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Santiesteban SN, Li S, Abrams D, Alsalmi S, Androic D, Aniol K, Arrington J, Averett T, Ayerbe Gayoso C, Bane J, Barcus S, Barrow J, Beck A, Bellini V, Bhatt H, Bhetuwal D, Biswas D, Camsonne A, Castellanos J, Chen J, Chen JP, Chrisman D, Christy ME, Clarke C, Covrig S, Cruz-Torres R, Day D, Dutta D, Fuchey E, Gal C, Garibaldi F, Gautam TN, Gogami T, Gomez J, Guèye P, Hague TJ, Hansen JO, Hauenstein F, Henry W, Higinbotham DW, Holt RJ, Hyde C, Itabashi K, Kaneta M, Karki A, Katramatou AT, Keppel CE, King PM, Kurbany L, Kutz T, Lashley-Colthirst N, Li WB, Liu H, Liyanage N, Long E, Lovato A, Mammei J, Markowitz P, McClellan RE, Meddi F, Meekins D, Michaels R, Mihovilovič M, Moyer A, Nagao S, Nguyen D, Nycz M, Olson M, Ou L, Owen V, Palatchi C, Pandey B, Papadopoulou A, Park S, Petkovic T, Premathilake S, Punjabi V, Ransome RD, Reimer PE, Reinhold J, Riordan S, Rocco N, Rodriguez VM, Schmidt A, Schmookler B, Segarra EP, Shahinyan A, Širca S, Slifer K, Solvignon P, Su T, Suleiman R, Tang L, Tian Y, Tireman W, Tortorici F, Toyama Y, Uehara K, Urciuoli GM, Votaw D, Williamson J, Wojtsekhowski B, Wood S, Ye ZH, Zhang J, Zheng X. Novel Measurement of the Neutron Magnetic Form Factor from A=3 Mirror Nuclei. Phys Rev Lett 2024; 132:162501. [PMID: 38701469 DOI: 10.1103/physrevlett.132.162501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/05/2023] [Accepted: 02/21/2024] [Indexed: 05/05/2024]
Abstract
The electromagnetic form factors of the proton and neutron encode information on the spatial structure of their charge and magnetization distributions. While measurements of the proton are relatively straightforward, the lack of a free neutron target makes measurements of the neutron's electromagnetic structure more challenging and more sensitive to experimental or model-dependent uncertainties. Various experiments have attempted to extract the neutron form factors from scattering from the neutron in deuterium, with different techniques providing different, and sometimes large, systematic uncertainties. We present results from a novel measurement of the neutron magnetic form factor using quasielastic scattering from the mirror nuclei ^{3}H and ^{3}He, where the nuclear effects are larger than for deuterium but expected to largely cancel in the cross-section ratios. We extracted values of the neutron magnetic form factor for low-to-modest momentum transfer, 0.6
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Affiliation(s)
| | - S Li
- University of New Hampshire, Durham, New Hampshire 03824, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - D Abrams
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - S Alsalmi
- Kent State University, Kent, Ohio 44240, USA
- King Saud University, Riyadh 11451, Kingdom of Saudi Arabia
| | - D Androic
- University of Zagreb, Zagreb, Croatia
| | - K Aniol
- California State University, Los Angeles, California 90032, USA
| | - J Arrington
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - T Averett
- William and Mary, Williamsburg, Virginia 23185, USA
| | | | - J Bane
- University of Tennessee, Knoxville, Tennessee 37966, USA
| | - S Barcus
- William and Mary, Williamsburg, Virginia 23185, USA
| | - J Barrow
- University of Tennessee, Knoxville, Tennessee 37966, USA
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Beck
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | | | - H Bhatt
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Bhetuwal
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Biswas
- Hampton University, Hampton, Virginia 23669, USA
| | - A Camsonne
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Castellanos
- Florida International University, Miami, Florida 33199, USA
| | - J Chen
- William and Mary, Williamsburg, Virginia 23185, USA
| | - J-P Chen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D Chrisman
- Michigan State University, East Lansing, Michigan 48824, USA
| | - M E Christy
- Hampton University, Hampton, Virginia 23669, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Clarke
- Stony Brook, State University of New York, New York 11794, USA
| | - S Covrig
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Cruz-Torres
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - D Day
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - D Dutta
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - E Fuchey
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - C Gal
- University of Virginia, Charlottesville, Virginia 22904, USA
| | | | - T N Gautam
- Hampton University, Hampton, Virginia 23669, USA
| | - T Gogami
- Tohoku University, Sendai, Japan
| | - J Gomez
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Guèye
- Hampton University, Hampton, Virginia 23669, USA
- Michigan State University, East Lansing, Michigan 48824, USA
| | - T J Hague
- Kent State University, Kent, Ohio 44240, USA
| | - J O Hansen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Hauenstein
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - W Henry
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - D W Higinbotham
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R J Holt
- Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - C Hyde
- Old Dominion University, Norfolk, Virginia 23529, USA
| | | | - M Kaneta
- Tohoku University, Sendai, Japan
| | - A Karki
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | | | - C E Keppel
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P M King
- Ohio University, Athens, Ohio 45701, USA
| | - L Kurbany
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - T Kutz
- Stony Brook, State University of New York, New York 11794, USA
| | | | - W B Li
- William and Mary, Williamsburg, Virginia 23185, USA
| | - H Liu
- Columbia University, New York, New York 10027, USA
| | - N Liyanage
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - E Long
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - A Lovato
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
- Computational Science Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
- INFN-TIFPA Trento Institute for Fundamental Physics and Applications, 38123 Trento, Italy
| | - J Mammei
- University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - P Markowitz
- Florida International University, Miami, Florida 33199, USA
| | - R E McClellan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Michaels
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Mihovilovič
- Jožef Stefan Institute, 1000 Ljubljana, Slovenia
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institut für Kernphysik, Johannes Gutenberg-Universität Mainz, DE-55128 Mainz, Germany
| | - A Moyer
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - S Nagao
- Tohoku University, Sendai, Japan
| | - D Nguyen
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - M Nycz
- Kent State University, Kent, Ohio 44240, USA
| | - M Olson
- Saint Norbert College, De Pere, Wisconsin 54115, USA
| | - L Ou
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - V Owen
- William and Mary, Williamsburg, Virginia 23185, USA
| | - C Palatchi
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - B Pandey
- Hampton University, Hampton, Virginia 23669, USA
| | - A Papadopoulou
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - S Park
- Stony Brook, State University of New York, New York 11794, USA
| | | | - S Premathilake
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - V Punjabi
- Norfolk State University, Norfolk, Virginia 23529, USA
| | - R D Ransome
- Rutgers University, New Brunswick, New Jersey 08854, USA
| | - P E Reimer
- Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - J Reinhold
- Florida International University, Miami, Florida 33199, USA
| | - S Riordan
- Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - N Rocco
- Theoretical Physics Department, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - V M Rodriguez
- División de Ciencias y Tecnología, Universidad Ana G. Méndez, Recinto de Cupey, San Juan 00926, Puerto Rico
| | - A Schmidt
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - B Schmookler
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - E P Segarra
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | | | - S Širca
- Jožef Stefan Institute, 1000 Ljubljana, Slovenia
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - K Slifer
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - P Solvignon
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - T Su
- Kent State University, Kent, Ohio 44240, USA
| | - R Suleiman
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L Tang
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Y Tian
- Syracuse University, Syracuse, New York 13244, USA
| | - W Tireman
- Northern Michigan University, Marquette, Michigan 49855, USA
| | | | - Y Toyama
- Tohoku University, Sendai, Japan
| | - K Uehara
- Tohoku University, Sendai, Japan
| | | | - D Votaw
- Michigan State University, East Lansing, Michigan 48824, USA
| | - J Williamson
- University of Glasgow, Glasgow, G12 8QQ Scotland, United Kingdom
| | - B Wojtsekhowski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Z H Ye
- Argonne National Laboratory, Lemont, Illinois 60439, USA
- Tsinghua University, Beijing, China
| | - J Zhang
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - X Zheng
- University of Virginia, Charlottesville, Virginia 22904, USA
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Tan S, Kader Z, Day D, Chen D, Nicholls SJ, Ramkumar S. Cardiotoxicity in Oncology Guidelines: Discrepancies Do Matter. Heart Lung Circ 2024:S1443-9506(24)00122-7. [PMID: 38453605 DOI: 10.1016/j.hlc.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/29/2024] [Accepted: 02/06/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Sean Tan
- Victorian Heart Institute, Monash University, Melbourne, Vic, Australia; Monash Heart, Victorian Heart Hospital, Melbourne, Vic, Australia.
| | - Zainel Kader
- Monash Heart, Victorian Heart Hospital, Melbourne, Vic, Australia
| | - Daphne Day
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Vic, Australia; Department of Oncology, Monash Health, Melbourne, Vic, Australia
| | - Daniel Chen
- Prince of Wales and St George Hospitals, South Eastern Sydney Local Health District, Sydney, NSW, Australia; Hatter Cardiovascular Institute, University College of London, London, UK
| | - Stephen J Nicholls
- Victorian Heart Institute, Monash University, Melbourne, Vic, Australia; Monash Heart, Victorian Heart Hospital, Melbourne, Vic, Australia
| | - Satish Ramkumar
- Victorian Heart Institute, Monash University, Melbourne, Vic, Australia; Monash Heart, Victorian Heart Hospital, Melbourne, Vic, Australia
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Blennerhassett R, Hamad N, Grech L, Kwok A, Choi T, Forsyth C, Jagger J, Opat S, Harris S, Chan BA, Nguyen M, Bain N, Day D, Segelov E. Attitudes towards COVID-19 vaccination in adults with haematological malignancies. Acta Haematol 2024:000536548. [PMID: 38290477 DOI: 10.1159/000536548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 01/29/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION Despite people with haematological malignancies being particularly vulnerable to severe COVID-19 infection and complications, vaccine hesitancy may be a barrier to optimal vaccination. This study explored attitudes towards COVID-19 vaccination in people with haematological malignancies. METHODS People with haematological malignancies at nine Australian health services were surveyed between June and October, 2021. Sociodemographic and clinical characteristics were collected. Attitudes towards COVID-19 vaccination were explored using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale, and the Disease Influenced Vaccine Acceptance Scale-Six. Open-ended comments were qualitatively analysed. RESULTS A total of 869 people with haematological malignancies (mean age 64.2 years, 43.6% female) participated. Most participants (85.3%) reported that they had received at least one COVID-19 vaccine dose. Participants who were younger, spoke English as a non-dominant language, and had a shorter time since diagnosis were less likely to be vaccinated. Those who were female or spoke English as their non-dominant language reported greater vaccine side-effects concerns. Younger participants reported greater concerns about the vaccine impacting their treatment. CONCLUSION People with haematological malignancies reported high vaccine uptake, however, targeted education for specific participant groups may address vaccine hesitancy concerns, given the need for COVID-19 vaccine boosters.
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Day D, Park JJ, Coward J, Markman B, Lemech C, Kuo JC, Prawira A, Brown MP, Bishnoi S, Kotasek D, Strother RM, Cosman R, Su R, Ma Y, Yue Z, Hu HH, Wu R, Li P, Tse AN. A first-in-human phase 1 study of nofazinlimab, an anti-PD-1 antibody, in advanced solid tumors and in combination with regorafenib in metastatic colorectal cancer. Br J Cancer 2023; 129:1608-1618. [PMID: 37731023 PMCID: PMC10646086 DOI: 10.1038/s41416-023-02431-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND We assessed nofazinlimab, an anti-PD-1 antibody, in solid tumors and combined with regorafenib in metastatic colorectal cancer (mCRC). METHODS This phase 1 study comprised nofazinlimab dose escalation (phase 1a) and expansion (phase 1b), and regorafenib dose escalation (80 or 120 mg QD, days 1-21 of 28-day cycles) combined with 300-mg nofazinlimab Q4W (part 2a) to determine safety, efficacy, and RP2D. RESULTS In phase 1a (N = 21), no dose-limiting toxicity occurred from 1 to 10 mg/kg Q3W, with 200 mg Q3W determined as the monotherapy RP2D. In phase 1b (N = 87), 400-mg Q6W and 200-mg Q3W regimens were found comparable. In part 2a (N = 14), both regimens were deemed plausible RP2Ds. Fatigue was the most frequent treatment-emergent adverse event (AE) in this study. Any-grade and grade 3/4 nofazinlimab-related AEs were 71.4% and 14.3%, 56.3% and 5.7%, and 57.1% and 21.4% in phases 1a, 1b, and part 2a, respectively. ORRs were 14.3% and 25.3% in phases 1a and 1b, respectively. In part 2a, no patients had radiological responses. CONCLUSIONS Nofazinlimab monotherapy was well tolerated and demonstrated preliminary anti-tumor activity in multiple tumor types. Regorafenib plus nofazinlimab had a manageable safety profile but was not associated with any response in mCRC. CLINICAL TRIAL REGISTR ATION Clinicaltrials.gov (NCT03475251).
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Affiliation(s)
- Daphne Day
- Department of Medical Oncology, Monash Health, Clayton, VIC, Australia.
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.
| | - John J Park
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Jermaine Coward
- Medical Oncology, Icon Cancer Care - South Brisbane, South Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Herston, QLD, Australia
| | - Ben Markman
- Department of Medical Oncology, Monash Health, Clayton, VIC, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Charlotte Lemech
- Drug Development, Scientia Clinical Research, Randwick, NSW, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - James C Kuo
- Drug Development, Scientia Clinical Research, Randwick, NSW, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Amy Prawira
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Department of Medical Oncology, The Kinghorn Cancer Centre, St. Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
| | - Michael P Brown
- Cancer Clinical Trials Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
- School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Sarwan Bishnoi
- Medical Oncology, Ashford Cancer Centre Research and ICON Cancer Centre, Kurralta Park and Division of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Dusan Kotasek
- Medical Oncology, Ashford Cancer Centre Research and ICON Cancer Centre, Kurralta Park and Division of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - R Matthew Strother
- Medical Oncology, Christchurch Hospital, Christchurch, Canterbury, New Zealand
| | - Rasha Cosman
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Department of Medical Oncology, The Kinghorn Cancer Centre, St. Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
| | - Rila Su
- Translational Medicine and Early Development, CStone Pharmaceuticals (Suzhou) Co., Ltd., Suzhou, China
| | - Yiding Ma
- Clinical Department, CStone Pharmaceuticals (Suzhou) Co., Ltd., Suzhou, China
| | - Zenglian Yue
- Translational Medicine and Early Development, CStone Pharmaceuticals (Suzhou) Co., Ltd., Suzhou, China
| | - Hui-Han Hu
- Translational Medicine and Early Development, CStone Pharmaceuticals (Suzhou) Co., Ltd., Suzhou, China
| | - Rachel Wu
- Clinical Department, CStone Pharmaceuticals (Suzhou) Co., Ltd., Suzhou, China
| | - Peiqi Li
- Translational Medicine and Early Development, CStone Pharmaceuticals (Suzhou) Co., Ltd., Suzhou, China
| | - Archie N Tse
- Translational Medicine and Early Development, CStone Pharmaceuticals (Suzhou) Co., Ltd., Suzhou, China
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Hernando‐Calvo A, Malone E, Day D, Prawira A, Weinreb I, Yang SYC, Wong H, Rodriguez A, Jennings S, Eliason A, Wang L, Spreafico A, Siu LL, Hansen AR. Selinexor for the treatment of recurrent or metastatic salivary gland tumors: Results from the GEMS-001 clinical trial. Cancer Med 2023; 12:20299-20310. [PMID: 37818869 PMCID: PMC10652322 DOI: 10.1002/cam4.6589] [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: 06/21/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVES We aimed to evaluate the activity of selinexor, an oral selective inhibitor of nuclear export, in patients with recurrent or metastatic salivary gland tumors (SGT). METHODS GEMS-001 is an open-label Phase 2 study for patients with recurrent or metastatic SGT with two parts. In Part 1 of the protocol, patients had tumor samples profiled with targeted next generation sequencing as well as immunohistochemistry for androgen receptor, HER-2 and ALK. For Part 2, patients with no targeted therapies available were eligible to receive selinexor 60 mg given twice weekly every 28 days. The primary endpoint was objective response rate. Secondary endpoints included progression-free survival (PFS) and prevalence of druggable alterations across SGT. RESULTS One hundred patients were enrolled in GEMS-001 and underwent genomic and immunohistochemistry profiling. A total of 21 patients who lacked available matched therapies were treated with selinexor. SGT subtypes (WHO classification) included adenoid cystic carcinoma (n = 10), salivary duct carcinoma (n = 3), acinic cell carcinoma (n = 2), myoepithelial carcinoma (n = 2), carcinoma ex pleomorphic adenoma (n = 2) and other (n = 2). Of 18 evaluable patients, stable disease (SD) was observed in 17 patients (94%) (SD ≥6 months in 7 patients (39%)). However, no objective responses were observed. The median PFS was 4.9 months (95% confidence interval, 3.4-10). The most common treatment-related Grade 1-2 adverse events were nausea [17 patients (81%)], fatigue [16 patients (76%)], and dysgeusia [12 patients (57%)]. Most common treatment-related Grade 3-4 adverse events were hyponatremia [3 patients (14%)], neutrophil count decrease [3 patients (14%)] and cataracts [2 patients (10%)]. No treatment-related deaths were observed. CONCLUSIONS Although tumor reduction was observed across participants, single agent selinexor anti-tumor activity was limited.
