1
|
Bratland Å, Munoz-Couselo E, Mortier L, Roshdy O, González R, Schachter J, Arance AM, Grange F, Meyer N, Joshi AJ, Billan S, Hughes BGM, Grob JJ, Ramakrishnan K, Ge J, Gumuscu B, Swaby RF, Gutzmer R. Health-Related Quality of Life with Pembrolizumab in Patients with Locally Advanced or Recurrent or Metastatic Cutaneous Squamous Cell Carcinoma: KEYNOTE-629. Dermatol Ther (Heidelb) 2023; 13:3165-3180. [PMID: 37943491 PMCID: PMC10689716 DOI: 10.1007/s13555-023-01059-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/12/2023] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION At first interim analysis of KEYNOTE-629, health-related quality of life (HRQoL) with pembrolizumab was stable or improved over 48 weeks in recurrent or metastatic (R/M) cutaneous squamous cell carcinoma (cSCC). HRQoL results from the second interim analysis in R/M or locally advanced (LA) cSCC are presented. METHODS Patients received pembrolizumab 200 mg every 3 weeks for ≤ 2 years. Change in EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EQ-5D-5L scores were exploratory end points. Primary analysis was performed at week 12 to ensure adequate completion/compliance. Descriptive analyses were also conducted through weeks 48 and 75 for the LA and R/M cohorts, respectively. RESULTS At data cutoff (29 July 2020), mean scores in the LA cohort (n = 47) were stable from baseline to week 12 for EORTC QLQ-C30 global health status (GHS)/quality of life (QoL) (-0.27 points [95% confidence interval (CI) -10.93 to 10.39]), physical functioning (-1.29 points [95% CI -8.77 to 6.19]), and EQ-5D-5L visual analog scale (2.06 [95% CI -7.70 to 11.82]). HRQoL remained stable through week 48 in the LA cohort; 76.6% and 74.5% of patients had improved or stable GHS/QoL and physical functioning scores, respectively. HRQoL continued to show stability or improvement through week 75 in the R/M cohort (n = 99); 71.7% and 64.6% of patients had improved or stable GHS/QoL and physical functioning scores, respectively. CONCLUSIONS Pembrolizumab has demonstrated antitumor activity and manageable safety. The current analysis shows pembrolizumab treatment preserved HRQoL. Collectively, these results support pembrolizumab as standard of care for LA or R/M cSCC. TRIAL REGISTRATION ClinicalTrials.gov, NCT03284424-September 15, 2017.
Collapse
Affiliation(s)
- Åse Bratland
- Head and Neck Oncology, Oslo University Hospital, Sognsvannsveien 20, 0372, Oslo, Norway.
| | - Eva Munoz-Couselo
- Department of Medical Oncology, Melanoma and Other Skin Tumors Unit, Vall d'Hebron Hospital, Passeig de la Vall d'Hebron, 119, 08035, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Passeig de la Vall d'Hebron, 119, 08035, Barcelona, Spain
| | - Laurent Mortier
- Department of Dermatology, INSERM U 1189, Université Lille, Centre Hospitalier Regional Universitaire de Lille, 2, Avenue Oscar Lambret, 59037, Lille, France
| | - Osama Roshdy
