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Gombos A, Goncalves A, Curigliano G, Bartsch R, Kyte JA, Ignatiadis M, Awada A. How I treat endocrine-dependent metastatic breast cancer. ESMO Open 2023; 8:100882. [PMID: 36806375 PMCID: PMC9969253 DOI: 10.1016/j.esmoop.2023.100882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 02/19/2023] Open
Abstract
Estrogen receptor-positive (ER+)/HER2-negative (HER2-), the so-called luminal-type breast cancer, is the most frequent subset, accounting for around 70% of all breast cancer cases. Endocrine therapy (ET) combined with cyclin-dependent kinases (CDK) 4/6 inhibitors is the standard first option in the management of advanced luminal breast cancer independently of disease extension. Classically, patients undergo multiple lines of ET ± targeted treatments until endocrine resistance occurs and palliative chemotherapy is proposed. Understanding endocrine resistance mechanisms and development of novel ET options is one of the main challenges in current clinical research. Another area of utmost interest is the improvement of post-endocrine therapeutic approaches. Among others, the development of antibody-drug conjugates (ADCs) is very promising, and some of these drugs will probably soon become a part of the therapeutic arsenal against this incurable disease. This review paper provides an overview of currently available treatment options in ER+/HER2- metastatic breast cancer and extensively discusses new approaches in late clinical development.
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Affiliation(s)
- A Gombos
- Department of Medical Oncology Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - A Goncalves
- Institut Paoli Calmettes, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm U1068, CNRS U7258, Aix Marseille University, Marseille, France
| | - G Curigliano
- European Institute of Oncology, University of Milano, Milano, Italy
| | - R Bartsch
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - J A Kyte
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - M Ignatiadis
- Department of Medical Oncology Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - A Awada
- Department of Medical Oncology Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
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Castelo-Branco L, Morgan G, Prelaj A, Scheffler M, Canhão H, Van Meerbeeck JP, Awada A. Challenges and knowledge gaps with immune checkpoint inhibitors monotherapy in the management of patients with non-small-cell lung cancer: a survey of oncologist perceptions. ESMO Open 2023; 8:100764. [PMID: 36640544 PMCID: PMC10024152 DOI: 10.1016/j.esmoop.2022.100764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/26/2022] [Revised: 11/13/2022] [Accepted: 12/05/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Immune checkpoint-inhibitors (ICIs) are changing outcomes in different cancer settings, notably for patients with non-small-cell lung cancer (NSCLC). There are, however, still important gaps of evidence for clinical practice when using these novel treatments. In this study, we assessed physicians' opinion and experience on challenges for clinical practice with ICIs monotherapy in NSCLC. METHODS A survey was conducted on experienced physicians treating patients with NSCLC with ICIs. Two rounds of pilot tests were carried out for validation among a group of experts. Topics under analysis were in relation to treatment of elderly populations, performance status, brain metastases, use of steroids or antibiotics, the effects of gut microbiome, autoimmune diseases, human immunodeficiency virus infection, solid organ transplants, use of anti-programmed cell death protein 1 versus anti-programmed death-ligand 1 drugs, atypical tumour responses, predictors of response, duration of treatment and a final open question on additional relevant challenges. RESULTS Two hundred and twenty-one answers were collected, including 106 (48%) valid answers from experts for final analysis (physicians who have treated at least 20 patients with NSCLC with ICIs). The vast majority agreed that the selected topics in this study are important challenges ahead and more evidence is needed. Moreover, predictors of response, treating brain metastasis, shorter duration of treatment, the effects of gut microbiome and concomitant use of steroids were voted the most important topics to be further addressed in prospective clinical research. CONCLUSIONS This survey contributed to understanding which are the main challenges for clinical practice with ICIs monotherapy in NSCLC. It can also contribute to guide further clinical research, considering the opinions and experience of those who regularly treat NSCLC patients with ICIs.
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Affiliation(s)
- L Castelo-Branco
- NOVA National School of Public Health, NOVA University, Lisbon, Portugal.
| | - G Morgan
- Skåne University Hospital, Division of Medical and Radiation Oncology, Lund, Sweden
| | - A Prelaj
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - M Scheffler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Cologne, Germany
| | - H Canhão
- EPIDOC Unit, Comprehensive Health Research Center (CHRC), NOVA Medical School, NOVA University, Lisbon; Centro Hospitalar Universitario Lisboa Central, Lisbon, Portugal
| | | | - A Awada
- Oncology Medicine Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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3
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Perez-Gracia JL, Penel N, Calvo E, Awada A, Arkenau HT, Amaral T, Grünwald V, Sanmamed MF, Castelo-Branco L, Bodoky G, Lolkema MP, Di Nicola M, Casali P, Giuliani R, Pentheroudakis G. Streamlining clinical research: an ESMO awareness call to improve sponsoring and monitoring of clinical trials. Ann Oncol 2023; 34:70-77. [PMID: 36209982 DOI: 10.1016/j.annonc.2022.09.162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/08/2022] [Revised: 09/22/2022] [Accepted: 09/28/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND During recent years, the burden of bureaucracy in clinical research has increased dramatically, adversely impacting the activity of investigators and clinical research teams. Although compliance with the Declaration of Helsinki, the guidelines for Good Clinical Practice (GCP), and other applicable regulations remains unquestionable, their overinterpretation and substitution by the internal operating procedures of sponsors and Contract Research Organizations (CROs) have increased the administrative burden. A survey conducted by the European Society for Medical Oncology (ESMO) Clinical Research Observatory (ECRO) among 940 investigators confirmed that they considered that the administrative burden in clinical research is excessive; that administrative procedures could be reduced without affecting the safety and the rights of the patients and the quality of the data; and that bureaucracy represents an obstacle for clinical research. METHODS A panel of physicians with extensive experience in clinical research, composed by members of the ECRO and the ESMO Scientific Medical and Public Policy divisions, analyzed clinical trial procedures related to administrative workflow, pharmacovigilance, and medical care. RESULTS The panel identified situations that generate debate between investigators and sponsors/CROs and selected real clinical scenarios that exemplify such situations. The panel discussed and proposed specific recommendations for those situations, based on GCP. CONCLUSIONS This initiative aspires to streamline clinical research procedures and to become a platform for discussion among all clinical trial stakeholders, with the aim of promoting the sustainability of clinical research and the care of cancer patients.
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Affiliation(s)
- J L Perez-Gracia
- Department of Oncology, University Clinic of Navarra and Health Research Institute of Navarra (IdiSNA), Pamplona, Spain.
| | - N Penel
- Centre Oscar Lambret and Lille University, Lille, France
| | - E Calvo
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - A Awada
- Institut Jules Bordet, Université Libre de Bruxelles (Head of the Oncology Medicine Department), Brussels, Belgium
| | | | - T Amaral
- Division of Dermato-Oncology, Department of Dermatology, University of Tuebingen, Tuebingen, Germany; Cluster of Excellence iFIT (EXC 2180) 'Image Guided and Functionally Instructed Tumor Therapies', Tuebingen, Germany
| | - V Grünwald
- University Hospital Essen, Clinic for Medical Oncology and Clinic for Urology, Essen, Germany
| | - M F Sanmamed
- Department of Oncology, University Clinic of Navarra and Health Research Institute of Navarra (IdiSNA), Pamplona, Spain
| | - L Castelo-Branco
- Scientific and Medical Division, ESMO - European Society for Medical Oncology, 6900 - Lugano, Switzerland; NOVA National School of Public Health, NOVA University, Lisbon, Portugal
| | | | - M P Lolkema
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M Di Nicola
- Immunotherapy and Innovative Therapeutics Unit, Oncology and Hematology Department Fondazione, IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - P Casali
- Fondazione IRCCS Istituto Nazionale Tumori and University of Milan, Milan, Italy
| | - R Giuliani
- The Clatterbridge Cancer Centre, Liverpool, UK
| | - G Pentheroudakis
- Scientific and Medical Division, European Society for Medical Oncology, Lugano, Switzerland
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Thouvenin J, Van Marcke C, Decoster L, Raicevic G, Punie K, Vandenbulcke M, Salgado R, Van Valckenborgh E, Maes B, Joris S, Steichel DV, Vranken K, Jacobs S, Dedeurwaerdere F, Martens G, Devos H, Duhoux FP, Rasschaert M, Pauwels P, Geboes K, Collignon J, Tejpar S, Canon JL, Peeters M, Rutten A, Van de Mooter T, Vermeij J, Schrijvers D, Demey W, Lybaert W, Van Huysse J, Mebis J, Awada A, Claes KBM, Hebrant A, Van der Meulen J, Delafontaine B, Bempt IV, Maetens J, de Hemptinne M, Rottey S, Aftimos P, De Grève J. PRECISION: the Belgian molecular profiling program of metastatic cancer for clinical decision and treatment assignment. ESMO Open 2022; 7:100524. [PMID: 35970014 PMCID: PMC9434164 DOI: 10.1016/j.esmoop.2022.100524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022] Open
Abstract
PRECISION is an initiative from the Belgian Society of Medical Oncology (BSMO) in collaboration with several stakeholders, encompassing four programs that aim to boost genomic and clinical knowledge with the ultimate goal to offer patients with metastatic solid tumors molecularly guided treatments. The PRECISION 1 study has led to the creation of a clinico-genomic database. The Belgian Approach for Local Laboratory Extensive Tumor Testing (BALLETT) and GeNeo studies will increase the number of patients with advanced cancer that have comprehensive genotyping of their cancer. The PRECISION 2 project consists of investigator-initiated phase II studies aiming to provide access to a targeted drug for patients whose tumors harbor actionable mutations in case the matched drug is not available through reimbursement or clinical trials in Belgium.
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Affiliation(s)
- J Thouvenin
- Hospices Civils de Lyon, Medical Oncology, Lyon, France; Institut Jules Bordet, Medical Oncology Clinic, Brussels, Belgium
| | | | - L Decoster
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Punie
- KU Leuven University Hospitals Leuven, General Medical Oncology, Leuven, Belgium
| | | | - R Salgado
- GasthuisZusters Antwerpen, Pathology, Antwerp, Belgium
| | | | - B Maes
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - S Joris
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Vranken
- Pediatric Oncology, WIV-ISP, Leuven, Belgium
| | | | | | - G Martens
- Laboratoriumgeneeskunde, AZ Delta, Roeselare, Belgium
| | - H Devos
- Laboratoriumgeneeskunde, AZ Sint-Jan, Bruges, Belgium
| | - F P Duhoux
- UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
| | - M Rasschaert
- Universitair Ziekenhuis Antwerpen, Medical Oncology, Antwerpen, Belgium; Medical Oncology, AZ Monica, Deurne, Belgium
| | - P Pauwels
- Universitair Ziekenhuis Antwerpen, Pathology, Antwerpen, Belgium
| | - K Geboes
- Division of Digestive Oncology, Department of Gastroenterology, UZ Gent, Gent, Belgium; Department of Internal Medicine and Pediatrics, UZ Gent, Gent, Belgium
| | - J Collignon
- Medical Oncology, CHU de Liege - Hospital Sart Tilman, Liège, Belgium
| | | | - J-L Canon
- Grand Hôpital de Charleroi Site Notre Dame, Service d'Oncologie-Hématologie, Charleroi, Belgium
| | - M Peeters
- Universitair Ziekenhuis Antwerpen, Oncology, Antwerpen, Belgium
| | - A Rutten
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - T Van de Mooter
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Vermeij
- ZNA Middelheim, Medical Oncology, Antwerpen, Belgium
| | | | - W Demey
- AZ Klina, Medical Oncology, Brasschaat, Belgium
| | - W Lybaert
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Van Huysse
- AZ Sint-Jan Brugge-Oostende, Pathology, Brugge, Belgium
| | - J Mebis
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - A Awada
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | | | | | | | | | | | | | | | - S Rottey
- Medical Oncology Department, UZ Gent, Gent, Belgium
| | - P Aftimos
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | - J De Grève
- UZ Brussel, Medical Oncology, Brussels, Belgium.
