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Shaker N, Phelps R, Cabala CT, Niedt G, Sangueza OP, Pradhan D. Cutaneous Involvement by Diffuse Large B-Cell Lymphoma With Dual B-Cell and T-Cell Clonality and Heavy Admixed T-Cell Infiltrate: Answer. Am J Dermatopathol 2023; 45:859-860. [PMID: 37982471 DOI: 10.1097/dad.0000000000002576] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University, Wexner Medical Center, Columbus, OH
| | - Robert Phelps
- Department of Dermatology, Mount Sinai Medical Center, New York, NY
- Department of Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Carlos Torres Cabala
- Department of Dermatopathology and Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - George Niedt
- Department of Dermatology, Mount Sinai Medical Center, New York, NY
- Department of Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Omar P Sangueza
- Department of Dermatology, Wake Forest University, School of Medicine, Medical Center BoulevardWinston-Salem, NC
- Department of Dermatopathology, Wake Forest University, School of Medicine, Medical Center BoulevardWinston-Salem, NC; and
| | - Dinesh Pradhan
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
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Shaker N, Phelps R, Cabala CT, Niedt G, Sangueza OP, Pradhan D. Navigating the Complexity of Dual Clonality in Cutaneous Lymphoma: Challenge. Am J Dermatopathol 2023; 45:e103-e104. [PMID: 37982477 DOI: 10.1097/dad.0000000000002575] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Robert Phelps
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Carlos Torres Cabala
- Department of Dermatopathology and Pathology, The University of Texas, MD Anderson Cancer Center, Houston, TX
| | - George Niedt
- Departments of Dermatology and Dermatopathology, Mount Sinai Medical Center, New York, NY
| | - Omar P Sangueza
- Departments of Dermatology and Dermatopathology, Wake Forest University, School of Medicine, Medical Center Boulevard, Winston-Salem, NC; and
| | - Dinesh Pradhan
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
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El Hussein S, Wang W, Wang SA, Loghavi S, Wang X, Qiu L, Fang H, Medeiros LJ, Aung PP, Torres Cabala C, Jorgensen JL, Pemmaraju N, Khoury JD. Blastic plasmacytoid dendritic cell neoplasm with history of myeloma and concomitant acute undifferentiated leukemia: Illustration of morphologic and immunophenotypic challenges of an emerging phenomenon. Leuk Lymphoma 2021; 62:3296-3299. [PMID: 34304666 DOI: 10.1080/10428194.2021.1957878] [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: 10/20/2022]
Affiliation(s)
- Siba El Hussein
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Wei Wang
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sa A Wang
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sanam Loghavi
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Xiaoqiong Wang
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lianqun Qiu
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Hong Fang
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - L Jeffrey Medeiros
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Phyu P Aung
- Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carlos Torres Cabala
- Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jeffrey L Jorgensen
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Naveen Pemmaraju
- Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Joseph D Khoury
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Gru A, Battistella M, Pulitzer M, Pawade J, Beltraminelli H, Cabala CT, Guitart J, Piris MA, Harris NL, Feldman A, Hong E, Scarisbrick J, Kim Y. Updates from the central pathology review in patients with advanced stage mycosis fungoides (MF) and Sezary syndrome (SS) for the Global PROCLIPI study. Eur J Cancer 2018. [DOI: 10.1016/j.ejca.2018.07.185] [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: 10/28/2022]
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Amaria RN, Trinh VA, Gu J, McIntyre S, Cabala CT, Simien R, Diab A, Tawbi HA, Davies MA, Wong MK, Hwu P, Glitza IC, Patel SP, Hwu WJ. Abstract 3640: Treatment strategies using anti-PD1/PD-L1 (anti-PD) and BRAF/MEK inhibitor (BRAFi) therapy: a retrospective study comparing sequential vs. concurrent administration in BRAF-mutated metastatic melanoma (BMMM). Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-3640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: It is unclear whether anti-PD and BRAFi therapy should be administered sequentially or concurrently in patients (pts) with BMMM, although clinical trials using varying strategies are ongoing. We performed a retrospective, single-center analysis of BMMM pts who received anti-PD therapy either sequentially or concurrent with BRAFi therapy. Methods: A total of 457 metastatic melanoma pts (excluding uveal) were treated with anti-PD therapy at MD Anderson Cancer Center from 11/2009-12/2015. Of those, 148 pts had BMMM and were categorized into 4 treatment groups: BRAFi-naïve treated with anti-PD alone (group 1) N=39 (26%); BRAFi-naive treated with combination therapy (group 2) N=30 (20%); BRAFi-refractory treated with anti-PD alone (group 3) N=45 (31%); and BRAFi-refractory treated with combination therapy (group 4) N=34 (23%). Clinical outcomes were analyzed and tabulated for each group. Pretreatment tissue samples were obtained for correlative biomarker immunohistochemistry (IHC) analyses. Results: BMMM pts with elevated LDH are more likely to receive upfront combination therapy. BRAFi-refractory pts have a higher incidence of brain metastases than BRAFi-naïve pts. The clinical outcomes of overall responses, median PFS and OS are provided in the table. Preliminary biomarker IHC analyses in 11 pts showed PD-L1 expression on the tumor cells correlated with median PFS and OS : 15 mo and 22 mo, respectively in 7 pts with PD-L1 >1%, vs. 6.5 mo and 12 mo in 4 pts with PD-L1 <1%. Conclusions: Single-agent anti-PD therapy is an effective strategy in BMMM pts who are either BRAFi-naïve or refractory. Combination therapy of anti-PD and BRAFi in either BRAFi-naïve or refractory BMMM did not appear to improve clinical outcomes. Confirmation data are needed from ongoing prospective randomized clinical trials.
GroupLDH > upper limit normal (%)Prior CNS metastases (%)Prior anti CLTA-4 exposure (%)Number of anti PD-1 doses (#)Overall Responses CRs + PRs (%)Median PFS (mo)Median OS (mo)Group 1 BRAFi-naïve; anti-PD alone23.72317.912.530.8 + 25.6= 56.41021Group 2 BRAFi-naïve; combination37.9206.710.523.3 + 43.3 = 66.6 812.5Group 3 BRAFi- refractory; anti-PD alone254073.31637.8 + 17.8= 55.6925Group 4 BRAFi- refractory; combination17.644.172.711.529.4 + 5.9 = 35.3519
Citation Format: Rodabe N. Amaria, Van A. Trinh, Jun Gu, Susan McIntyre, Carlos Torres Cabala, Rinata Simien, Adi Diab, Hussein A. Tawbi, Michael A. Davies, Michael K. Wong, Patrick Hwu, Isabella C. Glitza, Sapna P. Patel, Wen Jen Hwu. Treatment strategies using anti-PD1/PD-L1 (anti-PD) and BRAF/MEK inhibitor (BRAFi) therapy: a retrospective study comparing sequential vs. concurrent administration in BRAF-mutated metastatic melanoma (BMMM) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3640.
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Affiliation(s)
| | | | - Jun Gu
- MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Adi Diab
- MD Anderson Cancer Center, Houston, TX
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