- Division of Dermatology, McGill University, 845 Sherbrooke St W, Montreal, QC, H3A 0G4, Canada
| | - Rene González
- Surgical Oncology, Centro Estatal de Cancerologiade Chihuahua, C. Ejercito Mexicano 3700, 31000, Chihuahua, Mexico
| | - Jacob Schachter
- Division of Oncology, Level 2, Cancer Center (Oncology Institute), Sheba Medical Center-Tel Hashomer, Emek HaEla Street 1, 52621, Ramat Gan, Israel
| | - Ana M Arance
- Medical Oncology, Hospital Clinic de Barcelona, Carrer de Villarroel, 170, 08036, Barcelona, Spain
| | - Florent Grange
- Dermatology/Oncology, CHU Reims-Hôpital Robert Debre, Avenue du General Koenig Service de Dermatologie, 51100, Reims, France
- Dermatology Department, Valence Hospital, 179 Bd Maréchal Juin, 26000, Valence, France
| | - Nicolas Meyer
- Onco-Dermatology, Institut Claudius Regaud, Institut Universitaire du Cancer and CHU, 1 Avenue Irene Joliot Curie, 31059, Toulouse, France
| | - Abhishek Jagdish Joshi
- Department of Medical Oncology, Townsville University Hospital, 55 Keane Street, Douglas, QLD, 4814, Australia
| | - Salem Billan
- Head and Neck Malignancies Unit, Rambam Health Care Campus, Technion-Israel Institute of Technology, HaAliya HaShniya St 8, 52621, Haifa, Israel
| | - Brett G M Hughes
- Oncology, Clinical Research Unit, Medical Oncology, Royal Brisbane and Women's Hospital, Butterfield Street, Ground Floor, Building 34, Herston, QLD, 4029, Australia
- Department of Oncology, University of Queensland, 308 Queen St, Brisbane, QLD, 4000, Australia
| | - Jean-Jacques Grob
- Dermatology, AIX-Marseille University and APHM Hospital Marseille, 264 Rue Saint Pierre, 13385, Marseille, France
| | | | - Joy Ge
- Medical Oncology, Merck & Co., Inc., 2025 E Scott Ave, Rahway, NJ, 07065, USA
| | - Burak Gumuscu
- Medical Oncology, Merck & Co., Inc., 2025 E Scott Ave, Rahway, NJ, 07065, USA
| | - Ramona F Swaby
- Medical Oncology, Merck & Co., Inc., 2025 E Scott Ave, Rahway, NJ, 07065, USA
| | - Ralf Gutzmer
- Department of Dermatology, Skin Cancer Center Hannover, Hannover Medical School, Carl-Neuberg-Str. 1, 60325, Hannover, Germany
- Department of Dermatology, Johannes Wesling Medical Center Hans-Nolte-Straße 1, 32429, Minden, Germany
- Ruhr University Bochum, Universitätsstraße 150, 44801, Bochum, Germany
| |
Collapse
|
2
|
Hughes BGM, Munoz-Couselo E, Mortier L, Bratland Å, Gutzmer R, Roshdy O, González Mendoza R, Schachter J, Arance A, Grange F, Meyer N, Joshi A, Billan S, Zhang P, Gumuscu B, Swaby RF, Grob JJ. Corrigendum to 'Pembrolizumab for locally advanced and recurrent/metastatic cutaneous squamous cell carcinoma (KEYNOTE-629 study): an open-label, nonrandomized, multicenter, phase II trial: [Annals of Oncology Volume 32, Issue 10, October 2021, Pages 1276-1285]. Ann Oncol 2022; 33:853. [PMID: 35690517 DOI: 10.1016/j.annonc.2022.05.517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- B G M Hughes
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston; University of Queensland, Brisbane, Australia.
