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Hurvitz S, Kalinsky K, Tripathy D, Sledge G, Gradishar W, O'Shaughnessy J, Modi S, Park H, McCartney A, Frentzas S, Shannon C, Cuff K, Eek R, Martin Jimenez M, Curigliano G, Jerusalem G, Huang C, Press M, Lu J. 273TiP ACE-Breast-03: A phase II study patients with HER2-positive metastatic breast cancer whose disease is resistant or refractory to T-DM1, and/or T-DXd, and/or tucatinib-containing regimens treated with ARX788. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1857] [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: 11/30/2022] Open
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Huang CS, Toi M, Im YH, Iwata H, Sohn J, Wang HC, Masuda N, Im SA, Lu Y, Haddad N, Sakaguchi S, Hurt K, Neven P, Llombart-Cussac A, Sledge G. 45O Abemaciclib plus fulvestrant in East Asian women with HR+, HER2- advanced breast cancer: Overall survival from MONARCH 2. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.065] [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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Cardoso F, Costa A, Senkus E, Aapro M, André F, Barrios CH, Bergh J, Bhattacharyya G, Biganzoli L, Cardoso MJ, Carey L, Corneliussen-James D, Curigliano G, Dieras V, El Saghir N, Eniu A, Fallowfield L, Fenech D, Francis P, Gelmon K, Gennari A, Harbeck N, Hudis C, Kaufman B, Krop I, Mayer M, Meijer H, Mertz S, Ohno S, Pagani O, Papadopoulos E, Peccatori F, Penault-Llorca F, Piccart MJ, Pierga JY, Rugo H, Shockney L, Sledge G, Swain S, Thomssen C, Tutt A, Vorobiof D, Xu B, Norton L, Winer E. 3rd ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 3). Ann Oncol 2017; 28:3111. [PMID: 28327998 PMCID: PMC5834023 DOI: 10.1093/annonc/mdx036] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Toi M, Huang C, Im YH, Iwata H, Sohn J, Wang HC, Masuda N, Lin Y, Sakaguchi S, Bourayou N, Llombart A, Sledge G. MONARCH 2: Abemaciclib in combination with fulvestrant in Asian women with HR+, HER2- advanced breast cancer who progressed on endocrine therapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx654.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Cardoso F, Costa A, Senkus E, Aapro M, André F, Barrios C, Bergh J, Bhattacharyya G, Biganzoli L, Cardoso M, Carey L, Corneliussen-James D, Curigliano G, Dieras V, El Saghir N, Eniu A, Fallowfield L, Fenech D, Francis P, Gelmon K, Gennari A, Harbeck N, Hudis C, Kaufman B, Krop I, Mayer M, Meijer H, Mertz S, Ohno S, Pagani O, Papadopoulos E, Peccatori F, Penault-Llorca F, Piccart M, Pierga J, Rugo H, Shockney L, Sledge G, Swain S, Thomssen C, Tutt A, Vorobiof D, Xu B, Norton L, Winer E. Corrigendum to “3rd ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 3)” [Breast 31 (February 2017) 244–259]. Breast 2017; 32:269-270. [DOI: 10.1016/j.breast.2017.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Cardoso F, Costa A, Senkus E, Aapro M, André F, Barrios CH, Bergh J, Bhattacharyya G, Biganzoli L, Cardoso MJ, Carey L, Corneliussen-James D, Curigliano G, Dieras V, El Saghir N, Eniu A, Fallowfield L, Fenech D, Francis P, Gelmon K, Gennari A, Harbeck N, Hudis C, Kaufman B, Krop I, Mayer M, Meijer H, Mertz S, Ohno S, Pagani O, Papadopoulos E, Peccatori F, Penault-Llorca F, Piccart MJ, Pierga JY, Rugo H, Shockney L, Sledge G, Swain S, Thomssen C, Tutt A, Vorobiof D, Xu B, Norton L, Winer E. 3rd ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 3). Ann Oncol 2017; 28:16-33. [PMID: 28177437 PMCID: PMC5378224 DOI: 10.1093/annonc/mdw544] [Citation(s) in RCA: 258] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- F. Cardoso
- European School of Oncology & Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal
| | - A. Costa
- European School of Oncology, Milan, Italy and European School of Oncology, Bellinzona, Switzerland
| | - E. Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - M. Aapro
- Breast Center, Genolier Cancer Center, Genolier, Switzerland
| | - F. André
- Department of Medical Oncology, Gustave Roussy Institute, Villejuif, France
| | - C. H. Barrios
- Department of Medicine, PUCRS School of Medicine, Porto Alegre, Brazil
| | - J. Bergh
- Department of Oncology/Radiumhemmet, Karolinska Institutet & Cancer Center Karolinska and Karolinska University Hospital, Stockholm, Sweden
| | | | - L. Biganzoli
- Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - M. J. Cardoso
- Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal
| | - L. Carey
- Department of Hematology and Oncology, UNC Lineberger Comprehensive Cancer Center
| | | | - G. Curigliano
- Division of Experimental Therapeutics, European Institute of Oncology, Milan, Italy
| | - V. Dieras
- Department of Medical Oncology, Institut Curie, Paris, France
| | - N. El Saghir
- NK Basile Cancer Institute Breast Center of Excellence, American University of Beirut, Beirut, Lebanon
| | - A. Eniu
- Department of Breast Tumors, Cancer Institute ‘I. Chiricuta’, Cluj-Napoca, Romania
| | - L. Fallowfield
- Brighton & Sussex Medical School, University of Sussex, Falmer, UK
| | - D. Fenech
- Breast Care Support Group, Europa Donna Malta, Mtarfa, Malta
| | - P. Francis
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - K. Gelmon
- BC Cancer Agency, Vancouver Cancer Centre, Vancouver, Canada
| | - A. Gennari
- Department of Medical Oncology, Galliera Hospital, Genoa, Italy
| | - N. Harbeck
- Brustzentrum der Universitat München, Munich, Germany
| | - C. Hudis
- Breast Medicine Service, Memorial Sloan-Kettering Cancer Centre, New York, USA
| | - B. Kaufman
- Sheba Medical Center, Tel Hashomer, Israel
| | - I. Krop
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston
| | - M. Mayer
- Advanced Breast Cancer.org, New York, USA
| | - H. Meijer
- Department of Radiation Oncology, Radvoud University Medical Center, Nijmegen, The Netherlands
| | - S. Mertz
- Metastatic Breast Cancer Network US, Inversness, USA
| | - S. Ohno
- Breast Oncology Centre, Cancer Institute Hospital, Tokyo, Japan
| | - O. Pagani
- Oncology Institute of Southern Switzerland and Breast Unit of Southern Switzerland, Bellinzona, Switzerland
| | | | - F. Peccatori
- European School of Oncology, Milan, Italy and Bellinzona, Switzerland
| | - F. Penault-Llorca
- Jean Perrin Centre, Comprehensive Cancer Centre, Clermont Ferrand, France
| | - M. J. Piccart
- Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - J. Y. Pierga
- Department of Medical Oncology, Institut Curie-Université Paris Descartes, Paris, France
| | - H. Rugo
- Department of Medicine, Breast Oncology Program, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco
| | - L. Shockney
- Department of Surgery and Oncology, Johns Hopkins Breast Center, Baltimore
| | - G. Sledge
- Indiana University Medical CTR, Indianapolis
| | - S. Swain
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, USA
| | - C. Thomssen
- Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle an der Saale, Germany
| | - A. Tutt
- Breakthrough Breast Cancer Research Unit, King’s College London and Guy’s and St Thomas’s NHS Foundation Trust, London, UK
| | - D. Vorobiof
- Sandton Oncology Centre, Johannesburg, South Africa
| | - B. Xu
- Department of Medical Oncology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - L. Norton
- Breast Cancer Program, Memorial Sloan-Kettering Cancer Centre, New York
| | - E. Winer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
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7
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Sparano J, Gray R, Zujewski J, Makower D, Pritchard K, Albain K, Hayes D, Geyer C, Dees C, Perez E, Keane M, Vallejos C, Goggins T, Mayer I, Brufsky A, Toppmeyer D, Kaklamani V, Atkins J, Olson J, Sledge G. 5BA Prospective trial of endocrine therapy alone in patients with estrogen-receptor positive, HER2-negative, node-negative breast cancer: Results of the TAILORx low risk registry. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31935-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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8
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Cardoso F, Costa A, Norton L, Senkus E, Aapro M, André F, Barrios CH, Bergh J, Biganzoli L, Blackwell KL, Cardoso MJ, Cufer T, El Saghir N, Fallowfield L, Fenech D, Francis P, Gelmon K, Giordano SH, Gligorov J, Goldhirsch A, Harbeck N, Houssami N, Hudis C, Kaufman B, Krop I, Kyriakides S, Lin UN, Mayer M, Merjaver SD, Nordström EB, Pagani O, Partridge A, Penault-Llorca F, Piccart MJ, Rugo H, Sledge G, Thomssen C, Van't Veer L, Vorobiof D, Vrieling C, West N, Xu B, Winer E. ESO-ESMO 2nd international consensus guidelines for advanced breast cancer (ABC2)†. Ann Oncol 2014; 25:1871-1888. [PMID: 25234545 PMCID: PMC4176456 DOI: 10.1093/annonc/mdu385] [Citation(s) in RCA: 284] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 08/11/2014] [Indexed: 12/23/2022] Open
Affiliation(s)
- F Cardoso
- European School of Oncology & Breast Unit, Champalimaud Cancer Center, Lisbon, Portugal.
| | - A Costa
- European School of Oncology, Milan, Italy; European School of Oncology, Bellinzona, Switzerland
| | - L Norton
- Breast Cancer Program, Memorial Sloan-Kettering Cancer Centre, New York, USA
| | - E Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - M Aapro
- Division of Oncology, Institut Multidisciplinaire d'Oncologie, Genolier, Switzerland
| | - F André
- Department of Medical Oncology, Gustave-Roussy Institute, Villejuif, France
| | - C H Barrios
- Department of Medicine, PUCRS School of Medicine, Porto Alegre, Brazil
| | - J Bergh
- Department of Oncology/Radiumhemmet, Karolinska Institutet & Cancer Center Karolinska and Karolinska University Hospital, Stockholm, Sweden
| | - L Biganzoli
- Department of Medical Oncology, Sandro Pitigliani Oncology Centre, Prato, Italy
| | - K L Blackwell
- Breast Cancer Clinical Program, Duke Cancer Institute, Durham, USA
| | - M J Cardoso
- Breast Unit, Champalimaud Cancer Center, Lisbon, Portugal
| | - T Cufer
- University Clinic Golnik, Medical Faculty Ljubljana, Ljubljana, Slovenia
| | - N El Saghir
- NK Basile Cancer Institute Breast Center of Excellence, American University of Beirut Medical Center, Beirut, Lebanon
| | - L Fallowfield
- Brighton & Sussex Medical School, University of Sussex, Falmer, UK
| | - D Fenech
- Breast Care Support Group, Europa Donna Malta, Mtarfa, Malta
| | - P Francis
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - K Gelmon
- BC Cancer Agency, Vancouver, Canada
| | - S H Giordano
- Departments of Health Services Research and Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, USA
| | - J Gligorov
- APHP Tenon, IUC-UPMC, Francilian Breast Intergroup, AROME, Paris, France
| | - A Goldhirsch
- Program of Breast Health, European Institute of Oncology, Milan, Italy
| | - N Harbeck
- Brustzentrum der Universität München, Munich, Denmark
| | - N Houssami
- Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - C Hudis
- Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - B Kaufman
- Sheba Medical Center, Tel Hashomer, Israel
| | - I Krop
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | | | - U N Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | | | - S D Merjaver
- University of Michigan Medical School and School of Public Health, Ann Arbor, USA
| | - E B Nordström
- Europa Donna Sweden & Bröstcancerföreningarnas Riksorganisation, BRO, Sundbyberg, Sweden
| | - O Pagani
- Oncology Institute of Southern Switzerland and Breast Unit of Southern Switzerland, Bellinzona, Switzerland
| | - A Partridge
- Department Medical Oncology, Division of Women's Cancers, Dana-Farber Cancer Institute, Boston, USA
| | - F Penault-Llorca
- Jean Perrin Centre, Comprehensive Cancer Centre, Clermont Ferrand, France
| | - M J Piccart
- Department of Medicine, Institut Jules Bordet, Brussels, Belgium
| | - H Rugo
- Department of Medicine, Breast Oncology Program, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco
| | - G Sledge
- Indiana University Medical CTR, Indianapolis, USA
| | - C Thomssen
- Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle an der Saale, Germany
| | - L Van't Veer
- Breast Oncology Program, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, USA
| | - D Vorobiof
- Sandton Oncology Centre, Johannesburg, South Africa
| | - C Vrieling
- Department of Radiotherapy, Clinique des Grangettes, Geneva, Switzerland
| | - N West
- Nursing Division, Health Board, Cardiff and Vale University, Cardiff, UK
| | - B Xu
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - E Winer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
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9
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Cardoso F, Costa A, Norton L, Senkus E, Aapro M, André F, Barrios CH, Bergh J, Biganzoli L, Blackwell KL, Cardoso MJ, Cufer T, El Saghir N, Fallowfield L, Fenech D, Francis P, Gelmon K, Giordano SH, Gligorov J, Goldhirsch A, Harbeck N, Houssami N, Hudis C, Kaufman B, Krop I, Kyriakides S, Lin UN, Mayer M, Merjaver SD, Nordström EB, Pagani O, Partridge A, Penault-Llorca F, Piccart MJ, Rugo H, Sledge G, Thomssen C, Van't Veer L, Vorobiof D, Vrieling C, West N, Xu B, Winer E. ESO-ESMO 2nd international consensus guidelines for advanced breast cancer (ABC2). Breast 2014; 23:489-502. [PMID: 25244983 DOI: 10.1016/j.breast.2014.08.009] [Citation(s) in RCA: 194] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 08/12/2014] [Indexed: 12/25/2022] Open
Affiliation(s)
- F Cardoso
- European School of Oncology & Breast Unit, Champalimaud Cancer Center, Lisbon, Portugal.
