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Márquez-Rodas I, Longo F, Rodriguez-Ruiz ME, Calles A, Ponce S, Jove M, Rubio-Viqueira B, Perez-Gracia JL, Gómez-Rueda A, López-Tarruella S, Ponz-Sarvise M, Álvarez R, Soria-Rivas A, de Miguel E, Ramos-Medina R, Castañon E, Gajate P, Sempere-Ortega C, Jiménez-Aguilar E, Aznar MA, Calvo A, Lopez-Casas PP, Martín-Algarra S, Martín M, Tersago D, Quintero M, Melero I. Intratumoral nanoplexed poly I:C BO-112 in combination with systemic anti-PD-1 for patients with anti-PD-1-refractory tumors. Sci Transl Med 2021; 12:12/565/eabb0391. [PMID: 33055241 DOI: 10.1126/scitranslmed.abb0391] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 08/13/2020] [Indexed: 01/01/2023]
Abstract
Intratumoral therapies, especially Toll-like receptor agonists, can trigger both the innate and adaptive immune systems. BO-112 is a nanoplexed form of polyinosinic:polycytidylic acid (poly I:C) that induces local and systemic immunotherapeutic effects in mouse models. In a multicenter phase 1 clinical trial, repeated intratumoral administrations of BO-112 induced an increase in tumor cell necrosis and apoptosis, as well as augmented immune reactivity according to gene expression profiling. The first three cohorts receiving BO-112 as a monotherapy resulted in a recommended dose of 1 mg that could be safely repeated. Two grade 3 to 4 adverse reactions in the form of reversible thrombocytopenia were reported. In a fourth cohort of 28 patients with tumors that had primary resistance to anti-programmed cell death protein-1 (PD-1), the combination of intratumoral BO-112 with nivolumab or pembrolizumab was also well tolerated, and 3 patients (2 with melanoma and 1 with renal cell carcinoma) achieved partial responses, with 10 more patients having stable disease at 8 to 12 weeks. Thus, local BO-112 combined with a systemic anti-PD-1 agent might be a strategy to revert anti-PD-1 resistance.
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Affiliation(s)
- Iván Márquez-Rodas
- Medical Oncology Department, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERONC, Madrid 28007, Spain.
| | - Federico Longo
- Medical Oncology Department, Hospital Ramón y Cajal, IRYCIS and CIBERONC, Madrid28034, Spain
| | | | - Antonio Calles
- Medical Oncology Department, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERONC, Madrid 28007, Spain
| | - Santiago Ponce
- Medical Oncology Department, Hospital 12 de Octubre, Madrid 28041, Spain
| | - Maria Jove
- Medical Oncology Department, Institut Català d'Oncologia, Barcelona 08908, Spain
| | - Belén Rubio-Viqueira
- Medical Oncology Department, Hospital Universitario Quirónsalud, Madrid 28223, Spain
| | | | - Ana Gómez-Rueda
- Medical Oncology Department, Hospital Ramón y Cajal, IRYCIS and CIBERONC, Madrid28034, Spain
| | - Sara López-Tarruella
- Medical Oncology Department, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERONC, Madrid 28007, Spain
| | | | - Rosa Álvarez
- Medical Oncology Department, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERONC, Madrid 28007, Spain
| | - Ainara Soria-Rivas
- Medical Oncology Department, Hospital Ramón y Cajal, IRYCIS and CIBERONC, Madrid28034, Spain
| | - Enrique de Miguel
- Radiology Department, Hospital General Universitario Gregorio Marañón, Madrid 28007, Spain
| | - Rocío Ramos-Medina
- Medical Oncology Department, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERONC, Madrid 28007, Spain
| | - Eduardo Castañon
- Medical Oncology Department, Clínica Universidad de Navarra, Pamplona 31008, Spain
| | - Pablo Gajate
- Medical Oncology Department, Hospital Ramón y Cajal, IRYCIS and CIBERONC, Madrid28034, Spain
| | | | | | - M Angela Aznar
- CIMA and Clínica Universidad de Navarra and CIBERONC, Pamplona 31008, Spain
| | - Aitana Calvo
- Medical Oncology Department, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERONC, Madrid 28007, Spain
| | - Pedro P Lopez-Casas
- Highlight Therapeutics (formerly known as Bioncotech Therapeutics), Valencia 46980, Spain
| | | | - Miguel Martín
- Medical Oncology Department, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERONC, Madrid 28007, Spain
| | - Dominique Tersago
- Highlight Therapeutics (formerly known as Bioncotech Therapeutics), Valencia 46980, Spain
| | - Marisol Quintero
- CIMA and Clínica Universidad de Navarra and CIBERONC, Pamplona 31008, Spain
| | - Ignacio Melero
- CIMA and Clínica Universidad de Navarra and CIBERONC, Pamplona 31008, Spain
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Rubio-Viqueira B, Tarruella MM, Lazaro M, Estevez SV, Cordoba-Ortega J, Maiques IM, Gonzalez JG, Cordellat AB, Valdivia-Bautista J, Arenas CG, Torres JS. 55P MOREL: Multicenter observational study on treatment and PD-L1 testing in patients (pts) with newly diagnosed stage IV NSCLC in Spain. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.542] [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: 11/28/2022] Open
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Gadgeel S, Rodríguez-Abreu D, Speranza G, Esteban E, Felip E, Dómine M, Hui R, Hochmair MJ, Clingan P, Powell SF, Cheng SYS, Bischoff HG, Peled N, Grossi F, Jennens RR, Reck M, Garon EB, Novello S, Rubio-Viqueira B, Boyer M, Kurata T, Gray JE, Yang J, Bas T, Pietanza MC, Garassino MC. Updated Analysis From KEYNOTE-189: Pembrolizumab or Placebo Plus Pemetrexed and Platinum for Previously Untreated Metastatic Nonsquamous Non–Small-Cell Lung Cancer. J Clin Oncol 2020; 38:1505-1517. [DOI: 10.1200/jco.19.03136] [Citation(s) in RCA: 410] [Impact Index Per Article: 102.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE In KEYNOTE-189, first-line pembrolizumab plus pemetrexed-platinum significantly improved overall survival (OS) and progression-free survival (PFS) compared with placebo plus pemetrexed-platinum in patients with metastatic nonsquamous non‒small-cell lung cancer (NSCLC), irrespective of tumor programmed death-ligand 1 (PD-L1) expression. We report an updated analysis from KEYNOTE-189 (ClinicalTrials.gov: NCT02578680 ). METHODS Patients were randomly assigned (2:1) to receive pemetrexed and platinum plus pembrolizumab (n = 410) or placebo (n = 206) every 3 weeks for 4 cycles, then pemetrexed maintenance plus pembrolizumab or placebo for up to a total of 35 cycles. Eligible patients with disease progression in the placebo-combination group could cross over to pembrolizumab monotherapy. Response was assessed per RECIST (version 1.1) by central review. No alpha was assigned to this updated analysis. RESULTS As of September 21, 2018 (median follow-up, 23.1 months), the updated median (95% CI) OS was 22.0 (19.5 to 25.2) months in the pembrolizumab-combination group versus 10.7 (8.7 to 13.6) months in the placebo-combination group (hazard ratio [HR], 0.56; 95% CI, 0.45 to 0.70]). Median (95% CI) PFS was 9.0 (8.1 to 9.9) months and 4.9 (4.7 to 5.5) months, respectively (HR, 0.48; 95% CI, 0.40 to 0.58). Median (95% CI) time from randomization to objective tumor progression on next-line treatment or death from any cause, whichever occurred first (progression-free-survival-2; PFS-2) was 17.0 (15.1 to 19.4) months and 9.0 (7.6 to 10.4) months, respectively (HR, 0.49; 95% CI, 0.40 to 0.59). OS and PFS benefits with pembrolizumab were observed regardless of PD-L1 expression or presence of liver/brain metastases. Incidence of grade 3-5 adverse events was similar in the pembrolizumab-combination (71.9%) and placebo-combination (66.8%) groups. CONCLUSION First-line pembrolizumab plus pemetrexed-platinum continued to demonstrate substantially improved OS and PFS in metastatic nonsquamous NSCLC, regardless of PD-L1 expression or liver/brain metastases, with manageable safety and tolerability.