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Affiliation(s)
- Alberto Hernando‐Calvo
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre. Department of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Eoghan Malone
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre. Department of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Daphne Day
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre. Department of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Amy Prawira
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre. Department of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Ilan Weinreb
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | | | - Horace Wong
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | | | | | | | - Lisa Wang
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | - Anna Spreafico
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre. Department of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Lillian L. Siu
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre. Department of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Aaron R. Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre. Department of MedicineUniversity of TorontoTorontoOntarioCanada
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Grech L, Loe BS, Day D, Freeman D, Kwok A, Nguyen M, Bain N, Segelov E. The Disease Influenced Vaccine Acceptance Scale-Six (DIVAS-6): Validation of a Measure to Assess Disease-Related COVID-19 Vaccine Attitudes and Concerns. Behav Med 2023; 49:402-411. [PMID: 35703037 DOI: 10.1080/08964289.2022.2082358] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 02/17/2022] [Revised: 04/28/2022] [Accepted: 05/23/2022] [Indexed: 01/07/2023]
Abstract
Patients with underlying comorbidities are particularly vulnerable to poor outcomes from SARS-CoV-2 infection. Despite the context-specific nature of vaccine hesitancy, there are currently no scales that incorporate disease or treatment-related hesitancy factors. We developed a six-item scale assessing disease-related COVID-19 vaccine attitudes and concerns (The Disease Influenced COVID-19 Vaccine Acceptance Scale-Six: DIVAS-6). A survey incorporating the DIVAS-6 was completed by 4683 participants with severe and/or chronic illness (3560 cancer; 842 diabetes; 281 multiple sclerosis (MS)). The survey included the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale, demographic, disease-related, and vaccination status questions. The six items loaded onto two factors (disease complacency and vaccine vulnerability) using exploratory factor analysis and exploratory structural equation modeling. The two factors were internally consistent. Measurement invariance analysis showed the two factors displayed psychometric equivalence across the patient groups. Each factor significantly correlated with the two Oxford COVID-19 Vaccine scales, showing convergent validity. The summary score showed acceptable ability to discriminate vaccination status across diseases, with the total sample providing good-to-excellent discriminative ability. The DIVAS-6 has two factors measuring COVID-19 vaccine attitudes and concerns relating to potential complications of SARS-CoV-2 infection due to underlying disease (disease complacency) and vaccine-related impact on disease progression and treatment (vaccine vulnerability). This is the first validated scale to measure disease-related COVID-19 vaccine concerns and has been validated in people with cancer, diabetes, and MS. It is quick to administer and should assist with guiding information delivery about COVID-19 vaccination in medically vulnerable populations.
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Affiliation(s)
- Lisa Grech
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Bao Sheng Loe
- The Psychometrics Centre, University of Cambridge, Cambridge, UK
| | - Daphne Day
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
- Department of Oncology, Monash Health, Melbourne, Australia
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Alastair Kwok
- Department of Oncology, Monash Health, Melbourne, Australia
| | - Mike Nguyen
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
- Department of Oncology, Monash Health, Melbourne, Australia
| | - Nathan Bain
- Department of Oncology, Monash Health, Melbourne, Australia
| | - Eva Segelov
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
- Department of Oncology, Monash Health, Melbourne, Australia
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Loong HH, Shimizu T, Prawira A, Tan AC, Tran B, Day D, Tan DSP, Ting FIL, Chiu JW, Hui M, Wilson MK, Prasongsook N, Koyama T, Reungwetwattana T, Tan TJ, Heong V, Voon PJ, Park S, Tan IB, Chan SL, Tan DSW. Recommendations for the use of next-generation sequencing in patients with metastatic cancer in the Asia-Pacific region: a report from the APODDC working group. ESMO Open 2023; 8:101586. [PMID: 37356359 PMCID: PMC10319859 DOI: 10.1016/j.esmoop.2023.101586] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/27/2023] [Accepted: 05/18/2023] [Indexed: 06/27/2023] Open
Abstract
INTRODUCTION Next-generation sequencing (NGS) diagnostics have shown clinical utility in predicting survival benefits in patients with certain cancer types who are undergoing targeted drug therapies. Currently, there are no guidelines or recommendations for the use of NGS in patients with metastatic cancer from an Asian perspective. In this article, we present the Asia-Pacific Oncology Drug Development Consortium (APODDC) recommendations for the clinical use of NGS in metastatic cancers. METHODS The APODDC set up a group of experts in the field of clinical cancer genomics to (i) understand the current NGS landscape for metastatic cancers in the Asia-Pacific (APAC) region; (ii) discuss key challenges in the adoption of NGS testing in clinical practice; and (iii) adapt/modify the European Society for Medical Oncology guidelines for local use. Nine cancer types [breast cancer (BC), gastric cancer (GC), nasopharyngeal cancer (NPC), ovarian cancer (OC), prostate cancer, lung cancer, and colorectal cancer (CRC) as well as cholangiocarcinoma and hepatocellular carcinoma (HCC)] were identified, and the applicability of NGS was evaluated in daily practice and/or clinical research. Asian ethnicity, accessibility of NGS testing, reimbursement, and socioeconomic and local practice characteristics were taken into consideration. RESULTS The APODDC recommends NGS testing in metastatic non-small-cell lung cancer (NSCLC). Routine NGS testing is not recommended in metastatic BC, GC, and NPC as well as cholangiocarcinoma and HCC. The group suggested that patients with epithelial OC may be offered germline and/or somatic genetic testing for BReast CAncer gene 1 (BRCA1), BRCA2, and other OC susceptibility genes. Access to poly (ADP-ribose) polymerase inhibitors is required for NGS to be of clinical utility in prostate cancer. Allele-specific PCR or a small-panel multiplex-gene NGS was suggested to identify key alterations in CRC. CONCLUSION This document offers practical guidance on the clinical utility of NGS in specific cancer indications from an Asian perspective.
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Affiliation(s)
- H H Loong
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - T Shimizu
- Department of Pulmonary Medicine and Medical Oncology, Wakayama Medical University Graduate School of Medicine, Wakayama, Japan
| | - A Prawira
- Cancer Trials and Research Unit, Prince of Wales Hospital, Sydney, Australia
| | - A C Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - B Tran
- Department of Oncology, Peter MacCallum Cancer Centre, Melbourne
| | - D Day
- Department of Oncology, Monash Health and Monash University, Australia
| | - D S P Tan
- Department of Haematology-Oncology, National University Cancer Institute, Singapore
| | - F I L Ting
- Department of Medicine, Dr. Pablo O. Torre Memorial Hospital, Bacolod, Philippines
| | - J W Chiu
- Department of Medicine, The University of Hong Kong, HKSAR, Pok Fu Lam, Hong Kong, China
| | - M Hui
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, Australia
| | - M K Wilson
- Department of Medical Oncology, Auckland City Hospital, Auckland, New Zealand
| | - N Prasongsook
- Division of Medical Oncology, Phramongkutklao Hospital, Bangkok, Thailand
| | - T Koyama
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - T Reungwetwattana
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - T J Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - V Heong
- Department Medical Oncology, Tan Tock Seng Hospital, Singapore
| | - P J Voon
- Radiotherapy and Oncology Department, Hospital Umum Sarawak, Kuching, Malaysia
| | - S Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - I B Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - S L Chan
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - D S W Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
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Day D, Toh HC, Ali R, Foo EMJ, Simes J, Chia JWK, Segelov E. Operational Challenges of an Asia-Pacific Academic Oncology Clinical Trial. JCO Glob Oncol 2023; 9:e2300040. [PMID: 37364220 PMCID: PMC10497275 DOI: 10.1200/go.23.00040] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/25/2023] [Accepted: 05/05/2023] [Indexed: 06/28/2023] Open
Abstract
PURPOSE The Asia-Pacific (APAC) region is a major focus for multinational clinical trials, although its cultural, linguistic, economic, and regulatory diversity pose significant challenges for trial conduct, particularly for academic clinical trials. METHODS We describe our experience running the investigator-initiated phase III randomized, fully accrued, Aspirin for Dukes C and high-risk Dukes B Colorectal cancer trial (ASCOLT, ClinicalTrials.gov identifier: NCT00565708, N = 1,587), studying the benefit of aspirin in resected high-risk colorectal cancer. ASCOLT opened in 2008 and is the first large academic adjuvant trial fully conducted in the APAC region. Centrally coordinated by the Trial Management Team at the National Cancer Centre Singapore, it has involved 74 sites across 12 APAC countries/regions, including five middle-income countries. RESULTS Challenges encountered included regulatory complexity, communication and logistical barriers, limited funding and resources, disparate experience and infrastructure across sites, recruitment holds because of changes in local laws, patient attrition, and disruptions caused by the COVID-19 pandemic. Over 100 contracts and 49 ethics board reviews were required, contributing to a lengthy prestudy preparation time of 2 years and start-up times of approximately 6 months per site. Some of the mitigating actions included engaging local cooperative groups (eg, the Australasian Gastro-Intestinal Trials Group in Australia and New Zealand) and seven contract research organizations to manage sites, regular communication with the central team, transition to electronic data management, and a centralized drug-dispensing system. CONCLUSION To ensure an efficient and patient-centered clinical trials environment in the APAC region and sustained growth, we suggest coordinated approaches to harmonize regulatory processes, APAC academic oncology trials consortia to streamline processes and provide governance, and ongoing commitment from governments, funding agents, and industry.
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Affiliation(s)
- Daphne Day
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Department of Oncology, Monash Health, Melbourne, VIC, Australia
| | - Han Chong Toh
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Raghib Ali
- Public Health Research Centre, New York University, Abu Dhabi, United Arab Emirates
| | | | - John Simes
- University of Sydney NHMRC Clinical Trials Centre, Sydney, NSW, Australia
| | | | - Eva Segelov
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Faculty of Medicine, University of Bern, Bern, Switzerland
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Chan A, Day D, Hui R, McCarthy N, Wilson R, Faltaos D, Shaw M, Murphy C. Abstract P3-07-15: Preliminary data from a Phase 1b dose escalation study of OP-1250, an oral CERAN, in combination with palbociclib in patients with advanced and/or metastatic estrogen receptor (ER)-positive, HER2-negative breast cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p3-07-15] [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: 03/06/2023]
Abstract
Abstract
Background: OP-1250 is a small molecule oral complete estrogen receptor antagonist (CERAN) that binds the ligand binding domain of the ER and completely blocks ER-driven transcriptional activity. CDK4/6 inhibitors in combination with endocrine therapy have improved progression free survival and overall survival for patients (pts) with metastatic breast cancer (MBC) in the first- and second-line settings. However, most patients will progress and newer combinations such as with OP-1250 may provide improved clinical outcome. OP-1250 potently inactivates both wild-type ER and mutant forms of ER. The latter confers ligand independent activity and is a mechanism of resistance to standard of care endocrine therapies. In preclinical studies, OP-1250 in combination with palbociclib demonstrated synergistic activity in models of wild-type ER and those containing ESR1 activating mutations, and in models of brain metastasis. A Phase 1/2 monotherapy study of OP-1250 is ongoing in MBC subjects who have received 1 or more prior endocrine therapies (NCT04505826). Monotherapy is well tolerated and the recommended phase 2 dose is 120 mg QD. The aim of this combination trial is to define the maximum tolerated dose (MTD), safety, tolerability, and pharmacokinetics (PK) of OP-1250 in combination with palbociclib. Methods: Eligibility criteria include pts with MBC or locally advanced breast cancer who have received no more than 1 prior line of endocrine therapy (prior CDK4/6 inhibitors and one line of chemotherapy are permitted) and measurable or non-measurable disease. Using a 3+3 design, cohorts are sequentially enrolled, and pts receive escalating doses of OP-1250 orally QD continuously in combination with 125 mg of palbociclib orally for 21 of 28 days. Pts are evaluable for dose limiting toxicities (DLTs) if >75% of both treatments were administered within the first 28-day treatment cycle. Blood is collected for PK on cycle 1 days 1, 2 and cycle 2 days 15, 16 for OP-1250 and cycle 1 day 15 for palbociclib. PK profiles, exposure parameters, and drug-drug interactions (DDIs) are assessed. Pts are monitored for adverse events (AE) and tumor assessments (RECIST 1.1) are conducted every two cycles. Results: As of July 7, 2022, 9 pts were evaluable for DLTs after 28 days of treatment in dose levels 30 mg, 60 mg, and 90 mg of OP-1250 in combination with palbociclib. No DLTs occurred at any of the dose levels. As of May 13, 2022, of the 7 pt safety data set, the most common Grade 1/2 treatment emergent adverse events (TEAE), which occurred in 2 patients, were nausea, gastroesophageal reflux, vomiting, and fatigue. Grade 3 neutropenia occurred in 4 pts and all were attributed to palbociclib by the investigator. No Grade 4 events were observed. OP-1250 was highly bioavailable and showed dose proportional exposure in combination with palbociclib. The single and multiple dose exposure of OP-1250 was consistent with that observed in the monotherapy study, indicating an absence of effect of palbociclib on OP-1250 PK. 90 mg steady-state evaluation is ongoing. Palbociclib concentrations at steady state did not demonstrate a meaningful difference from published exposure parameters for the three dose levels evaluated, indicating an absence of DDI. Conclusions: In the first three cohorts of OP-1250 and palbociclib, the combination was well tolerated and no DLTs occurred. There were no clinically significant DDIs observed between OP-1250 and palbociclib at the doses evaluated and exposure of each drug was consistent with observed monotherapy exposure levels. Dose escalation of OP-1250 continues to 120 mg, to be followed by dose expansion. Updated data will be presented. (NCT05266105)
Citation Format: Arlene Chan, Daphne Day, Rina Hui, Nicole McCarthy, Rosalind Wilson, Demiana Faltaos, Morena Shaw, Caitlin Murphy. Preliminary data from a Phase 1b dose escalation study of OP-1250, an oral CERAN, in combination with palbociclib in patients with advanced and/or metastatic estrogen receptor (ER)-positive, HER2-negative breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-07-15.
