improvement of the progression-free and overall survival. A number of negative results and number of positive results without robust clinical benefit have been reported from trials of treatments targeting tumor angiogenesis, and anti-angiogenesis therapies seem to be at the crossroads between a prosperous future and a downhill path. Appropriate predictive markers to select right the drugs for the right patients need to be developed to obtain clinical benefit from anti-VEGF therapies.
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Affiliation(s)
- Hidehito Horinouchi
- 1 Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan ; 2 Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Tokyo, Japan
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30
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Hall RD, Le TM, Haggstrom DE, Gentzler RD. Angiogenesis inhibition as a therapeutic strategy in non-small cell lung cancer (NSCLC). Transl Lung Cancer Res 2015; 4:515-23. [PMID: 26629420 DOI: 10.3978/j.issn.2218-6751.2015.06.09] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In many cancers, including non-small cell lung cancer (NSCLC), tumor angiogenesis pathways have been identified as important therapeutic targets. Angiogenesis is essential in the process of primary tumor growth, proliferation and metastasis. One of the best characterized group of protein factors for angiogenesis include the members of the vascular endothelial growth factor (VEGF) family, consisting of VEGF-(A-D), and placenta growth factor (PIGF). Targeting tumor angiogenesis has been approached through two primary methods, monoclonal antibodies that block VEGF-vascular endothelial growth factor receptor (VEGFR) binding or small molecule tyrosine kinase inhibitors (TKIs) that inhibit the downstream VEGFR mediated signaling. Many TKIs inhibit multiple pro-angiogenic and pro-proliferative pathways such as the mitogen activated protein (MAP) kinase pathway. Bevacizumab and ramucirumab, monoclonal antibodies targeting VEGF and the VEGFR, respectively, have each led to improvements in overall survival (OS) for NSCLC when added to standard first and second line chemotherapy, respectively. Small incremental gains seen with both bevacizumab and ramucirumab may be further improved upon by incorporating novel agents and treatment strategies, and many additional trials are ongoing.
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Affiliation(s)
- Richard D Hall
- 1 Division of Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, VA 22908, USA ; 2 Levine Cancer Institute, Carolinas Healthcare System, Charlotte, NC, USA
| | - Tri M Le
- 1 Division of Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, VA 22908, USA ; 2 Levine Cancer Institute, Carolinas Healthcare System, Charlotte, NC, USA
| | - Daniel E Haggstrom
- 1 Division of Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, VA 22908, USA ; 2 Levine Cancer Institute, Carolinas Healthcare System, Charlotte, NC, USA
| | - Ryan D Gentzler
- 1 Division of Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, VA 22908, USA ; 2 Levine Cancer Institute, Carolinas Healthcare System, Charlotte, NC, USA
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McKeegan EM, Ansell PJ, Davis G, Chan S, Chandran RK, Gawel SH, Dowell BL, Bhathena A, Chakravartty A, McKee MD, Ricker JL, Carlson DM, Ramalingam SS, Devanarayan V. Plasma biomarker signature associated with improved survival in advanced non-small cell lung cancer patients on linifanib. Lung Cancer 2015; 90:296-301. [DOI: 10.1016/j.lungcan.2015.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 09/01/2015] [Accepted: 09/13/2015] [Indexed: 11/28/2022]
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Li SC, Ma R, Wu JZ, Xiao X, Wu W, Li G, Chen B, Sharma A, Bai S, Dun BY, She JX, Tang JH. Delineation of gastric cancer subtypes by co-regulated expression of receptor tyrosine kinases and chemosensitivity genes. Am J Transl Res 2015; 7:1429-1439. [PMID: 26396673 PMCID: PMC4568798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 06/22/2015] [Indexed: 06/05/2023]
Abstract
Chemotherapy plays a key role in improving disease-free survival and overall survival of gastric cancer (GC); however, response rates are variable and a non-negligible proportion of patients undergo toxic and costly chemotherapeutic regimens without a survival benefit. Several studies have shown the existence of GC subtypes which may predict survival and respond differently to chemotherapy. It is also known that the expression level of chemotherapy-related and target therapy-related genes correlates with response to specific antitumor drugs. Nevertheless, these genes have not been considered jointly to define GC subtypes. In this study, we evaluated seven genes known to influence chemotherapeutic response (ERCC1, BRCA1, RRM1, TUBB3, STMN1, TYMS and TOP2A) and five receptor tyrosine kinases (RTKs) (EGFR, ERBB2, PDGFRB, VEGFR1 and VEGFR2). We demonstrate significant heterogeneity of gene expression among GC patients and identified four GC subtypes using the expression profiles of eight genes in two co-regulation groups: chemosensitivity (BRCA1, STMN1, TYMS and TOP2A) and RTKs (EGFR, PDGFRB, VEGFR1 and VEGFR2). The results are of immediate translational value regarding GC diagnostics and therapeutics, as many of these genes are curently widely used in relevant clinical testing.
