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Han CY, Lu KH, Corrigan G, Perez A, Kohring SD, Celestino J, Bedi D, Bedia E, Bevers T, Boruta D, Carlson M, Holman L, Leeds L, Mathews C, McCann G, Moore RG, Schlumbrecht M, Slomovitz B, Tobias D, Williams-Brown Y, Bevers MW, Liu J, Gornet TG, Handy BC, Lu Z, Bedia JS, Skates SJ, Bast RC. Normal Risk Ovarian Screening Study: 21-Year Update. J Clin Oncol 2024; 42:JCO2300141. [PMID: 38194613 DOI: 10.1200/jco.23.00141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 09/08/2023] [Accepted: 11/03/2023] [Indexed: 01/11/2024] Open
Abstract
PURPOSE The Normal Risk Ovarian Screening Study (NROSS) tested a two-stage screening strategy in postmenopausal women at conventional hereditary risk where significantly rising cancer antigen (CA)-125 prompted transvaginal sonography (TVS) and abnormal TVS prompted surgery to detect ovarian cancer. METHODS A total of 7,856 healthy postmenopausal women were screened annually for a total of 50,596 woman-years in a single-arm study (ClinicalTrials.gov identifier: NCT00539162). Serum CA125 was analyzed with the Risk of Ovarian Cancer Algorithm (ROCA) each year. If risk was unchanged and <1:2,000, women returned in a year. If risk increased above 1:500, TVS was undertaken immediately, and if risk was intermediate, CA125 was repeated in 3 months with a further increase in risk above 1:500 prompting referral for TVS. An average of 2% of participants were referred to TVS annually. RESULTS Thirty-four patients were referred for operations detecting 15 ovarian cancers and two borderline tumors with 12 in early stage (I-II). In addition, seven endometrial cancers were detected with six in stage I. As four ovarian cancers and two borderline tumors were diagnosed with a normal ROCA, the sensitivity for detecting ovarian and borderline cancer was 74% (17 of 23), and 70% of ROCA-detected cases (12 of 17) were in stage I-II. NROSS screening reduced late-stage (III-IV) disease by 34% compared with UKCTOCS controls and by 30% compared with US SEER values. The positive predictive value (PPV) was 50% (17 of 34) for detecting ovarian cancer and 74% (25 of 34) for any cancer, far exceeding the minimum acceptable study end point of 10% PPV. CONCLUSION While the NROSS trial was not powered to detect reduced mortality, the high specificity, PPV, and marked stage shift support further development of this strategy.
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Affiliation(s)
- Chae Young Han
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Karen H Lu
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gwen Corrigan
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Alexandra Perez
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sharlene D Kohring
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Joseph Celestino
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Deepak Bedi
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Enrique Bedia
- Unity Point Health, John Stoddard Cancer Center, Des Moines, IA
| | - Therese Bevers
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, TX
| | - David Boruta
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Matthew Carlson
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical School, Dallas, TX
| | - Laura Holman
- Department of Obstetrics and Gynecology, University of Oklahoma Medical School, Oklahoma City, OK
| | | | | | - Georgia McCann
- Department of Obstetrics and Gynecology, University of Texas San Antonio School of Medicine, San Antonio, TX
| | - Richard G Moore
- Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
| | | | - Brian Slomovitz
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
- Carol G. Simon Cancer Center, Atlantic Health, Morristown, NJ
| | - Dan Tobias
- Carol G. Simon Cancer Center, Atlantic Health, Morristown, NJ
| | - Yvette Williams-Brown
- Department of Obstetrics and Gynecology, Dell School of Medicine, University of Texas, Austin, TX
| | - Michael W Bevers
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jinsong Liu
- Department of Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Terrie G Gornet
- Department of Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Beverly C Handy
- Department of Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Zhen Lu
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jacob S Bedia
- MGH Biostatistics, Massachusetts General Hospital, Boston, MA
| | - Steven J Skates
- MGH Biostatistics, Massachusetts General Hospital, Boston, MA
| | - Robert C Bast
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX
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Scott S, McGowan VJ, Wildman J, Bidmead E, Hartley J, Mathews C, James B, Sullivan C, Bambra C, Sowden S. "I'll meet you at our bench": adaptation, innovation and resilience among VCSE organisations who supported marginalised and minoritised communities during the Covid-19 pandemic in Northern England - a qualitative focus group study. BMC Health Serv Res 2024; 24:7. [PMID: 38172856 PMCID: PMC10765907 DOI: 10.1186/s12913-023-10435-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The Covid-19 pandemic has exacerbated pre-existing inequalities and increased adversity and challenges for vulnerable and marginalised communities worldwide. In the UK, the Voluntary Community and Social Enterprise (VCSE) sector play a vital role in supporting the health and wellbeing of people who are marginalised or experiencing multiple complex needs. However, only a small number of studies have focused on the impact that Covid-19 had on the VCSE sector. METHODS As part of a Health Inequalities Impact Assessment (HIIA), we conducted qualitative focus groups with staff and volunteers from five organisations to examine short, medium and longer-term impacts of Covid-19 upon the VCSE sector in Northern England. Nine online focus groups were conducted between March and July 2021. FINDINGS Focus group transcripts were analysed using Framework Analysis and yielded three central themes: (1) exacerbation of pre-existing inequalities, adversity and challenges for vulnerable and marginalised populations; (2) the 'price' of being flexible, innovative and agile for VCSE staff and volunteers; and (3) the voluntary sector as a 'lifeline' - organisational pride and resilience. CONCLUSIONS While the voluntary sector 'adapted at pace' to provide support during Covid-19 and in its continued aftermath, this resilience has potentially come at the cost of workforce and volunteer wellbeing, compounded by political obstacles and chronic shortage in funding and support. The VCSE sector has a vital role to play in the post-lockdown 'levelling up' agenda. The expertise, capacity and resilience of VCSE organisations, and their ability to respond to Covid-19, should be celebrated, recognised and supported adequately to maintain its resilience. To not do so threatens the sector's sustainability and risks jeopardising attempts to involve the sector in addressing the social determinants of health.
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Affiliation(s)
- S Scott
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.
- NIHR Applied Research Collaboration North East and North Cumbria, St Nicholas' Hospital, Jubilee Road, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK.
| | - V J McGowan
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - J Wildman
- ScotCen, Scotiabank House, 6 South Charlotte Street, Edinburgh, EH2 4AW, UK
| | - E Bidmead
- Institute of Health, University of Cumbria, Fusehill Street, Carlisle, CA1 2HH, UK
- NIHR Applied Research Collaboration North East and North Cumbria, St Nicholas' Hospital, Jubilee Road, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
| | - J Hartley
- VONNE, 4th Floor, MEA House, Ellison Place, Newcastle upon Tyne, Tyne and Wear, NE1 8XS, UK
| | - C Mathews
- Office for Health Improvement and Disparities, Department of Health and Social Care, Waterfront 4, Goldcrest Way, Newburn Riverside, NE15 8NY, Newcastle upon Tyne, UK
| | - B James
- Office for Health Improvement and Disparities, Department of Health and Social Care, Waterfront 4, Goldcrest Way, Newburn Riverside, NE15 8NY, Newcastle upon Tyne, UK
| | - C Sullivan
- Office for Health Improvement and Disparities, Department of Health and Social Care, Waterfront 4, Goldcrest Way, Newburn Riverside, NE15 8NY, Newcastle upon Tyne, UK
| | - C Bambra
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
- NIHR Applied Research Collaboration North East and North Cumbria, St Nicholas' Hospital, Jubilee Road, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
| | - S Sowden
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
- Office for Health Improvement and Disparities, Department of Health and Social Care, Waterfront 4, Goldcrest Way, Newburn Riverside, NE15 8NY, Newcastle upon Tyne, UK
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Moore HJ, Lake AA, O’Malley CL, Bradford C, Gray N, Chang M, Mathews C, Townshend TG. The impact of COVID-19 on the hot food takeaway planning regulatory environment: perspectives of local authority professionals in the North East of England. Perspect Public Health 2024; 144:52-60. [PMID: 35929588 PMCID: PMC10757382 DOI: 10.1177/17579139221106343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Planning regulations have been used to prevent the over-proliferation of hot food takeaways, minimising the impact of local obesogenic environments. To help mitigate the effects of lockdown, the UK government introduced temporary changes in March 2020 to Planning Regulations for England, allowing food retailers to open for takeaway services beyond 'ancillary' level without needing to apply for planning permission through permitted development rights (PDR). Businesses are required to notify their local authority (LA) when they implement PDRs. To better understand the impact of regulations on the policy and practice of key professional groups, Public Health England commissioned Teesside University to undertake scoping research in the North East of England. METHODS A focus group and interviews were conducted with 15 professionals from 7 of 12 North East LAs. Professions included Planners, Public Health Leads, Environmental Health Officers and Town Centre Managers. Data were analysed using a codebook thematic analysis approach. An interpretation meeting with some participants was conducted. RESULTS LAs were not aware of most businesses notifying them of new regulation adherence despite taking up PDRs, but were considered low-priority with many lacking formal recording procedures. There were concerns about health consequences of the changes, and consensus relating to ongoing issues with capacity across all professional groups, largely due to the continuing pandemic and absence of a strategy out of temporary measures. Concerns existed around ensuring cessation of restaurants trading as takeaways, and hygiene inspections backlog. Many (personally) saw new takeaways as a lifeline, offering broader menus and preserving local economies. CONCLUSION Lack of information around the number of restaurants/pubs using PDR to trade as takeaway services, ongoing capacity issues of LAs and, at the time, the absence of a strategy post regulation changes, meant there were high levels of uncertainty regarding the impacts of these temporary measures.
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Affiliation(s)
- HJ Moore
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - AA Lake
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough TS1 3BA, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - CL O’Malley
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - C Bradford
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - N Gray
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - M Chang
- Healthy Places, Public Health England, London, UK WHO Collaborating Centre for Healthy Urban Environments, University of the West of England, Bristol, UK
| | - C Mathews
- Health and Wellbeing, North East, Public Health England, Newcastle upon Tyne, UK
| | - TG Townshend
- School of Architecture, Planning & Landscape, Newcastle University, Newcastle upon Tyne, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
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Oaknin A, Pothuri B, Gilbert L, Sabatier R, Brown J, Ghamande S, Mathews C, O'Malley DM, Kristeleit R, Boni V, Gravina A, Banerjee S, Miller R, Pikiel J, Mirza MR, Dewal N, Antony G, Dong Y, Zografos E, Veneris J, Tinker AV. Safety, Efficacy, and Biomarker Analyses of Dostarlimab in Patients with Endometrial Cancer: Interim Results of the Phase I GARNET Study. Clin Cancer Res 2023; 29:4564-4574. [PMID: 37363992 PMCID: PMC10643997 DOI: 10.1158/1078-0432.ccr-22-3915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/15/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE This interim report of the GARNET phase I trial presents efficacy and safety of dostarlimab in patients with advanced or recurrent endometrial cancer (EC), with an analysis of tumor biomarkers as prognostic indicators. PATIENTS AND METHODS A total of 153 patients with mismatch repair deficient (dMMR)/microsatellite instability-high (MSI-H) and 161 patients with mismatch repair proficient (MMRp)/microsatellite stable (MSS) EC were enrolled and dosed. Patients received 500 mg dostarlimab every 3 weeks for four cycles, then 1,000 mg every 6 weeks until progression. Primary endpoints were objective response rate (ORR) and duration of response (DOR). RESULTS A total of 143 patients with dMMR/MSI-H EC and 156 patients with MMRp/MSS EC were evaluated for efficacy. ORR was 45.5% (n = 65) and 15.4% (n = 24) for dMMR/MSI-H EC and MMRp/MSS EC, respectively. Median DOR for dMMR/MSI-H EC was not met (median follow-up, 27.6 months); median DOR for MMRp/MSS EC was 19.4 months. The ORRs by combined positive score (CPS) ≥1 status were 54.9% and 21.7% for dMMR/MSI-H EC and MMRp/MSS EC, respectively. ORRs by high tumor mutational burden (≥10 mutations/Mb) were 47.8% (43/90) and 45.5% (5/11) for dMMR/MSI-H EC and MMRp/MSS EC, respectively. ORR in TP53mut or POLεmut molecular subgroups was 18.1% (17/94) and 40.0% (2/5), respectively. The safety profile of dostarlimab was consistent with previous reports. CONCLUSIONS Dostarlimab demonstrated durable antitumor activity and safety in patients with dMMR/MSI-H EC. Biomarkers associated with EC may identify patients likely to respond to dostarlimab. See related commentary by Jangra and Dhani, p. 4521.
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Affiliation(s)
- Ana Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Bhavana Pothuri
- Gynecologic Oncology Group (GOG) and Department of Obstetrics/Gynecology, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Lucy Gilbert
- Division of Gynecologic Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Renaud Sabatier
- Department of Medical Oncology, Institut Paoli Calmettes, Aix-Marseille University, Marseille, France
| | - Jubilee Brown
- Division of Gynecologic Oncology, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina
| | - Sharad Ghamande
- Department of Obstetrics and Gynecology, Georgia Cancer Center, Augusta University, Augusta, Georgia
| | - Cara Mathews
- Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - David M. O'Malley
- Division of Gynecologic Oncology, The Ohio State University and the James Comprehensive Cancer Center, Columbus, Ohio
| | - Rebecca Kristeleit
- Department of Oncology, Guys and St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Adriano Gravina
- Clinical Trials Unit, Istituto Nazionale Tumori - IRCCS - Fondazione “Pascale” di Napoli, Naples, Italy
| | - Susana Banerjee
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | - Rowan Miller
- University College London, St. Bartholomew's Hospitals London, London, United Kingdom
| | - Joanna Pikiel
- Department of Chemotherapy, Regional Center of Oncology, Gdansk, Poland
| | - Mansoor R. Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital and Nordic Society of Gynaecologic Oncology–Clinical Trial Unit, Copenhagen, Denmark
| | | | | | | | | | | | - Anna V. Tinker
- BC Cancer - Vancouver, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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Hagemann IS, Deng W, Zaino RJ, Powell MA, Gunderson Jackson C, Cosgrove C, Mathews C, Pearl ML, Waggoner S, Ghebre R, Lele S, Guntupalli S, Secord AA, Ioffe O, Rasty G, Singh M, Soslow R, Creasman W, Mutch DG. Mixed clear cell/endometrioid and clear cell/serous carcinoma of the uterus are clinicopathologically similar to pure clear cell carcinoma: An NRG Oncology/Gynecologic Oncology Group (GOG-210) study of 311 women. Gynecol Oncol 2023; 177:38-45. [PMID: 37634258 PMCID: PMC10806844 DOI: 10.1016/j.ygyno.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES Clear cell carcinoma is a high-risk subtype of endometrial cancer. Some patients have a mixture of clear cell carcinoma with other histologic types (endometrioid or serous) or cannot be neatly assigned to one of these types. Protocol GOG-8032 within GOG-210 was designed to determine whether these tumors differ from pure clear cell carcinoma in stage at diagnosis, initial pattern of spread, or patient survival. METHODS The term "mixed" was applied to tumors with multiple identifiable components, and "indeterminate" was applied to tumors with features intermediate between different histologic types. Three hundred eleven women with pure, mixed, or indeterminate clear cell carcinoma were identified in a larger cohort of patients undergoing hysterectomy for endometrial cancer in GOG-210. Histologic slides were centrally reviewed by expert pathologists. Baseline and follow-up data were analyzed. RESULTS One hundred thirty-six patients had pure clear cell carcinoma and 175 had a mixed or indeterminate clear cell pattern. Baseline clinicopathologic characteristics were similar except for a small difference in age at presentation. Univariate survival analysis confirmed the significance of typical endometrial cancer prognostic factors. Patients in the mixed categories had disease-free and overall survival similar to pure clear cell carcinoma, but the indeterminate clear cell/endometrioid group had longer survival. CONCLUSION In clear cell endometrial cancer, the presence of a definite admixed endometrioid or serous component did not correlate with a significant difference in prognosis. Patients whose tumors had indeterminate clear cell features had better prognosis. Some of these tumors may be endometrioid tumors mimicking clear cell carcinoma.
