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Weisman M, Shields M, Althouse S, Durm G, Lautenschlaeger T. Evaluation of Pneumonitis in a Phase II Study of Consolidation Immunotherapy with Nivolumab and Ipilimumab or Nivolumab Alone following Concurrent Chemoradiotherapy for Unresectable Stage IIIA/IIIB Non-small Cell Lung Cancer (NSCLC). Int J Radiat Oncol Biol Phys 2023; 117:S168-S169. [PMID: 37784419 DOI: 10.1016/j.ijrobp.2023.06.270] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Unresectable stage III Non-Small-Cell-Lung-Cancer (NSCLC) has had an evolving landscape of treatment options with the approvals of immuno-oncologic (IO) therapy. There have been relatively few studies that have evaluated the risk of pneumonitis in patients receiving IO after concurrent chemoradiation treatment (CCRT). This study is to evaluate the relationship of pneumonitis and radiation dose in patients receiving consolidative IO with Nivolumab or Nivolumab plus ipilimumab. MATERIALS/METHODS Patients with stage III NSCLC who underwent CCRT were enrolled on BTCRC-LUN16-081, a randomized phase II trial assessing the efficacy of nivolumab or nivolumab plus ipilimumab as consolidation therapy. These patients were evaluated for radiation dose parameters and correlation with pneumonitis was examined. RESULTS After CCRT, patients were enrolled to receive consolidative IO therapy on BTCRC-LUN16-081, and 104 patients had Dose Volume Histogram (DVH) information available for analysis. Of these patients, 58 (55.8%) had stage IIIA and 46 (44.2%) had stage IIIB disease according to 7th edition IASLC. During this period 29 patients (27.9%) had at least grade 2 pneumonitis. Utilizing logistic regression and evaluating different cut offs for lung V20, patients receiving a V20 of greater than 23% had a higher risk of grade 2 or greater pneumonitis (p-value 0.0246, 38% vs. 16%). There was no significant difference in rates of pneumonitis between the two different IO regimens. Traditional lung DVH cutoffs (V5>65%, V20>35%, mean >20 Gy) were not associated with pneumonitis in this study. CONCLUSION The use of nivolumab or nivolumab plus ipilimumab after definitive CCRT is safe and effective. Lung V20 > 23% was associated with a higher risk of Grade 2 or higher pneumonitis. Radiation dose constraints for lungs in patients receiving consolidative IO after CCRT should continue to be evaluated and optimized when feasible.
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Affiliation(s)
- M Weisman
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN
| | - M Shields
- Department of Medical Oncology, Indiana University School of Medicine, Indianapolis, IN
| | - S Althouse
- Department of Biostatistics, Simon Cancer, Center, Indiana University School of Medicine, Indianapolis, IN
| | - G Durm
- Department of Medical Oncology, Indiana University School of Medicine, Indianapolis, IN
| | - T Lautenschlaeger
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN
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Shahani S, Durm G, Althouse S, Liu Z, Hanna N. PP01.64 A Safety and Efficacy Analysis Comparing Elderly vs Nonelderly Patients Treated with Consolidation Immunotherapy after Chemoradiation for stage III NSCLC from the BTCRC LUN 16-081 Clinical Trial. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.090] [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: 01/30/2023]
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Sarkar K, Torresgrossa-Allen S, Langer MP, Durm G, Narayanan S, Elzey BD, Won YY. Abstract 304: Effect of paclitaxel stereochemistry on x-ray-triggered release of paclitaxel from CaWO4/paclitaxel-coloaded PEG-PLA nanoparticles. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-304] [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
Head and neck squamous cell carcinoma (HNSCC) is the 8th most common cancer in the United States predominantly affecting people over 65 years of age with an increasing rate of incidence across the world. Current therapies for HNSCC include surgical resection, chemotherapy (CT), and radiotherapy (RT). For locally advanced/unresectable HNSCC, the CT-RT combination (“chemoradiation”) has been shown to be more effective than CT or RT alone, and is currently the standard of care. Intratumoral (IT) chemotherapy-based chemoradiation has the potential to overcome the limitations of conventional systemic CT-RT that severely affects a patient’s quality of life. For realization of maximum benefits from IT CT-RT, our team has developed a radiation-controlled drug release nanoparticle formulation (paclitaxel (PTX) and CaWO4 nanoparticles (CWO NPs) co-encapsulated within a capsule formed by poly(ethylene glycol)-poly (lactic acid) (PEG-PLA), named “PEG-PLA/CWO/PTX NPs”). This unique formulation releases PTX only when it is exposed to X-ray irradiation. We have previously reported that IT-administered PEG-PLA/CWO/PTX NPs stay