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Teuwen LA, Young J, Davies A, Hudson J, Bourlon de los Rios M, Prenen H, Segelov E. 432P Representation of countries and gender in abstracts at the 2022 American Society of Clinical Oncology Annual Scientific Meeting (ASCO ASM). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.463] [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: 12/07/2022] Open
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Davies A, Buckley D, Raghunath A, Martin K, Prenen H, Cook O, Segelov E. 278MO Adherence optimisation, benefits, and limitations of oral anti-cancer therapy: A systematic review of patient preferences. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.305] [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: 12/07/2022] Open
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Ou S, Moreno Garcia V, Gil Bazo I, Prenen H, Moreno I, Johnson M, Castañón Álvarez E, Nagasaka M, Adeyemi S, Barasa B, Bol K, Doze P, Engbers A, Joe A, Stalbovskaya V, Laus G, Call J. MCLA-129, a human anti-EGFR and anti-c-MET bispecific antibody, in patients with advanced NSCLC and other solid tumors: an ongoing phase 1/2 study. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01124-8] [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: 11/03/2022]
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Patel M, Lee JS, De Miguel M, Burns T, Falcon Gonzalez A, Kim T, Krebs M, Prenen H, Shacham Shmueli E, Desai J, Lorusso P, Sacher A, Choi Y, Dharia N, Lin M, Mandlekar S, Royer-Joo S, Schutzman J, Garralda E. 459MO Phase Ia study to evaluate GDC-6036 monotherapy in patients with solid tumors with a KRAS G12C mutation. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.588] [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] Open
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Gadgeel S, Al-Mondhiry J, Ahn MJ, Kim SW, Paz-Ares L, Prenen H, Boyer M, Bustamante Alvarez J, Solomon B, Huang S, Minocha M, Kistler M, Hashemi Sadraei N. 1549TiP DeLLphi-303: Phase Ib first-line combination study of tarlatamab, a DLL3-targeting half-life extended bispecific T-cell engager (HLE BiTE®), with carboplatin, etoposide, and PD-L1 inhibition in extensive stage small cell lung cancer (ES-SCLC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1643] [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: 11/27/2022] Open
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Sacher A, Patel M, Miller W, Desai J, Garralda E, Bowyer S, Kim T, De Miguel M, Falcon A, Krebs M, Lee J, Cheng M, Han SW, Shacham-Shmueli E, Forster M, Jerusalem G, Massarelli E, Paz-Ares Rodriguez L, Prenen H, Walpole I, Arbour K, Choi Y, Dharia N, Lin M, Mandlekar S, Royer Joo S, Shi Z, Schutzman J, LoRusso P. OA03.04 Phase I A Study to Evaluate GDC-6036 Monotherapy in Patients with Non-small Cell Lung Cancer (NSCLC) with KRAS G12C Mutation. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.023] [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: 10/14/2022]
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Lenz HJ, Prenen H, Van Cutsem E, Kössler T, Mayol JF, Trapani F, Tihy M, Rubbia-Brandt L, Toso C, Bogenrieder T, Belnoue E, Derouazi M, Kopetz S. Abstract CT507: ATP128 vaccine with ezabenlimab promotes antigen-specific immune responses in stage IV colorectal cancer in the KISIMA-01 phase 1b trial. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-ct507] [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: KISIMA࣪ is a vaccine platform based on a single chimeric fusion protein, containing a proprietary cell-penetrating peptide (CPP) for antigen delivery, a proprietary Toll-like receptor (TLR)-peptide agonist with self-adjuvant properties and a modulable multi-antigenic domain (Mad). ATP128 vaccine targets 3 antigens: carcinoembryonic antigen (CEA), Survivin and Achaete-scute complex homolog 2 (ASCL2); it is used in combination with a PD-1 inhibitor in the treatment of MSS/MMR proficient stage IV colorectal cancer (CRC) patients, after first line of standard of care therapy or as perioperative administration in patients with resectable liver metastases.
Method: KISIMA-01 (NCT04046445) is an open-label, multi-center Phase 1b trial to investigate the safety, tolerability and immunogenicity of AT128 alone or in combination with the anti-PD-1 antibody ezabenlimab in patients with stage IV CRC. ATP128 is given SC q2w for the first 3 immunizations (prime) and q4w for the last 3 immunizations (boost). Ezabenlimab is administered q3w starting with the first ATP128 administration. Blood and tissue samples are collected before, during and after ATP128 treatment to monitor the induction of a tumor associated antigen-specific immune response (ELISpot) and immune-related changes in the peripheral blood and in the tumor microenvironment by immunohistochemistry (IHC) and flow cytometry.
Results: In more than 50% of evaluated patients treated with ATP128 alone or with ezabenlimab, a cellular immune response against at least one out of three antigens was observed as determined by IFN-γ ELISpot analyses of patient PBMCs after the 3rd vaccination. Analysis of liver metastases by IHC indicated that evaluated patients were positive for all 3 antigens in ATP128. Furthermore, for the patients with paired biopsies, a significant increase in CD8 T cells infiltration into the tumor parenchyma was observed after 3 vaccine administrations, along with a significantly higher proportion of CD45RO expressing memory cells within the CD4 population as compared to baseline. Tumor infiltrating lymphocytes (TILs) flow cytometry analysis comparing untreated (historical controls) and ATP128/ezabenlimab-treated patients showed a similar quantity of the different infiltrated subsets but an improved quality of infiltrated T cells, indicated by an increase (more than 2-fold) in proportion of central memory T cells and an impressive decrease of the proportion of cells positive for exhaustion markers expression in KISIMA-01 patients.
Conclusions: Analyses indicate induction of ATP128-specific immune response in the peripheral circulation and increased infiltration of TILs into liver metastases with an improved quality of T cells.
Citation Format: Heinz-Josef Lenz, Hanz Prenen, Eric Van Cutsem, Thibaud Kössler, Jean-François Mayol, Francesca Trapani, Matthieu Tihy, Laura Rubbia-Brandt, Christian Toso, Thomas Bogenrieder, Elodie Belnoue, Madiha Derouazi, Scott Kopetz. ATP128 vaccine with ezabenlimab promotes antigen-specific immune responses in stage IV colorectal cancer in the KISIMA-01 phase 1b trial [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 CT507.