| | - A Costa
- European School of Oncology, Milan, Italy; European School of Oncology, Bellinzona, Switzerland
| | - L Norton
- Breast Cancer Program, Memorial Sloan-Kettering Cancer Centre, New York, USA
| | - E Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - M Aapro
- Division of Oncology, Institut Multidisciplinaire d'Oncologie, Genolier, Switzerland
| | - F André
- Department of Medical Oncology, Gustave-Roussy Institute, Villejuif, France
| | - C H Barrios
- Department of Medicine, PUCRS School of Medicine, Porto Alegre, Brazil
| | - J Bergh
- Department of Oncology/Radiumhemmet, Karolinska Institutet & Cancer Center Karolinska and Karolinska University Hospital, Stockholm, Sweden
| | - L Biganzoli
- Department of Medical Oncology, Sandro Pitigliani Oncology Centre, Prato, Italy
| | - K L Blackwell
- Breast Cancer Clinical Program, Duke Cancer Institute, Durham, USA
| | - M J Cardoso
- Breast Unit, Champalimaud Cancer Center, Lisbon, Portugal
| | - T Cufer
- University Clinic Golnik, Medical Faculty Ljubljana, Ljubljana, Slovenia
| | - N El Saghir
- NK Basile Cancer Institute Breast Center of Excellence, American University of Beirut Medical Center, Beirut, Lebanon
| | - L Fallowfield
- Brighton & Sussex Medical School, University of Sussex, Falmer, UK
| | - D Fenech
- Breast Care Support Group, Europa Donna Malta, Mtarfa, Malta
| | - P Francis
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - K Gelmon
- BC Cancer Agency, Vancouver, Canada
| | - S H Giordano
- Departments of Health Services Research and Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, USA
| | - J Gligorov
- APHP Tenon, IUC-UPMC, Francilian Breast Intergroup, Arome, Paris, France
| | - A Goldhirsch
- Program of Breast Health, European Institute of Oncology, Milan, Italy
| | - N Harbeck
- Brustzentrum der Universität München, Munich, DE, USA
| | - N Houssami
- Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - C Hudis
- Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - B Kaufman
- Sheba Medical Center, Tel Hashomer, Israel
| | - I Krop
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | | | - U N Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - M Mayer
- Advanced BC.org, New York, USA
| | - S D Merjaver
- University of Michigan Medical School and School of Public Health, Ann Arbor, USA
| | - E B Nordström
- Europa Donna Sweden & Bröstcancerföreningarnas Riksorganisation, BRO, Sundbyberg, Sweden
| | - O Pagani
- Oncology Institute of Southern Switzerland and Breast Unit of Southern Switzerland, Bellinzona, Switzerland
| | - A Partridge
- Department Medical Oncology, Division of Women's Cancers, Dana-Farber Cancer Institute, Boston, USA
| | - F Penault-Llorca
- Jean Perrin Centre, Comprehensive Cancer Centre, Clermont Ferrand, France
| | - M J Piccart
- Department of Medicine, Institut Jules Bordet, Brussels, Belgium
| | - H Rugo
- Department of Medicine, Breast Oncology Program, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, USA
| | - G Sledge
- Indiana University Medical CTR, Indianapolis, USA
| | - C Thomssen
- Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle an der Saale, DE, Germany
| | - L Van't Veer
- Breast Oncology Program, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, USA
| | - D Vorobiof
- Sandton Oncology Centre, Johannesburg, South Africa
| | - C Vrieling
- Department of Radiotherapy, Clinique des Grangettes, Geneva, Switzerland
| | - N West
- Nursing Division, Health Board, Cardiff and Vale University, Cardiff, UK
| | - B Xu
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - E Winer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
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Sacco RL, Smith SC, Holmes D, Shurin S, Brawley O, Cazap E, Glass R, Komajda M, Koroshetz W, Mayer-Davis E, Mbanya JC, Sledge G, Varmus H. Accelerating progress on non-communicable diseases. Lancet 2013; 382:e4-5. [PMID: 21933747 DOI: 10.1016/s0140-6736(11)61477-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- R L Sacco
- American Heart Association, Dallas, TX 75231, USA.
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11
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Cardoso F, Costa A, Norton L, Cameron D, Cufer T, Fallowfield L, Francis P, Gligorov J, Kyriakides S, Lin N, Pagani O, Senkus E, Thomssen C, Aapro M, Bergh J, Di Leo A, El Saghir N, Ganz PA, Gelmon K, Goldhirsch A, Harbeck N, Houssami N, Hudis C, Kaufman B, Leadbeater M, Mayer M, Rodger A, Rugo H, Sacchini V, Sledge G, van't Veer L, Viale G, Krop I, Winer E. 1st International consensus guidelines for advanced breast cancer (ABC 1). Breast 2012; 21:242-52. [PMID: 22425534 DOI: 10.1016/j.breast.2012.03.003] [Citation(s) in RCA: 242] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The 1st international Consensus Conference for Advanced Breast Cancer (ABC 1) took place on November 2011, in Lisbon. Consensus guidelines for the management of this disease were developed. This manuscript summarizes these international consensus guidelines.
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Affiliation(s)
- F Cardoso
- European School of Oncology & Breast Unit, Champalimaud Cancer Center, Lisbon, Portugal.
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12
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Miller K, Estes M, Perkins S, Schneider B, Matei D, Storniolo A, Ingram D, Yoder M, Kern K, Sledge G. An Exploratory Study of the Biological Activity of Sunitinib as a Component of Neoadjuvant Therapy for Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: The neoadjuvant setting provides an ideal opportunity to explore the impact of sunitinib alone and in combination with paclitaxel on the functional status of tumor vasculature as indicated by changes in tumor interstitial pressure (IFP) and circulating progenitor cell (CPC) subsets.Methods: Patients(pts.) with newly diagnosed stage Ic-IIIc breast cancer were treated with sunitinib monotherapy (100 mg Day 1; 37.5 mg D2-14) prior to the initiation of paclitaxel (80 mg/M2 D1,8,15 every 28 days x 4 cycles) with sunitinib (25 mg/d). IFP and CPC subsets were assessed at baseline and after sunitinib monotherapy. IFP was measured in three separate areas of the tumor using a micropressure transducer catheter; mean and highest IFP recorded were analyzed. Improvements in poly-chromatic flow cytometry allowed distinction of pro-angiogenic (pCPC = Live/AC133+CD34bright/CD31+CD45dim\), from non-angiogenic (nCPC = Live/AC133-CD34bright/CD31+/CD45dim\), CPCs that cannot be quantified separately using previously reported protocols1. Baseline CPC subsets were also compared to age and gender matched healthy controls.Results: From July 2008 to May 2009, 14 pts were enrolled; baseline and post-sunitinib IFP and CPC data are available for 12 and 11 pts respectively. The median age was 48 (range 32-69). Mean pretreatment tumor diameter was 3.2 cm. Sunitinib monotherapy was generally well tolerated; two patients developed grade III toxicities including hypertension (n=1) and hand-foot syndrome (n=1). Sunitinib significantly decreased mean IFP (18.87 mmHg vs. 6.38 mmHg; p=0.002); similar results were obtained when only the maximum IFP was considered (22.32 mmHg vs. 8.36 mmHg; p=0.003). pCPC frequency was not different between pts and healthy controls (0.099% vs. 0.076%, p=0.24) but the p:nCPC ratio was significantly higher in pts compared to healthy controls (3.26 vs. 1.46; p=0.001) suggesting a shift toward vascular damage and/or active angiogenesis. Both pCPC frequency (0.099 vs. 0.022; p=0.001) and p:nCPC ratio (3.26 vs. 0.78; p=0.001) significantly decreased after sunitinib monotherapy. Analysis of paclitaxel + sunitinib is too early (n=4).Conclusion: Sunitinib, through its effects on VEGF-mediated vascular permeability, markedly reduces tumor IFP. In addition sunitinib profoundly reduces pCPCs that are thought to be important for angiogenesis in human cancers. Accrual is ongoing (planned N=40). Analysis of IFP and CPC subsets after paclitaxel + sunitinib as well as additional correlates will be presented.1 Duda et al. (2007). Nat. Protocol 2, 805-810.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 202.
