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Song Y, Liu W, Niu Y, Cisternas G, Huang F, Garcia-Vargas J, Childs B, Mehra A, Li T, Hiemeyer F, Zhai J, Reschke S, Granvil C, Zhu J. 260P A phase I study of copanlisib, a pan-class I phosphatidylinositol 3-kinase (PI3K) inhibitor, in Chinese patients with relapsed indolent non-Hodgkin lymphoma (iNHL). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Dreyling M, Santoro A, Leppä S, Demeter J, Follows G, Lenz G, Kim W, Mollica L, Nagler A, Phipps Diong C, Provencio M, Magagnoli M, Munoz J, Hiemeyer F, Liu L, Miriyala A, Rodrigues L, Garcia-Vargas J, Childs B, Zinzani P. EFFICACY AND SAFETY IN HIGH-RISK RELAPSED OR REFRACTORY INDOLENT FOLLICULAR LYMPHOMA PATIENTS TREATED WITH COPANLISIB. Hematol Oncol 2019. [DOI: 10.1002/hon.57_2631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- M. Dreyling
- Department of Medicine III; University Hospital (LMU); Munich Germany
| | - A. Santoro
- Cancer Center; Humanitas Clinical and Research Center; Rozzano Italy
| | - S. Leppä
- Comprehensive Cancer Center; Helsinki University Hospital; Helsinki Finland
| | - J. Demeter
- First Department of Internal Medicine; Semmelweis University; Budapest Hungary
| | - G.A. Follows
- Haematology; Cambridge University Hospitals NHS Foundation Trust; Cambridge United Kingdom
| | - G. Lenz
- Translational Oncology; University Hospital Münster; Münster Germany
| | - W.S. Kim
- Hematology and Oncology; Sungkyunkwan University School of Medicine, Samsung Medical Center; Seoul Republic of Korea
| | - L. Mollica
- Clinical Research in Hematology and Clinical Oncology; Maisonneuve-Rosemont Hospital Research Centre; Montréal Quebec Canada
| | - A. Nagler
- Chaim Sheba Medical Center; Tel Aviv University; Tel HaShomer Israel
| | - C. Phipps Diong
- Department of Haematology; Singapore General Hospital; Bukit Merah Singapore
| | - M. Provencio
- Medical Oncology; Health Research Institute, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid; Madrid Spain
| | - M. Magagnoli
- Cancer Center; Humanitas Clinical and Research Center; Rozzano Italy
| | - J. Munoz
- Hematology and Oncology; Banner MD Anderson Cancer Center Clinic; Gilbert United States
| | - F. Hiemeyer
- Pharmaceutical Division; Bayer AG; Berlin Germany
| | - L. Liu
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - A. Miriyala
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | | | - J. Garcia-Vargas
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - B.H. Childs
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - P.L. Zinzani
- Institute of Hematology “Seràgnoli”; University of Bologna; Bologna Italy
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Panayiotidis P, Kellner A, Follows G, Mollica L, Nagler A, Özcan M, Santoro A, Hiemeyer F, Liu L, Garcia-Vargas J, Childs B, Zinzani P, Dreyling M. COPANLISIB TREATMENT OF PATIENTS WITH RELAPSED OR REFRACTORY MARGINAL ZONE LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.69_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- P. Panayiotidis
- School of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - A. Kellner
- Hematology; Kaposi Mór Teaching Hospital; Kaposvár Hungary
| | - G.A. Follows
- Haematology; Cambridge University Hospitals NHS Foundation Trust; Cambridge United Kingdom
| | - L. Mollica
- Clinical Research in Hematology and Clinical Oncology; Maisonneuve-Rosemont Hospital Research Centre; Montréal Quebec Canada
| | - A. Nagler
- Chaim Sheba Medical Center; Tel Aviv University; Tel HaShomer Israel
| | - M. Özcan
- Hematology; Ankara University; Ankara Turkey
| | - A. Santoro
- Cancer Center; Humanitas Clinical and Research Center; Rozzano Italy
| | - F. Hiemeyer
- Pharmaceutical Division; Bayer AG; Berlin Germany
| | - L. Liu
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - J. Garcia-Vargas
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - B.H. Childs
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - P.L. Zinzani
- Institute of Hematology "Seràgnoli"; University of Bologna; Bologna Italy
| | - M. Dreyling
- Department of Medicine III; University Hospital (LMU); Munich Germany
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Zinzani P, Santoro A, Leppä S, Demeter J, Follows G, Lenz G, Kim W, Mollica L, Nagler A, Phipps Diong C, Provencio M, Magagnoli M, Munoz J, Miriyala A, Liu L, Zhang M, Garcia-Vargas J, Childs B, Dreyling M. SAFETY ANALYSIS OF PATIENTS WITH A MEDICAL HISTORY OF RESPIRATORY DISORDERS TREATED WITH COPANLISIB FROM THE CHRONOS-1 STUDY IN RELAPSED OR REFRACTORY INDOLENT B-CELL LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.58_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- P.L. Zinzani
