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Francini E, Ou FS, Rhoades J, Wolfe EG, O’Connor EP, Ha G, Gydush G, Kelleher KM, Bhatt RS, Balk SP, Sweeney CJ, Adalsteinsson VA, Taplin ME, Choudhury AD. Circulating Cell-Free DNA as Biomarker of Taxane Resistance in Metastatic Castration-Resistant Prostate Cancer. Cancers (Basel) 2021; 13:4055. [PMID: 34439209 PMCID: PMC8391478 DOI: 10.3390/cancers13164055] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/10/2021] [Indexed: 11/17/2022] Open
Abstract
There are no biomarkers predictive of resistance to docetaxel or cabazitaxel validated for patients with metastatic castration-resistant prostate cancer (mCRPC). We assessed the association between ABCB1 amplification and primary resistance to docetaxel or cabazitaxel for patients with mCRPC, using circulating cell-free DNA (cfDNA). Patients with ≥1 plasma sample drawn within 12 months before starting docetaxel (cohort A) or cabazitaxel (cohort B) for mCRPC were identified from the Dana-Farber Cancer Institute IRB approved database. Sparse whole genome sequencing was performed on the selected cfDNA samples and tumor fractions were estimated using the computational tool ichorCNA. We evaluated the association between ABCB1 amplification or other copy number alterations and primary resistance to docetaxel or cabazitaxel. Of the selected 176 patients, 45 samples in cohort A and 21 samples in cohort B had sufficient tumor content. No significant association was found between ABCB1 amplification and primary resistance to docetaxel (p = 0.58; odds ratio (OR) = 1.49) or cabazitaxel (p = 0.97; OR = 1.06). No significant association was found between exploratory biomarkers and primary resistance to docetaxel or cabazitaxel. In this study, ABCB1 amplification did not predict primary resistance to docetaxel or cabazitaxel for mCRPC. Future studies including ABCB1 amplification in a suite of putative biomarkers and a larger cohort may aid in drawing definitive conclusions.
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Affiliation(s)
- Edoardo Francini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; (E.P.O.); (G.H.); (K.M.K.); (C.J.S.); (M.-E.T.); (A.D.C.)
| | - Fang-Shu Ou
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA; (F.-S.O.); (E.G.W.)
| | - Justin Rhoades
- Eli and Edythe L. Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; (J.R.); (G.G.); (V.A.A.)
| | - Eric G. Wolfe
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA; (F.-S.O.); (E.G.W.)
| | - Edward P. O’Connor
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; (E.P.O.); (G.H.); (K.M.K.); (C.J.S.); (M.-E.T.); (A.D.C.)
| | - Gavin Ha
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; (E.P.O.); (G.H.); (K.M.K.); (C.J.S.); (M.-E.T.); (A.D.C.)
- Eli and Edythe L. Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; (J.R.); (G.G.); (V.A.A.)
| | - Gregory Gydush
- Eli and Edythe L. Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; (J.R.); (G.G.); (V.A.A.)
| | - Kaitlin M. Kelleher
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; (E.P.O.); (G.H.); (K.M.K.); (C.J.S.); (M.-E.T.); (A.D.C.)
| | - Rupal S. Bhatt
- Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (R.S.B.); (S.P.B.)
| | - Steven P. Balk
- Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; (R.S.B.); (S.P.B.)
| | - Christopher J. Sweeney
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; (E.P.O.); (G.H.); (K.M.K.); (C.J.S.); (M.-E.T.); (A.D.C.)
| | - Viktor A. Adalsteinsson
- Eli and Edythe L. Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; (J.R.); (G.G.); (V.A.A.)
| | - Mary-Ellen Taplin
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; (E.P.O.); (G.H.); (K.M.K.); (C.J.S.); (M.-E.T.); (A.D.C.)
| | - Atish D. Choudhury
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; (E.P.O.); (G.H.); (K.M.K.); (C.J.S.); (M.-E.T.); (A.D.C.)
- Eli and Edythe L. Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; (J.R.); (G.G.); (V.A.A.)