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Nader-Marta G, Martins-Branco D, Agostinetto E, Bruzzone M, Ceppi M, Danielli L, Lambertini M, Kotecki N, Awada A, de Azambuja E. Efficacy of tyrosine kinase inhibitors for the treatment of patients with HER2-positive breast cancer with brain metastases: a systematic review and meta-analysis. ESMO Open 2022; 7:100501. [PMID: 35653982 PMCID: PMC9160675 DOI: 10.1016/j.esmoop.2022.100501] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/09/2022] [Indexed: 12/03/2022] Open
Abstract
Background Brain metastases (BMs) are frequent events in patients with HER2-positive metastatic breast cancer (MBC) and are associated with poor prognosis. Small-molecule anti-HER2 tyrosine kinase inhibitors (TKIs) are promising agents for the treatment of BM. In this study, we assess the clinical outcomes of patients with HER2-positive MBC and BM treated with TKI-containing regimens compared with those treated with non-TKI-containing regimens. Materials and methods PubMed, Embase, Cochrane Library, and conference proceedings (ASCO, SABCS, ESMO, and ESMO Breast) were searched up to June 2021. The primary endpoint was progression-free survival (PFS) in patients with BM. Secondary endpoints included PFS in patients without BM and overall survival (OS). The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Overall effects were pooled using random-effects models. Results This systematic review and meta-analysis included data from 2437 patients (490 with and 1947 without BM at baseline) enrolled in five trials assessing tucatinib-, lapatinib-, pyrotinib-, or afatinib-based combinations. A nonstatistically significant PFS benefit favoring TKI-containing regimens was observed in both patients with BM [hazard ratio (HR) 0.67, 95% confidence interval (CI) 0.41-1.12; P = 0.13] and without BM (HR 0.55, 95% CI 0.24-1.26; P = 0.16). Sensitivity analysis, excluding each study singly, demonstrated a significant PFS benefit favoring TKI-containing regimens in patients with BM after the exclusion of afatinib from the analysis (HR 0.56, 95% CI 0.35-0.90; P = 0.016). No statistically significant differences in OS were observed between the comparison groups. Conclusions A trend in PFS favoring TKI-containing regimens was observed in patients with BM. Sensitivity analysis including only trials that evaluated regimens containing tucatinib, lapatinib, or pyrotinib demonstrated a significant PFS benefit favoring TKI-containing regimens in patients with BM. The optimal therapy for HER2+ BC BMs remains unknown. Anti-HER2 TKIs are effective for treating MBC. This study examined the efficacy of TKI for the treatment of patients with BM. A trend toward improved PFS favoring TKIs was observed in patients with BM. There was no significant difference in OS between TKIs versus non-TKI regimens.
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Affiliation(s)
- G Nader-Marta
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.
| | - D Martins-Branco
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - E Agostinetto
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - M Bruzzone
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, School of Medicine, University of Genova, Genova, Italy
| | - M Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, School of Medicine, University of Genova, Genova, Italy
| | - L Danielli
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - N Kotecki
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - A Awada
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - E de Azambuja
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
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Cufer T, Kosty M, Osterlund P, Jezdic S, Pyle D, Awada A, Close J, El-Saghir N, Lordick F, Rutkowski P, Tfayli A, Wildiers H. Current landscape of ESMO/ASCO Global Curriculum adoption and medical oncology recognition: a global survey. ESMO Open 2021; 6:100219. [PMID: 34924144 PMCID: PMC8710493 DOI: 10.1016/j.esmoop.2021.100219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background With the implementation of multidisciplinary treatment and development of multiple novel anticancer drugs in parallel with expanding knowledge of supportive and palliative care, a need for separate training and specialisation in medical oncology emerged. A Global Curriculum (GC) in medical oncology, developed and updated by a joint European Society for Medical Oncology/American Society of Clinical Oncology (ESMO/ASCO) GC Task Force/Working Group (GC WG), greatly contributed to the recognition of medical oncology worldwide. Material and methods ESMO/ASCO GC WG carried out a global survey on medical oncology recognition and GC adoption in 2019. Results Based on our survey, medical oncology is recognised as a separate specialty or sub-specialty in 47/62 (75%) countries participating in the survey; with a great majority of them (39/47, 83%) recognising medical oncology as a standalone specialty. Additionally, in 9 of 62 (15%) countries, medical oncology is trained together with haematology as a specialty in haemato-oncology or together with radiotherapy as a specialty in clinical oncology. As many as two-thirds of the responding countries reported that the ESMO/ASCO GC has been either fully or partially adopted or adapted in their curriculum. It has been adopted in a vast majority of countries with established training in medical oncology (28/41; 68%) and adapted in 12 countries with mixed training in haemato-oncology, clinical oncology or other specialty responsible for training on systemic anticancer treatment. Conclusions With 75% of participating countries reporting medical oncology as a separate specialty or sub-specialty and as high as 68% of them reporting on GC adoption, the results of our survey on global landscape are reassuring. Despite a lack of data for some regions, this survey represents the most comprehensive and up-to-date information about recognition of medical oncology and GC adoption worldwide and will allow both societies to further improve the dissemination of the GC and global recognition of medical oncology, thus contributing to better cancer care worldwide. ESMO/ASCO Global Curriculum (GC) supported medical oncology (MO) as a standalone specialty or sub-specialty worldwide. The ESMO/ASCO GC Working Group regularly updates the GC and conducted a worldwide survey on GC adoption and MO recognition. Based on the survey, MO is recognised as a specialty or sub-specialty in the majority (47/62; 75%) of participating countries. ESMO/ASCO GC has been adopted or adapted in 68% of participating countries without significant differences around the world. This most comprehensive information about MO recognition and GC adoption will support their further dissemination worldwide.
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Affiliation(s)
- T Cufer
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
| | - M Kosty
- Division of Hematology/Oncology, Scripps Clinic, La Jolla, USA
| | - P Osterlund
- Department of Oncology, Tampere University Hospital and University of Tampere, Tampere, Finland; Department of Oncology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - S Jezdic
- Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - D Pyle
- International Affairs, American Society of Clinical Oncology (ASCO), Alexandria, USA
| | - A Awada
- Medical Oncology Clinic, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - J Close
- University of Florida College of Medicine, Gainesville, USA
| | - N El-Saghir
- Department of Internal Medicine, NK Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - F Lordick
- Department of Oncology, University Cancer Center Leipzig, Leipzig University Medical Center, Leipzig, Germany
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - A Tfayli
- Department of Internal Medicine, NK Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - H Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
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Cufer T, Kosty M, Osterlund P, Jezdic S, Pyle D, Awada A, Close J, El-Saghir N, Lordick F, Rutkowski P, Tfayli A, Wildiers H. 1826P Current landscape of ESMO/ASCO Global Curriculum adoption and medical oncology recognition: A global survey. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.714] [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: 11/25/2022] Open
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Castelo-Branco L, Awada A, Pentheroudakis G, Perez-Gracia JL, Mateo J, Curigliano G, Banerjee S, Giuliani R, Lordick F, Cervantes A, Tabernero J, Peters S. Beyond the lessons learned from the COVID-19 pandemic: opportunities to optimize clinical trial implementation in oncology. ESMO Open 2021; 6:100237. [PMID: 34411971 PMCID: PMC8302832 DOI: 10.1016/j.esmoop.2021.100237] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 01/04/2023] Open
Affiliation(s)
- L Castelo-Branco
- Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - A Awada
- Head of the Oncology Medicine Department, Institut Jules Bordet, Université libre de Bruxelles, Belgium
| | - G Pentheroudakis
- Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland.
| | - J L Perez-Gracia
- Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain
| | - J Mateo
- Vall d'Hebron Institute of Oncology (VHIO) and Vall d'Hebron University Hospital, Barcelona, Spain
| | - G Curigliano
- Istituto Europeo di Oncologia, IRCCS and University of Milano, Milano, Italy
| | - S Banerjee
- The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London
| | - R Giuliani
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - F Lordick
- Department of Oncology, Gastroenterology, Hepatology, Pulmonology, and Infectious Diseases, University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, Leipzig, Germany
| | - A Cervantes
- Hospital Clinic Universitario, Biomedical Research institute INCLIVA, University of Valencia, Valencia, Spain
| | - J Tabernero
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), UVic-UCC, Barcelona, Spain
| | - S Peters
- Oncology Department - CHUV, Lausanne University, Lausanne, Switzerland
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Sands J, Paz-Ares L, Besse B, Peters S, Sala M, López-Vilariño J, Fernández C, Kahatt C, Zeaiter A, Nieto A, Siguero M, Zaman K, Arrondeau J, Delord JP, Martínez M, Antón A, Awada A, Kristeleit R, Olmedo M, Rubio M, Sarantopoulos J, Mosquera-Martinez J, D’Arcangelo M, Santoro A, Trigo JM, Subbiah V, Arrondeau J. MO01.09 Phase 2 Basket Trial of Lurbinectedin in Small-Cell Lung Cancer (SCLC): Analysis of Efficacy by Baseline Characteristics. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.057] [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: 10/22/2022]
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Subbiah V, Paz-Ares L, Besse B, Moreno V, Peters S, Sala M, López-Vilariño J, Fernández C, Kahatt C, Zeaiter A, Zaman K, Delord JP, Martínez M, Antón A, Awada A, Kristeleit R, Olmedo M, Rubio M, Sarantopoulos J, D’Arcangelo M, Santoro A, Trigo JM, Sands J. MO01.08 Phase 2 Basket Trial of Lurbinectedin in Second-line SCLC: Characteristics and Outcomes in Treatment Responders. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.056] [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: 10/22/2022]
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Adams S, Schmid P, Rugo HS, Winer EP, Loirat D, Awada A, Cescon DW, Iwata H, Campone M, Nanda R, Hui R, Curigliano G, Toppmeyer D, O'Shaughnessy J, Loi S, Paluch-Shimon S, Tan AR, Card D, Zhao J, Karantza V, Cortés J. Pembrolizumab monotherapy for previously treated metastatic triple-negative breast cancer: cohort A of the phase II KEYNOTE-086 study. Ann Oncol 2020; 30:397-404. [PMID: 30475950 DOI: 10.1093/annonc/mdy517] [Citation(s) in RCA: 494] [Impact Index Per Article: 123.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Treatment options for previously treated metastatic triple-negative breast cancer (mTNBC) are limited. In cohort A of the phase II KEYNOTE-086 study, we evaluated pembrolizumab as second or later line of treatment for patients with mTNBC. PATIENTS AND METHODS Eligible patients had centrally confirmed mTNBC, ≥1 systemic therapy for metastatic disease, prior treatment with anthracycline and taxane in any disease setting, and progression on or after the most recent therapy. Patients received pembrolizumab 200 mg intravenously every 3 weeks for up to 2 years. Primary end points were objective response rate in the total and PD-L1-positive populations, and safety. Secondary end points included duration of response, disease control rate (percentage of patients with complete or partial response or stable disease for ≥24 weeks), progression-free survival, and overall survival. RESULTS All enrolled patients (N = 170) were women, 61.8% had PD-L1-positive tumors, and 43.5% had received ≥3 previous lines of therapy for metastatic disease. ORR (95% CI) was 5.3% (2.7-9.9) in the total and 5.7% (2.4-12.2) in the PD-L1-positive populations. Disease control rate (95% CI) was 7.6% (4.4-12.7) and 9.5% (5.1-16.8), respectively. Median duration of response was not reached in the total (range, 1.2+-21.5+) and in the PD-L1-positive (range, 6.3-21.5+) populations. Median PFS was 2.0 months (95% CI, 1.9-2.0), and the 6-month rate was 14.9%. Median OS was 9.0 months (95% CI, 7.6-11.2), and the 6-month rate was 69.1%. Treatment-related adverse events occurred in 103 (60.6%) patients, including 22 (12.9%) with grade 3 or 4 AEs. There were no deaths due to AEs. CONCLUSIONS Pembrolizumab monotherapy demonstrated durable antitumor activity in a subset of patients with previously treated mTNBC and had a manageable safety profile. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT02447003.
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Affiliation(s)
- S Adams
- Department of Medicine, Perlmutter Cancer Center, New York University School of Medicine, New York, USA.
| | - P Schmid
- Centre for Experimental Cancer Medicin, Barts Cancer Institute, Queen Mary University London, London, UK
| | - H S Rugo
- Department of Medicine, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco
| | - E P Winer
- Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | | | - A Awada
- Oncology Medicine Departmen, Institut Jules Bordet, Universite Libre de Bruxelles, Brussels, Belgium
| | - D W Cescon
- Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - H Iwata
- Aichi Cancer Center Hospital, Nagoya, Japan
| | - M Campone
- Institut de Cancerologie de l'Ouest, Nantes, France
| | - R Nanda
- Department of Medicin, Section of Hematology/Oncology, The University of Chicago, Chicago, USA
| | - R Hui
- Westmead Hospital and the University of Sydney, Sydney, Australia
| | - G Curigliano
- Department of Oncology and Hematology, University of Milano, Milan; IEO, European Institute of Oncology IRCCS, Milano, Milan, Italy
| | - D Toppmeyer
- Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, USA
| | - J O'Shaughnessy
- Baylor University Medical Center, Dallas; Texas Oncology, Dallas; US Oncology, Dallas, USA
| | - S Loi
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - S Paluch-Shimon
- Breast Cancer Service for Young Women, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - A R Tan
- Levine Cancer Institute, Atrium Health, Charlotte
| | - D Card
- Merck & Co., Inc., Kenilworth, USA
| | - J Zhao
- Merck & Co., Inc., Kenilworth, USA
| | | | - J Cortés
- Breast Cancer Program, Vall d'Hebron Institute of Oncology, Barcelona; Ramon y Cajal University Hospital, Madrid; IOB Institute of Oncology, Quiron Group, Barcelona, Spain
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12
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Trigo Perez J, Subbiah V, Besse B, Moreno V, López R, Sala M, Ponce S, Fernendez C, Nieto A, Kahatt C, Zeaiter A, Zaman K, Boni V, Arrondeau J, Martinez M, Delord J, Awada A, Kristeleit R, Longo F, Sarantopoulos J, Rubio M, Anton A, Wannesson L, Valdivia J, Shappiro G, Villalobos V, Santoro A, D'Arcangelo M, Aparicio L, Paz-Ares L. P1.12-03 Antitumor Activity of Single Agent Lurbinectedin in Patients with Relapsed SCLC Occurring ≥30 Days After Last Platinum Dose. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1116] [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: 11/29/2022]
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13
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Awada A, Argacha JF, Collart P, Unger P. P809Effects of air temperature and pollution on Takotsubo cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0408] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Air temperature and pollution are the main environmental factors influencing cardiovascular mortality and risk of myocardial infarction. Takotsubo cardiomyopathy (TCM) is a transient and reversible myocardial dysfunction whose cause and pathogenesis remain incompletely understood, but which, unlike acute coronary syndrome, does not involve obstructive coronary atherosclerosis or plaque rupture. The potential role of the environment on the risk to develop TCM remains poorly defined.