- Institute of Hematology “Seràgnoli”; University of Bologna; Bologna Italy
| | - A. Santoro
- Cancer Center; Humanitas Clinical and Research Center; Rozzano Italy
| | - S. Leppä
- Comprehensive Cancer Center; Helsinki University Hospital; Helsinki Finland
| | - J. Demeter
- First Department of Internal Medicine; Semmelweis University; Budapest Hungary
| | - G.A. Follows
- Haematology; Cambridge University Hospitals NHS Foundation Trust; Cambridge United Kingdom
| | - G. Lenz
- Translational Oncology; University Hospital Münster; Münster Germany
| | - W.S. Kim
- Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - L. Mollica
- Clinical Research in Hematology and Clinical Oncology; Maisonneuve-Rosemont Hospital Research Centre; Montréal, Quebec Canada
| | - A. Nagler
- Chaim Sheba Medical Center; Tel Aviv University; Tel HaShomer Israel
| | - C. Phipps Diong
- Department of Haematology; Singapore General Hospital; Bukit Merah Singapore
| | - M. Provencio
- Health Research Institute; Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid; Madrid Spain
| | - M. Magagnoli
- Cancer Center; Humanitas Clinical and Research Center; Rozzano Italy
| | - J. Munoz
- Hematology and Oncology; Banner MD Anderson Cancer Center Clinic; Gilbert United States
| | - A. Miriyala
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - L. Liu
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - M. Zhang
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - J. Garcia-Vargas
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - B.H. Childs
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - M. Dreyling
- Department of Medicine III; University Hospital (LMU); Munich Germany
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Dreyling M, Morschhauser F, Bouabdallah K, Bron D, Cunningham D, Assouline SE, Verhoef G, Linton K, Thieblemont C, Vitolo U, Hiemeyer F, Giurescu M, Garcia-Vargas J, Gorbatchevsky I, Liu L, Koechert K, Peña C, Neves M, Childs BH, Zinzani PL. Phase II study of copanlisib, a PI3K inhibitor, in relapsed or refractory, indolent or aggressive lymphoma. Ann Oncol 2018. [PMID: 28633365 PMCID: PMC5834070 DOI: 10.1093/annonc/mdx289] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [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] [Indexed: 12/21/2022] Open
Abstract
Background Copanlisib is a pan-class I phosphatidylinositol 3-kinase inhibitor with predominant activity against the α- and δ-isoforms. Patients and methods This phase II study evaluated the response rate of copanlisib administered intravenously on days 1, 8, and 15 of a 28-day cycle, in patients with indolent or aggressive malignant lymphoma. Archival tumor tissues were used for immunohistochemistry, gene-expression profiling, and mutation analysis. Results Thirty-three patients with indolent lymphoma and 51 with aggressive lymphoma received copanlisib. Follicular lymphoma (48.5%) and peripheral T-cell lymphoma (33.3%) were the most common histologic subtypes. Most patients (78.6%) had received prior rituximab and 54.8% were rituximab-refractory. Median duration of treatment was 23 and 8 weeks in the indolent and aggressive cohorts, respectively (overall range 2-138). Eighty patients were evaluated for efficacy. The objective response rate was 43.7% (14/32) in the indolent cohort and 27.1% (13/48) in the aggressive cohort; median progression-free survival was 294 days (range 0-874) and 70 days (range 0-897), respectively; median duration of response was 390 days (range 0-825) and 166 days (range 0-786), respectively. Common adverse events included hyperglycemia (57.1%; grade ≥3, 23.8%), hypertension (54.8%; grade ≥3, 40.5%), and diarrhea (40.5%; grade ≥3, 4.8%), all generally manageable. Neutropenia occurred in 28.6% of patients (grade 4, 11.9%). Molecular analyses showed enhanced antitumor activity in tumors with upregulated phosphatidylinositol 3-kinase pathway gene expression. Conclusion Intravenous copanlisib demonstrated promising efficacy and manageable toxicity in heavily pretreated patients with various subtypes of indolent and aggressive malignant lymphoma. Subtype-specific studies of copanlisib in patients with follicular, peripheral T-cell, and mantle cell lymphomas are ongoing. This trial is registered with ClinicalTrials.gov number NCT01660451 (Part A).
