1
|
Vize CJ, Kim SK, Matthews T, Macsai M, Merrell R, Hsu S, Kundu MG, Yoon J, Kennedy E, Pai M, Bain E, Lassman AB, Moazami G. A Phase 3b Study for Management of Ocular Side Effects in Patients with Epidermal Growth Factor Receptor-Amplified Glioblastoma Receiving Depatuxizumab Mafodotin. Ophthalmic Res 2023; 66:1030-1043. [PMID: 37257422 PMCID: PMC10413800 DOI: 10.1159/000531142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 05/09/2023] [Indexed: 06/02/2023]
Abstract
INTRODUCTION The Understanding New Interventions with GBM ThErapy (UNITE) study was designed to assess the effect of prophylaxis for ocular side effects (OSEs) in patients with glioblastoma receiving the antibody-drug conjugate (ADC) depatuxizumab mafodotin. UNITE (NCT03419403) was a phase 3b, open-label, randomized, exploratory study performed at 18 research sites in 5 countries. METHODS The study enrolled adult patients with epidermal growth factor receptor-amplified, histologically confirmed, newly diagnosed supratentorial glioblastoma or grade IV gliosarcoma, and a Karnofsky Performance Status ≥70, receiving depatuxizumab mafodotin. All patients were administered depatuxizumab mafodotin during concurrent radiotherapy and temozolomide and with adjuvant temozolomide. Ninety patients were to be randomized (1:1:1) to OSE prophylactic treatments with each depatuxizumab mafodotin infusion: (a) standard steroid eye drops, (b) standard steroid eye drops plus vasoconstrictor eye drops and cold compress, or (c) enhanced steroids plus vasoconstrictor eye drops and cold compress. A Corneal Epitheliopathy Adverse Event (CEAE) scale was devised to capture symptoms, grade OSEs (scale of 0-5), and inform ADC dose modifications. The primary endpoint was the frequency of a required change in OSE management due to inadequate control of OSEs, defined as decline from baseline in visual acuity (using logarithm of the minimum angle of resolution [LogMAR] scale) or a Grade ≥3 CEAE event, in the worst eye in the first 8 weeks of treatment; unless otherwise specified, the treatment period refers to both the chemoradiation and adjuvant phases. RESULTS The UNITE study was stopped early after interim analysis of separate phase III trial showed no difference in survival from depatuxizumab mafodotin. Forty patients were randomized (38 received depatuxizumab mafodotin). Overall, 23 patients experienced inadequate control of OSEs that required change in OSE management within 8 weeks of treatment, with 21 (70.0%) experiencing ≥+0.3 change on LogMAR scale in baseline-adjusted visual acuity and 12 reporting a grade ≥3 CEAE. There were no definitive differences among prophylactic treatments. CONCLUSIONS The premature cessation of the study precludes definitive conclusions regarding the OSE prophylaxis strategies. No new clinically significant safety findings were noted. Despite these limitations, this study highlights the need for novel assessment tools to better understand and mitigate OSEs associated with ADCs.
Collapse
Affiliation(s)
- Colin J. Vize
- Department of Ophthalmology, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Stella K. Kim
- Department of Ophthalmology and Visual Science, University of Texas McGovern Medical School, Houston, TX, USA
| | - Tim Matthews
- Birmingham Neuro-Ophthalmology Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Marian Macsai
- Northshore University Health System, Glenview, IL, USA
| | - Ryan Merrell
- NorthShore University Health System, Evanston, IL, USA
| | - Sigmund Hsu
- The Vivian L. Smith Department of Neurosurgery, University of Texas McGovern Medical School, Houston, TX, USA
| | | | | | | | | | | | - Andrew B. Lassman
- Division of Neuro-Oncology, Department of Neurology and the Herbert Irving Comprehensive Cancer Center, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA
| | - Golnaz Moazami
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
2
|
Maniar R, Gallitano SM, Husain S, Moazami G, Weiss MJ, Shu CA. Unusual Adverse Events in a Patient With BRAF-Mutated Non-Small Cell Lung Cancer Treated With BRAF/MEK Inhibition. J Natl Compr Canc Netw 2023; 21:232-234. [PMID: 36758579 DOI: 10.6004/jnccn.2022.7084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/29/2022] [Indexed: 02/11/2023]
Abstract
BRAF/MEK inhibition remains standard of care for treatment of BRAF-mutated non-small cell lung cancer (NSCLC). Although common adverse events (AEs) have been reported through clinical trials and ongoing clinical practice, only a handful of reports have detailed unusual adverse events associated with these medications. This report presents a patient with BRAF-mutated NSCLC treated with dabrafenib and trametinib who experienced 2 unusual AEs-Sweet syndrome and MEK-associated retinopathy-that responded to steroid treatment. The patient was able to continue BRAF/MEK inhibition through a coordinated multidisciplinary approach. This case highlights the importance for all clinicians to recognize unusual AEs associated with BRAF/MEK inhibition, particularly in the setting of expanded use for all BRAF V600E-mutated solid tumors.