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Affiliation(s)
- Arlene Chan
- 1Breast Cancer Research Centre – Western Australia, Hollywood Consulting Centre, Nedlands, WA 6009, Australia, Perth, Australia
| | - Daphne Day
- 2Medicine Monash Health, Clayton, VIC 3168, Australia
| | - Rina Hui
- 3Westmead Hospital, Westmead, NSW 2145, Australia
| | - Nicole McCarthy
- 4Icon Cancer Center, Wesley Medical Centre, Auchenflower, Australia
| | | | | | | | - Caitlin Murphy
- 8Barwon Health, Andrew Love Cancer Centre, Geelong, VIC 3220, Australia
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Zhao J, Yu X, Huang D, Ma Z, Gao B, Cui J, Chu Q, Zhou Q, Sun M, Day D, Wu J, Pan H, Wang L, Voskoboynik M, Wang Z, Liu Y, Li H, Zhang J, Peng Y, Wu YL. SAFFRON-103: a phase 1b study of the safety and efficacy of sitravatinib combined with tislelizumab in patients with locally advanced or metastatic non-small cell lung cancer. J Immunother Cancer 2023; 11:jitc-2022-006055. [PMID: 36808075 PMCID: PMC9944269 DOI: 10.1136/jitc-2022-006055] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Some patients with locally advanced/metastatic non-small cell lung cancer (NSCLC) respond poorly to anti-programmed cell death protein 1 (PD-1)/anti-programmed death-ligand 1 (PD-L1) treatments. Combination with other agents may improve the outcomes. This open-label, multicenter, phase 1b trial investigated the combination of sitravatinib, a spectrum-selective tyrosine kinase inhibitor, plus anti-PD-1 antibody tislelizumab. METHODS Patients with locally advanced/metastatic NSCLC were enrolled (Cohorts A, B, F, H, and I; N=22-24 per cohort). Cohorts A and F included patients previously treated with systemic therapy, with anti-PD-(L)1-resistant/refractory non-squamous (cohort A) or squamous (cohort F) disease. Cohort B included patients previously treated with systemic therapy, with anti-PD-(L)1-naïve non-squamous disease. Cohorts H and I included patients without prior systemic therapy for metastatic disease, no prior anti-PD-(L)1/immunotherapy, with PD-L1-positive non-squamous (cohort H) or squamous (cohort I) histology. Patients received sitravatinib 120 mg orally one time per day plus tislelizumab 200 mg intravenously every 3 weeks, until study withdrawal, disease progression, unacceptable toxicity, or death. The primary endpoint was safety/tolerability among all treated patients (N=122). Secondary endpoints included investigator-assessed tumor responses and progression-free survival (PFS). RESULTS Median follow-up was 10.9 months (range: 0.4-30.6). Treatment-related adverse events (TRAEs) occurred in 98.4% of the patients, with ≥Grade 3 TRAEs in 51.6%. TRAEs led to discontinuation of either drug in 23.0% of the patients. Overall response rate was 8.7% (n/N: 2/23; 95% CI: 1.1% to 28.0%), 18.2% (4/22; 95% CI: 5.2% to 40.3%), 23.8% (5/21; 95% CI: 8.2% to 47.2%), 57.1% (12/21; 95% CI: 34.0% to 78.2%), and 30.4% (7/23; 95% CI: 13.2% to 52.9%) in cohorts A, F, B, H, and I, respectively. Median duration of response was not reached in cohort A and ranged from 6.9 to 17.9 months across other cohorts. Disease control was achieved in 78.3-90.9% of the patients. Median PFS ranged from 4.2 (cohort A) to 11.1 months (cohort H). CONCLUSIONS In patients with locally advanced/metastatic NSCLC, sitravatinib plus tislelizumab was tolerable for most patients, with no new safety signals and overall safety profiles consistent with known profiles of these agents. Objective responses were observed in all cohorts, including in patients naïve to systemic and anti-PD-(L)1 treatments, or with anti-PD-(L)1 resistant/refractory disease. Results support further investigation in selected NSCLC populations. TRIAL REGISTRATION NUMBER NCT03666143.
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Affiliation(s)
- Jun Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - Xinmin Yu
- Department of Medical Oncology, Cancer Hospital of University of Chinese Academy of Sciences & Zhejiang Cancer Hospital, Hangzhou, China
| | - Dingzhi Huang
- Department of Thoracic Medical Oncology, Tianjin Cancer Hospital, Tianjin, China
| | - Zhiyong Ma
- Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital, Zhengzhou, China
| | - Bo Gao
- Blacktown Hospital and University of Sydney, Sydney, New South Wales, Australia
| | - Jiuwei Cui
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Qian Chu
- Department of Oncology, Tongji Hospital, Wuhan, China
| | - Qing Zhou
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Meili Sun
- Department of Oncology, Jinan Central Hospital, Shandong University, Jinan, China
| | - Daphne Day
- Medical Oncology, Monash Health and Monash University, Melbourne, Victoria, Australia
| | - Jingxun Wu
- Department of Medical Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Hongming Pan
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | | | - Mark Voskoboynik
- Medical Oncology, Nucleus Network, Melbourne, VIC, Australia and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Zhehai Wang
- Department of Internal Medicine - Oncology, Shandong Cancer Hospital & Institute, Jinan, China
| | - Yunpeng Liu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China
| | - Hui Li
- BeiGene (Shanghai) Co., Ltd, Shanghai, China
| | - Juan Zhang
- BeiGene (Beijing) Co., Ltd, Beijing, China
| | - Yanyan Peng
- BeiGene (Shanghai) Co., Ltd, Shanghai, China
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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11
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Rudin CM, Pandha HS, Zibelman M, Akerley WL, Harrington KJ, Day D, Hill AG, O'Day SJ, Clay TD, Wright GM, Jennens RR, Gerber DE, Rosenberg JE, Ralph C, Campbell DC, Curti BD, Merchan JR, Ren Y, Schmidt EV, Guttman L, Gupta S. Phase 1, open-label, dose-escalation study on the safety, pharmacokinetics, and preliminary efficacy of intravenous Coxsackievirus A21 (V937), with or without pembrolizumab, in patients with advanced solid tumors. J Immunother Cancer 2023; 11:e005007. [PMID: 36669791 PMCID: PMC9872507 DOI: 10.1136/jitc-2022-005007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Accepted: 10/14/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Oncolytic virus V937 showed activity and safety with intratumoral administration. This phase 1 study evaluated intravenous V937±pembrolizumab in patients with advanced solid tumors. METHODS Patients had advanced non-small cell lung cancer (NSCLC), urothelial cancer, metastatic castration-resistant prostate cancer, or melanoma in part A (V937 monotherapy), and metastatic NSCLC or urothelial cancer in part B (V937+pembrolizumab). Prior immunotherapy was permitted >28 days before study treatment. Patients received intravenous V937 on days 1, 3, and 5 (also on day 8 in part B) of the first 21-day cycle and on day 1 of subsequent cycles for eight cycles. Three ascending dose-escalation cohorts were studied. Dose-escalation proceeded if no dose-limiting toxicities (DLTs) occurred in cycle 1 of the previous cohort. In part B, patients also received pembrolizumab 200 mg every 3 weeks from day 8 for 2 years; dose-expansion occurred at the highest-dose cohort. Serial biopsies were performed. RESULTS No DLTs occurred in parts A (n=18) or B (n=85). Grade 3-5 treatment-related adverse events (AEs) were not observed in part A and were experienced by 10 (12%) patients in part B. The most frequent treatment-related AEs (any grade) in part B were fatigue (36%), pruritus (18%), myalgia (14%), diarrhea (13%), pyrexia (13%), influenza-like illness (12%), and nausea (12%). At the highest tested dose, median intratumoral V937 concentrations were 117,631 copies/mL on day 8, cycle 1 in part A (n=6) and below the detection limit for most patients (86% (19/22)) on day 15, cycle 1 in part B. Objective response rates were 6% (part A), 9% in the NSCLC dose-expansion cohort (n=43), and 20% in the urothelial cancer dose-expansion cohort (n=35). CONCLUSIONS Intravenous V937+pembrolizumab had a manageable safety profile. Although V937 was detected in tumor tissue, in NSCLC and urothelial cancer, efficacy was not greater than that observed in previous studies with pembrolizumab monotherapy. TRIAL REGISTRATION NUMBER NCT02043665.
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Affiliation(s)
- Charles M Rudin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Professor of Medicine, Weill Cornell Medical College, New York, New York, USA
| | | | | | - Wallace L Akerley
- Division of Medical Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Kevin J Harrington
- The Royal Marsden/The Institute of Cancer Research NIHR Biomedical Research Centre, London, UK
| | - Daphne Day
- Department of Oncology, Monash Health and Monash University, Clayton, Victoria, Australia
| | - Andrew G Hill
- Tasman Oncology Research Ltd, Southport, Queensland, Australia
| | - Steven J O'Day
- John Wayne Cancer Institute, Providence St John's Health Center, Santa Monica, California, USA
| | - Timothy D Clay
- Medical Oncology, St. John of God Subiaco Hospital, Perth, Western Australia, Australia
| | - Gavin M Wright
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Fitzroy, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
| | | | - David E Gerber
- Division of Hematology-Oncology, Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jonathan E Rosenberg
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Christy Ralph
- Division of Medical Oncology, Institute of Oncology, St. James's University Hospital, Leeds, UK
| | - David C Campbell
- Western Health, Sunshine Hospital, St Albans, Victoria, Australia
| | - Brendan D Curti
- Earle A. Chiles Research Institute at Robert W. Franz Cancer Center, Providence Cancer Institute, Portland, Oregon, USA
| | - Jaime R Merchan
- University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Yixin Ren
- Merck & Co., Inc, Rahway, New Jersey, USA
| | | | - Lisa Guttman
- Practical Clinical, Mississauga, Ontario, Canada
| | - Sumati Gupta
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
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Tan S, Day D, Nicholls SJ, Segelov E. Immune Checkpoint Inhibitor Therapy in Oncology: Current Uses and Future Directions: JACC: CardioOncology State-of-the-Art Review. JACC CardioOncol 2022; 4:579-597. [PMID: 36636451 PMCID: PMC9830229 DOI: 10.1016/j.jaccao.2022.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/07/2022] [Indexed: 12/24/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) are a major class of immuno-oncology therapeutics that have significantly improved the prognosis of various cancers, both in (neo)adjuvant and metastatic settings. Unlike other conventional therapies, ICIs elicit antitumor effects by enhancing host immune systems to eliminate cancer cells. There are 3 approved ICI classes by the U.S. Food and Drug Administration: inhibitors targeting cytotoxic T lymphocyte associated antigen 4, programmed death 1/programmed death-ligand 1, and lymphocyte-activation gene 3, with many more in development. ICIs are commonly associated with distinct toxicities, known as immune-related adverse events, which can arise during treatment or less frequently be of late onset, usually relating to excessive activation of the immune system. Acute cardiovascular immune-related adverse events such as myocarditis are rare; however, data suggesting chronic cardiovascular sequelae are emerging. This review presents the current landscape of ICIs in oncology, with a focus on important aspects relevant to cardiology.
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Affiliation(s)
- Sean Tan
- Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia,Monash Heart, Monash Health, Clayton, Victoria, Australia,Address for correspondence: Dr Sean Tan, Victorian Heart Institute, Monash University, Wellington Road, Victoria 3800, Australia. @_SeanXTan
| | - Daphne Day
- School of Clinical Sciences, Monash Health, Monash University, Melbourne, Victoria, Australia,Department of Oncology, Monash Health, Clayton, Victoria, Australia
| | - Stephen J. Nicholls
- Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia,Monash Heart, Monash Health, Clayton, Victoria, Australia
| | - Eva Segelov
- School of Clinical Sciences, Monash Health, Monash University, Melbourne, Victoria, Australia,Department of Oncology, Monash Health, Clayton, Victoria, Australia
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Nguyen M, Bain N, Grech L, Kwok A, Hamad N, Tognela A, Chan B, Nott L, Harris S, Chau N, Underhill C, Day D, McCartney A, Webber K, Segelov E. 1614P Influence of cancer on COVID-19 vaccine beliefs, attitudes and uptake. Ann Oncol 2022. [PMCID: PMC9472538 DOI: 10.1016/j.annonc.2022.07.1707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Bain N, Nguyen M, Grech L, Day D, McCartney A, Webber K, Kwok A, Harris S, Chau H, Chan B, Nott L, Hamad N, Tognela A, Underhill C, Loe BS, Freeman D, Segelov E. COVID-19 Vaccine Hesitancy in Australian Patients with Solid Organ Cancers. Vaccines (Basel) 2022; 10:vaccines10091373. [PMID: 36146450 PMCID: PMC9503648 DOI: 10.3390/vaccines10091373] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Vaccination is the cornerstone of the global public health response to the COVID-19 pandemic. Excess morbidity and mortality of COVID-19 infection is seen in people with cancer. COVID-19 vaccine hesitancy has been observed in this medically vulnerable population, although associated attitudes and beliefs remain poorly understood. Methods: An online cross-sectional survey of people with solid organ cancers was conducted through nine health services across Australia. Demographics, cancer-related characteristics and vaccine uptake were collected. Perceptions and beliefs regarding COVID-19 vaccination were assessed using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale and the Disease Influenced Vaccine Acceptance Scale-6. Results: Between June and October 2021, 2691 people with solid organ cancers completed the survey. The median age was 62.5 years (SD = 11.8; range 19–95), 40.9% were male, 71.3% lived in metropolitan areas and 90.3% spoke English as their first language. The commonest cancer diagnoses were breast (36.6%), genitourinary (18.6%) and gastrointestinal (18.3%); 59.2% had localized disease and 56.0% were receiving anti-cancer therapy. Most participants (79.7%) had at least one COVID-19 vaccine dose. Vaccine uptake was higher in people who were older, male, metropolitan, spoke English as a first language and had a cancer diagnosis for more than six months. Vaccine hesitancy was higher in people who were younger, female, spoke English as a non-dominant language and lived in a regional location, and lower in people with genitourinary cancer. Vaccinated respondents were more concerned about being infected with COVID-19 and less concerned about vaccine safety and efficacy. Conclusions: People with cancer have concerns about acquiring COVID-19, which they balance against vaccine-related concerns about the potential impact on their disease progress and/or treatment. Detailed exploration of concerns in cancer patients provides valuable insights, both for discussions with individual patients and public health messaging for this vulnerable population.
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Affiliation(s)
- Nathan Bain
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
| | - Mike Nguyen
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
- Correspondence: ; Tel.: +61-3-8572-2392
| | - Lisa Grech
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Daphne Day
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Amelia McCartney
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Kate Webber
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Alastair Kwok
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
| | - Sam Harris
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC 3550, Australia
| | - Hieu Chau
- Department of Oncology, Latrobe Regional Hospital, Traralgon, VIC 3844, Australia
| | - Bryan Chan
- Department of Oncology, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia
- School of Medicine, Griffith University, Birtinya, QLD 4575, Australia
| | - Louise Nott
- Icon Cancer Centre Hobart, Hobart, TAS 7000, Australia
| | - Nada Hamad
- Department of Hematology, St Vincent’s Hospital Sydney, Darlinghurst, NSW 2010, Australia
- School of Clinical Medicine, Medicine & Health, University of New South Wales, Kensington, NSW 2052, Australia
- School of Medicine, University of Notre Dame Australia, Chippendale, NSW 2007, Australia
| | - Annette Tognela
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW 2560, Australia
| | - Craig Underhill
- Border Medical Oncology Research Unit, Albury, NSW 2640, Australia
- Rural Medical School, University of New South Wales, Albury, NSW 2640, Australia
| | - Bao Sheng Loe
- The Psychometrics Centre, University of Cambridge, Cambridge CB2 1AG, UK
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
- Oxford Health National Health Service Foundation Trust, Oxford OX3 7JX, UK
| | - Eva Segelov
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia
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Maccora J, Garland SN, Ftanou M, Day D, White M, Lopez VA, Mortimer D, Diggens J, Phillips AJK, Wallace R, Alexander M, Boyle F, Stafford L, Francis PA, Bei B, Wiley JF. The sleep, cancer and rest (SleepCaRe) trial: Rationale and design of a randomized, controlled trial of cognitive behavioral and bright light therapy for insomnia and fatigue in women with breast cancer receiving chemotherapy. Contemp Clin Trials 2022; 120:106877. [PMID: 35961468 DOI: 10.1016/j.cct.2022.106877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Insomnia and fatigue symptoms are common in breast cancer. Active cancer treatment, such as chemotherapy, appears to be particularly disruptive to sleep. Yet, sleep complaints often go unrecognised and under treated within routine cancer care. The abbreviated delivery of cognitive behavioral therapy for Insomnia (CBTI) and bright light therapy (BLT) may offer accessible and cost-effective sleep treatments in women receiving chemotherapy for breast cancer. METHODS The Sleep, Cancer and Rest (SleepCaRe) Trial is a 6-month multicentre, randomized, controlled, 2 × 2 factorial, superiority, parallel group trial. Women receiving cytotoxic chemotherapy for breast cancer at tertiary Australian hospitals will be randomly assigned 1:1:1:1 to one of four, non-pharmacological sleep interventions: (a) Sleep Hygiene and Education (SHE); (b) CBTI; (c) BLT; (d) CBT-I + BLT combined and simultaneously delivered. Each sleep intervention is delivered over 6 weeks, and will comprise an introductory session, a mid-point phone call, and regular emails. The primary (insomnia, fatigue) and secondary (health-related quality of life, rest activity rhythms, sleep-related impairment) outcomes will be assessed via online questionnaires at five time-points: baseline (t0, prior to intervention), mid-point intervention (t2, Week 4), post-intervention (t3, Week 7), 3-months (t4, Week 18), and 6-months follow-up (t5, Week 30). CONCLUSIONS This study will report novel data concerning the comparative and combined efficacy of CBT-I and BLT during chemotherapy. Findings will contribute to the development of evidence-based early sleep and fatigue intervention during chemotherapy for breast cancer. Clinical trial information Registered with the Australian New Zealand Clinical Trials Registry (http://anzctr.org.au/), Registration Number: ACTRN12620001133921.