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Affiliation(s)
- K. Miller
- 1Indiana University Melvin and Bren Simon Cancer Center, IN,
| | - M. Estes
- 1Indiana University Melvin and Bren Simon Cancer Center, IN,
| | - S. Perkins
- 1Indiana University Melvin and Bren Simon Cancer Center, IN,
| | - B. Schneider
- 1Indiana University Melvin and Bren Simon Cancer Center, IN,
| | - D. Matei
- 1Indiana University Melvin and Bren Simon Cancer Center, IN,
| | - A. Storniolo
- 1Indiana University Melvin and Bren Simon Cancer Center, IN,
| | - D. Ingram
- 1Indiana University Melvin and Bren Simon Cancer Center, IN,
| | - M. Yoder
- 1Indiana University Melvin and Bren Simon Cancer Center, IN,
| | | | - G. Sledge
- 1Indiana University Melvin and Bren Simon Cancer Center, IN,
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13
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Radovich M, Clare S, Clare S, Pardo I, Hancock B, Sledge G, Rufenbarger C, Rufenbarger C, Storniolo A, Storniolo A, Mathieson T, Mathieson T, Sun J, Sun J, Henry J, Henry J, Hilligoss E, Elliott J, Richt R, Hickenbotham M, Glasscock J, Liu Y, Schneider B. Next-Generation Whole Transcriptome Sequencing of Triple-Negative Breast Tumors and Normal Tissues. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-6134] [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: Triple-negative breast cancer predominately affects pre-menopausal women and women of African-American descent and has been plagued by the absence of targeted therapies leading to poor survival. Using a new cutting edge technology, next-generation sequencing, we embarked on a study to analyze the whole transcriptomes of triple-negative tumors and normal tissues from pre-menopausal women in order to comprehensively identify new targets by analyzing all full length transcripts expressed in these tissues. This approach is independent of pre-determined gene selection as is common with microarrays, and allows for the analysis of RNA species that have not been previously profiled in breast cancer.Methods: cDNA libraries were created from RNA isolated from 8 triple-negative tumors and 2 normal breast tissues. Triple negative tumors were procured from Origene Technologies and normal breast tissues were procured from the Susan G. Komen for the Cure tissue bank at Indiana University. Normal samples were from healthy pre-menopausal volunteers with no history of disease. In order to eliminate bias from stromal tissue, normal samples were laser capture microdissected for ductal cells and RNA extracted from the excised tissue. cDNA libraries were prepared and subsequently sequenced on an Applied Biosystems (ABI) SOLiD3 sequencer using a 50bp fragment run. Mapping of whole reads to the human genome was performed using the SOLiD Analysis Pipeline Tool software (ABI) followed by a split-read alignment in order to map reads crossing exon-exon junctions. Gene expression profiles for each sample were then created and statistically compared to identify the most differentially expressed genes. In order to analyze for fusion genes, a split-read alignment of non-mapping reads to a composite transcriptome formed from previously mapped reads (clusters) was performed.Results: Sequencing of the 10 samples produced 513 million filtered reads equaling 25.66GB of data. Mapping of the reads to the genome revealed 1.14 million transcribed regions (exons). A preliminary analysis of gene expression shows 55.2% of the transcribed loci to have significant differential expression between tumor and normal. In a further analysis for gene fusions, several candidate fusions were bioinformatically detected. These are currently being reviewed and validated.Discussion: Herein we present a preliminary analysis of the transcriptomes of triple-negative breast cancers in comparison to normal tissues. A multitude of analyses are ongoing, including but not limited to: gene fusions, differentially expressed novel genes, novel transcripts, alternative splicing, intrinsic subtyping, and presence of viral genes. In addition 2 more triple-negative tumors and 8 normal samples will also be sequenced. In the current analysis, differentially expressed non-coding RNAs was highly pervasive among the samples indicating a major role of this RNA species in tumorigenesis. In addition, triple-negative breast cancers may contain fusion genes that could be “drivers” of this malignancy. Further validation of these differentially expressed RNAs and fusion genes in a larger set of samples with subsequent functional studies is planned.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6134.
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Affiliation(s)
| | - S. Clare
- 1Indiana University School of Medicine, IN,
| | - S. Clare
- 2Susan G. Komen for the Cure Tissue Bank at the IU Simon Cancer Center, IN,
| | - I. Pardo
- 1Indiana University School of Medicine, IN,
| | - B. Hancock
- 1Indiana University School of Medicine, IN,
| | - G. Sledge
- 1Indiana University School of Medicine, IN,
| | - C. Rufenbarger
- 2Susan G. Komen for the Cure Tissue Bank at the IU Simon Cancer Center, IN,
| | | | | | - A. Storniolo
- 2Susan G. Komen for the Cure Tissue Bank at the IU Simon Cancer Center, IN,
| | | | - T. Mathieson
- 2Susan G. Komen for the Cure Tissue Bank at the IU Simon Cancer Center, IN,
| | - J. Sun
- 1Indiana University School of Medicine, IN,
| | - J. Sun
- 2Susan G. Komen for the Cure Tissue Bank at the IU Simon Cancer Center, IN,
| | - J. Henry
- 1Indiana University School of Medicine, IN,
| | - J. Henry
- 2Susan G. Komen for the Cure Tissue Bank at the IU Simon Cancer Center, IN,
| | | | | | | | | | | | - Y. Liu
- 1Indiana University School of Medicine, IN,
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14
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Sparano J, Gray R, Goldstein L, Childs B, Brassard D, Bugarini R, Rowley S, Baker J, Shak S, Badve S, Baehner F, Kenny P, Perez E, Shulman L, Martino S, Sledge G, Davidson N. Gene Expression Profiling of Phenotypically-Defined Hormone-Receptor Positive Breast Cancer: Evidence for Increased Transcriptional Activity of the Insulin Growth Factor Receptor Pathway and Other Pathways. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-5165] [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: Approximately 70% of all breast cancers are hormone receptor (HR)-positive tumors that are sensitive to endocrine therapy, but some patients have recurrence despite adjuvant endocrine therapy. We performed an exploratory analysis of gene expression in HR-pos operable breast cancer in order to identify potential novel therapeutic targets and biomarkers associated with recurrence. Methods: RNA was extracted from primary tumor samples obtained from 776 patients with stage I-III breast cancer treated with adjuvant chemohormonal therapy in trial E2197 (JCO 2008; 26: 4092-4099), of whom 458 had HR-pos disease (defined in a central lab; JCO 2008; 26: 2473). We evaluated RNA expression patterns (by quantitative RT-PCR using a panel of 371 rationally selected genes) in HR-pos cases compared with the HR-neg cases using weighted T statistics, and determined which genes in the HR-pos, HER2-neg group were associated with recurrence (using Cox proportional hazards model score test, Korn's adjusted P value <5% with false discovery rate < 10%).Results: The top 10 genes exhibiting significantly higher expression in the HR-pos group (p≤ 6.17e-160) included ESR1 plus 5 estrogen regulated genes, confirming our approach of evaluating gene expression in phenotypically-defined subsets. Other pathways that exhibited higher expression in the HR-pos group (among the 40 top genes with higher expression, p<8.66e-53) included the insulin growth factor (IGF) (IRS1, IGFR1, IGFB2), Ras (RhoB, RhoC, RAB27B, GGPS1), and HER pathways (ERBB2, ERBB3, ERBB4), and other genes involved in apoptosis (BCL2, BCL2L1, BAG1, NME6, BBC3), signaling (MAPK3, SEMA3F, RXRA), mismatch repair (MSH3), cell cycle regulation (CCND1), stress response (HSPB1), and tumor suppressor genes (TP53BP1, APC). These patterns were similar in HER2-pos cases. Pathway analysis (Ingenuity) revealed substantial interconnectivity among these genes, especially between IGFR1, ERB2/3/4, MAPK3, BCL2, and CCND1, but not RhoB/RhoC. Genes for which increased expression was associated with increased recurrence included those associated with proliferation (TOP2A, AURKB, PLK1) and apoptosis (BIRC5 - survivin).Conclusions: This exploratory analysis reveals several pathways that exhibit higher transcriptional expression in HR-pos disease, some of which are also associated with a higher risk of recurrence, suggesting that they may be potential therapeutic targets. This provides rationale for testing agents currently available in the clinic that inhibit the IGF and other pathways.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5165.
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Affiliation(s)
- J. Sparano
- 1Eastern Cooperative Oncology Group, MA,
| | - R. Gray
- 1Eastern Cooperative Oncology Group, MA,
| | | | | | | | | | | | | | | | - S. Badve
- 1Eastern Cooperative Oncology Group, MA,
| | | | - P. Kenny
- 1Eastern Cooperative Oncology Group, MA,
| | - E. Perez
- 4North Central Cancer Treatment Group, MN,
| | | | | | - G. Sledge
- 1Eastern Cooperative Oncology Group, MA,
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15
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Badve S, Shen C, Thorat M, Li L, Gagnon R, Koehler M, Ellis C, O'Shaughnessy J, Baselga J, Sledge G. 5BA Identification of gene expression profiles that predict response to HER2-targeted therapy. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)72035-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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16
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Baselga J, Gianni L, Gradishar WJ, Hudis C, Perez EA, Piccart-Gebhart M, Schwartzberg LS, Sledge G, Fleming TR. Phase IIb double-blind, randomized, placebo-controlled trials for the efficacy and safety of sorafenib in patients (pts) with metastatic or locally advanced breast cancer (BC): Review of the Trials to Investigate the Effects of Sorafenib in BC (TIES) program. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e12000] [Citation(s) in RCA: 3] [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
e12000 Sorafenib is a potent multikinase inhibitor approved by the FDA and EMEA for the treatment of advanced renal cell carcinoma and hepatocellular carcinoma. As a single agent, sorafenib has been shown to have activity in pts with BC. Here, we review the TIES program, a compilation of currently ongoing investigator-sponsored phase IIb multinational, randomized, double-blind, placebo-controlled studies that aim to determine the optimal sequencing of pharmacologic agents for the treatment of BC. All studies will combine sorafenib with first- and/or second-line chemotherapy and/or hormonal therapy in pts with HER2-negative metastatic or locally advanced BC, enroll 220 pts, stratify pts by visceral vs nonvisceral disease, allow pts with evaluable and measurable disease, and include pts with treated brain metastases. The primary endpoint of all trials will be progression-free survival. Secondary endpoints will be safety, overall survival, objective response rate, duration of response, and time to progression. Some studies will also assess quality of life, pharmacokinetic sampling, and biomarkers. Additional information on four of the trials is shown below (Table). Patient characteristics and accruals will be reported. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- J. Baselga
- Vall d’ Hebron University Hospital, Barcelona, Spain; Istituto Nazionale Tumori, Milan, Italy; Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic, Jacksonville, FL; Institut Jules Bordet, Brussels, Belgium; West Clinic, Memphis, TN; University of Indiana, Indianapolis, IN; University of Washington, Seattle, WA
| | - L. Gianni
- Vall d’ Hebron University Hospital, Barcelona, Spain; Istituto Nazionale Tumori, Milan, Italy; Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic, Jacksonville, FL; Institut Jules Bordet, Brussels, Belgium; West Clinic, Memphis, TN; University of Indiana, Indianapolis, IN; University of Washington, Seattle, WA
| | - W. J. Gradishar
- Vall d’ Hebron University Hospital, Barcelona, Spain; Istituto Nazionale Tumori, Milan, Italy; Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic, Jacksonville, FL; Institut Jules Bordet, Brussels, Belgium; West Clinic, Memphis, TN; University of Indiana, Indianapolis, IN; University of Washington, Seattle, WA
| | - C. Hudis
- Vall d’ Hebron University Hospital, Barcelona, Spain; Istituto Nazionale Tumori, Milan, Italy; Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic, Jacksonville, FL; Institut Jules Bordet, Brussels, Belgium; West Clinic, Memphis, TN; University of Indiana, Indianapolis, IN; University of Washington, Seattle, WA
| | - E. A. Perez
- Vall d’ Hebron University Hospital, Barcelona, Spain; Istituto Nazionale Tumori, Milan, Italy; Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic, Jacksonville, FL; Institut Jules Bordet, Brussels, Belgium; West Clinic, Memphis, TN; University of Indiana, Indianapolis, IN; University of Washington, Seattle, WA
| | - M. Piccart-Gebhart
- Vall d’ Hebron University Hospital, Barcelona, Spain; Istituto Nazionale Tumori, Milan, Italy; Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic, Jacksonville, FL; Institut Jules Bordet, Brussels, Belgium; West Clinic, Memphis, TN; University of Indiana, Indianapolis, IN; University of Washington, Seattle, WA
| | - L. S. Schwartzberg
- Vall d’ Hebron University Hospital, Barcelona, Spain; Istituto Nazionale Tumori, Milan, Italy; Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic, Jacksonville, FL; Institut Jules Bordet, Brussels, Belgium; West Clinic, Memphis, TN; University of Indiana, Indianapolis, IN; University of Washington, Seattle, WA
| | - G. Sledge
- Vall d’ Hebron University Hospital, Barcelona, Spain; Istituto Nazionale Tumori, Milan, Italy; Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic, Jacksonville, FL; Institut Jules Bordet, Brussels, Belgium; West Clinic, Memphis, TN; University of Indiana, Indianapolis, IN; University of Washington, Seattle, WA
| | - T. R. Fleming
- Vall d’ Hebron University Hospital, Barcelona, Spain; Istituto Nazionale Tumori, Milan, Italy; Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic, Jacksonville, FL; Institut Jules Bordet, Brussels, Belgium; West Clinic, Memphis, TN; University of Indiana, Indianapolis, IN; University of Washington, Seattle, WA
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17