Collapse
Affiliation(s)
- Rohan Maniar
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
| | - Stephanie M Gallitano
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Sameera Husain
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York
| | - Golnaz Moazami
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York.,Harkness Eye Center, New York, New York
| | - Michael J Weiss
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York.,Harkness Eye Center, New York, New York
| | - Catherine A Shu
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
3
|
Lassman AB, Pugh SL, Wang TJC, Aldape K, Gan HK, Preusser M, Vogelbaum MA, Sulman EP, Won M, Zhang P, Moazami G, Macsai MS, Gilbert MR, Bain EE, Blot V, Ansell PJ, Samanta S, Kundu MG, Armstrong TS, Wefel JS, Seidel C, de Vos FY, Hsu S, Cardona AF, Lombardi G, Bentsion D, Peterson RA, Gedye C, Bourg V, Wick A, Curran WJ, Mehta MP. Depatuxizumab mafodotin in EGFR-amplified newly diagnosed glioblastoma: A phase III randomized clinical trial. Neuro Oncol 2022; 25:339-350. [PMID: 35849035 PMCID: PMC9925712 DOI: 10.1093/neuonc/noac173] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Approximately 50% of newly diagnosed glioblastomas (GBMs) harbor epidermal growth factor receptor gene amplification (EGFR-amp). Preclinical and early-phase clinical data suggested efficacy of depatuxizumab mafodotin (depatux-m), an antibody-drug conjugate comprised of a monoclonal antibody that binds activated EGFR (overexpressed wild-type and EGFRvIII-mutant) linked to a microtubule-inhibitor toxin in EGFR-amp GBMs. METHODS In this phase III trial, adults with centrally confirmed, EGFR-amp newly diagnosed GBM were randomized 1:1 to radiotherapy, temozolomide, and depatux-m/placebo. Corneal epitheliopathy was treated with a combination of protocol-specified prophylactic and supportive measures. There was 85% power to detect a hazard ratio (HR) ≤0.75 for overall survival (OS) at a 2.5% 1-sided significance level (ie traditional two-sided p ≤ 0.05) by log-rank testing. RESULTS There were 639 randomized patients (median age 60, range 22-84; 62% men). Prespecified interim analysis found no improvement in OS for depatux-m over placebo (median 18.9 vs. 18.7 months, HR 1.02, 95% CI 0.82-1.26, 1-sided p = 0.63). Progression-free survival was longer for depatux-m than placebo (median 8.0 vs. 6.3 months; HR 0.84, 95% confidence interval [CI] 0.70-1.01, p = 0.029), particularly among those with EGFRvIII-mutant (median 8.3 vs. 5.9 months, HR 0.72, 95% CI 0.56-0.93, 1-sided p = 0.002) or MGMT unmethylated (HR 0.77, 95% CI 0.61-0.97; 1-sided p = 0.012) tumors but without an OS improvement. Corneal epitheliopathy occurred in 94% of depatux-m-treated patients (61% grade 3-4), causing 12% to discontinue. CONCLUSIONS Interim analysis demonstrated no OS benefit for depatux-m in treating EGFR-amp newly diagnosed GBM. No new important safety risks were identified.