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Affiliation(s)
- M Dreyling
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - F Morschhauser
- Hematology Department, Hôpital Claude Huriez, Unité GRITA, Lille University, Lille
| | - K Bouabdallah
- Department of Hematology and Cellular Therapy, University Hospital of Bordeaux, Pessac, France
| | - D Bron
- Department of Clinical and Experimental Hematology, Jules Bordet Institute (Free University of Brussels - ULB), Brussels, Belgium
| | - D Cunningham
- Department of Clinical and Experimental Haematology, The Royal Marsden Hospital, Sutton, UK
| | - S E Assouline
- Division of Hematology, Jewish General Hospital, Montreal, Canada
| | - G Verhoef
- Department of Haematology, University Hospital Leuven, Leuven, Belgium
| | - K Linton
- Department of Haemato-oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - C Thieblemont
- Department of Hemato-oncology, APHP-Hôpital Saint-Louis, Paris.,Diderot University, Sorbonne Paris Cité, Paris.,EA3788, Descartes University, Paris, France
| | - U Vitolo
- Department of Oncology and Hematology, Città della Salute e della Scienza di Torino, Torino, Italy
| | | | | | | | | | - L Liu
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, USA
| | | | - C Peña
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, USA
| | | | - B H Childs
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, USA
| | - P L Zinzani
- Department of Hematology and Oncology, Policlinico S. Orsola-Malpighi, Bologna, Italy
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Liu L, Köchert K, Seidel H, Garcia-Vargas J, Childs B, Follows G, Bouabdallah K, Dreyling M, Peña C. Tumor gene expression signatures of BCR/PI3K dependence in association with copanlisib monotherapy activity in heavily pretreated patients with indolent NHL and follicular lymphoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx373.007] [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: 11/14/2022] Open
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Provencio Pulla M, Santoro A, Mollica L, Leppä S, Follows G, Lenz G, Kim W, Nagler A, Panayiotidis P, Demeter J, Özcan M, Kosinova M, Bouabdallah K, Morschhauser F, Ishida T, Huang L, Garcia-Vargas J, Childs B, Zinzani P, Dreyling M. Copanlisib treatment in patients with relapsed or refractory indolent B-cell lymphoma: Subgroup analyses from the CHRONOS-1 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx373.006] [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: 11/13/2022] Open
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Dreyling M, Santoro A, Mollica L, Leppä S, Follows G, Lenz G, Kim W, Nagler A, Panayiotidis P, Demeter J, Özcan M, Kosinova M, Bouabdallah K, Morschhauser F, Stevens D, Trevarthen D, Giurescu M, Liu L, Koechert K, Peña C, Cupit L, Yin S, Hiemeyer F, Garcia-Vargas J, Childs B, Zinzani P. COPANLISIB IN PATIENTS WITH RELAPSED OR REFRACTORY INDOLENT B-CELL LYMPHOMA (CHRONOS-1). Hematol Oncol 2017. [DOI: 10.1002/hon.2437_107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Dreyling
- Medizinische Klinik und Poliklinik III; Klinikum der Universität München-Grosshadern; Munich Germany
| | - A. Santoro
- Department of Oncology and Hematology, Humanitas Cancer Center; Humanitas Clinical and Research Institute; Rozzano MI Italy
| | - L. Mollica
- Department of Hematology; Hôpital Maisonneuve-Rosemont-Montreal; Montreal Quebec Canada
| | - S. Leppä
- Department of Oncology; Helsinki University Central Hospital Cancer Center; Helsinki Finland
| | - G.A. Follows
- Department of Haematology; Cambridge University Hospitals NHS Foundation Trust Addenbrooke's Hospital; Cambridge UK
| | - G. Lenz
- Translational Oncology; University Hospital Münster; Münster Germany
| | - W. Kim
- Division of Hematology and Oncology, Department of Medicine; Sungkyunkwan University School of Medicine, Samsung Medical Center; Seoul Republic of Korea
| | - A. Nagler
- Hematology Division; Chaim Sheba Medical Center- Tel Aviv University; Tel-Hashomer Israel
| | - P. Panayiotidis
- Division of Hematology; Laikon University Hospital, National and Kapodistrian University of Athens; Athens Greece
| | - J. Demeter
- First Department of Internal Medicine, Division of Haematology; Semmelweis University; Budapest Hungary
| | - M. Özcan
- Department of Hematology; Ankara University School of Medicine; Ankara Turkey
| | - M. Kosinova
- Department of Hematology; Kemerovo Regional Clinical Hospital; Kemerovo Russian Federation
| | - K. Bouabdallah
- Service d'Hématologie et de Thérapie Cellulaire; University Hospital of Bordeaux; Pessac France