Methods
We aimed to study the effects of air temperature, particulate matter (PM) and gaseous pollutants (NO2 and ozone) on hospitalization rate forTCM.
All hospitalizations in Belgian Hospitals for TCM (ICD 9:429.83) from 2009 to 2014 were recorded. National air pollution parameters were extracted from the Belgian Environment Agency database. A time-stratified and temperature-matched (except for air temperature effect) case-crossover analysis of the risk of TCM was performed. The main analysis focused on 0-day lag time (lag 0) between exposure and TCM; a lag structure analysis up to lag 4 was also performed.
Results
1840 patients were included in the study (88% women). More TCM occurred during the warm compared to the cold period (fig.1; chi2p value <0.05). At lag 0, each decrease of 1°C in ambient air temperature increased the odds ratio (OR) of TCM of 1.020 (IC 95%: 1.003–1.035). This effect was more pronounced during the cold period and at lag 4 (RR 1.060; IC 95%: 1.031–1.091). Conversely, during the warm period and between lag 1 and 4, an increase of 1°C in ambient air temperature increased the RR of TCM (OR 1.053 at lag 3; IC 95%: 1.021–1.086). No significant association was found between TCM and PM10, PM2.5, NO2at any lag. During the warm period, each increase in 10μg/m3 in ozone from lag 1 to 3 increased the risk of TCM (OR 1.089 at lag 3, IC 95%: 1.017–1.168).
Conclusions
Air temperature strongly influences the onset of TCM. Both cold spells and heat waves seem to be associated with the development of TCM. Ozone exposure also increases the risk of TCM during the warm period, whereas particulate and NO2 pollution do not seem to play a significant role. These patterns seem to differ from those previously reported with STEMI.
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Affiliation(s)
- A Awada
- CHU Saint Pierre, Brussels, Belgium
| | - J F Argacha
- University Hospital (UZ) Brussels, Brussels, Belgium
| | - P Collart
- Université libre de Bruxelles (ULB), Brussels, Belgium
| | - P Unger
- CHU Saint Pierre, Brussels, Belgium
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Awada A. Pharmacological and non pharmacological treatment of Alzheimer's disease. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.205] [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: 11/15/2022]
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15
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Kotecki N, Gombos A, Awada A. Adjuvant therapeutic approaches of HER2-positive breast cancer with a focus on neratinib maleate. Expert Rev Anticancer Ther 2019; 19:447-454. [DOI: 10.1080/14737140.2019.1613892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- N. Kotecki
- Oncology Medicine Department, Jules Bordet Institute, Université Libre de Bruxelles
| | - A. Gombos
- Oncology Medicine Department, Jules Bordet Institute, Université Libre de Bruxelles
| | - A. Awada
- Oncology Medicine Department, Jules Bordet Institute, Université Libre de Bruxelles
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16
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Fontaine C, Van den Eynden G, de Wind R, Boisson A, Renard V, Van den Bulck H, Vuylsteke P, Glorieux P, Dopchie C, Decoster L, De Grève J, Awada A, Wildiers H, Willard-Gallo K. Abstract P2-08-47: Evaluation of stromal tumor-infiltrating lymphocytes (sTIL) and tertiary lymphoid structures (TLS) in early breast cancer patients with triple negative breast cancer(TNBC) included in a prospective study of neoadjuvant chemotherapy (NAC) with Epirubicin and cyclophosphamide (EC) and carboplatin-paclitaxel (PC) (BSMO 2014-01). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-47] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: BSMO 2014-01 is a completed prospective phase 2 study evaluating the efficacy of neoadjuvant EC and PC. One of the secondary endpoints was the correlation of sTIL with response, pCR and survival. We also assessed the relationship between sTIL and TLS in the diagnostic biopsies.
Methods: Stromal TIL (sTIL) were evaluated on H&E stained tumor biopsies before the start of the NAC according to the criteria described by Salgado et al(1). Scores were defined as "low" or "high" if lymphocytic infiltration in the stroma around the tumor was ≤ 10% or > 10%. TLS are ectopic lymph node-like structures recently identified in breast cancer. TLS were counted using a dual IHC stain for CD3 (T cells) and CD20 (B cells) and categorized as "little" if the TLS occupied < 10% or "moderate to abundant" if they occupied ≥ 10% of the adjacent tissue. The correlation between sTIL and pathologic parameters was analyzed using the chi-square test; DFS and OS between the groups was estimated by using the log-rank test.
Results: So far we could quantify the number of sTIL in 38 out of 63 TNBC pts treated with neoadjuvant EC-PC. Twenty eight pts had a high sTIL score and 10 pts had a low sTIL score. The high-sTIL group (19/28) achieved a numerical higher pathologic complete remission (pCR) rate than the low-sTIL group (5/10) (p=0.3); both groups had a comparable disease free survival of 28.6 mths and 26.7 mths respectively (p=0.7). The overall survival was similar:29 mths and 27.8 mths respectively (p=0.8). Stromal TLS were identified in 10 out 23 samples available for this analysis and we could demonstrate a positive correlation between high levels of sTIL and high levels of moderate to abundant TLS(CD3) in the adjacent tissue in six out of the ten samples in which TLS were present (p=0.1).
Conclusion: These preliminary results could not confirm the results published by Denkert et al earlier this year(2). A trend for correlation of the presence of high sTIL with moderate to abundant levels of TLS was found. Analysis on the remaining samples of all patients included in the study and correlation with outcome is ongoing and these completed results will be presented.
(1)Assessing Tumor-infiltrating lymphocytes in solid tumors. Hendry S, Salgado R et al. Adv Anat Pathol 2017; 235-251.
(2)Tumour-infiltrating lymphocytes and prognosis in different subtypes of breast cancer. Denkert C et al. Lancet Oncol 2018; 40-50.
Citation Format: Fontaine C, Van den Eynden G, de Wind R, Boisson A, Renard V, Van den Bulck H, Vuylsteke P, Glorieux P, Dopchie C, Decoster L, De Grève J, Awada A, Wildiers H, Willard-Gallo K. Evaluation of stromal tumor-infiltrating lymphocytes (sTIL) and tertiary lymphoid structures (TLS) in early breast cancer patients with triple negative breast cancer(TNBC) included in a prospective study of neoadjuvant chemotherapy (NAC) with Epirubicin and cyclophosphamide (EC) and carboplatin-paclitaxel (PC) (BSMO 2014-01) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-47.
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Affiliation(s)
- C Fontaine
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - G Van den Eynden
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - R de Wind
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - A Boisson
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - V Renard
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - H Van den Bulck
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - P Vuylsteke
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - P Glorieux
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - C Dopchie
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - L Decoster
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - J De Grève
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - A Awada
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - H Wildiers
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
| | - K Willard-Gallo
- UZ Brussel, Jette, Belgium; Institut Jules Bordet, Brussels, Belgium; UZ Leuven, Leuven, Belgium; BSMO, Brussels, Belgium
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17
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Diamond JR, Potter D, Salkeni M, Silverman P, Haddad T, Forget F, Awada A, Canon JL, Danso M, Lortholary A, Bourgeois H, Tan-Chiu E, Patel C, Neuwirth R, Leonard EJ, Lim B. Abstract PD1-09: Phase 2 safety and efficacy results of TAK-228 in combination with exemestane or fulvestrant in postmenopausal women with ER-positive/HER2-negative metastatic breast cancer previously treated with everolimus. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd1-09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: TAK-228 is an investigational, oral and highly selective ATP-competitive inhibitor of TORC1/2. Targeting the PI3K/AKT/mTOR pathway with the dual TORC1/2 inhibitor TAK-228 may restore sensitivity to endocrine therapies in patients (pts) with breast cancer who have progressed on the combination of an endocrine agent plus a TORC1 inhibitor. Here we report data from the phase 2 portion of a phase 1b/2 study of TAK-228 plus exemestane (E) or fulvestrant (F).
Methods: Postmenopausal women with ER+ and HER2-, inoperable or metastatic breast cancer (MBC) following everolimus (EVE) plus E or F after progression, received oral TAK-228 (4 mg QD) plus E (25 mg QD) or F (500 mg monthly) for 28-day cycles until progressive disease (PD) or unacceptable toxicity (NCT02049957). Pts were enrolled into parallel cohorts based on prior response to EVE plus E or F and were given the same prior therapy (E or F) at their established dose: EVE-sensitive, defined as disease progression after complete response (CR), partial response (PR), or ≥6 mos stable disease (SD); or EVE-resistant, defined as disease progression without a CR or PR, or after <6 mos SD. Primary endpoint was clinical benefit rate at 16 wks (CR, PR, or SD at 16 wks; CBR-16). Secondary endpoints included CBR at 24 wks (CBR-24), overall response rate (ORR), progression-free survival (PFS), overall survival (OS) and safety.
Results: From Oct 2015 to Dec 2017, 94 pts were enrolled. Median age was 58 y (range 32–83). At baseline, most pts (67%) had stage IV disease and others were stage IA–IIIC (24%), other (3%) or unknown (5%); 94% of EVE-sensitive (93% E vs 100% F) and 88% of EVE-resistant pts (91% E vs 75% F) had received ≥4 prior lines of therapy. Pts received a median of 3 cycles (1–15) of TAK-228. At data cutoff (24 Apr 2018), 98% of pts had discontinued treatment, mainly due to PD (76%) or adverse events (AEs; 14%). CBR-16 was 41% (n=21) in EVE-sensitive and 26% (n=11) in EVE-resistant pts (table). CBR-24 was 24% in EVE-sensitive (19% E vs 50% F) and 23% in EVE-resistant (23% E vs 25% F) pts. Eleven of 21 pts who achieved CBR-16 also achieved CBR-24 (6 SD, 5 PR) in the EVE-sensitive cohort and 8 of 11 pts in the EVE-resistant cohort (6 SD, 2 PR). The ORR was 12% in EVE-sensitive pts and 9% in EVE-resistant pts (table). Median PFS (95% CI) was 4.1 mos (2.2–5.5) and 3.4 mos (1.9–5.4), and median OS (95% CI) was 15.9 mos (14.1–19.5) and 14.0 mos (13.0–16.0) in the EVE-sensitive and -resistant cohorts, respectively. Drug-related any grade and grade ≥3 AEs were seen in 90% and 29% of pts, respectively. Most common drug-related any grade AEs were nausea (50%), fatigue (38%), hyperglycemia and diarrhea (each 29%); 22% of pts reported a serious AE. No deaths were reported. Treatment is ongoing in two pts.
Conclusion: TAK-228 plus E or F showed modest clinical benefit in pts with previously treated, EVE-sensitive or -resistant MBC, with an acceptable safety profile.
EVE-sensitive (N=51)EVE-resistant (N=43) TAK-228+TAK-228+Best response, n (%)E (n=43)F (n=8)E (n=35)F (n=8)ORR=CR+PR4 (9)2 (25)3 (9)1 (13)CR001 (3)0PR4 (9)2 (25)2 (6)1 (13)CBR-1617 (40)4 (50)9 (26)2 (25)
Citation Format: Diamond JR, Potter D, Salkeni M, Silverman P, Haddad T, Forget F, Awada A, Canon J-L, Danso M, Lortholary A, Bourgeois H, Tan-Chiu E, Patel C, Neuwirth R, Leonard EJ, Lim B. Phase 2 safety and efficacy results of TAK-228 in combination with exemestane or fulvestrant in postmenopausal women with ER-positive/HER2-negative metastatic breast cancer previously treated with everolimus [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD1-09.