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Miller K, Christmon D, Perkins S, Sun J, Schneider B, Storniolo A, Clare S, Ozerdem U, Sledge G. A pilot study of vascular endothelial growth factor inhibition with bevacizumab in patients with lymphedema following breast cancer treatment. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9523] [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
9523 Background: Lymphedema is a significant long-term complication of primary therapy for breast cancer. Anecdotally, several patients (pts) with metastatic disease treated with bevacizumab monotherapy noted improvement in long-standing lymphedema. This pilot study was conducted to explore these observations prospectively. Methods: We used an existing biospecimen bank to conduct a case-control study to compare VEGF-A, -C, -D and VEGFR-3 serum concentrations in breast cancer pts with and without lymphedema (matched for age and LN status). In a separate pilot trial, pts with significant unilateral lymphedema receive bevacizumab, 15 mg/kg every 3 weeks. Baseline assessments include arm volume, interstitial fluid pressure (IFP), extracellular fluid volume by lymphometer (ECF), quality of life (QOL) and plasma VEGF-C, -D, and R3. IFP is measured serially for 24 hours after the first treatment; arm volume, ECF, QOL, and plasma VEGF-C/D/R3 are assessed at 3 and 6 weeks. Results: Samples were available for 16 pts with chronic lymphedema and 31 matched controls. Median VEGF-C levels were significantly increased in pts with lymphedema (6895 pg/ml vs. 5349 pg/ml, p=0.001). Twelve pts have been enrolled in the pilot trial. Median duration of lymphedema was 6.3 years (0.5–16.6) Median time since surgery was 5.5 years (1.9–17.6); median time since radiation (n=10) was 5.1 years (1.3–8.3). Complete IFP data is available in 9 pts. Baseline IFP was significantly higher in the affected compared to unaffected arm (7.63 vs. -0.87 mmHg; p=0.0023). Mean IFP in the affected arm decreased an average of 41.9% 24 hours after bevacizumab infusion (7.63 vs. 4.88 mmHg; p=0.07). ECF, VEGF-1, and VEGF-R3 levels all significantly decreased three weeks after initial treatment. Two patients met the definition of response with a ≥ 25% reduction in excess arm volume though the mean difference in excess arm volume did not significantly change (p=0.19). Conclusions: Preliminary data supports the hypothesis that VEGF plays a central role in the development and persistence of lymphedema after local therapy for breast cancer. Bevacizumab acutely decreases IFP, leading to a decrease in ECF and modest improvement in arm volume. [Table: see text]
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Affiliation(s)
- K. Miller
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; LaJolla Institute of Molecular Medicine, La Jolla, CA
| | - D. Christmon
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; LaJolla Institute of Molecular Medicine, La Jolla, CA
| | - S. Perkins
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; LaJolla Institute of Molecular Medicine, La Jolla, CA
| | - J. Sun
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; LaJolla Institute of Molecular Medicine, La Jolla, CA
| | - B. Schneider
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; LaJolla Institute of Molecular Medicine, La Jolla, CA
| | - A. Storniolo
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; LaJolla Institute of Molecular Medicine, La Jolla, CA
| | - S. Clare
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; LaJolla Institute of Molecular Medicine, La Jolla, CA
| | - U. Ozerdem
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; LaJolla Institute of Molecular Medicine, La Jolla, CA
| | - G. Sledge
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; LaJolla Institute of Molecular Medicine, La Jolla, CA
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18
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Carlson RW, O'Neill A, Vidaurre T, Gomez HL, Badve S, Sledge G. Randomized phase II trial of gefitinib plus anastrozole or fulvestrant in postmenopausal, metastatic breast cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1013] [Citation(s) in RCA: 7] [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
1013 Background: Preclinical data documents interactions between the signal transduction pathways for ER and for EGFR, and these interactions may relate to endocrine resistance in ER+ breast cancer. Limited clinical data is available. Methods: This multi-institutional, single-stage, non-comparative, randomized phase II study tested the EGFR tyrosine kinase inhibitor gefitinib 250 mg daily PO plus endocrine therapy with either anastrozole 1 mg/day PO (AG Arm) versus fulvestrant 250 mg IM every 4-weeks (FG Arm). Eligible pts were postmenopausal women with ER+ and/or PgR+ measurable metastatic breast cancer with no prior endocrine therapy for metastatic disease, no prior adjuvant AI or fulvestrant, no more than two chemotherapy regimens for metastatic disease, ECOG status 0–2, no CNS metastasis, and adequate bone marrow, liver, and renal function. Primary endpoint was RECIST determined clinical benefit (CR+PR+SD for ≥6 mos) and secondary endpoints were toxicity and interaction of biomarkers with clinical benefit. Results: 148 pts were registered, and 142 pts are eligible and analyzable, 73 to AG and 69 to FG. Treatment groups were balanced for race, age, ECOG status, and sites of disease. Median follow-up is 35 mos. Median N of 4-week cycles of treatment is 6 (range 1–42) in both groups. Treatment was terminated for disease progression in 74% v 75%, toxicity 7% v 10%, death 1% v 3%, withdrawal 8% v 1%, and other 3% v 7% in the AG v FG arms, respectively. Clinical benefit rate (95% CI) is 42% (30%-53%) v 38% (28%-52%) for AG v FG, respectively. Response rates are CR 3% v 4%, PR 21% v 17%, SD for ≥6 mos 18% v 17% for AG v FG. Median PFS is 5.7 mos v 5.2 mos and median OS is 30.2 mos v 23.8 mos for AG v FG, respectively. Overall worst toxicity grade experienced for AG is G1 and 2 = 62%; G3 = 28%; G4 = 4%, G5 = 3%; for FG was G1 and 2 = 58%; G3 = 27%; G4 = 7%; G5 = 4%. G3 + G4 + G5 toxicities occurring in ≥5% of either treatment are diarrhea (5% v 13%), SGOT elevation (7% v 8%), and infection without neutropenia (1% v 6%) for AG v FG. Conclusions: Both anastrozle and fulvestrant are active endocrine agents in combination with gefitinib and both are generally well tolerated. Anastrozole plus gefitinib appears to be the better combination to take forward for phase III comparisons. [Table: see text]
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Affiliation(s)
- R. W. Carlson
- Stanford University, Stanford, CA; Dana-Farber Cancer Institute, Boston, MA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Indiana University Cancer Center, Indianapolis, IN
| | - A. O'Neill
- Stanford University, Stanford, CA; Dana-Farber Cancer Institute, Boston, MA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Indiana University Cancer Center, Indianapolis, IN
| | - T. Vidaurre
- Stanford University, Stanford, CA; Dana-Farber Cancer Institute, Boston, MA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Indiana University Cancer Center, Indianapolis, IN
| | - H. L. Gomez
- Stanford University, Stanford, CA; Dana-Farber Cancer Institute, Boston, MA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Indiana University Cancer Center, Indianapolis, IN
| | - S. Badve
- Stanford University, Stanford, CA; Dana-Farber Cancer Institute, Boston, MA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Indiana University Cancer Center, Indianapolis, IN
| | - G. Sledge
- Stanford University, Stanford, CA; Dana-Farber Cancer Institute, Boston, MA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Indiana University Cancer Center, Indianapolis, IN
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19
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Duchnowska R, Jassem J, Shen C, Thorat M, Li L, Morimiya A, Zhao Q, Biernat W, Mandat T, Staszkiewicz R, Och W, Szostak W, Gugala K, Trojanowski T, Czartoryska-Arlukowicz B, Szczylik C, Nakshatri H, Steeg P, Sledge G, Badve S. Molecular characteristics of matched brain metastasis (BM) versus the primary breast cancer (PBC). Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-2028] [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
Abstract #2028
Background: Brain is increasingly a site of relapse in breast cancer patients, however the molecular patho-physiology of this process is not well understood. Using a novel assay allowing high-throughput analysis of gene expression from formalin-fixed paraffin-embedded (FFPET) tumor samples, we compared molecular characteristics of BM with those of the PBC in a series of breast cancer patients who underwent excision of brain metastasis.
 Methods: In each patient we performed molecular analysis of paired archived FFPET specimens from both the PBC and excised BM. Of the 37 pairs of PBC/BM samples, 24 pairs had sufficient pathology material for molecular analysis. Patient characteristics: mean age at PBC diagnosis was 46.7 years (range 27-67 years); 7 (29%) ER+, 17 (71%) ER-, 12 (50%) HER2-positive(3+). We performed cDNA-mediated annealing, selection, extension and ligation (DASL) assay (Illumina Corp) for expression of 502 known cancer genes, using 200 ng RNA. Statistical analysis for microarrays (SAM) accounting for the pairing of the primary and metastasized tumors was used to identify differentially expressed genes while controlling the false discovery rate (FDR <0.01). BeadStudio™ Absolute correlation clustering was used to cluster samples based on their expression profiles.
 Results: In only 7 (29%) cases matched PBC and BM pair clustered together on unsupervised hierarchical clustering, the pairs in remaining cases clustered apart. Comparison of the two groups (PBC and BM) showed that 41 genes were up regulated in BM, including proliferation genes (CDC2, CDC25a, CCNA2 and E2F family), anti-apoptotic (BIRC5), DNA repair (RAD51, -54b, XRCC2, BRCA2, BARD1, TOP1), angiogenesis (VEGF), and development of drug resistance (ABCB1, -G2). In contrast, the 43 genes that were down regulated in BM included those associated with invasion (MMP2, -3, -14), cellular motility, and epithelial to mesenchymal transformation (CDH11). Additional analysis to validate these trends and to identify potential therapeutic targets is underway.
 Conclusions: Although some BM retain remarkable similarity to the PBC, majority exhibit considerable deviation in their gene expression profile. These “adaptive” changes include greater resistance to drug therapy, increased DNA repair, a reversal back to the epithelial phenotype and decreased capacity for cell motility and invasion.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2028.
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Affiliation(s)
- R Duchnowska
- 1 Military Institute of Medicine, Warsaw, Poland
| | - J Jassem
- 2 Medical University, Gdansk, Poland
| | - C Shen
- 2 Medical University, Gdansk, Poland
| | - M Thorat
- 3 Indiana University, Indianapolis
| | - L Li
- 3 Indiana University, Indianapolis
| | | | - Q Zhao
- 3 Indiana University, Indianapolis
| | - W Biernat
- 2 Medical University, Gdansk, Poland
| | - T Mandat
- 1 Military Institute of Medicine, Warsaw, Poland
| | | | - W Och
- 4 General Hospital, Olsztyn, Poland
| | | | - K Gugala
- 4 General Hospital, Olsztyn, Poland
| | | | | | - C Szczylik
- 1 Military Institute of Medicine, Warsaw, Poland
| | | | - P Steeg
- 7 National Cancer Institute, Bethesda
| | - G Sledge
- 3 Indiana University, Indianapolis
| | - S Badve
- 3 Indiana University, Indianapolis
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20
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O'Shaughnessy J, Blackwell KL, Burstein H, Storniolo AM, Sledge G, Baselga J, Koehler M, Laabs S, Florance A, Roychowdhury D. A randomized study of lapatinib alone or in combination with trastuzumab in heavily pretreated HER2+ metastatic breast cancer progressing on trastuzumab therapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.1015] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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Matei D, Kelich S, Cao L, Menning N, Emerson R, Emerson R, Rao J, Sledge G. Induction of VEGF secretion in ovarian cancer by PDGF BB. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5557] [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
5557 Background: We identified the PDGFR as a potential target in epithelial ovarian carcinoma (EOC). This led us to test whether inhibition of the receptor affects ovarian cancer cell proliferation and survival and regulates other processes critical to tumor growth and metastasis. We postulated that the PDGF-PDGFR axis regulates VEGF secretion in EOC. Methods: VEGF secretion in ovarian tumors, cancer cells, serum and ascites was measured by IHC, Western Blot and ELISA. The HOG Gyn03–62 protocol was a phase II protocol for patients with recurrent platinum resistant EOC. Patients were treated with imatinib and docetaxel. Serum and tumor samples from patients enrolled on this protocol were analyzed for VEGF. Results: VEGF expression was quantified by IHC in ovarian tumors. Of 21 PDGFR expressing ovarian tumors, seven specimens immunostained strongly for VEGF and six tumors demonstrated 2+ VEGF reactive extracellular (secreted) material. PDGF and VEGF secretion was measured in 17 specimens of malignant EOC ascites. The levels of PDGF BB and VEGF were strongly correlated (Pearson coefficient =0.728, p-value=0.001), suggesting that the two pathways interconnect. There was no correlation between PDGF AA and VEGF levels. VEGF levels were measured in 13 paired serum samples from patients enrolled in the clinical protocol HOG: Gyn03–62, before and after treatment. VEGF serum levels were stabilized or decreased in 9 of 13 EOC patients treated with imatinib. In conditioned media from primary cells, VEGF secretion was four fold higher for tumor derived cells than for cells derived from the normal ovarian epithelium. PDGF increased ten-fold VEGF secretion in PDGFR expressing immortalized ovarian cells (C272/hTert/E7 and C889/hTert), while imatinib reduced VEGF production to basal state. The effects of imatinib were mediated via inhibition of Akt and MAPK pathways, by stabilization of HIF1 alpha. In ovarian cancer cells overexpressing consitutively active Akt, imatinib inhibited only partially the secretion of VEGF compared to control cells, suggesting that the PI3K/Akt pathway is significantly implicated in PDGF-stimulated VEGF secretion. Conclusions: These results suggest that by blocking the PDGFR, imatinib inhibits VEGF production. This affects the tumor microenvironment favoring ovarian tumor growth and metastasis. No significant financial relationships to disclose.