Collapse
Affiliation(s)
- Andrew B Lassman
- Corresponding Author: Andrew B. Lassman, MD, Division of Neuro-Oncology, Department of Neurology, Vagelos College of Physicians and Surgeons, Herbert Irving Comprehensive Cancer Center, Columbia University, and New York-Presbyterian Hospital, 710 West 168th Street, New York, NY, USA. ()
| | - Stephanie L Pugh
- RTOG Foundation Statistics and Data Management Center, American College of Radiology, Philadelphia, Pennsylvania
| | - Tony J C Wang
- Department of Radiation Oncology (in Neurological Surgery), Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, New York, USA,Herbert Irving Comprehensive Cancer Center, New York, New York, USA
| | - Kenneth Aldape
- Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | - Hui K Gan
- Cancer Therapies and Biology Group, Centre of Research Excellence in Brain Tumours, Olivia Newton-John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Melbourne, Australia,La Trobe University School of Cancer Medicine, Heidelberg, Victoria, Australia,Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia
| | - Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | | | - Erik P Sulman
- Department of Radiation Oncology, New York University, Grossman School of Medicine, New York, New York, USA,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
| | - Minhee Won
- RTOG Foundation Statistics and Data Management Center, American College of Radiology, Philadelphia, Pennsylvania
| | | | - Golnaz Moazami
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, New York, USA
| | - Marian S Macsai
- NorthShore University HealthSystem, Department of Ophthalmology, University of Chicago Pritzker School of Medicine, Evanston, Illinois, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | | | | | | | | | | | | | - Jeffrey S Wefel
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Filip Y de Vos
- University Medical Center Utrecht, Cancer Center, Utrecht, The Netherlands
| | - Sigmund Hsu
- Department of Neurosurgery, University of Texas Health Sciences Center, McGovern School of Medicine, Houston, Texas, USA
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research-FICMAC/Clinical and Translational Oncology Group, Brain Tumor Section, Bogotá, Colombia
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | | | - Craig Gedye
- Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Véronique Bourg
- Department of Neurology, Côte d’Azur University, Nice, France
| | - Antje Wick
- Heidelberg University Medical Center, Heidelberg, Germany
| | | | - Minesh P Mehta
- Miami Cancer Institute, Baptist Hospital, Miami, Florida, USA
| |
Collapse
|
4
|
Affiliation(s)
- Maya Ramachandran
- School of Medicine (MR), University of Missouri-Columbia, Columbia, Missouri; Division of Hematology and Oncology (JEA), Columbia University Irving Medical Center, New York, New York; Departments of Pathology and Cell Biology (DCP), Neurology (MRW), Radiology (G. Moonis), and Ophthalmology (G. Moazami), Columbia University Irving Medical Center, New York, New York
| | | | | | | | | | | |
Collapse
|
5
|
Wang A, Halbach VV, Dowd CF, Alexander MD, Hallam DK, Ghodke B, Moazami G, Mandigo GK, Lavine SD, Meyers PM. Delayed-Onset Cranial Nerve Palsy After Transvenous Embolization of Indirect Carotid Cavernous Fistulas. J Neuroophthalmol 2021; 41:e639-e643. [PMID: 32868558 DOI: 10.1097/wno.0000000000001067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Carotid cavernous fistulas (CCF) often present with diplopia secondary to cranial nerve palsy (CNP). Immediate development of postoperative CNP has been described in the literature. This study described delayed-onset of CNP after complete and reconfirmed obliteration of the CCF and resolution of initial CNP. METHODS A retrospective analysis was performed on patients with indirect CCF between 1987 and 2006 at 4 academic endovascular centers. Details of the endovascular procedures, embolic agents used, and complications were studied. Partial or complete obliteration was determined. Immediate and delayed cranial nerve palsies were independently assessed. RESULTS A total of 267 patients with symptomatic indirect CCF underwent transvenous endovascular treatment. Four patients (1.5%) developed delayed abducens nerve (VI) palsy after complete resolution of presenting symptoms after embolization. Delayed presentation ranged between 3 and 13 months after complete resolution of initial double vision and cranial nerve palsies. Transvenous coil embolization through the inferior petrosal sinus was performed in all 4 affected patients. All had follow-up angiography confirming durable closure of their CCF. MRI did not show new mass lesions or abnormal soft tissue enhancement. In all 4 patients, their abducens nerve (VI) palsy remained. CONCLUSIONS Delayed CNP can develop despite complete endovascular obliteration of the CCF. The cause of delayed CNP is not yet determined, but may represent fibrosis and ischemia. Long-term follow-up is needed even after complete neurological and radiological recovery is attained in the immediate perioperative period.