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Affiliation(s)
- Shu-Chun Li
- Clinical Oncology Research Center, Jiangsu Cancer Hospital Nanjing, Jiangsu Province, People's Republic of China ; Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Georgia Regents University Augusta, GA ; Sino-American Institute of Translational Medicine, Nanjing Tech University Nanjing, Jiangsu Province, People's Republic of China
| | - Rong Ma
- Clinical Oncology Research Center, Jiangsu Cancer Hospital Nanjing, Jiangsu Province, People's Republic of China
| | - Jian-Zhong Wu
- Clinical Oncology Research Center, Jiangsu Cancer Hospital Nanjing, Jiangsu Province, People's Republic of China
| | - Xia Xiao
- Sino-American Institute of Translational Medicine, Nanjing Tech University Nanjing, Jiangsu Province, People's Republic of China
| | - Wei Wu
- Zhenjiang Jintai Life Technologies Zhenjiang, Jiangsu Province, People's Republic of China
| | - Gang Li
- Clinical Oncology Research Center, Jiangsu Cancer Hospital Nanjing, Jiangsu Province, People's Republic of China
| | - Bo Chen
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Georgia Regents University Augusta, GA ; Sino-American Institute of Translational Medicine, Nanjing Tech University Nanjing, Jiangsu Province, People's Republic of China
| | - Ashok Sharma
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Georgia Regents University Augusta, GA
| | - Shan Bai
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Georgia Regents University Augusta, GA
| | - Bo-Ying Dun
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Georgia Regents University Augusta, GA
| | - Jin-Xiong She
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Georgia Regents University Augusta, GA
| | - Jin-Hai Tang
- Clinical Oncology Research Center, Jiangsu Cancer Hospital Nanjing, Jiangsu Province, People's Republic of China
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Pilotto S, Novello S, Peretti U, Kinspergher S, Ciuffreda L, Milella M, Carbognin L, Vavalà T, Ferrara R, Caccese M, Tortora G, Bria E. An overview of angiogenesis inhibitors in Phase II studies for non-small-cell lung cancer. Expert Opin Investig Drugs 2015; 24:1143-61. [DOI: 10.1517/13543784.2015.1056341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Hu FR, Gao F, Qi XS. Linifanib for treatment of hepatocellular carcinoma: An overview of clinical trials. Shijie Huaren Xiaohua Zazhi 2015; 23:2568-2573. [DOI: 10.11569/wcjd.v23.i16.2568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Linifanib achieves the antitumor activity by inhibiting all vascular endothelial growth factor receptors and platelet-derived growth factor receptors. We aim to review the findings of clinical trials of linifanib for the treatment of hepatocellular carcinoma (HCC). Several phase I clinical trials have confirmed the safety of linifanib in patients with solid malignancy. One phase Ⅱ clinical trial has shown the clinical efficacy of linifanib alone for the treatment of HCC. Recently, a phase Ⅲ randomized controlled trial showed that, compared with sorafenib, linifanib cannot significantly improve the overall survival of HCC patients. Thus, linifanib is not recommended as the first-line therapy for advanced HCC. However, because linifanib could significantly prolong the time-to-progression and progression-free survival time and increase the objective response rate, future studies might be necessary to explore the clinical utility of linifanib as a second-line therapy for advanced HCC.