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Affiliation(s)
- D. Matei
- Indiana Univ, Indianapolis, IN; UCLA, Los Angeles, CA
| | - S. Kelich
- Indiana Univ, Indianapolis, IN; UCLA, Los Angeles, CA
| | - L. Cao
- Indiana Univ, Indianapolis, IN; UCLA, Los Angeles, CA
| | - N. Menning
- Indiana Univ, Indianapolis, IN; UCLA, Los Angeles, CA
| | - R. Emerson
- Indiana Univ, Indianapolis, IN; UCLA, Los Angeles, CA
| | - R. Emerson
- Indiana Univ, Indianapolis, IN; UCLA, Los Angeles, CA
| | - J. Rao
- Indiana Univ, Indianapolis, IN; UCLA, Los Angeles, CA
| | - G. Sledge
- Indiana Univ, Indianapolis, IN; UCLA, Los Angeles, CA
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Abstract
1013 Background: C alone has good activity and tolerability in metastatic breast cancer (MBC) and when combined with docetaxel improves response and survival. C combined with B in heavily pretreated MBC improved the response rate but not PFS. In untreated MBC, the addition of B to chemotherapy significantly improves progression-free survival (PFS) which suggests that B, is most effective in early disease. Methods: Primary objective of this single-arm, 2-phase study, is to evaluate PFS in MBC patients receiving first-line treatment with C 1,000 mg/m2 twice daily on days 1–15 (28 doses) and B 15 mg/kg on day 1. Treatment was repeated every 21 days until progression. Eligibility criteria included HER2-negative MBC previously untreated for metastatic disease; ECOG performance status =1; no prior anti-angiogenic or oral fluoropyrimidine therapy. A sample size of 109 patients (including dropouts) was required to give 90% power to test an improvement from 4 months median PFS to 5.6 months with the two-sided test (a 5%) Results: At data cut-off, 103 patients had received study medication. Present results are based on 103 patients (ITT population), except tumor response which is based on 91 patients who had response evaluation. The average # of cycles received in first phase is 6.8. 84 pts.are alive at this time. 38.5% (35/91) pts. have had a response: complete response 5.5%; partial response 33.0%. Stable disease is 42.9% with 81.4% clinical benefit. Planned dose received is 77.7 % for C and 99.0 % for B. The majority of adverse events (AEs) were mild or moderate. The most common grade 3 AEs were hand-foot syndrome (13%) and pain (10%); grade 4 pulmonary embolism occurred in 2% in the first phase of the study. Conclusions: Updated results with longer follow-up including toxicity, TTP and PFS will be presented at the meeting. It appears that in first-line C+B is active for MBC and is well tolerated, with few grade 3/4 toxicities. [Table: see text]
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Affiliation(s)
- G. Sledge
- Indiana University, Indianapolis, IN; Roche Laboratories Inc., Nutley, NJ; Northwestern University, Chicago, IL
| | - K. Miller
- Indiana University, Indianapolis, IN; Roche Laboratories Inc., Nutley, NJ; Northwestern University, Chicago, IL
| | - C. Moisa
- Indiana University, Indianapolis, IN; Roche Laboratories Inc., Nutley, NJ; Northwestern University, Chicago, IL
| | - W. Gradishar
- Indiana University, Indianapolis, IN; Roche Laboratories Inc., Nutley, NJ; Northwestern University, Chicago, IL
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Wang M, Gradishar WJ, Sparano JA, Perez EA, Sledge G. A phase II trial of capecitabine (C) in combination with the farnesyltransferase (FT) inhibitor (FTI), tipifarnib (T), in patients (pt) with metastatic breast cancer (MBC): ECOG trial 1103. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.1036] [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
1036 Background: Approximately 30% of human cancers have mutated Ras genes that produce proteins that remain in an active state causing uncontrolled proliferative signals. Post-translational modification of Ras include farneyslation catalyzed by FT. Tipifarnib (R115777) is an oral FTI active against human tumor cell lines and exhibiting modest single agent activity in pts with previously treated MBC. A previous phase I trial reported that CT inhibited farneyslation in peripheral blood mononuclear cells without affecting the pharmacokinetics of either agent. Objective: To evaluate objective response rate (ORR) of CT in taxane refractory MBC and to secondarily evaluate associated toxicity and progression-free survival (PFS). Methods: Pt with measurable MBC, previously treated (rx) with an anthracycline and relapse on a taxane or within 30 days (d). Study rx: T- 300 mg, po BID × 14 d plus C- 1,000 mg/m2, po BID × 14 d, followed by 7 d rest. Tumor reassessment was repeated q 3 cycles. The study was designed to detect improvement in ORR from 25% with C alone to 40% for the CT combination (90.5% power; type I error rate of 9.9%; 21 responses in 64 eligible pt needed to be promising. Results: 66/71 pt are available for primary analysis. Median age 50 yrs. Performance status: 0–1, 100%. ORR: PR-4.8% (3/62) [95% CI 0.01, 0.13], SD - 21% (13/62) [ 95% CI 0.12, 0.33]. Median survival - 10.6 months. Toxicity (%): anemia - 8(G3/4), neutropenia - 30 (G3/4), thrombocytopenia - 8 (G3/4), HFS-8 (G3), nausea/vomiting - 11(G3), diarrhea - 8 (G3), sensory neuropathy - 5 (G3). Conclusion: CT in taxane -refractory MBC has low antitumor activity without excessive toxicity. More mature data, including PFS, will be presented. No significant financial relationships to disclose.
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Affiliation(s)
- M. Wang
- Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; Montefiore Hosp, New York, NY; Mayo Clinic, Jacksonville, FL; Indiana U., Indianapolis, IN
| | - W. J. Gradishar
- Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; Montefiore Hosp, New York, NY; Mayo Clinic, Jacksonville, FL; Indiana U., Indianapolis, IN
| | - J. A. Sparano
- Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; Montefiore Hosp, New York, NY; Mayo Clinic, Jacksonville, FL; Indiana U., Indianapolis, IN
| | - E. A. Perez
- Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; Montefiore Hosp, New York, NY; Mayo Clinic, Jacksonville, FL; Indiana U., Indianapolis, IN
| | - G. Sledge
- Dana-Farber Cancer Institute, Boston, MA; Northwestern University, Chicago, IL; Montefiore Hosp, New York, NY; Mayo Clinic, Jacksonville, FL; Indiana U., Indianapolis, IN
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Moulder SL, O’Neill A, Arteaga C, Pins M, Sparano J, Sledge G, Davidson N. Final Results of ECOG1100: A phase I/II study of combined blockade of the ErbB receptor network in patients with HER2- overexpressing metastatic breast cancer (MBC). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.1033] [Citation(s) in RCA: 3] [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
1033 Background: Activation of EGF receptor has been associated with resistance to trastuzumab in breast cancer cell lines. EGFR tyrosine kinase inhibitors inhibit HER2 phosphorylation and synergize with trastuzumab in HER2+ cell lines that co-express EGFR. Methods: Pts with MBC and HER2 overexpression by immunohistochemistry (3+) and/or HER2 gene-amplification by FISH, 0–2 prior chemotherapy regimens for met disease, LVEF 50%, and no prior trastuzumab were treated with trastuzumab 2 mg/kg/wk and gefitinib 250- 500 mg/day until disease progression, unacceptable toxicity or withdrawal of consent. The phase I portion of the trial used a 3+3 design to determine MTD. In the phase II portion of the trial, patients were stratified based upon prior chemotherapy exposure (Group 1= no prior exposure to chemotherapy, Group 2= prior exposure to 1–2 chemotherapy regimens). Response measured using RECIST criteria. The primary endpoint was to increase proportion progression free from 50 to 65% at 6 months in Group 1 and from 50 to 70% at 3 months in Group 2. Results: Phase I: DLT (Grade 3 diarrhea) occurred in 2/3 patients treated at the 500 mg/day dose level of gefitinib in combination with weekly trastuzumab. 0/3 patients treated at the 250 mg/day dose level experienced DLT. This was considered MTD and was the dose selected for the Phase II portion of the trial. Phase II: 36 eligible pts were enrolled. Most patients were ECOG PS of 0 and had visceral organ involvement. Of the patients enrolled in Group 1, one pt achieved a CR, one PR and 7 had SD (≥ 24 weeks). Median time to progression (TTP) was 2.9 months (95% CI, 2.5–4). In Group 2 no responses were observed with a median TTP of 2.5 months (95% CI, 1.5- 2.7). Most common severe toxicities were rash (grade 3, 14%) and diarrhea (grade 3, 30%). No grade 3 cardiac toxicity was encountered. Conclusions: Trastuzumab in combination with gefitinib at doses of 250 mg/day demonstrated an acceptable toxicity profile; however, during planned interim analysis, the TTP did not meet predetermined statistical endpoints required for study continuation. These results do not support the further use of this combination and have implications for other trials using trastuzumab and EGFR TK inhibitors simultaneously. [Table: see text]
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Affiliation(s)
- S. L. Moulder
- MD Anderson Cancer Ctr, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Vanderbilt University Medical Center, Nashville, TN; Northwestern University, Chicago, IL; Montefiore Medical Center, New York, NY; Indiana University Medical Center, Indianapolis, IN; John Hopkins University, Baltimore, MD; Eastern Cooperative Oncology Group
| | - A. O’Neill
- MD Anderson Cancer Ctr, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Vanderbilt University Medical Center, Nashville, TN; Northwestern University, Chicago, IL; Montefiore Medical Center, New York, NY; Indiana University Medical Center, Indianapolis, IN; John Hopkins University, Baltimore, MD; Eastern Cooperative Oncology Group
| | - C. Arteaga
- MD Anderson Cancer Ctr, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Vanderbilt University Medical Center, Nashville, TN; Northwestern University, Chicago, IL; Montefiore Medical Center, New York, NY; Indiana University Medical Center, Indianapolis, IN; John Hopkins University, Baltimore, MD; Eastern Cooperative Oncology Group
| | - M. Pins
- MD Anderson Cancer Ctr, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Vanderbilt University Medical Center, Nashville, TN; Northwestern University, Chicago, IL; Montefiore Medical Center, New York, NY; Indiana University Medical Center, Indianapolis, IN; John Hopkins University, Baltimore, MD; Eastern Cooperative Oncology Group
| | - J. Sparano