Collapse
Affiliation(s)
- Arthur Wang
- Neurosurgery and Radiology (AW, GKM, SDL, PMM), Columbia University Medical Center, New York, New York; Radiology and Biomedical Imaging (VVH, CFD), UCSF, San Francisco, California; Radiology and Imaging Sciences (MDA), University of Utah, Salt Lake City, Utah; Radiology (DKH, BG), University of Washington, Seattle, Washington; and Department of Ophthalmology (GM), Columbia University Medical Center, New York, New York
| | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Al-Aswad LA, Elgin CY, Patel V, Popplewell D, Gopal K, Gong D, Thomas Z, Joiner D, Chu CK, Walters S, Ramachandran M, Kapoor R, Rodriguez M, Alcantara-Castillo J, Maestre GE, Lee JH, Moazami G. Real-Time Mobile Teleophthalmology for the Detection of Eye Disease in Minorities and Low Socioeconomics At-Risk Populations. Asia Pac J Ophthalmol (Phila) 2021; 10:461-472. [PMID: 34582428 PMCID: PMC8794049 DOI: 10.1097/apo.0000000000000416] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To examine the benefits and feasibility of a mobile, real-time, community-based, teleophthalmology program for detecting eye diseases in the New York metro area. DESIGN Single site, nonrandomized, cross-sectional, teleophthalmologic study. METHODS Participants underwent a comprehensive evaluation in a Wi-Fi-equipped teleophthalmology mobile unit. The evaluation consisted of a basic anamnesis with a questionnaire form, brief systemic evaluations and an ophthalmologic evaluation that included visual field, intraocular pressure, pachymetry, anterior segment optical coherence tomography, posterior segment optical coherence tomography, and nonmydriatic fundus photography. The results were evaluated in real-time and follow-up calls were scheduled to complete a secondary questionnaire form. Risk factors were calculated for different types of ophthalmological referrals. RESULTS A total of 957 participants were screened. Out of 458 (48%) participants that have been referred, 305 (32%) had glaucoma, 136 (14%) had narrow-angle, 124 (13%) had cataract, 29 had (3%) diabetic retinopathy, 9 (1%) had macular degeneration, and 97 (10%) had other eye disease findings. Significant risk factors for ophthalmological referral consisted of older age, history of high blood pressure, diabetes mellitus, Hemoglobin A1c measurement of ≥6.5, and stage 2 hypertension. As for the ocular parameters, all but central corneal thickness were found to be significant, including having an intraocular pressure >21 mm Hg, vertical cup-to-disc ratio ≥0.5, visual field abnormalities, and retinal nerve fiber layer thinning. CONCLUSIONS Mobile, real-time teleophthalmology is both workable and effective in increasing access to care and identifying the most common causes of blindness and their risk factors.
Collapse
Affiliation(s)
- Lama A. Al-Aswad
- New York University (NYU) Grossman school of Medicine, NYU Langone Health, NY, US
| | - Cansu Yuksel Elgin
- New York University (NYU) Grossman school of Medicine, NYU Langone Health, NY, US
| | - Vipul Patel
- New York University (NYU) Grossman school of Medicine, NYU Langone Health, NY, US
| | | | | | | | | | | | | | | | | | | | - Maribel Rodriguez
- New York University (NYU) Grossman school of Medicine, NYU Langone Health, NY, US
| | | | | | | | | |
Collapse
|
7
|
Nuzbrokh Y, Jauregui R, Oh JK, Moazami G, Sparrow JR, Tsang SH. Presumed Chloroquine Retinopathy With Short-term Therapy for Glioblastoma Multiforme. JAMA Ophthalmol 2021; 138:1215-1217. [PMID: 32910143 DOI: 10.1001/jamaophthalmol.2020.3251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Yan Nuzbrokh
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York.,Jonas Children's Vision Care, New York, New York.,Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Ruben Jauregui
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York.,Jonas Children's Vision Care, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Jin Kyun Oh
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York.,Jonas Children's Vision Care, New York, New York.,State University of New York at Downstate Medical Center, Brooklyn
| | - Golnaz Moazami
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York
| | - Janet R Sparrow
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York.,Jonas Children's Vision Care, New York, New York.,Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York
| | - Stephen H Tsang
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York.,Jonas Children's Vision Care, New York, New York.,Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York.,Harkness Eye Institute, Columbia University Medical Center, New York, New York
| |
Collapse
|
8
|
Mahallati H, Roberts JK, Assal A, Bhutani D, Park DC, Moazami G. Asymmetric optic disc edema in a young patient with POEMS: A rare presentation of a rare disease. Am J Ophthalmol Case Rep 2021; 22:101064. [PMID: 33786404 PMCID: PMC7994727 DOI: 10.1016/j.ajoc.2021.101064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 11/11/2020] [Accepted: 02/21/2021] [Indexed: 11/06/2022] Open
Abstract
Purpose To describe a case of asymmetric optic disc edema presenting as the initial ocular feature of POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy, Skin changes) syndrome. Observations A 29-year-old female patient presented with 3 weeks history of blurred vision, proptosis, and peripheral neuropathy as well as hypothyroidism. Fundoscopy revealed optic disc edema associated with visual loss in the left eye. Following a computed tomography (CT) scan and a positron emission tomography/CT (PET/CT) scan which respectively revealed hepatomegaly and multiple osteosclerotic lesions, as well as laboratory findings of monoclonal gammopathy and elevated vascular endothelial growth factor (VEGF) levels, she was diagnosed with POEMS syndrome. After treatment with an autologous stem cell transplant, the optic disc edema and blurred vision resolved. Conclusions and importance The most reported ocular manifestation of POEMS syndrome, a rare and complex multisystem disorder, is bilateral optic disc edema that typically occurs in older males. Therefore, this report presents an uncommon case of asymmetric optic disc edema in a younger, female patient.