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Affiliation(s)
- JR Diamond
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - D Potter
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - M Salkeni
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - P Silverman
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - T Haddad
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - F Forget
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - A Awada
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - J-L Canon
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - M Danso
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - A Lortholary
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - H Bourgeois
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - E Tan-Chiu
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - C Patel
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - R Neuwirth
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - EJ Leonard
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
| | - B Lim
- University of Colorado Cancer Center, Aurora, CO; University of Minnesota, Minneapolis, MN; West Virginia University, Morgantown, WV; University Hospitals Cleveland Medical Center, Cleveland, OH; Mayo Clinic, Rochester, MN; Centre Hospitalier de l'Ardenne, Libramont, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium; Grand Hôpital de Charleroi, Charleroi, Belgium; Virginia Oncology Associates – Hampton, Chesapeake, VA; Centre Catherine de Sienne, Nantes, France; Clinique Victor Hugo - Centre Jean Bernard, Sarthe, France; Florida Cancer Research Institute, Plantation, FL; Millennium Pharmaceuticals, Inc., a Wholly Owned Subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA; M.D. Anderson Cancer Center, Houston, TX
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Cho B, Daste A, Ravaud A, Salas S, Isambert N, McClay E, Awada A, Borel C, Gulley J, Ojalvo L, Helwig C, Rolfe P, Penel N. M7824 (MSB0011359C), a bifunctional fusion protein targeting PD-L1 and TGF-β, in patients (pts) with advanced SCCHN: Results from a phase I cohort. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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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Awada A, Eskens F, Robbrecht D, Lassen U, Sorensen M, Schellens J, de Groot J, Jungels C, Aftimos P, Fretland S, Thorsson L, Guren T. A first-in-class, first-in-human phase I/IIa trial of CAN04, targeting interleukin-1 receptor accessory protein (IL1RAP), in patients with solid tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.045] [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: 11/15/2022] Open
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Flament A, Hendlisz A, Shaza L, Aspeslagh S, Vouche M, Donckier V, Awada A, Machiels JP, van den Eynde M, Canon JL, Carrasco J, Lonez C, Lehmann F. Phase I studies assessing the safety and clinical activity of multiple doses of a NKG2D-based CAR-T therapy, CYAD-01, in metastatic colorectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.157] [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: 11/15/2022] Open
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El Hachem G, Jungels C, Larsimont D, Awada A. [Retroperitoneal mixed malignant mullerian tumor : exceptional localisation and prognosis]. ACTA ACUST UNITED AC 2018; 39:146-149. [PMID: 29964388 DOI: 10.30637/2018.17-072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Primary retroperitoneal carcinosarcoma or mixed malignant mullerian tumor (MMMT) is an extremely rare clinical entity. These aggressive tumors arise most commonly from genital tract. The retroperitoneal location is exceptional. Here we report the case of a 63-years old female diagnosed with heterologous, extra-genital, retroperitoneal carcinosarcoma, with malignant cells in the ascitic fluid and extra-ovarian metastatic implants. She was treated with complete radical surgical treatment consisting of resection of the retroperitoneal tumor, with omentectomy, hysterectomy, bilateral salpingooophorectomy and lumbo-aortic and pelvic lymphadenectomy. She received adjuvant chemotherapy with 6 cycles of Carboplatin and Paclitaxel. She is in complete clinical and radiological remission since the end of chemotherapy, for a total of 113 months. To our knowledge, this is the longest reported disease free survival of the extra-genital retroperitoneal MMMT. This case and the review of the literature illustrate the importance of surgical treatment. However, there are no evidence-based guidelines for the systemic management of these tumors.
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Affiliation(s)
- G El Hachem
- Clinique d'Oncologie médicale, Institut Jules Bordet, ULB
| | - C Jungels
- Clinique d'Oncologie médicale, Institut Jules Bordet, ULB
| | - D Larsimont
- Clinique d'Anatomie pathologique, Institut Jules Bordet, ULB
| | - A Awada
- Clinique d'Anatomie pathologique, Institut Jules Bordet, ULB
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Psyrri A, Fortpied C, Koutsodontis G, Avgeris M, Kroupis C, Goutas N, Menis J, Herman L, Giurgea L, Remenár É, Degardin M, Pateras IS, Langendijk JA, van Herpen CML, Awada A, Germà-Lluch JR, Kienzer HR, Licitra L, Vermorken JB. Evaluation of the impact of tumor HPV status on outcome in patients with locally advanced unresectable head and neck squamous cell carcinoma (HNSCC) receiving cisplatin, 5-fluorouracil with or without docetaxel: a subset analysis of EORTC 24971 study. Ann Oncol 2018. [PMID: 28651338 DOI: 10.1093/annonc/mdx320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background EORTC 24971 was a phase III trial demonstrating superiority of induction regimen TPF (docetaxel, cisplatin, 5-fluorouracil) over PF (cisplatin/5-fluorouracil), in terms of progression-free (PFS) and overall survival (OS) in locoregionally advanced unresectable head and neck squamous cell carcinomas. We conducted a retrospective analysis of prospectively collected data aiming to evaluate whether only HPV(-) patients (pts) benefit from adding docetaxel to PF, in which case deintensifying induction treatment in HPV(+) pts could be considered. Patients and methods Pretherapy tumor biopsies (blocks or slides) were assessed for high-risk HPV by p16 immunohistochemistry, PCR and quantitative PCR. HPV-DNA+ and/or p16+ tumors were subjected to in situ hybridization (ISH) and HPV E6 oncogene expression qRT-PCR analysis. Primary and secondary objectives were to evaluate the value of HPV/p16 status as predictive factor of treatment benefit in terms of PFS and OS. The predictive effect was analyzed based on the model used in the primary analysis of the study with the addition of a treatment by marker interaction term and tested at two-sided 5% significance level. Results Of 358, 119 pts had available tumor samples and 58 of them had oropharyngeal cancer. Median follow-up was 8.7 years. Sixteen of 119 (14%) evaluable samples were p16+ and 20 of 79 (25%) evaluable tumors were HPV-DNA+. 13 of 40 pts (33%) assessed with HPV-DNA ISH and 12 of 28 pts (43%) assessed for HPV E6 mRNA were positive. The preplanned analysis showed no statistical evidence of predictive value of HPV/p16 status for PFS (P = 0.287) or OS (P = 0.118). Conclusions The incidence of HPV positivity was low in the subset of EORTC 24971 pts analyzed. In this analysis only powered to detect a large treatment by marker interaction, there was no statistical evidence that treatment effect found overall was different in magnitude in HPV(+) or HPV(-) pts. These results do not justify selection of TPF versus PF according to HPV status.
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Affiliation(s)
- A Psyrri
- Section of Medical Oncology, Second Department of Internal Medicine, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - G Koutsodontis
- Section of Medical Oncology, Second Department of Internal Medicine, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - M Avgeris
- Department of Biochemistry and Molecular Biology, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - C Kroupis
- Department of Clinical Biochemistry, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - N Goutas
- Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - J Menis
- EORTC Headquarters, Brussels, Belgium
| | - L Herman
- EORTC Headquarters, Brussels, Belgium
| | - L Giurgea
- EORTC Headquarters, Brussels, Belgium
| | - É Remenár
- Department of Head and Neck Surgery, National Institute of Oncology, Budapest, Hungary
| | - M Degardin
- Department of Oncology, Centre Oscar Lambret, Lille, France
| | - I S Pateras
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - J A Langendijk
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - C M L van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Awada
- Medical Oncology Clinic, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - J R Germà-Lluch
- Institut Català d'Oncologia, ICO L'Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - H R Kienzer
- 3rd Medical Department, Oncology and Hematology Center, Kaiser Franz Josef Spital/SMZ Sud, Vienna, Austria
| | - L Licitra
- Head and Neck Cancer Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, and University of Milan, Milan, Italy
| | - J B Vermorken
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium
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Specenier PM, Remenar E, Buter J, Schrijvers DL, Bergamini C, Licitra LF, Awada A, Clement PM, Fortpied C, Menis J, Vermorken JB. TPF plus cetuximab induction chemotherapy followed by biochemoradiation with weekly cetuximab plus weekly cisplatin or carboplatin: a randomized phase II EORTC trial. Ann Oncol 2018; 28:2219-2224. [PMID: 28911062 DOI: 10.1093/annonc/mdx300] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Our aim was to test the safety of cetuximab added to chemoradiation with either cisplatin or carboplatin after prior induction chemotherapy. Methods Patients with stage III/IV unresectable, squamous cell carcinoma of the head and neck received up to four cycles of TPF-E (cisplatin and docetaxel 75 mg/m2 on day 1 followed by 5-FU 750 mg/m2/day as a continuous infusion on days 1-5 plus cetuximab at a loading dose of 400 mg/m2 followed by a weekly dose of 250 mg/m2), with prophylactic antibiotics but no growth factors. Patients not progressing after four cycles of TPF-E were randomly assigned to radiotherapy (70 Gy over 7 weeks in 2 Gy fractions) and weekly cetuximab with either weekly cisplatin 40 mg/m2 or carboplatin, AUC of 1.5 mg/ml/min. Primary endpoint was feasibility. Results Forty-seven patients were recruited. One patient did not start TPF (hypersensitivity reaction during the cetuximab loading dose). Induction TPF-E was discontinued in 12 patients due to toxicity (6 patients), medical decision (2), death (1), patient refusal (1), protocol violation (1), co-morbidity (1). Three further patients were not randomized [progressive disease (1), protocol violation (1), toxicity and co-morbidity (1)]. Of particular interest are three patients who suffered from bowel perforation, one patient who died as results of pneumonia and septic shock, and a second patient who was found dead at home 12 days after starting TPF-E (cause of death unknown). Weekly cisplatin and carboplatin was stopped early in seven and four patients, respectively. Radiotherapy was stopped in two patients with cisplatin and interrupted in one patient with cisplatin and four patients with carboplatin. Conclusions The addition of cetuximab to full dose TPF induction chemotherapy led to unacceptable complications and premature closing of the study. Only 34 out of 46 patients completed four cycles of TPF-E and only 30 started biochemoradiation.
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Affiliation(s)
- P M Specenier
- Department of Oncology, Antwerp University Hospital, Edegem and Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - E Remenar
- Head & Neck Department, National Institute for Oncology, Budapest, Hungary
| | - J Buter
- Department of Oncology, Head and Neck Unit, Free University Medical Center, Amsterdam, The Netherlands
| | - D L Schrijvers
- Department of Hematology Oncology, Hospital Network Antwerp, Antwerp, Belgium
| | - C Bergamini
- Head and Neck Cancer Medical Oncology Unit, IRCCS National Cancer Institute, Milan, Italy
| | - L F Licitra
- Head and Neck Cancer Medical Oncology Unit, IRCCS National Cancer Institute, Milan, Italy
| | - A Awada
- Medical Oncology Clinic, Institute Jules Bordet, Brussels
| | - P M Clement
- Department of Oncology, Catholic University of Louvain, Louvain
| | - C Fortpied
- European Organisation for Research and Treatment of Cancer, EORTC Headquarters, Brussels, Belgium
| | - J Menis
- European Organisation for Research and Treatment of Cancer, EORTC Headquarters, Brussels, Belgium
| | - J B Vermorken
- Department of Oncology, Antwerp University Hospital, Edegem and Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Bachelot T, Kabos P, Yardley D, Dieras V, Costigan T, Klise S, Awada A. Abstract P1-17-03: Abemaciclib for the treatment of brain metastases secondary to hormone receptor positive breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-17-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Although a lower percentage of patients with hormone receptor-positive (HR+) metastatic breast cancer (MBC) develop brain metastases when compared with triple negative and HER2+ MBC patients, there are no regulatory approved systemic agents for the treatment of HR+ breast cancer brain metasteses, and this remains an unmet medical need. Standard local treatment options include surgery, stereotactic radiosurgery (SRS), and/or whole brain radiation therapy (WBRT). Abemaciclib, an oral selective CDK4 and 6 inhibitor administered on a continuous dosing schedule, has demonstrated clinical activity and an acceptable safety profile in heavily pre-treated HR+ MBC patients. Preclinically, abemaciclib crosses the blood-brain barrier, which is further supported clinically by detectable levels of abemaciclib similar to plasma levels in resected brain metastases in a subset of patients with HR+, HER2- MBC as previously reported for the current study. Together these data provide further rationale for evaluating abemaciclib in patients with brain metastases.