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Lee S, Zhang S, Ma C, Ou FS, Wolfe EG, Ogino S, Niedzwiecki D, Saltz LB, Mayer RJ, Mowat RB, Whittom R, Hantel A, Benson A, Atienza D, Messino M, Kindler H, Venook A, Gross CP, Irwin ML, Meyerhardt JA, Fuchs CS. Race, Income, and Survival in Stage III Colon Cancer: CALGB 89803 (Alliance). JNCI Cancer Spectr 2021; 5:pkab034. [PMID: 34104867 PMCID: PMC8178799 DOI: 10.1093/jncics/pkab034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/10/2020] [Accepted: 02/19/2021] [Indexed: 01/01/2023] Open
Abstract
Background Disparities in colon cancer outcomes have been reported across race and socioeconomic status, which may reflect, in part, access to care. We sought to assess the influences of race and median household income (MHI) on outcomes among colon cancer patients with similar access to care. Methods We conducted a prospective, observational study of 1206 stage III colon cancer patients enrolled in the CALGB 89803 randomized adjuvant chemotherapy trial. Race was self-reported by 1116 White and 90 Black patients at study enrollment; MHI was determined by matching 973 patients’ home zip codes with publicly available US Census 2000 data. Multivariate analyses were adjusted for baseline sociodemographic, clinical, dietary, and lifestyle factors. All statistical tests were 2-sided. Results Over a median follow-up of 7.7 years, the adjusted hazard ratios for Blacks (compared with Whites) were 0.94 (95% confidence interval [CI] = 0.66 to 1.35, P = .75) for disease-free survival, 0.91 (95% CI = 0.62 to 1.35, P = .65) for recurrence-free survival, and 1.07 (95% CI = 0.73 to 1.57, P = .73) for overall survival. Relative to patients in the highest MHI quartile, the adjusted hazard ratios for patients in the lowest quartile were 0.90 (95% CI = 0.67 to 1.19, Ptrend = .18) for disease-free survival, 0.89 (95% CI = 0.66 to 1.22, Ptrend = .14) for recurrence-free survival, and 0.87 (95% CI = 0.63 to 1.19, Ptrend = .23) for overall survival. Conclusions In this study of patients with similar health-care access, no statistically significant differences in outcomes were found by race or MHI. The substantial gaps in outcomes previously observed by race and MHI may not be rooted in differences in tumor biology but rather in access to quality care.
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Affiliation(s)
| | - Sui Zhang
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Chao Ma
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Fang-Shu Ou
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, USA
| | - Eric G Wolfe
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, USA
| | - Shuji Ogino
- Department of Oncologic Pathology, Dana-Farber/Partners CancerCare and Harvard Medical School, Boston, MA, USA.,Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Donna Niedzwiecki
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | | | - Robert J Mayer
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Rex B Mowat
- Toledo Community Hospital Oncology Program, Toledo, OH, USA
| | | | - Alexander Hantel
- Loyola University Stritch School of Medicine, Naperville, IL, USA
| | - Al Benson
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | | | - Michael Messino
- Southeast Clinical Oncology Research Consortium, Mission Hospitals, Asheville, NC, USA
| | - Hedy Kindler
- University of Chicago Comprehensive Cancer Center, Chicago, IL, USA
| | - Alan Venook
- University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA, USA
| | - Cary P Gross
- Yale School of Medicine, Department of Internal Medicine, New Haven, CT, USA
| | | | - Jeffrey A Meyerhardt
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Charles S Fuchs
- Yale School of Medicine, New Haven, CT, USA.,Yale Cancer Center, Smilow Cancer Hospital and Yale School of Medicine, New Haven, CT, USA.,Genentech, South San Francisco, CA, USA
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3
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Francini E, Ou FS, Lazzi S, Petrioli R, Multari AG, Pesola G, Messuti L, Colombo E, Livellara V, Bazzurri S, Cherri S, Miano ST, Wolfe EG, Alberts SR, Hubbard JM, Yoon HH, Francini G. The prognostic value of CD3+ tumor-infiltrating lymphocytes for stage II colon cancer according to use of adjuvant chemotherapy: A large single-institution cohort study. Transl Oncol 2020; 14:100973. [PMID: 33338878 PMCID: PMC7750416 DOI: 10.1016/j.tranon.2020.100973] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 11/28/2022] Open
Abstract
Low CD3+ TILs rate was associated with shorter OS in those with stage II colon cancer who did not receive adjuvant therapy. CD3+ TILs rate was not prognostic for patients with stage II colon cancer who had adjuvant therapy. Low CD3+ TILs rate may be an additional risk factor for stage II colon cancer patients who did not have adjuvant therapy yet.