Collapse
Affiliation(s)
- Hana Mahallati
- Barnard College of Columbia University, 3009 Broadway, New York, NY, USA
| | - James Kirkland Roberts
- Neurological Institute of New York, Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, USA
| | - Amer Assal
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, 630 West 168th Street, New York, NY, USA
| | - Divaya Bhutani
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, 630 West 168th Street, New York, NY, USA
| | - David C Park
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, 630 West 168th Street, New York, NY, USA
| | - Golnaz Moazami
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, 635 West 165th Street, New York, NY, USA
| |
Collapse
|
9
|
Vize CJ, Kim SK, Matthews T, Macsai M, Merrell R, Hsu S, Kundu MG, Yoon J, Kennedy E, Pai M, Bain E, Lassman AB, Moazami G. Dysregulation of miR-637 Is Involved in the Development of Retinopathy in Hypertension Patients and Serves a Regulatory Role in Retinol Endothelial Cell Proliferation. Ophthalmic Res 2021; 66:1-7. [PMID: 33530086 PMCID: PMC10413800 DOI: 10.1159/000514915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/28/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND MicroRNAs play an important role in the proliferation and migration of retinal endothelial cells in patients with hypertension and hypertensive retinopathy (HR). This study aimed to investigate the clinical value of miR-637 in HR and its role in retinal endothelial cell proliferation and migration. METHODS A total of 126 subjects were recruited for the study, including 42 patients with hypertension (male/female 25/17), 42 healthy individuals (male/female 20/22), and 42 cases with HR (male/female 20/22). Except SBP and DBP, there was no significant difference in other indexes among the three groups. Quantitative real-time PCR was used to detect the expression of miR-637. The receiver operating curve (ROC) was used for diagnosis value analysis. Logistic regression analysis was used to evaluate the relationship between miR-637 and HR. CCK-8 and Transwell were used to detect the effect of miR-637 on the proliferation and migration of human umbilical vein endothelial cells. RESULTS Compared with hypertensive patients, HR patients had the lowest expression of miR-637. The area under the curve of miR-637 detected by the ROC curve method is 0.892, which has the ability to distinguish hypertension and HR patients. Logistic regression analysis showed that miR-637 was an independent influencing factor in HR. Cell experiment results showed that overexpression of miR-637 significantly inhibited cell proliferation and migration, while downregulation of miR-637 had the opposite effect. Luciferase analysis showed that STAT3 was the target gene of miR-637. CONCLUSION Our data indicate that miR-637 is a potential noninvasive marker for patients with HR. The action of miR-637 on STAT3 may inhibit the proliferation and migration of retinal endothelial cells, providing a possible target for the treatment of HR.
Collapse
Affiliation(s)
- Colin J. Vize
- Department of Ophthalmology, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Stella K. Kim
- Department of Ophthalmology and Visual Science, University of Texas McGovern Medical School, Houston, TX, USA
| | - Tim Matthews
- Birmingham Neuro-Ophthalmology Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Marian Macsai
- Northshore University Health System, Glenview, IL, USA
| | - Ryan Merrell
- NorthShore University Health System, Evanston, IL, USA
| | - Sigmund Hsu
- The Vivian L. Smith Department of Neurosurgery, University of Texas McGovern Medical School, Houston, TX, USA
| | | | | | | | | | | | - Andrew B. Lassman
- Division of Neuro-Oncology, Department of Neurology and the Herbert Irving Comprehensive Cancer Center, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA
| | - Golnaz Moazami
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
10
|
Wefel JS, Won M, Lassman A, Stern Y, Wang T, Aldape K, Armstrong T, Vogelbaum M, Sulman E, Moazami G, Macsai M, Gilbert M, Bain E, Blot V, Gan H, Preusser M, Ansell P, Samanta S, Kundu M, Seidel C, de Vos F, Hsu S, Cardona A, Lombardi G, Bentsion D, Peterson R, Gedye C, Lebrun-Frenay C, Wick A, Pugh S, Curran W, Mehta M. CTNI-51. NEUROCOGNITIVE FUNCTION (NCF) OUTCOMES OF RTOG FOUNDATION 3508: A PHASE 3 TRIAL OF ABT-414 WITH CONCURRENT CHEMORADIATION AND ADJUVANT TEMOZOLOMIDE IN PATIENTS WITH EGFR-AMPLIFIED NEWLY DIAGNOSED GBM. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.217] [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: 11/14/2022] Open