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Affiliation(s)
| | - Delvys Rodríguez-Abreu
- Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Giovanna Speranza
- Centre Integré de Cancérologie de la Montérégie, Hôpital Charles-Le Moyne, Greenfield Park, Quebec, Canada
| | - Emilio Esteban
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Enriqueta Felip
- Vall d’Hebron University, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | - Manuel Dómine
- Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Rina Hui
- Westmead Hospital and University of Sydney, Sydney, New South Wales, Australia
| | - Maximilian J. Hochmair
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Vienna, Austria
| | - Philip Clingan
- Southern Medical Day Care Centre, Wollongong, New South Wales, Australia
| | | | | | | | - Nir Peled
- Soroka Medical Center, Ben-Gurion University, Beer Sheva, Israel
| | - Francesco Grossi
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Martin Reck
- LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany
| | - Edward B. Garon
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA
| | - Silvia Novello
- Department of Oncology, University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano, Italy
| | | | - Michael Boyer
- Chris O’Brien Lifehouse, Camperdown, New South Wales, Australia
| | | | | | | | | | | | - Marina C. Garassino
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy
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Couñago F, Luna J, Guerrero LL, Vaquero B, Guillén-Sacoto MC, González-Merino T, Taboada B, Díaz V, Rubio-Viqueira B, Díaz-Gavela AA, Marcos FJ, del Cerro E. Management of oligometastatic non-small cell lung cancer patients: Current controversies and future directions. World J Clin Oncol 2019; 10:318-339. [PMID: 31799148 PMCID: PMC6885452 DOI: 10.5306/wjco.v10.i10.318] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/30/2019] [Accepted: 09/15/2019] [Indexed: 02/06/2023] Open
Abstract
Oligometastatic non-small cell lung cancer (NSCLC) describes an intermediate stage of NSCLC between localized and widely-disseminated disease. This stage of NSCLC is characterized by a limited number of metastases and a more indolent tumor biology. Currently, the management of oligometastatic NSCLC involves radical treatment (radiotherapy or surgery) that targets the metastatic lesions and the primary tumor to achieve disease control. This approach offers the potential to achieve prolonged survival in patients who, in the past, would have only received palliative measures. The optimal therapeutic strategies for the different scenarios of oligometastatic disease (intracranial vs extracranial disease, synchronous vs metachronous) remain undefined. Given the lack of head-to-head studies comparing radiotherapy to surgery in these patients, the decision to apply surgery or radiotherapy (with or without systemic treatment) must be based on prognostic factors that allow us to classify patients. This classification will allow us to select the most appropriate therapeutic strategy on an individualized basis. In the future, the molecular or microRNA profiles will likely improve the treatment selection process. The objective of the present article is to review the most relevant scientific evidence on the management of patients with oligometastatic NSCLC, focusing on the role of radiotherapy and surgery. We also discuss areas of controversy and future directions.
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Affiliation(s)
- Felipe Couñago
- Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, Pozuelo de Alarcón, Madrid 28223, Spain
- Department of Radiation Oncology, Hospital La Luz, Madrid 28003, Spain
- Clinical Department, Faculty of Biomedicine, Universidad Europea, Madrid 28223, Spain
| | - Javier Luna
- Department of Radiation Oncology, Hospital Fundación Jiménez Díaz, Madrid 28040, Spain
| | | | - Blanca Vaquero
- Department of Radiation Oncology, Hospital La Luz, Madrid 28003, Spain
| | | | | | - Begoña Taboada
- Department of Radiation Oncology, Complexo Hospitalario Universitario Santiago de Compostela, Santiago de Compostela 15706, Spain
| | - Verónica Díaz
- Department of Radiation Oncology, Hospital Universitario Puerta del Mar, Cádiz 11009, Spain
| | - Belén Rubio-Viqueira
- Department of Medical Oncology, Hospital Universitario Quirónsalud Madrid, Pozuelo de Alarcón, Madrid 28223, Spain
| | - Ana Aurora Díaz-Gavela
- Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, Pozuelo de Alarcón, Madrid 28223, Spain
- Department of Radiation Oncology, Hospital La Luz, Madrid 28003, Spain
- Clinical Department, Faculty of Biomedicine, Universidad Europea, Madrid 28223, Spain
| | - Francisco José Marcos
- Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, Pozuelo de Alarcón, Madrid 28223, Spain
- Department of Radiation Oncology, Hospital La Luz, Madrid 28003, Spain
- Clinical Department, Faculty of Biomedicine, Universidad Europea, Madrid 28223, Spain
| | - Elia del Cerro
- Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, Pozuelo de Alarcón, Madrid 28223, Spain
- Department of Radiation Oncology, Hospital La Luz, Madrid 28003, Spain
- Clinical Department, Faculty of Biomedicine, Universidad Europea, Madrid 28223, Spain
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Lopez Castro R, Lianes P, Nogueron Martnez E, Diz Tain P, Calzas J, Juan Vidal O, Sereno Moyano M, Muñoz M, Guillot Morales M, Capdevila Riera L, Campillo Fuentes J, Valdivia-Bautista J, Cobo Dols M, Paredes Lario A, Mielgo Rubio X, Majem Tarruella M, Martínez M, Sanchez Torres J, Rubio-Viqueira B, Provencio M. Spanish registry of thoracic tumors (TTR): Interim analyses of comorbidities, risk associations, personal and family history of cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz266.007] [Citation(s) in RCA: 1] [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: 11/13/2022] Open
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Garassino MC, Gadgeel S, Esteban E, Felip E, Speranza G, Angelis FD, Domine M, Clingan P, Hochmair MJ, Powell SF, Cheng SYS, Bischoff HG, Peled N, Grossi F, Jennens RR, Reck M, Hui R, Garon EB, Boyer M, Rubio-Viqueira B, Novello S, Kurata T, Gray JE, Cardellino A, Yang J, Pietanza MC, Rodríguez-Abreu D. Abstract CT043: Outcomes among patients (pts) with metastatic nonsquamous NSCLC with liver metastases or brain metastases treated with pembrolizumab (pembro) plus pemetrexed-platinum: Results from the KEYNOTE-189 study. Clin Trials 2019. [DOI: 10.1158/1538-7445.am2019-ct043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gandhi L, Rodgríguez-Abreu D, Gadgeel S, Esteban E, Felip E, Angelis FD, Domine M, Clingan P, Hochmair MJ, Powell S, Cheng SYS, Bischoff HG, Peled N, Grossi F, Jennens RR, Reck M, Hui R, Garon EB, Boyer M, Rubio-Viqueira B, Novello S, Kurata T, Gray JE, Vida JJ, Wei Z, Yang J, Raftopoulos H, Pietanza MC, Garassino MC. Abstract CT075: KEYNOTE-189: Randomized, double-blind, phase 3 study of pembrolizumab (pembro) or placebo plus pemetrexed (pem) and platinum as first-line therapy for metastatic NSCLC. Clin Trials 2018. [DOI: 10.1158/1538-7445.am2018-ct075] [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: 11/16/2022]
