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Azanza JR, Mensa J, Barberán J, Vázquez L, Pérez de Oteyza J, Kwon M, Yáñez L, Aguado JM, Cubillo Gracian A, Solano C, Ruiz Camps I, Fortún J, Salavert Lletí M, Gudiol C, Olave Rubio T, Solano C, García-Vidal C, Rovira Tarrats M, Suárez-Lledó Grande M, González-Sierra P, Dueñas Gutiérrez C. Recommendations on the use of azole antifungals in hematology-oncology patients. Rev Esp Quimioter 2023; 36:236-258. [PMID: 37017117 DOI: 10.37201/req/013.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
The administration of antifungals for therapeutic and, especially, prophylactic purposes is virtually a constant in patients requiring hematology-oncology treatment. Any attempt to prevent or treat Aspergillus or Mucor infections requires the administration of some drugs in the azole group, which include voriconazole, posaconazole and isavuconazole, noted for their activity against these pathogens. One very relevant aspect is the potential risk of interaction when associated with one of the antineoplastic drugs used to treat hematologic tumors, with serious complications. In this regard, acalabrutinib, bortezomib, bosutinib, carfilzomib, cyclophosphamide, cyclosporine A, dasatinib, duvelisib, gilteritinib, glasdegib, ibrutinib, imatinib, nilotinib, ponatinib, prednisone, ruxolitinib, tacrolimus, all-transretinoic acid, arsenic trioxide, venetoclax, or any of the vinca alkaloids, are very clear examples of risk, in some cases because their clearance is reduced and in others because of increased risk of QTc prolongation, which is particularly evident when the drug of choice is voriconazole or posaconazole.
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Affiliation(s)
- J R Azanza
- José Ramón Azanza,Servicio de Farmacología Clínica. Clínica Universitaria de Navarra. Pamplona. Spain.
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Kundranda M, Gracian AC, Zafar SF, Meiri E, Bendell J, Algül H, Rivera F, Ahn ER, Watkins D, Pelzer U, Charu V, Zalutskaya A, Kuesters G, Pipas JM, Santillana S, Askoxylakis V, Ko AH. Randomized, double-blind, placebo-controlled phase II study of istiratumab (MM-141) plus nab-paclitaxel and gemcitabine versus nab-paclitaxel and gemcitabine in front-line metastatic pancreatic cancer (CARRIE). Ann Oncol 2021; 31:79-87. [PMID: 31912800 DOI: 10.1016/j.annonc.2019.09.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/25/2019] [Accepted: 09/24/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Preclinical data suggest that dual blockade of the insulin-like growth factor-1 receptor (IGF-1R) and HER3 pathways has superior activity to IGF-1R blockade alone in pancreatic ductal adenocarcinoma (PDAC). We tested whether istiratumab, an IGF-1R- and ErbB3-bispecific antibody, can enhance the efficacy of standard of care (SOC) chemotherapy in patients with metastatic PDAC selected for high IGF-1 serum levels. PATIENTS AND METHODS CARRIE was an international, randomized, double-blind, placebo-controlled phase II study for patients with previously untreated metastatic PDAC. In part 1, 10 patients were evaluated for pharmacokinetics and safety. In part 2, patients with high free serum IGF-1 levels were randomized 1 : 1 to receive either istiratumab [2.8 g intravenously (i.v.) every 2 weeks] or placebo combined with gemcitabine/nab-paclitaxel at approved dose schedule. The co-primary endpoints were progression-free survival (PFS) in patients with high IGF-1 levels and PFS in patients with both high serum IGF-1 levels and heregulin (HRG)+ tumors. Key secondary endpoints were overall survival (OS), objective response rate (ORR) by RECIST v.1.1, and adverse events (AEs) rate. RESULTS A total of 317 patients were screened, with 88 patients randomized in part 2 (experimental arm n = 43; control n = 45). In the high IGF-1 cohort, median PFS was 3.6 and 7.3 months in the experimental versus control arms, respectively [hazard ratio (HR) = 1.88, P = 0.027]. In the high IGF-1/HRG+ subgroup (n = 44), median PFS was 4.1 and 7.3 months, respectively (HR = 1.39, P = 0.42). Median OS and ORR for the overall population were similar between two arms. No significant difference in serious or grade ≥3 AEs was observed, although low-grade AEs leading to early discontinuation were higher in the experimental (39.5%) versus control arm (24.4%). CONCLUSIONS Istiratumab failed to improve the efficacy of SOC chemotherapy in this patient setting. High serum IGF-1 levels did not appear to be an adverse prognostic factor when compared with non-biomarker-selected historic controls. CLINICAL TRIAL REGISTRATION NUMBERS ClinicalTrials.gov: NCT02399137; EUDRA CT: 2014-004572-34.