- MD Anderson Cancer Ctr, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Vanderbilt University Medical Center, Nashville, TN; Northwestern University, Chicago, IL; Montefiore Medical Center, New York, NY; Indiana University Medical Center, Indianapolis, IN; John Hopkins University, Baltimore, MD; Eastern Cooperative Oncology Group
| | - G. Sledge
- MD Anderson Cancer Ctr, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Vanderbilt University Medical Center, Nashville, TN; Northwestern University, Chicago, IL; Montefiore Medical Center, New York, NY; Indiana University Medical Center, Indianapolis, IN; John Hopkins University, Baltimore, MD; Eastern Cooperative Oncology Group
| | - N. Davidson
- MD Anderson Cancer Ctr, Houston, TX; Dana-Farber Cancer Institute, Boston, MA; Vanderbilt University Medical Center, Nashville, TN; Northwestern University, Chicago, IL; Montefiore Medical Center, New York, NY; Indiana University Medical Center, Indianapolis, IN; John Hopkins University, Baltimore, MD; Eastern Cooperative Oncology Group
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Piccart M, Burzykowski T, Buyse M, Nabholtz J, Carmichael J, Lück H, Sledge G, Paridaens R, Biganzoli L, Therasse P. Meta-analysis of taxanes alone or in combination with anthracyclines versus non taxane-based regimens as first-line therapy of patients with metastatic breast cancer (MBC): a lesson from the past and a message for the future. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)80454-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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de la Garza Salazar J, Içli F, Pienkowski T, Aapro M, Hortobagyi G, Martin M, Piccart M, Sledge G, Pritchard K, Albain K. ABREAST: A new global registry of adjuvant strategies in patients with early stage breast cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.576] [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)
- J. de la Garza Salazar
- INCan Mexico, Mexico City, Mexico; Ibni Sina Hosp, Ankara, Turkey; Maria Sklodowska-Curie Memorial Cancer Ctr, Warsaw, Poland; Clin de Genolier, Genolier, Switzerland; UT MD Anderson Cancer Ctr, Houston, TX; Hosp Clin San Carlos, Madrid, Spain; Inst Jules Bordet, Brussels, Belgium; Indiana Univ Medcl Ctr, Indianapolis, IN; Toronto-Sunnybrook Regional Cancer Ctr, Toronto, ON, Canada; Lolola Univ Medcl Ctr, Maywood, IL
| | - F. Içli
- INCan Mexico, Mexico City, Mexico; Ibni Sina Hosp, Ankara, Turkey; Maria Sklodowska-Curie Memorial Cancer Ctr, Warsaw, Poland; Clin de Genolier, Genolier, Switzerland; UT MD Anderson Cancer Ctr, Houston, TX; Hosp Clin San Carlos, Madrid, Spain; Inst Jules Bordet, Brussels, Belgium; Indiana Univ Medcl Ctr, Indianapolis, IN; Toronto-Sunnybrook Regional Cancer Ctr, Toronto, ON, Canada; Lolola Univ Medcl Ctr, Maywood, IL
| | - T. Pienkowski
- INCan Mexico, Mexico City, Mexico; Ibni Sina Hosp, Ankara, Turkey; Maria Sklodowska-Curie Memorial Cancer Ctr, Warsaw, Poland; Clin de Genolier, Genolier, Switzerland; UT MD Anderson Cancer Ctr, Houston, TX; Hosp Clin San Carlos, Madrid, Spain; Inst Jules Bordet, Brussels, Belgium; Indiana Univ Medcl Ctr, Indianapolis, IN; Toronto-Sunnybrook Regional Cancer Ctr, Toronto, ON, Canada; Lolola Univ Medcl Ctr, Maywood, IL
| | - M. Aapro
- INCan Mexico, Mexico City, Mexico; Ibni Sina Hosp, Ankara, Turkey; Maria Sklodowska-Curie Memorial Cancer Ctr, Warsaw, Poland; Clin de Genolier, Genolier, Switzerland; UT MD Anderson Cancer Ctr, Houston, TX; Hosp Clin San Carlos, Madrid, Spain; Inst Jules Bordet, Brussels, Belgium; Indiana Univ Medcl Ctr, Indianapolis, IN; Toronto-Sunnybrook Regional Cancer Ctr, Toronto, ON, Canada; Lolola Univ Medcl Ctr, Maywood, IL
| | - G. Hortobagyi
- INCan Mexico, Mexico City, Mexico; Ibni Sina Hosp, Ankara, Turkey; Maria Sklodowska-Curie Memorial Cancer Ctr, Warsaw, Poland; Clin de Genolier, Genolier, Switzerland; UT MD Anderson Cancer Ctr, Houston, TX; Hosp Clin San Carlos, Madrid, Spain; Inst Jules Bordet, Brussels, Belgium; Indiana Univ Medcl Ctr, Indianapolis, IN; Toronto-Sunnybrook Regional Cancer Ctr, Toronto, ON, Canada; Lolola Univ Medcl Ctr, Maywood, IL
| | - M. Martin
- INCan Mexico, Mexico City, Mexico; Ibni Sina Hosp, Ankara, Turkey; Maria Sklodowska-Curie Memorial Cancer Ctr, Warsaw, Poland; Clin de Genolier, Genolier, Switzerland; UT MD Anderson Cancer Ctr, Houston, TX; Hosp Clin San Carlos, Madrid, Spain; Inst Jules Bordet, Brussels, Belgium; Indiana Univ Medcl Ctr, Indianapolis, IN; Toronto-Sunnybrook Regional Cancer Ctr, Toronto, ON, Canada; Lolola Univ Medcl Ctr, Maywood, IL
| | - M. Piccart
- INCan Mexico, Mexico City, Mexico; Ibni Sina Hosp, Ankara, Turkey; Maria Sklodowska-Curie Memorial Cancer Ctr, Warsaw, Poland; Clin de Genolier, Genolier, Switzerland; UT MD Anderson Cancer Ctr, Houston, TX; Hosp Clin San Carlos, Madrid, Spain; Inst Jules Bordet, Brussels, Belgium; Indiana Univ Medcl Ctr, Indianapolis, IN; Toronto-Sunnybrook Regional Cancer Ctr, Toronto, ON, Canada; Lolola Univ Medcl Ctr, Maywood, IL
| | - G. Sledge
- INCan Mexico, Mexico City, Mexico; Ibni Sina Hosp, Ankara, Turkey; Maria Sklodowska-Curie Memorial Cancer Ctr, Warsaw, Poland; Clin de Genolier, Genolier, Switzerland; UT MD Anderson Cancer Ctr, Houston, TX; Hosp Clin San Carlos, Madrid, Spain; Inst Jules Bordet, Brussels, Belgium; Indiana Univ Medcl Ctr, Indianapolis, IN; Toronto-Sunnybrook Regional Cancer Ctr, Toronto, ON, Canada; Lolola Univ Medcl Ctr, Maywood, IL
| | - K. Pritchard
- INCan Mexico, Mexico City, Mexico; Ibni Sina Hosp, Ankara, Turkey; Maria Sklodowska-Curie Memorial Cancer Ctr, Warsaw, Poland; Clin de Genolier, Genolier, Switzerland; UT MD Anderson Cancer Ctr, Houston, TX; Hosp Clin San Carlos, Madrid, Spain; Inst Jules Bordet, Brussels, Belgium; Indiana Univ Medcl Ctr, Indianapolis, IN; Toronto-Sunnybrook Regional Cancer Ctr, Toronto, ON, Canada; Lolola Univ Medcl Ctr, Maywood, IL
| | - K. Albain
- INCan Mexico, Mexico City, Mexico; Ibni Sina Hosp, Ankara, Turkey; Maria Sklodowska-Curie Memorial Cancer Ctr, Warsaw, Poland; Clin de Genolier, Genolier, Switzerland; UT MD Anderson Cancer Ctr, Houston, TX; Hosp Clin San Carlos, Madrid, Spain; Inst Jules Bordet, Brussels, Belgium; Indiana Univ Medcl Ctr, Indianapolis, IN; Toronto-Sunnybrook Regional Cancer Ctr, Toronto, ON, Canada; Lolola Univ Medcl Ctr, Maywood, IL
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Ragaz J, Miller K, Badve S, Dayachko Y, Dunn S, Nielsen T, Brodie A, Huntsman D, Bajdik C, Sledge G. Adverse association of expressed vascular endothelial growth factor (VEGF) with long-term outcome of stage I-III breast cancer (BrCa), with co-expression data of VEGF and Her2, Cox2, uPA and ER. Results from the British Columbia Tissue Microarray Project. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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)
- J. Ragaz
- McGill University, Montreal, PQ, Canada; Indiana University Medical Centre, Indianapolis, IN; BCCA/Vancouver Hospital, University of British Columbia, Vancouver, BC, Canada; University of Maryland, Baltimore, MD
| | - K. Miller
- McGill University, Montreal, PQ, Canada; Indiana University Medical Centre, Indianapolis, IN; BCCA/Vancouver Hospital, University of British Columbia, Vancouver, BC, Canada; University of Maryland, Baltimore, MD
| | - S. Badve
- McGill University, Montreal, PQ, Canada; Indiana University Medical Centre, Indianapolis, IN; BCCA/Vancouver Hospital, University of British Columbia, Vancouver, BC, Canada; University of Maryland, Baltimore, MD
| | - Y. Dayachko
- McGill University, Montreal, PQ, Canada; Indiana University Medical Centre, Indianapolis, IN; BCCA/Vancouver Hospital, University of British Columbia, Vancouver, BC, Canada; University of Maryland, Baltimore, MD
| | - S. Dunn
- McGill University, Montreal, PQ, Canada; Indiana University Medical Centre, Indianapolis, IN; BCCA/Vancouver Hospital, University of British Columbia, Vancouver, BC, Canada; University of Maryland, Baltimore, MD
| | - T. Nielsen
- McGill University, Montreal, PQ, Canada; Indiana University Medical Centre, Indianapolis, IN; BCCA/Vancouver Hospital, University of British Columbia, Vancouver, BC, Canada; University of Maryland, Baltimore, MD
| | - A. Brodie
- McGill University, Montreal, PQ, Canada; Indiana University Medical Centre, Indianapolis, IN; BCCA/Vancouver Hospital, University of British Columbia, Vancouver, BC, Canada; University of Maryland, Baltimore, MD
| | - D. Huntsman
- McGill University, Montreal, PQ, Canada; Indiana University Medical Centre, Indianapolis, IN; BCCA/Vancouver Hospital, University of British Columbia, Vancouver, BC, Canada; University of Maryland, Baltimore, MD
| | - C. Bajdik
- McGill University, Montreal, PQ, Canada; Indiana University Medical Centre, Indianapolis, IN; BCCA/Vancouver Hospital, University of British Columbia, Vancouver, BC, Canada; University of Maryland, Baltimore, MD
| | - G. Sledge
- McGill University, Montreal, PQ, Canada; Indiana University Medical Centre, Indianapolis, IN; BCCA/Vancouver Hospital, University of British Columbia, Vancouver, BC, Canada; University of Maryland, Baltimore, MD
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Ragaz J, Lippman M, Van Rijn M, Brodie A, Jelovac D, Nielsen T, Dedhar S, Huntsman D, Hayes M, Dunn S, Cheung M, Sledge G, Chia S, Harris A, Bajdik C, Speers C, Spinelli J, Hayes D. 2. Survival Impact of HER-2/Neu, Cox-2, Urokinase Plasminogen Activator (upa), Cytokeratin 17/5,6 and other Markers with Long-Term Outcome of Early Breast Cancer. Report from the British Columbia Tissue Micro-Array Project (BCTMAP). Breast Cancer Res Treat 2003. [DOI: 10.1023/a:1023979226714] [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]
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Starnes T, Robertson MJ, Sledge G, Kelich S, Nakshatri H, Broxmeyer HE, Hromas R. Cutting edge: IL-17F, a novel cytokine selectively expressed in activated T cells and monocytes, regulates angiogenesis and endothelial cell cytokine production. J Immunol 2001; 167:4137-40. [PMID: 11591732 DOI: 10.4049/jimmunol.167.8.4137] [Citation(s) in RCA: 256] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A novel secreted cytokine, termed IL-17F, was cloned using nested RACE PCR. This cytokine bears homology to IL-17. IL-17F was expressed only in activated CD4(+) T cells and activated monocytes. Recombinant human IL-17F did not stimulate the proliferation of hematopoietic progenitors or the migration of mature leukocytes. However, it markedly inhibited the angiogenesis of human endothelial cells and induced endothelial cells to produce IL-2, TGF-beta, and monocyte chemoattractant protein-1.