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Affiliation(s)
- Ian S Hagemann
- Washington University School of Medicine, St. Louis, MO, United States of America.
| | - Wei Deng
- NRG Oncology, Clinical Trial Development Division; Biostatistics & Bioinformatics: Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America.
| | - Richard J Zaino
- Pennsylvania State University, Hershey, PA, United States of America.
| | - Matthew A Powell
- Washington University School of Medicine, St. Louis, MO, United States of America.
| | - Camille Gunderson Jackson
- University of Oklahoma Health Sciences Center and Stephenson Cancer Center, Oklahoma City, OK, United States of America.
| | - Casey Cosgrove
- Ohio State University Comprehensive Cancer Center, Columbus, OH, United States of America.
| | - Cara Mathews
- Women & Infants Hospital, Providence, RI, United States of America.
| | - Michael L Pearl
- Stony Brook University Medical Center, Stony Brook, NY, United States of America.
| | | | - Rahel Ghebre
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States of America.
| | - Shashikant Lele
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America.
| | - Saketh Guntupalli
- University of Colorado Cancer Center, Aurora, CO, United States of America.
| | | | - Olga Ioffe
- University of Maryland School of Medicine, Baltimore, MD, United States of America.
| | - Golnar Rasty
- University of Toronto, Markham, Ontario, Canada.
| | - Meenakshi Singh
- Stony Brook University Medical Center, Stony Brook, NY, United States of America
| | - Robert Soslow
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
| | - William Creasman
- Medical University of South Carolina Medical Center, Charleston, SC, United States of America.
| | - David G Mutch
- Washington University School of Medicine, St. Louis, MO, United States of America.
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Goulden S, Shen Q, Coleman RL, Mathews C, Hunger M, Pahwa A, Schade R. Outcomes for Dostarlimab and Real-World Treatments in Post-platinum Patients With Advanced/Recurrent Endometrial Cancer: The GARNET Trial Versus a US Electronic Health Record-Based External Control Arm. J Health Econ Outcomes Res 2023; 10:53-61. [PMID: 37701519 PMCID: PMC10493167 DOI: 10.36469/001c.77484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/10/2023] [Indexed: 09/14/2023]
Abstract
Background: Patients with advanced or recurrent endometrial cancer (EC) have limited treatment options following platinum-based chemotherapy and poor prognosis. The single-arm, Phase I GARNET trial (NCT02715284) previously reported dostarlimab efficacy in mismatch repair-deficient/microsatellite instability-high advanced or recurrent EC. Objectives: The objective of this study was to compare overall survival (OS) and describe time to treatment discontinuation (TTD) for dostarlimab (GARNET Cohort A1 safety population) with an equivalent real-world external control arm receiving non-anti-programmed death (PD)-1/PD-ligand (L)1/2 treatments (constructed using data from a nationwide electronic health record-derived de-identified database and applied GARNET eligibility criteria). Methods: Propensity scores constructed from prognostic factors, identified by literature review and clinical experts, were used for inverse probability of treatment weighting (IPTW). Kaplan-Meier curves were constructed and OS/TTD was estimated (Cox regression model was used to estimate the OS-adjusted hazard ratio). Results: Dostarlimab was associated with a 52% lower risk of death vs real-world treatments (hazard ratio, 0.48; 95% confidence interval [CI], 0.35-0.66). IPTW-adjusted median OS for dostarlimab (N=143) was not estimable (95% CI, 19.4-not estimable) versus 13.1 months (95% CI, 8.3-15.9) for real-world treatments (N = 185). Median TTD was 11.7 months (95% CI, 6.0-38.7) for dostarlimab and 5.3 months (95% CI, 4.1-6.0) for the real-world cohort. Discussion: Consistent with previous analyses, patients treated with dostarlimab had significantly longer OS than patients in the US real-world cohort after adjusting for the lack of randomization using stabilized IPTW. Additionally, patients had a long TTD when treated with dostarlimab, suggesting a favorable tolerability profile. Conclusion: Patients with advanced or recurrent EC receiving dostarlimab in GARNET had significantly lower risk of death than those receiving real-world non-anti-PD-(L)1/2 treatments.
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Affiliation(s)
| | - Qin Shen
- GSK, Collegeville, Pennsylvania, USA
| | | | - Cara Mathews
- Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Oaknin A, Gilbert L, Tinker AV, Brown J, Mathews C, Press J, Sabatier R, O'Malley DM, Samouelian V, Boni V, Duska L, Ghamande S, Ghatage P, Kristeleit R, Leath C, Dong Y, Veneris J, Pothuri B. A plain language summary of results from the GARNET study of dostarlimab in patients with endometrial cancer. Future Oncol 2023; 19:1709-1714. [PMID: 37381977 DOI: 10.2217/fon-2022-1157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
WHAT IS THIS SUMMARY ABOUT? Dostarlimab, also known by the brand name JEMPERLI, is a medicine that can be used to treat certain types of endometrial cancer. GARNET is an ongoing phase 1 clinical study that is testing the safety and side effects of dostarlimab and the best way to administer it to patients. The results presented in this summary are from a time point in the middle of the study. WHAT WERE THE RESULTS? The results from the GARNET study published in 2022 showed how well dostarlimab worked for people participating in the study. Dostarlimab was found to reduce the size of tumors in patients with certain types of endometrial cancer. The patients treated with dostarlimab had side effects that could be managed and few severe side effects. WHAT DO THE RESULTS MEAN? The results of the GARNET study led to dostarlimab being approved to treat patients with certain types of endometrial cancer. For patients with advanced-stage endometrial cancer, or endometrial cancer that has come back after chemotherapy (recurrent), there are few treatment options. The results suggest that dostarlimab may provide long-term benefits for these patients.
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Affiliation(s)
- Ana Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital
| | | | - Anna V Tinker
- Department of Gynecologic Oncology, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Jubilee Brown
- Department of Medicine, BC Cancer, Vancouver, BC, Canada
| | - Cara Mathews
- Division of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Joshua Press
- Department of Gynecological Oncology, Women & Infants Hospital of Rhode Island, Providence, RI, USA
| | - Renaud Sabatier
- Gynecologic Oncology & Pelvic Surgery, Swedish Cancer Institute, Seattle, WA, USA
| | - David M O'Malley
- Department of Medical Oncology, Institut Paoli Calmettes, Aix-Marseille University, Marseille, France
| | - Vanessa Samouelian
- Department of Obstetrics & Gynecology, The Ohio State University James Comprehensive Cancer Center, Columbus, OH, USA
| | - Valentina Boni
- Gynecologic Oncology Service, Department of Obstetrics & Gynecology, Université de Montréal, Montreal, QC, Canada
| | - Linda Duska
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Sharad Ghamande
- Department of Gynecological Oncology, Emily Couric Clinical Cancer Center, University of Virginia, Charlottesville, VA, USA
| | | | - Rebecca Kristeleit
- Department of Gynecological Oncology, University of Calgary, Calgary, AB, Canada
| | - Charles Leath
- Department of Oncology, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Yuping Dong
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jennifer Veneris
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
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Eskander RN, Sill MW, Beffa L, Moore RG, Hope JM, Musa FB, Mannel R, Shahin MS, Cantuaria GH, Girda E, Mathews C, Kavecansky J, Leath CA, Gien LT, Hinchcliff EM, Lele SB, Landrum LM, Backes F, O'Cearbhaill RE, Al Baghdadi T, Hill EK, Thaker PH, John VS, Welch S, Fader AN, Powell MA, Aghajanian C. Pembrolizumab plus Chemotherapy in Advanced Endometrial Cancer. N Engl J Med 2023; 388:2159-2170. [PMID: 36972022 PMCID: PMC10351614 DOI: 10.1056/nejmoa2302312] [Citation(s) in RCA: 109] [Impact Index Per Article: 109.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
BACKGROUND Standard first-line chemotherapy for endometrial cancer is paclitaxel plus carboplatin. The benefit of adding pembrolizumab to chemotherapy remains unclear. METHODS In this double-blind, placebo-controlled, randomized, phase 3 trial, we assigned 816 patients with measurable disease (stage III or IVA) or stage IVB or recurrent endometrial cancer in a 1:1 ratio to receive pembrolizumab or placebo along with combination therapy with paclitaxel plus carboplatin. The administration of pembrolizumab or placebo was planned in 6 cycles every 3 weeks, followed by up to 14 maintenance cycles every 6 weeks. The patients were stratified into two cohorts according to whether they had mismatch repair-deficient (dMMR) or mismatch repair-proficient (pMMR) disease. Previous adjuvant chemotherapy was permitted if the treatment-free interval was at least 12 months. The primary outcome was progression-free survival in the two cohorts. Interim analyses were scheduled to be triggered after the occurrence of at least 84 events of death or progression in the dMMR cohort and at least 196 events in the pMMR cohort. RESULTS In the 12-month analysis, Kaplan-Meier estimates of progression-free survival in the dMMR cohort were 74% in the pembrolizumab group and 38% in the placebo group (hazard ratio for progression or death, 0.30; 95% confidence interval [CI], 0.19 to 0.48; P<0.001), a 70% difference in relative risk. In the pMMR cohort, median progression-free survival was 13.1 months with pembrolizumab and 8.7 months with placebo (hazard ratio, 0.54; 95% CI, 0.41 to 0.71; P<0.001). Adverse events were as expected for pembrolizumab and combination chemotherapy. CONCLUSIONS In patients with advanced or recurrent endometrial cancer, the addition of pembrolizumab to standard chemotherapy resulted in significantly longer progression-free survival than with chemotherapy alone. (Funded by the National Cancer Institute and others; NRG-GY018 ClinicalTrials.gov number, NCT03914612.).
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Affiliation(s)
- Ramez N Eskander
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Michael W Sill
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Lindsey Beffa
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Richard G Moore
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Joanie M Hope
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Fernanda B Musa
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Robert Mannel
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Mark S Shahin
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Guilherme H Cantuaria
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Eugenia Girda
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Cara Mathews
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Juraj Kavecansky
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Charles A Leath
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Lilian T Gien
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Emily M Hinchcliff
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Shashikant B Lele
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Lisa M Landrum
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Floor Backes
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Roisin E O'Cearbhaill
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Tareq Al Baghdadi
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Emily K Hill
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Premal H Thaker
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Veena S John
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Stephen Welch
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Amanda N Fader
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Matthew A Powell
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
| | - Carol Aghajanian
- From the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, Rebecca and John Moores Cancer Center, La Jolla (R.N.E.), and the Kaiser Permanente National Cancer Institute Community Oncology Research Program (NCORP), Antioch Medical Center, Antioch (J.K.) - both in California; the Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo (M.W.S., S.B.L.), the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester (R.G.M.), the Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and the Department of Medicine, Weill Cornell Medical College, New York (R.E.O., C.A.), and the Northwell Health Cancer Institute, New Hyde Park (V.S.J.) - all in New York; the Case Comprehensive Cancer Center, Cleveland Clinic Foundation, Cleveland (L.B.), and Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus (F.B.); the Pacific Cancer Research Consortium, NCORP, Alaska Women's Cancer Care, and Providence Alaska Cancer Center, Anchorage (J.M.H.); the Pacific Cancer Research Consortium, NCORP, Swedish Medical Center-First Hill, Seattle (F.B.M.); the University of Oklahoma Health Sciences Center, Oklahoma City (R.M.); Jefferson Abington Hospital, Asplundh Cancer Pavilion of Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA (M.S.S.); Georgia NCORP, Atlanta (G.H.C.); Rutgers Cancer Institute of New Jersey, New Brunswick (E.G.); Women and Infants Hospital, Legoretta Cancer Center, Alpert Medical School, Brown University, Providence, RI (C.M.); the University of Alabama at Birmingham-Deep South Research Consortium, O'Neal Comprehensive Cancer Center, University of Alabama Hospital, Birmingham (C.A.L.); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto (L.T.G.), and the London Regional Cancer Program, London, ON (S.W.) - both in Canada; Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago (E.M.H.); the Indiana University Health Simon Cancer Center, Indianapolis (L.M.L.); the Michigan Cancer Research Consortium, NCORP, Trinity Health IHA Medical Group, Ypsilanti (T.A.B.); the University of Iowa Hospitals and Clinics, Iowa City (E.K.H.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis (P.H.T., M.A.P.); and the Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore (A.N.F.)