within the tumor for at least a month, producing significant therapeutic effects in terms of tumor suppression and survival in mouse models of HNSCC. This work demonstrates the effect of PTX stereochemistry on radiation-controlled release of the drug from a nano polymer matrix system (PEG-PLA/CWO/PTX NPs). The stereoisomertic characteristics of PTX products from two different manufacturers (“PTX-S”, and “PTX-B”) were analyzed by Raman spectroscopy, circular dichroism and 2D HMQC/NOESY NMR measurements. In their unencapsulated (free) state, PTX-S and PTX-B were comparable in their ability to kill cancer cells in vitro. However, they were found to be significantly different in water solubility; PTX-S (water solubility ≈ 4.69 μg/mL) is about 19 times more water soluble than PTX-B (water solubility ≈ 0.25 μg/mL). This difference in water solubility was found to cause a large difference in X-ray-triggered release kinetics of the PTX loaded within the PEG-PLA/CWO/PTX NPs in both in vitro and in vivo environments; PTX-S is released from PEG-PLA/CWO NPs significantly faster upon X-ray irradiation than PTX-B. This difference in release kinetics produced an interesting difference in their time-dependent therapeutic effects; at short times (< 1 month), concurrent PEG-PLA/CWO/PTX-S NPs produced a greater tumor suppression effect; on the other hand, PEG-PLA/CWO/PTX-B NPs had a longer lasting radio-sensitizing effect. In summary, the stereoisomers of PTX exhibit significantly different PK characteristics when used with controlled release carriers, even though they are pharmacologically indistinguishable in their unformulated form.
Citation Format: Kaustabh Sarkar, Sandra Torresgrossa-Allen, Mark P. Langer, Gregory Durm, Sanjeev Narayanan, Bennett D. Elzey, You-Yeon Won. Effect of paclitaxel stereochemistry on x-ray-triggered release of paclitaxel from CaWO4/paclitaxel-coloaded PEG-PLA nanoparticles [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 304.
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Affiliation(s)
| | | | - Mark P. Langer
- 2Indiana University School of Medicine, Indianapolis, IN
| | - Gregory Durm
- 2Indiana University School of Medicine, Indianapolis, IN
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Kalra M, Henry E, McCann K, Karuturi MS, Bustamante Alvarez JG, Parkes A, Wesolowski R, Wei M, Mougalian SS, Durm G, Qin A, Schonewolf C, Trivedi M, Armaghani AJ, Wilson FH, Iams WT, Turk AA, Vikas P, Cecchini M, Lubner S, Pathak P, Spencer K, Koshkin VS, Labriola MK, Marshall CH, Beckermann KE, Sharifi MN, Bejjani AC, Hotchandani V, Housri S, Housri N. Making National Cancer Institute-Designated Comprehensive Cancer Center Knowledge Accessible to Community Oncologists via an Online Tumor Board: Longitudinal Observational Study. JMIR Cancer 2022; 8:e33859. [PMID: 35588361 PMCID: PMC9164098 DOI: 10.2196/33859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/07/2022] [Accepted: 03/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Expert knowledge is often shared among multidisciplinary academic teams at tumor boards (TBs) across the country, but these conversations exist in silos and do not reach the wider oncology community. OBJECTIVE Using an oncologist-only question and answer (Q&A) website, we sought to document expert insights from TBs at National Cancer Institute-designated Comprehensive Cancer Centers (NCI-CCCs) to provide educational benefits to the oncology community. METHODS We designed a process with the NCI-CCCs to document and share discussions from the TBs focused on areas of practice variation on theMednet, an interactive Q&A website of over 13,000 US oncologists. The faculty translated the TB discussions into concise, non-case-based Q&As on theMednet. Answers were peer reviewed and disseminated in email newsletters to registered oncologists. Reach and engagement were measured. Following each Q&A, a survey question asked how the TB Q&As impacted the readers' practice. RESULTS A total of 23 breast, thoracic, gastrointestinal, and genitourinary programs from 16 NCI-CCC sites participated. Between December 2016 and July 2021, the faculty highlighted 368 questions from their TBs. Q&As were viewed 147,661 times by 7381 oncologists at 3515 institutions from all 50 states. A total of 277 (75%) Q&As were viewed every month. Of the 1063 responses to a survey question on how the Q&A affected clinicians' practices, 646 (61%) reported that it confirmed their current practice, 163 (20%) indicated that a Q&A would change their future practice, and 214 (15%) reported learning something new. CONCLUSIONS Through an online Q&A platform, academics at the NCI-CCCs share knowledge outside the walls of academia with oncologists across the United States. Access to up-to-date expert knowledge can reassure clinicians' practices, significantly impact patient care in community practices, and be a source of new knowledge and education.