| | - F. Morschhauser
- Department of Hematology; CHRU - Hôpital Claude Huriez; Lille France
| | - D.A. Stevens
- Medical Oncology; Norton Cancer Institute; Louisville-KY USA
| | - D. Trevarthen
- Medical Oncology; Comprehensive Cancer Care and Research Institute of Colorado; Englewood-CO USA
| | - M. Giurescu
- Pharmaceutical Division, Bayer AG; Berlin Germany
| | - L. Liu
- Biomarkers; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - K. Koechert
- Pharmaceutical Division, Bayer AG; Berlin Germany
| | - C. Peña
- Biomarkers; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - L. Cupit
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - S. Yin
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - F. Hiemeyer
- Pharmaceutical Division, Bayer AG; Berlin Germany
| | - J. Garcia-Vargas
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - B.H. Childs
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - P. Zinzani
- Department of Hematology; Institute of Hematology "L. e A. Seràgnoli"- University of Bologna; Bologna Italy
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Zinzani P, Dreyling M, Patnaik A, Morschhauser F, Benson A, Genvresse I, Miriyala A, Garcia-Vargas J, Childs B. INTEGRATED SAFETY DATA WITH COPANLISIB MONOTHERAPY FROM PHASE I AND II TRIALS IN PATIENTS WITH RELAPSED INDOLENT NON-HODGKIN'S LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- P. Zinzani
- Department of Hematology; Institute of Hematology "L. e A. Seràgnoli"- University of Bologna; Bologna Italy
| | - M. Dreyling
- Medizinische Klinik und Poliklinik III; Klinikum der Universität München-Grosshadern; Munich Germany
| | - A. Patnaik
- Medical Oncology; South Texas Accelerated Research Therapeutics (START) Center for Cancer Care; San Antonio TX USA
| | - F. Morschhauser
- Department of Hematology; CHRU - Hôpital Claude Huriez; Lille France
| | - A. Benson
- Clinical Statistics; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - I. Genvresse
- Pharmaceutical Division, Bayer AG; Berlin Germany
| | - A. Miriyala
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - J. Garcia-Vargas
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - B.H. Childs
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
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Sartor O, Heinrich D, Mariados N, Vidal MM, Keizman D, Karlsson CT, Peer A, Procopio G, Frank S, Pulkkanen K, Rosenbaum E, Severi S, Perez JT, Wagner V, Garcia-Vargas J, Li R, Nordquist L. Radium-223 re-treatment from an international, prospective, open-label study in patients with castration-resistant prostate cancer and bone metastases. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.36] [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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Finkelstein S, Michalski J, O'Sullivan J, Parker C, Garcia-Vargas J, Sartor O. External Beam Radiation Therapy (EBRT) Use and Safety With Radium-223 Dichloride (Ra-223) in Patients With Castration-Resistant Prostate Cancer (CRPC) and Symptomatic Bone Metastases (mets) From the ALSYMPCA Trial. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.482] [Citation(s) in RCA: 3] [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: 11/25/2022]
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Michalski J, Sartor O, Parker C, Shan M, Garcia-Vargas J, Aksnes A, Vogelzang N. Radium-223 Dichloride (Ra-223) Impact on Skeletal-Related Events, External Beam Radiation Therapy (EBRT), and Pain in Patients With Castration-Resistant Prostate Cancer (CRPC) With Bone Metastases: Updated Results From the Phase 3 ALSYMPCA Trial. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.280] [Citation(s) in RCA: 3] [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: 10/26/2022]
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Parker C, Nilsson S, Heinrich D, Helle SI, O'Sullivan JM, Fosså SD, Chodacki A, Wiechno P, Logue J, Seke M, Widmark A, Johannessen DC, Hoskin P, Bottomley D, James ND, Solberg A, Syndikus I, Kliment J, Wedel S, Boehmer S, Dall'Oglio M, Franzén L, Coleman R, Vogelzang NJ, O'Bryan-Tear CG, Staudacher K, Garcia-Vargas J, Shan M, Bruland ØS, Sartor O. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med 2013; 369:213-23. [PMID: 23863050 DOI: 10.1056/nejmoa1213755] [Citation(s) in RCA: 2169] [Impact Index Per Article: 197.