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Siegfried NL, De Voux A, Jona K, Yun JA, Chetty T, Mabona M, Els F, Mdose H, Kuonza L, Hsiao M, Mathews C. SARS-CoV-2 Transmission Risk in the School Environment: a pilot case-ascertained prospective study to inform future school-based surveillance. S Afr Med J 2023; 113:30-38. [PMID: 37170607 DOI: 10.7196/samj.2023.v113i5.16736] [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] [Received: 03/06/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND There is no current active or passive disease surveillance programme focused on schools in South Africa. As such the country is missing an opportunity to rapidly and effectively flag and address pathogen outbreaks, for example SARS-CoV-2, in a key closed setting. Furthermore, the role of school transmission in the spread of the SARS-CoV-2 virus within communities is uncertain. Objective. This pilot study, conducted during March 2022 in Cape Town, aimed to indicate the feasibility of conducting intense active contact-tracing in a school environment prior to a large national study to compare school versus community SARS-CoV-2 transmission risk. Methods. We conducted a pilot school-level case-ascertained prospective study with a component of enhanced surveillance. Following study initiation, the first learner at a participating school who tested SARS-CoV-2 positive (via Polymerase Chain Reaction (PCR) or a Rapid Antigen Test (RAT)) was invited to join the study as the index case and all their school-based close contacts were followed up telephonically, monitored for symptoms for 14 days, and tested using a PCR if any symptoms were reported. Results. On 8th March 2022, a student with RAT laboratory-confirmed COVID-19 was identified and they and their guardian consented to participate as the index case. Of the 11 eligible close contacts, six provided consent/assent and completed symptom monitoring calls until the end of the 14-day study period. The Secondary Attack Rate (SAR) was 2/11 (18.18%) of all close contacts who were at risk of infection, 2/4 (50.0%) of all those close contacts who developed symptoms, and 2/4 (50.0%) of all those close contacts who developed symptoms and were tested for SARS-CoV-2. During the same period, the school reported that nine of the 926 learner body tested COVID-19 positive (0.97%). Total hours spent conducting monitoring for 6 learners was 27 hours, with each learner requiring approximately 4.5 hours of contact time during the study period. Conclusion. This is the first South African school-based COVID-19 transmission study, the results of which can inform national discussions regarding the role of schools and school-based active and passive surveillance in pathogen prevention and control.
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Affiliation(s)
- N L Siegfried
- Health Systems Research Unit, South African Medical Council, Tygerberg, South Africa. Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - A De Voux
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - K Jona
- Health Systems Research Unit, South African Medical Council, and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J A Yun
- Health Systems Research Unit, South African Medical Council, and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Chetty
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - M Mabona
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - F Els
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - H Mdose
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - L Kuonza
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - M Hsiao
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - C Mathews
- Health Systems Research Unit, South African Medical Council, and Faculty of Health Sciences, University of Cape Town, South Africa.
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DiSilvestro P, Banerjee S, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke GS, Gourley C, Oza A, González-Martín A, Aghajanian C, Bradley W, Mathews C, Liu J, McNamara J, Lowe ES, Ah-See ML, Moore KN. Overall Survival With Maintenance Olaparib at a 7-Year Follow-Up in Patients With Newly Diagnosed Advanced Ovarian Cancer and a BRCA Mutation: The SOLO1/GOG 3004 Trial. J Clin Oncol 2023; 41:609-617. [PMID: 36082969 PMCID: PMC9870219 DOI: 10.1200/jco.22.01549] [Citation(s) in RCA: 107] [Impact Index Per Article: 107.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
PURPOSE In SOLO1/GOG 3004 (ClinicalTrials.gov identifier: NCT01844986), maintenance therapy with the poly(ADP-ribose) polymerase inhibitor olaparib provided a sustained progression-free survival benefit in patients with newly diagnosed advanced ovarian cancer and a BRCA1 and/or BRCA2 (BRCA) mutation. We report overall survival (OS) after a 7-year follow-up, a clinically relevant time point and the longest follow-up for any poly(ADP-ribose) polymerase inhibitor in the first-line setting. METHODS This double-blind phase III trial randomly assigned patients with newly diagnosed advanced ovarian cancer and a BRCA mutation in clinical response to platinum-based chemotherapy to maintenance olaparib (n = 260) or placebo (n = 131) for up to 2 years. A prespecified descriptive analysis of OS, a secondary end point, was conducted after a 7-year follow-up. RESULTS The median duration of treatment was 24.6 months with olaparib and 13.9 months with placebo, and the median follow-up was 88.9 and 87.4 months, respectively. The hazard ratio for OS was 0.55 (95% CI, 0.40 to 0.76; P = .0004 [P < .0001 required to declare statistical significance]). At 7 years, 67.0% of olaparib patients versus 46.5% of placebo patients were alive, and 45.3% versus 20.6%, respectively, were alive and had not received a first subsequent treatment (Kaplan-Meier estimates). The incidence of myelodysplastic syndrome and acute myeloid leukemia remained low, and new primary malignancies remained balanced between treatment groups. CONCLUSION Results indicate a clinically meaningful, albeit not statistically significant according to prespecified criteria, improvement in OS with maintenance olaparib in patients with newly diagnosed advanced ovarian cancer and a BRCA mutation and support the use of maintenance olaparib to achieve long-term remission in this setting; the potential for cure may also be enhanced. No new safety signals were observed during long-term follow-up.
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Affiliation(s)
- Paul DiSilvestro
- Program in Women's Oncology, Women & Infants Hospital, Providence, RI
- Paul DiSilvestro, MD, Women & Infants Hospital, 101 Dudley St, Providence, RI 02905; e-mail:
| | - Susana Banerjee
- The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | - Nicoletta Colombo
- University of Milan-Bicocca and Istituto Europeo di Oncologia IRCCS, Milan, Italy
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Byoung-Gie Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ana Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Michael Friedlander
- University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | | | - Anne Floquet
- Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France
| | - Alexandra Leary
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France
- Institut Gustave-Roussy, Villejuif, France
| | - Gabe S. Sonke
- The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Charlie Gourley
- Cancer Research UK Scotland Center, University of Edinburgh, Edinburgh, United Kingdom
| | - Amit Oza
- Princess Margaret Cancer Center, Toronto, ON, Canada
| | - Antonio González-Martín
- Clínica Universidad de Navarra, Madrid, Spain
- Program In Solid Tumours, CIMA, Pamplona, Spain
| | | | - William Bradley
- Froedtert and the Medical College of Wisconsin, Milwaukee, WI
| | - Cara Mathews
- Program in Women's Oncology, Women & Infants Hospital, Providence, RI
| | - Joyce Liu
- Dana-Farber Cancer Institute, Boston, MA
| | - John McNamara
- Biostatistics, Oncology Biometrics, Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | - Elizabeth S. Lowe
- Global Medicines Development, Oncology, AstraZeneca, Gaithersburg, MD
| | - Mei-Lin Ah-See
- Oncology R&D, Late-stage Development, AstraZeneca, Cambridge, United Kingdom
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11
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Ramos SZ, Kulkarni A, Oliver M, Danilack VA, Mathews C. Frailty as a predictor of delayed initiation of adjuvant chemotherapy in patients with ovarian cancer. Int J Gynecol Cancer 2023; 33:57-65. [PMID: 36423959 DOI: 10.1136/ijgc-2022-003603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to identify whether frailty is associated with the time between surgery and the initiation of chemotherapy for patients with ovarian cancer. METHODS This retrospective cohort study included patients 18 years or older with stage II to IV ovarian cancer who underwent primary debulking surgery at a tertiary medical center between July 2006 and July 2015. Basic demographics and clinical information were obtained from a departmental database and the electronic medical record. The Modified Frailty Index (mFI) was calculated based on 10 comorbidities and functional status yielding 11 items total. Patients were categorized by a total score: 0-1=no frailty, 2=moderate frailty and 3+=high frailty. RESULTS Among 451 patients, 359 had mFI scores of 0-1, 60 had a score of 2, and 32 had scores of 3+. Mean time from surgery to initiation of chemotherapy was 37 days. Mean number of days between surgery and initiation of chemotherapy increased with increasing frailty score: 36 days for the not frail group, 39 days for the moderate frailty group, and 54 days for the high frailty group (p<0.001). Time to initiation of chemotherapy of 42 days or more occurred in 23% of the no frailty group, 28% in the moderate frailty group, and 63% in the high frailty group (p<0.001). Overall survival decreased with increasing frailty scores. CONCLUSION High mFI scores lead to a greater delay between surgery and chemotherapy initiation. Being able to predict delays in initiation of chemotherapy may allow oncologists to consider neoadjuvant chemotherapy, pre-habilitation before surgery, and improved preoperative counseling in high-risk patients.
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Affiliation(s)
- Sebastian Z Ramos
- Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
| | - Amita Kulkarni
- Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
| | - Matthew Oliver
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
| | - Valery A Danilack
- Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
| | - Cara Mathews
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
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12
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Thiel KW, Devor EJ, Filiaci VL, Mutch D, Moxley K, Alvarez Secord A, Tewari KS, McDonald ME, Mathews C, Cosgrove C, Dewdney S, Aghajanian C, Samuelson MI, Lankes HA, Soslow RA, Leslie KK. TP53 Sequencing and p53 Immunohistochemistry Predict Outcomes When Bevacizumab Is Added to Frontline Chemotherapy in Endometrial Cancer: An NRG Oncology/Gynecologic Oncology Group Study. J Clin Oncol 2022; 40:3289-3300. [PMID: 35658479 PMCID: PMC9553389 DOI: 10.1200/jco.21.02506] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/28/2022] [Accepted: 04/15/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The status of p53 in a tumor can be inferred by next-generation sequencing (NGS) or by immunohistochemistry (IHC). We examined the association between p53 IHC and sequence and whether p53 IHC alone, or integrated with TP53 NGS, predicts the outcome. METHODS From GOG-86P, a randomized phase II study of chemotherapy combined with either bevacizumab or temsirolimus in advanced endometrial cancer, 213 cases had p53 protein expression data measured by IHC and TP53 NGS data. An analysis was designed to integrate p53 expression by IHC with the presence or absence of a TP53 mutation. These variables were further correlated with progression-free survival (PFS) and overall survival (OS) in the chemotherapy plus bevacizumab arms versus the chemotherapy plus temsirolimus arm. RESULTS In the analysis of p53 IHC, the most striking treatment effect favoring bevacizumab was in cases where p53 was overexpressed (PFS hazard ratio [HR]: 0.46, 95% CI, 0.26 to 0.88; OS HR: 0.31, 95% CI, 0.16 to 0.62). On integrated analysis, patients with TP53 missense mutations and p53 protein overexpression had a similar treatment effect on PFS (HR: 0.41, 95% CI, 0.22 to 0.83) and OS (HR: 0.28, 95% CI, 0.14 to 0.59) favoring bevacizumab plus chemotherapy relative to temsirolimus plus chemotherapy. Concordance between TP53 NGS and p53 IHC was 88%. Concordance was 92% when cases with TP53 mutations and POLE mutations or mismatch repair deficiency were removed. CONCLUSION IHC for p53 alone or when integrated with sequencing for TP53 identifies a specific, high-risk tumor genotype/phenotype for which bevacizumab is particularly beneficial in improving outcomes when combined with chemotherapy.
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Affiliation(s)
- Kristina W. Thiel
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - Eric J. Devor
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - Virginia L. Filiaci
- NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - David Mutch
- Washington University School of Medicine, Siteman Cancer Center, St Louis, MO
| | - Katherine Moxley
- Stephenson Cancer Center, Gynecologic Cancers Clinic, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | | | | | - Megan E. McDonald
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - Cara Mathews
- Women and Infants Hospital in Rhode Island/The Warren Alpert Medical School of Brown University, Providence, RI
| | - Casey Cosgrove
- Ohio State University Medical Center, James Cancer Hospital and Solove Research Institute, Obstetrics and Gynecology, Columbus, OH
| | | | - Carol Aghajanian
- Memorial Sloan Kettering Cancer and Weill Cornell Medical Center, New York, NY
| | - Megan I. Samuelson
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - Heather A. Lankes
- Biopathology Center, The Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - Robert A. Soslow
- The University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Kimberly K. Leslie
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
- The University of New Mexico Health Sciences Center, Albuquerque, NM
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13
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Mathews C, Lorusso D, Coleman RL, Boklage S, Garside J. An Indirect Comparison of the Efficacy and Safety of Dostarlimab and Doxorubicin for the Treatment of Advanced and Recurrent Endometrial Cancer. Oncologist 2022; 27:1058-1066. [PMID: 36124638 PMCID: PMC9732237 DOI: 10.1093/oncolo/oyac188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/26/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND There is no clear standard of care for advanced/recurrent endometrial cancer (EC) following platinum-based therapy. Dostarlimab is approved for patients with mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) advanced/recurrent EC. This indirect treatment comparison (ITC) assessed dostarlimab efficacy and safety from the single-arm GARNET (NCT02715284) trial compared with doxorubicin from ZoptEC (NCT01767155). PATIENTS AND METHODS Patient-level data and study variables from GARNET Cohort A1 (dMMR/MSI-H EC) and the ZoptEC doxorubicin control arm were merged. Patients were matched based on eligibility criteria (main analysis population). Safety population included all patients who received treatment. The primary efficacy comparison outcome, overall survival (OS), was calculated using a Cox proportional hazards model, with adjusted stabilized inverse probability of treatment weighting. Modified assessment-scheduled matching Kaplan--Meier analysis was used for progression-free survival (PFS) and time to deterioration (TTD) in quality of life (QoL). RESULTS In the main analysis population, median (95% CI) OS was not reached (NR; 18.0 months--NR) for dostarlimab (n = 92) and was 11.2 (10.0-13.1) months for doxorubicin (n = 233; HR: 0.41 [95% CI: 0.28-0.61]); median PFS was 12.2 (3.3-NR) and 4.9 (4.1-6.6) months, respectively. Median TTD in QoL was NR (2.5-NR; n = 61) and 4.5 (4.1-5.4; n = 188) months, respectively. Similar rates of adverse events (AEs, 11.6% vs 15.3%) and serious AEs (34.1% vs 30.1%) were observed with dostarlimab (n = 129) and doxorubicin (n = 249). Grade ≥3 AEs occurred in 48.1% vs 78.3%, respectively. CONCLUSION This ITC suggests a favorable benefit:risk profile for dostarlimab in patients with dMMR/MSI-H advanced/recurrent EC.