Methods: Study I3Y-MC-JPBO (NCT02308020) is an open-label, Phase 2, Simon 2-Stage trial evaluating the safety and efficacy of abemaciclib up to 200 mg BID in 4 cohorts of patients with brain metastases secondary to HR+ MBC, NSCLC, or melanoma. With regard to HR+ MBC, one cohort included HR+, HER2- patients, another one included HR+/HER2+ patients. All HR+ MBC patients enrolled to 1 of these 2 cohorts were required to have at least 1 measurable brain lesion. The primary objective was objective intracranial response rate as defined by Response Assessment in Neuro-Oncology brain metastases response criteria. Stage 1 was to enroll 23 evaluable patients per study part; if ≥2 respond to abemaciclib, 33 additional evaluable patients were to be enrolled to Stage 2. Secondary CNS objectives include best overall response, duration of response, and clinical benefit rate.
Results: For Stage 1 efficacy, in patients with HR+, HER2+ MBC futility was met. However, for HR+, HER2- patients, 2 confirmed, durable partial responses were observed and enrollment to Stage 2 is ongoing.
Conclusions: Previously, this study provided evidence that abemaciclib penetrates brain metastases in patients with HR+, HER2- MBC. The current results provide sufficient evidence of anti-tumor activity on brain metastases in patients with HR+, HER2- MBC to merit further exploration, but not for patients with HR+, HER2+ disease. Safety and tolerability results are similar to those previously reported for abemaciclib, with the majority of adverse events being gastrointestinal.
Citation Format: Bachelot T, Kabos P, Yardley D, Dieras V, Costigan T, Klise S, Awada A. Abemaciclib for the treatment of brain metastases secondary to hormone receptor positive breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-17-03.
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Affiliation(s)
- T Bachelot
- Centre Léon Bérard, Lyon, Cedex, France; University of Colorado Denver School of Medicine, Aurora, CO; Tennessee Oncology, Nashville, TN; Institut Curie Paris and Centre Eugene Marquis Renne, Paris, Cedex 05, France; Eli Lilly and Company, Indianapolis, IN; Institut Jules Bordet, Brussels, Belgium
| | - P Kabos
- Centre Léon Bérard, Lyon, Cedex, France; University of Colorado Denver School of Medicine, Aurora, CO; Tennessee Oncology, Nashville, TN; Institut Curie Paris and Centre Eugene Marquis Renne, Paris, Cedex 05, France; Eli Lilly and Company, Indianapolis, IN; Institut Jules Bordet, Brussels, Belgium
| | - D Yardley
- Centre Léon Bérard, Lyon, Cedex, France; University of Colorado Denver School of Medicine, Aurora, CO; Tennessee Oncology, Nashville, TN; Institut Curie Paris and Centre Eugene Marquis Renne, Paris, Cedex 05, France; Eli Lilly and Company, Indianapolis, IN; Institut Jules Bordet, Brussels, Belgium
| | - V Dieras
- Centre Léon Bérard, Lyon, Cedex, France; University of Colorado Denver School of Medicine, Aurora, CO; Tennessee Oncology, Nashville, TN; Institut Curie Paris and Centre Eugene Marquis Renne, Paris, Cedex 05, France; Eli Lilly and Company, Indianapolis, IN; Institut Jules Bordet, Brussels, Belgium
| | - T Costigan
- Centre Léon Bérard, Lyon, Cedex, France; University of Colorado Denver School of Medicine, Aurora, CO; Tennessee Oncology, Nashville, TN; Institut Curie Paris and Centre Eugene Marquis Renne, Paris, Cedex 05, France; Eli Lilly and Company, Indianapolis, IN; Institut Jules Bordet, Brussels, Belgium
| | - S Klise
- Centre Léon Bérard, Lyon, Cedex, France; University of Colorado Denver School of Medicine, Aurora, CO; Tennessee Oncology, Nashville, TN; Institut Curie Paris and Centre Eugene Marquis Renne, Paris, Cedex 05, France; Eli Lilly and Company, Indianapolis, IN; Institut Jules Bordet, Brussels, Belgium
| | - A Awada
- Centre Léon Bérard, Lyon, Cedex, France; University of Colorado Denver School of Medicine, Aurora, CO; Tennessee Oncology, Nashville, TN; Institut Curie Paris and Centre Eugene Marquis Renne, Paris, Cedex 05, France; Eli Lilly and Company, Indianapolis, IN; Institut Jules Bordet, Brussels, Belgium
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Fontaine C, Cappoen N, Renard V, Van Den Bulk H, Vuylsteke P, Glorieux P, Decoster L, Vanhoeij M, De Grève J, Awada A, Wildiers H. Updated results of the Breast cancer task force phase II study of neoadjuvant weekly carboplatin (Cp) added to paclitaxel (P) followed by epirubicin (E) and cyclophosphamide (C) in triple negative breast cancer (TNBC) patients (pts). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Loi S, Adams S, Schmid P, Cortés J, Cescon D, Winer E, Toppmeyer D, Rugo H, De Laurentiis M, Nanda R, Iwata H, Awada A, Tan A, Wang A, Aktan G, Karantza V, Salgado R. Relationship between tumor infiltrating lymphocyte (TIL) levels and response to pembrolizumab (pembro) in metastatic triple-negative breast cancer (mTNBC): Results from KEYNOTE-086. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.005] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [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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Fontaine C, Cappoen N, Renard V, Vuylsteke P, Van Den Bulck H, Glorieux P, t'Kint de Roodenbeke D, Dopchie C, Decoster L, Vanacker L, De Grève J, Awada A, Wildiers H. Abstract P5-16-06: Neoadjuvant weekly carboplatin and paclitaxel followed by dose dense epirubicin and cyclophosphamide in triple negative breast cancer patients: A single arm phase II study from the Belgian Society of Medical Oncology. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-16-06] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Triple negative breast cancer (TNBC) remains a challenging disease with dismal prognosis. Platinum analogs have not yet shown to improve long term outcome in this setting, but are associated with increased pathological complete response rate (pCR) at the cost of higher toxicity.
Aim: To further increase or maintain the high pCR rate with platinum containing schedules while decreasing toxicity by administering low dose weekly carboplatin instead of high-dose 3 weekly carboplatin as in CALGB 40603.(1)
Patients and methods: We evaluated the tolerability and the impact of the addition of weekly carboplatin (CP) to paclitaxel (P) and dose dense epirubicin-cyclofosfamide (EC) on pCR in an open-label multicenter phase II study in stage II/III TNBC patients (pts). Sixty three pts received dose dense paclitaxel (P:80mg/m2/wk) concurrent with carboplatin (CP: AUC=2) for 12 wks, followed by two-weekly epirubicin (E:90mg/m2) and cyclophosphamide (C:600mg/m2) for 4 cycles. The primary endpoint is pCR in the breast and axilla. Additionally treatment deliveryand adverse events are recorded. A correlative assessment of germline mutations in homologous recombination (HR) genes is planned. Pts are monitored for response by magnetic resonance and mammography and also for relapse free survival and time to treatment failure. The study size sample has been calculated according to the optimal Simon's two-stage design method. The target sample size was 63 patients with 80% power to detect a pCR rate of ≥47% (α= 0.05).
Results: Accrual to the study is completed with 63 eligible pts with operable, noninflammatory stage II and III TNBC included. Most patients were between 40 and 60 yrs old and were clinical stageT2 tumors. Half of the pts were clinically node + and 70% were G3. Sixty six percent had breast conserving surgery. Sixteen out of 26 (61.5%) of the currently evaluable pts achieved a pCR rate in the breast and axilla. The other ongoing patients have not yet reached this endpoint. Four out of 21 evaluable pts that completed the chemotherapy missed two or more doses of CP due to neutropenia(NP) G3/4(2), general deterioration G3(1) and polyneuropathy(PNP) G3(1) and seven pts needed one dose reduction of P and/or CP due to NP G3-4 (3-2) and PNP G2(1) and one abdominal infection.
Conclusion: These preliminary data suggest that the addition of weekly carboplatinum to neoadjuvant paclitaxel and EC is feasible and has a promising pCR rate in the breast and axilla as high as 61.5% in early TNBC pts. More mature toxicity and outcome data and correlation with genome analysis will be presented.
(1) Impact of the addition of carboplatin and/or bevacizumab to neoadjuvant once per week paclitaxel followed by dose-dense doxorubicin and cyclophosphamide on pathologic complete response rates in stage II to III triple-negative breast cancer: CALGB 40603(Alliance) Sikov WM et al. J Clin Oncol 33:13-21; 2014.
Citation Format: Fontaine C, Cappoen N, Renard V, Vuylsteke P, Van Den Bulck H, Glorieux P, t'Kint de Roodenbeke D, Dopchie C, Decoster L, Vanacker L, De Grève J, Awada A, Wildiers H. Neoadjuvant weekly carboplatin and paclitaxel followed by dose dense epirubicin and cyclophosphamide in triple negative breast cancer patients: A single arm phase II study from the Belgian Society of Medical Oncology [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-16-06.
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Affiliation(s)
- C Fontaine
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - N Cappoen
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - V Renard
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - P Vuylsteke
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - H Van Den Bulck
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - P Glorieux
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - D t'Kint de Roodenbeke
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - C Dopchie
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - L Decoster
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - L Vanacker
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - J De Grève
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - A Awada
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
| | - H Wildiers
- UZ Brussel, Jette, Brussels, Belgium; University Hospitals Leuven, Leuven, Belgium; Belgian Society of Medical Oncology (BSMO), Jette, Brussels, Belgium; Jules Bordet Institute, Brussels, Belgium
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Krop I, Abramson V, Colleoni M, Holmes FA, Estevez L, Hart L, Awada A, Zamagni C, Morris P, Schwartzberg L, Chan S, Wheatley D, Guculp A, Biganzoli L, Steinberg J, Gianni L, Trudeau M, Kelly CM, Uppal H, Tudor IC, Peterson A, Winer E, Yardley DA. Abstract P2-08-01: Results from a randomized placebo-controlled phase 2 trial evaluating exemestane ± enzalutamide in patients with hormone receptor–positive breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-08-01] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- I Krop
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - V Abramson
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - M Colleoni
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - FA Holmes
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - L Estevez
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - L Hart
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - A Awada
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - C Zamagni
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - P Morris
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - L Schwartzberg
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - S Chan
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - D Wheatley
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - A Guculp
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - L Biganzoli
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - J Steinberg
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - L Gianni
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - M Trudeau
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - CM Kelly
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - H Uppal
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - IC Tudor
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - A Peterson
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - E Winer
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - DA Yardley
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
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Miqueu P, Awada A, De Valeriola D, Piccart M. How do cancer centres communicate clinical trials opportunities to patients on their websites? Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30511-7] [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: 11/25/2022]
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Massard C, Soria J, Stathis A, Delord J, Awada A, Peters S, Lewin J, Bekradda M, Rezai K, Zeng Z, Azher H, Perez S, Siu L. A phase Ib trial with MK-8628/OTX015, a small molecule inhibitor of bromodomain (BRD) and extra-terminal (BET) proteins, in patients with selected advanced solid tumors. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32609-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sauri T, Awada A, Calvo E, Moreno V, Szyldergemajn S, Elez E, Barthelemy P, Boni V, Doger B, Teruel CF, Soto-Matos A, Tabernero J, Aftimos P. Lurbinectedin (PM01183) administered once (D1) every 3 weeks (q3w) in combination with capecitabine (XEL) in patients (pts) with metastatic breast (MBC), colorectal (CRC) or pancreatic (PaC) cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw368.35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sideris S, Aoun F, Martinez CN, Latifyan S, Awada A, Costante G, Gil T. Role of corticosteroids in prostate cancer progression: implications for treatment strategy in metastatic castration-resistant patients. J Endocrinol Invest 2016; 39:729-38. [PMID: 26786788 DOI: 10.1007/s40618-016-0430-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 01/04/2016] [Indexed: 11/27/2022]
Abstract
Corticosteroid agents (CA) are widely used in the treatment of metastatic castration-resistant prostate cancer (mCRPC) either as concomitant treatment with active agents such as docetaxel, cabazitaxel and abiraterone or in a palliative setting, predominantly due to their anti-inflammatory activity. However, the chronic use of CA has numerous side effects, especially in case of steroid-induced adrenal insufficiency. Furthermore, the latest clinical and preclinical data demonstrate that CA themselves are likely to promote tumour progression in certain populations of patients with mCRPC. Therefore, the role of CA in advanced disease should be carefully weighed for each patient and their withdrawal should be considered in some patients. This is necessary, especially in clinical trials that need good performance status patients to evaluate the activity and the safety of emerging drugs in mCRPC that do not require the concurrent use of CA. In oncology, there is no consensus on an algorithm of gradual steroid tapering and frequently the approach to this procedure is empirical. An algorithm is presented in this article based on clinical observations. Prospective studies are necessary to evaluate the efficacy and safety of the above-proposed algorithm in metastatic castration-resistant prostate cancer.