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Affiliation(s)
- Heinz-Josef Lenz
- 1University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - Hanz Prenen
- 2University Hospital Antwerp, Antwerp, Belgium
| | - Eric Van Cutsem
- 3University Hospitals Gasthuisberg, Leuven and KULeuven, Leuven, Belgium
| | | | | | | | - Matthieu Tihy
- 7University Hospitals of Geneva and Faculty of Medicine Geneva, Geneva, Switzerland
| | - Laura Rubbia-Brandt
- 7University Hospitals of Geneva and Faculty of Medicine Geneva, Geneva, Switzerland
| | - Christian Toso
- 8eneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | | | | | - Scott Kopetz
- 9University of Texas MD Anderson Cancer Center, Houston, TX
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Taieb J, Arnold D, Prenen H, Sangro B, Pernot S, Zeka B, Kaufmann N, Gjoreski A, Iezzi R, Pereira P. P-17 Real-life use and long-term effectiveness results from CIREL – the multi-centre, observational study on irinotecan-eluting transarterial chemoembolization in CRLM. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.108] [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] Open
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Prenen H, Kyi C, Van Lancker G, Patel S, Mittag D, Weaver A, Bol K, Stalbovskaya V, Pulini J, Zhou G, Dong Z, Asatiani E, Hodi F. 136P Phase I dose escalation study of MCLA-145, a bispecific antibody targeting CD137 and PD-L1 in solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.155] [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: 10/19/2022] Open
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Price T, Prenen H, Lugowska I, Falchook G, Monzon J, Arkenau H, Chawla S, Hui M, Kuboki Y, Dziadziuszko R, Ozawa Y, Elez Fernandez M, Rocha Lima C, Subbiah V, Tan D, Wang K, Hindoyan A, Shi W, Kistler M, Hashemi Sadraei N. 142P Updated results from a phase I, open-label, multicenter, first-in-human study of AMG 404, a checkpoint inhibitor, in patients with advanced solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.161] [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: 10/19/2022] Open
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Hansen A, Gomez-Roca C, Lolkema M, Verlingue L, Italiano A, Spicer J, Steeghs N, Bauman J, Fayette J, Niu J, Prenen H, Dejardin D, Boetsch C, Kraxner A, Evers S, Vardar T, Keshelava N, Teichgräber V, Bonomi M. 906P Simlukafusp α and cetuximab combination in patients with recurrent, unresectable or metastatic squamous cell carcinoma of the head and neck. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1316] [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] Open
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Domen A, Deben C, Hermans C, Lambrechts H, Siozopoulou V, Pauwels P, Van De Wiel M, Janssens A, Hendriks J, van Schil P, Vandamme T, Prenen H, Peeters M, Lardon F, Wouters A. 1178P Senescence signature affects overall survival in non-small cell lung cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1782] [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: 10/20/2022] Open
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Dowlati A, Byers L, Johnson M, Aljumaily R, Prenen H, Zhang A, Minocha M, Shetty A, Hashemi Sadraei N. 1668TiP Phase Ib study of AMG 757, a half-life extended bispecific T-cell engager immuno-oncology therapy, combined with AMG 404, an anti-PD-1 antibody, in patients with small cell lung cancer (SCLC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.252] [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: 10/20/2022] Open
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Delombaerde D, Vervloet D, Franssen C, Croes L, Gremonprez F, Prenen H, Peeters M, Vulsteke C. Clinical implications of isolated troponinemia following immune checkpoint inhibitor therapy. ESMO Open 2021; 6:100216. [PMID: 34271309 PMCID: PMC8287144 DOI: 10.1016/j.esmoop.2021.100216] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/18/2021] [Accepted: 06/28/2021] [Indexed: 01/27/2023] Open
Abstract
Cardiovascular adverse events induced by immune checkpoint inhibitors (ICIs) have gained significant interest over the past decade due to their impact on short- and long-term outcomes. They were initially thought to be rare, but the increasing use of ICIs in the treatment of both advanced and early stages of various malignancies has resulted in a substantial increase in their incidence. Different guidelines have proposed screening measures for ICI-induced myocarditis by incorporating troponin measurements at baseline and during the first few weeks of treatment. However, no specific guidelines have been developed yet regarding the interpretation of an asymptomatic rise in troponins. This state-of-the art review aims to provide an overview of the clinical relevance of elevated troponins during checkpoint inhibition and recommendations on how to manage elevated troponin levels during ICI therapy.
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Affiliation(s)
- D Delombaerde
- Integrated Cancer Center Ghent, Department of Medical Oncology, AZ Maria Middelares, Ghent, Belgium; Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium.
| | - D Vervloet
- Department of Cardiology, AZ Maria Middelares, Ghent, Belgium
| | - C Franssen
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - L Croes
- Integrated Cancer Center Ghent, Department of Medical Oncology, AZ Maria Middelares, Ghent, Belgium; Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium
| | - F Gremonprez
- Integrated Cancer Center Ghent, Department of Medical Oncology, AZ Maria Middelares, Ghent, Belgium
| | - H Prenen
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium; Multidisciplinary Oncologic Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium
| | - M Peeters
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium; Multidisciplinary Oncologic Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium
| | - C Vulsteke
- Integrated Cancer Center Ghent, Department of Medical Oncology, AZ Maria Middelares, Ghent, Belgium; Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium
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Bennett S, Søreide K, Gholami S, Pessaux P, Teh C, Segelov E, Kennecke H, Prenen H, Myrehaug S, Callegaro D, Hallet J. Strategies for the delay of surgery in the management of resectable hepatobiliary malignancies during the COVID-19 pandemic. Curr Oncol 2020; 27:e501-e511. [PMID: 33173390 PMCID: PMC7606047 DOI: 10.3747/co.27.6785] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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] [Indexed: 01/08/2023] Open
Abstract
Objective We aimed to review data about delaying strategies for the management of hepatobiliary cancers requiring surgery during the covid-19 pandemic. Background Given the covid-19 pandemic, many jurisdictions, to spare resources, have limited access to operating rooms for elective surgical activity, including cancer, thus forcing deferral or cancellation of cancer surgeries. Surgery for hepatobiliary cancer is high-risk and particularly resource-intensive. Surgeons must critically appraise which patients will benefit most from surgery and which ones have other therapeutic options to delay surgery. Little guidance is currently available about potential delaying strategies for hepatobiliary cancers when surgery is not possible. Methods An international multidisciplinary panel reviewed the available literature to summarize data relating to standard-of-care surgical management and possible mitigating strategies to be used as a bridge to surgery for colorectal liver metastases, hepatocellular carcinoma, gallbladder cancer, intrahepatic cholangiocarcinoma, and hilar cholangiocarcinoma. Results Outcomes of surgery during the covid-19 pandemic are reviewed. Resource requirements are summarized, including logistics and adverse effects profiles for hepatectomy and delaying strategies using systemic, percutaneous and radiation ablative, and liver embolic therapies. For each cancer type, the long-term oncologic outcomes of hepatectomy and the clinical tools that can be used to prognosticate for individual patients are detailed. Conclusions There are a variety of delaying strategies to consider if availability of operating rooms decreases. This review summarizes available data to provide guidance about possible delaying strategies depending on patient, resource, institution, and systems factors. Multidisciplinary team discussions should be leveraged to consider patient- and tumour-specific information for each individual case.