Background High tumor infiltrating lymphocytes (TILs) density was previously shown to be associated with favorable prognosis for patients with colon cancer (CC). However, the impact of TILs on overall survival (OS) of stage II CC patients who received adjuvant chemotherapy (ADJ) or not (no-ADJ) is unknown. We assessed the prognostic value of CD3+ TILs in stage II CC patients according to whether they had ADJ or not. Methods Patients treated with curative surgery for stage II CC (2002–2013) were selected from the Santa Maria alle Scotte Hospital registry. TILs at the invasive front, center of tumor, and stroma were determined by immunohistochemistry and manually quantified as the rate of TILs/total tissue areas. High TILs (H-TILs) was defined as >20%. Patients were categorized as high or low TILs (L-TILs) and ADJ or no-ADJ. Results Of the 678 patients included, 137 (20%) received ADJ and 541 (80%) did not. The distribution of the 4 groups were: 16% (L-TIL/ADJ), 64% (L-TIL/no-ADJ), 5% (H-TIL/ADJ), 15% (H-TIL/no-ADJ). Compared to H-TILs/no-ADJ, ADJ patients showed a significantly increased OS (P<.01) regardless of the TILs rate whereas L-TILs/no-ADJ had significantly decreased OS and higher risk of death (HR=1.41; 95% CI, 1.06–1.88; P<.0001). On multivariable analysis, the unfavorable prognostic value of L-TILs (vs. H-TILs) for no-ADJ patients was confirmed (HR=1.36; 95% CI 1.02, 1.82; P=.0373). Conclusion Low CD3+ TILs rate was associated with shorter OS in those with stage II colon cancer who did not receive adjuvant therapy. Low CD3+ TILs could be considered an additional risk factor for still ADJ-untreated stage II CC patients, which could facilitate clinical decision making.
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Affiliation(s)
- Edoardo Francini
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy.
| | | | - Stefano Lazzi
- Department of Human Pathology and Oncology, University of Siena, Siena, Italy
| | | | | | | | | | | | | | | | - Sara Cherri
- Santa Maria Alle Scotte Hospital, Siena, Italy
| | | | | | | | | | | | - Guido Francini
- Department of Medical and Surgical Sciences and Neuroscience, University of Siena, Siena, Italy
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Van Blarigan EL, Zhang S, Ou FS, Venlo A, Ng K, Atreya C, Van Loon K, Niedzwiecki D, Giovannucci E, Wolfe EG, Lenz HJ, Innocenti F, O'Neil BH, Shaw JE, Polite BN, Hochster HS, Atkins JN, Goldberg RM, Mayer RJ, Blanke CD, O'Reilly EM, Fuchs CS, Meyerhardt JA. Association of Diet Quality With Survival Among People With Metastatic Colorectal Cancer in the Cancer and Leukemia B and Southwest Oncology Group 80405 Trial. JAMA Netw Open 2020; 3:e2023500. [PMID: 33125497 PMCID: PMC7599454 DOI: 10.1001/jamanetworkopen.2020.23500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Diet has been associated with survival in patients with stage I to III colorectal cancer, but data on patients with metastatic colorectal cancer are limited. OBJECTIVE To examine the association between diet quality and overall survival among individuals with metastatic colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This was a prospective cohort study of patients with metastatic colorectal cancer who were enrolled in the Cancer and Leukemia Group B (Alliance) and Southwest Oncology Group 80405 trial between October 27, 2005, and February 29, 2012, and followed up through January 2018. EXPOSURES Participants completed a validated food frequency questionnaire within 4 weeks after initiation of first-line treatment for metastatic colorectal cancer. Diets were categorized according to the Alternative Healthy Eating Index (AHEI), Alternate Mediterranean Diet (AMED) score, Dietary Approaches to Stop Hypertension (DASH) score, and Western and prudent dietary patterns derived using principal component analysis. Participants were categorized into sex-specific quintiles. MAIN OUTCOMES AND MEASURES Multivariable hazard ratios (HRs) and 95% CIs for overall survival. RESULTS In this cohort study of 1284 individuals with metastatic colorectal cancer, the median age was 59 (interquartile range [IQR]: 51-68) years, median body mass index was 27.2 (IQR, 24.1-31.4), 521 (41%) were female, and 1102 (86%) were White. There were 1100 deaths during a median follow-up of 73 months (IQR, 64-87 months). We observed an inverse association between the AMED score and risk of death (HR quintile 5 vs quintile 1, 0.83; 95% CI, 0.67-1.04; P = .04 for trend), but the point estimates were not statistically significant. None of the other diet scores or patterns were associated with overall survival. CONCLUSIONS AND RELEVANCE In this prospective analysis of patients with metastatic colorectal cancer, diet quality assessed at initiation of first-line treatment for metastatic disease was not associated with overall survival.