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Aversa C, Leone F, Zucchini G, Serini G, Geuna E, Milani A, Valdembri D, Martinello R, Montemurro F. Linifanib: current status and future potential in cancer therapy. Expert Rev Anticancer Ther 2015; 15:677-687. [DOI: 10.1586/14737140.2015.1042369] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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36
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Ramalingam SS, Shtivelband M, Soo RA, Barrios CH, Makhson A, Segalla JGM, Pittman KB, Kolman P, Pereira JR, Srkalovic G, Belani CP, Axelrod R, Owonikoko TK, Qin Q, Qian J, McKeegan EM, Devanarayan V, McKee MD, Ricker JL, Carlson DM, Gorbunova VA. Randomized phase II study of carboplatin and paclitaxel with either linifanib or placebo for advanced nonsquamous non-small-cell lung cancer. J Clin Oncol 2015; 33:433-41. [PMID: 25559798 PMCID: PMC5478045 DOI: 10.1200/jco.2014.55.7173] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Linifanib, a potent, selective inhibitor of vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) receptors, has single-agent activity in non-small-cell lung cancer (NSCLC). We evaluated linifanib with carboplatin and paclitaxel as first-line therapy of advanced nonsquamous NSCLC. PATIENTS AND METHODS Patients with stage IIIB/IV nonsquamous NSCLC were randomly assigned to 3-week cycles of carboplatin (area under the curve 6) and paclitaxel (200 mg/m(2)) with daily placebo (arm A), linifanib 7.5 mg (arm B), or linifanib 12.5 mg (arm C). The primary end point was progression-free survival (PFS); secondary efficacy end points included overall survival (OS) and objective response rate. RESULTS One hundred thirty-eight patients were randomly assigned (median age, 61 years; 57% men; 84% smokers). Median PFS times were 5.4 months (95% CI, 4.2 to 5.7 months) in arm A (n = 47), 8.3 months (95% CI, 4.2 to 10.8 months) in arm B (n = 44), and 7.3 months (95% CI, 4.6 to 10.8 months) in arm C (n = 47). Hazard ratios (HRs) for PFS were 0.51 for arm B versus A (P = .022) and 0.64 for arm C versus A (P = .118). Median OS times were 11.3, 11.4, and 13.0 months in arms A, B, and C, respectively. HRs for OS were 1.08 for arm B versus A (P = .779) and 0.88 for arm C versus A (P = .650). Both linifanib doses were associated with increased toxicity, including a higher incidence of adverse events known to be associated with VEGF/PDGF inhibition. Baseline plasma carcinoembryonic antigen/cytokeratin 19 fragments biomarker signature was associated with PFS improvement and a trend toward OS improvement with linifanib 12.5 mg. CONCLUSION Addition of linifanib to chemotherapy significantly improved PFS (arm B), with a modest trend for survival benefit (arm C) and increased toxicity reflective of known VEGF/PDGF inhibitory effects.
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Affiliation(s)
- Suresh S Ramalingam
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL.