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Affiliation(s)
- Jordan Maccora
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Melbourne, VIC 3800, Australia.
| | | | - Maria Ftanou
- Peter MacCallum Cancer Centre, Melbourne, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Daphne Day
- Department of Oncology Monash Health, Melbourne, Australia; Monash University, Melbourne, Australia.
| | - Michelle White
- Department of Oncology Monash Health, Melbourne, Australia; Monash University, Melbourne, Australia.
| | | | - Duncan Mortimer
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Australia.
| | | | - Andrew J K Phillips
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Melbourne, VIC 3800, Australia.
| | - Rebecca Wallace
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Melbourne, VIC 3800, Australia.
| | - Marliese Alexander
- Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
| | | | - Lesley Stafford
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
| | | | - Bei Bei
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Melbourne, VIC 3800, Australia; Centre for Women's Mental Health, Royal Women's Hospital, Melbourne, Australia.
| | - Joshua F Wiley
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Melbourne, VIC 3800, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia.
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16
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Tan S, Day D, Nicholls SJ, Segelov E. Atherosclerotic Cardiovascular Risk With Combination Avelumab and Axitinib. J Clin Oncol 2022; 40:3467-3469. [PMID: 35709408 DOI: 10.1200/jco.22.00712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sean Tan
- Sean Tan, MBBS, Victorian Heart Institute, Monash University, Melbourne, Australia, Monash Heart, Monash Health, Clayton, Victoria, Australia; Daphne Day, MBBS, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia, Department of Oncology, Monash Health, Clayton, Victoria, Australia; Stephen J. Nicholls, MBBS, PhD, Victorian Heart Institute, Monash University, Melbourne, Australia, Monash Heart, Monash Health, Clayton, Victoria, Australia; and Eva Segelov, MBBS, PhD, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia, Department of Oncology, Monash Health, Clayton, Victoria, Australia
| | - Daphne Day
- Sean Tan, MBBS, Victorian Heart Institute, Monash University, Melbourne, Australia, Monash Heart, Monash Health, Clayton, Victoria, Australia; Daphne Day, MBBS, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia, Department of Oncology, Monash Health, Clayton, Victoria, Australia; Stephen J. Nicholls, MBBS, PhD, Victorian Heart Institute, Monash University, Melbourne, Australia, Monash Heart, Monash Health, Clayton, Victoria, Australia; and Eva Segelov, MBBS, PhD, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia, Department of Oncology, Monash Health, Clayton, Victoria, Australia
| | - Stephen J Nicholls
- Sean Tan, MBBS, Victorian Heart Institute, Monash University, Melbourne, Australia, Monash Heart, Monash Health, Clayton, Victoria, Australia; Daphne Day, MBBS, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia, Department of Oncology, Monash Health, Clayton, Victoria, Australia; Stephen J. Nicholls, MBBS, PhD, Victorian Heart Institute, Monash University, Melbourne, Australia, Monash Heart, Monash Health, Clayton, Victoria, Australia; and Eva Segelov, MBBS, PhD, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia, Department of Oncology, Monash Health, Clayton, Victoria, Australia
| | - Eva Segelov
- Sean Tan, MBBS, Victorian Heart Institute, Monash University, Melbourne, Australia, Monash Heart, Monash Health, Clayton, Victoria, Australia; Daphne Day, MBBS, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia, Department of Oncology, Monash Health, Clayton, Victoria, Australia; Stephen J. Nicholls, MBBS, PhD, Victorian Heart Institute, Monash University, Melbourne, Australia, Monash Heart, Monash Health, Clayton, Victoria, Australia; and Eva Segelov, MBBS, PhD, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia, Department of Oncology, Monash Health, Clayton, Victoria, Australia
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17
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Gu S, de Souza PL, Shi Y, Han W, Luo S, Chen J, Day D, Frentzas S, Park JJ, Shao G, Wu S, Fang M, Haydon AM, Sun S, Lei K, Ding L, Zuo R, Gan X, Zhao Y, Chen X. A phase I dose-escalation and expansion study of HBM4003, an anti-CTLA-4 heavy chain only monoclonal antibody, in patients with advanced solid tumors. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.2641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2641 Background: HBM4003 is a fully human heavy chain only monoclonal antibody (HCAb) to CTLA-4, which has been engineered to deplete Treg cells by enhanced antibody-dependent cellular cytotoxicity (ADCC) activity. In the Phase 1 dose escalation part, HBM4003 showed favorable safety and efficacy profile in patients (pts) with advanced solid tumors. Here, we present the updated data from the dose escalation part and most recent safety and clinical activity data from three expansion cohorts of pts with advanced hepatocellular carcinoma (HCC), melanoma, and renal cell carcinoma (RCC). Methods: In the dose-escalation part, pts were enrolled into 3 dose levels (DL): 0.3mg/kg QW (28-day cycle), 0.45mg/kg Q3W (21-day cycle), and 0.6mg/kg Q3W (21-day cycle). In the dose-expansion part, pts with advanced HCC, melanoma, and RCC received 0.45 mg/kg Q3W (21-day cycle). Tumor measurements were performed every 6 weeks for up to 12 months and subsequently every 12 weeks per RECIST v1.1. Results: In total 60 pts were included for this analysis, including 24 pts with advanced solid tumors in the dose escalation part and 36 pts in the dose expansion part: 18 pts with HCC, 4 pts with melanoma, and 14 pts with RCC, from 12 sites in mainland China, 5 sites in Australia, and 1 site in Hong Kong. 46 pts (77%) received ≥ 2 lines of previous systemic therapies and 37 pts (62%) received previous PD-1/PD-L1 treatment. For the HCC cohort, 19 pts were treated in dose-escalation (1 pt, 0.45 mg/kg Q3W) and dose-expansion parts. All 19 pts received previous PD-1/PD-L1 therapy. 12 pts were evaluable for efficacy. Two had stable disease (SD), 2 pts had partial response (PR) as best response. For 12 evaluable pts, ORR was 16.7% and disease control rate (DCR) was 33.3%. For the RCC cohort, 19 pts were treated in dose-escalation and dose-expansion parts; 18 pts were evaluable for efficacy. Eight had SD as best response; the DCR was 44.4%. Overall, the most common treatment-related adverse event (TRAE) (incidence ≥ 10%) of all grades was rash (16 [26.7%] pts). At the 0.45 mg/kg Q3W DL, the most common TRAE of all grades was hepatic function abnormalities (12 [27.9%] pts) and rash (12 [27.9%] pts). 30 (69.8%) pts reported Gr 1 or 2 TRAEs. Gr ≥3 TRAEs occurred in 4 (9.3%) pts. 1 pt reported Gr 4 TRAE: blood creatine phosphokinase increased. No Gr 5 TRAE was reported. TRAE leading to discontinuation occurred in 4 pts. In mouse model, only tumor infiltrating lymphocytes Treg was depleted upon HBM4003 treatment while no Treg change in blood and spleen. In pts, Treg depletion was observed only in tumor tissue on day 21 post dosing. Overall, HBM4003 demonstrated dose proportional pharmacokinetics and low immunogenicity. Conclusions: HBM4003 showed a favorable safety profile, promising antitumor activity and intratumoral Treg depletion in pts with advanced solid tumors at the 0.45 mg/kg Q3W DL. Clinical trial information: NCT04135261.
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Affiliation(s)
- Shanzhi Gu
- Department of Interventional Radiology, Hunan Cancer Hospital, Changsha, China
| | - Paul L. de Souza
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Yuankai Shi
- Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China
| | - Weiqing Han
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Center, Changsha, China
| | - SuXia Luo
- Henan Cancer Hospital, Zhengzhou, China
| | - Jing Chen
- Union Hospital Affiliated with Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Daphne Day
- Royal Melbourne Hospital, Surrey Hills, Australia
| | | | - John J. Park
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Guoliang Shao
- Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Shikai Wu
- Peking University First Hospital, Beijing, China
| | - Meiyu Fang
- Zhejiang Cancer Hospital, Hangzhou, China
| | | | | | - Kaijian Lei
- Department of Oncology,the Second People's Hospital of Yibin City, Yibin, China
| | | | - Rui Zuo
- Harbour BioMed, Shanghai, China
| | - Xin Gan
- Harbour BioMed, Shanghai, China
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18
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Day D, Grech L, Nguyen M, Bain N, Kwok A, Harris S, Chau H, Chan B, Blennerhassett R, Nott L, Hamad N, Tognela A, Hoffman D, McCartney A, Webber K, Wong J, Underhill C, Sillars B, Winkel A, Savage M, Loe BS, Freeman D, Segelov E. Serious Underlying Medical Conditions and COVID-19 Vaccine Hesitancy: A Large Cross-Sectional Analysis from Australia. Vaccines (Basel) 2022; 10:vaccines10060851. [PMID: 35746458 PMCID: PMC9230066 DOI: 10.3390/vaccines10060851] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 01/27/2023] Open
Abstract
As COVID-19 vaccinations became available and were proven effective in preventing serious infection, uptake amongst individuals varied, including in medically vulnerable populations. This cross-sectional multi-site study examined vaccine uptake, hesitancy, and explanatory factors amongst people with serious and/or chronic health conditions, including the impact of underlying disease on attitudes to vaccination. A 42-item survey was distributed to people with cancer, diabetes, or multiple sclerosis across ten Australian health services from 30 June to 5 October 2021. The survey evaluated sociodemographic and disease-related characteristics and incorporated three validated scales measuring vaccine hesitancy and vaccine-related beliefs generally and specific to their disease: the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale and the Disease Influenced Vaccine Acceptance Scale-Six. Among 4683 participants (2548 [54.4%] female, 2108 [45.0%] male, 27 [0.6%] other; mean [SD] age, 60.6 [13.3] years; 3560 [76.0%] cancer, 842 [18.0%] diabetes, and 281 [6.0%] multiple sclerosis), 3813 (81.5%) self-reported having at least one COVID-19 vaccine. Unvaccinated status was associated with younger age, female sex, lower education and income, English as a second language, and residence in regional areas. Unvaccinated participants were more likely to report greater vaccine hesitancy and more negative perceptions toward vaccines. Disease-related vaccine concerns were associated with unvaccinated status and hesitancy, including greater complacency about COVID-19 infection, and concerns relating to vaccine efficacy and impact on their disease and/or treatment. This highlights the need to develop targeted strategies and education about COVID-19 vaccination to support medically vulnerable populations and health professionals.
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Affiliation(s)
- Daphne Day
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia; (M.N.); (N.B.); (A.K.); (A.M.); (K.W.); (E.S.)
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia; (L.G.); (J.W.)
- Correspondence: ; Tel.: +61-3-8572-2392
| | - Lisa Grech
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia; (L.G.); (J.W.)
| | - Mike Nguyen
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia; (M.N.); (N.B.); (A.K.); (A.M.); (K.W.); (E.S.)
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia; (L.G.); (J.W.)
| | - Nathan Bain
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia; (M.N.); (N.B.); (A.K.); (A.M.); (K.W.); (E.S.)
| | - Alastair Kwok
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia; (M.N.); (N.B.); (A.K.); (A.M.); (K.W.); (E.S.)
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia; (L.G.); (J.W.)
| | - Sam Harris
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC 3550, Australia;
| | - Hieu Chau
- Department of Oncology, Latrobe Regional Hospital, Traralgon, VIC 3844, Australia;
| | - Bryan Chan
- Department of Oncology, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia;
- School of Medicine, Griffith University, Birtinya, QLD 4575, Australia;
| | - Richard Blennerhassett
- Central Coast Haematology, North Gosford, NSW 2250, Australia;
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Louise Nott
- Icon Cancer Centre Hobart, Hobart, TAS 7000, Australia;
| | - Nada Hamad
- Department of Haematology, St Vincent’s Hospital Sydney, Darlinghurst, NSW 2010, Australia;
- School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Kensington, NSW 2052, Australia
- School of Medicine, University of Notre Dame Australia, Chippendale, NSW 2007, Australia
| | - Annette Tognela
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW 2560, Australia;
| | | | - Amelia McCartney
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia; (M.N.); (N.B.); (A.K.); (A.M.); (K.W.); (E.S.)
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia; (L.G.); (J.W.)
| | - Kate Webber
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia; (M.N.); (N.B.); (A.K.); (A.M.); (K.W.); (E.S.)
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia; (L.G.); (J.W.)
| | - Jennifer Wong
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia; (L.G.); (J.W.)
- Monash Diabetes, Monash Health, Clayton, VIC 3168, Australia
| | - Craig Underhill
- Border Medical Oncology, Albury, NSW 2640, Australia;
- Rural Medical School, University of New South Wales, Albury, NSW 2640, Australia
| | - Brett Sillars
- Department of Endocrinology, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia;
| | - Antony Winkel
- School of Medicine, Griffith University, Birtinya, QLD 4575, Australia;
- Department of Neurology, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia
| | - Mark Savage
- Department of Endocrinology, Bendigo Health, Bendigo, VIC 3550, Australia;
| | - Bao Sheng Loe
- The Psychometrics Centre, University of Cambridge, Cambridge CB2 1AG, UK;
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK;
- Oxford Health National Health Service Foundation Trust, Oxford OX3 7JX, UK
| | - Eva Segelov
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia; (M.N.); (N.B.); (A.K.); (A.M.); (K.W.); (E.S.)
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia; (L.G.); (J.W.)
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Zhou Q, Yu X, Gao B, Ma Z, Chu Q, Huang D, Zhao J, Day D, Body A, Pan H, Cui J, Li H, Sun J, Zhang J, Fei C, Wu YL. 2P Sitravatinib + tislelizumab in patients with metastatic non-small cell lung cancer (NSCLC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.064] [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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20
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Nguyen M, Bain N, Grech L, Hamad N, Chan BA, Blennerhassett R, Nott LM, Harris SJ, Chau NMH, Underhill C, Williams J, Kwok A, McCartney A, Webber K, Day D, Segelov E. Lower COVID-19 vaccination rates amongst Australians with gastrointestinal (GI) compared to other cancers. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.4_suppl.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
648 Background: People with cancer are at higher risk of serious illness and death from COVID-19 infection. We investigated the differences in COVID-19 vaccine uptake and attitudes in people with various solid organ and hematological malignancies. Methods: An online survey of adult patients with cancer attending eight health services across four states in Australia, was conducted from June to September 2021. Demographics, cancer history and vaccination status were recorded. Only completed surveys were analysed. Variables were compared with chi-squared and multivariable analysis using logistic regression. Vaccine hesitancy was assessed using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford Vaccine Confidence and Complacency Scale, and the Monash Disease Vaccine Acceptance Scale. T-test analysis was used to examine relationships between the scales and groups. Results: There were 2997 evaluable responses; 53.2% female, 61.8% from metropolitan areas, 27.5% with metastatic solid organ disease and 50.6% on current anti-cancer treatment. Patients with GI cancers comprised 13.5% (n = 405), compared with hematological 28.4%, breast 24.6%, genitourinary 14.1% and other cancer types 19.4%. Vaccination rates were significantly lower for respondents with GI cancers compared to other cancer types (71.6% v 79.3%; p< 0.001). Significant differences in the GI cancer population compared to all others were: more males ( p < 0.001), lower level of education ( p= 0.001), fewer reporting English as first language ( p = 0.02) and shorter time since cancer diagnosis ( p < 0.001). These remained significant after logistic regression. Among GI cancer respondents, factors associated with being vaccinated compared to unvaccinated included: older age ( p < 0.001), higher education level ( p = 0.03) and English as first language ( p = 0.01). There was no significant difference in the scales measuring vaccine hesitancy, confidence and complacency, for the GI cancer population compared to other cancers. As expected, there were significant differences in all scales comparing vaccinated to unvaccinated respondents with GI cancers. Conclusions: In our large, contemporary survey, Australians with GI cancers report lower COVID-19 vaccine uptake compared with patients with other cancer types. We identified demographic and disease related characteristics that contribute to these differences. Interventions and targeted communication are required for people with GI cancers to maximise vaccination uptake in this medically vulnerable group.