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Affiliation(s)
- S Sideris
- Medical Oncology Clinic, Jules Bordet Institute, Boulevard de Waterloo 121, 1000, Brussels, Belgium
| | - F Aoun
- Urology Department, Jules Bordet Institute, Boulevard de Waterloo 121, 1000, Brussels, Belgium
| | - C N Martinez
- Medical Oncology Clinic, Jules Bordet Institute, Boulevard de Waterloo 121, 1000, Brussels, Belgium
| | - S Latifyan
- Medical Oncology Clinic, Jules Bordet Institute, Boulevard de Waterloo 121, 1000, Brussels, Belgium
| | - A Awada
- Medical Oncology Clinic, Jules Bordet Institute, Boulevard de Waterloo 121, 1000, Brussels, Belgium
| | - G Costante
- Endocrinology Department, Jules Bordet Institute, Boulevard de Waterloo 121, 1000, Brussels, Belgium.
| | - T Gil
- Medical Oncology Clinic, Jules Bordet Institute, Boulevard de Waterloo 121, 1000, Brussels, Belgium
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Rugo HS, Cortes J, Awada A, O'Shaughnessy J, Twelves C, Im SA, Hannah AL, Lu L, Sy S, Caygill K, Zajchowski D, Davis DW, Hoch U, Perez EA. Abstract P1-13-02: Early change in topoisomerase 1 (Top1) positive circulating tumor cells (CTCs) is associated with overall survival (OS) in patients with advanced breast cancer after treatment with etirinotecan pegol. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-13-02] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Etirinotecan pegol (EP) is a long-acting Top1 inhibitor providing sustained levels of active metabolite throughout the entire chemotherapy cycle. The phase 3 BEACON trial compared EP to treatment of physician's choice (TPC) in patients with advanced breast cancer, demonstrating a non-statistically significant 2.1 month difference in survival favoring EP in the intent to treat population. A novel aspect of the BEACON trial is to explore the utility of biomarkers measured in CTCs for predicting efficacy with EP. Pre- and post-treatment CTCs were isolated from blood of 77% of the 852 BEACON patients. Target-specific pharmacodynamic biomarkers for EP measured in CTCs were analyzed to identify patients most responsive to treatment with EP.
Methods: Donation of blood samples for CTC analysis was voluntary. Participating BEACON patients had serial (baseline, Cycle 2 Day 1 [C2D1], Cycle 4 Day 1 [C4D1], End of Treatment) 7.5-mL whole blood samples drawn in EDTA tubes and shipped within 96 hours ambient to ApoCell (Houston, TX) for processing. PBMCs were separated by Ficoll® gradient, and CTCs were isolated using ApoStream® technology. Isolated cells were deposited on three slides and stained for DAPI, CD45, cytokeratin markers, as well as Top1, Top2, Ki67, γH2AX, Rad51, ABCG2, and TUNEL. Biomarkers were quantified by iCys® laser scanning cytometer equipped with image analysis software, and correlated with OS using Cox multiple regression and Kaplan-Meier analyses.
Results: The CTC substudy yielded 611 pre-treatment, 519 C2D1, 268 C4D1, and 431 End of Treatment samples. Among the successfully processed blood samples, 98% had detectable CTCs, with a median of 63, 46, 51, and 57 CTCs/mL at baseline, C2D1, C4D1, and End of Treatment, respectively. Cox regression analyses of CTC number and percentage of Top1, Top2, Ki67, or TUNEL positive CTCs identified a correlation for post-treatment number of Top1-positive CTCs with OS in patients receiving EP. To assess the impact of Top1-positive CTCs, patients were classified as Top1-High (> median) or Top1-Low (≤ median) based on the percent of Top1-positive CTCs at baseline. Among the Top1-High patients at baseline, significantly improved OS (HR 0.54, p=0.007) was observed for those who converted to Top1-Low after their first treatment with EP (C2D1), but not TPC (HR 1.12, p=0.613). These results suggest that decreased number of Top1-positive CTCs may reflect EP target engagement with Top1, as these patients derived the most benefit from treatment.
Conclusions: CTC collection and analysis was successfully incorporated into the phase 3 BEACON study, with 77% patient participation. CTC detection rate using ApoStream® was high, permitting evaluation of biomarkers at baseline and post-treatment. Significantly improved OS was observed in patients who had a decreased number of Top1-positive CTCs following cycle 1 of EP.
Citation Format: Rugo HS, Cortes J, Awada A, O'Shaughnessy J, Twelves C, Im S-A, Hannah AL, Lu L, Sy S, Caygill K, Zajchowski D, Davis DW, Hoch U, Perez EA. Early change in topoisomerase 1 (Top1) positive circulating tumor cells (CTCs) is associated with overall survival (OS) in patients with advanced breast cancer after treatment with etirinotecan pegol. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-13-02.
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Affiliation(s)
- HS Rugo
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - J Cortes
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - A Awada
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - J O'Shaughnessy
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - C Twelves
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - S-A Im
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - AL Hannah
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - L Lu
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - S Sy
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - K Caygill
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - D Zajchowski
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - DW Davis
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - U Hoch
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
| | - EA Perez
- University of California, San Francisco, San Francisco, CA; Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Consultant, Sebastopol, CA; Nektar Therapeutics, San Francisco, CA; Oncology Consulting Services, San Francisco, CA; Apocell, Inc., Houston, TX; Mayo Clinic, Jacksonville, FL
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Cortes J, Awada A, Perez EA, Rugo HS, Twelves C, Im SA, Zhao C, Hoch U, Ney J, Hannah AL, O'Shaughnessy J. Abstract P4-11-08: Impact of treatment on quality of life (QOL) in the BEACON study, a randomized phase III trial of etirinotecan pegol (EP) versus treatment of physician's choice (TPC) in patients (pts) with advanced breast cancer (aBC) whose disease has progressed following anthracycline (A), taxane (T) and capecitabine (C). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-11-08] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The need remains for novel agents that prolong survival and/or improve QOL in women with aBC. EP is a long-acting topoisomerase 1 inhibitor engineered to produce sustained exposure to irinotecan and its active metabolite SN38. Given previous efficacy seen in an earlier phase II trial in MBC, EP 145 mg/m2 every 3 weeks was compared to TPC (one of 7 single-agent regimens) in the randomized phase 3 BEACON study (NCT01492101). As reported at ASCO 2015 (abstract 1001), EP prolonged median overall survival by 2.1 months, although this did not reach statistical significance (12.4 vs 10.3 months; HR 0.87, p=0.08). Grade ≥ 3 adverse events were significantly less common with EP (48% vs 63% with TPC, p<0.001). We now present results of the QOL analyses.
Methods: Patients completed validated health-related QoL (HRQoL) questionnaires, EORTC QLQ-C30 (version 3.0) and breast cancer-specific QLQ-BR23, pretreatment and every 8 weeks until progression, death or withdrawal of consent. Questionnaires were scored according to the EORTC manual. For each scale, raw scores were standardized via a linear transformation to a range from 0 to 100. Absolute scores and changes from baseline were analyzed longitudinally and categorically using a 5-point difference calculated by treatment group. Comparisons between treatment groups were conducted to evaluate the differences in global health status, functional scores and symptoms over time.
Results: The majority of patients who were randomized (total: 733/852 [86%], EP: 378/429 [88%], TPC: 355/423 [84%]) completed at least one post-baseline HRQoL questionnaire. In the EORTC QLQ-C30, grade ≥ 3 AEs significantly impacted HRQoL measured by global health status and 5 additional functional domains. Of the six domains, compared to TPC in a longitudinal analysis, EP was statistically superior in the mean treatment effect through Week 32 in global health status p=0.02 and physical functioning scale p=0.01. EP was also numerically superior in all other scales. In EORTC QLQ-C30 and BR-23, a total of 13 symptoms were measured and categorically analyzed. There were no treatment differences in 7 of 13 symptom scales. EP was associated with worsening of 3 symptom scales: appetite loss, nausea/vomiting, and diarrhea. TPC was associated with worsening of 2 symptom scales: dyspnea and systemic side effects.
Conclusions: In the phase 3 BEACON trial comparing EP to TPC, the more favorable toxicity profile of EP resulted in an improvement in global health status and physical function (results of the symptom scales confirmed the different toxicities of the two arms). EP remains a promising investigational therapy for aBC.
Citation Format: Cortes J, Awada A, Perez EA, Rugo HS, Twelves C, Im S-A, Zhao C, Hoch U, Ney J, Hannah AL, O'Shaughnessy J. Impact of treatment on quality of life (QOL) in the BEACON study, a randomized phase III trial of etirinotecan pegol (EP) versus treatment of physician's choice (TPC) in patients (pts) with advanced breast cancer (aBC) whose disease has progressed following anthracycline (A), taxane (T) and capecitabine (C). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-11-08.
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Affiliation(s)
- J Cortes
- Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Mayo CLinic, Jacksonville, FL; University of California, San Francisco, San Francisco, CA; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Nektar Therapeutics, San Francisco, CA; Consultant, Sebastopol, CA; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX
| | - A Awada
- Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Mayo CLinic, Jacksonville, FL; University of California, San Francisco, San Francisco, CA; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Nektar Therapeutics, San Francisco, CA; Consultant, Sebastopol, CA; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX
| | - EA Perez
- Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Mayo CLinic, Jacksonville, FL; University of California, San Francisco, San Francisco, CA; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Nektar Therapeutics, San Francisco, CA; Consultant, Sebastopol, CA; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX
| | - HS Rugo
- Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Mayo CLinic, Jacksonville, FL; University of California, San Francisco, San Francisco, CA; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Nektar Therapeutics, San Francisco, CA; Consultant, Sebastopol, CA; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX
| | - C Twelves
- Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Mayo CLinic, Jacksonville, FL; University of California, San Francisco, San Francisco, CA; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Nektar Therapeutics, San Francisco, CA; Consultant, Sebastopol, CA; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX
| | - S-A Im
- Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Mayo CLinic, Jacksonville, FL; University of California, San Francisco, San Francisco, CA; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Nektar Therapeutics, San Francisco, CA; Consultant, Sebastopol, CA; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX
| | - C Zhao
- Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Mayo CLinic, Jacksonville, FL; University of California, San Francisco, San Francisco, CA; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Nektar Therapeutics, San Francisco, CA; Consultant, Sebastopol, CA; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX
| | - U Hoch
- Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Mayo CLinic, Jacksonville, FL; University of California, San Francisco, San Francisco, CA; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Nektar Therapeutics, San Francisco, CA; Consultant, Sebastopol, CA; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX
| | - J Ney
- Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Mayo CLinic, Jacksonville, FL; University of California, San Francisco, San Francisco, CA; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Nektar Therapeutics, San Francisco, CA; Consultant, Sebastopol, CA; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX
| | - AL Hannah
- Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Mayo CLinic, Jacksonville, FL; University of California, San Francisco, San Francisco, CA; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Nektar Therapeutics, San Francisco, CA; Consultant, Sebastopol, CA; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX
| | - J O'Shaughnessy
- Vall D'Hebron University Hospital, Barcelona, Spain; Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Mayo CLinic, Jacksonville, FL; University of California, San Francisco, San Francisco, CA; University of Leeds, Leeds, United Kingdom; Seoul National University College of Medicine, Seoul, Korea; Nektar Therapeutics, San Francisco, CA; Consultant, Sebastopol, CA; Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX
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Morello V, Hultberg A, De Jonge N, Huyghe L, Hanssens V, Brouckaert P, Saunders M, Dreier T, Thibault A, Rolfo C, Aftimos P, Awada A, Michieli P, de Haard H. Abstract P2-05-17: ARGX-111 depletes MET-expressing circulating tumor cells via enhanced ADCC, resulting in inhibition of metastasis. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-05-17] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Several lines of experimental evidence suggest that Hepatocyte Growth Factor (HGF) and its receptor MET play an important role in breast cancer progression and drug resistance. To date, targeted MET inhibitors in clinical development have primarily shown cytostatic rather than cytotoxic effects. Development of a cytotoxic MET inhibitor would serve to complement standard breast cancer therapy, especially when administered in the adjuvant/neo-adjuvant setting.
We have developed ARGX-111, a human antibody antagonist of MET function. ARGX-111 blocks both HGF-dependent and -independent signaling, down-regulates tumor cell surface expression of MET and kills MET-overexpressing cells by enhanced antibody-dependent cellular cytotoxicity (ADCC).
ARGX-111 was shown to be more efficacious than an ADCC-inactive control antibody in both HGF-dependent and -independent tumor xenograft models. ADCC reporter assays confirmed the cytotoxic effects of ARGX-111 in patient-derived primary tumor specimens, including MET-expressing breast cancer stem-like cells. In an orthotopic mouse model of metastatic mammary carcinoma (MDA-MB-231), adjuvant or neo-adjuvant treatment with ARGX-111 was significantly more effective in depleting circulating tumor cells (CTCs) and suppressing the development of bone and lung metastases than the ADCC-inactive control.