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Affiliation(s)
- S Bennett
- Canada: Department of Surgery, University of Toronto, Toronto, ON (Bennett, Callegaro, Hallet); Department of Radiation Oncology, University of Toronto, Toronto, ON (Myrehaug); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON (Hallet)
| | - K Søreide
- Norway: Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, and Department of Clinical Medicine, University of Bergen, Bergen
| | - S Gholami
- United States: Division of Surgical Oncology, Department of Surgery, University of California, Davis, CA (Gholami); Virginia Mason Cancer Institute, Seattle, WA (Kennecke)
| | - P Pessaux
- France: Department of Surgery, Institut Hospitalo-Universitaire de Strasbourg, Strasbourg
| | - C Teh
- Philippines: Institute of Surgery, St. Luke's Medical Center, Quezon City; Department of Surgery, Makati Medical Center, Makati; and Department of General Surgery, National Kidney and Transplant Institute, Quezon City
| | - E Segelov
- Australia: Monash University and Monash Health, Melbourne
| | - H Kennecke
- United States: Division of Surgical Oncology, Department of Surgery, University of California, Davis, CA (Gholami); Virginia Mason Cancer Institute, Seattle, WA (Kennecke)
| | - H Prenen
- Belgium: Department of Oncology, University Hospital Antwerp, Antwerp
| | - S Myrehaug
- Canada: Department of Surgery, University of Toronto, Toronto, ON (Bennett, Callegaro, Hallet); Department of Radiation Oncology, University of Toronto, Toronto, ON (Myrehaug); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON (Hallet)
| | - D Callegaro
- Canada: Department of Surgery, University of Toronto, Toronto, ON (Bennett, Callegaro, Hallet); Department of Radiation Oncology, University of Toronto, Toronto, ON (Myrehaug); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON (Hallet)
- Italy: Department of Surgery, Fondazione irccs Istituto Nazionale Tumori, Milan
| | - J Hallet
- Canada: Department of Surgery, University of Toronto, Toronto, ON (Bennett, Callegaro, Hallet); Department of Radiation Oncology, University of Toronto, Toronto, ON (Myrehaug); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON (Hallet)
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Calvo E, Spira A, Prenen H, Ohe Y, Rottey S, Gazzah A, Millward M, Moreno V, Italiano A, Alanko T, Yoh K, Cassier P, Seto T, Afar D, Englert S, Komarnitsky P, Lambert S, Parikh A, Vosganian G, Gao B. Phase I open-label study evaluating the safety, pharmacokinetics, and preliminary efficacy of ABBV-181 and rovalpituzumab tesirine (ROVA-T) in patients with small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz264.012] [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: 11/12/2022] Open
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Van Cutsem E, Machiels J, Van den Eynde M, Prenen H, Hendlisz A, Shaza L, Carrasco J, Canon J, Sotiropoulou P, Breman E, Alcantar E, Flament A. Phase 1 studies assessing the safety and clinical activity of autologous and allogeneic NKG2D-based CAR-T therapy in metastatic colorectal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz157.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Triest L, Debeuckelaere C, Vandamme T, Van Den Heuvel B, Van Den Brande J, Papadimitriou K, Rasschaert M, Prenen H, Peeters M. Should Anti-EGFR Agents Be Used in Right-Sided RAS Wild-type Advanced Colorectal Cancer? Curr Colorectal Cancer Rep 2019. [DOI: 10.1007/s11888-019-00439-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Thomas M, Depypere L, Moons J, Coosemans W, Lerut T, Prenen H, Haustermans K, Van Veer H, Nafteux P. PO-0805 Analysis of esophageal cancer patients treated with neoadjuvant therapy who never made it to surgery. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31225-3] [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: 11/27/2022]
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Chiritescu G, Dumon K, Verslype C, Prenen H, Houbiers G, Peeters M, Janssens J, Van Daele D, Laurent S, Arts J, Hendrickx K, Borbath I, Ferrante M, Bastin F, Goeminne J, Van Laethem J, Vanderstraeten E, Decaestecker J, Van Vaerenbergh W, Delhougne B, Van Cutsem E. Gemcitabine with nab-paclitaxel in patients with locally advanced or metastatic pancreatic ductal adenocarcinoma (PDAC): A quality of life randomized cross-over study (QOLINPAC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.002] [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: 11/14/2022] Open
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Decoster L, Kenis C, Naessens B, Houbiers G, De Man M, Lambecht G, Monsaert E, Moons V, Vergauwe P, Prenen H, Van Cutsem E, Beutels E, Frijns D, Wildiers H. AVAPLUS: Impact of geriatric assessment on first-line treatment duration (TD) and progression free survival (PFS) in mCRC patients ≥ 70 years. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.94] [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] Open
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Van Cutsem E, Decoster L, Houbiers G, Naessens B, De Man M, Lambrecht G, Monsaert E, Moons V, Vergauwe P, Kenis C, Wildiers H, Opstaele L, Van De Walle E, Prenen H. PD-030 Prospective non-interventional study to collect data on the use of bevacizumab and conventional chemotherapy for the treatment of previously untreated metastatic colorectal cancer in patient's ≥70 years. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw200.30] [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: 11/14/2022] Open
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Finisguerra V, Prenen H, Mazzone M. Preclinical and clinical evaluation of MET functions in cancer cells and in the tumor stroma. Oncogene 2016; 35:5457-5467. [PMID: 26996670 DOI: 10.1038/onc.2016.36] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 01/09/2016] [Accepted: 01/09/2016] [Indexed: 02/06/2023]
Abstract
A lot of attention has been dedicated to investigate the role of the tyrosine kinase receptor MET in tumors. The acquired notion that cancer cells from different histological origin strictly rely on the engagement of this specific oncogene for their growth and survival has certainly justified the development and the use of MET-targeted therapies in the clinic. However, the function and involvement of this pathway in the stroma (that often constitutes >50% of the global cellularity of the tumor) may offer the opportunity to conceive new patient stratification criteria, rational drug design and guided trials of new combination treatments. In this review, we will summarize and discuss the role of MET in cancer cells but especially in different stromal compartments, in light of the results showed by past and recent preclinical and clinical trials with anti-MET drugs.
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Affiliation(s)
- V Finisguerra
- Ludwig Institute for Cancer Research, Brussels, Belgium.,de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - H Prenen
- Digestive Oncology, University Hospitals Leuven and Department of Oncology, KU Leuven, Leuven, Belgium
| | - M Mazzone
- Lab of Molecular Oncology and Angiogenesis, Vesalius Research Center, VIB, Leuven, Belgium.,Lab of Molecular Oncology and Angiogenesis, Vesalius Research Center, Department of Oncology, KU Leuven, Leuven, Belgium
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Van Cutsem E, Prenen H, D'Haens G, Bennouna J, Carrato A, Ducreux M, Bouché O, Sobrero A, Latini L, Staines H, Oum'Hamed Z, Dressler H, Studeny M, Capdevila J. A phase I/II, open-label, randomised study of nintedanib plus mFOLFOX6 versus bevacizumab plus mFOLFOX6 in first-line metastatic colorectal cancer patients. Ann Oncol 2015; 26:2085-91. [PMID: 26272806 DOI: 10.1093/annonc/mdv286] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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: 02/16/2015] [Accepted: 06/27/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND This randomised, open-label, phase I/II study evaluated the efficacy and safety of nintedanib, an oral, triple angiokinase inhibitor, combined with chemotherapy, relative to bevacizumab plus chemotherapy as first-line therapy in patients with metastatic colorectal cancer (mCRC). PATIENTS AND METHODS Patients with histologically confirmed mCRC (adenocarcinoma), an Eastern Cooperative Oncology Group performance status ≤ 2 and adequate organ function were included. Patients were randomised 2:1 to receive nintedanib 150 mg or 200 mg b.i.d. plus mFOLFOX6 (oxaliplatin 85 mg/m(2), l-leucovorin 200 mg/m(2) or d,l-leucovorin 400 mg/m(2), 5-fluoruracil bolus 400 mg/m(2) followed by 2400 mg/m(2), every 2 weeks) or bevacizumab (5 mg/kg every 2 weeks) plus mFOLFOX6. During phase I, patients underwent a 3 + 3 dose-escalation schema to determine the maximum tolerated dose (MTD) of nintedanib in combination with mFOLFOX6. The primary end point was progression-free survival (PFS) rate at 9 months. Objective response (OR) was a secondary end point. RESULTS The nintedanib recommended phase II dose was 200 mg b.i.d. plus mFOLFOX6 based on safety data from phase I (n = 12). Of 128 patients randomised in the phase II part, 126 received treatment (nintedanib plus mFOLFOX6, n = 85; bevacizumab plus mFOLFOX6, n = 41). PFS at 9 months was 62.1% with nintedanib and 70.2% with bevacizumab [difference: -8.1% (95% confidence interval -27.8 to 11.5)]. Confirmed ORs were recorded in 63.5% and 56.1% of patients in the nintedanib and bevacizumab groups, respectively. The incidence of adverse events (AEs) considered related to treatment was 98.8% with nintedanib and 97.6% with bevacizumab; the incidence of serious AEs was 37.6% with nintedanib and 53.7% with bevacizumab. The pharmacokinetics of nintedanib and the components of mFOLFOX6 were unaffected by their combination. CONCLUSIONS Nintedanib in combination with mFOLFOX6 showed efficacy as first-line therapy in patients with mCRC with a manageable safety profile and further studies in this population are warranted.