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Radium-223 dichloride (radium-223), an alpha emitter, selectively targets bone metastases with alpha particles. We assessed the efficacy and safety of radium-223 as compared with placebo, in addition to the best standard of care, in men with castration-resistant prostate cancer and bone metastases. METHODS In our phase 3, randomized, double-blind, placebo-controlled study, we randomly assigned 921 patients who had received, were not eligible to receive, or declined docetaxel, in a 2:1 ratio, to receive six injections of radium-223 (at a dose of 50 kBq per kilogram of body weight intravenously) or matching placebo; one injection was administered every 4 weeks. In addition, all patients received the best standard of care. The primary end point was overall survival. The main secondary efficacy end points included time to the first symptomatic skeletal event and various biochemical end points. A prespecified interim analysis, conducted when 314 deaths had occurred, assessed the effect of radium-223 versus placebo on survival. An updated analysis, when 528 deaths had occurred, was performed before crossover from placebo to radium-223. RESULTS At the interim analysis, which involved 809 patients, radium-223, as compared with placebo, significantly improved overall survival (median, 14.0 months vs. 11.2 months; hazard ratio, 0.70; 95% confidence interval [CI], 0.55 to 0.88; two-sided P=0.002). The updated analysis involving 921 patients confirmed the radium-223 survival benefit (median, 14.9 months vs. 11.3 months; hazard ratio, 0.70; 95% CI, 0.58 to 0.83; P<0.001). Assessments of all main secondary efficacy end points also showed a benefit of radium-233 as compared with placebo. Radium-223 was associated with low myelosuppression rates and fewer adverse events. CONCLUSIONS In this study, which was terminated for efficacy at the prespecified interim analysis, radium-223 improved overall survival. (Funded by Algeta and Bayer HealthCare Pharmaceuticals; ALSYMPCA ClinicalTrials.gov number, NCT00699751.).
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Affiliation(s)
- C Parker
- Royal Marsden National Health Service Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
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Sandler H, Nilsson S, Parker C, Garcia-Vargas J, Staudacher K, Hoskin P. Radium-223 Chloride Safety and Use of External Beam Radiation Therapy (EBRT) in the Phase III Randomized Trial (ALSYMPCA) in Patients With Castration-resistant Prostate Cancer (CRPC) and Bone Metastases. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.019] [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: 11/28/2022]
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Rizvi S, Lis J, Boileau K, Garcia-Vargas J. Incidence of thromboembolism in patients receiving vorinostat: Clinical trial and post-marketing data from more than 1,800 patients. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e14547] [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
e14547 Background: Thromboembolic events (TEEs) occur in approximately 10–15% of advanced cancer patients. Risk factors include cancer therapy and extent and type of malignancy. Vorinostat, a histone deacetylase inhibitor, has been licensed in the USA for the treatment of cutaneous manifestations in patients with cutaneous T-cell lymphoma (CTCL) who have progressive, persistent, or recurrent disease on or following two systemic therapies. TEEs were observed in 6/86 patients (7.0%) enrolled in vorinostat CTCL clinical trials at licensure. To gain further insight into the association between TEEs and vorinostat treatment, we analyzed data from vorinostat clinical trials and post-marketing surveillance (PMS) reports. Methods: Serious adverse events (SAEs) reported through November 3, 2008, among patients receiving vorinostat in completed and ongoing clinical trials, PMS reports, and published literature were reviewed for terms consistent with TEEs. A committee of independent (non-Merck employees) academic experts evaluated these reports. Although no safety signals were observed, the committee recommended that d-dimer and/or plasmin-antiplasmin assays should be conducted. This recommendation has been implemented in three ongoing studies ( NCT00486720 , NCT00632931 , NCT006429542) and will provide further information on clotting parameters among patients being treated with vorinostat. Results: During the reporting period, data from >1,845 cancer patients who received vorinostat were reviewed. Irrespective of causality, 107 patients (<5.8%) reported TEE SAEs (Table). Of these, 47 (<2.6%) had TEE SAEs that were rated as related to vorinostat, four of which were fatal. As of the data cut off, review of the special assays in the three studies did not result in any conclusive correlation. Conclusions: The incidence rate of TEEs observed in vorinostat studies is similar to reported rates of TEEs for advanced cancer patients. [Table: see text] [Table: see text]