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Affiliation(s)
- Erin L Van Blarigan
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Sui Zhang
- Dana-Farber/Partners CancerCare, Boston, Massachusetts
| | - Fang-Shu Ou
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, Minnesota
| | - Alan Venlo
- Department of Medicine, University of California, San Francisco
| | - Kimmie Ng
- Dana-Farber/Partners CancerCare, Boston, Massachusetts
| | - Chloe Atreya
- Department of Medicine, University of California, San Francisco
| | | | - Donna Niedzwiecki
- Alliance Statistics and Data Center, Duke University, Durham, North Carolina
| | - Edward Giovannucci
- Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eric G Wolfe
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, Minnesota
| | - Heinz-Josef Lenz
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles
| | - Federico Innocenti
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy; Department of Medicine-Hematology, University of North Carolina at Chapel Hill
| | - Bert H O'Neil
- Simon Cancer Center, Indiana University School of Medicine, Indianapolis
| | | | - Blase N Polite
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Howard S Hochster
- Department of Medical Oncology, Yale University School of Medicine, New Haven, Connecticut
| | - James N Atkins
- Southeast Clinical Oncology Research Consortium, Winston-Salem, North Carolina
| | | | | | - Charles D Blanke
- SWOG Group Chair's Office, Knight Cancer Institute, Oregon Health & Science University, Portland
| | | | - Charles S Fuchs
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut
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Cathcart-Rake EJ, Zahrieh D, Smith DS, Young S, Wolfe EG, O'Connor A, Thome S, Lacouture ME, Register T, Piens J, McCue S, Loprinzi CL. Nasal vestibulitis: An MNCCTN natural history trial—Nasal vestibulitis symptoms associated with paclitaxel, docetaxel, and other chemotherapy agents. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e24086] [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
e24086 Background: Nasal vestibulitis has been infrequently described as a side effect of cancer-directed therapy; however, a preliminary study reported that 71% of patients undergoing taxane chemotherapy experienced nasal vestibulitis symptoms. This natural history trial describes the incidence, characteristics, and severity of nasal vestibulitis symptoms among patients undergoing paclitaxel, docetaxel, and non-taxane chemotherapy. Methods: Eligible participants who reported baseline (prior to starting chemotherapy) nasal symptoms ≤ 2 on a 10-point scale were enrolled in this trial upon initiation of a new treatment regimen, involving paclitaxel or docetaxel, or non-taxane chemotherapy. Participants completed nasal symptom logs each time they received a dose of therapy until either the regimen was stopped or four months had passed. The proportion of patients reporting new nasal symptoms was estimated within each cohort with the 95% exact confidence interval (CI). A cumulative incidence model was utilized to quantify the incidence of treatment-emergent nasal symptoms within each cohort, while controlling for age, sex, smoking history, and history of asthma or allergies. Results: Thirty-five participants received paclitaxel, 21 received docetaxel, and 25 received other types of chemotherapy. 86.4% of participants were female, mean age was 60.2 ± 11.2 years; 93.8% of participants completed 2 or more surveys. A higher percentage of participants in the paclitaxel cohort experienced new nasal vestibulitis symptoms than participants in the other two cohorts. The percentage (95% CI) of participants with nasal symptoms, for patients receiving paclitaxel, docetaxel, and non-taxane chemotherapy were 74.3% (56.7%, 87.5%), 47.6% (25.7%, 70.2%), and 44.0% (24.4%, 65.1%), respectively. Epistaxis was reported by 60% of participants in the paclitaxel cohort. Paclitaxel-receiving participants also reported nasal dryness (48.6%), scabbing (40.0%), and pain (20.0%). Nearly half of participants reported moderate symptoms (4-7 out of a 10-point scale), with 8.6% reporting symptoms as severe (8-10 on a 10-point scale). Conclusions: Nasal vestibulitis is a common side effect of chemotherapy, especially paclitaxel chemotherapy.