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Gandhi L, Rodríguez-Abreu D, Gadgeel S, Esteban E, Felip E, De Angelis F, Domine M, Clingan P, Hochmair MJ, Powell SF, Cheng SYS, Bischoff HG, Peled N, Grossi F, Jennens RR, Reck M, Hui R, Garon EB, Boyer M, Rubio-Viqueira B, Novello S, Kurata T, Gray JE, Vida J, Wei Z, Yang J, Raftopoulos H, Pietanza MC, Garassino MC. Pembrolizumab plus Chemotherapy in Metastatic Non-Small-Cell Lung Cancer. N Engl J Med 2018; 378:2078-2092. [PMID: 29658856 DOI: 10.1056/nejmoa1801005] [Citation(s) in RCA: 4088] [Impact Index Per Article: 681.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND First-line therapy for advanced non-small-cell lung cancer (NSCLC) that lacks targetable mutations is platinum-based chemotherapy. Among patients with a tumor proportion score for programmed death ligand 1 (PD-L1) of 50% or greater, pembrolizumab has replaced cytotoxic chemotherapy as the first-line treatment of choice. The addition of pembrolizumab to chemotherapy resulted in significantly higher rates of response and longer progression-free survival than chemotherapy alone in a phase 2 trial. METHODS In this double-blind, phase 3 trial, we randomly assigned (in a 2:1 ratio) 616 patients with metastatic nonsquamous NSCLC without sensitizing EGFR or ALK mutations who had received no previous treatment for metastatic disease to receive pemetrexed and a platinum-based drug plus either 200 mg of pembrolizumab or placebo every 3 weeks for 4 cycles, followed by pembrolizumab or placebo for up to a total of 35 cycles plus pemetrexed maintenance therapy. Crossover to pembrolizumab monotherapy was permitted among the patients in the placebo-combination group who had verified disease progression. The primary end points were overall survival and progression-free survival, as assessed by blinded, independent central radiologic review. RESULTS After a median follow-up of 10.5 months, the estimated rate of overall survival at 12 months was 69.2% (95% confidence interval [CI], 64.1 to 73.8) in the pembrolizumab-combination group versus 49.4% (95% CI, 42.1 to 56.2) in the placebo-combination group (hazard ratio for death, 0.49; 95% CI, 0.38 to 0.64; P<0.001). Improvement in overall survival was seen across all PD-L1 categories that were evaluated. Median progression-free survival was 8.8 months (95% CI, 7.6 to 9.2) in the pembrolizumab-combination group and 4.9 months (95% CI, 4.7 to 5.5) in the placebo-combination group (hazard ratio for disease progression or death, 0.52; 95% CI, 0.43 to 0.64; P<0.001). Adverse events of grade 3 or higher occurred in 67.2% of the patients in the pembrolizumab-combination group and in 65.8% of those in the placebo-combination group. CONCLUSIONS In patients with previously untreated metastatic nonsquamous NSCLC without EGFR or ALK mutations, the addition of pembrolizumab to standard chemotherapy of pemetrexed and a platinum-based drug resulted in significantly longer overall survival and progression-free survival than chemotherapy alone. (Funded by Merck; KEYNOTE-189 ClinicalTrials.gov number, NCT02578680 .).
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antineoplastic Agents, Immunological/adverse effects
- Antineoplastic Agents, Immunological/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/mortality
- Carcinoma, Non-Small-Cell Lung/secondary
- Disease-Free Survival
- Double-Blind Method
- Female
- Follow-Up Studies
- Humans
- Kaplan-Meier Estimate
- Lung Neoplasms/drug therapy
- Lung Neoplasms/genetics
- Lung Neoplasms/mortality
- Lung Neoplasms/pathology
- Male
- Middle Aged
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Affiliation(s)
- Leena Gandhi
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Delvys Rodríguez-Abreu
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Shirish Gadgeel
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Emilio Esteban
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Enriqueta Felip
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Flávia De Angelis
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Manuel Domine
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Philip Clingan
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Maximilian J Hochmair
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Steven F Powell
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Susanna Y-S Cheng
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Helge G Bischoff
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Nir Peled
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Francesco Grossi
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Ross R Jennens
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Martin Reck
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Rina Hui
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Edward B Garon
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Michael Boyer
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Belén Rubio-Viqueira
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Silvia Novello
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Takayasu Kurata
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Jhanelle E Gray
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - John Vida
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Ziwen Wei
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Jing Yang
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Harry Raftopoulos
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - M Catherine Pietanza
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
| | - Marina C Garassino
- From NYU Perlmutter Cancer Center, New York (L.G.); Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria (D.R.-A.), Hospital Universitario Central de Asturias, Oviedo (E.E.), Vall d'Hebron University, Vall d'Hebron Institute of Oncology, Barcelona (E.F.), and Fundación Jiménez Díaz (M.D.) and Hospital Universitario Quirón Madrid (B.R.-V.), Madrid - all in Spain; Karmanos Cancer Institute, Detroit (S.G.); Integrated Health and Social Services Centres, Montérégie Centre, Greenfield Park, QC (F.D.A.), and Sunnybrook Health Sciences Centre, Toronto (S.Y.-S.C.) - both in Canada; Southern Medical Day Care Centre, Wollongong, NSW (P.C.), Epworth Healthcare, Richmond, VIC (R.R.J.), Westmead Hospital and University of Sydney, Sydney (R.H.), and Chris O'Brien Lifehouse, Camperdown, NSW (M.B.) - all in Australia; Otto Wagner Hospital, Vienna (M.J.H.); Sanford Health, Sioux Falls, SD (S.F.P.); Thoraxklinik, Heidelberg (H.G.B.), and LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf (M.R.) - both in Germany; Davidoff Cancer Center, Tel Aviv University, Petah Tikva, Israel (N.P.); Ospedale Policlinico San Martino, Genoa (F.G.), University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano (S.N.), and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (M.C.G.) - all in Italy; David Geffen School of Medicine at UCLA, Los Angeles (E.B.G.); Kansai Medical University Hospital, Osaka, Japan (T.K.); Moffitt Cancer Center, Tampa, FL (J.E.G.); and Merck, Kenilworth, NJ (J.V., Z.W., J.Y., H.R., M.C.P.)