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Affiliation(s)
| | | | | | - Nada Hamad
- St Vincent’s Hospital Sydney, Darlinghurst, Australia
| | | | | | | | - Samuel J. Harris
- Department of Medical Oncology, Bendigo Health, Bendigo, Australia
| | | | | | - Janne Williams
- Southern Melbourne Integrated Cancer Service, Melbourne, Australia
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21
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Nguyen M, Bain N, Grech L, Choi T, Harris S, Chau H, Freeman D, Kwok A, Williams J, McCartney A, Webber K, Day D, Segelov E. COVID-19 vaccination rates, intent, and hesitancy in patients with solid organ and blood cancers: A multicenter study. Asia Pac J Clin Oncol 2022; 18:570-577. [PMID: 35043559 DOI: 10.1111/ajco.13754] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/13/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION People with cancer are at higher risk of serious illness and death from COVID-19 infection. We investigated COVID-19 vaccine uptake among patients with solid organ and blood cancers and explored factors related to hesitancy. METHODS Cross-sectional online survey of adults with a history of cancer at three health services across metropolitan and regional Victoria. Vaccine hesitancy was measured by the validated Oxford COVID-19 vaccine hesitancy scale. RESULTS There were 1073 respondents: 56% female; median age 62 years (range 23 - 91). Commonest tumor types included breast 29%, gastrointestinal 19%, hematological 15%, genitourinary 15%, and lung 8%. Thirty-six percent had metastatic disease, and 54% were receiving active anticancer treatment. Eighty-four percent of respondents indicated positive intent toward COVID-19 vaccination, 10% were undecided, and 6% indicated negative attitudes. At least one vaccine dose had been received by 65% of respondents, leaving 35% unvaccinated. Fifty-eight percent of unvaccinated patients answered that they would "definitely" or "probably" take a vaccine. Higher vaccine uptake was significantly associated with older age, male gender, English as first language, longer time since cancer diagnosis, and not being on current anticancer treatment. Concerns regarding vaccine side effects, particularly thrombosis, and the desire for clear medical advice were prominent among unvaccinated respondents. CONCLUSION Despite being eligible for COVID-19 vaccination since March 2021, a substantial minority of patients with cancer remained unvaccinated as of August 2021. Targeted communication and educational resources addressing vaccine safety in the context of cancer are key to promoting vaccine uptake in this vulnerable population.
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Affiliation(s)
- Mike Nguyen
- Oncology Department, Monash Health, Clayton, Victoria, Australia.,School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Nathan Bain
- Oncology Department, Monash Health, Clayton, Victoria, Australia
| | - Lisa Grech
- School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Tammie Choi
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia
| | - Sam Harris
- Bendigo Health, Bendigo, Victoria, Australia
| | - Hieu Chau
- Latrobe Regional Hospital, Traralgon, Victoria, Australia
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Alastair Kwok
- Oncology Department, Monash Health, Clayton, Victoria, Australia
| | - Janne Williams
- Southern Melbourne Integrated Cancer Service, Melbourne, Victoria, Australia
| | - Amelia McCartney
- Oncology Department, Monash Health, Clayton, Victoria, Australia.,School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Kate Webber
- Oncology Department, Monash Health, Clayton, Victoria, Australia.,School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Daphne Day
- Oncology Department, Monash Health, Clayton, Victoria, Australia.,School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Eva Segelov
- Oncology Department, Monash Health, Clayton, Victoria, Australia.,School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
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22
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Goh J, Coward J, Gao B, Pires Da Silva I, Voskoboynik M, Day D, Body A, Gan H, Li X, Sun J, Fei C, Yang L, Millward M. 153P Safety/tolerability and antitumor activity of sitravatinib plus tislelizumab (TIS) in patients with advanced platinum-resistant ovarian cancer (PROC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.172] [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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23
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Melough M, Day D, Fretts A, Wang S, Flynn J, de Boer I, Zhu H, Kannan K, Sathyanarayana S. Associations of Dietary Intake with Urinary Melamine Concentrations among Children aged 4-6 Years in the GAPPS Cohort. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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24
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Gao B, Ma Z, Yu X, Huang D, Zhao J, Day D, Body A, Zhou Q, Chu Q, Pan H, Cui J, Chen C, Xiang X, Fei C, Yang L, Wu YL. 1284P Sitravatinib + tislelizumab in patients with anti-PD-(L)1 refractory/resistant metastatic NSCLC. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1886] [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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25
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Menon S, Davies A, Frentzas S, Hawkins CA, Segelov E, Day D, Markman B. Recruitment, outcomes, and toxicity trends in phase I oncology trials: Six-year experience in a large institution. Cancer Rep (Hoboken) 2021; 5:e1465. [PMID: 34245134 PMCID: PMC8842700 DOI: 10.1002/cnr2.1465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/16/2021] [Accepted: 05/18/2021] [Indexed: 11/15/2022] Open
Abstract
Background With the rapid influx of novel anti‐cancer agents, phase I clinical trials in oncology are evolving. Historically, response rates on early phase trials have been modest with the clinical benefit and ethics of enrolment debated. However, there is a paucity of real‐world data in this setting. Aim To better understand the changing landscape of phase I oncology trials, we performed a retrospective review at our institution to examine patient and trial characteristics, screening outcomes, and treatment outcomes. Methods and results We analyzed all consecutive adult patients with advanced solid organ malignancies who were screened across phase I trials from January 2013 to December 2018 at a single institution. During this period, 242 patients were assessed for 28 different trials. Median age was 64 years (range 30–89) with an equal sex distribution. Among 257 screening visits, the overall screen failure rate was 18%, resulting in 212 patients being enrolled onto a study. Twenty‐six trials (93%) involved immunotherapeutic agents or molecular targeted agents either alone or in combination, with only two trials of cytotoxic agents (7%). Twenty‐two (13.4%) of the 209 treated patients experienced a total of 33 grade 3 or higher treatment‐related adverse events. There was one treatment‐related death (0.5%). Of 190 response‐evaluable patients, 7 (4%) had a complete response, 34 (18%) a partial response, and 59 (31%) experienced stable disease for a disease control rate of 53%. The median overall survival for our cohort was 8.0 (95% CI: 6.8–9.2) months. Conclusion The profile of phase I trials at our institution are consistent with the changing early drug development landscape. Response rates and overall survival in our cohort are superior to historically reported rates and comparable to contemporaneous studies. Severe treatment‐related toxicity was relatively uncommon, and treatment‐related mortality was rare.
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Affiliation(s)
- Siddharth Menon
- Monash Health, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,La Trobe University, Melbourne, Australia
| | | | - Sophia Frentzas
- Monash Health, Melbourne, Australia.,Monash University, Melbourne, Australia
| | | | - Eva Segelov
- Monash Health, Melbourne, Australia.,Monash University, Melbourne, Australia
| | - Daphne Day
- Monash Health, Melbourne, Australia.,Monash University, Melbourne, Australia
| | - Ben Markman
- Monash Health, Melbourne, Australia.,The Alfred Hospital, Melbourne, Australia
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Goh J, Coward J, Gao B, da Silva IP, Voskoboynik M, Day D, Body AL, Gan HK, Chen C, Xiang X, Fei C, Yang L, Millward M. Abstract CT013: Safety/tolerability and preliminary antitumor activity of sitravatinib plus tislelizumab in patients with advanced platinum-resistant ovarian cancer (PROC). Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-ct013] [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: Combining a PD-1 inhibitor and an agent with immune modulatory and antitumor properties may enhance antitumor activity of either agent. Sitravatinib, a spectrum-selective TKI targeting TAM receptors (Tyro3/Axl/MerTK) and VEGFR2, reduces the number of myeloid-derived suppressor cells and regulatory T cells while increasing the ratio of M1/M2-polarized macrophages, which may overcome an immunosuppressive tumor microenvironment and augment antitumor immune responses. Tislelizumab, an anti-PD-1 antibody engineered to minimize binding to FcγR on macrophages and abrogate antibody-dependent phagocytosis, has shown single-agent clinical activity in patients (pts) with advanced solid tumors. This open-label, multicohort, phase 1b study assessed safety/tolerability and preliminary antitumor activity of sitravatinib + tislelizumab in advanced solid tumors (BGB-900-103; NCT03666143). We report results from the PROC cohort. Methods: Anti-PD-(L)1 antibody-naïve pts with histologically confirmed, advanced PROC (disease progression <6 mo after last platinum treatment) were enrolled. While platinum-resistant pts were included, pts with platinum-refractory disease were excluded. Patients received sitravatinib 120 mg PO QD and tislelizumab 200 mg IV Q3W. Primary endpoint was safety/tolerability of sitravatinib + tislelizumab. Key secondary endpoints were investigator-assessed objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS) per RECIST v1.1; overall survival (OS) was also assessed. PD-L1 IHC assay (Ventana SP263) and assessment of plasma VEGF/serum CXCL10 were retrospective. Results: As of Oct 13, 2020, 60 PROC pts were enrolled; 13 (22%) remained on treatment. Median age was 64 yrs (range 26-80); pts received a median of 4 (range 1-11) prior regimens. Median follow-up was 6.0 mo (range 0.2-23.4). Treatment-emergent adverse events (TEAEs) of any grade/grade ≥3 occurred in 97%/68% of pts; TEAEs led to sitravatinib dose reduction in 50% of pts. Nausea (33%), hypertension (18%), and abdominal pain (12%) were the most commonly reported grade ≥3 TEAEs. The 2 fatal AEs (malignant GI obstruction, dyspnea) were deemed unrelated to treatment. Confirmed ORR was 26.4% (95% CI, 15.3-40.3), with 14 pts achieving partial response; DCR was 77.4% (95% CI, 63.8-87.7). Median duration of response was 4.7 mo (95% CI, 2.8-not estimable). There was no clear association between PD-L1 expression and clinical response; plasma VEGF and serum CXCL10 increased after treatment (P<0.0001 for both). Median PFS was 4.1 mo (95% CI, 4.0-5.1); preliminary median OS was 12.9 mo (95% CI, 6.3-17.2). Conclusions: Sitravatinib + tislelizumab was tolerable and showed preliminary antitumor activity in pts with advanced PROC. Further investigation of sitravatinib + tislelizumab in PROC is warranted.
Citation Format: Jeffrey Goh, Jermaine Coward, Bo Gao, Ines P. da Silva, Mark Voskoboynik, Daphne Day, Amy L. Body, Hui K. Gan, Cheng Chen, Xiao Xiang, Cong Fei, Liu Yang, Michael Millward. Safety/tolerability and preliminary antitumor activity of sitravatinib plus tislelizumab in patients with advanced platinum-resistant ovarian cancer (PROC) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr CT013.
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Affiliation(s)
| | | | - Bo Gao
- 2Blacktown Cancer and Haematology Centre, Blacktown, Australia
| | | | - Mark Voskoboynik
- 4Nucleus Network, Melbourne, Australia and Central Clinical School, Monash University, Melbourne, Australia
| | - Daphne Day
- 5Monash Health and Monash University, Melbourne, Australia
| | - Amy L. Body
- 5Monash Health and Monash University, Melbourne, Australia
| | - Hui K. Gan
- 6Austin Health, Heidelberg, VIC, Australia
| | - Cheng Chen
- 7BeiGene (Beijing) Co., Ltd., Beijing, China
| | - Xiao Xiang
- 7BeiGene (Beijing) Co., Ltd., Beijing, China
| | - Cong Fei
- 7BeiGene (Beijing) Co., Ltd., Beijing, China
| | - Liu Yang
- 7BeiGene (Beijing) Co., Ltd., Beijing, China
| | - Michael Millward
- 8Linear Clinical Research & University of Western Australia, Nedlands, Australia
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27
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Ali M, Kua H, Giddings C, Day D, McDowell L. Synchronous p16 + nasopharyngeal and oropharyngeal squamous cell carcinoma: a case report and review. Clin Case Rep 2021; 9:1350-1353. [PMID: 33768842 PMCID: PMC7981711 DOI: 10.1002/ccr3.3765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022] Open
Abstract
We report a case of synchronous p16+ SCC involving both the nasopharynx and base of tongue treated with definitive chemo-radiotherapy with concurrent high dose cisplatin. The nasopharyngeal lesion was detected incidentally on PET/CT imaging. Head and neck clinicians treating p16+ SCC should consider the possibility of synchronous lesions, including lesions which may be located in the lymphoid tissue of the nasopharynx.
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Affiliation(s)
- Muhammad Ali
- Department of Radiation OncologyPeter MacCallum Cancer CentreMelbourneVic.Australia
| | - Hock Kua
- Department of PathologyMonash HealthMelbourneVic.Australia
| | - Charles Giddings
- Department of Head and Neck SurgeryMonash HealthMelbourneVic.Australia
| | - Daphne Day
- Department of Medical OncologyMonash HealthMelbourneVic.Australia
- Faculty of MedicineMonash UniversityMelbourneVic.Australia
| | - Lachlan McDowell
- Department of Radiation OncologyPeter MacCallum Cancer CentreMelbourneVic.Australia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVic.Australia
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28
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Bhetuwal D, Matter J, Szumila-Vance H, Kabir ML, Dutta D, Ent R, Abrams D, Ahmed Z, Aljawrneh B, Alsalmi S, Ambrose R, Androic D, Armstrong W, Asaturyan A, Assumin-Gyimah K, Ayerbe Gayoso C, Bandari A, Basnet S, Berdnikov V, Bhatt H, Biswas D, Boeglin WU, Bosted P, Brash E, Bukhari MHS, Chen H, Chen JP, Chen M, Christy EM, Covrig S, Craycraft K, Danagoulian S, Day D, Diefenthaler M, Dlamini M, Dunne J, Duran B, Evans R, Fenker H, Fomin N, Fuchey E, Gaskell D, Gautam TN, Gonzalez FA, Hansen JO, Hauenstein F, Hernandez AV, Horn T, Huber GM, Jones MK, Joosten S, Karki A, Keppel C, Khanal A, King PM, Kinney E, Ko HS, Kohl M, Lashley-Colthirst N, Li S, Li WB, Liyanage AH, Mack D, Malace S, Markowitz P, Meekins D, Michaels R, Mkrtchyan A, Mkrtchyan H, Nazeer SJ, Nanda S, Niculescu G, Niculescu I, Nguyen D, Pandey B, Park S, Pooser E, Puckett A, Rehfuss M, Reinhold J, Santiesteban N, Sawatzky B, Smith GR, Sun A, Tadevosyan V, Trotta R, Wood SA, Yero C, Zhang J. Ruling out Color Transparency in Quasielastic ^{12}C(e,e^{'}p) up to Q^{2} of 14.2 (GeV/c)^{2}. Phys Rev Lett 2021; 126:082301. [PMID: 33709760 DOI: 10.1103/physrevlett.126.082301] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/15/2020] [Accepted: 01/14/2021] [Indexed: 06/12/2023]
Abstract
Quasielastic ^{12}C(e,e^{'}p) scattering was measured at spacelike 4-momentum transfer squared Q^{2}=8, 9.4, 11.4, and 14.2 (GeV/c)^{2}, the highest ever achieved to date. Nuclear transparency for this reaction was extracted by comparing the measured yield to that expected from a plane-wave impulse approximation calculation without any final state interactions. The measured transparency was consistent with no Q^{2} dependence, up to proton momenta of 8.5 GeV/c, ruling out the quantum chromodynamics effect of color transparency at the measured Q^{2} scales in exclusive (e,e^{'}p) reactions. These results impose strict constraints on models of color transparency for protons.