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Affiliation(s)
- E Van Cutsem
- Digestive Oncology, University Hospitals Leuven and KULeuven, Leuven, Belgium
| | - H Prenen
- Digestive Oncology, University Hospitals Leuven and KULeuven, Leuven, Belgium
| | - G D'Haens
- Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands Imelda GI Clinical Research Centre, Bonheiden, Belgium
| | - J Bennouna
- Department of Medical Oncology, Centre René Gauducheau, Nantes, France
| | - A Carrato
- Department of Medical Oncology, Ramon y Cajal University Hospital, Madrid, Spain
| | - M Ducreux
- Gustave-Roussy Cancer Campus, Institut Gustave Roussy, Paris University of Paris-Sud, Le Kremlin Bicêtre, Paris
| | - O Bouché
- Department of Digestive Oncology, CHU Reims, Reims, France
| | - A Sobrero
- Department of Medical Oncology, San Martino Hospital, Genoa
| | - L Latini
- Oncology Unit, Macerata Hospital, Macerata, Italy
| | - H Staines
- Medical and Drug Regulatory Affairs, Boehringer Ingelheim France S.A.S., Reims, France
| | - Z Oum'Hamed
- Medical and Drug Regulatory Affairs, Boehringer Ingelheim France S.A.S., Reims, France
| | - H Dressler
- Global Pharmacovigilance, Boehringer Ingelheim, Ingelheim, Germany
| | - M Studeny
- Division of Medicine/Department of Clinical Development, Boehringer Ingelheim, Vienna, Austria
| | - J Capdevila
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Macarulla T, Cervantes A, Tabernero J, Roselló S, Van Cutsem E, Tejpar S, Prenen H, Martinelli E, Troiani T, Laffranchi B, Jego V, von Richter O, Ciardiello F. Phase I study of FOLFIRI plus pimasertib as second-line treatment for KRAS-mutated metastatic colorectal cancer. Br J Cancer 2015; 112:1874-81. [PMID: 25989270 PMCID: PMC4580393 DOI: 10.1038/bjc.2015.144] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 02/25/2015] [Accepted: 03/25/2015] [Indexed: 11/09/2022] Open
Abstract
Background: The mitogen-activated protein kinase (MAPK) pathway has been implicated in the molecular pathogenesis of human cancers, including metastatic colorectal cancer (mCRC). This provides a rationale for the development of MAPK-targeted agents such as pimasertib. Methods: Patients with KRAS mutant mCRC were treated in the second-line setting with FOLFIRI (5-fluorouracil/folinic acid/irinotecan) plus pimasertib. The primary objective of the safety run-in phase was to determine the maximum-tolerated dose (MTD) and the recommended phase II dose of pimasertib combined with FOLFIRI. Results: Sixteen patients were enrolled in the trial. Ten and six patients were treated daily with 45 and 60 mg of pimasertib plus FOLFIRI, respectively. The MTD was considered to be 45 mg per day. The most common treatment-emergent adverse events were diarrhoea, nausea, vomiting, asthenia and skin/rash event. Of the 15 patients in the efficacy analysis group, two patients had partial response, nine patients had stable disease, three patients had progressive disease as their best overall response and one patient could not be evaluated. Conclusions: Dose escalation of pimasertib in combination with FOLFIRI was limited by toxicity. At the MTD of 45 mg per day, pimasertib was adequately tolerated in patients with mCRC and no unexpected or new safety signals or concerns were identified.
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Affiliation(s)
- T Macarulla
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, P Vall d'Hebron 119-129, Barcelona 08035, Spain
| | - A Cervantes
- Department of Haematology and Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Avda Blasco Ibáñez 17, Valencia 46010, Spain
| | - J Tabernero
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, P Vall d'Hebron 119-129, Barcelona 08035, Spain
| | - S Roselló
- Department of Haematology and Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Avda Blasco Ibáñez 17, Valencia 46010, Spain
| | - E Van Cutsem
- Department of Gastroenterology, University Hospitals Gasthuisberg and KU Leuven, Herestraat 49, Leuven 3000, Belgium
| | - S Tejpar
- Department of Gastroenterology, University Hospitals Gasthuisberg and KU Leuven, Herestraat 49, Leuven 3000, Belgium
| | - H Prenen
- Department of Gastroenterology, University Hospitals Gasthuisberg and KU Leuven, Herestraat 49, Leuven 3000, Belgium
| | - E Martinelli
- Department of Experimental and Clinical Medicine, Second University of Naples, Via S Pansini 5, Naples 80131, Italy
| | - T Troiani
- Department of Experimental and Clinical Medicine, Second University of Naples, Via S Pansini 5, Naples 80131, Italy
| | - B Laffranchi
- Merck Serono SA, 9 Chemin des Mines, Geneva 1202, Switzerland
| | - V Jego
- Merck Serono SA, 9 Chemin des Mines, Geneva 1202, Switzerland
| | - O von Richter
- Merck KGaA, Frankfurter Strasse 250, F131/102, Darmstadt 64293, Germany
| | - F Ciardiello
- Department of Experimental and Clinical Medicine, Second University of Naples, Via S Pansini 5, Naples 80131, Italy
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Van Cutsem E, Boni C, Tabernero J, Massuti B, Middleton G, Dane F, Reichardt P, Pimentel FL, Cohn A, Follana P, Clemens M, Zaniboni A, Moiseyenko V, Harrison M, Richards DA, Prenen H, Pernot S, Ecstein-Fraisse E, Hitier S, Rougier P. Docetaxel plus oxaliplatin with or without fluorouracil or capecitabine in metastatic or locally recurrent gastric cancer: a randomized phase II study. Ann Oncol 2015; 26:149-156. [PMID: 25416687 DOI: 10.1093/annonc/mdu496] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [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: 12/13/2022] Open
Abstract
BACKGROUND Docetaxel/cisplatin/infusional 5-fluorouracil (5-FU; DCF) is a standard chemotherapy regimen for patients with advanced gastric cancer (GC). This phase II study evaluated docetaxel/oxaliplatin (TE), docetaxel/oxaliplatin/5-FU (TEF), and docetaxel/oxaliplatin/capecitabine (TEX) in patients with advanced GC. PATIENTS AND METHODS Patients with metastatic or locally recurrent gastric adenocarcinoma (including carcinoma of the gastro-oesophageal junction) were randomly assigned (1 : 1 : 1) to TE, TEF, or TEX. Each regimen was tested at two doses before full evaluation at optimized dose levels. The primary end point was progression-free survival (PFS). Overall survival (OS), tumour response, and safety were also assessed. A therapeutic index (median PFS relative to the incidence of febrile neutropenia) was calculated for each regimen and compared with DCF (historical data). RESULTS Overall, 248 patients were randomly assigned to receive optimized dose treatment. Median PFS was longer with TEF (7.66 [95% confidence interval (CI): 6.97-9.40] months) versus TE (4.50 [3.68-5.32] months) and TEX (5.55 [4.30-6.37] months). Median OS was 14.59 (95% CI: 11.70-21.78) months for TEF versus 8.97 (7.79-10.87) months for TE and 11.30 (8.08-14.03) months for TEX. The rate of tumour response (complete or partial) was 46.6% (95% CI 35.9-57.5) for TEF versus 23.1% (14.3-34.0) for TE and 25.6% (16.6-36.4) for TEX. The frequency and type of adverse events (AEs) were similar across the three arms. Common grade 3/4 AEs were fatigue (21%), sensory neuropathy (14%), and diarrhoea (13%). Febrile neutropenia was reported in 2% (TEF), 14% (TE), and 9% (TEX) of patients. The therapeutic index was improved with TEF versus TEX, TE, or DCF. CONCLUSION These results suggest that TEF is worthy of evaluation as an arm in a phase III trial or as a backbone regimen for new targeted agents in advanced GC. CLINICALTRIALS.GOV: Identifier Trial registration number: NCT00382720.