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Affiliation(s)
- S. Rizvi
- Merck & Co Inc., Upper Gwynedd, PA
| | - J. Lis
- Merck & Co Inc., Upper Gwynedd, PA
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Trédaniel J, Descourt R, Moro-Sibilot D, Misset J, Gachard E, Garcia-Vargas J, Roben E, Zalcman G. Vorinostat in combination with gemcitabine and cisplatinum in patients with advanced non-small cell lung cancer (NSCLC): A Phase I dose-escalation study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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
8049 Background: Preclinical data indicate that vorinostat, a histone deacetylase inhibitor, enhances the efficacy of gemcitabine and platinum chemotherapy agents. This study investigated the dose-limiting toxicities (DLTs) and maximum tolerated dose (MTD) of vorinostat plus gemcitabine and a platinum agent in patients (pts) with advanced NSCLC. Methods: Eligible pts (aged ≥18 years; stage IIIB/IV NSCLC, ECOG performance status ≤1, no prior systemic chemotherapy [except adjuvant]) were sequentially enrolled on escalating doses of vorinostat plus gemcitabine and a platinum agent (standard 3+3 design) for ≤6 cycles ( Table ). Carboplatin regimens were to be investigated if dose levels 1 or 2 exceeded the MTD. Results: 28 pts enrolled to date (M/F: 22/6; median age: [range] 55 [34–70] years; 20 chemonaïve) at 5 dose levels ( Table ). Two pts had DLTs: elevated creatinine leading to cisplatin dose reduction (dose level 2) and febrile neutropenia (dose level 5) ( Table ). Dose level 5 was achieved without reaching the MTD; however, based on clinical tolerability, dose level 4 was chosen as the recommended dose (RD). 24 pts had adverse events (AEs): 86% mild/moderate, 53% not considered treatment-related. The most common drug-related Grade 3/4 AEs were thrombocytopenia (19 events) and neutropenia (14 events). Serious AEs occurred in 15 pts, and 5 deaths occurred (1 ‘probably‘ and 4 ‘definitely not‘ treatment-related). Of 19 evaluable pts at 5 dose levels, 9 (47%) had a partial response, 8 stable disease, and 2 disease progression ( Table ). Updated results of pts treated at the RD in an expansion cohort will be presented. Conclusions: These phase I data suggest that vorinostat can be administered with standard doses of gemcitabine and cisplatin and the combination is active in the initial treatment of metastatic NSCLC: randomized trials are needed to determine whether addition of vorinostat improves outcomes in such pts. [Table: see text] [Table: see text]
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Affiliation(s)
- J. Trédaniel
- Hôpital Saint-Louis, Paris, France; Institut de Cancérologie et d'Hématologie, CHU Morvan, Brest, France; PMAC Clinique de Pneumologie, CHU Grenoble, France; Merck Sharp & Dohme, Paris, France; Merck Research Laboratories, Upper Gwynedd, PA; Service Pneumologie et Centre Recherche Clinique, CHU de Caen, France
| | - R. Descourt
- Hôpital Saint-Louis, Paris, France; Institut de Cancérologie et d'Hématologie, CHU Morvan, Brest, France; PMAC Clinique de Pneumologie, CHU Grenoble, France; Merck Sharp & Dohme, Paris, France; Merck Research Laboratories, Upper Gwynedd, PA; Service Pneumologie et Centre Recherche Clinique, CHU de Caen, France
| | - D. Moro-Sibilot
- Hôpital Saint-Louis, Paris, France; Institut de Cancérologie et d'Hématologie, CHU Morvan, Brest, France; PMAC Clinique de Pneumologie, CHU Grenoble, France; Merck Sharp & Dohme, Paris, France; Merck Research Laboratories, Upper Gwynedd, PA; Service Pneumologie et Centre Recherche Clinique, CHU de Caen, France
| | - J. Misset
- Hôpital Saint-Louis, Paris, France; Institut de Cancérologie et d'Hématologie, CHU Morvan, Brest, France; PMAC Clinique de Pneumologie, CHU Grenoble, France; Merck Sharp & Dohme, Paris, France; Merck Research Laboratories, Upper Gwynedd, PA; Service Pneumologie et Centre Recherche Clinique, CHU de Caen, France
| | - E. Gachard
- Hôpital Saint-Louis, Paris, France; Institut de Cancérologie et d'Hématologie, CHU Morvan, Brest, France; PMAC Clinique de Pneumologie, CHU Grenoble, France; Merck Sharp & Dohme, Paris, France; Merck Research Laboratories, Upper Gwynedd, PA; Service Pneumologie et Centre Recherche Clinique, CHU de Caen, France
| | - J. Garcia-Vargas