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Affiliation(s)
- D Bhetuwal
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - J Matter
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - H Szumila-Vance
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M L Kabir
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Dutta
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - R Ent
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D Abrams
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - Z Ahmed
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - B Aljawrneh
- North Carolina A & T State University, Greensboro, North Carolina 27411, USA
| | - S Alsalmi
- Kent State University, Kent, Ohio 44240, USA
| | - R Ambrose
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - D Androic
- University of Zagreb, Zagreb, Croatia
| | - W Armstrong
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - A Asaturyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - K Assumin-Gyimah
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - C Ayerbe Gayoso
- Mississippi State University, Mississippi State, Mississippi 39762, USA
- The College of William & Mary, Williamsburg, Virginia 23185, USA
| | - A Bandari
- The College of William & Mary, Williamsburg, Virginia 23185, USA
| | - S Basnet
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - V Berdnikov
- Catholic University of America, Washington, DC 20064, USA
| | - H Bhatt
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Biswas
- Hampton University, Hampton, Virginia 23669, USA
| | - W U Boeglin
- Florida International University, University Park, Florida 33199, USA
| | - P Bosted
- The College of William & Mary, Williamsburg, Virginia 23185, USA
| | - E Brash
- Christopher Newport University, Newport News, Virginia 23606, USA
| | | | - H Chen
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - J P Chen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Chen
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - E M Christy
- Hampton University, Hampton, Virginia 23669, USA
| | - S Covrig
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K Craycraft
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Danagoulian
- North Carolina A & T State University, Greensboro, North Carolina 27411, USA
| | - D Day
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - M Diefenthaler
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Dlamini
- Ohio University, Athens, Ohio 45701, USA
| | - J Dunne
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - B Duran
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - R Evans
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - H Fenker
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - N Fomin
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - E Fuchey
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T N Gautam
- Hampton University, Hampton, Virginia 23669, USA
| | - F A Gonzalez
- Stony Brook University, Stony Brook, New York 11794, USA
| | - J O Hansen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Hauenstein
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A V Hernandez
- Catholic University of America, Washington, DC 20064, USA
| | - T Horn
- Catholic University of America, Washington, DC 20064, USA
| | - G M Huber
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - M K Jones
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Joosten
- Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - A Karki
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - C Keppel
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Khanal
- Florida International University, University Park, Florida 33199, USA
| | - P M King
- Ohio University, Athens, Ohio 45701, USA
| | - E Kinney
- University of Colorado Boulder, Boulder, Colorado 80309, USA
| | - H S Ko
- Institut de Physique Nucleaire, Orsay, France
| | - M Kohl
- Hampton University, Hampton, Virginia 23669, USA
| | | | - S Li
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - W B Li
- The College of William & Mary, Williamsburg, Virginia 23185, USA
| | - A H Liyanage
- Hampton University, Hampton, Virginia 23669, USA
| | - D Mack
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Malace
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Markowitz
- Florida International University, University Park, Florida 33199, USA
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Michaels
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Mkrtchyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - H Mkrtchyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - S J Nazeer
- Hampton University, Hampton, Virginia 23669, USA
| | - S Nanda
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - G Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - I Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - D Nguyen
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - B Pandey
- Hampton University, Hampton, Virginia 23669, USA
| | - S Park
- Stony Brook University, Stony Brook, New York 11794, USA
| | - E Pooser
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Puckett
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - M Rehfuss
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - J Reinhold
- Florida International University, University Park, Florida 33199, USA
| | - N Santiesteban
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - B Sawatzky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - G R Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Sun
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - V Tadevosyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - R Trotta
- Catholic University of America, Washington, DC 20064, USA
| | - S A Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Yero
- Florida International University, University Park, Florida 33199, USA
| | - J Zhang
- Stony Brook University, Stony Brook, New York 11794, USA
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29
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Yero C, Abrams D, Ahmed Z, Ahmidouch A, Aljawrneh B, Alsalmi S, Ambrose R, Armstrong W, Asaturyan A, Assumin-Gyimah K, Ayerbe Gayoso C, Bandari A, Bane J, Basnet S, Berdnikov VV, Bericic J, Bhatt H, Bhetuwal D, Biswas D, Boeglin WU, Bosted P, Brash E, Bukhari MHS, Chen H, Chen JP, Chen M, Christy ME, Covrig S, Craycraft K, Danagoulian S, Day D, Diefenthaler M, Dlamini M, Dunne J, Duran B, Dutta D, Ent R, Evans R, Fenker H, Fomin N, Fuchey E, Gaskell D, Gautam TN, Gonzalez FA, Hansen JO, Hauenstein F, Hernandez AV, Horn T, Huber GM, Jones MK, Joosten S, Kabir ML, Karki A, Keppel CE, Khanal A, King P, Kinney E, Lashley-Colthirst N, Li S, Li WB, Liyanage AH, Mack DJ, Malace SP, Matter J, Meekins D, Michaels R, Mkrtchyan A, Mkrtchyan H, Nazeer SJ, Nanda S, Niculescu G, Niculescu M, Nguyen D, Nuruzzaman N, Pandey B, Park S, Perdrisat CF, Pooser E, Rehfuss M, Reinhold J, Sawatzky B, Smith GR, Sun A, Szumila-Vance H, Tadevosyan V, Wood SA, Zhang J. Probing the Deuteron at Very Large Internal Momenta. Phys Rev Lett 2020; 125:262501. [PMID: 33449750 DOI: 10.1103/physrevlett.125.262501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/27/2020] [Accepted: 12/02/2020] [Indexed: 06/12/2023]
Abstract
We measure ^{2}H(e,e^{'}p)n cross sections at 4-momentum transfers of Q^{2}=4.5±0.5 (GeV/c)^{2} over a range of neutron recoil momenta p_{r}, reaching up to ∼1.0 GeV/c. We obtain data at fixed neutron recoil angles θ_{nq}=35°, 45°, and 75° with respect to the 3-momentum transfer q[over →]. The new data agree well with previous data, which reached p_{r}∼500 MeV/c. At θ_{nq}=35° and 45°, final state interactions, meson exchange currents, and isobar currents are suppressed and the plane wave impulse approximation provides the dominant cross section contribution. We compare the new data to recent theoretical calculations, where we observe a significant discrepancy for recoil momenta p_{r}>700 MeV/c.
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Affiliation(s)
- C Yero
- Florida International University, University Park, Florida 33199, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D Abrams
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - Z Ahmed
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - A Ahmidouch
- North Carolina Agricultural and Technical State University, Greensboro, North Carolina 27411, USA
| | - B Aljawrneh
- North Carolina Agricultural and Technical State University, Greensboro, North Carolina 27411, USA
| | - S Alsalmi
- Kent State University, Kent, Ohio 44240, USA
| | - R Ambrose
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - W Armstrong
- Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - A Asaturyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), 2 Alikhanian Brothers Street, 0036, Yerevan, Armenia
| | - K Assumin-Gyimah
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - C Ayerbe Gayoso
- College of William & Mary, Williamsburg, Virginia 23185, USA
| | - A Bandari
- College of William & Mary, Williamsburg, Virginia 23185, USA
| | - J Bane
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Basnet
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - V V Berdnikov
- Catholic University of America, Washington, D.C. 20064, USA
| | - J Bericic
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - H Bhatt
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Bhetuwal
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Biswas
- Hampton University, Hampton, Virginia 23669, USA
| | - W U Boeglin
- Florida International University, University Park, Florida 33199, USA
| | - P Bosted
- College of William & Mary, Williamsburg, Virginia 23185, USA
| | - E Brash
- Christopher Newport University, Newport News, Virginia 23606, USA
| | | | - H Chen
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - J P Chen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Chen
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - M E Christy
- Hampton University, Hampton, Virginia 23669, USA
| | - S Covrig
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K Craycraft
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Danagoulian
- North Carolina Agricultural and Technical State University, Greensboro, North Carolina 27411, USA
| | - D Day
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - M Diefenthaler
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Dlamini
- Ohio University, Athens, Ohio 45701, USA
| | - J Dunne
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - B Duran
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - D Dutta
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - R Ent
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Evans
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - H Fenker
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - N Fomin
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - E Fuchey
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T N Gautam
- Hampton University, Hampton, Virginia 23669, USA
| | - F A Gonzalez
- Stony Brook University, Stony Brook, New York 11794, USA
| | - J O Hansen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Hauenstein
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A V Hernandez
- Catholic University of America, Washington, D.C. 20064, USA
| | - T Horn
- Catholic University of America, Washington, D.C. 20064, USA
| | - G M Huber
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - M K Jones
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Joosten
- Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - M L Kabir
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - A Karki
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - C E Keppel
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Khanal
- Florida International University, University Park, Florida 33199, USA
| | - P King
- Ohio University, Athens, Ohio 45701, USA
| | - E Kinney
- University of Colorado Boulder, Boulder, Colorado 80309, USA
| | | | - S Li
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - W B Li
- College of William & Mary, Williamsburg, Virginia 23185, USA
| | - A H Liyanage
- Hampton University, Hampton, Virginia 23669, USA
| | - D J Mack
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S P Malace
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Matter
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Michaels
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Mkrtchyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), 2 Alikhanian Brothers Street, 0036, Yerevan, Armenia
| | - H Mkrtchyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), 2 Alikhanian Brothers Street, 0036, Yerevan, Armenia
| | - S J Nazeer
- Hampton University, Hampton, Virginia 23669, USA
| | - S Nanda
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - G Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - M Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - D Nguyen
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - N Nuruzzaman
- Rutgers University, New Brunswick, New Jersey 08854, USA
| | - B Pandey
- Hampton University, Hampton, Virginia 23669, USA
| | - S Park
- Stony Brook University, Stony Brook, New York 11794, USA
| | - C F Perdrisat
- College of William & Mary, Williamsburg, Virginia 23185, USA
| | - E Pooser
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Rehfuss
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - J Reinhold
- Florida International University, University Park, Florida 33199, USA
| | - B Sawatzky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - G R Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Sun
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - H Szumila-Vance
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - V Tadevosyan
- A.I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), 2 Alikhanian Brothers Street, 0036, Yerevan, Armenia
| | - S A Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Zhang
- Stony Brook University, Stony Brook, New York 11794, USA
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David S, Ho G, Day D, Harris M, Tan J, Goel S, Hanna GG, Srivastava R, Kruss G, McDowell L, White M. Enhanced toxicity with CDK 4/6 inhibitors and palliative radiotherapy: Non-consecutive case series and review of the literature. Transl Oncol 2020; 14:100939. [PMID: 33227663 PMCID: PMC7689545 DOI: 10.1016/j.tranon.2020.100939] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 11/25/2022] Open
Abstract
CDK 4/6 inhibitors are commonly used in patients with advanced hormone receptor positive breast cancer. Many patients receive palliative radiotherapy for symptomatic disease concomitantly with a CDK 4/6 inhibitor. There is a paucity of data on the safety of combining a CDK 4/6 inhibitor with palliative radiotherapy. We report on 5 cases at our institution where enhanced radiotherapy toxicity was observed when RT was delivered during or prior to treatment with a CDK 4/6 inhibitor. We review pre-clinical and mechanistic data and hypothesise on possible mechanisms for this phenomenon.
Current first-line systemic treatment in most patients with metastatic hormone receptor-positive, HER-2 negative breast cancer is an aromatase inhibitor in combination with a cyclin dependant kinase (CDK) 4/6 inhibitor. Frequently, these patients require palliative radiotherapy (RT) for symptomatic disease management. There is a paucity of data on the safety of combining a CDK 4/6 inhibitor with palliative RT, with conflicting case reports in the literature. We report on 5 cases at our institution where enhanced radiotherapy toxicity was observed when palliative doses of RT was delivered during or prior to treatment with a CDK 4/6 inhibitor. After review of pre-clinical and mechanistic data, we hypothesise that the effects of CDK4/6 inhibition on normal tissue and the tumour microenvironment may impede tissue recovery and exacerbate acute radiation and radiation recall toxicities. Further studies are required to clarify the potential toxicities of this combination. Clinicians should consider the potential risks when combining CDK 4/6 inhibitors with palliative RT and individualise patient management accordingly.
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Affiliation(s)
- Steven David
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Monash Cancer Centre, East Bentleigh, VIC, Australia.
| | - Gwo Ho
- Monash Cancer Centre, East Bentleigh, VIC, Australia; School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Daphne Day
- Monash Cancer Centre, East Bentleigh, VIC, Australia; School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Marion Harris
- Monash Cancer Centre, East Bentleigh, VIC, Australia
| | - Jennifer Tan
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Monash Cancer Centre, East Bentleigh, VIC, Australia
| | - Shom Goel
- Department of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, VIC, Australia
| | - Gerard G Hanna
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, VIC, Australia
| | | | - Gill Kruss
- Monash Cancer Centre, East Bentleigh, VIC, Australia
| | - Lachlan McDowell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, VIC, Australia
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Day D, Chia J, Foo E, Ali R, Toh H, Segelov E. 98P Operational challenges of an Asian Pacific (APAC) academic oncology clinical trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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32
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Markman B, Day D, Park J, Coward J, Bishnoi S, Kotasek D, Eek R, Brown M, Lemech C, Kuo J, Prawira A, Strother R, Zhang Q, Wang L, Chen R, Ma Y, Qin Z, Tse A. 1057P Preliminary pharmacokinetics (PK), safety and efficacy of two dosing regimens of CS1003 (anti-PD-1) in solid tumours: 200 mg every 3-week (Q3W) and 400 mg every 6-week (Q6W) dosing. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1177] [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: 10/23/2022] Open
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33
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Day D, Prawira A, Spreafico A, Waldron J, Karithanam R, Giuliani M, Weinreb I, Kim J, Cho J, Hope A, Bayley A, Ringash J, Bratman SV, Jang R, O'Sullivan B, Siu LL, Hansen AR. Phase I trial of alpelisib in combination with concurrent cisplatin-based chemoradiotherapy in patients with locoregionally advanced squamous cell carcinoma of the head and neck. Oral Oncol 2020; 108:104753. [PMID: 32464516 DOI: 10.1016/j.oraloncology.2020.104753] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 05/07/2019] [Revised: 04/11/2020] [Accepted: 04/26/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Deregulation of the PI3K signalling pathway is frequent in squamous cell carcinoma of the head and neck (SCCHN) and may be implicated in radioresistance. We report on the results from a phase I 3 + 3 dose escalation study of alpelisib, a class I α-specific PI3K inhibitor in combination with concurrent cisplatin-based chemoradiation (CRT) in patients with locoregionally advanced SCCHN (LA-SCCHN). METHODS Eligible patients had previously untreated LA-SCCHN and were candidates for CRT. The primary objective was to evaluate safety and determine the recommended phase II dose (RP2D). Alpelisib was given orally once daily at two dose levels: 200 mg and 250 mg. CRT consisted of cisplatin 100 mg/m2 IV every three weeks and standard fractionation radiotherapy (IMRT) 70 Gy in 35 fractions. RESULTS Nine patients were enrolled (six alpelisib 200 mg, three 250 mg). Oropharynx was the primary site in all patients (seven p16-positive; five T1-2N2M0, four T3-4N2-3M0 [AJCC 7th edition]). All patients completed CRT within seven weeks. Grade 3 alpelisib-related toxicities occurred in four patients. No dose-limiting toxicity (DLT) was observed at 200 mg among three DLT-evaluable patients. Two of two DLT-evaluable patients treated at 250 mg experienced DLTs (inability to complete ≥75% alpelisib secondary to radiation dermatitis and febrile neutropenia). Thus, RP2D was declared at 200 mg. After median follow-up of 39.7 months, two patients developed pulmonary metastases despite locoregional control. Three-year overall survival was 77.8% (95% CI 36.5%-93.9%). CONCLUSION Alpelisib at 200 mg has a manageable safety profile in combination with cisplatin-based CRT in LA-SCCHN.
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Affiliation(s)
- D Day
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - A Prawira
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - A Spreafico
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - J Waldron
- Radiation Medicine Program, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - R Karithanam
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - M Giuliani
- Radiation Medicine Program, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - I Weinreb
- Department of Laboratory Medicine and Pathobiology, University Health Network, University of Toronto, Toronto, ON, Canada
| | - J Kim
- Radiation Medicine Program, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - J Cho
- Radiation Medicine Program, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - A Hope
- Radiation Medicine Program, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - A Bayley
- Radiation Medicine Program, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - J Ringash
- Radiation Medicine Program, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - S V Bratman
- Radiation Medicine Program, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - R Jang
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - B O'Sullivan
- Radiation Medicine Program, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - L L Siu
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - A R Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada.