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Affiliation(s)
- E Van Cutsem
- Digestive Oncology, University Hospitals Leuven and KU Leuven, Leuven, Belgium.
| | - C Boni
- Department of Oncology, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - J Tabernero
- Department of Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona
| | - B Massuti
- Medical Oncology Service, Alicante University Hospital, Alicante, Spain
| | - G Middleton
- Department of Medical Oncology, University of Birmingham, Birmingham, UK
| | - F Dane
- Department of Medical Oncology, Marmara University Medical Faculty, Istanbul, Turkey
| | - P Reichardt
- Interdisciplinary Oncology, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - F L Pimentel
- Oncology, Hospital de São Sebastião, Santa Maria da Feira, Portugal
| | - A Cohn
- US Oncology Research, Rocky Mountain Cancer Centers, Denver, USA
| | - P Follana
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - M Clemens
- Department of Internal Medicine I, Klinikum Mutterhaus der Borromaeerinnen, Trier, Germany
| | - A Zaniboni
- Medical Oncology, Fondazione Poliambulanza - Istituto Ospedaliero, Brescia, Italy
| | - V Moiseyenko
- Medical Oncology, N.N. Petrov Oncology SRI, St Petersburg, Russia
| | - M Harrison
- Department of Clinical Oncology, Mount Vernon Cancer Centre, Northwood, UK
| | - D A Richards
- US Oncology Research, Texas Oncology-Tyler, Tyler, USA
| | - H Prenen
- Digestive Oncology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - S Pernot
- Digestive Oncology, Universite Paris-V European Hospital Georges Pompidou, APHP, Paris, France
| | | | - S Hitier
- Statistics, Sanofi, Chilly-Mazarin, France
| | - P Rougier
- Digestive Oncology, Universite Paris-V European Hospital Georges Pompidou, APHP, Paris, France
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Weekes C, Parnis F, Thaler J, Prenen H, Letourneau R, Raymond E, Santoro A, Garcia-Carbonero R, Weis J, Romano A, McGovern D, Penenberg D, Von Hoff D. Nab-Paclitaxel (Nab-P) Plus Gemcitabine (Gem) Vs Gem Alone for Patients (Pts) with Metastatic Pancreatic Cancer (Pc): Subgroup Analyses of the Mpact Trial Based on the Presence of Liver Metastases (Lms) and Number of Metastatic Sites. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.78] [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: 11/12/2022] Open
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Dirix P, Deroose C, Nafteux P, Lerut T, Coolen J, De Hertogh G, Prenen H, Van Cutsem E, Haustermans J. PD-0129: FDG-PET/CT for prediction and assessment of pathological response to induction CRT for esophageal carcinoma. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30234-6] [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: 11/30/2022]
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Prenen H, Geva R, Piessevaux H, Tejpar S, Verslype C, Vannoote J, Mortier L, Van Cutsem E. Bevacizumab plus chemotherapy as salvage treatment in chemorefractory patients with metastatic colorectal cancer: A retrospective analysis. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14095] [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: 11/20/2022] Open
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30
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Van Cutsem E, Boni C, Tabernero J, Massuti B, Richards DA, Prenen H, Steinberg I, Rougier P. Randomized phase II study (GATE study) of docetaxel plus oxaliplatin with or without fluorouracil or capecitabine in metastatic or locally recurrent gastric cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [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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31
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Prenen H, D'Haens G, Capdevila J, Carrato A, Sobrero A, Ducreux M, François E, Staines H, Amellal N, Van Cutsem E. A phase I dose escalation study of BIBF 1120 combined with FOLFOX in metastatic colorectal cancer (mCRC) patients (pts). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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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Piessevaux H, Buyse M, De Roock W, Prenen H, Schlichting M, Van Cutsem E, Tejpar S. Radiological tumor size decrease at week 6 is a potent predictor of outcome in chemorefractory metastatic colorectal cancer treated with cetuximab (BOND trial). Ann Oncol 2009; 20:1375-82. [PMID: 19465422 DOI: 10.1093/annonc/mdp011] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Early radiological tumor shrinkage may be associated with better long-term outcome in chemorefractory metastatic colorectal cancer (cmCRC) treated with cetuximab. We aimed at validating this in a large and independent series. PATIENTS AND METHODS Of the 329 patients, 289 had a measurement both at baseline and week 6. Tumor shrinkage was expressed as a relative decrease compared with baseline and categorized according to a previously reported cut-off value ( approximately 10%) or used as a continuous variable. RESULTS Median time to progression (TTP) was 6.1 [95% confidence interval (CI) 5.1-7.2] versus 1.5 months (95% CI 1.4-1.7) in patients with [99 patients (34.3%)] or without [190 patients (65.7%)] tumor shrinkage, respectively, at week 6 [hazard ratio (HR) 0.23 (95% CI 0.17-0.32)]. The median overall survival (OS) was 13.7 (CI NA) versus 6.9 months (95% CI 6.1-7.7) [HR 0.21 (95% CI 0.14-0.32)], respectively. In a multivariate model, early tumor decrease outperformed skin toxicity as a predictor of long-term outcome. CONCLUSIONS Tumor shrinkage at 6 weeks is a strong predictor of TTP and OS in cmCRC patients treated with cetuximab with or without irinotecan. This suggests early tumor shrinkage is the hallmark of efficacy of cetuximab and reliably identifies the subpopulation that is sensitive to the drug. Early tumor shrinkage can be used as a marker of efficacy in clinical practice, as such or in combination.