Taken together, these results provide a rationale for clinical investigation of ARGX-111 in the early breast cancer setting. An ongoing Phase 1 study (NCT02055066) is examining the effects of ARGX-111 on CTCs, alongside the assessment of its safety and efficacy.
Citation Format: Morello V, Hultberg A, De Jonge N, Huyghe L, Hanssens V, Brouckaert P, Saunders M, Dreier T, Thibault A, Rolfo C, Aftimos P, Awada A, Michieli P, de Haard H. ARGX-111 depletes MET-expressing circulating tumor cells via enhanced ADCC, resulting in inhibition of metastasis. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-05-17.
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Affiliation(s)
- V Morello
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - A Hultberg
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - N De Jonge
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - L Huyghe
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - V Hanssens
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - P Brouckaert
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - M Saunders
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - T Dreier
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - A Thibault
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - C Rolfo
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - P Aftimos
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - A Awada
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - P Michieli
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
| | - H de Haard
- University of Torino Medical School; arGEN-X; Inflammation Research Center; Universitair Ziekenhuis Antwerpen; Institut Jules Bordet
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Gebhart G, Lamberts LE, Wimana Z, Garcia C, Emonts P, Ameye L, Stroobants S, Huizing M, Aftimos P, Tol J, Oyen WJG, Vugts DJ, Hoekstra OS, Schröder CP, Menke-van der Houven van Oordt CW, Guiot T, Brouwers AH, Awada A, de Vries EGE, Flamen P. Molecular imaging as a tool to investigate heterogeneity of advanced HER2-positive breast cancer and to predict patient outcome under trastuzumab emtansine (T-DM1): the ZEPHIR trial. Ann Oncol 2015; 27:619-24. [PMID: 26598545 DOI: 10.1093/annonc/mdv577] [Citation(s) in RCA: 241] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 11/17/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Only human epidermal growth factor receptor (HER)2 status determined by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) has been validated to predict efficacy of HER2-targeting antibody-drug-conjugate trastuzumab emtansine (T-DM1). We propose molecular imaging to explore intra-/interpatient heterogeneity in HER2 mapping of metastatic disease and to identify patients unlikely to benefit from T-DM1. PATIENTS AND METHODS HER2-positive mBC patients with IHC3+ or FISH ≥ 2.2 scheduled for T-DM1 underwent a pretreatment HER2-positron emission tomography (PET)/computed tomography (CT) with (89)Zr-trastuzumab. [(18)F]2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT was performed at baseline and before T-DM1 cycle 2. Patients were grouped into four HER2-PET/CT patterns according to the proportion of FDG-avid tumor load showing relevant (89)Zr-trastuzumab uptake (>blood pool activity): patterns A and B were considered positive (>50% or all of the tumor load 'positive'); patterns C and D were considered negative (>50% or all of the tumor load 'negative'). Early FDG-PET/CT was defined as nonresponding when >50% of the tumor load showed no significant reduction of FDG uptake (<15%). Negative (NPV) and positive predictive values (PPV) of HER2-PET/CT, early FDG response and their combination were assessed to predict morphological response (RECIST 1.1) after three T-DM1 cycles and time-to-treatment failure (TTF). RESULTS In the 56 patients analyzed, 29% had negative HER2-PET/CT while intrapatient heterogeneity (patterns B and C) was found in 46% of patients. Compared with RECIST1.1, respective NPV/PPV for HER2-PET/CT were 88%/72% and 83%/96% for early FDG-PET/CT. Combining HER2-PET/CT and FDG-PET/CT accurately predicted morphological response (PPV and NPV: 100%) and discriminated patients with a median TTF of only 2.8 months [n = 12, 95% confidence interval (CI) 1.4-7.6] from those with a TTF of 15 months (n = 25, 95% CI 9.7-not calculable). CONCLUSIONS Pretreatment imaging of HER2 targeting, combined with early metabolic response assessment holds great promise for improving the understanding of tumor heterogeneity in mBC and for selecting patients who will/will not benefit from T-DM1. CLINICALTRIALSGOV IDENTIFIER NCT01565200.
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Affiliation(s)
- G Gebhart
- Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - L E Lamberts
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Z Wimana
- Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - C Garcia
- Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - P Emonts
- Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - L Ameye
- Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium
| | | | - M Huizing
- Antwerp University Hospital, Antwerpen, Belgium
| | - P Aftimos
- Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - J Tol
- Radboud University Medical Center Nijmegen, Nijmegen
| | - W J G Oyen
- Radboud University Medical Center Nijmegen, Nijmegen
| | - D J Vugts
- VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - O S Hoekstra
- VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - C P Schröder
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - T Guiot
- Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - A H Brouwers
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A Awada
- Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - E G E de Vries
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - P Flamen
- Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium
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Venugopal B, Awada A, Evans TRJ, Dueland S, Hendlisz A, Rasch W, Hernes K, Hagen S, Aamdal S. A first-in-human phase I and pharmacokinetic study of CP-4126 (CO-101), a nucleoside analogue, in patients with advanced solid tumours. Cancer Chemother Pharmacol 2015; 76:785-92. [PMID: 26289594 DOI: 10.1007/s00280-015-2846-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 08/05/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND CP-4126 (gemcitabine elaidate, previously CO-101) is a lipid-drug conjugate of gemcitabine designed to circumvent human equilibrative nucleoside transporter1-related resistance to gemcitabine. The purpose of this study was to determine the maximum tolerated dose (MTD) and the recommended phase II dose (RP2D) of CP-4126, and to describe its pharmacokinetic profile. METHODS Eligible patients with advanced refractory solid tumours, and adequate performance status, haematological, renal and hepatic function, were treated with one of escalating doses of CP-4126 administered by a 30-min intravenous infusion on days 1, 8 and 15 of a 28-day cycle. Blood and urine samples were collected to determine the pharmacokinetics (PKs) of CP-4126. RESULTS Forty-three patients, median age 59 years (range 18-76; male = 27, female = 16), received one of ten dose levels (30-1600 mg/m(2)). Dose-limiting toxicities included grade 3 anaemia, grade 3 fatigue and grade 3 elevation of transaminases. The MTD and RP2D were 1250 mg/m(2) on basis of the toxicity and PK data. CP-4126 followed dose-dependent kinetics and maximum plasma concentrations occurred at the end of CP-4126 infusion. Seven patients achieved stable disease sustained for ≥3 months, including two patients with pancreatic cancer who had progressed on or after gemcitabine exposure. CONCLUSIONS CP-4126 was well tolerated with comparable toxicity profile to gemcitabine. Future studies are required to determine its anti-tumour efficacy, either alone or in combination with other cytotoxic chemotherapy regimens.
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MESH Headings
- Adolescent
- Adult
- Aged
- Antimetabolites, Antineoplastic/administration & dosage
- Antimetabolites, Antineoplastic/adverse effects
- Antimetabolites, Antineoplastic/pharmacokinetics
- Antimetabolites, Antineoplastic/therapeutic use
- Cohort Studies
- Deoxycytidine/administration & dosage
- Deoxycytidine/adverse effects
- Deoxycytidine/analogs & derivatives
- Deoxycytidine/pharmacokinetics
- Deoxycytidine/therapeutic use
- Disease Progression
- Dose-Response Relationship, Drug
- Drug Monitoring
- Drug Resistance, Neoplasm
- Drugs, Investigational/administration & dosage
- Drugs, Investigational/adverse effects
- Drugs, Investigational/pharmacokinetics
- Drugs, Investigational/therapeutic use
- Female
- Half-Life
- Humans
- Male
- Metabolic Clearance Rate
- Middle Aged
- Neoplasms/blood
- Neoplasms/drug therapy
- Neoplasms/metabolism
- Neoplasms/pathology
- Tumor Burden/drug effects
- Young Adult
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Affiliation(s)
- B Venugopal
- Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, UK.
- Institute of Cancer Sciences, University of Glasgow, Switchback Road, Glasgow, G61 1BD, UK.
| | - A Awada
- Institut Jules Bordet, Université Libre de Bruxelles, 121, Boulevard de Waterloo, 1000, Brussels, Belgium
| | - T R J Evans
- Beatson West of Scotland Cancer Centre, 1053 Great Western Road, Glasgow, G12 0YN, UK
- Institute of Cancer Sciences, University of Glasgow, Switchback Road, Glasgow, G61 1BD, UK
| | - S Dueland
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - A Hendlisz
- Institut Jules Bordet, Université Libre de Bruxelles, 121, Boulevard de Waterloo, 1000, Brussels, Belgium
| | - W Rasch
- Clavis Pharma ASA, Parkveien 53 B, 0256, Oslo, Norway
| | - K Hernes
- Clavis Pharma ASA, Parkveien 53 B, 0256, Oslo, Norway
| | - S Hagen
- Clavis Pharma ASA, Parkveien 53 B, 0256, Oslo, Norway
| | - S Aamdal
- Department of Oncology, Oslo University Hospital, Oslo, Norway
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Van Herpen C, Banerji U, Mommers E, Koper N, Goedings P, Lopez J, Awada A, Fiebrich H, Aftimos P. 333 Phase I dose-escalation trial with the DNA-alkylating anti-HER2 antibody-drug conjugate SYD985. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30197-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Spicer J, Awada A, Brunsvig P, Saunders A, Olsen W, Nicolaisen B, Rekdal O, Laruelle M, Marjuadi F, Vakili J, Aftimos P, Barthelemy P, Deva S, Baurain J. 528 Intratumoural treatment with LTX-, an oncolytic peptide immunotherapy, in patients with advanced metastatic disease induces CD8 effector cells and regression in some injected tumours. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30329-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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40
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Cortes J, Crown J, Awada A, Schmid P, Gianni L, Garcia-Estevez L, Martinez-Janez N, Chan S, Steinberg J, Blaney M, Tudor I, Uppal H, Peterson A, Miller K, Yardley D, Hudis C, Traina T. 1802 Overall survival (OS) from the phase 2 study of enzalutamide (ENZA), an androgen receptor (AR) signaling inhibitor, in AR+ advanced triple-negative breast cancer (aTNBC). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30756-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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El Hajj P, Gilot D, Migault M, Theunis A, van Kempen LC, Salés F, Fayyad-Kazan H, Badran B, Larsimont D, Awada A, Bachelot L, Galibert MD, Ghanem G, Journe F. SNPs at miR-155 binding sites of TYRP1 explain discrepancy between mRNA and protein and refine TYRP1 prognostic value in melanoma. Br J Cancer 2015; 113:91-8. [PMID: 26068396 PMCID: PMC4647532 DOI: 10.1038/bjc.2015.194] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/19/2015] [Accepted: 04/29/2015] [Indexed: 01/01/2023] Open
Abstract
Background: We previously demonstrated an inverse correlation between tyrosinase-related protein 1 (TYRP1) mRNA expression in melanoma metastases and patient survival. However, TYRP1 protein was not detected in half of tissues expressing mRNA and did not correlate with survival. Based on a study reporting that 3′ untranslated region (UTR) of TYRP1 mRNA contains two miR-155-5p (named miR-155) binding sites exhibiting single-nucleotide polymorphisms (SNPs) that promote (matched miRNA–mRNA interaction) mRNA decay or not (mismatched), we aimed to investigate the role of miR-155 in the regulation of TYRP1 mRNA expression and protein translation accounting for these SNPs. Methods: The effect of miR-155 on TYRP1 mRNA/protein expression was evaluated in two melanoma cell lines harbouring matched or mismatched miR-155–TYRP1 mRNA interaction after transfection with pre-miR-155. In parallel, 192 skin and lymph node melanoma metastases were examined for TYRP1 mRNA/protein, miR-155 and SNPs and correlated with patient survival. TYRP1 mRNA, SNPs at its 3′UTR and miR-155 were analysed by RT–qPCR, whereas TYRP1 protein was evaluated by western blot in cell lines and by immunohistochemistry in metastatic tissues. Results: The miR-155 induced a dose-dependent TYRP1 mRNA decay and hampered its translation into protein in the line with the ‘match' genotype. In melanoma metastases, TYRP1 mRNA inversely correlated with miR-155 expression but not with TYRP1 protein in the ‘match' group, whereas it positively correlated with protein but not with miR-155 in the ‘mismatch' group. Consequently, in the latter group, TYRP1 protein inversely correlated with survival. Conclusion: Polymorphisms in 3′UTR of TYRP1 mRNA can affect TYRP1 mRNA regulation by miR-155 and its subsequent translation into protein. These SNPs can render TYRP1 mRNA and protein expression nonsusceptible to miR-155 activity and disclose a prognostic value for TYRP1 protein in a subgroup of melanoma patients. These data support the interest in the prognostic value of melanogenic markers and propose TYRP1 to refine prognosis in patients with advanced disease.