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Senan S, Brade A, Wang LH, Vansteenkiste J, Dakhil S, Biesma B, Martinez Aguillo M, Aerts J, Govindan R, Rubio-Viqueira B, Lewanski C, Gandara D, Choy H, Mok T, Hossain A, Iscoe N, Treat J, Koustenis A, San Antonio B, Chouaki N, Vokes E. PROCLAIM: Randomized Phase III Trial of Pemetrexed-Cisplatin or Etoposide-Cisplatin Plus Thoracic Radiation Therapy Followed by Consolidation Chemotherapy in Locally Advanced Nonsquamous Non-Small-Cell Lung Cancer. J Clin Oncol 2016; 34:953-62. [PMID: 26811519 DOI: 10.1200/jco.2015.64.8824] [Citation(s) in RCA: 297] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The phase III PROCLAIM study evaluated overall survival (OS) of concurrent pemetrexed-cisplatin and thoracic radiation therapy (TRT) followed by consolidation pemetrexed, versus etoposide-cisplatin and TRT followed by nonpemetrexed doublet consolidation therapy. PATIENTS AND METHODS Patients with stage IIIA/B unresectable nonsquamous non-small-cell lung cancer randomly received (1:1) pemetrexed 500 mg/m(2) and cisplatin 75 mg/m(2) intravenously every 3 weeks for three cycles plus concurrent TRT (60 to 66 Gy) followed by pemetrexed consolidation every 3 weeks for four cycles (arm A), or standard therapy with etoposide 50 mg/m(2) and cisplatin 50 mg/m(2) intravenously, every 4 weeks for two cycles plus concurrent TRT (60 to 66 Gy) followed by two cycles of consolidation platinum-based doublet chemotherapy (arm B). The primary objective was OS. The study was designed as a superiority trial with 80% power to detect an OS hazard ratio of 0.74 with a type 1 error of .05. RESULTS Enrollment was stopped early because of futility. Five hundred ninety-eight patients were randomly assigned (301 to arm A, 297 to arm B) and 555 patients (283 in arm A, 272 in arm B) were treated. Arm A was not superior to arm B in terms of OS (hazard ratio, 0.98; 95% CI, 0.79 to 1.20; median, 26.8 v 25.0 months; P = .831). Arm A had a significantly lower incidence of any drug-related grade 3 to 4 adverse events (64.0% v 76.8%; P = .001), including neutropenia (24.4% v 44.5%; P < .001), during the overall treatment period. CONCLUSION Pemetrexed-cisplatin combined with TRT followed by consolidation pemetrexed was not superior to standard chemoradiotherapy for stage III unresectable nonsquamous non-small-cell lung cancer.
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Affiliation(s)
- Suresh Senan
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France.
| | - Anthony Brade
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Lu-Hua Wang
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Johan Vansteenkiste
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Shaker Dakhil
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Bonne Biesma
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Maite Martinez Aguillo
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Joachim Aerts
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Ramaswamy Govindan
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Belén Rubio-Viqueira
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Conrad Lewanski
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - David Gandara
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Hak Choy
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Tony Mok
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Anwar Hossain
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Neill Iscoe
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Joseph Treat
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Andrew Koustenis
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Bélen San Antonio
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Nadia Chouaki
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
| | - Everett Vokes
- Suresh Senan, VU Medical Center, Amsterdam; Bonne Biesma, Jeroen Bosch Hospital, 's-Hertogenbosch; and Joachim Aerts, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, the Netherlands; Anthony Brade, Princess Margaret Hospital, University of Toronto; Neill Iscoe, Eli Lilly Canada, Toronto, Ontario, Canada; Lu-hua Wang, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing; Tony Mok, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, People's Republic of China; Johan Vansteenkiste, University Hospital KU Leuven, Leuven, Belgium; Shaker Dakhil, Cancer Center of Kansas, Wichita, KS; Ramaswamy Govindan, Washington University School of Medicine, Saint Louis, MO; David Gandara, University of California, Davis Health System, Sacramento, CA; Hak Choy, UT Southwestern Medical Center, Dallas, TX; Anwar Hossain, Joseph Treat, and Andrew Koustenis, Eli Lilly and Company, Indianapolis, IN; Everett Vokes, University of Chicago, Chicago, IL; Maite Martinez Aguillo, Hospital of Navarre, Irunlarrea, Pamplona; Belén Rubio-Viqueira, Hospital Universitario Quirón Madrid; and Bélen San Antonio, Eli Lilly and Company, Madrid, Spain; Conrad Lewanski, Charing Cross Hospital, London, United Kingdom; and Nadia Chouaki, Eli Lilly and Company, Neuilly-sur-Seine, France
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Mornex F, Senan S, Hennequin C, Lartigau E, Brade A, Wang L, Vansteenkiste J, Dakhil S, Biesma B, Martinez Aguillo M, Aerts J, Govindan R, Rubio-Viqueira B, Lewanski C, Gandara D, Choy H, Mok T, Hossain A, Iscoe N, Treat J, Koustenis A, Chouaki N, Vokes E. PROCLAIM : résultats finaux de survie globale de l’essai de phase III : pemetrexed cisplatine ou étoposide cisplatine, plus radiothérapie thoracique suivie d’une chimiothérapie de consolidation dans le CBNPC non épidermoïde localement avancé. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.674] [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: 11/27/2022]
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Senan S, Brade AM, Wang L, Vansteenkiste JF, Dakhil SR, Biesma B, Martinez Aguillo M, Aerts J, Govindan R, Rubio-Viqueira B, Lewanski CR, Gandara DR, Choy H, Mok T, Hossain A, Iscoe NA, Treat J, Koustenis AG, Chouaki N, Vokes EE. Final overall survival (OS) results of the phase III PROCLAIM trial: Pemetrexed (Pem), cisplatin (Cis) or etoposide (Eto), Cis plus thoracic radiation therapy (TRT) followed by consolidation cytotoxic chemotherapy (CTX) in locally advanced nonsquamous non-small cell lung cancer (nsNSCLC). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.7506] [Citation(s) in RCA: 7] [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: 11/20/2022] Open
Affiliation(s)
- Suresh Senan
- VU University Medical Center, Amsterdam, Netherlands
| | - Anthony M. Brade
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - Luhua Wang
- Department of Radiation Oncology, Cancer Institute (Hospital) Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | | - Bonne Biesma
- Department of Pulmonology, Jeroen Bosch Hospital, 's-Hertogenbosch, Netherlands
| | | | - Joachim Aerts
- Department of Pulmonology, Erasmus MC Rotterdam/Amphia Hospital Breda, Breda, Netherlands
| | | | | | | | - David R. Gandara
- University of California Davis Comprehensive Cancer Center, Sacramento, CA
| | - Hak Choy
- The University of Texas Southwestern Medical Center, Dallas, TX
| | - Tony Mok
- Chinese University of Hong Kong, Shatin, Hong Kong
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Calles A, Rubio-Viqueira B, Hidalgo M. Primary human non-small cell lung and pancreatic tumorgraft models--utility and applications in drug discovery and tumor biology. ACTA ACUST UNITED AC 2013; Chapter 14:Unit 14.26. [PMID: 23744711 DOI: 10.1002/0471141755.ph1426s61] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The number of therapeutic options for lung and pancreatic cancer is increasing because of the identification of new druggable molecular targets and development of new drug combinations. Reproducible, biologically relevant in vivo pre-clinical models are critical for this effort. The generation of patient-derived tumor xenografts has proven useful for integrating drug screening with biomarker discovery, discovering fundamental information in tumor biology, prioritizing drugs for clinical investigation, and personalizing treatments for these tumors. The protocol described in this unit details how to establish a direct in vivo subcutaneous primary tumorgraft and maintenance passages. The predictive value of a tumorgraft platform to guide personalized medicine is illustrated with the case of a patient with refractory advanced non-small cell lung cancer (NSCLC). The outcome of a patient for whom their own pancreatic tumorgraft revealed a remarkable sensitivity to mitomycin C based on a PALB2 mutation is also detailed.