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Affiliation(s)
- Maitri Kalra
- Division of Hematology/Oncology, Department of Medicine, Indiana University Health Ball Memorial Hospital, Fishers, IN, United States
| | - Elizabeth Henry
- Division of Hematology/Oncology, Department of Medicine, Loyola University Stritch School of Medicine, Maywood, IL, United States
| | - Kelly McCann
- Division of Hematology/Oncology, Department of Medicine, University of California, Los Angeles, Beverly Hills, CA, United States
| | - Meghan S Karuturi
- Division of Hematology/Oncology, Department of Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jean G Bustamante Alvarez
- Division of Hematology/Oncology, Department of Medicine, West Virginia University, Morgantown, WV, United States
| | - Amanda Parkes
- Division of Hematology/Oncology, Department of Medicine, University of Wisconsin, Madison, WI, United States
| | - Robert Wesolowski
- Division of Hematology/Oncology, Department of Medicine, Ohio State University, Columbus, OH, United States
| | - Mei Wei
- Division of Hematology/Oncology, Department of Medicine, University of Utah, Utah City, UT, United States
| | - Sarah S Mougalian
- Department of Radiation/Oncology, Yale University School of Medicine, New Haven, CT, United States
| | - Gregory Durm
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Angel Qin
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Caitlin Schonewolf
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Meghna Trivedi
- Division of Hematology/Oncology, Department of Medicine, Herbert-Irving Comprehensive Cancer Center, Columbia University, New York, NY, United States
| | - Avan J Armaghani
- Division of Hematology/Oncology, Department of Medicine, Moffitt Cancer Center University of South Florida, Tampa, FL, United States
| | - Frederick H Wilson
- Department of Radiation/Oncology, Yale University School of Medicine, New Haven, CT, United States
| | - Wade T Iams
- Division of Oncology, Department of Medicine, Vanderbilt University, Nashville, TN, United States
| | - Anita A Turk
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Praveen Vikas
- Division of Hematology/Oncology, Department of Medicine, University of Iowa, Iowa City, IA, United States
| | - Michael Cecchini
- Department of Radiation/Oncology, Yale University School of Medicine, New Haven, CT, United States
| | - Sam Lubner
- Division of Hematology/Oncology, Department of Medicine, University of Wisconsin, Madison, WI, United States
| | - Priyadarshini Pathak
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Kristen Spencer
- Division of Hematology/Oncology, Department of Medicine, Rutgers University Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Vadim S Koshkin
- Division of Hematology/Oncology, Department of Medicine, University of California, Los Angeles, Beverly Hills, CA, United States
| | - Matthew K Labriola
- Division of Hematology/Oncology, Department of Medicine, Duke University, Durham, NC, United States
| | - Catherine H Marshall
- Division of Oncology, Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Katy E Beckermann
- Division of Oncology, Department of Medicine, Vanderbilt University, Nashville, TN, United States
| | - Marina N Sharifi
- Division of Hematology/Oncology, Department of Medicine, University of Wisconsin, Madison, WI, United States
| | - Anthony C Bejjani
- Division of Hematology/Oncology, Department of Medicine, Veterans Health Administration Greater Los Angeles Health System, Los Angeles, CA, United States
| | | | | | - Nadine Housri
- Department of Radiation/Oncology, Yale University School of Medicine, New Haven, CT, United States
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Mamdani H, Matosevic S, Khalid AB, Durm G, Jalal SI. Immunotherapy in Lung Cancer: Current Landscape and Future Directions. Front Immunol 2022; 13:823618. [PMID: 35222404 PMCID: PMC8864096 DOI: 10.3389/fimmu.2022.823618] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [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: 11/27/2021] [Accepted: 01/20/2022] [Indexed: 12/11/2022] Open
Abstract