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Affiliation(s)
- M Kundranda
- Medical Oncology, Banner MD Anderson Cancer Center, Gilbert, USA
| | - A C Gracian
- Medical Oncology, Centro Integral Oncologico Clara Campal, Madrid, Spain; Departamento de Ciencias Médicas Clínicas, Universidad CEU San Pablo, Madrid, Spain
| | - S F Zafar
- Hematology and Oncology, Florida Cancer Specialists, Fort Myers, USA
| | - E Meiri
- Medical Oncology, Comprehensive Care and Research Center, Atlanta, USA
| | - J Bendell
- GI Oncology, Sarah Cannon Research Institute/Tennessee Oncology, Nashville, USA
| | - H Algül
- TUM School of Medicine, Klinikum rechts der Isar, Medizinische Klinik II, Technical University of Munich, Munich, Germany
| | - F Rivera
- Medical Oncology, Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - E R Ahn
- Medical Oncology, Cancer Treatment Centers of America Chicago, Zion, USA
| | - D Watkins
- Department of Medicine, Royal Marsden Hospital, Sutton, UK
| | - U Pelzer
- Charité - Universitätsmedizin Berlin, Germany
| | - V Charu
- Hematology/Oncology, Pacific Cancer Medical Center, Anaheim, USA
| | - A Zalutskaya
- Clinical Development, Merrimack Pharmaceuticals, Inc., Cambridge, USA
| | - G Kuesters
- Clinical Development, Merrimack Pharmaceuticals, Inc., Cambridge, USA
| | - J M Pipas
- Clinical Development, Merrimack Pharmaceuticals, Inc., Cambridge, USA
| | - S Santillana
- Clinical Development, Merrimack Pharmaceuticals, Inc., Cambridge, USA
| | - V Askoxylakis
- Clinical Development, Merrimack Pharmaceuticals, Inc., Cambridge, USA
| | - A H Ko
- Hematology/Oncology, University of California San Francisco Cancer Center, San Francisco, USA.
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Kundranda M, Gracian AC, Zafar SF, Meiri E, Bendell J, Algül H, Rivera F, Ahn ER, Watkins D, Pelzer U, Charu V, Zalutskaya A, Kuesters G, Pipas JM, Santillana S, Askoxylakis V, Ko AH. Corrigendum to 'Randomized, double-blind, placebo-controlled phase II study of istiratumab (MM-141) plus nab-paclitaxel and gemcitabine versus nab-paclitaxel and gemcitabine in front-line metastatic pancreatic cancer (CARRIE)': Annals of Oncology, Volume 31, Issue 1, 2020, Pages 79-87. Ann Oncol 2020; 31:1094. [PMID: 32507672 DOI: 10.1016/j.annonc.2020.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- M Kundranda
- Medical Oncology, Banner MD Anderson Cancer Center, Gilbert, USA
| | - A C Gracian
- Medical Oncology, Centro Integral Oncologico Clara Campal, Universidad CEU San Pablo, Madrid, Spain; Departamento de Ciencias Médicas Clínicas, Universidad CEU San Pablo, Madrid, Spain
| | - S F Zafar
- Hematology and Oncology, Florida Cancer Specialists, Fort Myers, USA
| | - E Meiri
- Medical Oncology, Comprehensive Care and Research Center, Atlanta, USA
| | - J Bendell
- GI Oncology, Sarah Cannon Research Institute/Tennessee Oncology, Nashville, USA
| | - H Algül
- TUM School of Medicine, Klinikum rechts der Isar, Medizinische Klinik II, Technical University of Munich, Munich, Germany
| | - F Rivera
- Medical Oncology, Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - E R Ahn
- Medical Oncology, Cancer Treatment Centers of America Chicago, Zion, USA
| | - D Watkins
- Department of Medicine, Royal Marsden Hospital, Sutton, UK
| | - U Pelzer
- Charité - Universitätsmedizin, Berlin, Germany
| | - V Charu
- Hematology/Oncology, Pacific Cancer Medical Center, Anaheim, USA
| | - A Zalutskaya
- Clinical Development, Merrimack Pharmaceuticals, Inc., Cambridge, USA
| | - G Kuesters
- Clinical Development, Merrimack Pharmaceuticals, Inc., Cambridge, USA
| | - J M Pipas
- Clinical Development, Merrimack Pharmaceuticals, Inc., Cambridge, USA
| | - S Santillana
- Clinical Development, Merrimack Pharmaceuticals, Inc., Cambridge, USA
| | - V Askoxylakis
- Clinical Development, Merrimack Pharmaceuticals, Inc., Cambridge, USA
| | - A H Ko
- Hematology/Oncology, University of California San Francisco Cancer Center, San Francisco, USA.
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Hernando Requejo O, Lopez Gonzalez M, Sanchez Saugar E, Cubillo Gracian A, Vicente Lopez E, Montero Luis A, Ciervide Jurio R, Garcia Aranda M, Valero Albarran J, Gonzalo Ruiz S, Alonso Gutierrez R, Rodriguez Pascual J, Quijano Collazo Y, Perez Moreno J, Fernandez Leton P, Rubio Rodriguez C. EP-1474: IMRT and Integrated-boost as neoadjuvant chemoradiation for rectal cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31783-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Cubillo Gracian A, Dean A, Muñoz A, Hidalgo M, Pazo-Cid R, Martin M, Macarulla Mercade T, Lipton L, Harris M, Manzano-Mozo J, Maurel J, Guillen-Ponce C, Tebbutt N, Cooray P, Sohal D, Zalupski M, Kolevska T, Stagg R, Goldstein D. YOSEMITE: A 3 arm double-blind randomized phase 2 study of gemcitabine, paclitaxel protein-bound particles for injectable suspension, and placebo (GAP) versus gemcitabine, paclitaxel protein-bound particles for injectable suspension and either 1 or 2 truncated courses of demcizumab (GAD). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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