Abstract
Abstract
RTOG 3508/AbbVie M13-813/INTELLANCE-1 was a phase 3 trial of depatuximab-mafodotin (depatux-m, formerly ABT-414) that accrued 639 patients with EGFR-amplified newly diagnosed GBM. At the pre-specified interim OS analysis, the futility criteria were met and there was no survival benefit from adding depatux-m to SOC. Pre-specified secondary NCF analyses included time to decline in verbal learning and memory as assessed by the HVLT-R Total Recall based on the reliable change index. Exploratory NCF analyses examined changes in other HVLT-R outcomes over time. As corneal epitheliopathy causing visual impairment is a known toxicity of depatux-m, NCF tests that did not depend on visual acuity were employed. NCF testing occurred at baseline, day 1 of the first cycle of adjuvant depatux-m, every other cycle (i.e., 8 weeks) thereafter, and at progression. Compliance with test completion was 95% at screening and 80%, 70%, 58%, 51%, 47% thereafter through cycle 9. The most common reasons for missing data was site error. Time to HVLT-R Total Recall decline trended worse in the depatux-m arm compared to placebo but the difference was not significant (12 month deterioration: 41.2%, 95% CI: 3.50–47.2 vs 32.4%, 95% CI: 26.6- 38.4, p=0.052). The depatux-m arm, in comparison to the placebo arm, showed greater decline from baseline on the HVLT-R at the following time points: cycle 3 (Total Recall: mean= -1.8, SD=5.7 vs mean= -0.5, SD=5.5, respectively, p=0.046; Delayed Recall: mean= -1.1, SD=3.0 vs. mean= -0.2, SD=2.7, respectively, p=0.01), cycle 7 (Total Recall: mean= -0.6, SD=5.1 vs mean= 1.4, SD=5.0, respectively, p=0.009; Delayed Recall: mean -0.6, SD=3.0 vs. mean= 0.5, SD=2.7, respectively, p=0.01), and cycle 9 (Delayed Recall: mean=-0.4, SD=2.7 vs. mean= 0.8, SD=2.4, respectively, p=0.003). Depatux-m added to concurrent chemoradiation and adjuvant temozolomide was associated with faster time to deterioration and worse episodic learning and memory over time than placebo.
Collapse
Affiliation(s)
| | | | - Andrew Lassman
- New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
| | | | - Tony Wang
- NYP / Columbia University Irving Medical Center, New York, NY, USA
| | - Kenneth Aldape
- National Cancer Institute, National Institute of Health, Bethesda, MD, USA
| | | | | | - Erik Sulman
- Department of Radiation Oncology at NYU Grossman School of Medicine, New York, NY, USA
| | | | | | | | | | | | - Hui Gan
- Olivia Newton-John Cancer Research Institute, Heideleberg, VIC, Australia
| | | | | | | | | | | | - Filip de Vos
- Universitair Medisch Centrum Utrecht, Utrecht, Netherlands
| | - Sigmund Hsu
- Memorial Hermann Texas Medical Center, Houston, TX, USA
| | | | | | - Dmitry Bentsion
- Sverdlovsk Regional Oncology Center, Ekaterinburg, Russian Federation
| | - Richard Peterson
- Metro MN Community Oncology Research Consortium, St Louis Park, MN, USA
| | - Craig Gedye
- Calvary Mater Newcastle, Waratah, NSW, Australia
| | | | - Antje Wick
- Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Walter Curran
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | | |
Collapse
|
11
|
Lassman A, Pugh S, Wang T, Aldape K, Gan H, Preusser M, Vogelbaum M, Sulman E, Won M, Zhang P, Moazami G, Macsai M, Gilbert M, Bain E, Blot V, Ansell P, Samanta S, Kundu M, Seidel C, De Vos F, Hsu S, Cardona A, Lombardi G, Bentsion D, Peterson R, Gedye C, Lebrun-Frénay C, Wick A, Curran W, Mehta M. ACTR-21. A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED PHASE 3 TRIAL OF DEPATUXIZUMAB MAFODOTIN (ABT-414) IN EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) AMPLIFIED (AMP) NEWLY DIAGNOSED GLIOBLASTOMA (nGBM). Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz175.064] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Approximately 50% of nGBMs harbor EGFR-amp. Depatuxizumab mafodotin (depatux-m) is an antibody drug conjugate: a monoclonal antibody that binds activated EGFR (wild-type and EGFRvIII mutant) linked to a microtubule-inhibitor toxin. Pre-clinical and earlier clinical trials suggested efficacy.