| | - E Munoz-Couselo
- Hospital Vall D Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - L Mortier
- University of Lille, Inserm U 1189, CHU Lille, Lille, France
| | | | - R Gutzmer
- Department of Dermatology and Allergy, Skin Cancer Center Hannover, Medizinische Hochschule Hannover, Hanover; Mühlenkreiskliniken, Ruhr University Bochum Campus Minden, Minden, Germany
| | - O Roshdy
- Jewish General Hospital, Montreal, Canada
| | | | - J Schachter
- Chaim Sheba Medical Center at Tel HaShomer, Ramat Gan, Israel
| | - A Arance
- Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - F Grange
- Dermatology Department, Center Hospitalier Universitaire de Reims-Hôpital Robert Debre, Reims
| | - N Meyer
- Dermatology, Institut Universitaire du Cancer and CHU de Toulouse, Toulouse, France
| | - A Joshi
- Department of Medical Oncology, Townsville University Hospital, Townsville, Australia
| | - S Billan
- The Head and Neck Center, Oncology Department, Rambam Health Care Campus, Haifa, Israel
| | - P Zhang
- Merck & Co., Inc., Kenilworth, USA
| | | | | | - J-J Grob
- Service de Dermatologie et Cancérologie Cutanée, Aix-Marseille University, Marseille, France
| |
Collapse
|
3
|
Hughes BG, Munoz-Couselo E, Mortier L, Bratland Å, Gutzmer R, Roshdy O, Mendoza RG, Schachter J, Arance A, Grange F, Meyer N, Joshi A, Billan S, Zhang P, Gumuscu B, Swaby RF, Grob JJ. Abstract CT006: Phase 2 study of pembrolizumab (pembro) for locally advanced (LA) or recurrent/metastatic (R/M) cutaneous squamous cell carcinoma (cSCC): KEYNOTE-629. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-ct006] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In the multicenter, open-label, nonrandomized, phase 2 KEYNOTE-629 trial, pembro has demonstrated clinically meaningful and durable antitumor activity with a manageable safety profile for R/M cSCC based on the first interim analysis (IA). Here, we present the second IA of KEYNOTE-629, which reports the initial efficacy and safety data for the LA cohort and updated data for the R/M cohort in cSCC.Methods: Eligible patients (pts) were ≥18 years old, had histologically confirmed cSCC (LA or R/M) with measurable disease per RECIST 1.1 by blinded independent central review (BICR), an ECOG PS score of 0 or 1, and adequate organ function. Pts received intravenous pembro 200 mg every 3 weeks for up to 35 infusions (~ 2 years) or until protocol-specified treatment discontinuation criteria were met. The primary endpoint was ORR per RECIST 1.1 by BICR. Secondary endpoints were DOR, DCR, and PFS, all per RECIST 1.1 by BICR; OS; and safety and tolerability. Results: A total of 159 pts were enrolled and treated with pembro (LA, n=54; R/M, n=105). The median time from the first dose to data cutoff (July 29, 2020) was 14.9 (range, 10.1-19.4) mo for the LA cohort and 27.2 (range, 24.6-32.0) mo for the R/M cohort. In the LA cohort, 22.2% of pts were treated with prior systemic therapy with curative intent. In the R/M cohort, 86.7% of pts received ≥1 prior systemic therapy. Updated efficacy outcomes are summarized in the table. Across cohorts, grade 3-5 treatment-related AEs occurred in 11.9% of pts. Grade 3-5 immune-related AEs occurred in 8.2% of pts. Conclusions: Pembro confirmed robust and durable antitumor activity, with promising survival in LA and R/M cSCC. AEs with pembro in this study were generally consistent with its established safety profile. These data support the use of pembro for cSCC.
LA cSCC(N=54)R/M cSCC(N=105)Total(N=159)ORR, % (95% CI)50.0 (36.1-63.9)35.2 (26.2-45.2)40.3 (32.6-48.3)DCR (SD ≥12 wks + ORR), % (95% CI)64.8 (50.6-77.3)52.4 (42.4-62.2)56.6 (48.5-64.4)Best overall response, n (%)CR9 (16.7)11 (10.5)20 (12.6)PR18 (33.3)26 (24.8)44 (27.7)SD13 (24.1)30 (28.6)43 (27.0)SD≥12 wks8 (14.8)18 (17.1)26 (16.4)PD9 (16.7)28 (26.7)37 (23.3)NE1 (1.9)2 (1.9)3 (1.9)No assessment4 (7.4)8 (7.6)12 (7.5)DOR, median (range), moNR (1.0+-17.2+)NR (2.7-30.4+)NR (1.0+-30.4+)Patients with extended responses≥12 months, n (%)10 (84.1)25 (77.8)35 (80.3)PFS, median (95% CI), moNR (5.5-NR)5.7 (3.1-8.5)7.8 (5.3-12.3)12-mo PFS rate, % (95% CI)54.4 (39.6-67.0)36.4 (27.0- 45.9)42.4 (34.3-50.2)OS, median (95% CI), moNR (NR-NR)23.8 (13.4-29.8)26.4 (19.5-NR)12-mo OS rate, % (95% CI)73.6 (59.5-83.4)61.0 (50.9-69.5)65.1 (57.1-72.0)
Citation Format: Brett G.M. Hughes, Eva Munoz-Couselo, Laurent Mortier, Åse Bratland, Ralf Gutzmer, Osama Roshdy, Rene González Mendoza, Jacob Schachter, Ana Arance, Florent Grange, Nicolas Meyer, Abhishek Joshi, Salem Billan, Pingye Zhang, Burak Gumuscu, Ramona F. Swaby, Jean-Jacques Grob. Phase 2 study of pembrolizumab (pembro) for locally advanced (LA) or recurrent/metastatic (R/M) cutaneous squamous cell carcinoma (cSCC): KEYNOTE-629 [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 CT006.