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Haugen B, French J, Worden FP, Konda B, Sherman EJ, Dadu R, Gianoukakis AG, Wolfe EG, Foster NR, Bowles DW, Wirth LJ. Lenvatinib plus pembrolizumab combination therapy in patients with radioiodine-refractory (RAIR), progressive differentiated thyroid cancer (DTC): Results of a multicenter phase II international thyroid oncology group trial. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.6512] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
6512 Background: Lenvatinib is an approved therapy for patients with RAIR DTC. While the overall response rate (ORR) is high, few patients achieve a complete response (CR) and most patients eventually have progressive disease (PD). Combination lenvatinib and pembrolizumab is being explored in many different cancers, and this combination has been approved for advanced endometrial carcinoma. Methods: Patients with RAIR DTC with Response Evaluation Criteria in Solid Tumor (RECIST v1.1) measurable PD (<14 months (mo) prior to registration) were enrolled in this single-arm multicenter phase II study. Patients were excluded if they had received previous VEGFR-directed multikinase therapy. The lenvatinib starting dose was 20 mg/day orally and pembrolizumab was 200mg IV every 3 weeks. The primary endpoint was CR. ORR, progression-free survival (PFS) and safety graded by Common Terminology Criteria for Adverse Events v4.0 were secondary endpoints. Results: Thirty patients were enrolled. The median age was 62.5 years, and 53% of the patients were women. Seventy percent of patients had grade 3 adverse events (AEs) and 10 percent had grade 4 AEs. There were no treatment-related deaths. The most common > grade 3 AEs were hypertension (47%), weight loss (13%), maculopapular rash (13%), leukopenia (7%), diarrhea (7%) and oral mucositis (7%). Twenty-one patients (70%) required lenvatinib dose reduction. Of 29 evaluable patients, 18 (62%) had a partial response (PR) and 10 (35%) had stable disease (SD). The clinical benefit rate (ORR +SD) was 97%. Median time to tumor nadir was 7.4 mo (1.6-17.8 mo). Median PFS was not yet reached. The PFS at 12 months was 74%. Median time on therapy was 9.9 mo (3.2-18.9 mo). Fourteen patients are continuing therapy (7.6-18.9 mo). Six of these patients (43%) have not yet reached tumor size nadir. Three patients (10%) had > 80% target tumor shrinkage. Conclusions: Lenvatinib plus pembrolizumab is reasonably tolerated in patients with RAIR DTC. To date, there have been no documented complete responses. Combination lenvatinib plus pembrolizumab therapy has a high ORR in patients with RAIR DTC. Continuation of this study will help determine the depth and length of the responses. Clinical trial information: NCT02973997 .