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Affiliation(s)
- Cara Mathews
- Corresponding author: Cara Mathews, MD, 101 Dudley Street, Providence RI 02905, USA. Tel.: +1 401 453 7520;
| | - Domenica Lorusso
- Fondazione Policlinico Gemelli of Rome, Rome, Italy,Department of Gynecologic Oncology, Catholic University of Sacred Heart, Rome, Italy
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14
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Oaknin A, Pothuri B, Gilbert L, Sabatier R, Brown J, Ghamande S, Mathews C, O'Malley D, Boni V, Gravina A, Banerjee S, Miller R, Pikiel J, Mirza M, Duan T, Han X, Zildjian S, Dewal N, J.Veneris, Tinker A. 547P Efficacy of dostarlimab in endometrial cancer (EC) by molecular subtype: A post hoc analysis of the GARNET study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.675] [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: 11/01/2022] Open
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15
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Cadoo K, Simpkins F, Mathews C, Liu YL, Provencher D, McCormick C, ElNaggar AC, Altman AD, Gilbert L, Black D, Kabil N, Bennett J, Munley J, Aghajanian C. Olaparib treatment for platinum-sensitive relapsed ovarian cancer by BRCA mutation and homologous recombination deficiency status: Phase II LIGHT study primary analysis. Gynecol Oncol 2022; 166:425-431. [PMID: 35803835 PMCID: PMC9909678 DOI: 10.1016/j.ygyno.2022.06.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/20/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Olaparib treatment resulted in significant improvement in objective response rates (ORRs) and progression-free survival (PFS) over non‑platinum chemotherapy in patients with BRCA1/BRCA2-mutated (BRCAm) platinum-sensitive relapsed ovarian cancer (PSROC) and ≥2 prior lines of platinum-based chemotherapy in the phase III SOLO3 study. LIGHT (NCT02983799) prospectively evaluated olaparib treatment for patients with PSROC and known BRCAm and homologous recombination deficiency (HRD) status. METHODS In this phase II open-label multicenter study, patients with PSROC and ≥1 prior line of platinum-based chemotherapy were assigned to cohorts by presence of germline BRCAm (gBRCAm), somatic BRCAm (sBRCAm), HRD-positive tumors without BRCAm, or HRD-negative tumors. The primary endpoint was investigator-assessed ORR. Secondary endpoints included disease control rate (DCR) and PFS. Tumors were analyzed using Myriad BRACAnalysis CDx and myChoice HRD assays; HRD-positive tumors were defined using a genomic instability score of ≥42. RESULTS Of 272 enrolled patients, 271 received olaparib and 270 were included in efficacy analyses. At data cut-off, ORRs in the gBRCAm, sBRCAm, HRD-positive, and HRD-negative cohorts were 69.3%, 64.0%, 29.4%, and 10.1%, respectively. DCRs were 96.0%, 100.0%, 79.4%, and 75.3% in each cohort, respectively. Median PFS was 11.0, 10.8, 7.2, and 5.4 months, respectively. The most common (≥ 20%) treatment-emergent adverse events included nausea, fatigue/asthenia, vomiting, anemia, constipation, diarrhea, and decreased appetite. CONCLUSIONS Olaparib treatment demonstrated activity across all cohorts. The greatest efficacy was observed in the BRCAm cohorts, regardless of gBRCAm/sBRCAm. For patients without a BRCAm, greater efficacy was observed in the HRD-positive than the HRD-negative cohorts. The safety profile was consistent with that established in previous olaparib studies.
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Affiliation(s)
- Karen Cadoo
- Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY, USA,.
| | - Fiona Simpkins
- Department of Obstetrics and Gynecology, Jordan Center for Gynecologic Oncology at the Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Cara Mathews
- Program in Women’s Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, RI, USA
| | - Ying L. Liu
- Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY, USA
| | | | | | | | - Alon D. Altman
- CancerCare Manitoba, Research Institute of Oncology and Hematology, University of Manitoba, Winnipeg Manitoba, Canada
| | - Lucy Gilbert
- Division of Gynecologic Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Destin Black
- Willis-Knighton Cancer Center, Shreveport, LA, USA
| | | | | | | | - Carol Aghajanian
- Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY, USA
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16
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DiSilvestro P, Banerjee S, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke G, Gourley C, Oza A, Gonzalez Martin A, Aghajanian C, Bradley W, Mathews C, McNamara J, Lowe E, Moore K. 517O Overall survival (OS) at 7-year (y) follow-up (f/u) in patients (pts) with newly diagnosed advanced ovarian cancer (OC) and a BRCA mutation (BRCAm) who received maintenance olaparib in the SOLO1/GOG-3004 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.645] [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: 11/01/2022] Open
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17
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Tinker A, Pothuri B, Gilbert L, Sabatier R, Brown J, Ghamande S, Mathews C, O'Malley D, Boni V, Gravina A, Banerjee S, Miller R, Pikiel J, Mirza M, Duan T, Antony G, Zildjian S, Zografos E, Veneris J, Oaknin A. 548P Progression-free survival (PFS) and overall survival (OS) in advanced/recurrent (AR) mismatch repair deficient/microsatellite instability–high or proficient/stable (dMMR/MSI-H or MMRp/MSS) endometrial cancer (EC) treated with dostarlimab in the GARNET study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.676] [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: 11/26/2022] Open
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18
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Kristeleit R, Mathews C, Redondo A, Boklage S, Hanlon J, Im E, Brown J. Patient-reported outcomes in the GARNET trial in patients with advanced or recurrent mismatch repair-deficient/microsatellite instability-high endometrial cancer treated with dostarlimab. Int J Gynecol Cancer 2022; 32:ijgc-2022-003492. [PMID: 35973737 PMCID: PMC9554028 DOI: 10.1136/ijgc-2022-003492] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/05/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE There is an increase in patient-reported outcome assessments to gain information on new drug candidates from the patient's perspective. A data gap remains in patient-reported outcome measurements for anti-programmed death 1 (anti-PD-1) therapies in endometrial cancer. We present patient-reported outcome measures collected from patients with mismatch repair-deficient/microsatellite instability-high advanced or recurrent endometrial cancer treated with dostarlimab, an anti-PD-1 monoclonal antibody, in an expansion cohort of the GARNET trial. METHODS GARNET (NCT02715284) is a phase I single-arm study of dostarlimab monotherapy in multiple tumor types. Patients with advanced or recurrent mismatch repair-deficient/microsatellite instability-high endometrial cancer were treated with 500 mg of intravenous dostarlimab once every 3 weeks for four cycles, then 1000 mg of intravenous dostarlimab every 6 weeks. Patient-reported outcome assessments were an exploratory endpoint, measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30). RESULTS At data cut-off, 88 patients with mismatch repair-deficient endometrial cancer were included in the analysis. Patient-reported outcome assessment completion was >95.5% throughout cycle 7 of the trial, with no individual domain completion <90.9%. Quality of life, emotional functioning, and social functioning showed improvement compared with baseline. All symptom scores showed either improvement or stability from baseline through cycle 7. Categorical change in response across all symptom scales and single-item response scores showed stability or improvement for most patients. For patients who saw a worsening of their categorical change in response, ≤7.4% experienced a 2-category worsening and ≤2.5% experienced a 3-category worsening. CONCLUSIONS Most patients remained stable or had improved quality of life while receiving dostarlimab for the treatment of recurrent or advanced mismatch repair-deficient endometrial cancer. TRIAL REGISTRATION NUMBER NCT02715284.
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Affiliation(s)
| | - Cara Mathews
- Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
| | - Andres Redondo
- Department of Medical Oncology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | | | | | - Ellie Im
- GSK, Waltham, Massachusetts, USA
| | - Jubilee Brown
- Levine Cancer Institute, Atrium Health, Charlotte, North Carolina, USA
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Oaknin A, Gilbert L, Tinker A, SABATIER R, Brown J, Mathews C, Boni V, Samouelian V, O’Malley D, Jewell A, Banerjee S, Antony G, Veneris JV, Pothuri B. Antitumor activity and safety of dostarlimab therapy in patients with endometrial cancer by age subgroups: A post-hoc analysis from the GARNET trial (210). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01435-4] [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: 11/04/2022]
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20
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Mayadev J, Zamarin D, Deng W, Lankes H, Pesci G, Park K, Banbury B, Sherry N, Ghamande S, Holman L, Mathews C, O’Cearbhaill R, Aghajanian C, Schilder R. Safety and immunogenicity of Anti PD-L1 (Atezolizumab) given as an immune primer or concurrently with extended field chemoradiotherapy for node positive locally advanced cervical cancer: an NRG Oncology trial (024). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01242-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Mathews C, Lorusso D, Coleman R, Parks D, Garside J. The comparative clinical effectiveness of dostarlimab versus doxorubicin in the treatment of advanced/recurrent endometrial cancer (216). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01441-x] [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: 11/16/2022]
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22
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Mathews C, Kirby S. P244 The experiences of taking Kaftrio® for cystic fibrosis (CF). J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00573-2] [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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23
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Mindel EL, Mathews C. P242 Young people’s views on Kaftrio®: a peer research project. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00571-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Oaknin A, Gilbert L, Tinker AV, Brown J, Mathews C, Press J, Sabatier R, O'Malley DM, Samouelian V, Boni V, Duska L, Ghamande S, Ghatage P, Kristeleit R, Leath CIII, Guo W, Im E, Zildjian S, Han X, Duan T, Veneris J, Pothuri B. Safety and antitumor activity of dostarlimab in patients with advanced or recurrent DNA mismatch repair deficient/microsatellite instability-high (dMMR/MSI-H) or proficient/stable (MMRp/MSS) endometrial cancer: interim results from GARNET—a phase I, single-arm study. J Immunother Cancer 2022; 10:jitc-2021-003777. [PMID: 35064011 PMCID: PMC8785197 DOI: 10.1136/jitc-2021-003777] [Citation(s) in RCA: 117] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 01/22/2023] Open
Abstract
Background Dostarlimab is a humanized monoclonal antibody that binds with high affinity to PD-1, resulting in inhibition of binding to PD-L1 and PD-L2. We report interim data from patients with endometrial cancer (EC) participating in a phase I trial of single-agent dostarlimab. Methods GARNET, an ongoing, single-arm, open-label, phase I trial of intravenous dostarlimab in advanced solid tumors, is being undertaken at 123 sites. Two cohorts of patients with EC were recruited: those with dMMR/MSI-H disease (cohort A1) and those with proficient/stable (MMRp/MSS) disease (cohort A2). Patients received dostarlimab 500 mg every 3 weeks for 4 cycles, then dostarlimab 1000 mg every 6 weeks until disease progression. The primary endpoints were objective response rate (ORR) and duration of response (DOR) per RECIST V.1.1, as assessed by blinded independent central review. Results Screening began on April 10, 2017, and 129 and 161 patients with advanced EC were enrolled in cohorts A1 and A2, respectively. The median follow-up duration was 16.3 months (IQR 9.5–22.1) for cohort A1 and 11.5 months (IQR 11.0–25.1) for cohort A2. In cohort A1, ORR was 43.5% (95% CI 34.0% to 53.4%) with 11 complete responses and 36 partial responses. In cohort A2, ORR was 14.1% (95% CI 9.1% to 20.6%) with three complete responses and 19 partial responses. Median DOR was not reached in either cohort. In the combined cohorts, the majority of treatment-related adverse events (TRAEs) were grade 1–2 (75.5%), most commonly fatigue (17.6%), diarrhea (13.8%), and nausea (13.8%). Grade≥3 TRAEs occurred in 16.6% of patients, and 5.5% discontinued dostarlimab because of TRAEs. No deaths were attributable to dostarlimab. Conclusion Dostarlimab demonstrated durable antitumor activity in both dMMR/MSI-H (ORR 43.5%) and MMRp/MSS EC (ORR 14.1%) with a manageable safety profile. Trial registration number NCT02715284.
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Affiliation(s)
- Ana Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Lucy Gilbert
- Department of Gynecologic Oncology, McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Anna V Tinker
- Department of Medicine, BC Cancer, Vancouver, British Columbia, Canada
| | - Jubilee Brown
- Division of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina, USA
| | - Cara Mathews
- Department of Gynecological Oncology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
| | - Joshua Press
- Gynecologic Oncology and Pelvic Surgery, Swedish Cancer Institute, Seattle, Washington State, USA
| | - Renaud Sabatier
- Department of Medical Oncology, Institut Paoli Calmettes, Aix-Marseille University, Marseille, France
| | - David M O'Malley
- Department of Obstetrics and Gynecology, The Ohio State University James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Vanessa Samouelian
- Gynecologic Oncology Service, Department of Obstetrics and Gynecology, Université de Montréal, Montreal, Québec, Canada
| | - Valentina Boni
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Linda Duska
- Department of Gynecological Oncology, Emily Couric Clinical Cancer Center, University of Virginia, Charlottesville, Virginia, USA
| | - Sharad Ghamande
- Georgia Cancer Center, Augusta University, Augusta, Georgia, USA
| | - Prafull Ghatage
- Department of Gynecological Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Rebecca Kristeleit
- Department of Oncology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Charles III Leath
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Wei Guo
- GlaxoSmithKline, Waltham, Massachusetts, USA
| | - Ellie Im
- GlaxoSmithKline, Waltham, Massachusetts, USA
| | | | - Xinwei Han
- GlaxoSmithKline, Waltham, Massachusetts, USA
| | - Tao Duan
- GlaxoSmithKline, Waltham, Massachusetts, USA
| | | | - Bhavana Pothuri
- Department of Obstetrics and Gynecology, NYU Langone Health, Perlmutter Cancer Center, New York University, New York, New York, USA
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25
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Oaknin A, Tinker AV, Gilbert L, Samouëlian V, Mathews C, Brown J, Barretina-Ginesta MP, Moreno V, Gravina A, Abdeddaim C, Banerjee S, Guo W, Danaee H, Im E, Sabatier R. Clinical activity and safety of the anti-PD-1 monoclonal antibody dostarlimab for patients with recurrent or advanced dMMR endometrial cancer. Future Oncol 2021; 17:3781-3785. [PMID: 34427115 DOI: 10.2217/fon-2021-0598] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This document provides a short summary of the GARNET trial which was published in JAMA Oncology in October 2020. At the end of this document, there are links to websites where you can find more information about this study. The trial enrolled adult participants with advanced solid tumors. This report is restricted to patients with a particular type of endometrial cancer that has a deficient mismatch repair (dMMR) status. Patients received a trial treatment called dostarlimab (also known by the brand name Jemperli). In the US, dostarlimab is approved as a single therapy in adult patients with dMMR recurrent or advanced endometrial cancer that has progressed on or after platinum-based chemotherapy. In the EU, dostarlimab is approved as a single therapy in adult patients with recurrent or advanced dMMR/microsatellite instability-high (MSI-H) endometrial cancer that has progressed on or after treatment with a platinum-containing regimen. The GARNET trial looked at dostarlimab given intravenously to patients with dMMR endometrial cancer from 7 countries. The trial showed that dostarlimab was successful in shrinking the tumor in 42% of these patients. In general, the percentage of participants who experienced medical problems (referred to as side effects) was low and within expectations for this type of treatment. ClinicalTrials.gov NCT number: NCT02715284. To read the full Plain Language Summary of this article, click on the View Article button above and download the PDF. Link to original article here.