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Affiliation(s)
- H Piessevaux
- Service de Gastro-entérologie, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
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Lambrechts D, De Roock W, Prenen H, De Schutter J, Jacobs B, Biesmans B, Claes B, De Hertogh G, Van Cutsem E, Tejpar S. The role of KRAS, BRAF, NRAS, and PIK3CA mutations as markers of resistance to cetuximab in chemorefractory metastatic colorectal cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [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
4020 Background: KRAS mutations (MUT) negatively affect outcome after cetuximab (CTX) in metastatic colorectal cancer (mCRC). As only 40% of KRAS wild-type (WT) respond it is possible that other MUT, constitutively activating the Ras/Erk or PI3K/Akt pathways, are present in the non-responding KRAS WT. We analyzed the KRAS, BRAF, NRAS & PIK3CA MUT status in 276 chemorefractory CRC treated with CTX +- irinotecan and correlated the MUT status with outcome. Methods: KRAS codon 12,13, 61&146, BRAF V600E, NRAS codon 12&13, PIK3CA E542K, E545K, A, G, V (exon 9), H1047Y, R, L (exon 20), N345K, R88Q and Q546K MUT were evaluated on FFPE primary CRC using the Sequenom MALDI TOF MassArray system. A two- sided Fisher's exact test was used to evaluate the association between PIK3CA, KRAS, BRAF & NRAS MUT and objective response (OR). Progression-free (PFS) and overall survival (OS) were estimated by the Kaplan-Meier method. Results: 116/276 (42%) CRC had a KRAS MUT, 96% of which occurred in codon 12 or 13. KRAS WT was associated with OR (p<.0001), longer median PFS (p<.0001) and OS (p<.0001). 15/153 (9.8%) KRAS WT had a BRAF MUT. BRAF WT was associated with OR (p=.01), longer PFS (p<.0001) and OS (p=.007). 5/98 (5%) KRAS WT had an NRAS MUT and none of these showed OR. KRAS, BRAF and NRAS MUT were mutually exclusive. The combined KRAS/BRAF/NRAS WT state was associated with OR (p<.0001), longer PFS (p<.0001) and OS (p<.0001). 23/200 (12%) CRC carried a PIK3CA mutation: 5/39 (13%) of responders and 18/160 (11%) of non-responders (p=.781). Median PFS and OS were not associated with PIK3CA MUT state (p=.760 & p=.698) overall, nor in the KRAS/BRAF/NRAS WT subgroup (p=.946 & p=.509). 5/13 (38.5%) PIK3CA MUT KRAS/BRAF/NRAS WT CRC showed an OR. 13/107 (12%) of KRAS/BRAF/NRAS WT and 10/93 (11%) of KRAS/BRAF/NRAS MUT tumors harbored a PIK3CA MUT (p=.826). Conclusions: KRAS, BRAF & NRAS MUT are mutually exclusive and occur in at least 47% of CRC. Like KRAS WT, BRAF WT state of the primary is significantly associated with outcome in mCRC treated with CTX. The combined KRAS/BRAF/NRAS WT state is significantly associated with outcome. PIK3CA MUT occur independently of the KRAS/BRAF/NRAS MUT status. We cannot provide any evidence for a strong role of PIK3CA MUT as a marker in determining outcome to CTX. [Table: see text]
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Affiliation(s)
- D. Lambrechts
- KULeuven, Leuven, Belgium; University Hospital Gasthuisberg, KULeuven, Leuven, Belgium
| | - W. De Roock
- KULeuven, Leuven, Belgium; University Hospital Gasthuisberg, KULeuven, Leuven, Belgium
| | - H. Prenen
- KULeuven, Leuven, Belgium; University Hospital Gasthuisberg, KULeuven, Leuven, Belgium
| | - J. De Schutter
- KULeuven, Leuven, Belgium; University Hospital Gasthuisberg, KULeuven, Leuven, Belgium
| | - B. Jacobs
- KULeuven, Leuven, Belgium; University Hospital Gasthuisberg, KULeuven, Leuven, Belgium
| | - B. Biesmans
- KULeuven, Leuven, Belgium; University Hospital Gasthuisberg, KULeuven, Leuven, Belgium
| | - B. Claes
- KULeuven, Leuven, Belgium; University Hospital Gasthuisberg, KULeuven, Leuven, Belgium
| | - G. De Hertogh
- KULeuven, Leuven, Belgium; University Hospital Gasthuisberg, KULeuven, Leuven, Belgium
| | - E. Van Cutsem
- KULeuven, Leuven, Belgium; University Hospital Gasthuisberg, KULeuven, Leuven, Belgium
| | - S. Tejpar
- KULeuven, Leuven, Belgium; University Hospital Gasthuisberg, KULeuven, Leuven, Belgium
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Prenen H, Jacobs B, De Roock W, Van Oirbeek R, Biesmans B, De Schutter J, Fieuws S, Laurent-Puig P, Van Cutsem E, Tejpar S. Use of amphiregulin and epiregulin mRNA expression in primary tumors to predict outcome in metastatic colorectal cancer treated with cetuximab. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4019] [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
4019 Background: To study the power of two epidermal growth factor receptor (EGFR) ligands, epiregulin (EREG) and amphiregulin (AREG) expression in primary tumors to predict the outcome in patients with chemorefractory metastatic colorectal cancer (cmCRC) treated with the combination of cetuximab plus irinotecan. Methods: Gene expression measurements and KRAS mutation analysis were performed on archival formalin-fixed paraffin-embedded primary tumors of 220 cmCRC patients. Response was measured using RECIST criteria. The relation between ligand expression levels and outcome was evaluated using logistic regression for response and Cox regression for survival data. ROC analysis was performed for response and survival data. Confidence intervals (CI) for the performance indices were obtained with a non-parametric bootstrap procedure. Findings were externally validated on a series of 67 samples treated in a similar setting. Results: In KRAS wild-type (WT) patients, there was a significant association between log-transformed ligand expression and response (EREG: Odds ratio for objective response 1.90 (p=0.0005, 95%CI:1.27–2.83), c-index=0.681; AREG: Odds ratio for objective response: 1.82 (p=0.0017, 95%CI:1.22–2.72), c-index=0.673). In a Cox- regression model log-transformed ligand expression was significantly associated to progression-free survival (PFS) and overall survival (OS) (EREG: hazard ratio (HR) for PFS: 0.61 (p<0.001, 95%CI:0.51–0.73), cτ-index=0.696; AREG: HR for PFS: 0.60 (95%CI:0.50–0.74), cτ-index=0.671; EREG: HR for OS: 0.61 (p<0.001, 95%CI:0.50–0.73), cτ-index=0.667; AREG: HR for OS: 0.65 (p<0.001, 95%CI:0.54–0.78), cτ-index=0.642). There was no predictive power of ligand expression in KRAS mutant patients. Conclusions: Expression of EGFR ligands in primary tumors significantly predicts favorable outcome in KRAS WT cmCRC treated with cetuximab and irinotecan. [Table: see text]
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Affiliation(s)
- H. Prenen
- University Hospital Gasthuisberg, KULeuven, Leuven, Belgium; KULeuven, Leuven, Belgium; Université Paris- Descartes, Paris, France
| | - B. Jacobs
- University Hospital Gasthuisberg, KULeuven, Leuven, Belgium; KULeuven, Leuven, Belgium; Université Paris- Descartes, Paris, France
| | - W. De Roock
- University Hospital Gasthuisberg, KULeuven, Leuven, Belgium; KULeuven, Leuven, Belgium; Université Paris- Descartes, Paris, France
| | - R. Van Oirbeek
- University Hospital Gasthuisberg, KULeuven, Leuven, Belgium; KULeuven, Leuven, Belgium; Université Paris- Descartes, Paris, France
| | - B. Biesmans
- University Hospital Gasthuisberg, KULeuven, Leuven, Belgium; KULeuven, Leuven, Belgium; Université Paris- Descartes, Paris, France
| | - J. De Schutter
- University Hospital Gasthuisberg, KULeuven, Leuven, Belgium; KULeuven, Leuven, Belgium; Université Paris- Descartes, Paris, France
| | - S. Fieuws
- University Hospital Gasthuisberg, KULeuven, Leuven, Belgium; KULeuven, Leuven, Belgium; Université Paris- Descartes, Paris, France
| | - P. Laurent-Puig
- University Hospital Gasthuisberg, KULeuven, Leuven, Belgium; KULeuven, Leuven, Belgium; Université Paris- Descartes, Paris, France
| | - E. Van Cutsem
- University Hospital Gasthuisberg, KULeuven, Leuven, Belgium; KULeuven, Leuven, Belgium; Université Paris- Descartes, Paris, France
| | - S. Tejpar
- University Hospital Gasthuisberg, KULeuven, Leuven, Belgium; KULeuven, Leuven, Belgium; Université Paris- Descartes, Paris, France
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Abstract
Cholangiocarcinoma is a rare malignancy associated with poor prognosis and high mortality. Surgical resection is the only chance for cure depending on careful patient selection. There are no well-conducted studies regarding the role of adjuvant chemotherapy. Preliminary data suggest that liver transplantation could offer long-term survival in selected patients when combined with neoadjuvant chemoradiotherapy. The literature regarding treatment results with specific regimens in the adjuvant setting is limited and no general recommendation can be given. In patients with locally advanced or metastatic disease, most studies are small, non-randomized phase II trials, and many studies comprise a mix of bile duct cancers, gallbladder cancer, and either pancreatic or hepatocellular cancers. In metastatic cancer, phase II studies with several cytotoxics, including gemcitabine, the platinums, and the fluoropyrimidines, have shown a modest and often short-lasting activity. No single chemotherapy agent or combination regimen can therefore be recommended as a standard of care at present. In this review, we give an overview of chemotherapy in the adjuvant, neoadjuvant, and advanced settings.