Over the past decade, lung cancer treatment has undergone a major paradigm shift. A greater understanding of lung cancer biology has led to the development of many effective targeted therapies as well as of immunotherapy. Immune checkpoint inhibitors (ICIs) have shown tremendous benefit in the treatment of non-small cell lung cancer (NSCLC) and are now being used as first-line therapies in metastatic disease, consolidation therapy following chemoradiation in unresectable locally advanced disease, and adjuvant therapy following surgical resection and chemotherapy in resectable disease. Despite these benefits, predicting who will respond to ICIs has proven to be difficult and there remains a need to discover new predictive immunotherapy biomarkers. Furthermore, resistance to ICIs in lung cancer is frequent either because of a lack of response or disease progression after an initial response. The utility of ICIs in the treatment of small cell lung cancer (SCLC) remains limited to first-line treatment of extensive stage disease in combination with chemotherapy with modest impact on overall survival. It is thus important to explore and exploit additional targets to reap the full benefits of immunotherapy in the treatment of lung cancer. Here, we will summarize the current state of immunotherapy in lung cancer, discuss novel targets, and explore the intersection between DNA repair defects and immunotherapy.
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Affiliation(s)
- Hirva Mamdani
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Sandro Matosevic
- Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, IN, United States
| | - Ahmed Bilal Khalid
- Department of Internal Medicine, Indiana University, Indianapolis, IN, United States
| | - Gregory Durm
- Department of Internal Medicine, Division of Hematology/Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Shadia I Jalal
- Department of Internal Medicine, Division of Hematology/Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, United States
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Gandara D, Marrone K, Govindan R, Skoulidis F, Durm G, Clarke J, Frank R, Krauss J, Snyder W, Dai T, Mather O, Cifuentes P, Hindoyan A, Anderson A, Burns T. Abstract P05-02: A phase 1b study evaluating the combination of sotorasib, a KRASG12C inhibitor, and afatinib, a pan-ErbB tyrosine kinase inhibitor, in advanced KRAS p.G12C mutated non-small cell lung cancer (NSCLC). Mol Cancer Ther 2021. [DOI: 10.1158/1535-7163.targ-21-p05-02] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: Sotorasib, a specific, irreversible KRASG12C inhibitor, was recently FDA-approved for adults with KRAS p.G12C-mutated locally advanced or metastatic NSCLC who received prior systemic therapy. The multi-arm phase 1b CodeBreaK101 master study is designed to evaluate the safety and tolerability of sotorasib in combination with both targeted and non-targeted therapies. Here we report the first safety and interim efficacy of sotorasib and afatinib, a pan-ErbB tyrosine kinase inhibitor, that had displayed synergistic antitumor activity in vitro. Methods: Patients with advanced KRAS p.G12C mutated NSCLC who had disease progression on prior therapies, including KRASG12C inhibitors, were enrolled in this dose exploration/expansion study. Patients were treated with 960 mg sotorasib QD and afatinib (20 mg or 30mg QD). Primary endpoint was safety/tolerability. Secondary endpoint was efficacy, including objective response rate (ORR) and disease control rate (DCR) per RECIST 1.1. Results: Based on a July 12, 2021 snapshot, 33 pts with NSCLC (median age: 65.0 yrs) were enrolled. Ten pts received 20 mg afatinib/960 mg sotorasib QD (cohort 1) and 23 pts received 30 mg afatinib/960 mg sotorasib QD (cohort 2). Across both cohorts, the median number of prior therapies was 2 (range 0-7; 66.7% ≥ 2 prior lines) and 5 pts (15.2%) received prior sotorasib. The most common treatment-related adverse events (TRAEs) included diarrhea (23 pts [69.7%], 7 pts [21.2%] grade 3), nausea (7 pts [21.2%], all grade ≤ 2), and vomiting (6 pts [18.2%], all grade ≤ 2). Grade ≥ 3 TRAEs occurred in 30% pts within each dose cohort, with diarrhea being the most common. Eight pts (24.2%) discontinued sotorasib and/or afatinib due to an AE, with diarrhea leading to discontinuation in 5 pts. Median treatment duration of sotorasib/afatinib combination was 64.0 days (Q1, 29.0; Q3, 128.0). For cohort 1 (N=10 that includes 4 pts who received prior sotorasib), the ORR was 20.0% and DCR was 70.0% (2-confirmed partial response (PR), 5-stable disease (SD), 1-progressive disease (PD), 2-not available); among the KRASG12C inhibitor-naïve patients, the ORR was 33.3%. For cohort 2 (N=23 that includes 1 pt who received prior sotorasib), the ORR was 34.8% and DCR was 73.9% (8-confirmed PR, 9-SD, 4-PD, 2-not available). Among 5 pts receiving prior sotorasib, 3 had SD, 1 PD, and 1 withdrew from study due to an AE prior to any scan. EGFR co-mutation at baseline was detected in 4 of 24 pts; 2 of 4 pts responded to combination therapy. Conclusions: In this first report of a combination of sotorasib and a pan-ErbB inhibitor, combining sotorasib with afatinib was feasible in a heavily pre-treated KRAS p.G12C mutated NSCLC population that included 15% who progressed on prior sotorasib. The AEs observed are not new or novel to either agent, with diarrhea being the most common. Investigation is ongoing to further explore this combination in an expansion cohort of the CodeBreaK101 master protocol.
Citation Format: David Gandara, Kristen Marrone, Ramaswamy Govindan, Ferdinandos Skoulidis, Gregory Durm, Jeffrey Clarke, Richard Frank, John Krauss, Wendy Snyder, Tian Dai, Omar Mather, Paul Cifuentes, Antreas Hindoyan, Abraham Anderson, Timothy Burns. A phase 1b study evaluating the combination of sotorasib, a KRASG12C inhibitor, and afatinib, a pan-ErbB tyrosine kinase inhibitor, in advanced KRAS p.G12C mutated non-small cell lung cancer (NSCLC) [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2021 Oct 7-10. Philadelphia (PA): AACR; Mol Cancer Ther 2021;20(12 Suppl):Abstract nr P05-02.
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Affiliation(s)
- David Gandara
- 1University of California Davis Comprehensive Cancer Center, Sacramento, CA,
| | | | - Ramaswamy Govindan
- 3Alvin J Siteman Cancer Center at Washington University School of Medicine, St Louis, MO,
| | | | - Gregory Durm
- 5Indiana University School of Medicine, Indianapolis, IN,
| | | | | | - John Krauss
- 8University of Michigan Medical School, Ann Arbor, MI,
| | | | | | | | | | | | | | - Timothy Burns
- 10University of Pittsburgh Medical Center, Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA
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Krueger E, Secinti E, Wu W, Hanna N, Durm G, Einhorn L, Jalal S, Mosher CE. Measurement of patients' acceptable symptom levels and priorities for symptom improvement in advanced lung cancer. Support Care Cancer 2021; 29:5895-5904. [PMID: 33763726 DOI: 10.1007/s00520-021-06159-z] [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: 11/30/2020] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Little research has assessed cancer patients' success criteria and priorities for symptom improvement to inform patient-centered care. Thus, we modified and tested a measure of these constructs for advanced lung cancer patients. We compared acceptable severity levels following symptom treatment across eight symptoms and identified patient subgroups based on symptom importance. METHODS Advanced lung cancer patients (N=102) completed a one-time survey, including the modified Patient-Centered Outcomes Questionnaire (PCOQ), standard symptom measures, and other clinical characteristics. RESULTS The modified PCOQ showed evidence of construct validity through associations with theoretically related constructs. Symptom severity and importance were moderately correlated. Levels of acceptable symptom severity were low and did not differ across the eight symptoms. Four patient subgroups were identified: (1) those who rated all symptoms as low in importance (n=12); (2) those who rated bronchial symptoms and sleep problems as low in importance and all other symptoms as moderately important (n=29); (3) those who rated nausea and emotional distress as low in importance and all other symptoms as moderately important (n=23); and (4) those who rated all symptoms as highly important (n=33). Subgroups were unrelated to clinical characteristics, except for functional status. CONCLUSION The modified PCOQ showed evidence of construct validity. Patients considered low symptom severity to be acceptable, irrespective of the symptom. Findings suggest that symptom severity and importance are related yet distinct aspects of the advanced lung cancer symptom experience. Patients have heterogeneous priorities for symptom improvement, which has implications for tailoring treatment.