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Affiliation(s)
- Ana Oaknin
- Medical Oncology Department, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna V Tinker
- Division of Medical Oncology, BC Cancer-Vancouver, Vancouver, British Columbia, Canada
| | - Lucy Gilbert
- Division of Gynecologic Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Vanessa Samouëlian
- Gynecologic Oncology Service, Department of Obstetrics and Gynecology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Cara Mathews
- Women and Infants' Program in Women's Oncology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Jubilee Brown
- Levine Cancer Institute, Division of Gynecologic Oncology, Atrium Health, Charlotte, North Carolina
| | - Maria-Pilar Barretina-Ginesta
- Medical Oncology Department, Catalan Institute of Oncology, Girona, Spain.,Girona Biomedical Research Institute, Department of Medical Sciences, Medical School University of Girona, Girona, Spain
| | - Victor Moreno
- START Madrid-Fundación Jiménez Díaz, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Adriano Gravina
- Struttura Complessa Sperimentazioni Cliniche, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy
| | - Cyril Abdeddaim
- Department of Gynecological Oncology, Centre de Lutte Contre le Cancer-Centre Oscar Lambret, Lille, France
| | - Susana Banerjee
- Gynaecology Unit, The Royal Marsden National Health Service Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | - Wei Guo
- Oncology Development Bioststats Unit, GlaxoSmithKline, Waltham, Massachusetts
| | - Hadi Danaee
- Experimental Medicine Unit, GlaxoSmithKline, Waltham, Massachusetts
| | - Ellie Im
- Oncology Clinical Development-Immuno-Oncology Clinical Unit, GlaxoSmithKline, Waltham, Massachusetts
| | - Renaud Sabatier
- Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille-Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Department of Medical Oncology, Aix-Marseille University, Inserm, Centre National de la Recherche Scientifique, Marseille, France
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Kulkarni A, Chiem A, Singh K, Mathews C, DiSilvestro PA, Beffa L. The similarities and differences between mesonephric carcinoma and mesonephric-like carcinoma: Two cases. Gynecol Oncol Rep 2021; 37:100856. [PMID: 34527803 PMCID: PMC8429952 DOI: 10.1016/j.gore.2021.100856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 01/18/2023] Open
Abstract
Mesonephric carcinomas are rare cancers that arise from mesonephric remnants. Mesonephric-like carcinomas are similar but with mesonephric differentiation. These cases add to the limited literature of these separate but similar entities.
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Affiliation(s)
- Amita Kulkarni
- Department of Obstetrics and Gynecology, Women and Infants Hospital, Alpert Medical School, Brown University, Providence, RI 02905, United States
| | - Adrian Chiem
- The Warren Alpert Medical School, Brown University, Providence, RI 02905, United States
| | - Kamaljeet Singh
- Department of Pathology, Women and Infants Hospital, Alpert Medical School, Brown University, Providence, RI 02905, United States
| | - Cara Mathews
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Alpert Medical School, Brown University, Providence, RI 02905, United States
| | - Paul A DiSilvestro
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Alpert Medical School, Brown University, Providence, RI 02905, United States
| | - Lindsey Beffa
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Alpert Medical School, Brown University, Providence, RI 02905, United States
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Hamilton E, Goel S, Arend R, Chu C, Richardson D, Corr B, John V, Janku F, Hays J, Michenzie M, Reichmann W, Achour H, Sherman M, Ruiz-Soto R, Mathews C. 728P A phase Ib/II study of rebastinib and paclitaxel in advanced/metastatic platinum-resistant ovarian cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Oaknin A, Gilbert L, Tinker A, Brown J, Mathews C, Press J, Sabatier R, O'Malley D, Samouelian V, Boni V, Duska L, Ghamande S, Ghatage P, Kristeleit R, Leath C, Han X, Kumar S, Duan T, Im E, Pothuri B. 76P Analysis of antitumor activity of dostarlimab by tumor mutational burden (TMB) in patients (pts) with endometrial cancer (EC) in the GARNET trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Colombo N, Moore K, Scambia G, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke GS, Gourley C, Banerjee S, Oza A, González-Martín A, Aghajanian C, Bradley WH, Kim JW, Mathews C, Liu J, Lowe ES, Bloomfield R, DiSilvestro P. Tolerability of maintenance olaparib in newly diagnosed patients with advanced ovarian cancer and a BRCA mutation in the randomized phase III SOLO1 trial. Gynecol Oncol 2021; 163:41-49. [PMID: 34353615 PMCID: PMC9555119 DOI: 10.1016/j.ygyno.2021.07.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/04/2021] [Accepted: 07/09/2021] [Indexed: 01/21/2023]
Abstract
Objectives. In the phase III SOLO1 trial (NCT01844986), maintenance olaparib provided a substantial progression-free survival benefit in patients with newly diagnosed, advanced ovarian cancer and a BRCA mutation who were in response after platinum-based chemotherapy. We analyzed the timing, duration and grade of the most common hematologic and non-hematologic adverse events in SOLO1. Methods. Eligible patients were randomized to olaparib tablets 300 mg twice daily (N = 260)or placebo (N = 131), with a 2-year treatment cap in most patients. Safety outcomes were analyzed in detail in randomized patients who received at least one dose of study drug (olaparib, n = 260; placebo, n = 130). Results. Median time to first onset of the most common hematologic (anemia, neutropenia, thrombocytopenia) and non-hematologic (nausea, fatigue/asthenia, vomiting) adverse events was <3 months in olaparibtreated patients. The first event of anemia, neutropenia, thrombocytopenia, nausea and vomiting lasted a median of <2 months and the first event of fatigue/asthenia lasted a median of 3.48 months in the olaparib group. These adverse events were manageable with supportive treatment and/or olaparib dose modification in most patients, with few patients requiring discontinuation of olaparib. Of 162 patients still receiving olaparib at month 24, 64.2% were receiving the recommended starting dose of olaparib 300 mg twice daily. Conclusions. Maintenance olaparib had a predictable and manageable adverse event profile in the newly diagnosed setting with no new safety signals identified. Adverse events usually occurred early, were largely manageable and led to discontinuation in a minority of patients.
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Affiliation(s)
- Nicoletta Colombo
- University of Milan-Bicocca and IEO European Institute of Oncology IRCCS, Milan, Italy.
| | - Kathleen Moore
- Stephenson Cancer Center at the University of Oklahoma, Oklahoma City, OK, United States
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome, Italy
| | - Ana Oaknin
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Michael Friedlander
- University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia
| | | | - Anne Floquet
- Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France
| | - Alexandra Leary
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France; Institut Gustave-Roussy, Villejuif, France
| | - Gabe S Sonke
- The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Charlie Gourley
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Susana Banerjee
- The Royal Marsden NHS Foundation Trust, and Institute of Cancer Research, London, United Kingdom
| | - Amit Oza
- Princess Margaret Cancer Centre, Toronto, Canada
| | | | - Carol Aghajanian
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - William H Bradley
- Froedtert and the Medical College of Wisconsin, Milwaukee, WI, United States
| | | | - Cara Mathews
- Women & Infants Hospital, Providence, RI, United States
| | - Joyce Liu
- Dana-Farber Cancer Institute, Boston, MA, United States
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DiSilvestro J, Raker C, Velasquez J, Mathews C. Preventing the primary debulking: An educational initiative to increase rates of salpingectomy at cesarean delivery. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)00774-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Friedlander M, Moore KN, Colombo N, Scambia G, Kim BG, Oaknin A, Lisyanskaya A, Sonke GS, Gourley C, Banerjee S, Oza A, González-Martín A, Aghajanian C, Bradley WH, Liu J, Mathews C, Selle F, Lortholary A, Lowe ES, Hettle R, Flood E, Parkhomenko E, DiSilvestro P. Patient-centred outcomes and effect of disease progression on health status in patients with newly diagnosed advanced ovarian cancer and a BRCA mutation receiving maintenance olaparib or placebo (SOLO1): a randomised, phase 3 trial. Lancet Oncol 2021; 22:632-642. [PMID: 33862001 DOI: 10.1016/s1470-2045(21)00098-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/04/2021] [Accepted: 02/15/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND In the phase 3 SOLO1 trial, maintenance olaparib provided a significant progression-free survival benefit versus placebo in patients with newly diagnosed, advanced ovarian cancer and a BRCA mutation in response after platinum-based chemotherapy. We analysed health-related quality of life (HRQOL) and patient-centred outcomes in SOLO1, and the effect of radiological disease progression on health status. METHODS SOLO1 is a randomised, double-blind, international trial done in 118 centres and 15 countries. Eligible patients were aged 18 years or older; had an Eastern Cooperative Oncology Group performance status score of 0-1; had newly diagnosed, advanced, high-grade serous or endometrioid ovarian cancer, primary peritoneal cancer, or fallopian tube cancer with a BRCA mutation; and were in clinical complete or partial response to platinum-based chemotherapy. Patients were randomly assigned (2:1) to either 300 mg olaparib tablets or placebo twice per day using an interactive voice and web response system and were treated for up to 2 years. Treatment assignment was masked for patients and for clinicians giving the interventions, and those collecting and analysing the data. Randomisation was stratified by response to platinum-based chemotherapy (clinical complete or partial response). HRQOL was a secondary endpoint and the prespecified primary HRQOL endpoint was the change from baseline in the Functional Assessment of Cancer Therapy-Ovarian Cancer Trial Outcome Index (TOI) score for the first 24 months. TOI scores range from 0 to 100 (higher scores indicated better HRQOL), with a clinically meaningful difference defined as a difference of at least 10 points. Prespecified exploratory endpoints were quality-adjusted progression-free survival and time without significant symptoms of toxicity (TWiST). HRQOL endpoints were analysed in all randomly assigned patients. The trial is ongoing but closed to new participants. This trial is registered with ClinicalTrials.gov, NCT01844986. FINDINGS Between Sept 3, 2013, and March 6, 2015, 1084 patients were enrolled. 693 patients were ineligible, leaving 391 eligible patients who were randomly assigned to olaparib (n=260) or placebo (n=131; one placebo patient withdrew before receiving any study treatment), with a median duration of follow-up of 40·7 months (IQR 34·9-42·9) for olaparib and 41·2 months (32·2-41·6) for placebo. There was no clinically meaningful change in TOI score at 24 months within or between the olaparib and placebo groups (adjusted mean change in score from baseline over 24 months was 0·30 points [95% CI -0·72 to 1·32] in the olaparib group vs 3·30 points [1·84 to 4·76] in the placebo group; between-group difference of -3·00, 95% CI -4·78 to -1·22; p=0·0010). Mean quality-adjusted progression-free survival (olaparib 29·75 months [95% CI 28·20-31·63] vs placebo 17·58 [15·05-20·18]; difference 12·17 months [95% CI 9·07-15·11], p<0·0001) and the mean duration of TWiST (olaparib 33·15 months [95% CI 30·82-35·49] vs placebo 20·24 months [17·36-23·11]; difference 12·92 months [95% CI 9·30-16·54]; p<0·0001) were significantly longer with olaparib than with placebo. INTERPRETATION The substantial progression-free survival benefit provided by maintenance olaparib in the newly diagnosed setting was achieved with no detrimental effect on patients' HRQOL and was supported by clinically meaningful quality-adjusted progression-free survival and TWiST benefits with maintenance olaparib versus placebo. FUNDING AstraZeneca and Merck Sharp & Dohme.
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Affiliation(s)
- Michael Friedlander
- University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, NSW, Australia.
| | - Kathleen N Moore
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
| | - Nicoletta Colombo
- University of Milan-Bicocca, Milan, Italy; Istituto Europeo di Oncologia IRCCS, Milan, Italy
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica, Rome, Italy
| | - Byoung-Gie Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ana Oaknin
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Gabe S Sonke
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Charlie Gourley
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Susana Banerjee
- The Royal Marsden NHS Foundation Trust, London, UK; Institute of Cancer Research, London, UK
| | - Amit Oza
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | | | | | - Joyce Liu
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Frédéric Selle
- Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France
| | - Alain Lortholary
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France; Centre Catherine de Sienne Hopital privé du Confluent, Nantes, France
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Hagemann IS, Deng W, Zaino RJ, Powell MA, Gunderson C, Cosgrove C, Mathews C, Pearl ML, Waggoner S, Ghebre R, Lele S, Guntupalli S, Secord AA, Ioffe O, Park K, Rasty G, Singh M, Soslow R, Creasman W, Mutch DG. The presence of an endometrioid component does not alter the clinicopathologic profile or survival of patients with uterine serous cancer: A gynecologic oncology group (GOG/NRG) study of 934 women. Gynecol Oncol 2021; 160:660-668. [PMID: 33423806 DOI: 10.1016/j.ygyno.2020.12.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/28/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE While most cases of endometrial cancer can readily be classified as pure endometrioid, pure serous, or another type, others show an apparent mixture of serous and endometrioid components, or indeterminate serous versus endometrioid features. Since serous histology carries a worse prognosis than endometrioid, Gynecologic Oncology Group protocol GOG-8032 was established to examine whether the presence of a non-serous component is a favorable feature in an otherwise serous cancer. METHODS 934 women with serous cancer were prospectively identified among a larger group enrolled in GOG-0210. Six expert gynecologic pathologists classified each case as pure serous (SER, n=663), mixed serous and endometrioid (SER-EM-M, n=138), or indeterminate serous v. endometrioid (SER-EM-I, n=133) by H&E morphology. Follow-up data from GOG-0210 were analyzed. RESULTS The subgroups did not differ on BMI, race, ethnicity, lymphovascular invasion, cervical invasion, ovary involvement, peritoneal involvement, omental involvement, FIGO stage, or planned adjuvant treatment. SER-EM-M patients were younger (p=0.0001) and less likely to have nodal involvement (p=0.0287). SER patients were less likely to have myoinvasion (p=0.0002), and more likely to have adnexal involvement (p=0.0108). On univariate analysis, age, serous subtype, race, and components of FIGO staging predicted both progression-free and overall survival. On multiple regression, however, serous subtype (SER, SER-EM-M, or SER-EM-I) did not significantly predict survival. CONCLUSIONS There were few clinicopathologic differences between cases classified as SER, SER-EM-M, and SER-EM-I. Cases with a mixture of serous and endometrioid morphology, as well as cases with morphology indeterminate for serous v. endometrioid type, had the same survival as pure serous cases. NCT#: NCT00340808.
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Affiliation(s)
- Ian S Hagemann
- Washington University School of Medicine, St. Louis, MO, USA.
| | - Wei Deng
- NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics: Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
| | | | | | - Camille Gunderson
- University of Oklahoma Health Sciences Center and Stephenson Cancer Center, Oklahoma City, OK, USA.
| | - Casey Cosgrove
- Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
| | | | - Michael L Pearl
- Stony Brook University Medical Center, Stony Brook, NY, USA.
| | | | - Rahel Ghebre
- University of Minnesota Medical School, Minneapolis, MN, USA.
| | | | | | | | - Olga Ioffe
- University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Kay Park
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | | | | | - Robert Soslow
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - William Creasman
- Medical University of South Carolina Medical Center, Charleston, SC, USA.
| | - David G Mutch
- Washington University School of Medicine, St. Louis, MO, USA.