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Affiliation(s)
- C. Verslype
- Digestive Oncology Unit, University Hospital GasthuisbergLeuvenBelgium
| | - H. Prenen
- Digestive Oncology Unit, University Hospital GasthuisbergLeuvenBelgium
| | - E. Van Cutsem
- Digestive Oncology Unit, University Hospital GasthuisbergLeuvenBelgium
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36
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Dewaele B, Floris G, Sciot R, Prenen H, Wozniak A, Guillou L, Coindre J, Fletcher C, Schöffski P, Debiec-Rychter M. Tyrosine kinases as possible therapeutic targets in pulmonary artery intimal sarcoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.10055] [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
10055 Background: Pulmonary artery intimal sarcomas (PAIS) are very rare, highly malignant and clinically aggressive tumors, with yet elusive underlying pathogenic mechanisms and histogenesis. Our aim was to gain molecular insight in the oncogenic events leading to PAIS development, and to investigate the possibility of a pharmacological approach for the treatment of PAIS, specifically targeting the receptor tyrosine kinases (RTK) activated in these tumors. Methods: Fourteen cases of advanced high grade poorly differentiated PAIS were analyzed by immunohistochemistry and selectively by a variety of cytogenetic/molecular techniques, e.g. karyotyping, FISH, mRNA in situ hybridization, array-CGH, tyrosine kinases RT-PCR assay and Western blotting analysis. The study was supplemented by sequencing of PDGFRA, PDGFRB, KIT, VEGFR-1, VEGFR-2 and EGFR genes. Ex vivo functional assays were applied to test the sensitivity of PAIS primary tumor cells to different, clinically approved RTK inhibitors. Results: We demonstrate that (1) PAIS do not have mutations within the kinase domains of PDGFRs, KIT, VEGFRs or EGFR, (2) all cases show a similar cytogenetic molecular profile, characterized by amplification of PDGFRA/KIT/VEGFR2 and MDM2/CDK4 genes, while EGFR, PDGFRB and VEGFR1 are frequently polysomic but rarely highly amplified, (3) high level of expression of PDGFRA, VEGFR1/VEGFR2 and EGFR is uniformly present in the tested tumors, (4) PAIS demonstrate activation (phosphorylation) of PDGFRA and downstream PI3K-AKT and MAP-Kinase signaling pathways, (4) in ex vivo assays, a potent effect of BMS354825 on proliferation and survival of primary cells of PAIS is proven. Conclusions: PDGFRA is amplified and activated in PAIS, thus constituting one of many possible targets for the therapy. Tested inhibitors showed differential efficacy for inhibition of PAIS cells by ex vivo assays. No significant financial relationships to disclose.
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Affiliation(s)
- B. Dewaele
- Catholic University, Leuven, Belgium; University Hospital Leuven, Leuven, Belgium; University of Lausanne, Lausanne, Switzerland; Institut Bergonié, Bordeaux, France; Brigham and Women's Hospital, Boston, MA
| | - G. Floris
- Catholic University, Leuven, Belgium; University Hospital Leuven, Leuven, Belgium; University of Lausanne, Lausanne, Switzerland; Institut Bergonié, Bordeaux, France; Brigham and Women's Hospital, Boston, MA
| | - R. Sciot
- Catholic University, Leuven, Belgium; University Hospital Leuven, Leuven, Belgium; University of Lausanne, Lausanne, Switzerland; Institut Bergonié, Bordeaux, France; Brigham and Women's Hospital, Boston, MA
| | - H. Prenen
- Catholic University, Leuven, Belgium; University Hospital Leuven, Leuven, Belgium; University of Lausanne, Lausanne, Switzerland; Institut Bergonié, Bordeaux, France; Brigham and Women's Hospital, Boston, MA
| | - A. Wozniak
- Catholic University, Leuven, Belgium; University Hospital Leuven, Leuven, Belgium; University of Lausanne, Lausanne, Switzerland; Institut Bergonié, Bordeaux, France; Brigham and Women's Hospital, Boston, MA
| | - L. Guillou
- Catholic University, Leuven, Belgium; University Hospital Leuven, Leuven, Belgium; University of Lausanne, Lausanne, Switzerland; Institut Bergonié, Bordeaux, France; Brigham and Women's Hospital, Boston, MA
| | - J. Coindre
- Catholic University, Leuven, Belgium; University Hospital Leuven, Leuven, Belgium; University of Lausanne, Lausanne, Switzerland; Institut Bergonié, Bordeaux, France; Brigham and Women's Hospital, Boston, MA
| | - C. Fletcher
- Catholic University, Leuven, Belgium; University Hospital Leuven, Leuven, Belgium; University of Lausanne, Lausanne, Switzerland; Institut Bergonié, Bordeaux, France; Brigham and Women's Hospital, Boston, MA
| | - P. Schöffski
- Catholic University, Leuven, Belgium; University Hospital Leuven, Leuven, Belgium; University of Lausanne, Lausanne, Switzerland; Institut Bergonié, Bordeaux, France; Brigham and Women's Hospital, Boston, MA
| | - M. Debiec-Rychter
- Catholic University, Leuven, Belgium; University Hospital Leuven, Leuven, Belgium; University of Lausanne, Lausanne, Switzerland; Institut Bergonié, Bordeaux, France; Brigham and Women's Hospital, Boston, MA
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37
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Prenen H, Dewaele B, Cools J, Mentens N, Stefan C, Sciot R, Schöffski P, Marynen P, van Oosterom A, Debiec-Rychter M. 563 POSTER In vitro activity of the multi-targeted kinase inhibitor sorafenib (BAY43-9006) against gastrointestinal stromal tumor (GIST) mutants refractory to imatinib mesylate. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)70568-7] [Citation(s) in RCA: 2] [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: 11/24/2022] Open
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Schöffski P, Dumez H, Clement P, Hoeben A, Prenen H, Wolter P, Joniau S, Roskams T, Van Poppel H. Emerging role of tyrosine kinase inhibitors in the treatment of advanced renal cell cancer: a review. Ann Oncol 2006; 17:1185-96. [PMID: 16418310 DOI: 10.1093/annonc/mdj133] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [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: 01/02/2023] Open
Abstract
Advanced and metastatic renal cell cancer (RCC) is resistant to conventional chemotherapy. Only a very small number of patients survive long term after immunotherapy. However, any effect of interleukin-2 (IL-2) and/or interferon on median overall survival is small, and treatment-associated toxicities may be severe. The disease is therefore an area of high unmet medical need. Activation of the VEGF and EGF/RAS/RAF/MAP kinase pathways is frequent in solid tumours such as RCC. Such activation is implicated in tumour angiogenesis and proliferation. VEGF and EGF receptors and molecules (such as RAF kinase) involved in downstream signalling are therefore potential appropriate targets for drug therapy. Several antibodies and low molecular weight tyrosine kinase inhibitors (TKIs) have completed phase II clinical trials. Phase II studies of multitargeted agents, which include inhibition of VEGFR tyrosine kinase in their repertoire (sorafenib, sunitinib and AG 013736), show clear second-line activity in metastatic RCC. The same is true of the anti-VEGF antibody, bevacizumab. In a randomised phase III comparison against placebo in pretreated patients, sorafenib doubled median progression free survival (24 versus 12 weeks). Studies now in progress will determine whether benefits seen second-line will also be evident first-line, and whether the activity of novel agents can be increased by combining them with each other, with cytokines, or with chemotherapy.