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Affiliation(s)
- P El Hajj
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, 1 Rue Heger-Bordet, 1000 Brussels, Belgium
| | - D Gilot
- CNRS UMR 6290, Université de Rennes 1, 2 Avenue du Pr. Léon Bernard, 35000 Rennes, France
| | - M Migault
- CNRS UMR 6290, Université de Rennes 1, 2 Avenue du Pr. Léon Bernard, 35000 Rennes, France
| | - A Theunis
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, 1 Rue Heger-Bordet, 1000 Brussels, Belgium
| | - L C van Kempen
- Department of Pathology, McGill University and Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, H3T 1E2 Montreal, QC, Canada
| | - F Salés
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, 1 Rue Heger-Bordet, 1000 Brussels, Belgium
| | - H Fayyad-Kazan
- Laboratory of Experimental Hematology, Institut Jules Bordet, Université Libre de Bruxelles, 1 Rue Heger-Bordet, 1000 Brussels, Belgium
| | - B Badran
- Department of Biochemistry, Lebanese University, Rafic Campus, 1003 Hadath-Beirut, Lebanon
| | - D Larsimont
- Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, 1 Rue Heger-Bordet, 1000 Brussels, Belgium
| | - A Awada
- Clinic of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, 1 Rue Heger-Bordet, 1000 Brussels, Belgium
| | - L Bachelot
- CNRS UMR 6290, Université de Rennes 1, 2 Avenue du Pr. Léon Bernard, 35000 Rennes, France
| | - M-D Galibert
- CNRS UMR 6290, Université de Rennes 1, 2 Avenue du Pr. Léon Bernard, 35000 Rennes, France
| | - G Ghanem
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, 1 Rue Heger-Bordet, 1000 Brussels, Belgium
| | - F Journe
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, 1 Rue Heger-Bordet, 1000 Brussels, Belgium
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Cortes Castan J, Schmid P, Awada A, Uppal H, Tudor I, Blaney M, Steinberg J, Yardley D, Hudis C, Traina T. Stage 1 results from MDV3100-11: A 2-stage study of enzalutamide (ENZA), an androgen receptor (AR) inhibitor, in advanced AR+ triple-negative breast cancer (TNBC). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv115.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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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Awada A, Rizk W, Rizk T. Un cas de « CLIPPERS » guéri par immunothérapie cinq ans avant la description du syndrome. Rev Neurol (Paris) 2015; 171:397-8. [DOI: 10.1016/j.neurol.2014.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 11/23/2014] [Accepted: 11/29/2014] [Indexed: 11/29/2022]
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Awada A, Wahab A, Moussa R. [Craniocervical mass in a chronic hemodialyzed patient]. Rev Neurol (Paris) 2015; 171:394-5. [PMID: 25555851 DOI: 10.1016/j.neurol.2014.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 10/04/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
Affiliation(s)
- A Awada
- Service de neurologie, hôtel-Dieu de France, université St-Joseph, boulevard A.-Naccache, BP 166830, Beyrouth, Achrafieh, Liban.
| | - A Wahab
- Service de neurologie, hôtel-Dieu de France, université St-Joseph, boulevard A.-Naccache, BP 166830, Beyrouth, Achrafieh, Liban
| | - R Moussa
- Service de neurochirurgie, hôtel-Dieu de France, université St-Joseph, boulevard A.-Naccache, BP 166830, Beyrouth, Achrafieh, Liban
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Jacobs J, Zwaenepoel K, Aftimos P, Rolfo C, Rottey S, de Lendonck LY, Silence K, Awada A, Thibault A, Pauwels P. 108 CD70 (TNFSF7), a receptor involved in acute immune modulation of viral infection, is frequently overexpressed in solid and hematological malignancies. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70234-5] [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: 10/24/2022]
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46
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Polastro L, de Saint Aubain N, Lemort M, Delhaye F, Awada A. [Cardiac metastase of a soft tissue sarcoma: a case report and a review of the literature]. Rev Med Brux 2014; 35:499-503. [PMID: 25619049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Soft tissue sarcomas represent rare tumors. They recur most often locally and in the lungs. We report the case of a 58-year woman who was treated for awith chemotherapy and then surgery. About a year after the end of the treatment an intracardiac mass was identified during a follow up chest CT-scan. The patient underwent a surgical resection of that mass found to bel myxoid chondrosarcoma metastasis. Only 2 cases of cardiac dissemination of extraskeletal myxoid chondrosarcoma have been described. The differential diagnosis of intracardiac masses is discussed. In some carefully selected cases atrisks of obstructive shock or embolization and unique metastatic location, cardiac surgery should be considered.
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Twelves C, Cortes J, Olivo M, He Y, Awada A. Efficacy of Eribulin in a Second-Line or Later Setting in Patients (Pts) with Metastatic Breast Cancer (Mbc): a Pooled Analysis. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu329.42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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48
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Sauri T, Aftimos P, Szyldergemajn S, Elez E, Barthelemy P, Moreno R, Soto-Matos A, Extremera S, Tabernero J, Awada A. Lurbinectedin (Pm01183) on Days (D) 1 & 8 in Combination with Capecitabine (Xel) in Patients (Pts) with Metastatic Breast (Mbc), Colorectal (Crc) or Pancreatic (Pac) Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu331.42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rothé F, Laes JF, Lambrechts D, Smeets D, Vincent D, Maetens M, Fumagalli D, Michiels S, Drisis S, Moerman C, Detiffe JP, Larsimont D, Awada A, Piccart M, Sotiriou C, Ignatiadis M. Plasma circulating tumor DNA as an alternative to metastatic biopsies for mutational analysis in breast cancer. Ann Oncol 2014; 25:1959-1965. [PMID: 25185240 DOI: 10.1093/annonc/mdu288] [Citation(s) in RCA: 178] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Molecular screening programs use next-generation sequencing (NGS) of cancer gene panels to analyze metastatic biopsies. We interrogated whether plasma could be used as an alternative to metastatic biopsies. PATIENTS AND METHODS The Ion AmpliSeq™ Cancer Hotspot Panel v2 (Ion Torrent), covering 2800 COSMIC mutations from 50 cancer genes was used to analyze 69 tumor (primary/metastases) and 31 plasma samples from 17 metastatic breast cancer patients. The targeted coverage for tumor DNA was ×1000 and for plasma cell-free DNA ×25 000. Whole blood normal DNA was used to exclude germline variants. The Illumina technology was used to confirm observed mutations. RESULTS Evaluable NGS results were obtained for 60 tumor and 31 plasma samples from 17 patients. When tumor samples were analyzed, 12 of 17 (71%, 95% confidence interval (CI) 44% to 90%) patients had ≥1 mutation (median 1 mutation per patient, range 0-2 mutations) in either p53, PIK3CA, PTEN, AKT1 or IDH2 gene. When plasma samples were analyzed, 12 of 17 (71%, 95% CI: 44-90%) patients had ≥1 mutation (median 1 mutation per patient, range 0-2 mutations) in either p53, PIK3CA, PTEN, AKT1, IDH2 and SMAD4. All mutations were confirmed. When we focused on tumor and plasma samples collected at the same time-point, we observed that, in four patients, no mutation was identified in either tumor or plasma; in nine patients, the same mutations was identified in tumor and plasma; in two patients, a mutation was identified in tumor but not in plasma; in two patients, a mutation was identified in plasma but not in tumor. Thus, in 13 of 17 (76%, 95% CI 50% to 93%) patients, tumor and plasma provided concordant results whereas in 4 of 17 (24%, 95% CI 7% to 50%) patients, the results were discordant, providing complementary information. CONCLUSION Plasma can be prospectively tested as an alternative to metastatic biopsies in molecular screening programs.
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Affiliation(s)
- F Rothé
- Breast Cancer Translational Research Laboratory J.C. Heuson, Université Libre de Bruxelles, Institut Jules Bordet, Brussels
| | - J-F Laes
- OncoDNA, Gosselies, KU Leuven, Leuven
| | - D Lambrechts
- Laboratory of Translational Genetics, KU Leuven, Leuven; Vesalius Research Center, VIB, Leuven, Belgium
| | - D Smeets
- Laboratory of Translational Genetics, KU Leuven, Leuven; Vesalius Research Center, VIB, Leuven, Belgium
| | - D Vincent
- Breast Cancer Translational Research Laboratory J.C. Heuson, Université Libre de Bruxelles, Institut Jules Bordet, Brussels
| | - M Maetens
- Breast Cancer Translational Research Laboratory J.C. Heuson, Université Libre de Bruxelles, Institut Jules Bordet, Brussels
| | - D Fumagalli
- Breast Cancer Translational Research Laboratory J.C. Heuson, Université Libre de Bruxelles, Institut Jules Bordet, Brussels
| | - S Michiels
- Department of Biostatistic and Epidemiology, Gustave Roussy, Univ. Paris-Sud, Villejuif, France
| | - S Drisis
- Department of Radiology, Université Libre de Bruxelles, Institut Jules Bordet, Brussels
| | - C Moerman
- Department of Radiology, Université Libre de Bruxelles, Institut Jules Bordet, Brussels
| | | | - D Larsimont
- Department of Pathology, Université Libre de Bruxelles, Institut Jules Bordet, Brussels
| | - A Awada
- Department of Medical Oncology, Université Libre de Bruxelles, Institut Jules Bordet, Brussels
| | - M Piccart
- Department of Medical Oncology, Université Libre de Bruxelles, Institut Jules Bordet, Brussels
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory J.C. Heuson, Université Libre de Bruxelles, Institut Jules Bordet, Brussels; Department of Medical Oncology, Université Libre de Bruxelles, Institut Jules Bordet, Brussels.
| | - M Ignatiadis
- Breast Cancer Translational Research Laboratory J.C. Heuson, Université Libre de Bruxelles, Institut Jules Bordet, Brussels; Department of Medical Oncology, Université Libre de Bruxelles, Institut Jules Bordet, Brussels
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Awada A, Bondarenko IN, Bonneterre J, Nowara E, Ferrero JM, Bakshi AV, Wilke C, Piccart M. A randomized controlled phase II trial of a novel composition of paclitaxel embedded into neutral and cationic lipids targeting tumor endothelial cells in advanced triple-negative breast cancer (TNBC). Ann Oncol 2014; 25:824-831. [PMID: 24667715 DOI: 10.1093/annonc/mdu025] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [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] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND EndoTAG-1, composed of paclitaxel embedded in liposomal membranes targeting tumor endothelial cells, was evaluated for safety and efficacy in advanced triple-negative breast cancer (TNBC). PATIENTS AND METHODS One hundred and forty patients were treated with weekly EndoTAG-1 (22 mg/m(2)) plus paclitaxel (70 mg/m(2)), twice weekly EndoTAG-1 (2× 44 mg/m(2)), or weekly paclitaxel (90 mg/m(2)) for greater than or equal to four cycles (3-week treatment + 1-week rest) or until progression/toxicity. Primary end point was progression-free survival (PFS) rate evaluated centrally after four cycles of therapy (week 16). The study was not powered for intergroup comparisons. RESULTS The PFS rate at week 16 was 59.1% [one-sided 95% CI: 45.6, ∞] on combination treatment, 34.2% [21.6, ∞] on EndoTAG-1, and 48.0% [30.5, ∞] on paclitaxel. Median PFS reached 4.2, 3.4, and 3.7 months, respectively. After complete treatment (week 41 analysis), median overall survival (OS) was 13.0, 11.9, and 13.1 months for the modified Intention-to-Treat (ITT) population and 15.1, 12.5, and 8.9 months for the per-protocol population, respectively. The clinical benefit rate was 53%, 31%, and 36% for the treatment groups. Safety analysis revealed known toxicities of the drugs with slight increases of grade 3/4 neutropenia on combination therapy. CONCLUSION Treatment of advanced TNBC with a combination of EndoTAG-1 and standard paclitaxel [Taxol® (Bristol-Myers Squibb GmbH), or equivalent generic formulation] was well tolerated and showed antitumor efficacy. The positive trend needs to be confirmed in a randomized phase III trial. STUDY REGISTRATION European Clinical Trials Database: EudraCT number 2006-002221-23. ClinicalTrials.gov identifier: NCT00448305.
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Affiliation(s)
- A Awada
- Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium.
| | - I N Bondarenko
- Dnepropetrovsk State Medical Academy, Dnepropetrovsk, Ukraine
| | - J Bonneterre
- Oscar Lambret Center of Fight Against Cancer, Lille, France
| | - E Nowara
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - J M Ferrero
- Antoine Lacassagne Center of Fight Against Cancer, Nice, France
| | - A V Bakshi
- Kaushalya Medical Foundation, Thane, India
| | - C Wilke
- Medigene AG, Martinsried, Germany
| | - M Piccart
- Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium
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