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Affiliation(s)
| | | | | | - Bhavana Konda
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | | | - Ramona Dadu
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | - Lori J. Wirth
- Massachusetts General Hospital Cancer Center and Harvard University, Boston, MA
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Francini E, Ou FS, Rhoades J, Wolfe EG, O'Connor E, Ha G, Gregory G, Kelleher K, Bhatt RS, Balk SP, Sweeney C, Adalsteinsson V, Taplin ME, Choudhury AD. Circulating-free DNA (cfDNA) as biomarker of taxane resistance in metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.174] [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
174 Background: Docetaxel (D) and cabazitaxel (C) are standard chemotherapies for mCRPC. A reliable biomarker predictive of resistance to D or C is yet to be identified. We aimed to assess the association between genetic amplification of the multidrug resistance transporter ABCB1 (ABCB1 amp) and primary resistance (RES) to D or C for mCRPC, using cfDNA. Methods: A cohort (A) of 136 patients (pts) with at least 1 plasma sample drawn and stored within 1 year prior to starting D for mCRPC (2002-2014) and a cohort (B) of 42 pts with at least 1 plasma sample from within 1 year prior to starting C for mCRPC (2010-2016) were identified from the Dana-Farber Cancer Institute IRB approved database. Whole genome sequencing (WGS) at 0.1x coverage, termed ultra-low pass WGS (ULP-WGS), was performed on cfDNA extracted from the selected samples (1000μL/subject) and sequencing data were analyzed using a tool called ichorCNA to identify cases with sufficient tumor DNA content (>7%) for accurate detection of copy number alterations (CNAs) including ABCB1 amp. Primary objective was the association between ABCB1 amp and RES to D or C. RES was defined as lack of response (no PSA50 decline or radiologic response per RECIST criteria 1.1, within 4 months from treatment start). Odds ratio (OR) was used to compare odds of RES to D or C for pts with ABCB1 amp and P-values were calculated by Fisher’s exact test. Results: Of the selected 178 pts, 66 had tumor fraction >7%: 45 pts in cohort A and 21 in cohort B. No significant association was noted between ABCB1 amp and RES to D (P=0.7123; OR=1.600) or C (P=1.000; OR=1.0606). RES was observed in 26 pts (57.8%) of cohort A and 18 (85.7%) of cohort B. ABCB1 amp was found in 9 pts (20%; 95% CI, 9.6-34.6) in group A and 6 of them (66%) had RES to D. ABCB1 amp rate among D-resistant men was 23.1% (95% CI, 9.0-43.7). In group B, 2 pts (9.5%; 95% CI, 1.2-30.4) had ABCB1 amp and both of them had RES to C. ABCB1 rate among C-resistant pts was 11.1% (95% CI, 1.4-34.7). Conclusions: In this study, ABCB1 amp using cfDNA did not show statistically significant correlation with RES to D or C for pts with mCRPC. Future studies including ABCB1 amp in a suite of putative biomarkers and larger sample size may aid drawing definitive conclusions.
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Affiliation(s)
| | | | | | | | | | - Gavin Ha
- Broad Institute of MIT and Harvard, Cambridge, MA
| | | | | | | | | | - Christopher Sweeney
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA
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Leon-Ferre RA, Novotny PJ, Wolfe EG, Faubion SS, Ruddy KJ, Flora D, Dakhil CSR, Rowland KM, Graham ML, Le-Lindqwister N, Smith TJ, Loprinzi CL. Oxybutynin vs Placebo for Hot Flashes in Women With or Without Breast Cancer: A Randomized, Double-Blind Clinical Trial (ACCRU SC-1603). JNCI Cancer Spectr 2020; 4:pkz088. [PMID: 32337497 PMCID: PMC7050158 DOI: 10.1093/jncics/pkz088] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/12/2019] [Accepted: 10/17/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Hot flashes (HFs) negatively affect quality of life among perimenopausal and postmenopausal women. This study investigated the efficacy of oxybutynin vs placebo in decreasing HFs. METHODS In this randomized, multicenter, double-blind study, women with and without breast cancer with 28 or more HFs per week, lasting longer than 30 days, who were not candidates for estrogen-based therapy, were assigned to oral oxybutynin (2.5 mg twice a day or 5 mg twice a day) or placebo for 6 weeks. The primary endpoint was the intrapatient change from baseline in weekly HF score between each oxybutynin dose and placebo using a repeated-measures mixed model. Secondary endpoints included changes in weekly HF frequency, HF-related daily interference scale questionnaires, and self-reported symptoms. RESULTS We enrolled 150 women. Baseline characteristics were well balanced. Mean (SD) age was 57 (8.2) years. Two-thirds (65%) were taking tamoxifen or an aromatase inhibitor. Patients on both oxybutynin doses reported greater reductions in the weekly HF score (5 mg twice a day: -16.9 [SD 15.6], 2.5 mg twice a day: -10.6 [SD 7.7]), placebo -5.7 (SD 10.2); P < .005 for both oxybutynin doses vs placebo), HF frequency (5 mg twice a day: -7.5 [SD 6.6], 2.5 mg twice a day: -4.8 [SD 3.2], placebo: -2.6 [SD 4.3]; P < .003 for both oxybutynin doses vs placebo), and improvement in most HF-related daily interference scale measures and in overall quality of life. Patients on both oxybutynin arms reported more side effects than patients on placebo, particularly dry mouth, difficulty urinating, and abdominal pain. Most side effects were grade 1 or 2. There were no differences in study discontinuation because of adverse effects. CONCLUSION Oxybutynin is an effective and relatively well-tolerated treatment option for women with HFs.