METHODS
RTOGF 3508/AbbVie M13-813 (INTELLANCE-1, NCT02573324) was a phase 3 academic-industry collaboration (RTOG-Foundation, AbbVie). Eligible adults (KPS ≥ 70, EGFR-amp nGBM, centrally confirmed histology and biomarkers) were randomized 1:1 to radiotherapy (RT) and temozolomide and either depatux-m (2.0 mg/kg during RT, 1.25 mg/kg thereafter, q 14 days) or placebo, stratified by region of world, RPA class, MGMT methylation, and EGFRvIII mutation. Primary endpoint was overall survival (OS), with 640 patients planned for randomization; 441 events yielded 85% power to detect 25% reduction in hazard of death (HR 0.75), one-sided 2.5% level of significance by stratified weighted log-rank.
RESULTS
2229 patients were screened and 639 (median age 60, range 22–84; 394 men, 62%) randomized. Pre-specified interim analysis after 346 events (≥ 75% required) found no OS improvement for depatux-m over placebo (median 18.9 vs. 18.7 months, HR 1.01, 95% CI 0.82–1.25, one-sided p= 0.63). Progression-free survival (PFS) trended toward depatux-m (median 8.0 vs. 6.3 months; HR 0.84, 95% CI 0.70–1.02), particularly among the ~50% with EGFRvIII mutation (median 8.3 vs. 5.9 months, HR 0.72, 95% CI 0.56–0.93) but without an OS improvement (median 19.8 vs. 18.2, HR=0.95, 95% CI 0.71–1.27). Ocular side effects (grade ≥ 1) occurred in 95% of depatux-m treated patients, 61% grade 3–4, causing 12% to discontinue, and were the most common treatment related adverse events.
CONCLUSION
Interim analysis demonstrated no OS benefit for treating EGFR-amp nGBM with depatux-m. PFS trended toward favoring depatux-m, particularly in the EGFRvIII harboring subgroup. No new important safety risks were identified. The trial was stopped for futility. Active patients are permitted to continue treatment.
Collapse
Affiliation(s)
- Andrew Lassman
- Columbia University Irving Medical Center, New York, NY, USA
| | - Stephanie Pugh
- RTOG Foundation, American College of Radiology, Philadelphia, PA, USA
| | - Tony Wang
- Columbia University Irving Medical Center, New York, NY, USA
| | - Kenneth Aldape
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Hui Gan
- Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, VIC, Australia
| | | | | | - Erik Sulman
- NYU Langone School of Medicine, New York, NY, USA
| | - Minhee Won
- RTOG Foundation, American College of Radiology, Philadelphia, PA, USA
| | - Peixin Zhang
- RTOG Foundation, American College of Radiology, Philadelphia, PA, USA
| | - Golnaz Moazami
- Columbia University Irving Medical Center, New York, NY, USA
| | - Marian Macsai
- NorthShore University HealthSystem, Glenview, IL, USA
| | - Mark Gilbert
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | | | | | | | - Filip De Vos
- University Medical Center Utrecht, Cancer Center, Department of Medical Oncology, Utrecht, Netherlands
| | | | - Andrés Cardona
- Clínica del Country, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | | | | | - Craig Gedye
- Calvary Mater Newcastle, Waratah, NSW, Australia
| | | | - Antje Wick
- University of Heidelberg, National Center for Tumor Diseases, Heidelberg, Germany
| | - Walter Curran
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | | |
Collapse
|
12
|
Kim S, Moazami G, Gomez E, Ocampo C, Bain E, Guseva M, Macsai M. ACTR-21. MANAGEMENT OF OCULAR SIDE EFFECTS IN PATIENTS WITH EGFR-AMPLIFIED GLIOBLASTOMA RECEIVING DEPATUXIZUMAB MAFODOTIN. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.055] [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: 11/12/2022] Open
Affiliation(s)
- Stella Kim
- The Robert Cizik Eye Clinic, Houston, TX, USA
| | - Golnaz Moazami
- Harkness Eye Institute Columbia Medical Center, New York, NY, USA
| | | | | | | | | | - Marian Macsai
- NorthShore University Health System, Glenview, IL, USA
| |
Collapse
|
13
|
Dolphin KW, Rubin PA, Moazami G, Kane S. Clinical case presentation: orbital reconstruction after traumatic optic neuropathy. J Craniomaxillofac Trauma 2002; 1:16-21. [PMID: 11951485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- K W Dolphin
- Albert Einstein College of Medicine, Bronx, NY, USA
| | | | | | | |
Collapse
|
14
|
Abstract
In vivo scanning slit confocal microscopy was performed in a patient with Fusarium solani keratitis. Morphologically distinctive abundant filamentous structures were observed intrastromally. Confocal microscopy of the culture plate growing F solani from the patient's corneal scraping revealed filaments morphologically similar to the filaments observed in vivo. After 1 week of medical therapy, subsequent confocal microscopy showed an increased load of filaments, supporting the decision to perform a penetrating keratoplasty. Confocal microscopy confirmed that all of the fungus was eradicated. This aided in the decision to administer corticosteroids and quickly discontinue antifungal agents.