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Affiliation(s)
- T Starnes
- Department of Medicine and Biochemistry, Walther Oncology Center, Indiana University Medical Center, Indianapolis, IN 46202, USA
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Gianni L, Dombernowsky P, Sledge G, Martin M, Amadori D, Arbuck SG, Ravdin P, Brown M, Messina M, Tuck D, Weil C, Winograd B. Cardiac function following combination therapy with paclitaxel and doxorubicin: an analysis of 657 women with advanced breast cancer. Ann Oncol 2001; 12:1067-73. [PMID: 11583187 DOI: 10.1023/a:1011655503511] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To determine the cardiotoxicity of paclitaxel (T) plus doxorubicin (A) combination therapy in women with advanced breast cancer. To define a dose range of A for use in AT. PATIENTS AND METHODS The effect of cumulative A dose on risk of congestive heart failure (CHF) and alterations of myocardial contractility (left ventricular ejection fraction [LVEF] decrease > or = 20% or to <50%) was estimated from pooled data from 10 trials of AT. RESULTS Thirty-one of 657 patients (4.7%) developed CHF at a median of 6.6 months (range 0.3-24.6) after initiation of AT. CHF was stabilized in 29 patients at a median of 17.3 months after diagnosis (range 4.1-31.2 months). The risk of developing CHF was < or = 5% at a total A dose < or = 380 mg/m2. In patients who received a total A dose > 440 mg/m2, the incidence of CHF was >25% but similar to that of A monotherapy. The risk of CHF was similar in women receiving AT or A monotherapy at a dose < or = 380 mg/m2 (2%-3%). LVEF progressively decreased in patients who received AT, especially at a cumulative A dose > 380 mg/m2. LVEF decreases were more frequent in patients who later developed CHF, but the majority of CHF patients did not experience LVEF alterations prior to symptoms. LVEF recovered after discontinuation of A in 25 of 67 women who developed LVEF < 50%. CONCLUSION The reported cardiac effects are consistent with anthracycline-related cardiotoxicity. AT is associated with a cardiac risk similar to that of A monotherapy up to a cumulative A dose of 340-380 mg/m2.
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Affiliation(s)
- L Gianni
- Unit of Medical Oncology A, Istituto Nazionale Tumori, Milan, Italy.
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Braun SE, Chen K, Blazar BR, Orchard PJ, Sledge G, Robertson MJ, Broxmeyer HE, Cornetta K. Flt3 ligand antitumor activity in a murine breast cancer model: a comparison with granulocyte-macrophage colony-stimulating factor and a potential mechanism of action. Hum Gene Ther 1999; 10:2141-51. [PMID: 10498246 DOI: 10.1089/10430349950017130] [Citation(s) in RCA: 33] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We have shown that Flk2/Flt3 ligand (Flt3L)-transduced tumor vaccine induces transferable T cell protection against a murine breast cancer cell line, but a direct comparison with the potent effector GM-CSF, the activity against preestablished tumors, and the mechanism of antitumor response in this breast cancer model are not known. We compared vaccination with C3L5 cells expressing Flt3L (C3Lt-Flt3L) and GM-CSF (C3L5-GMCSF) by injecting 1 x 10(4) cells subcutaneously into the chest wall and then, after 4 weeks, challenging the contralateral chest of tumor-free mice with parental C3L5 cells. C3L5-Flt3L and C3L5-GMCSF had reduced in vivo growth rates (25% tumor formation each) compared with 100% tumor formation of C3L5 cells expressing only neomycin phosphotransferase (C3L5-G1N). However, when tumor-free animals were challenged with parental C3L5 cells, C3L5-Flt3L vaccination was significantly better at preventing tumor growth (p < 0.05) than C3L5-GMCSF vaccination (33% of C3L5-Flt3L-vaccinated animals developed tumor compared with 77% of C3L5-GMCSF-vaccinated animals). Adoptive transfer of immunity for both vaccines was demonstrated; splenic T cells from tumor-free mice protected naive mice from parental tumor challenge. To simulate minimal disease, parental C3L5 cells at two concentrations (high, 5 x 10(3) cells; or low, 1 x 10(3) cells) were injected into the contralateral chest wall 4 days prior to treatment with C3L5-G1N or C3L5-Flt3L. C3L5-Flt3L treatment decreased contralateral parental tumor formation (high, 67% tumor free; low, 90% tumor free) compared with C3L5-G1N treatment (high and low, 0% tumor free). Immunodepletion of activated natural killer cells with anti-asialo-GM1 blocked C3L5-Flt3L- and C3L5 plus soluble Flt3L-mediated antitumor activity. Thus, Flt3L-transduced tumor cells manifest potent antitumor activity, apparently mediated, at least partially, by natural killer cells.
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Affiliation(s)
- S E Braun
- Department of Microbiology/Immunology, Indiana University School of Medicine, Indianapolis 46202, USA
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Breitfeld PP, Weisburd M, Overhage JM, Sledge G, Tierney WM. Pilot study of a point-of-use decision support tool for cancer clinical trials eligibility. J Am Med Inform Assoc 1999; 6:466-77. [PMID: 10579605 PMCID: PMC61390 DOI: 10.1136/jamia.1999.0060466] [Citation(s) in RCA: 33] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Many adults with cancer are not enrolled in clinical trials because caregivers do not have the time to match the patient's clinical findings with varying eligibility criteria associated with multiple trials for which the patient might be eligible. The authors developed a point-of-use portable decision support tool (DS-TRIEL) to automate this matching process. The support tool consists of a hand-held computer with a programmable relational database. A two-level hierarchic decision framework was used for the identification of eligible subjects for two open breast cancer clinical trials. The hand-held computer also provides protocol consent forms and schemas to further help the busy oncologist. This decision support tool and the decision framework on which it is based could be used for multiple trials and different cancer sites.
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Affiliation(s)
- P P Breitfeld
- Regenstrief Institute, Indiana University School of Medicine, Indianapolis 46202-2859, USA.
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Sun HB, Zhu YX, Yin T, Sledge G, Yang YC. MRG1, the product of a melanocyte-specific gene related gene, is a cytokine-inducible transcription factor with transformation activity. Proc Natl Acad Sci U S A 1998; 95:13555-60. [PMID: 9811838 PMCID: PMC24857 DOI: 10.1073/pnas.95.23.13555] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.2] [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] [Indexed: 12/27/2022] Open
Abstract
Identification of cytokine-inducible genes is imperative for determining the mechanisms of cytokine action. A cytokine-inducible gene, mrg1 [melanocyte-specific gene (msg1) related gene], was identified through mRNA differential display of interleukin (IL) 9-stimulated and unstimulated mouse helper T cells. In addition to IL-9, mrg1 can be induced by other cytokines and biological stimuli, including IL-1alpha, -2, -4, -6, and -11, granulocyte/macrophage colony-stimulating factor, interferon gamma, platelet-derived growth factor, insulin, serum, and lipopolysaccharide in diverse cell types. The induction of mrg1 by these stimuli appears to be transient, with induction kinetics similar to other primary response genes, implicating its role in diverse biological processes. Deletion or point mutations of either the Box1 motif (binds Janus kinase 1) or the signal transducer and activator of transcription 3 binding site-containing region within the intracellular domain of the IL-9 receptor ligand binding subunit abolished or greatly reduced mrg1 induction by IL-9, suggesting that the Janus kinase/signal transducer and activator of transcription signaling pathway is required for mrg1 induction, at least in response to IL-9. Transfection of mrg1 cDNA into TS1, an IL-9-dependent mouse T cell line, converted these cells to IL-9-independent growth through a nonautocrine mechanism. Overexpression of mrg1 in Rat1 cells resulted in loss of cell contact inhibition, anchorage-independent growth in soft agar, and tumor formation in nude mice, demonstrating that mrg1 is a transforming gene. MRG1 is a transcriptional activator and may represent a founding member of an additional family of transcription factors.
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Affiliation(s)
- H B Sun
- Department of Medicine (Hematology/Oncology), Indiana University School of Medicine, and Walther Cancer Institute, 1044 West Walnut Street, R4-272, Indianapolis, IN 46202, USA
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Chabannon C, Cornetta K, Lotz JP, Rosenfeld C, Shlomchik M, Yanovitch S, Marolleau JP, Sledge G, Novakovitch G, Srour EF, Burtness B, Camerlo J, Gravis G, Lee-Fischer J, Faucher C, Chabbert I, Krause D, Maraninchi D, Mills B, Kunkel L, Oldham F, Blaise D, Viens P. High-dose chemotherapy followed by reinfusion of selected CD34+ peripheral blood cells in patients with poor-prognosis breast cancer: a randomized multicentre study. Br J Cancer 1998; 78:913-21. [PMID: 9764583 PMCID: PMC2063121 DOI: 10.1038/bjc.1998.601] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Seventy-one patients with poor-prognosis breast cancer were enrolled after informed consent in a multicentre randomized study to evaluate the use of selected peripheral blood CD34+ cells to support haematopoietic recovery following high-dose chemotherapy. Patients who responded to conventional chemotherapy were mobilized with chemotherapy (mainly high-dose cyclophosphamide) and/or recombinant human granulocyte colony-stimulating factor (rhG-CSF). Patients who reached the threshold of 20 CD34+ cells per microl of peripheral blood underwent apheresis and were randomized at that time to receive either unmanipulated mobilized blood cells or selected CD34+ cells. For patients in the study arm, CD34+ cells were selected from aphereses using the Isolex300 device. Fifteen patients failed to mobilize peripheral blood progenitors and nine other patients were excluded for various reasons. Forty-seven eligible patients were randomized into two comparable groups. CD34+ cells were selected from aphereses in the study group. Haematopoietic recovery occurred at similar times in both groups. No side-effect related to the infusion of selected cells was observed. The frequency of epithelial tumour cells in aphereses was low (8 out of 42 evaluated patients), as determined by immunocytochemistry. We conclude that selected CD34+ cells safely support haematopoietic recovery following high-dose chemotherapy in patients with poor-prognosis breast cancer.
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Affiliation(s)
- C Chabannon
- Institut Paoli-Calmettes, Marseilles, France
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Chen K, Braun S, Lyman S, Fan Y, Traycoff CM, Wiebke EA, Gaddy J, Sledge G, Broxmeyer HE, Cornetta K. Antitumor activity and immunotherapeutic properties of Flt3-ligand in a murine breast cancer model. Cancer Res 1997; 57:3511-6. [PMID: 9270021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Flt3-Ligand (Flt3-L) is a stimulatory cytokine for a variety of hematopoietic lineages, including dendritic cells and B cells. The antitumor properties of Flt3-L were evaluated in C3H/HeN mice challenged with the syngeneic C3L5 murine breast cancer cell line. Eighty % of animals receiving 500 microg/kg/day of Chinese hamster ovary-derived human Flt3-L for 10 days were protected from tumor growth, whether the tumor challenge was administered on the first or fourth days of Flt3-L administration. The protection provided by soluble Flt3-L was transient. All tumor-free animals rechallenged 4 weeks after the primary challenge developed tumor. Transduction of C3L5 with retroviral vectors expressing human or murine Flt3-L did not influence in vitro growth or MHC expression but decreased in vivo tumor development to 0 and 10% of mice, respectively. This compares with tumor growth of 52% with interleukin-2 transduced C3L5 and over 85% with untransduced and control vector-transduced C3L5. Unlike animals treated with soluble Flt3-L, administration of Flt3-L as a tumor vaccine protected mice from a subsequent challenge with untransduced C3L5 in 60-78% of mice, compared to 0% of controls. Our initial work used the most common Flt3-L isoform, which is membrane bound but can undergo proteolytic cleavage to generate a soluble form. To evaluate the role of the various Flt3-L isoforms in preventing tumor formation, retroviral vectors encoding only the membrane-bound form or only the soluble isoform were evaluated in the C3L5 model. Tumor formation was similar with either isoform, preventing tumor formation in 80-90% of mice after the primary challenge and 88-89% after the secondary challenge. Splenocytes obtained 4 weeks after the secondary challenge conferred adoptive immunity to naive mice in 60% of animals. This initial report of antitumor activity by Flt3-L is consistent with its known stimulatory effect on antigen-presenting cells and suggests it may enhance the development of tumor vaccines.