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Affiliation(s)
- Antonio Calles
- Clinical Research Programme, Spanish National Cancer Research Centre-CNIO, Madrid, Spain
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Angulo B, Conde E, Suárez-Gauthier A, Plaza C, Martínez R, Redondo P, Izquierdo E, Rubio-Viqueira B, Paz-Ares L, Hidalgo M, López-Ríos F. A comparison of EGFR mutation testing methods in lung carcinoma: direct sequencing, real-time PCR and immunohistochemistry. PLoS One 2012; 7:e43842. [PMID: 22952784 PMCID: PMC3428292 DOI: 10.1371/journal.pone.0043842] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 07/30/2012] [Indexed: 01/06/2023] Open
Abstract
The objective of this study is to compare two EGFR testing methodologies (a commercial real-time PCR kit and a specific EGFR mutant immunohistochemistry), with direct sequencing and to investigate the limit of detection (LOD) of both PCR-based methods. We identified EGFR mutations in 21 (16%) of the 136 tumours analyzed by direct sequencing. Interestingly, the Therascreen EGFR Mutation Test kit was able to characterize as wild-type one tumour that could not be analyzed by direct sequencing of the PCR product. We then compared the LOD of the kit and that of direct sequencing using the available mutant tumours. The kit was able to detect the presence of a mutation in a 1% dilution of the total DNA in nine of the 18 tumours (50%), which tested positive with the real-time quantitative PCR method. In all cases, EGFR mutation was identified at a dilution of 5%. Where the mutant DNA represented 30% of the total DNA, sequencing was able to detect mutations in 12 out of 19 cases (63%). Additional experiments with genetically defined standards (EGFR ΔE746-A750/+ and EGFR L858R/+) yielded similar results. Immunohistochemistry (IHC) staining with exon 19-specific antibody was seen in eight out of nine cases with E746-A750del detected by direct sequencing. Neither of the two tumours with complex deletions were positive. Of the five L858R-mutated tumours detected by the PCR methods, only two were positive for the exon 21-specific antibody. The specificity was 100% for both antibodies. The LOD of the real-time PCR method was lower than that of direct sequencing. The mutation specific IHC produced excellent specificity.
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Affiliation(s)
- Bárbara Angulo
- Laboratorio de Dianas Terapéuticas, Faculty of Medicine, Centro Integral Oncológico “Clara Campal”, Hospital HM Universitario Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Esther Conde
- Laboratorio de Dianas Terapéuticas, Faculty of Medicine, Centro Integral Oncológico “Clara Campal”, Hospital HM Universitario Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Ana Suárez-Gauthier
- Laboratorio de Dianas Terapéuticas, Faculty of Medicine, Centro Integral Oncológico “Clara Campal”, Hospital HM Universitario Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Carlos Plaza
- Laboratorio de Dianas Terapéuticas, Faculty of Medicine, Centro Integral Oncológico “Clara Campal”, Hospital HM Universitario Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Rebeca Martínez
- Laboratorio de Dianas Terapéuticas, Faculty of Medicine, Centro Integral Oncológico “Clara Campal”, Hospital HM Universitario Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Pilar Redondo
- Laboratorio de Dianas Terapéuticas, Faculty of Medicine, Centro Integral Oncológico “Clara Campal”, Hospital HM Universitario Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Elisa Izquierdo
- Laboratorio de Dianas Terapéuticas, Faculty of Medicine, Centro Integral Oncológico “Clara Campal”, Hospital HM Universitario Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Belén Rubio-Viqueira
- Laboratorio de Dianas Terapéuticas, Faculty of Medicine, Centro Integral Oncológico “Clara Campal”, Hospital HM Universitario Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
- Gastrointestinal Cancer Clinical Research Unit, Spanish National Cancer Research Centre, Madrid, Spain
| | - Luis Paz-Ares
- Department of Oncology, Instituto de Biomedicina de Sevilla (IBIS) & Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Manuel Hidalgo
- Laboratorio de Dianas Terapéuticas, Faculty of Medicine, Centro Integral Oncológico “Clara Campal”, Hospital HM Universitario Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
- Gastrointestinal Cancer Clinical Research Unit, Spanish National Cancer Research Centre, Madrid, Spain
| | - Fernando López-Ríos
- Laboratorio de Dianas Terapéuticas, Faculty of Medicine, Centro Integral Oncológico “Clara Campal”, Hospital HM Universitario Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
- * E-mail:
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14
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Garrido-Laguna I, Uson M, Rajeshkumar NV, Tan AC, de Oliveira E, Karikari C, Villaroel MC, Salomon A, Taylor G, Sharma R, Hruban RH, Maitra A, Laheru D, Rubio-Viqueira B, Jimeno A, Hidalgo M. Tumor engraftment in nude mice and enrichment in stroma- related gene pathways predict poor survival and resistance to gemcitabine in patients with pancreatic cancer. Clin Cancer Res 2011; 17:5793-800. [PMID: 21742805 DOI: 10.1158/1078-0432.ccr-11-0341] [Citation(s) in RCA: 179] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE The goal of this study was to evaluate prospectively the engraftment rate, factors influencing engraftment, and predictability of clinical outcome of low-passage xenografts from patients with resectable pancreatic ductal adenocarcinoma (PDA) and to establish a bank of PDA xenografts. EXPERIMENTAL DESIGN Patients with resectable PDA scheduled for resection at the Johns Hopkins Hospital were eligible. Representative pieces of tumor were implanted in nude mice. The status of the SMAD4 gene and content of tumor-generating cells were determined by immunohistochemistry. Gene expression was carried out by using a U133 Plus 2.0 array. Patients were followed for progression and survival. RESULTS A total of 94 patients with PDA were resected, 69 tumors implanted in nude mice, and 42 (61%) engrafted. Engrafted carcinomas were more often SMAD4 mutant, and had a metastatic gene expression signature and worse prognosis. Tumors from patients resistant to gemcitabine were enriched in stroma-related gene pathways. Tumors sensitive to gemcitabine were enriched in cell cycle and pyrimidine gene pathways. The time to progression for patients who received treatment with gemcitabine for metastatic disease (n = 7) was double in patients with xenografts sensitive to gemcitabine. CONCLUSION A successful xenograft was generated in 61% of patients attempted, generating a pool of 42 PDA xenografts with significant biological information and annotated clinical data. Patients with PDA and SMAD4 inactivation have a better engraftment rate. Engraftment is a poor prognosis factor, and engrafted tumors have a metastatic gene expression signature. Tumors from gemcitabine-resistant patients were enriched in stromal pathways.