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Affiliation(s)
| | - Paul J Novotny
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Eric G Wolfe
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | | | | | - Daniel Flora
- Oncology/Hematology, St. Elizabeth Physicians, Crestview Hills, KY
| | | | | | - Mark L Graham
- Medical Oncology, Waverly Hematology/Oncology, Cary, NC
| | | | - Thomas J Smith
- Medical Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
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Albany C, Dockter T, Wolfe EG, Pachman DR, Wagner-Johnston ND, Lazzara KM, Sego LM, Edwards SI, Snow CI, Hanna N, Einhorn L, Loprinzi CL, Costello BA. Clinical course of patients with cisplatin (CDDP)-associated neuropathy compared to other neurotoxic chemotherapy. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e23078] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e23078 Background: There are limited patient (pt) reported outcome data regarding CDDP neurotoxicity. Methods: CDDP-induced peripheral neuropathy was evaluated in pts with testicular cancer planning to receive CDDP (20 mg/m2/d for 5 days) for ≥ 3 cycles. Neurotoxicity was assessed with the EORTC QLQ-CIPN20 tool before each CDDP cycle and every 2-4 months after, out to 18 months. We compared these data to our studies evaluating pts receiving doxorubicin/cyclophosphamide (AC), paclitaxel and oxaliplatin. The total score of the EORTC QLQ-CIPN20, each of the three subscale scores and each individual item was computed following the standard scoring algorithm and converted to a 0-100 scale. Descriptive statistics and graphical plots were utilized. Results: 54 pts receiving CDDP (mean age 33 years) and 18 pts receiving AC were evaluated. Following completion of CDDP, neuropathy symptoms (sensory neuropathy score and numbness/tingling in toes/feet) worsened for about 6 months (consistent with the so-called “coasting phenomena”), similar to what had previously been seen with oxaliplatin (but different than what had been seen with paclitaxel). For CDDP pts, during therapy, numbness and tingling in fingers/hands were more prominent, than the same symptoms in the toes/feet. After therapy was completed, numbness, and tingling became more prominent in toes/feet, but improved in the fingers/hands. After stopping therapy, shooting/burning pain did not worsen in upper or lower extremities. During therapy, CDDP pts had less problems than had previously been seen with oxaliplatin or paclitaxel, maybe because of the younger ages of the CDDP pts. With AC, all of the CIPN-20 sensory neuropathy scores were better than was seen in the pts receiving CDDP and also in pts receiving paclitaxel and oxaliplatin in previous evaluations. Conclusions: CDDP-induced neuropathy is more similar to oxaliplatin-induced neuropathy than paclitaxel-induced neuropathy. AC chemotherapy pts do not have substantial changes in CIPN 20 scores, consistent with the CIPN 20 instrument being a measure of chemotherapy-induced neuropathy, as opposed to more general chemotherapy-induced toxicities. Clinical trial information: NCT02677727.
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Affiliation(s)
- Costantine Albany
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
| | | | | | | | | | | | - Lina M Sego
- Indiana University Simon Cancer Center, Indianapolis, IN
| | - Sara I Edwards
- Indiana University Simon Cancer Center, Indianapolis, IN
| | | | - Nasser Hanna
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
| | - Lawrence Einhorn
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
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