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Oaknin A, Tinker AV, Gilbert L, Samouëlian V, Mathews C, Brown J, Barretina-Ginesta MP, Moreno V, Gravina A, Abdeddaim C, Banerjee S, Guo W, Danaee H, Im E, Sabatier R. Clinical Activity and Safety of the Anti-Programmed Death 1 Monoclonal Antibody Dostarlimab for Patients With Recurrent or Advanced Mismatch Repair-Deficient Endometrial Cancer: A Nonrandomized Phase 1 Clinical Trial. JAMA Oncol 2020; 6:1766-1772. [PMID: 33001143 PMCID: PMC7530821 DOI: 10.1001/jamaoncol.2020.4515] [Citation(s) in RCA: 189] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Question What is the clinical antitumor activity and safety of dostarlimab for patients with deficient mismatch repair endometrial cancer? Findings In this nonrandomized phase 1 clinical trial, the confirmed objective response rate was 42%; 13% of patients had a confirmed complete response, and 30% of patients had a confirmed partial response. Anemia (3%), colitis (2%), and diarrhea (2%) were the most common grade 3 or higher treatment-related adverse events. Meaning Dostarlimab was associated with clinically meaningful and durable antitumor activity with an acceptable safety profile for patients with deficient mismatch repair endometrial cancers that have progressed after prior platinum-based chemotherapy. Importance Deficient mismatch mutation repair mechanisms may sensitize endometrial cancers to anti–programmed death 1 (PD-1) therapies. Dostarlimab (TSR-042) is an investigational anti–PD-1 antibody that binds with high affinity to the PD-1 receptor. Objective To assess the antitumor activity and safety of dostarlimab for patients with deficient mismatch repair endometrial cancer. Design, Setting, and Participants This ongoing, open-label, single-group, multicenter study began part 1 on March 7, 2016, and began enrolling patients with deficient mismatch mutation repair endometrial cancer on May 8, 2017. Median follow-up was 11.2 months (range, 0.03 [ongoing] to 22.11 [ongoing] months; based on radiological assessments). Statistical analysis was performed July 8 to August 9, 2019. Interventions Patients received 500 mg of dostarlimab intravenously every 3 weeks for 4 doses, then 1000 mg every 6 weeks until disease progression, treatment discontinuation, or withdrawal. Main Outcomes and Measures The primary end point was objective response rate and duration of response by blinded independent central review using Response Evaluation Criteria in Solid Tumors, version 1.1. Results As of the data cutoff, 104 women (median age, 64.0 years [range, 38-80 years]) with deficient mismatch mutation repair endometrial cancers were enrolled and treated with dostarlimab. Of these, 71 had measurable disease at baseline and at 6 months or more of follow-up and were included in the analysis. There was a confirmed response in 30 patients (objective response rate, 42.3%; 95% CI, 30.6%-54.6%); 9 patients (12.7%) had a confirmed complete response, and 21 patients (29.6%) had a confirmed partial response. Responses were durable; the median duration of response was not reached (median follow-up was 11.2 months). The estimated likelihood of maintaining a response was 96.4% at 6 months and 76.8% at 12 months. Anemia (3 of 104 [2.9%]), colitis (2 of 104 [1.9%]), and diarrhea (2 of 104 [1.9%]) were the most common grade 3 or higher treatment-related adverse events. Conclusions and Relevance In this nonrandomized trial, dostarlimab was associated with clinically meaningful and durable antitumor activity with an acceptable safety profile for patients with deficient mismatch mutation repair endometrial cancers after prior platinum-based chemotherapy. Trial Registration ClinicalTrials.gov identifier: NCT02715284
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Affiliation(s)
- Ana Oaknin
- Medical Oncology Department, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna V Tinker
- Division of Medical Oncology, BC Cancer-Vancouver, Vancouver, British Columbia, Canada
| | - Lucy Gilbert
- Division of Gynecologic Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Vanessa Samouëlian
- Gynecologic Oncology Service, Department of Obstetrics and Gynecology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Cara Mathews
- Women and Infants' Program in Women's Oncology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Jubilee Brown
- Levine Cancer Institute, Division of Gynecologic Oncology, Atrium Health, Charlotte, North Carolina
| | - Maria-Pilar Barretina-Ginesta
- Medical Oncology Department, Catalan Institute of Oncology, Girona, Spain.,Girona Biomedical Research Institute, Department of Medical Sciences, Medical School University of Girona, Girona, Spain
| | - Victor Moreno
- START Madrid-Fundación Jiménez Díaz, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Adriano Gravina
- Struttura Complessa Sperimentazioni Cliniche, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy
| | - Cyril Abdeddaim
- Department of Gynecological Oncology, Centre de Lutte Contre le Cancer-Centre Oscar Lambret, Lille, France
| | - Susana Banerjee
- Gynaecology Unit, The Royal Marsden National Health Service Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | - Wei Guo
- Oncology Development Bioststats Unit, GlaxoSmithKline, Waltham, Massachusetts
| | - Hadi Danaee
- Experimental Medicine Unit, GlaxoSmithKline, Waltham, Massachusetts
| | - Ellie Im
- Oncology Clinical Development-Immuno-Oncology Clinical Unit, GlaxoSmithKline, Waltham, Massachusetts
| | - Renaud Sabatier
- Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille-Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Department of Medical Oncology, Aix-Marseille University, Inserm, Centre National de la Recherche Scientifique, Marseille, France
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Hanker LC, Oaknin A, Tinker A, Gilbert L, Samouëlian V, Mathews C, Brown J, Guo W, Danaee H, Im E, Sabatier R. Safety and efficacy of the anti-PD-1 monoclonal antibody dostarlimab in patients with recurrent or advanced dMMR endometrial cancer. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718221] [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: 10/23/2022] Open
Affiliation(s)
- LC Hanker
- AGO & University Hospital Schleswig-Holstein, Campus Lübeck, Department of Gynecology & Obstetrics
| | | | | | - L Gilbert
- Vall d’Hebron University Hospital, Vall d´Hebron Institute of Oncology (VHIO)
| | - V Samouëlian
- Gynecologic Oncology Service, Centre Hospitalier de l’Université de Montréal, Department of Obstetrics and Gynecology
| | - C Mathews
- Women and Infants Hospital of Rhode Island
| | - J Brown
- Levine Cancer Institute, Carolinas HealthCare System, Division of Gynecologic Oncology
| | | | | | | | - R Sabatier
- Aix-Marseille University, Department of Medical Oncology
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Siegfried N, Mathews C. COVID-19 and the school response: Looking back to learn what we can do better. S Afr Med J 2020; 110:727-728. [PMID: 32880297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 06/11/2023] Open
Affiliation(s)
- N Siegfried
- Independent Public Health Medicine Specialist; Chief Specialist Scientist, South African Medical Research Council, Cape Town, South Africa; Honorary Associate Professor, Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
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Zamarin D, Burger RA, Sill MW, Powell DJ, Lankes HA, Feldman MD, Zivanovic O, Gunderson C, Ko E, Mathews C, Sharma S, Hagemann AR, Khleif S, Aghajanian C. Randomized Phase II Trial of Nivolumab Versus Nivolumab and Ipilimumab for Recurrent or Persistent Ovarian Cancer: An NRG Oncology Study. J Clin Oncol 2020; 38:1814-1823. [PMID: 32275468 DOI: 10.1200/jco.19.02059] [Citation(s) in RCA: 183] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Single-agent PD-1 blockade exhibits limited efficacy in epithelial ovarian cancer (EOC). We evaluated ipilimumab plus nivolumab compared with nivolumab alone in women with persistent or recurrent EOC. METHODS Eligibility criteria included measurable disease, 1-3 prior regimens, and platinum-free interval (PFI) < 12 months. Participants were randomly allocated to intravenous nivolumab (every 2 weeks) or induction with nivolumab plus ipilimumab for 4 doses (every 3 weeks), followed by every-2-week maintenance nivolumab for a maximum of 42 doses. The primary null hypothesis was equal probability of objective response within 6 months of random allocation in each arm. RESULTS One hundred patients were allocated to receive either nivolumab (n = 49), or nivolumab plus ipilimumab (n = 51), with PFI of < 6 months in 62%. Six (12.2%) responses occurred within 6 months in the nivolumab group and 16 (31.4%) in the nivolumab plus ipilimumab group (odds ratio, 3.28; 85% CI, 1.54 to infinity; P = .034). The median progression-free survival (PFS) was 2 and 3.9 months in the nivolumab and nivolumab plus ipilimumab groups, respectively, with a PFI-stratified hazard ratio of 0.53 (95% CI, 0.34 to 0.82); the respective hazard ratio for death was 0.79 (95% CI, 0.44 to 1.42). Grade ≥ 3 related adverse events occurred in 33% of patients in the nivolumab group and 49% in the combination group, with no treatment-related deaths. PD-L1 expression was not significantly associated with response in either treatment group. CONCLUSION Compared with nivolumab alone, the combination of nivolumab and ipilimumab in EOC resulted in superior response rate and longer, albeit limited, PFS, with toxicity of the combination regimen comparable to prior reports. Additional combination studies to enhance durability of the dual regimen are warranted.
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Affiliation(s)
- Dmitriy Zamarin
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, NY
| | - Robert A Burger
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
| | - Michael W Sill
- Biostatistics and Bioinformatics, Clinical Trial Development Division, NRG Oncology, Roswell Park, Buffalo, NY
| | - Daniel J Powell
- Department of Pathology, University of Pennsylvania, Philadelphia, PA
| | - Heather A Lankes
- NRG Oncology Biospecimen Bank-Columbus, Biopathology Center, The Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - Michael D Feldman
- Department of Pathology, University of Pennsylvania, Philadelphia, PA
| | - Oliver Zivanovic
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, NY
| | - Camille Gunderson
- Stephenson Cancer Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma; Oklahoma City, OK
| | - Emily Ko
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
| | - Cara Mathews
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Providence, RI
| | | | - Andrea R Hagemann
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University, Saint Louis, MO
| | - Samir Khleif
- The Loop Immuno-oncology Laboratory, Lombardi Comprehensive Cancer Center, Georgetown University Medical School, Washington DC
| | - Carol Aghajanian
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, NY
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Carlson JW, Kauderer J, Hutson A, Carter J, Armer J, Lockwood S, Nolte S, Stewart BR, Wenzel L, Walker J, Fleury A, Bonebrake A, Soper J, Mathews C, Zivanovic O, Richards WE, Tan A, Alberts DS, Barakat RR. GOG 244-The lymphedema and gynecologic cancer (LEG) study: Incidence and risk factors in newly diagnosed patients. Gynecol Oncol 2019; 156:467-474. [PMID: 31837831 DOI: 10.1016/j.ygyno.2019.10.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To evaluate the incidence and risk factors for lymphedema associated with surgery for gynecologic malignancies on GOG study 244. METHODS Women undergoing a lymph node dissection for endometrial, cervical, or vulvar cancer were eligible for enrollment. Leg volume was calculated from measurements at 10-cm intervals starting 10 cm above the bottom of the heel to the inguinal crease. Measurements were obtained preoperatively and postoperatively at 4-6 weeks, and at 3-, 6-, 9-, 12-, 18-, and 24- months. Lymphedema was defined as a limb volume change (LVC) ≥10% from baseline and categorized as mild: 10-19% LVC; moderate: 20-40% LVC; or severe: >40% LVC. Risk factors associated with lymphedema were also analyzed. RESULTS Of 1054 women enrolled on study, 140 were inevaluable due to inadequate measurements or eligibility criteria. This left 734 endometrial, 138 cervical, and 42 vulvar patients evaluable for LVC assessment. Median age was 61 years (range, 28-91) in the endometrial, 44 years (range, 25-83) in the cervical, and 58 years (range, 35-88) in the vulvar group. The incidence of LVC ≥10% was 34% (n = 247), 35% (n = 48), and 43% (n = 18), respectively. The peak incidence of lymphedema was at the 4-6 week assessment. Logistic regression analysis showed a decreased risk with advanced age (p = 0.0467). An exploratory analysis in the endometrial cohort showed an increased risk with a node count >8 (p = 0.033). CONCLUSIONS For a gynecologic cancer, LVC decreased with age greater than 65, but increased with a lymph node count greater than 8 in the endometrial cohort. There was no association with radiation or other risk factors.
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Affiliation(s)
- Jay W Carlson
- Cancer Research for the Ozarks, 1235 E. Cherokee, Springfield, MO, 65804, USA.
| | - James Kauderer
- NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Elm & Carlton Sts., Buffalo, NY, 14263, USA.
| | - Alan Hutson
- NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Elm & Carlton Sts., Buffalo, NY, 14263, USA.
| | - Jeanne Carter
- Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, New York, NY, 10022, USA.
| | - Jane Armer
- Sinclair School of Nursing, DC 116.05, Mizzou North Suite 415, 115 Business Loop 70 West, Columbia, MO, 65010, USA.
| | - Suzy Lockwood
- Texas Christian University, Harris College of Nursing & Health Sciences, TCU Box 298620, Ft Worth, TX, 76129, USA.
| | - Susan Nolte
- Abington Memorial Hospital, 1200 Old York Road, Abington, PA, 19001, USA.
| | - Bob R Stewart
- Sinclair School of Nursing, DC 116.05, Mizzou North Suite 415, 115 Business Loop 70 West, Columbia, MO, 65010, USA.
| | - Lari Wenzel
- Program in Public Health, University of California, Irvine, Irvine, CA, USA; Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, Irvine, CA, USA; Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA.
| | - Joan Walker
- Stephenson Cancer Center, OUHSC, Oklahoma City, OK, 73104, USA.
| | - Aimee Fleury
- Women's Cancer Center of Nevada, 3131 la Canada St. Ste 241, Las Vegas, NV, 89169, USA.
| | - Albert Bonebrake
- Cancer Research for the Ozarks-Cox Health. Ferrell Duncan Clinic GYN-ONC, Springfield, MO, 65807, USA.
| | - John Soper
- B110 Physicians' Office BLDG, 170 Manning Drive, UNC School of Medicine, Chapel Hill, NC, 27599, USA.
| | - Cara Mathews
- Division of Gynecologic Oncology, Women & Infants Hospital of Rhode Island, Alpert School of Medicine at Brown University, 101 Dudley St., Providence, RI, 02905, USA.
| | - Oliver Zivanovic
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
| | - Wm Edward Richards
- Director of Gynecologic Oncology and Surgical Specialists, St. Joseph's/Candler Health System, 225 Candler Dr., Savannah, GA, 31405, USA.
| | - Annie Tan
- Minnesota Oncology, 11850 Blackfoot Street, NW, Suite 100, Coon Rapids MN 55433, USA.
| | - David S Alberts
- Department of Medicine, University of Arizona College of Medicine, 1501 N. Campbell Avenue, Tucson, AZ, 85724, USA.
| | - Richard R Barakat
- Northwell Health Cancer Institute, 1111 Marcus Avenue, New Hyde Park, NY, 11042, USA.