Collapse
Affiliation(s)
- Brett G.M. Hughes
- 1Royal Brisbane and Women's Hospital and University of Queensland, Herston, Brisbane, QLD, Australia
| | | | | | | | - Ralf Gutzmer
- 5Medizinische Hochschule Hannover, Hannover, Germany
| | - Osama Roshdy
- 6Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Jacob Schachter
- 8Chaim Sheba Medical Center at Tel HaShomer, Ramat Gan, Israel
| | - Ana Arance
- 9Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - Florent Grange
- 10Centre Hospitalier Universitaire de Reims–Hôpital Robert Debre, Reims, France
| | - Nicolas Meyer
- 11Institut Universitaire du Cancer and CHU de Toulouse, Toulouse, France
| | - Abhishek Joshi
- 12Townsville University Hospital, Townsville, Queensland, Australia
| | | | | | | | | | | |
Collapse
|
4
|
Lin L, Sabnis A, Chan E, Olivas V, Cade L, Pazarentzos E, Asthana S, Neel D, Yan JJ, Lu X, Pham L, Wang M, Karachaliou N, Cao MG, Manzano JL, Ramirez JL, Torres JM, Buttitta F, Rudin CM, Collisson EA, Algazi A, Robinson E, Osman I, Munoz-Couselo E, Cortes J, Frederick DT, Cooper ZA, McMahon M, Marchetti A, Rosell R, Flaherty KT, Wargo JA, Bivona TG. Abstract LB-239: The Hippo effector YAP promotes resistance to RAF and MEK targeted therapies. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-lb-239] [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
Resistance to RAF-MEK targeted therapy is a major clinical challenge. RAF-MEK inhibitors are initially but only transiently effective in some but not all BRAF mutant patients, and largely ineffective in RAS mutant patients because of resistance. Through a genetic screen in BRAF mutant tumor cells, we show that the Hippo pathway effector YAP acts as a parallel survival input to promote resistance to RAF-MEK inhibitor therapy. Combined YAP and RAF-MEK inhibition was synthetically lethal not only in several BRAF mutant tumor types but also in RAS mutant tumors. Increased YAP in BRAFV600E patient tumors was a biomarker of worse initial response to RAF inhibition in patients, establishing the clinical relevance of our findings. Our data uncover YAP as a novel mechanism of resistance to RAF-MEK targeted therapy. The findings unveil the synthetic lethality of YAP and RAF-MEK co-suppression as a promising strategy to enhance response and patient survival.