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Affiliation(s)
- P Schöffski
- Leuven Cancer Institute, Department of General Medical Oncology, University Hospital Gasthuisberg, Catholic University Leuven, Leuven, Belgium.
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39
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Schoeffski P, Wolter P, Himpe U, Dychter SS, Baum C, Prenen H, Wildiers H, Bex M, Dumez H. Sunitinib-related thyroid dysfunction: A single-center retrospective and prospective evaluation. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3092] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [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
3092 Background: Sunitinib is a multi-target tyrosine kinase inhibitor with anti-angiogenic and anti-proliferative activity mediated by signal blockade of VEGFR1/2, KIT, PDGFRα/β, and FLT-3. Phase II/III trials have demonstrated efficacy of the oral agent in Imatinib-resistant GIST and advanced renal cell cancer (RCC). We observed several cases of thyroid dysfunction in GIST during treatment with sunitinib suggesting that the drug may be associated with hypothyroidism. We therefore assessed the incidence and severity of thyroid dysfunction in cancer patients treated with sunitinib. Methods: Thyroid function (serum TSH, T3 and free thyroxin index) and thyroid antibodies (anti-TPO, -Tg and TSH-R-Ab) were evaluated retrospectively in a cohort of patients with GIST in a Phase III trial and in an expanded access program (1st part of the investigation) and in a prospective cohort of RCC and GIST patients treated in the framework of expanded access programs (2nd part). Sunitinib was given at a daily oral dose of 50 mg 4 weeks on, 2 weeks off. Thyroid parameters were assessed on days 1 and 28 of each treatment cycle in the prospective cohort. We report here the first TSH results, the full data set will be available at ASCO. Results: We identified a total of 46 patients who received sunitinib, and 33 of these patients were evaluable for thyroid function. 14 patients were analyzed retrospectively (all GIST), 19 patients prospectively (8 GIST, 11 RCC). 7 of these 19 patients (37%) showed an elevated TSH (>5 mIU/L) during treatment. In the retrospective analysis of 14 patients with a median treatment duration of 44 weeks, 8 patients (57%) had developed hypothyroidism. All patients with GIST in randomized Phase III trial remaining under active treatment with sunitinib for 58–80 weeks show an increased TSH (up to 83 mIU/L) during the course of treatment, requiring hormone substitution. In a cohort of 11 patients with RCC, after 6 weeks of treatment, 3 patients already have an increased TSH. Conclusions: Sunitinib is associated with a high incidence of thyroid dysfunction which requires further study. The mechanism by which Sunitinib induces thyroid dysfunction is yet unclear. No significant financial relationships to disclose.
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Affiliation(s)
- P. Schoeffski
- University Hospital, Leuven, Belgium; Pfizer Inc., La Jolla, CA
| | - P. Wolter
- University Hospital, Leuven, Belgium; Pfizer Inc., La Jolla, CA
| | - U. Himpe
- University Hospital, Leuven, Belgium; Pfizer Inc., La Jolla, CA
| | - S. S. Dychter
- University Hospital, Leuven, Belgium; Pfizer Inc., La Jolla, CA
| | - C. Baum
- University Hospital, Leuven, Belgium; Pfizer Inc., La Jolla, CA
| | - H. Prenen
- University Hospital, Leuven, Belgium; Pfizer Inc., La Jolla, CA
| | - H. Wildiers
- University Hospital, Leuven, Belgium; Pfizer Inc., La Jolla, CA
| | - M. Bex
- University Hospital, Leuven, Belgium; Pfizer Inc., La Jolla, CA
| | - H. Dumez
- University Hospital, Leuven, Belgium; Pfizer Inc., La Jolla, CA
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40
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Guetens G, Prenen H, De Boeck G, Van Dongen W, Esmans E, Lemière F, van Oosterom AT, Schöffski P, de Bruijn EA. Sensitive and specific quantification of the anticancer agent ZD1839 (Gefitinib) in plasma by on-column focusing capillary liquid chromatography-tandem mass spectrometry. J Chromatogr A 2005; 1082:2-5. [PMID: 16038188 DOI: 10.1016/j.chroma.2005.04.043] [Citation(s) in RCA: 13] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The development of an on-column focusing gradient capillary LC method coupled to tandem mass spectrometry (quadrupole-linear ion trap) for the quantitative determination of the anticancer agent ZD1839 (Gefitinib, Iressa) in blood plasma is described. Plasma samples (0.2 ml) were extracted with methyl tert-butyl ether. The analytes of interest, ZD1839 and the internal standard [(2)H8]ZD1839 (ZD1839-d8) were eluted on a 50 mm x 1 mm, 5 microm particle size, capillary ODS Hypersil column using an aqueous ammonium acetate gradient at 40 microl/min. Mass spectrometric detection was performed by a Q-Trap tandem mass spectrometer with electrospray positive ionisation, and monitored in the multiple reaction monitoring transitions 447 >128 and 455 >136, respectively. The limit of quantification of ZD18395 was 0.1 ng/ml. The method proved to be robust, allowing quantification of ZD1839 with sufficient precision, accuracy and sensitivity.
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Affiliation(s)
- G Guetens
- Lab of Experimental Oncology, Department of Clinical Oncology, University Hospital Leuven, Herestraat 49, B-3000 Leuven, Belgium.
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Landuyt B, Prenen H, Debiec-Rychter M, Sciot R, de Bruijn EA, van Oosterom AT. Differential protein expression profile in gastrointestinal stromal tumors. Amino Acids 2004; 27:335-7. [PMID: 15549490 DOI: 10.1007/s00726-004-0140-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2004] [Accepted: 10/04/2004] [Indexed: 10/26/2022]
Abstract
Gastrointestinal stromal tumors (GISTs) arise from the interstitial cells of Cajal through gain of function mutations of the oncogene KIT. Imatinib offers the first effective treatment for patients with GISTs, but the therapeutic outcome strongly depends on the type of KIT mutation. We used ProteinChip technology to investigate whether GISTs with different KIT mutations express different proteins. In total, 154 proteins were significantly differentially expressed in GISTs with exon 9 KIT mutation compared to GISTs with exon 11 KIT mutation.
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Affiliation(s)
- B Landuyt
- Laboratory of Experimental Oncology (LEO), University Hospital Gasthuisberg, Catholic University of Leuven, Leuven, Belgium.
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42
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Abstract
A 30-year-old man returning from a trip through India complained of epigastric pain, diarrhea, loss of weight, and jaundice. Stool examination was positive for Strongyloides stercoralis. On ultrasonographic investigation, intravenous cholangiography, and endoscopic retrograde cholangiopancreaticography, stenosis of the distal common bile duct and enlargement of the pancreatic head were observed. The patient was treated for the Strongyloides infection. The jaundice disappeared within days, the laboratory finding normalized, and the patient recovered rapidly. However, the ultrasonographic examination showed a complete recovery in the course of about 2 years. From this report we conclude that in patients with obstructive jaundice and Strongyloides stercoralis infection, serious abnormalities resembling pancreatic tumour or pancreatitis can be found on ultrasonographic and radiological investigations, and this should be considered in the differential diagnosis of pancreatic mass in patients living in or returning from endemic areas.
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