Collapse
Affiliation(s)
- G J Florakis
- Edward S. Harkness Eye Institute, Columbia University, New York, NY, USA
| | | | | | | | | |
Collapse
|
15
|
Worrall BB, Moazami G, Odel JG, Behrens MM. Anterior ischemic optic neuropathy and activated protein C resistance. A case report and review of the literature. J Neuroophthalmol 1997; 17:162-5. [PMID: 9304527] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Nonarteritic anterior ischemic optic neuropathy (AION) is a well-described entity that is believed to be caused by abnormal anatomy of the optic disc and to be precipitated by several stressors or disease states. Activated protein C resistance (APCR) is a recently described mutation of factor V (FV) gene that renders FV resistant to cleavage by activated protein C. APCR predisposes to thrombotic events. The case of a 61-year-old woman with AION and activated protein C resistance is presented, and the management is discussed. We thoroughly review the literature on these two conditions. We propose that a prospective analysis of the potential role of APCR in some cases of AION is needed and suggest that physicians consider this and other prothrombotic states when evaluating patients with AION.
Collapse
Affiliation(s)
- B B Worrall
- Department of Neurology, Columbia Presbyterian Medical Center, New York, New York 10032-2603, USA
| | | | | | | |
Collapse
|
16
|
Liu GT, Heher KL, Katowitz JA, Kazim M, Moazami G, Moshang T, Teener JW, Sladky J, Volpe NJ, Galetta SL. Prominent proptosis in childhood thyroid eye disease. Ophthalmology 1996; 103:779-84. [PMID: 8637687 DOI: 10.1016/s0161-6420(96)30616-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [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: 02/01/2023] Open
Abstract
BACKGROUND Orbital signs and symptoms occur in approximately one half of children with Graves disease, but the symptoms are usually minor and limited to the eyelids. Prominent proptosis is uncommon in children with this disorder. METHODS Review of eight children with prominent proptosis associated with thyroid eye disease. Four patients were treated at the Children's Hospital of Philadelphia, the other four at the Columbia Presbyterian Medical Center. RESULTS At initial presentation, children ranged in age from 3 to 16 years. There were five girls and three boys. Seven of eight children had hyperthyroidism at ophthalmic presentation. Four patients had restrictive myopathy, and all of the seven patients who underwent neuroimaging had extraocular muscle enlargement. Five patients were treated with lubrication. Two underwent orbital fat decompression. One patient had thyroid eye disease and myasthenia gravis. CONCLUSIONS Proptosis in childhood thyroid eye disease usually is associated with a hyperthyroid state. The proptosis may be dramatic, but corneal exposure and restrictive myopathy are seen in only some of the patients. Neuroimaging shows enlarged extraocular muscles. Most children with this complication can be treated conservatively with topical lubrication, but orbital fat decompression may be considered in patients with more advanced conditions.
Collapse
Affiliation(s)
- G T Liu
- Division of Neuro-opthalmology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Abstract
PURPOSE/METHODS The cause of Mooren's ulcer is unknown. We examined a patient with chronic hepatitis C who had a corneal ulceration that resembled Mooren's corneal ulcer. RESULTS/CONCLUSION The corneal ulceration progressed despite appropriate medical and surgical interventions. Recombinant interferon alpha 2b finally led to resolution of the process. The resolution correlated with normalization of the patient's liver function tests. Corneal ulcerations that resemble Mooren's ulcer may be associated with hepatitis C. Recombinant interferon alpha 2b seems to induce remission in the corneal as well as the systemic condition.
Collapse
Affiliation(s)
- G Moazami
- Edward S. Harkness Eye Institute, Columbia University, New York, NY 10032
| | | | | | | | | |
Collapse
|