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Affiliation(s)
- Ignacio Garrido-Laguna
- The Sidney Kimmel Comprehensive Cancer Center and the Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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15
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De Castro J, Domine M, Garcia-Bueno J, Saura S, García R, Sereno M, Juan Vidal O, Pujol E, Rubio-Viqueira B, Cobo M. Clinical outcomes for special populations of patients treated with first-line bevacizumab-based therapy in an observational study (AVVA). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e18033] [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: 11/20/2022] Open
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16
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Conde E, Angulo B, Redondo P, Toldos O, García-García E, Suárez-Gauthier A, Rubio-Viqueira B, Marrón C, García-Luján R, Sánchez-Céspedes M, López-Encuentra A, Paz-Ares L, López-Ríos F. The use of P63 immunohistochemistry for the identification of squamous cell carcinoma of the lung. PLoS One 2010; 5:e12209. [PMID: 20808915 PMCID: PMC2923180 DOI: 10.1371/journal.pone.0012209] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Accepted: 07/15/2010] [Indexed: 12/31/2022] Open
Abstract
Introduction While some targeted agents should not be used in squamous cell carcinomas (SCCs), other agents might preferably target SCCs. In a previous microarray study, one of the top differentially expressed genes between adenocarcinomas (ACs) and SCCs is P63. It is a well-known marker of squamous differentiation, but surprisingly, its expression is not widely used for this purpose. Our goals in this study were (1) to further confirm our microarray data, (2) to analize the value of P63 immunohistochemistry (IHC) in reducing the number of large cell carcinoma (LCC) diagnoses in surgical specimens, and (3) to investigate the potential of P63 IHC to minimize the proportion of “carcinoma NOS (not otherwise specified)” in a prospective series of small tumor samples. Methods With these goals in mind, we studied (1) a tissue-microarray comprising 33 ACs and 99 SCCs on which we performed P63 IHC, (2) a series of 20 surgically resected LCCs studied for P63 and TTF-1 IHC, and (3) a prospective cohort of 66 small thoracic samples, including 32 carcinoma NOS, that were further classified by the result of P63 and TTF-1 IHC. Results The results in the three independent cohorts were as follows: (1) P63 IHC was differentially expressed in SCCs when compared to ACs (p<0.0001); (2) half of the 20 (50%) LCCs were positive for P63 and were reclassified as SCCs; and (3) all P63 positive cases (34%) were diagnosed as SCCs. Conclusions P63 IHC is useful for the identification of lung SCCs.
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Affiliation(s)
- Esther Conde
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico “Clara Campal”, Hospital Universitario Madrid Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Bárbara Angulo
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico “Clara Campal”, Hospital Universitario Madrid Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Pilar Redondo
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico “Clara Campal”, Hospital Universitario Madrid Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Oscar Toldos
- Pathology, Thoracic Surgery and Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Elena García-García
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico “Clara Campal”, Hospital Universitario Madrid Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Ana Suárez-Gauthier
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico “Clara Campal”, Hospital Universitario Madrid Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Belén Rubio-Viqueira
- Oncology Department, Hospital Universitario Madrid Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
| | - Carmen Marrón
- Thoracic Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Montse Sánchez-Céspedes
- Genes and Cancer Group, Programa de Epigenetica y Biologia del Cancer-PEBC, Institut d'Investigacions Biomediques Bellvitge (IDIBELL), L'Hopitalet de Llobregat, Barcelona, Spain
| | | | - Luis Paz-Ares
- Oncology Department, Instituto de Biomedicina de Sevilla (IBIS) and Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Fernando López-Ríos
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico “Clara Campal”, Hospital Universitario Madrid Sanchinarro, Universidad San Pablo-CEU, Madrid, Spain
- * E-mail:
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17
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Garrido-Laguna I, Tan AC, Uson M, Angenendt M, Ma WW, Villaroel MC, Zhao M, Rajeshkumar NV, Jimeno A, Donehower R, Iacobuzio-Donahue C, Barrett M, Rudek MA, Rubio-Viqueira B, Laheru D, Hidalgo M. Integrated preclinical and clinical development of mTOR inhibitors in pancreatic cancer. Br J Cancer 2010; 103:649-55. [PMID: 20664591 PMCID: PMC2938261 DOI: 10.1038/sj.bjc.6605819] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The purpose of this work was to determine the efficacy of inhibiting mammalian target of rapamycin (mTOR) in pancreatic cancer preclinical models and translate preclinical observations to the clinic. METHODS Temsirolimus (20 mg Kg(-1) daily) was administered to freshly generated pancreatic cancer xenografts. Tumour growth inhibition was determined after 28 days. Xenografts were characterised at baseline by gene expression and comparative genomic hybridisation. Patients with advanced, gemcitabine-resistant pancreatic cancer were treated with sirolimus (5 mg daily). The primary end point was 6-month survival rate (6mSR). Correlative studies included immunohistochemistry assessment of pathway expression in baseline tumours, drug pharmacokinetics (PKs), response assessment by FDG-PET and pharmacodynamic effects in peripheral-blood mononuclear cells (PBMCs). RESULTS In all, 4 of 17 xenografts (23%) responded to treatment. Sensitive tumours were characterised by gene copy number variations and overexpression of genes leading to activation of the PI3K/Akt/mTOR pathway. Activation of p70S6K correlated with drug activity in the preclinical studies. Sirolimus was well tolerated in the clinic, showed predictable PKs, exerted pathway inhibition in post-treatment PBMCs and resulted in a 6mSR of 26%. No correlation, however, was found between activated p70S6K in tumour tissues and anti-tumour effects. CONCLUSION Sirolimus activity in pancreatic cancer was marginal and not predicted by the selected biomarker.
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Affiliation(s)
- I Garrido-Laguna
- The Sidney Kimmel Comprehensive Cancer Centre at Johns Hopkins and the Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University, Baltimore, MD, USA
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18
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Hidalgo M, Garrido-Laguna I, Uson M, De Oliveira E, Schulick R, Hruban RH, Maitra A, Jimeno A, Rubio-Viqueira B, Rajeshkumar NV. Activity of gemcitabine in direct patient-derived xenografts and clinical outcome: Validation of an in vivo model for drug development. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4528] [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: 11/20/2022] Open
Abstract
4528 Background: Novel drugs are urgently needed for pancreatic ductal adenocarcinoma (PDA). Current preclinical models may not recapitulate the biology of human cancers. Direct xenografts have the potential to better represent the biology of human cancer. We have completed a clinical trial in which surgically resected PDAs were xenografted into nude mice thus generating an in vivo platform for drug development and biomarker identification. Methods: PDAs resected at Johns Hopkins Hospital are implanted into nude mice. From November 2005 to December 2008, 240 patients were consented, 236 operated, 102 were resectable PDAs thus fulfilling the inclusion criteria. 104 patients had other histologies and 34 were unresectable PDAs. Xenografted tumors were treated with gemcitabine and the activity in the xenograft correlated with patient clinical outcome. Results: Out of these 102 cases, 77 were xenografted, 53 were engrafted and reached the treatment phase. 35 out of the 53 originator patients were clinically treated with gemcitabine. The median overall survival of resected patients was 646 days (similar to 660 days from CONKO-001 trial). Patients whose carcinomas engrafted had a shorter median overall survival (319 vs. 728 days, p=0.002), probably reflecting a more aggressive tumor biology in the engrafted group. The response rate of gemcitabine in xenografts based on RECIST criteria was 8% (similar to response rate to gemcitabine in phase III trial by Moore et al.). In the adjuvant setting, the median disease free survival (DFS) was significantly longer in those patients predicted as sensitive by the xenograft model (568 vs. 286 days, p=0.037). In the metastatic setting, the median time to progression (TTP) was longer in those patients predicted as sensitive by the model (126 vs. 73 days) though this difference was not statistically significant. Overall the correlation between gemcitabine activity in this model and clinical outcome as measured by DFS was 0.71 in the subgroup of patients whose xenografts had a TGI lower than -10%. Conclusions: This preclinical model predicts gemcitabine outcome in the clinic in the adjuvant setting. Further studies to analyze the causes of shorter survival in patients whose PDA engrafted are warranted. No significant financial relationships to disclose.