| | - Mikhail Shtivelband
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Ross A Soo
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Carlos H Barrios
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Anatoly Makhson
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - José G M Segalla
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Kenneth B Pittman
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Petr Kolman
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Jose R Pereira
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Gordan Srkalovic
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Chandra P Belani
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Rita Axelrod
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Taofeek K Owonikoko
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Qin Qin
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Jiang Qian
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Evelyn M McKeegan
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Viswanath Devanarayan
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Mark D McKee
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Justin L Ricker
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Dawn M Carlson
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
| | - Vera A Gorbunova
- Suresh S. Ramalingam and Taofeek K. Owonikoko, Winship Cancer Institute of Emory University, Atlanta, GA; Mikhail Shtivelband, Ironwood Cancer and Research Centers, Chandler, AZ; Ross A. Soo, National University Cancer Institute, National University Health System, Singapore, Singapore; Carlos H. Barrios, Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre; José G.M. Segalla, Hospital Amaral Carvalho, Jau; Jose R. Pereira, Instituto Brasileiro de Cancerologia Toracica, Sao Paulo, Brazil; Anatoly Makhson, Moscow City Oncology Hospital No. 62; Vera A. Gorbunova, N.N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia; Kenneth B. Pittman, The Queen Elizabeth Hospital, Woodville, South Australia, Australia; Petr Kolman, Hospital Kyjov, Kyjov, Czech Republic; Gordan Srkalovic, Sparrow Regional Cancer Center, Lansing, MI; Chandra P. Belani, Penn State Hershey Cancer Institute, Hershey; Rita Axelrod, Thomas Jefferson University Hospital, Philadelphia, PA; Qin Qin, Jiang Qian, Evelyn M. McKeegan, Viswanath Devanarayan, Mark D. McKee, Justin L. Ricker, and Dawn M. Carlson, AbbVie, North Chicago, IL
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Chiu YL, Lorusso P, Hosmane B, Ricker JL, Awni W, Carlson DM. Results of a phase I, open-label, randomized, crossover study evaluating the effects of linifanib on QTc intervals in patients with solid tumors. Cancer Chemother Pharmacol 2014; 73:213-7. [PMID: 24241212 PMCID: PMC3889813 DOI: 10.1007/s00280-013-2351-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 11/04/2013] [Indexed: 02/04/2023]
Abstract
PURPOSE Linifanib is a selective inhibitor of the vascular endothelial growth factor and platelet-derived growth factor family of tyrosine kinase inhibitors. The purpose of this high-precision QT study was to evaluate the effects of linifanib on cardiac repolarization in patients with advanced metastatic tumors. METHODS Enrolled patients (n = 24) had measurable disease refractory to standard therapies, ECOG performance status of 0-1, and adequate organ function. Patients were randomized in a 2-sequence, 2-period crossover design. Serial ECG measurements and pharmacokinetic samples were collected for each crossover period. An intersection-union test was performed for time-matched baseline-adjusted QTcF intervals. An exposure-response analysis was explored to correlate the plasma concentration and QTcF. RESULTS The maximum 95 % upper confidence bound for the baseline-adjusted QTcF was 4.3 ms at hour 3 at the maximum tolerated linifanib dose of 0.25 mg/kg. Linifanib did not meet the regulatory threshold (10 ms) for QT prolongation. Exposure-response modeling showed that the QTcF change was not significant at the maximum plasma concentration. CONCLUSIONS Linifanib does not significantly affect cardiac repolarization in patients with advanced solid tumors.
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Sechler M, Cizmic AD, Avasarala S, Van Scoyk M, Brzezinski C, Kelley N, Bikkavilli RK, Winn RA. Non-small-cell lung cancer: molecular targeted therapy and personalized medicine - drug resistance, mechanisms, and strategies. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2013; 6:25-36. [PMID: 23690695 PMCID: PMC3656464 DOI: 10.2147/pgpm.s26058] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Targeted therapies for cancer bring the hope of specific treatment, providing high efficacy and in some cases lower toxicity than conventional treatment. Although targeted therapeutics have helped immensely in the treatment of several cancers, like chronic myelogenous leukemia, colon cancer, and breast cancer, the benefit of these agents in the treatment of lung cancer remains limited, in part due to the development of drug resistance. In this review, we discuss the mechanisms of drug resistance and the current strategies used to treat lung cancer. A better understanding of these drug-resistance mechanisms could potentially benefit from the development of a more robust personalized medicine approach for the treatment of lung cancer.
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Affiliation(s)
- Marybeth Sechler
- Division of Pulmonary Sciences and Critical Care, University of Colorado, Aurora, CO, USA ; Program in Cancer Biology, University of Colorado, Aurora, CO, USA
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