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Affiliation(s)
- Ellen Krueger
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
| | - Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
| | - Nasser Hanna
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Gregory Durm
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lawrence Einhorn
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Shadia Jalal
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
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Durm G, Birdas T, Liu H, Jalal S, Kesler K, Rieger K, Ceppa D, Hanna N. P03.01 A Randomized Phase II Trial of Adjuvant Pembrolizumab vs Observation after Curative Resection for Stage I NSCLC with Primary Tumors Between 1-4 cm. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.374] [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: 10/21/2022]
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Yan M, Durm G, Jalal S, Einhorn L, Kesler K, Rieger K, Birdas T, Ceppa D, Hanna N. FP01.04 BTCRC LUN19-396: Adjuvant Chemotherapy Plus Atezolizumab in Stage IB-IIIA Resected NSCLC and Clearance of ctDNA. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.071] [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: 11/16/2022]
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Fakih M, Durm G, Govindan R, Falchook G, Soman N, Henary H, Hong D. MO01.30 Trial in Progress: A Phase 1b Study of Sotorasib, a KRAS (G12C) Inhibitor, in Combination with other Anticancer Therapies in Patients with Advanced Solid Tumors Harboring KRAS p.G12C Mutation (CodeBreaK101). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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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Hong D, Bang YJ, Barlesi F, Durm G, Falchook G, Govindan R, Dy G, Park K, Strickler J, Burns T, Kim J, Ang A, Lipford J, Ngarmchamnanrith G, Anderson A, Li B. MO01.31 Durability of Clinical Benefit and Biomarkers in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC) Treated with Sotorasib, a KRAS(G12C) Inhibitor. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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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Strickler J, Fakih M, Price T, Desai J, Durm G, Krauss J, Kuboki Y, Kim T, Sacher A, Henary H, Kim J, Hong D. 83MO AMG 510, a novel small molecule inhibitor of KRAS(G12C), for patients (pts) with advanced gastrointestinal (GI) cancers: Results from the CodeBreaK100 phase I trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.103] [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: 11/16/2022] Open
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Strickler J, Fakih M, Price T, Desai J, Durm G, Krauss J, Kuboki Y, Kim T, Sacher A, Henary H, Kim J, Hong D. SO-24 AMG 510, a novel small molecule inhibitor of KRAS G12C, for patients with advanced gastrointestinal cancers: Results from the CodeBreak 100 phase 1 trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Swiecicki P, Durm G, Bellile E, Brummel C, Pang M, Bhangale A, Brenner J, Worden F. A multi-center phase II trial evaluating the efficacy of palbociclib in combination with carboplatin for the treatment of unresectable recurrent or metastatic head and neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.134] [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: 11/15/2022]
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Govindan R, Fakih M, Price T, Falchook G, Desai J, Kuo J, Strickler J, Krauss J, Li B, Denlinger C, Durm G, Ngang J, Henary H, Ngarmchamnanrith G, Rasmussen E, Morrow P, Hong D. P2.15-C Phase 1 Trial Evaluating Safety, Efficacy, and PK of AMG 510, a Novel KRASG12C Inhibitor, in Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Govindan R, Fakih M, Price T, Falchook G, Desai J, Kuo J, Strickler J, Krauss J, Li B, Denlinger C, Durm G, Ngang J, Henary H, Ngarmchamnanrith G, Rasmussen E, Morrow P, Hong D. OA01.06 Safety, Efficacy, and Pharmacokinetics of AMG 510, a Novel KRASG12C Inhibitor, in Patients with Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mosher CE, Secinti E, Hirsh AT, Hanna N, Einhorn LH, Jalal SI, Durm G, Champion VL, Johns SA. Acceptance and Commitment Therapy for Symptom Interference in Advanced Lung Cancer and Caregiver Distress: A Pilot Randomized Trial. J Pain Symptom Manage 2019; 58:632-644. [PMID: 31255586 PMCID: PMC6754796 DOI: 10.1016/j.jpainsymman.2019.06.021] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 11/24/2022]