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Day D, Guo C, Kanjanapan Y, Tran B, Spreafico A, Joshua AM, Wang L, Abdul Razak AR, Leighl NB, Hansen AR, Butler MO, Siu LL, Desai J, Bedard PL. Survival in Early Phase Immuno-Oncology Trials: Development and Validation of a Prognostic Index. JNCI Cancer Spectr 2020; 3:pkz071. [PMID: 32337489 PMCID: PMC7050022 DOI: 10.1093/jncics/pkz071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/08/2019] [Accepted: 09/06/2019] [Indexed: 12/18/2022] Open
Abstract
Background Immuno-oncology (IO) is rapidly evolving in early drug development. We aimed to develop and prospectively validate a prognostic index for patients treated in IO phase I trials to assist with patient selection. Methods The development cohort included 192 advanced solid tumor patients treated in 13 IO phase I trials, targeting immune checkpoint and/or co-stimulatory molecules. A prognostic scoring system was developed from multivariate survival analysis of 10 clinical factors, and subsequently validated in two independent validation cohorts (n = 152 and n = 80). Results In the development cohort, median age was 57.5 years (range = 20.4-84.8 years). Median progression-free survival and overall survival (OS) were 13.4 and 73.6 weeks, respectively, 90-day mortality was 16%, and overall response rate was 20%. In multivariate analysis, Eastern Cooperative Oncology Group performance status greater than or equal to 1 (hazard ratio [HR] = 3.2, 95% confidence interval [CI] = 1.8 to 5.7; P < .001), number of metastatic sites greater than 2 (HR = 2.0, 95% CI = 1.3 to 3.1; P = .003), and albumin less than the lower limit of normal (HR = 1.8, 95% CI = 1.2 to 2.7; P = .007) were independent prognostic factors; comprising the Princess Margaret Immuno-oncology Prognostic Index (PM-IPI). Patients with a score of 2-3 compared with patients with a score of 0-1 had shorter OS (HR = 3.4, 95% CI = 1.9 to 6.1; P < .001), progression-free survival (HR = 2.3, 95% CI = 1.7 to 3.2; P < .001), higher 90-day mortality (odds ratio = 8.1, 95% CI = 3.0 to 35.4; P < .001), and lower overall response rate (odds ratio = 0.4, 95% CI = 0.2 to 0.8; P = .019). The PM-IPI retained prognostic ability in both validation cohorts and performed better than previously published phase I prognostic scores for predicting OS in all three cohorts. Conclusions The PM-IPI is a validated prognostic score for patients treated in phase I IO trials and may aid in improving patient selection.
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Affiliation(s)
- Daphne Day
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Christina Guo
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, Melbourne, Australia
| | - Yada Kanjanapan
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Ben Tran
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, Melbourne, Australia
| | - Anna Spreafico
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Anthony M Joshua
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Lisa Wang
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Albiruni R Abdul Razak
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Natasha B Leighl
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Aaron R Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Marcus O Butler
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Lillian L Siu
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Jayesh Desai
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, Melbourne, Australia
| | - Philippe L Bedard
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
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Segelov E, Prenen H, Day D, Macintyre CR, Foo EMJ, Ali R, Wang Q, Wei X, Lopes GDL, Ding K, Chen G, Chia JWK, Toh HC. Impact of the COVID-19 Epidemic on a Pan-Asian Academic Oncology Clinical Trial. JCO Glob Oncol 2020; 6:585-588. [PMID: 32293940 PMCID: PMC7193776 DOI: 10.1200/go.20.00072] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Eva Segelov
- Department of Oncology, Monash Health, and Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Hans Prenen
- Oncology Department, University Hospital Antwerp, Edegem, Belgium
| | - Daphne Day
- Department of Oncology, Monash Health, and Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
| | - C Raina Macintyre
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Raghib Ali
- Public Health Research Centre, New York University, Abu Dhabi, United Arab Emirates
| | - Quanyi Wang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Centre for Disease Prevention and Control, Beijing, People's Republic of China
| | - Xiaoting Wei
- Family Health International Clinical, Beijing, People's Republic of China
| | - Gilberto de Lima Lopes
- Global Oncology Program, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
| | - Kefeng Ding
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Gong Chen
- Department of Colorectal Surgery, Sun Yat-Sen University Cancer Centre, Guangzhou, People's Republic of China
| | | | - Han Chong Toh
- Department of Medical Oncology, National Cancer Centre Singapore, Singapore
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Nowak SH, Armenta R, Schwartz CP, Gallo A, Abraham B, Garcia-Esparza AT, Biasin E, Prado A, Maciel A, Zhang D, Day D, Christensen S, Kroll T, Alonso-Mori R, Nordlund D, Weng TC, Sokaras D. A versatile Johansson-type tender x-ray emission spectrometer. Rev Sci Instrum 2020; 91:033101. [PMID: 32259983 DOI: 10.1063/1.5121853] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/13/2020] [Indexed: 05/23/2023]
Abstract
We present a high energy resolution x-ray spectrometer for the tender x-ray regime (1.6-5.0 keV) that was designed and operated at Stanford Synchrotron Radiation Lightsource. The instrument is developed on a Rowland geometry (500 mm of radius) using cylindrically bent Johansson analyzers and a position sensitive detector. By placing the sample inside the Rowland circle, the spectrometer operates in an energy-dispersive mode with a subnatural line-width energy resolution (∼0.32 eV at 2400 eV), even when an extended incident x-ray beam is used across a wide range of diffraction angles (∼30° to 65°). The spectrometer is enclosed in a vacuum chamber, and a sample chamber with independent ambient conditions is introduced to enable a versatile and fast-access sample environment (e.g., solid/gas/liquid samples, in situ cells, and radioactive materials). The design, capabilities, and performance are presented and discussed.
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Affiliation(s)
- S H Nowak
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - R Armenta
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - C P Schwartz
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - A Gallo
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - B Abraham
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - A T Garcia-Esparza
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - E Biasin
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - A Prado
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - A Maciel
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - D Zhang
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - D Day
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - S Christensen
- National Renewable Energy Laboratory, 15013 Denver West Parkway, Golden, Colorado 80401, USA
| | - T Kroll
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - R Alonso-Mori
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - D Nordlund
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - T-C Weng
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
| | - D Sokaras
- SLAC National Accelerator Laboratory, 2575 Sand Hill Rd., Menlo Park, California 94025, USA
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Kanjanapan Y, Day D, Wang L, Al‐Sawaihey H, Abbas E, Namini A, Siu LL, Hansen A, Razak AA, Spreafico A, Leighl N, Joshua AM, Butler MO, Hogg D, Chappell MA, Soultani L, Chow K, Boujos S, Bedard PL. Hyperprogressive disease in early‐phase immunotherapy trials: Clinical predictors and association with immune‐related toxicities. Cancer 2019; 125:1341-1349. [DOI: 10.1002/cncr.31999] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/21/2018] [Accepted: 12/03/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Yada Kanjanapan
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Daphne Day
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Lisa Wang
- Biostatistics Department, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Hamad Al‐Sawaihey
- Joint Department of Medical Imaging, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Engy Abbas
- Joint Department of Medical Imaging, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Amirali Namini
- Joint Department of Medical Imaging, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Lillian L. Siu
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Aaron Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Albiruni Abdul Razak
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Anna Spreafico
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Natasha Leighl
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Anthony M. Joshua
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Marcus O. Butler
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - David Hogg
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Mary Anne Chappell
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Ludmilla Soultani
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Kayla Chow
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Samantha Boujos
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
| | - Philippe L. Bedard
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
- Drug Development Program, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada
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Ha FJ, Spain L, Dowling A, Kwan EM, Pezaro C, Day D, Chia PL, Tran B, Pook D, Weickhardt AJ. Timing of brain metastases development in metastatic renal cell cancer patients treated with targeted therapies and survival outcomes: An Australian multicenter study. Asia Pac J Clin Oncol 2019; 15:e97-e102. [PMID: 30701671 DOI: 10.1111/ajco.13109] [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] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 10/27/2018] [Indexed: 11/30/2022]
Abstract
AIM Targeted therapy (TT) has improved survival for metastatic renal cell carcinoma (mRCC). However, survival is usually limited if brain metastases (BMs) develop. We aimed to evaluate survival outcomes in mRCC patients based on timing of BM diagnosis. METHODS We conducted a multicenter, retrospective study of mRCC patients with BM who received TT at any point between 2005 and 2014. We determined overall survival (OS) from stage IV diagnosis, TT initiation and BM diagnosis, and prognostic factors. Patients were grouped into three categories: synchronous-BM, metachronous-BM diagnosed while conservatively managed (metachronous-BM before TT) and metachronous-BM diagnosed during TT. Survival was calculated by Kaplan-Meier method and predictors were calculated using Cox hazards regression. RESULTS Incidence of BM was 17% in mRCC patients treated with TT (two centers). Fifty-four mRCC-BM patients were identified from five tertiary centers. Twenty-eight percentage (15/54) had synchronous-BM, 28% (15/54) had metachranous-BM before TT and 44% (24/54) had metachronous-BM during TT. Most had central nervous system (CNS) symptoms at BM diagnosis (78%; 42/54). Median OS from stage IV diagnosis, TT commencement and BM diagnosis was 28 months (95% confidence interval [CI] 16-43), 19 months (95% CI 9-26) and 9 months (95% CI 5-16), respectively. Synchronous-BM group trended toward poorer survival from TT commencement (P = 0.06). Metachronous-BM during TT group had lower survival from BM diagnosis than synchronous-BM and metachronous-BM before TT group (P < 0.001). Eight of 50 deaths (16%) were from neurological complications. The presence of CNS symptoms did not predict worse survival from stage IV diagnosis (P = 0.73). CONCLUSION In patients with mRCC, the development of BM while on TT portends shorter prognosis compared with synchronous diagnosis of BM at stage IV disease or metachronous BM developed prior to commencing TT. The presence of CNS symptoms does not predict worse survival.
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Affiliation(s)
- Francis J Ha
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Hospital, Melbourne, Victoria, Australia
| | - Lavinia Spain
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Hospital, Melbourne, Victoria, Australia
| | - Anthony Dowling
- Department of Medical Oncology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Edmond M Kwan
- Department of Medical Oncology, Monash Health, Melbourne, Victoria, Australia
| | - Carmel Pezaro
- Eastern Health and Monash University, Melbourne, Victoria, Australia
| | - Daphne Day
- Department of Medical Oncology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Puey Ling Chia
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Hospital, Melbourne, Victoria, Australia
| | - Ben Tran
- Department of Medical Oncology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - David Pook
- Department of Medical Oncology, Monash Health, Melbourne, Victoria, Australia
| | - Andrew J Weickhardt
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Hospital, Melbourne, Victoria, Australia
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Armstrong W, Kang H, Liyanage A, Maxwell J, Mulholland J, Ndukum L, Ahmidouch A, Albayrak I, Asaturyan A, Ates O, Baghdasaryan H, Boeglin W, Bosted P, Brash E, Butuceanu C, Bychkov M, Carter P, Chen C, Chen JP, Choi S, Christy ME, Covrig S, Crabb D, Danagoulian S, Daniel A, Davidenko AM, Davis B, Day D, Deconinck W, Deur A, Dunne J, Dutta D, El Fassi L, Ellis C, Ent R, Flay D, Frlez E, Gaskell D, Geagla O, German J, Gilman R, Gogami T, Gomez J, Goncharenko YM, Hashimoto O, Higinbotham D, Horn T, Huber GM, Jones M, Jones MK, Kalantarians N, Kang HK, Kawama D, Keith C, Keppel C, Khandaker M, Kim Y, King PM, Kohl M, Kovacs K, Kubarovsky V, Li Y, Liyanage N, Luo W, Mack D, Mamyan V, Markowitz P, Maruta T, Meekins D, Melnik YM, Meziani ZE, Mkrtchyan A, Mkrtchyan H, Mochalov VV, Monaghan P, Narayan A, Nakamura SN, Nuruzzaman A, Pentchev L, Pocanic D, Posik M, Puckett A, Qiu X, Reinhold J, Riordan S, Roche J, Rondón OA, Sawatzky B, Shabestari M, Slifer K, Smith G, Soloviev LF, Solvignon P, Tadevosyan V, Tang L, Vasiliev AN, Veilleux M, Walton T, Wesselmann F, Wood S, Yao H, Ye Z, Zhang J, Zhu L. Revealing Color Forces with Transverse Polarized Electron Scattering. Phys Rev Lett 2019; 122:022002. [PMID: 30720291 DOI: 10.1103/physrevlett.122.022002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 10/18/2018] [Indexed: 06/09/2023]
Abstract
The Spin Asymmetries of the Nucleon Experiment measured two double spin asymmetries using a polarized proton target and polarized electron beam at two beam energies, 4.7 and 5.9 GeV. A large-acceptance open-configuration detector package identified scattered electrons at 40° and covered a wide range in Bjorken x (0.3<x<0.8). Proportional to an average color Lorentz force, the twist-3 matrix element, d[over ˜]_{2}^{p}, was extracted from the measured asymmetries at Q^{2} values ranging from 2.0 to 6.0 GeV^{2}. The data display the opposite sign compared to most quark models, including the lattice QCD result, and an unexpected scale dependence. Furthermore, when combined with the neutron data in the same Q^{2} range the results suggest a flavor independent average color Lorentz force.