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Carter J, Huang HQ, Armer J, Carlson JW, Lockwood S, Nolte S, Stewart BR, Kauderer J, Hutson A, Walker JL, Fleury AC, Bonebrake A, Soper JT, Mathews C, Zivanovic O, Richards WE, Tan A, Alberts DS, Barakat RR, Wenzel L. GOG 244 - The LymphEdema and Gynecologic cancer (LEG) study: The association between the gynecologic cancer lymphedema questionnaire (GCLQ) and lymphedema of the lower extremity (LLE). Gynecol Oncol 2019; 155:452-460. [PMID: 31679787 DOI: 10.1016/j.ygyno.2019.09.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/12/2019] [Accepted: 09/18/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To explore whether patient-reported lymphedema-related symptoms, as measured by the Gynecologic Cancer Lymphedema Questionnaire (GCLQ), are associated with a patient-reported diagnosis of lymphedema of the lower extremity (LLE) and limb volume change (LVC) in patients who have undergone radical surgery, including lymphadenectomy, for endometrial, cervical, or vulvar cancer on Gynecologic Oncology Group (GOG) study 244. METHODS Patients completed the baseline and at least one post-surgery GCLQ and LVC assessment. The 20-item GCLQ measures seven symptom clusters-aching, heaviness, infection-related, numbness, physical functioning, general swelling, and limb swelling. LLE was defined as a patient self-reported LLE diagnosis on the GCLQ. LVC was measured by volume calculations based on circumferential measurements. A linear mixed model was fitted for change in symptom cluster scores and GCLQ total score and adjusted for disease sites and assessment time. RESULTS Of 987 eligible patients, 894 were evaluable (endometrial, 719; cervical, 136; vulvar, 39). Of these, 14% reported an LLE diagnosis (endometrial, 11%; cervical, 18%; vulvar, 38%). Significantly more patients diagnosed versus not diagnosed with LLE reported ≥4-point increase from baseline on the GCLQ total score (p < 0.001). Changes from baseline were significantly larger on all GCLQ symptom cluster scores in patients with LLE compared to those without LLE. An LVC increment of >10% was significantly associated with reported general swelling (p < 0.001), heaviness (p = 0.005), infection-related symptoms (p = 0.002), and physical function (p = 0.006). CONCLUSIONS Patient-reported symptoms, as measured by the GCLQ, discerned those with and without a patient-reported LLE diagnosis and demonstrated predictive value. The GCLQ combined with LVC may enhance our ability to identify LLE.
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Affiliation(s)
- Jeanne Carter
- Memorial Sloan Kettering Cancer Center, Dept Surgery, Gynecology Service and Dept Psychiatry, New York, NY, 10022, USA.
| | - Helen Q Huang
- NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets., Buffalo, NY, 14263, USA.
| | - Jane Armer
- Sinclair School of Nursing, DC 116.05, Mizzou North Suite 415, 115 Business Loop 70 West, Columbia, MO 65010, USA.
| | - Jay W Carlson
- Cancer Research for the Ozarks, 1235 E. Cherokee, Springfield, MO, 65804, USA.
| | - Suzy Lockwood
- Texas Christian University, Harris College of Nursing & Health Sciences, TCU Box 298620, Ft Worth, TX, 76129, USA.
| | - Susan Nolte
- Abington Memorial Hospital, 1200 Old York Road, Abington, PA, 19001, USA.
| | - Bob R Stewart
- Sinclair School of Nursing, DC 116.05, Mizzou North Suite 415, 115 Business Loop 70 West, Columbia, MO, 65010, USA.
| | - James Kauderer
- NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets., Buffalo, NY, 14263, USA.
| | - Alan Hutson
- NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets., Buffalo, NY, 14263, USA.
| | - Joan L Walker
- Stephenson Cancer Center, OUHSC, Oklahoma City, OK, 73104, USA.
| | - Aimee C Fleury
- Women's Cancer Center of Nevada, 3131 la Canada St. Ste 241, Las Vegas, NV, 89169, USA.
| | - Albert Bonebrake
- Cancer Research for the Ozarks-Cox Health. Ferrell Duncan Clinic GYN-ONC, Springfield, MO, 65807, USA.
| | - John T Soper
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, 110 Physicians Office BLDG, 170 Manning Drive, Chapel Hill, NC, 27599, USA.
| | - Cara Mathews
- Division of Gynecologic Oncology, Women & Infants Hospital of Rhode Island, Alpert School of Medicine at Brown University, 101 Dudley St., Providence, RI, 02905, USA.
| | - Oliver Zivanovic
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
| | - William Edwards Richards
- Director of Gynecologic Oncology and Surgical Specialists, St. Joseph's/Candler Health System, 225 Candler Dr., Savannah, GA, 31405, USA.
| | - Annie Tan
- Minnesota Oncology, 11850 Blackfoot Street, NW, Suite 100, Coon Rapids, MN, 55433, USA.
| | - David S Alberts
- Department of Medicine, University of Arizona College of Medicine, 1501 N. Campbell Avenue, Tucson, AZ 85724, USA.
| | - Richard R Barakat
- Northwell Health Cancer Institute, 1111 Marcus Avenue, New Hyde Park, NY, 11042, USA.
| | - Lari Wenzel
- Program in Public Health, University of California, Irvine, Irvine, CA, USA; Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, Irvine, CA, USA; Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA.
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Weston E, Raker C, Huang D, Parker A, Robison K, Mathews C. The Association Between Mindfulness and Postoperative Pain: A Prospective Cohort Study of Gynecologic Oncology Patients Undergoing Minimally Invasive Hysterectomy. J Minim Invasive Gynecol 2019; 27:1119-1126.e2. [PMID: 31449907 DOI: 10.1016/j.jmig.2019.08.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/16/2019] [Accepted: 08/20/2019] [Indexed: 01/08/2023]
Abstract
STUDY OBJECTIVE To describe the association between preoperative dispositional mindfulness (the personality trait of being mindful) and postoperative pain in gynecologic oncology patients undergoing minimally invasive hysterectomy. DESIGN Prospective cohort study. SETTING University-affiliated teaching hospital. PATIENTS Gynecologic oncology patients (n = 126) planning minimally invasive hysterectomy. INTERVENTIONS Minimally invasive hysterectomy. MEASUREMENTS AND MAIN RESULTS Baseline mindfulness was assessed at the preoperative visit using the Five Facet Mindfulness Questionnaire (FFMQ). Postoperative pain and opioid usage were evaluated via chart review and surveys at postoperative visits at 1 to 2 weeks and 4 to 6 weeks. Higher baseline mindfulness was correlated with lower postoperative pain as measured by both the average and highest numeric pain scores during the inpatient stay (r = -.23, p = .020; r = -.21, p = .034). At the initial postoperative visit, pain score was also inversely correlated with preoperative mindfulness score (r = -.26, p = .008). This relationship was not observed at the final postoperative visit (r = -.08, p = .406). Pre-operative mindfulness and opioid usage were also inversely associated, though this relationship did not reach statistical significance (r = -.18, p = .066). CONCLUSION Mindfulness was previously shown to be a promising intervention for chronic pain treatment. Our study demonstrates that higher preoperative dispositional mindfulness is associated with more favorable postoperative pain outcomes, including lower pain scores but not lower opioid consumption. This relationship provides an opportunity to target the modifiable personality characteristic of mindfulness, to reduce postoperative pain in patients following gynecologic surgery.
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Affiliation(s)
- Erica Weston
- Brown University/Women and Infants Hospital of Rhode Island, Providence (all authors); Johns Hopkins School of Medicine, Baltimore, Maryland (Dr. Weston).
| | - Christina Raker
- Brown University/Women and Infants Hospital of Rhode Island, Providence (all authors)
| | - David Huang
- Brown University/Women and Infants Hospital of Rhode Island, Providence (all authors); University of California, San Francisco (Dr. Huang)
| | - Ashley Parker
- Brown University/Women and Infants Hospital of Rhode Island, Providence (all authors); Duke University, Durham, North Carolina (Parker)
| | - Katina Robison
- Brown University/Women and Infants Hospital of Rhode Island, Providence (all authors)
| | - Cara Mathews
- Brown University/Women and Infants Hospital of Rhode Island, Providence (all authors)
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Lokich E, Kole M, Raker C, Quddus MR, Mathews C. Molecular markers in uterine serous cancer: Correlation between endometrial biopsy and hysterectomy specimens. Gynecol Oncol Rep 2019; 29:98-101. [PMID: 31467960 PMCID: PMC6710608 DOI: 10.1016/j.gore.2019.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 12/21/2018] [Revised: 04/13/2019] [Accepted: 04/17/2019] [Indexed: 01/03/2023] Open
Abstract
Objectives To measure the correlation of molecular biomarkers between biopsy and final pathology specimens in uterine serous cancer (USC) and to establish the overall prevalence of specific biomarkers among subjects with USC. Methods Twenty eight patients with a diagnosis of USC and sufficient biopsy and hysterectomy specimens were identified. IHC was used to measure the biomarker status of EGFR, phospho-AKT, ER, PR, Her2/neu, and PTEN in FFPE tissue. The presence or absence of individual biomarkers was then compared between a given subject's diagnostic biopsy specimen and final hysterectomy specimen. Results In the cohort identified, average age was 72 and average BMI was 29. 75% of patients had full lymphadenectomy performed. The average time from biopsy to surgery was 33 days (range 9–91 days). The distribution of disease was 61% stage I (n = 17), 14% stage II (n = 4), 22% stage III (n = 6) and 4% stage IV (n = 1). Biopsy and hysterectomy specimens agreed 67% of the time for phospho-AKT, 80% for ER, 73% for PR, 83% for EGFR, 100% for Her2/neu and 95% for PTEN loss. Conclusions The measurement of specific biomarkers correlated well between subjects' biopsy and hysterectomy specimens in women with USC as measured by a pathologist using routine clinical techniques. Preoperative diagnostic biopsy may be a useful tool for guiding neoadjuvant targeted therapy in USC. Molecular biomarkers can be measured in endometrial biopsy specimens using routine clinical techniques. There was 100% correlation between biopsy and hysterectomy specimen staining for Her2/neu. Standardization of staining for molecular markers in endometrial cancers has potential to expand treatment options.
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Affiliation(s)
- Elizabeth Lokich
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Martha Kole
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Christina Raker
- Division of Research, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - M Ruhul Quddus
- Department of Pathology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Cara Mathews
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
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Abstract
Surgery is a cornerstone of gynecologic oncology. Minimally invasive techniques have been adopted rapidly, in lieu of open approaches, in cervical and endometrial cancer staging. In addition, nodal assessment has undergone significant changes with the introduction of SLN biopsies. The movement toward less is more has also been seen with perioperative and postoperative care and the advent of ERAS protocols, which attempt to maintain normal physiology with the goal of improving functional recovery. It is imperative that new technology be critically evaluated to ensure that oncologic outcomes are not compromised.
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Affiliation(s)
- Evelyn Cantillo
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont College of Medicine, 111 Colchester Avenue, Smith 408, Burlington, VT 05404, USA.
| | - Jenna B Emerson
- Program in Women' Oncology, Women and Infants Hospital, 101 Dudley Street, Providence, RI 02905, USA
| | - Cara Mathews
- Program in Women' Oncology, Women and Infants Hospital, 101 Dudley Street, Providence, RI 02905, USA
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Nessle CN, Ghosal S, Mathews C, Taylor D, Myers J, Raj A, Panigrahi A. Weak correlation of bleeding scores to platelet electron microscopy: A retrospective chart review of pediatric patients with delta-storage pool disorder. Pediatr Blood Cancer 2019; 66:e27505. [PMID: 30345617 DOI: 10.1002/pbc.27505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/11/2018] [Accepted: 09/24/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Delta granule storage pool deficiency (δ-SPD) is a rare platelet disorder in which a deficiency of platelet granules leads to poor aggregation, resulting in varying clinical bleeding phenotypes. Children with δ-SPD have variable laboratory results, making the proper diagnosis and evaluation controversial. OBJECTIVES To describe the demographic and laboratory trends of this population and to assess the value of electron microscopy in diagnostic evaluation and its correlation to bleeding symptoms. METHODS We performed a retrospective review of 109 pediatric patients diagnosed with δ-SPD. We collected demographic information and bleeding scores using a validated bleeding assessment tool. A descriptive and exploratory analysis was performed. RESULTS The majority of patients were female, with an average age at diagnosis of 11.61 years. Females were diagnosed at a significantly older age presenting most often with menorrhagia, while males presented most commonly with epistaxis. The majority showed normal lumiaggregometry, the mean platelet electron microscopy (PEM) value was 2.37, and the mean bleeding score was 6. Bleeding assessment tool and PEM had a significantly weak correlation. CONCLUSIONS Patients with more dense granules per platelet had higher bleeding scores than those with fewer dense granules per platelet. The current body of evidence does not favor the use of PEM in routine clinical practice, and results are difficult to interpret. In patients with severe mucocutaneous bleeding symptoms and normal platelet aggregation studies, consideration should be given to an alternative diagnosis and further evaluation is warranted.