Abstract
CONTEXT Advanced lung cancer patients typically have a poor prognosis and many symptoms that interfere with functioning, contributing to high rates of emotional distress in both patients and family caregivers. There remains a need for evidence-based interventions to improve functional outcomes and distress in this population. OBJECTIVES This pilot trial examined the feasibility and preliminary efficacy of telephone-based Acceptance and Commitment Therapy (ACT) for symptomatic, advanced lung cancer patients and their distressed family caregivers. Primary outcomes were patient symptom interference with functioning and patient and caregiver distress. METHODS Symptomatic, advanced lung cancer patients and distressed caregivers (n = 50 dyads) were randomly assigned to six sessions of ACT or an education/support condition. Patients completed measures of symptom interference and measures assessing the severity of fatigue, pain, sleep disturbance, and breathlessness. Patients and caregivers completed measures of distress and illness acceptance and struggle. RESULTS The eligibility screening rate (51%) and retention rate (76% at six weeks postintervention) demonstrated feasibility. No group differences were found with respect to patient and caregiver outcomes. Both groups showed a small, significant decrease in struggle with the illness over the study period, but did not show meaningful change in other outcomes. CONCLUSION Findings suggest that telephone-based ACT is feasible for many advanced lung cancer patients and caregivers, but may not substantially reduce symptom interference and distress. Low baseline levels of certain symptoms may have contributed to null findings. Next steps include applying ACT to specific, clinically meaningful symptom interference and varying intervention dose and modality.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
| | - Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Nasser Hanna
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Lawrence H Einhorn
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shadia I Jalal
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Richard L. Roudebush VAMC, Indianapolis, Indiana, USA
| | - Gregory Durm
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Shelley A Johns
- Indiana University School of Medicine, Center for Health Services Research, Regenstrief Institute, Indianapolis, Indiana, USA
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Govindan R, Fakih M, Price T, Falchook G, Desai J, Kuo J, Strickler J, Krauss J, Li B, Denlinger C, Durm G, Ngang J, Henary H, Ngarmchamnanrith G, Rasmussen E, Morrow P, Hong D. Phase I study of AMG 510, a novel molecule targeting KRAS G12C mutant solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Govindan R, Fakih M, Price T, Falchook G, Desai J, Kuo J, Strickler J, Krauss J, Li B, Denlinger C, Durm G, Ngang J, Henary H, Ngarmchamnanrith G, Rasmussen E, Morrow P, Hong D. OA02.02 Phase 1 Study of Safety, Tolerability, PK and Efficacy of AMG 510, a Novel KRASG12C Inhibitor, Evaluated in NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.412] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Anouti B, Althouse S, Durm G, Breen T, Hanna N. P1.16-01 Prognostic Variables Associated with Improved Outcomes in Stage III NSCLC Patients Treated with Consolidation Pembrolizumab. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.970] [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: 11/16/2022]
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Durm G, Althouse S, Sadiq A, Jalal S, Jabbour S, Zon R, Kloecker G, Fisher W, Reckamp K, Kio E, Langdon R, Adesunloye B, Gentzler R, Hanna N. OA01.07 Updated Results of a Phase II Trial of Concurrent Chemoradiation with Consolidation Pembrolizumab in Patients with Unresectable Stage III NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Zhang H, Wang W, Durm G, Kesler K, Kong F. Factors Associated With Survival in Patients With Non–small Cell Lung Cancer from a Single Institution Study of 3569 Patients. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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