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Affiliation(s)
- W Armstrong
- Temple University, Philadelphia, Pennsylvania 19122, USA
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - H Kang
- Seoul National University, Seoul, South Korea
| | - A Liyanage
- Hampton University, Hampton, Virginia 23669, USA
| | - J Maxwell
- University of Virginia, Charlottesville, Virginia 22904, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Mulholland
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - L Ndukum
- Mississippi State University, Starkville, Mississippi 39759, USA
| | - A Ahmidouch
- North Carolina A&M State University, Greensboro, North Carolina 27411, USA
| | - I Albayrak
- Hampton University, Hampton, Virginia 23669, USA
| | - A Asaturyan
- Yerevan Physics Institute, 0036, Yerevan, Armenia
| | - O Ates
- Hampton University, Hampton, Virginia 23669, USA
| | - H Baghdasaryan
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - W Boeglin
- Florida International University, Miami, Florida 33199, USA
| | - P Bosted
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - E Brash
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - C Butuceanu
- University of Regina, Regina, Saskatchewan, S4S 0A2, Canada
| | - M Bychkov
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - P Carter
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - C Chen
- Hampton University, Hampton, Virginia 23669, USA
| | - J-P Chen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Choi
- Seoul National University, Seoul, South Korea
| | - M E Christy
- Hampton University, Hampton, Virginia 23669, USA
| | - S Covrig
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D Crabb
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - S Danagoulian
- North Carolina A&M State University, Greensboro, North Carolina 27411, USA
| | - A Daniel
- Ohio University, Athens, Ohio 45701, USA
| | - A M Davidenko
- Kurchatov Institute-IHEP, Protvino, Moskva 123098, Russia
| | - B Davis
- North Carolina A&M State University, Greensboro, North Carolina 27411, USA
| | - D Day
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - W Deconinck
- William & Mary, Williamsburg, Virginia 23185, USA
| | - A Deur
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Dunne
- Mississippi State University, Starkville, Mississippi 39759, USA
| | - D Dutta
- Mississippi State University, Starkville, Mississippi 39759, USA
| | - L El Fassi
- Mississippi State University, Starkville, Mississippi 39759, USA
- Rutgers University, New Brunswick, New Jersey 08901, USA
| | - C Ellis
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Ent
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D Flay
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - E Frlez
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - O Geagla
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - J German
- North Carolina A&M State University, Greensboro, North Carolina 27411, USA
| | - R Gilman
- Rutgers University, New Brunswick, New Jersey 08901, USA
| | - T Gogami
- Tohoku University, Tohoku, Miyagi Prefecture 980-8577, Japan
| | - J Gomez
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - O Hashimoto
- Tohoku University, Tohoku, Miyagi Prefecture 980-8577, Japan
| | - D Higinbotham
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Horn
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - G M Huber
- University of Regina, Regina, Saskatchewan, S4S 0A2, Canada
| | - M Jones
- North Carolina A&M State University, Greensboro, North Carolina 27411, USA
| | - M K Jones
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - N Kalantarians
- University of Virginia, Charlottesville, Virginia 22904, USA
- Virginia Union University, Richmond, Virginia 23220, USA
| | - H-K Kang
- Seoul National University, Seoul, South Korea
| | - D Kawama
- Tohoku University, Tohoku, Miyagi Prefecture 980-8577, Japan
| | - C Keith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Keppel
- Hampton University, Hampton, Virginia 23669, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Khandaker
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - Y Kim
- Seoul National University, Seoul, South Korea
| | - P M King
- Ohio University, Athens, Ohio 45701, USA
| | - M Kohl
- Hampton University, Hampton, Virginia 23669, USA
| | - K Kovacs
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - V Kubarovsky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Rensselaer Polytechnic Institute, Troy, New York 12180, USA
| | - Y Li
- Hampton University, Hampton, Virginia 23669, USA
| | - N Liyanage
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - W Luo
- Lanzhou University, Lanzhou, Gansu Sheng, China
| | - D Mack
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - V Mamyan
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - P Markowitz
- Florida International University, Miami, Florida 33199, USA
| | - T Maruta
- Tohoku University, Tohoku, Miyagi Prefecture 980-8577, Japan
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Y M Melnik
- Kurchatov Institute-IHEP, Protvino, Moskva 123098, Russia
| | - Z-E Meziani
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - A Mkrtchyan
- Yerevan Physics Institute, 0036, Yerevan, Armenia
| | - H Mkrtchyan
- Yerevan Physics Institute, 0036, Yerevan, Armenia
| | - V V Mochalov
- Kurchatov Institute-IHEP, Protvino, Moskva 123098, Russia
| | - P Monaghan
- Hampton University, Hampton, Virginia 23669, USA
| | - A Narayan
- Mississippi State University, Starkville, Mississippi 39759, USA
| | - S N Nakamura
- Tohoku University, Tohoku, Miyagi Prefecture 980-8577, Japan
| | - A Nuruzzaman
- Mississippi State University, Starkville, Mississippi 39759, USA
| | - L Pentchev
- William & Mary, Williamsburg, Virginia 23185, USA
| | - D Pocanic
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - M Posik
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - A Puckett
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - X Qiu
- Hampton University, Hampton, Virginia 23669, USA
| | - J Reinhold
- Florida International University, Miami, Florida 33199, USA
| | - S Riordan
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - J Roche
- Ohio University, Athens, Ohio 45701, USA
| | - O A Rondón
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - B Sawatzky
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - M Shabestari
- University of Virginia, Charlottesville, Virginia 22904, USA
- Mississippi State University, Starkville, Mississippi 39759, USA
| | - K Slifer
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - G Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - L F Soloviev
- Kurchatov Institute-IHEP, Protvino, Moskva 123098, Russia
| | - P Solvignon
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - V Tadevosyan
- Yerevan Physics Institute, 0036, Yerevan, Armenia
| | - L Tang
- Hampton University, Hampton, Virginia 23669, USA
| | - A N Vasiliev
- Kurchatov Institute-IHEP, Protvino, Moskva 123098, Russia
| | - M Veilleux
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - T Walton
- Hampton University, Hampton, Virginia 23669, USA
| | - F Wesselmann
- Xavier University, New Orleans, Louisiana 70125, USA
| | - S Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - H Yao
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - Z Ye
- Hampton University, Hampton, Virginia 23669, USA
| | - J Zhang
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - L Zhu
- Hampton University, Hampton, Virginia 23669, USA
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Kanjanapan Y, Day D, Butler MO, Wang L, Joshua AM, Hogg D, Leighl NB, Razak ARA, Hansen AR, Boujos S, Chappell M, Chow K, Sherwin B, Stayner LA, Soultani L, Zambrana A, Siu LL, Bedard PL, Spreafico A. Delayed immune-related adverse events in assessment for dose-limiting toxicity in early phase immunotherapy trials. Eur J Cancer 2018; 107:1-7. [PMID: 30529898 DOI: 10.1016/j.ejca.2018.10.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [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: 06/26/2018] [Revised: 10/29/2018] [Accepted: 10/31/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Immunotherapy (IO) agents can cause late-onset immune-related adverse events (irAEs). In phase I trials, observation for dose-limiting toxicities (DLTs) is typically limited to the first cycle. The incidence of delayed-onset DLTs and their potential impact on dose determination have not been fully elucidated. PATIENTS AND METHODS Consecutive patients enrolled in early phase IO trials at Princess Margaret Cancer Centre between August 2012 and September 2016 were retrospectively reviewed, applying trial-specific definitions for DLTs. A clinically significant AE (csAE) was defined as a treatment-related adverse event requiring corticosteroids, hormone replacement, IO delay or discontinuation. RESULTS A total of 352 consecutive trial enrolments in 21 early phase clinical trials were included. Two-hundred seventy-eight patients (79%) received monotherapy and 74 (21%) received combination IO. Two hundred sixty (74%) patients experienced irAEs. There were two protocol-defined DLTs. Twenty (5.7%) patients had 24 csAEs qualifying as DLTs except for occurrence after the protocol-specified DLT period. One-hundred and six (10%) of irAEs were csAEs, including endocrine (26%), respiratory (14%), gastrointestinal (11%), general (10%), dermatological (8%), hepatic (8%), musculoskeletal (6%), pancreatic (6%), haematological, metabolic, neurological, cardiac (each 2%), infective and ocular (each 1%) events. The highest risk of first-onset csAE was during the first 4 weeks compared with the period from 4 weeks to end of treatment (odds ratio 3.13, 95% confidence interval 1.95-5.02). The median time to first onset csAE was significantly shorter with combination than monotherapy IO (32 vs. 146 days, P < 0.001). CONCLUSIONS In our series of early phase IO trials, the risk of csAE was highest during the initial 4 weeks on IO treatment, supporting the use of the conventional DLT period for dose escalation decision. However, there were 24 clinically significant late-onset DLTs in 5.7% of patients. Combination IO was associated with greater risk of and also earlier onset for csAE, which may need to be considered for early phase trial design.
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Affiliation(s)
- Y Kanjanapan
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - D Day
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - M O Butler
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - L Wang
- Biostatistics Department, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - A M Joshua
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - D Hogg
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - N B Leighl
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - A R Abdul Razak
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - A R Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - S Boujos
- Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - M Chappell
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - K Chow
- Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - B Sherwin
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - L-A Stayner
- Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - L Soultani
- Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - A Zambrana
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - L L Siu
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - P L Bedard
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - A Spreafico
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Drug Development Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
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Rudin C, Pandha H, Gupta S, Zibelman M, Akerley W, Day D, Hill A, Sanborn R, O'Day S, Clay T, Wright G, Jennens R, Gerber D, Rosenberg J, Ralph C, Campbell D, Curti B, Schmidt E, Grose M, Shafren D. Phase Ib KEYNOTE-200: A study of an intravenously delivered oncolytic virus, coxsackievirus A21 in combination with pembrolizumab in advanced NSCLC and bladder cancer patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.050] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Redgrave J, Day D, Leung H, Laud PJ, Ali A, Lindert R, Majid A. Safety and tolerability of Transcutaneous Vagus Nerve stimulation in humans; a systematic review. Brain Stimul 2018; 11:1225-1238. [PMID: 30217648 DOI: 10.1016/j.brs.2018.08.010] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/19/2018] [Accepted: 08/17/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Transcutaneous Vagus Nerve stimulation (tVNS) may be an alternative to surgically implanted VNS for epilepsy and other diseases. However, its safety and tolerability profile is unclear. OBJECTIVE We performed a systematic review of treatment harms from tVNS in humans. METHODS A systematic published and grey literature search was carried out to identify studies which deployed tVNS in human subjects. Study authors were contacted for safety/tolerability data if these were not available in the publication. Databases were searched from 1966 to May 2017. We noted study type, population, stimulation parameters, type and prevalence of side effects and/or serious adverse events (SAE). We also noted whether side effects/SAE were considered to be related to the tVNS and the proportion of participants dropping out of studies due to side effects. RESULTS 51 studies were included comprising a total of 1322 human subjects receiving tVNS. The most common side effects were: local skin irritation from electrode placement (240 participants, 18.2%), headache (47, 3.6%) and nasopharyngitis (23, 1.7%). Whilst heterogeneity in overall side effect event rates between studies was not accounted for by the frequency (Hz) or pulse width (ms) of stimulation, a minority (35 participants (2.6%)) dropped out of studies due to side effects. Overall, 30 SAE occurred but only 3 were assessed by the relevant researchers to be possibly caused by tVNS. CONCLUSION tVNS is safe and well tolerated at the doses tested in research studies to date.
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Affiliation(s)
- J Redgrave
- Sheffield Institute of Translational Neuroscience, Department of Neuroscience, University of Sheffield, UK.
| | - D Day
- Sheffield Institute of Translational Neuroscience, Department of Neuroscience, University of Sheffield, UK
| | - H Leung
- Sheffield Institute of Translational Neuroscience, Department of Neuroscience, University of Sheffield, UK
| | - P J Laud
- Sheffield Institute of Translational Neuroscience, Department of Neuroscience, University of Sheffield, UK
| | - A Ali
- Department of Geriatrics and Stroke, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - R Lindert
- Sheffield Institute of Translational Neuroscience, Department of Neuroscience, University of Sheffield, UK
| | - A Majid
- Sheffield Institute of Translational Neuroscience, Department of Neuroscience, University of Sheffield, UK
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Khoja L, Day D, Wei-Wu Chen T, Siu LL, Hansen AR. Tumour- and class-specific patterns of immune-related adverse events of immune checkpoint inhibitors: a systematic review. Ann Oncol 2018; 28:2377-2385. [PMID: 28945858 DOI: 10.1093/annonc/mdx286] [Citation(s) in RCA: 518] [Impact Index Per Article: 86.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Immune checkpoint inhibitor (ICI) monoclonal antibodies (mAbs) targeting cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed cell death protein 1 (PD-1) or its ligand (PD-L1) produce unique toxicity profiles. The objective of this review was to identify patterns and incidence of immune-related adverse events (irAE) based on tumour type and ICI class. Methods Medline, EMBASE and COCHRANE databases were searched to identify prospective monotherapy trials of ICIs from 2003 to November 2015. Paired reviewers selected studies for inclusion and extracted data. Odds ratio (OR), χ2 tests and multivariable regression models were used to analyse for effect size and associations. Results We identified 48 trials (6938 patients), including 26 CTLA-4, 17 PD-1, 2 PD-L1 trials, and 3 studies tested both CTLA-4 and PD-1. Grade 3/4 irAE were more common with CTLA-4 mAbs compared with PD-1 (31% versus 10%). All grades colitis (OR 8.7, 95% CI 5.8-12.9), hypophysitis (OR 6.5, 95% CI 3.0-14.3) and rash (OR 2.0, 95% CI 1.8-2.3) were more frequent with CTLA-4 mAbs; whereas pneumonitis (OR 6.4, 95% CI 3.2-12.7), hypothyroidism (OR 4.3, 95% CI 2.9-6.3), arthralgia (OR 3.5, 95% CI 2.6-4.8) and vitiligo (OR 3.5, 95% CI 2.3-5.3) were more common with PD-1 mAbs. Comparison of irAE from the three most studied tumour types in PD-1 mAbs trials [melanoma (n = 2048), non-small-cell lung cancer (n = 1030) and renal cell carcinoma (n = 573)] showed melanoma patients had a higher frequency of gastrointestinal and skin irAE and lower frequency of pneumonitis. Discussion CTLA-4 and PD-1 mAbs have distinct irAE profiles. Different immune microenvironments may drive histology-specific irAE patterns. Other tumour-dependent irAE profiles may be identified as data emerge from ICI trials.
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Affiliation(s)
- L Khoja
- Clinical Development Unit, Early Clinical Development, AstraZeneca UK plc, Melbourn Science Park, Melbourn, Hertfordshire;; Medical Oncology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - D Day
- Drug Development Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto;; Department of Medicine, University of Toronto, Toronto;; Ontario Institute for Cancer Research (OICR), Toronto, Canada
| | - T Wei-Wu Chen
- Department of Oncology, National Taiwan University Hospital, Taipei;; National Taiwan University Cancer Center, Taipei;; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - L L Siu
- Drug Development Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto;; Department of Medicine, University of Toronto, Toronto
| | - A R Hansen
- Drug Development Program, Division of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto;; Department of Medicine, University of Toronto, Toronto;.
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Kanjanapan Y, Day D, Wang L, Hansen AR, Abdul Razak AR, Spreafico A, Leighl NB, Joshua AM, Butler MO, Hogg D, Siu LL, Bedard PL. Hyperprogressive disease (HPD) in early-phase immunotherapy (IO) trials. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.3063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Yada Kanjanapan
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Daphne Day
- Royal Melbourne Hospital, Surrey Hills, Australia
| | - Lisa Wang
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | | | | | | | - Anthony M. Joshua
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Marcus O. Butler
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - David Hogg
- Princess Margaret Cancer Centre, Toronto, ON, Canada
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Wann A, Luen S, Day D, Spain L, O'Callaghan C, Yeo B, White S. Breath alcohol concentrations in patients undergoing taxane chemotherapy: An observational pilot study (BrACT study). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx676.006] [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: 11/14/2022] Open
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Mustard M, Day D, Lewis E. EVERY PATIENT MUST HAVE A DESTINATION: TRANSITIONING CARE WITHIN THE INTENSIVE CARE UNIT. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.469] [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] Open
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Kanjanapan Y, Day D, Butler M, Wang L, Joshua A, Hogg D, Leighl N, Razak A, Hansen A, Boujos S, Chappell M, Chow K, Paolo M, Sherwin B, Stayner LA, Soultani L, Zambrana A, Siu L, Bedard P, Spreafico A. Immune related adverse events (irAEs) in early phase immunotherapy (IO) trials: Implications for recommended phase 2 dose (RP2D) determination. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx367.030] [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: 11/12/2022] Open
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Day D, Monjazeb AM, Sharon E, Ivy SP, Rubin EH, Rosner GL, Butler MO. From Famine to Feast: Developing Early-Phase Combination Immunotherapy Trials Wisely. Clin Cancer Res 2017; 23:4980-4991. [PMID: 28864726 PMCID: PMC5736967 DOI: 10.1158/1078-0432.ccr-16-3064] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 03/12/2017] [Revised: 06/08/2017] [Accepted: 07/07/2017] [Indexed: 12/29/2022]
Abstract
Not until the turn of this century has immunotherapy become a fundamental component of cancer treatment. While monotherapy with immune modulators, such as immune checkpoint inhibitors, provides a subset of patients with durable clinical benefit and possible cure, combination therapy offers the potential for antitumor activity in a greater number of patients. The field of immunology has provided us with a plethora of potential molecules and pathways to target. This abundance makes it impractical to empirically test all possible combinations efficiently. We recommend that potential immunotherapy combinations be chosen based on sound rationale and available data to address the mechanisms of primary and acquired immune resistance. Novel trial designs may increase the proportion of patients receiving potentially efficacious treatments and, at the same time, better define the balance of clinical activity and safety. We believe that implementing a strategic approach in the early development of immunotherapy combinations will expedite the delivery of more effective therapies with improved safety and durable outcomes.
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Affiliation(s)
- Daphne Day
- Drug Development Program, Division of Medical Oncology & Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Arta M Monjazeb
- Department of Radiation Oncology, UC Davis Comprehensive Cancer Center, Sacramento, California
| | - Elad Sharon
- Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, Maryland
| | - S Percy Ivy
- Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, Maryland
| | - Eric H Rubin
- Merck Research Laboratories, Merck & Co., Inc., Kenilworth, New Jersey
| | - Gary L Rosner
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Marcus O Butler
- Drug Development Program, Division of Medical Oncology & Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Day D, Locke G, Chan K, Cheng S, Wang L, O'Sullivan B, Hansen A. Hyperfractionated twice daily re-irradiation (bid re-RT) and chemotherapy (CT) for locoregionally recurrent head and neck squamous cell carcinoma (LR HNSCC): A systematic review (SR). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx374.022] [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: 11/13/2022] Open
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Wong HL, Luechtefeld T, Prawira A, Patterson Z, Workman J, Day D, Chooback N, Nappi L, Samawi H, Lavoie JM, Spreafico A, Hansen A, Sahebjam S, Siu L, Ivy S, Paller C, Renouf D. Development of a web-based application using machine learning algorithms to facilitate systematic literature reviews. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx385.023] [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: 11/12/2022] Open
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