- Hôpital Saint-Louis, Paris, France; Institut de Cancérologie et d'Hématologie, CHU Morvan, Brest, France; PMAC Clinique de Pneumologie, CHU Grenoble, France; Merck Sharp & Dohme, Paris, France; Merck Research Laboratories, Upper Gwynedd, PA; Service Pneumologie et Centre Recherche Clinique, CHU de Caen, France
| | - E. Roben
- Hôpital Saint-Louis, Paris, France; Institut de Cancérologie et d'Hématologie, CHU Morvan, Brest, France; PMAC Clinique de Pneumologie, CHU Grenoble, France; Merck Sharp & Dohme, Paris, France; Merck Research Laboratories, Upper Gwynedd, PA; Service Pneumologie et Centre Recherche Clinique, CHU de Caen, France
| | - G. Zalcman
- Hôpital Saint-Louis, Paris, France; Institut de Cancérologie et d'Hématologie, CHU Morvan, Brest, France; PMAC Clinique de Pneumologie, CHU Grenoble, France; Merck Sharp & Dohme, Paris, France; Merck Research Laboratories, Upper Gwynedd, PA; Service Pneumologie et Centre Recherche Clinique, CHU de Caen, France
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Weber DM, Badros A, Jagannath S, Siegel D, Richon V, Rizvi S, Garcia-Vargas J, Reiser D, Anderson KC. A242 Vorinostat and Bortezomib in Relapsed/Refractory MM. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1557-9190(11)70519-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mitsiades C, Richardson PG, Grant S, Pei XY, Berenson JR, Richon V, Garcia-Vargas J, Rizvi S, Anderson KC. B257 Vorinostat in Combination with Other Anti-MM Agents. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1557-9190(11)70694-1] [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: 11/28/2022]
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Siegel DS, Hussein MA, Belani CP, Robert F, Rizvi S, Wigginton J, Randolph S, Crane R, Ganesan R, Garcia-Vargas J. Safety and tolerability of vorinostat—Experience from the vorinostat clinical trial program. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14580] [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: 11/20/2022] Open
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Misset J, Tredaniel J, Descourt R, Morot-Sibilot D, Zalcman G, Gachard E, Garcia-Vargas J, Rizvi S, Reiser D, Roben L. Vorinostat in combination with gemcitabine plus platinum in patients with advanced non-small-cell lung cancer: A phase I, dose-escalation study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14601] [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: 11/20/2022] Open
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Syed S, Calvo E, Papadopoulos KP, Ricart A, Dufresne T, Cooper J, Takimoto C, Suplick G, Garcia-Vargas J, Rowinsky EK. A phase I and pharmacokinetic study of nolatrexed dihydrochloride, a potent thymidylate synthase (TS) inhibitor, combined with docetaxel in patients with advanced cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.2115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S. Syed
- Cancer Therapy & Research Ctr, San Antonio, TX; Eximias Pharm Corp, Berwin, PA
| | - E. Calvo
- Cancer Therapy & Research Ctr, San Antonio, TX; Eximias Pharm Corp, Berwin, PA
| | - K. P. Papadopoulos
- Cancer Therapy & Research Ctr, San Antonio, TX; Eximias Pharm Corp, Berwin, PA
| | - A. Ricart
- Cancer Therapy & Research Ctr, San Antonio, TX; Eximias Pharm Corp, Berwin, PA
| | - T. Dufresne
- Cancer Therapy & Research Ctr, San Antonio, TX; Eximias Pharm Corp, Berwin, PA
| | - J. Cooper
- Cancer Therapy & Research Ctr, San Antonio, TX; Eximias Pharm Corp, Berwin, PA
| | - C. Takimoto
- Cancer Therapy & Research Ctr, San Antonio, TX; Eximias Pharm Corp, Berwin, PA
| | - G. Suplick
- Cancer Therapy & Research Ctr, San Antonio, TX; Eximias Pharm Corp, Berwin, PA
| | - J. Garcia-Vargas
- Cancer Therapy & Research Ctr, San Antonio, TX; Eximias Pharm Corp, Berwin, PA
| | - E. K. Rowinsky
- Cancer Therapy & Research Ctr, San Antonio, TX; Eximias Pharm Corp, Berwin, PA
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Thomas RJ, Williams M, Garcia-Vargas J. Lessons learned from raltitrexed--quality assurance, patient education and intensive supportive drugs to optimise tolerability. Clin Oncol (R Coll Radiol) 2003; 15:227-32. [PMID: 12924450 DOI: 10.1016/s0936-6555(03)00092-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although recent trials have raised concerns about the toxicity of raltitrexed monotherapy in patients with advanced colorectal cancer (aCRC), similar concerns have also been raised with other chemotherapy regimens in aCRC. The lessons learnt form our previous experiences with raltitrexed are, therefore, still important as they offer practical guidances