Citation Format: Luping Lin, Amit Sabnis, Elton Chan, Victor Olivas, Lindsay Cade, Evangelos Pazarentzos, Saurabh Asthana, Dana Neel, Jenny Jiacheng Yan, Xinyuan Lu, Luu Pham, Mingxue Wang, Niki Karachaliou, Maria G. Cao, Jose L. Manzano, Jose L. Ramirez, Jose M. Torres, Fiamma Buttitta, Charles M. Rudin, Eric A. Collisson, Alain Algazi, Eric Robinson, Iman Osman, Eva Munoz-Couselo, Javier Cortes, Dennie T. Frederick, Zachary A. Cooper, Martin McMahon, Antonio Marchetti, Rafael Rosell, Keith T. Flaherty, Jennifer A. Wargo, Trever G. Bivona. The Hippo effector YAP promotes resistance to RAF and MEK targeted therapies. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr LB-239. doi:10.1158/1538-7445.AM2015-LB-239
Collapse
Affiliation(s)
- Luping Lin
- 1University of California at San Francisco, san francisco, CA
| | - Amit Sabnis
- 1University of California at San Francisco, san francisco, CA
| | - Elton Chan
- 1University of California at San Francisco, san francisco, CA
| | - Victor Olivas
- 1University of California at San Francisco, san francisco, CA
| | - Lindsay Cade
- 1University of California at San Francisco, san francisco, CA
| | | | - Saurabh Asthana
- 1University of California at San Francisco, san francisco, CA
| | - Dana Neel
- 1University of California at San Francisco, san francisco, CA
| | | | - Xinyuan Lu
- 1University of California at San Francisco, san francisco, CA
| | - Luu Pham
- 1University of California at San Francisco, san francisco, CA
| | - Mingxue Wang
- 1University of California at San Francisco, san francisco, CA
| | - Niki Karachaliou
- 2Catalan Institute of Oncology Hospital Germans Trias i Pujol Badalona, Barcelona, Spain
| | - Maria G. Cao
- 2Catalan Institute of Oncology Hospital Germans Trias i Pujol Badalona, Barcelona, Spain
| | - Jose L. Manzano
- 2Catalan Institute of Oncology Hospital Germans Trias i Pujol Badalona, Barcelona, Spain
| | - Jose L. Ramirez
- 2Catalan Institute of Oncology Hospital Germans Trias i Pujol Badalona, Barcelona, Spain
| | | | | | | | | | - Alain Algazi
- 1University of California at San Francisco, san francisco, CA
| | | | | | | | - Javier Cortes
- 7Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | | | - Martin McMahon
- 1University of California at San Francisco, san francisco, CA
| | | | - Rafael Rosell
- 2Catalan Institute of Oncology Hospital Germans Trias i Pujol Badalona, Barcelona, Spain
| | | | | | | |
Collapse
|
5
|
Cortes J, Zucali PA, Santoro A, Munoz-Couselo E, Arnedos M, Cantero F, Kloos I, Depil S, Thomas E, Delaloge S. Abstract OT1-4-05: Phase I dose-escalation study of oral administration of abexinostat (S 78454, PCI-24781) given with tamoxifen 20 mg in the treatment of patients with advanced breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-ot1-4-05] [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: Around 20% of patients initially diagnosed with local stage breast cancer will develop metastatic breast cancer, with an about 23% median 5-year survival rate from diagnosis. Patients whose tumors express ER and PR (ER+, PR+) are frequently treated with antiestrogens and aromatase inhibitors (AI). Primary and secondary resistances to hormone therapy lead to tumor progression and shorten survival expectancy.
In preclinical models, treatment of ER+ breast cancer cells with HDAC inhibitors leads to transcriptional down regulation and post-translation modification of the ER. This treatment reverses tamoxifen-induced ER stabilization, followed by induction of pro-apoptotic genes and apoptotic cell death. Epigenetic modulation of ER signaling by HDAC inhibitor represents a novel strategy to reverse hormonal resistance.
Abexinostat is a hydroxamate-based pan-HDAC inhibitor of class I/II, in phase I/II clinical trials. Abexinostat inhibits tumor growth in a panel of commonly used ER+ breast cancer cell lines including ATCC and NCI. Abexinostat potentiates the anti-tumor activity of tamoxifen in vitro in ER+ breast cancer cells, by down-regulation of ER protein expression and its pro-growth response genes (PgR, Cyclin D). It abrogates AKT cell signaling by directly down-regulating AKT1 at the transcriptional and post-translational level. Furthermore, cell death is induced by activating the apoptotic program.
Study design: phase I dose-finding of abexinostat for 4 consecutive days each week of a 3-week cycle given in combination with daily tamoxifen at 20 mg. Dose levels of abexinostat, 120, 140 and 160 mg bid, of 3 to 6 patients will be explored. Two dose de-escalation levels (100/80 mg) are allowed depending on toxicity. Dose-Limiting Toxicities assessment will be done at the end of cycle 2. Once the Maximum Tolerated Dose is determined up to 20 additional patients will be treated at the recommended dose in a confirmatory cohort.