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Affiliation(s)
- C N Nessle
- Department of Pediatrics, University of Louisville, Louisville, Kentucky
| | - S Ghosal
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky
| | - C Mathews
- Department of Pediatrics, University of Louisville, Louisville, Kentucky
| | - D Taylor
- Department of Pediatrics, University of Louisville, Louisville, Kentucky
| | - J Myers
- Department of Pediatrics, University of Louisville, Louisville, Kentucky.,Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky
| | - A Raj
- Department of Pediatrics, University of Louisville, Louisville, Kentucky.,Department of Pediatric Hematology Oncology, University of Louisville, Louisville, Kentucky
| | - A Panigrahi
- Department of Pediatric Hematology Oncology, University of California-Davis, Davis, California
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Moore K, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke GS, Gourley C, Banerjee S, Oza A, González-Martín A, Aghajanian C, Bradley W, Mathews C, Liu J, Lowe ES, Bloomfield R, DiSilvestro P. Maintenance Olaparib in Patients with Newly Diagnosed Advanced Ovarian Cancer. N Engl J Med 2018; 379:2495-2505. [PMID: 30345884 DOI: 10.1056/nejmoa1810858] [Citation(s) in RCA: 1592] [Impact Index Per Article: 265.3] [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: 11/19/2022]
Abstract
BACKGROUND Most women with newly diagnosed advanced ovarian cancer have a relapse within 3 years after standard treatment with surgery and platinum-based chemotherapy. The benefit of the oral poly(adenosine diphosphate-ribose) polymerase inhibitor olaparib in relapsed disease has been well established, but the benefit of olaparib as maintenance therapy in newly diagnosed disease is uncertain. METHODS We conducted an international, randomized, double-blind, phase 3 trial to evaluate the efficacy of olaparib as maintenance therapy in patients with newly diagnosed advanced (International Federation of Gynecology and Obstetrics stage III or IV) high-grade serous or endometrioid ovarian cancer, primary peritoneal cancer, or fallopian-tube cancer (or a combination thereof) with a mutation in BRCA1, BRCA2, or both ( BRCA1/2) who had a complete or partial clinical response after platinum-based chemotherapy. The patients were randomly assigned, in a 2:1 ratio, to receive olaparib tablets (300 mg twice daily) or placebo. The primary end point was progression-free survival. RESULTS Of the 391 patients who underwent randomization, 260 were assigned to receive olaparib and 131 to receive placebo. A total of 388 patients had a centrally confirmed germline BRCA1/2 mutation, and 2 patients had a centrally confirmed somatic BRCA1/2 mutation. After a median follow-up of 41 months, the risk of disease progression or death was 70% lower with olaparib than with placebo (Kaplan-Meier estimate of the rate of freedom from disease progression and from death at 3 years, 60% vs. 27%; hazard ratio for disease progression or death, 0.30; 95% confidence interval, 0.23 to 0.41; P<0.001). Adverse events were consistent with the known toxic effects of olaparib. CONCLUSIONS The use of maintenance therapy with olaparib provided a substantial benefit with regard to progression-free survival among women with newly diagnosed advanced ovarian cancer and a BRCA1/2 mutation, with a 70% lower risk of disease progression or death with olaparib than with placebo. (Funded by AstraZeneca and Merck; SOLO1 ClinicalTrials.gov number, NCT01844986 .).
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Affiliation(s)
- Kathleen Moore
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Nicoletta Colombo
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Giovanni Scambia
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Byoung-Gie Kim
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Ana Oaknin
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Michael Friedlander
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Alla Lisyanskaya
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Anne Floquet
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Alexandra Leary
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Gabe S Sonke
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Charlie Gourley
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Susana Banerjee
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Amit Oza
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Antonio González-Martín
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Carol Aghajanian
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - William Bradley
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Cara Mathews
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Joyce Liu
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Elizabeth S Lowe
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Ralph Bloomfield
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Paul DiSilvestro
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
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de Vries PJ, Davids EL, Mathews C, Aarø LE. Measuring adolescent mental health around the globe: psychometric properties of the self-report Strengths and Difficulties Questionnaire in South Africa, and comparison with UK, Australian and Chinese data. Epidemiol Psychiatr Sci 2018; 27:369-380. [PMID: 28112065 PMCID: PMC6998978 DOI: 10.1017/s2045796016001207] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/15/2016] [Indexed: 11/06/2022] Open
Abstract
AIMS This study evaluated the psychometric properties of the Strengths and Difficulties Questionnaire Self-Report (SDQ-S) in South African adolescents, and compared findings with data from the UK, Australia and China. METHODS A sample of 3451 South African adolescents in grade 8, the first year of secondary school (Mage = 13.7 years), completed the SDQ-S in Afrikaans, English or isiXhosa. Means, group differences and internal consistency were analysed using SPSS V22, and confirmatory factor analyses were conducted using MPlus V7. RESULTS In the South African sample, significant gender differences were found for four of the five sub-scale means and for total difficulties, but gender differences of alpha scores were negligible. The internal consistency for the total difficulties, prosocial behaviour and emotional symptoms sub-scales were fair. UK cut-off values for caseness (set to identify the top 10% of scores in a UK sample) led to a higher proportion of South African adolescents classified in the 'abnormal' range on emotional and peer difficulties and a lower proportion classified in the 'abnormal' range for hyperactivity. South African cut-offs were therefore generated. The cross-country comparison with UK, Australian and Chinese data showed that South African adolescent boys and girls had the highest mean scores on total difficulties as well as on the subscales of emotional symptoms and conduct problems. In contrast, South African boys and girls had the lowest mean scores for hyperactivity/inattention. The UK boys and girls had the highest mean scores for hyperactivity/inattention, while the Australian sample had the highest scores for prosocial behaviours. The Chinese boys had the highest peer problem mean scores and Chinese boys and girls had the lowest means on prosocial behaviours. Confirmatory factor analyses showed significant item loadings with loadings higher than 0.40 for the emotional and prosocial behaviour sub-scales on the five-factor model, but not for all relevant items on the other three domains. CONCLUSIONS Findings support the potential usefulness of the SDQ-S in a South African setting, but suggest that the SDQ-S should not be used with UK cut-off values, and indicate the need for further validation and standardisation work in South African adolescents. We recommend that in-country cut-offs for 'caseness' should be used for clinical purposes in South Africa, that cross-country comparisons should be made with caution, and that further examination of naturalistic clusters and factors of the SDQ should be performed in culturally and contextually diverse settings.
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Affiliation(s)
- P. J. de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
- Adolescent Health Research Unit, University of Cape Town, South Africa
| | - E. L. Davids
- Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
- Adolescent Health Research Unit, University of Cape Town, South Africa
| | - C. Mathews
- Adolescent Health Research Unit, University of Cape Town, South Africa
- Health Systems Research Unit, Medical Research Council; & School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - L. E. Aarø
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
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McCarthy WA, Makhijani R, Miller K, Rojas K, Beffa L, Mathews C, Robison K, Quddus MR. Gastric-Type Endometrial Adenocarcinoma: Report of Two Cases in Patients From the United States. Int J Surg Pathol 2017; 26:377-381. [PMID: 29281925 DOI: 10.1177/1066896917743010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Gastric-type adenocarcinomas of the uterine cervix have been described within the literature in detail; however, the description of gastric-type endometrial adenocarcinomas is a recent development, with only two cases originating from Japan in the world literature to date. According to these prior reports, the recognition of this pattern of differentiation is critical, as it is often associated with deep myoinvasion, positive regional lymph nodes, and poor outcome despite appropriate adjuvant treatment. We present two cases of endometrial adenocarcinoma with gastric-type differentiation in patients from the United States with superficial myoinvasion and positive patient outcomes. Gastric-type differentiation in endometrial adenocarcinomas is rare and likely underrecognized. Continued reporting of these cases is necessary to further understand the natural history and clinical implications of this entity.
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Affiliation(s)
- Whitney A McCarthy
- 1 Women and Infants Hospital of Rhode Island and The Warren Alpert Medical School of Brown University, Providence, RI, USA.,2 Brown University, Providence, RI, USA
| | - Reeva Makhijani
- 1 Women and Infants Hospital of Rhode Island and The Warren Alpert Medical School of Brown University, Providence, RI, USA.,2 Brown University, Providence, RI, USA
| | - Katherine Miller
- 1 Women and Infants Hospital of Rhode Island and The Warren Alpert Medical School of Brown University, Providence, RI, USA.,2 Brown University, Providence, RI, USA
| | - Kristin Rojas
- 1 Women and Infants Hospital of Rhode Island and The Warren Alpert Medical School of Brown University, Providence, RI, USA.,2 Brown University, Providence, RI, USA
| | - Lindsey Beffa
- 1 Women and Infants Hospital of Rhode Island and The Warren Alpert Medical School of Brown University, Providence, RI, USA.,2 Brown University, Providence, RI, USA
| | - Cara Mathews
- 1 Women and Infants Hospital of Rhode Island and The Warren Alpert Medical School of Brown University, Providence, RI, USA.,2 Brown University, Providence, RI, USA
| | - Katina Robison
- 1 Women and Infants Hospital of Rhode Island and The Warren Alpert Medical School of Brown University, Providence, RI, USA.,2 Brown University, Providence, RI, USA
| | - M Ruhul Quddus
- 1 Women and Infants Hospital of Rhode Island and The Warren Alpert Medical School of Brown University, Providence, RI, USA.,2 Brown University, Providence, RI, USA
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Shinnick JK, Kumar N, Beffa L, Miller K, Friedman MA, Kalife E, DiSilvestro P, Mathews C. Management of Low-Grade Cervical Müllerian Adenosarcoma in a 14-Year-Old Girl. J Pediatr Adolesc Gynecol 2017; 30:652-654. [PMID: 28578185 DOI: 10.1016/j.jpag.2017.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 04/21/2017] [Accepted: 05/25/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Müllerian adenosarcomas of the cervix are composed of benign epithelial and malignant stromal components. The purpose of this report is to describe the clinical and histologic difficulties in diagnosis and to propose fertility-preserving management of low-grade lesions. CASE A 14-year-old girl presented with a friable lesion found to originate from the anterior cervical lip. Initially, clinical suspicion was for sarcoma botryoides, however, pathologic evaluation revealed a low-grade cervical Müllerian adenosarcoma. Cold knife conization was performed, and the mass was resected with clear margins. SUMMARY AND CONCLUSION Müllerian adenosarcoma of the cervix is difficult to diagnose in adolescents because of features more commonly associated with alternative diagnoses. For patients with low-grade lesions desiring future fertility, local excision with close follow-up is reasonable.
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Affiliation(s)
- Julia K Shinnick
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island.
| | - Natasha Kumar
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Lindsey Beffa
- Department of Gynecologic Oncology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Katherine Miller
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Mary Alexandra Friedman
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Elizabeth Kalife
- Department of Pathology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Paul DiSilvestro
- Department of Gynecologic Oncology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Cara Mathews
- Department of Gynecologic Oncology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
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Evans EC, Matteson KA, Orejuela FJ, Alperin M, Balk EM, El-Nashar S, Gleason JL, Grimes C, Jeppson P, Mathews C, Wheeler TL, Murphy M. Salpingo-oophorectomy at the Time of Benign Hysterectomy: A Systematic Review. Obstet Gynecol Surv 2017. [DOI: 10.1097/ogx.0000000000000430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Finer S, Iqbal MS, Lowe R, Ogunkolade BW, Pervin S, Mathews C, Smart M, Alam DS, Hitman GA. Is famine exposure during developmental life in rural Bangladesh associated with a metabolic and epigenetic signature in young adulthood? A historical cohort study. BMJ Open 2016; 6:e011768. [PMID: 27881521 PMCID: PMC5168545 DOI: 10.1136/bmjopen-2016-011768] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Famine exposure in utero can 'programme' an individual towards type 2 diabetes and obesity in later life. We sought to identify, (1) whether Bangladeshis exposed to famine during developmental life are programmed towards diabetes and obesity, (2) whether this programming was specific to gestational or postnatal exposure windows and (3) whether epigenetic differences were associated with famine exposure. DESIGN A historical cohort study was performed as part of a wider cross-sectional survey. Exposure to famine was defined through birth date and historical records and participants were selected according to: (A) exposure to famine in postnatal life, (B) exposure to famine during gestation and (C) unexposed. SETTING Matlab, a rural area in the Chittagong division of Bangladesh. PARTICIPANTS Young adult men and women (n=190) recruited to a historical cohort study with a randomised subsample included in an epigenetic study (n=143). OUTCOME MEASURES Primary outcome measures of weight, body mass index and oral glucose tolerance tests (0 and 120 min glucose). Secondary outcome measures included DNA methylation using genome-wide and targeted analysis of metastable epialleles sensitive to maternal nutrition. RESULTS More young adults exposed to famine in gestation were underweight than those postnatally exposed or unexposed. In contrast, more young adults exposed to famine postnatally were overweight compared to those gestationally exposed or unexposed. Underweight adults exposed to famine in gestation in utero were hyperglycaemic following a glucose tolerance test, and those exposed postnatally had elevated fasting glucose, compared to those unexposed. Significant differences in DNA methylation at seven metastable epialleles (VTRNA2-1, PAX8, PRDM-9, near ZFP57, near BOLA, EXD3) known to vary with gestational famine exposure were identified. CONCLUSIONS Famine exposure in developmental life programmed Bangladeshi offspring towards diabetes and obesity in adulthood but gestational and postnatal windows of exposure had variable effects on phenotype. DNA methylation differences were replicated at previously identified metastable epialleles sensitive to periconceptual famine exposure.
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Affiliation(s)
- S Finer
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
| | - M S Iqbal
- Center for Control and Chronic disease' to Initiative for Non-Communicable Diseases (INCD), Health System and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - R Lowe
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
| | - B W Ogunkolade
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
| | - S Pervin
- Center for Control and Chronic disease' to Initiative for Non-Communicable Diseases (INCD), Health System and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - C Mathews
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
| | - M Smart
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
| | - D S Alam
- Center for Control and Chronic disease' to Initiative for Non-Communicable Diseases (INCD), Health System and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - G A Hitman
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
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Miyazaki D, Mathews C, Sherif El Haraki A. 13: Validation of an educational simulation model for vaginal hysterectomy (VH) training design: Prospective cohort study. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2016.01.043] [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: 11/26/2022]
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Abstract
BACKGROUND There is currently no national screening programme for prostate cancer in England, but eligible men can request a prostate-specific antigen (PSA) test from their general practitioner (GP). There are no routinely available data to monitor the extent of PSA testing and referral. AIM The aim of this study was to investigate the rate of PSA testing in general practice and subsequent patterns of referral. DESIGN AND SETTING Data obtained from the Clinical Practice Research Datalink (CPRD) for men aged 45-84 years who had a PSA test during 2010-2011, registered in practices in England with linked Hospital Episode Statistics (HES) data. METHOD Patient data were linked to previous tests and consultations. Rates of PSA testing and proportions of men retested and referred to secondary care were calculated. RESULTS Overall, 8.74 (95% CI 8.67-8.82) of men per 100 person-years were tested at least once in 2010, and 9.45 (95% CI 9.37-9.53) in 2011. Rates increased with age and decreased with increasing level of deprivation. Of the 53,069 men tested in 2010, 11,289 (21.3%) had a previous PSA test within the past 12 months. Of men with raised PSA according to age specific guidelines, 22.4% (2113/9425) were referred to secondary care within 14 days, with 36% of the remainder retested within 6 months. CONCLUSIONS Rates of PSA testing have increased compared with earlier studies; the data suggest that many GPs are retesting men with raised PSA rather than referring immediately. More routine data on PSA testing, including reasons for testing, and subsequent management and outcomes, are required.
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Affiliation(s)
- S Moss
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - J Melia
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - J Sutton
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - C Mathews
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - M Kirby
- Faculty of Health and Human Sciences, University of Hertfordshire and the Prostate Centre, London, UK
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