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Affiliation(s)
- K Chen
- Department of Medicine, Indiana University School of Medicine, Indianapolis 46202, USA
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37
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Hromas R, Morris J, Cornetta K, Berebitsky D, Davidson A, Sha M, Sledge G, Rauscher F. Aberrant expression of the myeloid zinc finger gene, MZF-1, is oncogenic. Cancer Res 1995; 55:3610-4. [PMID: 7627970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The zinc finger gene MZF-1 is preferentially expressed in primitive hematopoietic cells and plays an important role in regulating myelopoiesis. Regulators of development are potential targets for neoplastic transformation. This study investigated whether unregulated expression of MZF-1 could function as an oncogene. Retroviral transduction and subsequent overexpression of MZF-1 resulted in loss of contact inhibition, loss of substrate dependence, and more rapid cell cycling in NIH 3T3 cells. The MZF-1-transformed 3T3 cells formed aggressive tumors in athymic mice. Disruption of the tight lineage- and stage-specific regulation of MZF-1 can result in neoplastic transformation of embryonic fibroblasts. Therefore, MZF-1 represents a novel oncogene.
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Affiliation(s)
- R Hromas
- Department of Medicine, Walther Oncology Center, Indiana University Medical Center, Indianapolis 46202, USA
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Orazi A, Gordon MS, John K, Sledge G, Neiman RS, Hoffman R. In vivo effects of recombinant human stem cell factor treatment. A morphologic and immunohistochemical study of bone marrow biopsies. Am J Clin Pathol 1995; 103:177-84. [PMID: 7531939 DOI: 10.1093/ajcp/103.2.177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Bone marrow (BM) aspirate and biopsy specimens from seven female patients with advanced or metastatic breast cancer and preserved marrow function treated on a phase I trial of recombinant methionyl human stem cell factor (r-metHuSCF; SCF) were evaluated by immunohistochemical staining before and after treatment with SCF. Doses of SCF included 10 g/kg/day in 2 patients, 25 micrograms/kg/day in 2 patients, and 50 micrograms/kg/day in 3 patients administered as subcutaneous bolus injections for 14 days. Following treatment, bone marrow cellularity increased up to 1.6-fold (P = NS), with an increased frequency of promyelocytes (P < .002), but an unchanged relative frequency of other marrow hematopoietic cells. The mean relative frequency of BM CD34+ progenitor cells increased from 0.9% to 1.8% (P < .001). The mean proportion of BM cells stained by Ki-67/MIB 1 and PCNA/PC10, monoclonal antibodies (MoAb) recognizing proliferation-associated nuclear proteins, increased from 18.6% to 35.4% (P < .003) and from 32.4% to 49.4% (P < .01), respectively. Most of the Ki-67 and PCNA positive cells were represented by promyelocytes, proerythroblasts, and myeloblasts. SCF therapy was not associated with marrow fibrosis or increases in the number of macrophages. Peripheral white blood cell counts increased 1.3- to 3.6-fold following SCF. The mean absolute neutrophil counts increased from 3.9 x 10(9)/L (range 2.6-5.3) to 7.2 x 10(9)/L (range 4.7-12.3), and reticulocyte counts increased by a mean of 1.5 fold (range 1.2-fold to 2.0-fold). No consistent difference in platelet counts was seen. These results suggest that SCF given in vivo is effective in increasing the frequency of CD34+ BM progenitor cells, and has the capacity to increase the proliferation and differentiation rate of hematopoietic precursor cells. These effects indicate that SCF may represent a cytokine capable of affecting multiple hematopoietic lineages.
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Affiliation(s)
- A Orazi
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis 46202
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Olivarez D, Ulbright T, DeRiese W, Foster R, Reister T, Einhorn L, Sledge G. Neovascularization in clinical stage A testicular germ cell tumor: prediction of metastatic disease. Cancer Res 1994; 54:2800-2. [PMID: 7513256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Increased numbers of blood vessels (angiogenesis or neovascularization) in certain primary tumors correlates with an increased risk for metastatic disease. We therefore conducted a blinded review of the resected testicular germ cell tumors of 65 clinical stage A patients to evaluate the usefulness of angiogenesis in identifying those patients with clinically occult nodal metastases (pathological stage B). Angiogenesis was assessed in the primary tumors using an immunohistochemical stain for factor VIII-related antigen assay for quantitation of microvessel counts. Of 65 clinical stage A patients, 43 had pathological stage B disease at retroperitoneal lymph node dissection. Eleven patients had microvessel counts > 30 microvessels/x 400 high powered field, and all of these patients had pathological stage B disease (P = 0.02 in univariate analysis). Multiple regression analysis using microvessel count and other histological findings found to be prognostic (venous invasion, lymphatic invasion, presence of embryonal carcinoma, and absence of yolk sac tumor) showed that only the absence of a yolk sac tumor component was significantly predictive of occult metastases. This study shows that angiogenesis, as measured by quantitation of microvessel counts in the primary tumor of germ cell neoplasms, is significantly predictive of occult nodal metastatic disease by univariate analysis in clinical stage A patients. The prospective use of angiogenesis quantitation needs to be defined.
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Affiliation(s)
- D Olivarez
- Indiana University Hospital, Indianapolis 46220
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Munshi NC, Loehrer PJ, Williams SD, Langefeld C, Sledge G, Nichols CR, Roth BJ, Neuman A, Walsh WB, Einhorn LH. Comparison of N-acetylcysteine and mesna as uroprotectors with ifosfamide combination chemotherapy in refractory germ cell tumors. Invest New Drugs 1992; 10:159-63. [PMID: 1428725 DOI: 10.1007/bf00877240] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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] [Indexed: 12/27/2022]
Abstract
From January 1983 through August 1988, 318 consecutive patients with refractory germ cell neoplasms were treated with ifosfamide-containing combination chemotherapy. The patients received ifosfamide at 1.2 gm/m2/day with cis-platin 20 mg/m2/day for 5 days and etoposide 75 mg/m2/day for 5 days or vinblastine 0.11 mg/kg on days 1 and 2 for each cycle. Of 277 evaluable patients, NAC was used as an uroprotector in the initial 86 patients while the latter 191 consecutive patients received mesna to reduce urothelial toxicity. Dosages of NAC was 2.0 gm po q 6 hr and for mesna 120 mg/m2 IV push prior to ifosfamide and then 1200 mg/m2/day as continuous infusion of 5 consecutive days. All patients received 3.0 liters of normal saline per day. The number of courses of chemotherapy given in the two groups were similar. Twenty-four of the 86 patients (27.9%) receiving NAC developed hematuria (13 patients - grade 1, 4 patients - grade 2, and 7 patients - grade 3 toxicity). While 8 out of 191 (4.2%) mesna patients developed hematuria (6 - grade 1 and 2 - grade 3) (p < 0.0001). The incidence of severity of renal toxicity was similar in the two groups. Ifosfamide dosage was reduced solely for urothelial toxicity in 11 patients receiving NAC compared with none of the patients receiving mesna (p < 0.0001). Chemotherapy response was similar in the two groups. In conclusion, mesna provides better urothelial protection from ifosfamide-induced toxicity than NAC and allows better maintenance of the drug dosage.
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Broxmeyer HE, Bicknell DC, Cooper S, Sledge G, Williams DE, McGuire WA, Coates TD. Qualitative functional deficiency of affinity-purified lactoferrin from neutrophils of patients with chronic myelogenous leukemia, and lactoferrin/H-ferritin-cell interactions in a patient with lactoferrin-deficiency with normal numbers of circulating leukocytes. Pathobiology 1991; 59:26-35. [PMID: 2043267 DOI: 10.1159/000163612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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] [Indexed: 12/30/2022] Open
Abstract
The iron-binding proteins lactoferrin (LF) and H-ferritin have been implicated in the negative regulation of myelopoiesis in vitro and in vivo. The present studies evaluated the functional activity of affinity-purified LF from polymorphonuclear neutrophils (PMN) of patients with chronic myelogenous leukemia (CML) and LF/H-ferritin-cell interactions in a nonleukemic patient with LF deficiency with normal levels of circulating blood leukocytes. Affinity-purified CML-PMN-LF was found to be qualitatively deficient as a suppressor of the release of colony-stimulating factors from mononuclear blood cells, adding to previous information from our group documenting defective LF-cell interactions in CML. LF was detected by immunoradiometric assay in PMN of the patient with LF deficiency, but at a much lower level than normal. This LF was found, however, to be active as a suppressor molecular against the patient's cells and normal donor cells. Patient cells were as responsive as normal cells to effects of purified milk LF. Decreased LF levels in this patient were associated with increased levels of monocyte H-ferritin inhibitory activity, consistent with the known suppressive effects in vitro of LF on H-ferritin release from monocytes. Patient marrow hematopoietic progenitor cells were as responsive as progenitors from normal donors to suppression by purified H-ferritin and prostaglandin E1. These results are consistent with a role of LF and H-ferritin in the control of myelopoiesis in this patient.
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Affiliation(s)
- H E Broxmeyer
- Department of Medicine (Hematology/Oncology), Indiana University School of Medicine, Indianapolis
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Martin D, Sutton G, Ulbright T, Sledge G, Stehman F, Ehrlich C. Deoxyribonucleic acid content as a prognostic index in gestational trophoblastic neoplasia. Gynecol Oncol 1989. [DOI: 10.1016/0090-8258(89)90987-6] [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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Eble JN, Sledge G. Cellular deoxyribonucleic acid content of renal oncocytomas: flow cytometric analysis of paraffin-embedded tissues from eight tumors. J Urol 1986; 136:522-4. [PMID: 3735527 DOI: 10.1016/s0022-5347(17)44935-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Formalin-fixed, paraffin-embedded tissues from eight renal oncocytomas were analyzed using a Coulter Epics V cell sorter. Samples were processed using Hedley's method modified by including centrifugation through sucrose, RNAse digestion, and propidium iodide staining. The nuclei were excited using 200 mw of laser power at 488 nm. The tissues were all from surgical specimens acquired between 1972 and 1983, and the neoplasms met stringent light and electron microscopic criteria for the diagnosis. Sixteen samples were analyzed from the eight tumors; the coefficients of variation on the interpretable G1 peaks ranged from 3.95 per cent to 7.62 per cent with a mean of 5.46 per cent. One of the tumors had been frozen and yielded uninterpretably wide peaks. Control samples of non-neoplastic kidney from six of the specimens had coefficients of variation in a similar range. All of the oncocytomas with acceptable histograms had single, sharp G1 peaks with no evidence of aneuploidy. Proliferative indices were calculated and ranged from 0.02 to 0.18 for the oncocytomas and from 0.01 to 0.03 for renal cortex. The mean of the ratios of proliferative indices between the oncocytomas and the corresponding renal cortical samples was 4.5. These data support the concept that renal oncocytomas are euploid neoplasms with significant growth rates and are consistent with their benign biologic behavior and propensity to grow locally to large size.
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