Main eligibility criteria: Female≥ 18 years with histologically confirmed primary adenocarcinoma of the breast; ER+ (IHC≥ 10%), HER2- tumors. Patients must have had tumor progression on an AI administered for advanced/metastatic disease OR recurrence while on or within 12 months of completion of adjuvant AI, OR recurrence within 12 months of adjuvant tamoxifen completion and must have had up to 3 prior chemotherapy regimens in metastatic/advanced setting. Patients must have progressive tumor measurable or evaluable (RECIST criteria version 1.1).
Main objectives: Primary: to assess the safety and the tolerability of the combination treatment and to determine a recommended Phase II dose. Secondary: to determine the pharmacokinetic profile of both the drugs in combination and metabolites; to measure tumor response to the combination; to measure drug target inhibition by assessing acetylation state of histones proteins, HbF level and HDAC2 expression in peripheral blood mononuclear cells and in peripheral blood samples; to assess circulating tumor cells; to analyze biomarkers on tissue sample and pharmacogenomic of genes implicated in the metabolism of combination (optional).
Status: Study opened in September 2012, currently recruiting.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr OT1-4-05.
Collapse
Affiliation(s)
- J Cortes
- Vall d'Hebron University Hospital, Barcelona, Spain; Istituto Clinico Humanitas IRCCS, Rozzano, Italy; Institut Gustave Roussy, Villejuif, France; Institut de Recherches Internationales Servier, Suresnes, France
| | - PA Zucali
- Vall d'Hebron University Hospital, Barcelona, Spain; Istituto Clinico Humanitas IRCCS, Rozzano, Italy; Institut Gustave Roussy, Villejuif, France; Institut de Recherches Internationales Servier, Suresnes, France
| | - A Santoro
- Vall d'Hebron University Hospital, Barcelona, Spain; Istituto Clinico Humanitas IRCCS, Rozzano, Italy; Institut Gustave Roussy, Villejuif, France; Institut de Recherches Internationales Servier, Suresnes, France
| | - E Munoz-Couselo
- Vall d'Hebron University Hospital, Barcelona, Spain; Istituto Clinico Humanitas IRCCS, Rozzano, Italy; Institut Gustave Roussy, Villejuif, France; Institut de Recherches Internationales Servier, Suresnes, France
| | - M Arnedos
- Vall d'Hebron University Hospital, Barcelona, Spain; Istituto Clinico Humanitas IRCCS, Rozzano, Italy; Institut Gustave Roussy, Villejuif, France; Institut de Recherches Internationales Servier, Suresnes, France
| | - F Cantero
- Vall d'Hebron University Hospital, Barcelona, Spain; Istituto Clinico Humanitas IRCCS, Rozzano, Italy; Institut Gustave Roussy, Villejuif, France; Institut de Recherches Internationales Servier, Suresnes, France
| | - I Kloos
- Vall d'Hebron University Hospital, Barcelona, Spain; Istituto Clinico Humanitas IRCCS, Rozzano, Italy; Institut Gustave Roussy, Villejuif, France; Institut de Recherches Internationales Servier, Suresnes, France
| | - S Depil
- Vall d'Hebron University Hospital, Barcelona, Spain; Istituto Clinico Humanitas IRCCS, Rozzano, Italy; Institut Gustave Roussy, Villejuif, France; Institut de Recherches Internationales Servier, Suresnes, France
| | - E Thomas
- Vall d'Hebron University Hospital, Barcelona, Spain; Istituto Clinico Humanitas IRCCS, Rozzano, Italy; Institut Gustave Roussy, Villejuif, France; Institut de Recherches Internationales Servier, Suresnes, France
| | - S Delaloge
- Vall d'Hebron University Hospital, Barcelona, Spain; Istituto Clinico Humanitas IRCCS, Rozzano, Italy; Institut Gustave Roussy, Villejuif, France; Institut de Recherches Internationales Servier, Suresnes, France
| |
Collapse
|