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Affiliation(s)
- M. Hidalgo
- Johns Hopkins University, Baltimore, MD; Centro Integral Oncologico Clara Campal, Madrid, Spain
| | - I. Garrido-Laguna
- Johns Hopkins University, Baltimore, MD; Centro Integral Oncologico Clara Campal, Madrid, Spain
| | - M. Uson
- Johns Hopkins University, Baltimore, MD; Centro Integral Oncologico Clara Campal, Madrid, Spain
| | - E. De Oliveira
- Johns Hopkins University, Baltimore, MD; Centro Integral Oncologico Clara Campal, Madrid, Spain
| | - R. Schulick
- Johns Hopkins University, Baltimore, MD; Centro Integral Oncologico Clara Campal, Madrid, Spain
| | - R. H. Hruban
- Johns Hopkins University, Baltimore, MD; Centro Integral Oncologico Clara Campal, Madrid, Spain
| | - A. Maitra
- Johns Hopkins University, Baltimore, MD; Centro Integral Oncologico Clara Campal, Madrid, Spain
| | - A. Jimeno
- Johns Hopkins University, Baltimore, MD; Centro Integral Oncologico Clara Campal, Madrid, Spain
| | - B. Rubio-Viqueira
- Johns Hopkins University, Baltimore, MD; Centro Integral Oncologico Clara Campal, Madrid, Spain
| | - N. V. Rajeshkumar
- Johns Hopkins University, Baltimore, MD; Centro Integral Oncologico Clara Campal, Madrid, Spain
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Tan A, Jimeno A, Garrido-Laguna I, Uson M, De Oliveira E, Wilson A, Rubio-Viqueira B, Rajeshkumar NV, Hidalgo M. Use of amolecular mimicry approach to identify effective agents in pancreatic cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4603] [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: 11/20/2022] Open
Abstract
4603 Background: We proposed a molecular mimicry approach (prêt-à-porter), based on pathway-expression signatures that systematically connect a query case with the most similar profile from a reference profile database and extrapolates the most effective drug for personalized medicine. Here we report the pre-clinical and clinical validation of this concept in pancreatic cancer treatment. Methods: Baseline gene expression profiles of 24 patients that received gemcitabine as adjuvant chemotherapy were collected. A patient is defined as sensitive and resistant to gemcitabine if the disease free survival (DFS) is more and less than 300 days, respectively. We also performed a small scale pre-clinical study on comparing patient-derived xenografts refractory to gemcitabine in a second-line treatment of prêt-à-porter choice of drugs vs. one-size-fits-all choice of drug (erlotinib). Four gemcitabine resistant xenografts were randomly assigned into control, erlotinib and the prêt-à-porter choice of drug groups. Tumor growth inhibition values (TGI) were calculated at the end of the experiment. Results: Using the molecular mimcry concept, where a patient is connected to a sensitive cell line, s/he will be predicted as sensitive to gemcitabine and vice versa. The prêt-à-porter achieved an overall prediction accuracy of 71% on these retrospective patient samples. Our approach correctly classified 67% and 75% of the patients that were sensitive and resistant to gemcitabine as adjuvant chemotherapy, respectively. The median DFS for the sensitive and resistant groups are 491 and 162 days, respectively. This difference was statistically significant (log-rank test, p = 0.04). Furthermore, the mean TGI% for the prêt-à-porter is about 10-fold lower than the erlotinib arm (3% vs. 30%, Chi-square test, p = 0.02) in the pre-clinical study. This demonstrates that prêt-à-porter approach can be used to tailor personalized medicine and achieved better clinical response as compared to the current treatment approach. Conclusions: We comprehensively validated the prêt-à-porter approach in pre-clinical and clinical data and demonstrated that this approach can be used as a powerful translation research tool in enriching patient selection of novel drugs in clinical trials and realizing personalized medicine. [Table: see text]
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Affiliation(s)
- A. Tan
- Johns Hopkins Medical Institute, Baltimore, MD; Centro Integral Oncologico, Madrid, Spain
| | - A. Jimeno
- Johns Hopkins Medical Institute, Baltimore, MD; Centro Integral Oncologico, Madrid, Spain
| | - I. Garrido-Laguna
- Johns Hopkins Medical Institute, Baltimore, MD; Centro Integral Oncologico, Madrid, Spain
| | - M. Uson
- Johns Hopkins Medical Institute, Baltimore, MD; Centro Integral Oncologico, Madrid, Spain
| | - E. De Oliveira
- Johns Hopkins Medical Institute, Baltimore, MD; Centro Integral Oncologico, Madrid, Spain
| | - A. Wilson
- Johns Hopkins Medical Institute, Baltimore, MD; Centro Integral Oncologico, Madrid, Spain
| | - B. Rubio-Viqueira
- Johns Hopkins Medical Institute, Baltimore, MD; Centro Integral Oncologico, Madrid, Spain
| | - N. V. Rajeshkumar
- Johns Hopkins Medical Institute, Baltimore, MD; Centro Integral Oncologico, Madrid, Spain
| | - M. Hidalgo
- Johns Hopkins Medical Institute, Baltimore, MD; Centro Integral Oncologico, Madrid, Spain
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Tan A, Jimeno A, Rubio-Viqueira B, Hidalgo M. NCI-60 gene set connectivity map (GS-CMAP): Connecting pathway-based gene expression profiles for therapeutic efficacy determination. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.3588] [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: 11/20/2022] Open
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21
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Martín-Santamaría S, Rodríguez JJ, de Pascual-Teresa S, Gordon S, Bengtsson M, Garrido-Laguna I, Rubio-Viqueira B, López-Casas PP, Hidalgo M, de Pascual-Teresa B, Ramos A. New scaffolds for the design of selective estrogen receptor modulators. Org Biomol Chem 2008; 6:3486-96. [DOI: 10.1039/b806918b] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jimeno A, Chan A, Rubio-Viqueira B, Zhang X, Cusatis G, Wheelhouse J, Varella-Garcia M, Hirsch FR, Kulesza P, Hidalgo M. Combined EGFR targeted therapy in a novel in vivo pancreas cancer model. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.14063] [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: 11/20/2022] Open
Abstract
14063 Background: EGFR inhibitors have a definite but limited activity in pancreatic cancer (PaCa). We have reported enhanced activity of dual EGFR therapy with a small molecule inhibitor (erlotinib) plus a monoclonal antibody (cetuximab) in head and neck cancer models. Human xenografted tumors recapitulate better the pathobiology of cancer than existing cell lines. Here we explored a dual EGFR targeting approach using a direct PaCa xenograft model, and sought after markers predicting efficacy. Methods: PaCa specimens obtained at the time surgery were implanted in nude mice and expanded to develop cohorts of tumor bearing mice suitable for drug evaluation. Ten cases were expanded, and within each case 4 groups of 6–8 mice each were treated with vehicle, erlotinib, cetuximab, and the combination of both for 28 days. Gene mutation analysis, gene amplification by fluorescence-in-situ hybridization, and immunohistochemistry (IHC) were done with untreated samples. Results: Two cases were sensitive to both single agents, but the combination did not induce higher efficacy in those. Two additional cases that were resistant to both single agents became sensitive with the combination. No egfr mutations were detected. Three and four cases carried low and high egfr polysomy (defined as [[Unsupported Character - ]] 4 copies in 10–40% and [[Unsupported Character - ]] 40% of the cells, respectively). No correlation was found between egfr copy number and efficacy. By IHC sensitive cases had a lower Ki67 proliferation index, and higher EGFR and nuclear pMAPK staining than resistant cases. The degree of Ki67 decrease after therapy correlated with efficacy. In cases resistant to the single agents but sensitive to the combination nuclear pMAPK only decreased with the dual targeting. Cases with high egfr polysomy were more labile to pharmacodynamic effects after treatment (such as EGFR or pMAPK decreases). Conclusions: EGFR inhibitors showed modest single agent antitumor effect that was enhanced with dual EGFR therapy in PaCa. No genomic markers predicted efficacy, although high egfr polysomy was associated with deeper pharmacodynamic inhibition, conceivably suggesting a phenomenon of pathway addiction. Higher pathway activation by IHC was linked with higher activity. No significant financial relationships to disclose.
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Affiliation(s)
- A. Jimeno
- Johns Hopkins University, Baltimore, MD; University of Colorado Cancer Center, Aurora, CO; University of Alabama at Birmingham, Birmingham, AL
| | - A. Chan
- Johns Hopkins University, Baltimore, MD; University of Colorado Cancer Center, Aurora, CO; University of Alabama at Birmingham, Birmingham, AL
| | - B. Rubio-Viqueira
- Johns Hopkins University, Baltimore, MD; University of Colorado Cancer Center, Aurora, CO; University of Alabama at Birmingham, Birmingham, AL
| | - X. Zhang
- Johns Hopkins University, Baltimore, MD; University of Colorado Cancer Center, Aurora, CO; University of Alabama at Birmingham, Birmingham, AL
| | - G. Cusatis
- Johns Hopkins University, Baltimore, MD; University of Colorado Cancer Center, Aurora, CO; University of Alabama at Birmingham, Birmingham, AL
| | - J. Wheelhouse
- Johns Hopkins University, Baltimore, MD; University of Colorado Cancer Center, Aurora, CO; University of Alabama at Birmingham, Birmingham, AL
| | - M. Varella-Garcia
- Johns Hopkins University, Baltimore, MD; University of Colorado Cancer Center, Aurora, CO; University of Alabama at Birmingham, Birmingham, AL
| | - F. R. Hirsch
- Johns Hopkins University, Baltimore, MD; University of Colorado Cancer Center, Aurora, CO; University of Alabama at Birmingham, Birmingham, AL
| | - P. Kulesza
- Johns Hopkins University, Baltimore, MD; University of Colorado Cancer Center, Aurora, CO; University of Alabama at Birmingham, Birmingham, AL
| | - M. Hidalgo
- Johns Hopkins University, Baltimore, MD; University of Colorado Cancer Center, Aurora, CO; University of Alabama at Birmingham, Birmingham, AL
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Hidalgo M, Rubio-Viqueira B, Weekes C, Song D, Shah P, Messersmith W, Messersmith W, Altiok S, Kulesza P, Maitra A, Jimeno A. In vivo platform for translational drug development and biomarker discovery in pancreatic cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4000 While there are many new agents entering clinical development, there is very little data to prioritize which agents should be explored in pancreas cancer. Furthermore, often there is no information on biomarkers that may predict the activity of these drugs in pancreas cancer. In this project, we have generated a cohort of 30 pancreatic cancer xenografts by implanting in nude mice tumor materials from surgical specimens. Molecular studies show that a) these tumors maintain the genetic features of the originator cancer such as KRAS, p53 and DPC4 gene status; b) tumors represent the heterogeneity of pancreatic cancer well (there is not selection of any genotype in the xenograft ) and c) features do not changed over time. We have used this platform to explore the activity of a battery with a total of 10 new anticancer agents including inhibitors of MAPK, EGFR, mTOR, src kinase, Ras oncogene, mitosis regulators, angiogenesis, heat shock protein and hedgehog pathway inhibitors using a methodology similar to a two stage phase II clinical trial. All agents are tested against 10 xenografts. Those inactive are not explored anymore. Active agents are tested against the full set of tumors. Thus far we have shown that inhibitors of mTOR and MAPK have substantial activity in this model while Ras interacting agents and EGFR targeted drugs have no single agent activity. For active agents, we have characterized the tumors for potential strategies and biormarkers that may predict activity using both a target-focus approach as well as general profiling approach. Signaling inhibitors are more active in tumors with evidence of activation of the targeted pathway. In addition, ex vivo assays indicate that the ability to inhibit the targeted pathway is associated with agent activity. This information may help to prioritize agents for clinical development in pancreatic cancer. [Table: see text]
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Affiliation(s)
| | | | - C. Weekes
- Johns Hopkins University, Baltimore, MD
| | - D. Song
- Johns Hopkins University, Baltimore, MD
| | - P. Shah
- Johns Hopkins University, Baltimore, MD
| | | | | | - S. Altiok
- Johns Hopkins University, Baltimore, MD
| | | | - A. Maitra
- Johns Hopkins University, Baltimore, MD
| | - A. Jimeno
- Johns Hopkins University, Baltimore, MD
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24
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Rubio-Viqueira B, Mezzadra H, Iacobuzio-Donahue C, Jimeno A, Zhang X, Maitra A, Altiok S, Hidalgo M. Optimizing targeted agents development in pancreatic cancer: A fine-needle aspirate biopsy (FNAB) based ex vivo and in vivo assay. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3002] [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: 11/20/2022] Open
Abstract
3002 Background: While targeted therapeutics effectively inhibit tumor growth with less toxicity than conventional chemotherapy, in general cancer patients show highly variable responses to them. This study aimed to develop and validate methods that permit the prediction and assessment of the efficacy of targeted therapeutics by using tumor fine needle aspiration biopsy (FNAB) samples Methods: A series of human primary pancreatic cancer were xenografted in nude mice by implanting tumor materials from surgically resected pancreatic cancer patients. Animals were treated with an epidermal growth factor receptor (EGFR) inhibitor, erlotinib, and the mTOR inhibitor temsirolimus or vehicle. Tumors were sampled by FNAB prior to (baseline) and after therapy. Tumor cells obtained by FNAB at baseline were exposed to erlotinib or temsirolimus for six hours ex vivo to prospectively predict tumor response. The degree of inhibition in phosphorylation of ERK1/2 and S6-Ribosomal Protein (S6-RP) downstream to EGFR and mTOR, respectively, were assessed by Western blot to determine the efficacy of the targeted drugs ex vivo and in vivo. The results were correlated with drug-mediated changes in tumor volumes. The effect of drugs on protein phosphorylation ex vivo was also analyzed in patient FNAB samples to show the clinical feasibility of the approach. Results: The degree of inhibition of target pathway activity in tumor cells treated with erlotinib or temsirolimus ex vivo closely correlates with tumor sensitivity in vivo. Xenograft animals sensitive to therapy showed the highest average inhibition of target protein phosphorylation in ex vivo assays, whereas tumors resistant to drugs gave the lowest one. Patient tumor samples yielded adequately cellular material to analyze the effect of erlotinib and temsirolimus in ex vivo assays. Conclusions: FNAB can be used to test ex vivo tumor response to targeted agents. These effects predicted pharmacodynamic as well as antitumor effects in a serie of pancreatic cancer xenografts. Implementation of these novel methods in clinical trials may be useful to identify patients that are likely to benefit from targeted therapeutics before being exposed to drugs and their potential side effects. No significant financial relationships to disclose.
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Affiliation(s)
| | - H. Mezzadra
- Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - A. Jimeno
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - X. Zhang
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - A. Maitra
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - S. Altiok
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - M. Hidalgo
- Johns Hopkins University School of Medicine, Baltimore, MD
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Rubio-Viqueira B, Jimeno A, Maitra A, Iacobuzio- Donahue C, Bouraoud N, Altiok S, Yeo C, Hidalgo M. Novel in vivo model for drug development in pancreas cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4098] [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] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | - C. Yeo
- Johns Hopkins Univ, Baltimore, MD
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