to optimise tolerability of chemotherapy for CRC in general. The aims of the study were to report the low-toxicity profile in 58 patients receiving raltitrexed when a rigorous patient information and education strategy was implemented together with an intensive supportive adjuvant drugs regimen from the start. After a discussion with the consultant, all patients received a further consultation with a specialist nurse, a series of bespoke information tools, including an information video and written guidelines on how to avoid, prevent and deal promptly with the side-effects of raltitrexed. They all received intravenous adjuvant ondansetron and dexamethasone, then oral domperidone, ranitidine and nystatin from cycle one. The dose intensity was 98% over 307 cycles. Toxicity associated with raltitrexed comprised grade 1/2 diarrhoea (31.6% of treatment cycles), nausea (12.4%) and vomiting (8.4%), with no grade 3/4 events; grade 1/2 alopecia (17.9%); grade 1 (only) stomatitis (2.3%) and grade 1/2/3 lethargy (70.3%, only 2.3% grade 3), anaemia (14.3%, only 0.3% grade 3) and neutropenia (3.3%, only 0.3% grade 3). There were no treatment-related deaths. The low toxicity, despite high-dose intensity, suggests that intensive supportive education and drugs should have a role in the future design of regimens containing raltitrexed and other chemotherapy regimens for colorectal carcinoma.
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Affiliation(s)
- R J Thomas
- Addenbrooke's Hospital Cambridge University NHS Trust, Cambridge and the Primrose Oncology Unit, Bedford, UK.
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Gambacorta M, Valentini V, Morganti A, Smaniotto D, Mantini G, Micciche F, Ratto C, Doglietto G, De Paoli A, Rossi C, Cellini N, Garcia-Vargas J. Preoperative chemoradiation with raltitrexed (tomudex) in T3–4 rectal carcinoma: a phase I-II study. Int J Radiat Oncol Biol Phys 2002. [DOI: 10.1016/s0360-3016(02)03490-9] [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: 11/26/2022]
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Mackay HJ, McInnes A, Paul J, Raby N, Lofts FJ, McDonald AC, Soukop M, Fullarton GM, Harris AL, Garcia-Vargas J, Evans TR. A phase II study of epirubicin, cisplatin and raltitrexed combination chemotherapy (ECT) in patients with advanced oesophageal and gastric adenocarcinoma. Ann Oncol 2001; 12:1407-10. [PMID: 11762812 DOI: 10.1023/a:1012552823543] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the efficacy of the combination of epirubicin, cisplatin and ralitrexed (Tomudex). ECT, in patients with advanced oesophageal or gastric adenocarcinoma. Efficacy was assessed primarily as response rate and secondarily in terms of toxicity, time to progression and survival. PATIENTS AND METHODS Twenty-one patients with histologically and/or cytologically proven unresectable (7) or metastatic (14) gastro-oesophageal adenocarcinoma, who had bi-dimensionally measurable disease, with ECOG performance status < or = 2. with adequate haematological, hepatic and renal function received first-line chemotherapy with epirubicin (50 mg/m2). cisplatin (60 mg/m2) and Tomudex (2.5 mg/m2), ECT, at three-weekly intervals. Treatment consisted of three cycles of chemotherapy, with a further three cycles if there was disease response or stabilisation. RESULTS ECT is an active regimen in the treatment of advanced gastro-oesophageal adenocarcinoma with an overall intention-to-treat response rate of 29% (95% confidence intervals (CI): 11%-52%). In addition, 4 (19%) patients had stable disease. Median time to progression was 19 weeks (95% CI: 7-31 weeks). Median overall survival was 18 weeks (95% CI: 11-24 weeks). Seventeen patients failed to complete the six cycles of treatment due to disease progression (5). toxicity (3), non-toxic death (1 pulmonary embolism, 1 cardiac), severe allergy to epirubicin (1), patient decision (1) and five patients after the study was discontinued early due to toxicity. There were three toxic deaths: two due to sepsis complicating neutropaenia and one due to cardiorespiratory failure following drug induced enteritis. Nine patients experienced grade 3 or 4 neutropaenia, two patients experienced grade 3 or 4 nausea and vomiting and one patient had grade 4 diarrhoea. CONCLUSIONS The combination of epirubicin, cisplatin and tomudex is active against advanced gastro-oesophageal adenocarcinoma but the toxicity suggests that further evaluation in a randomised comparison to ECF is not appropriate.
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Affiliation(s)
- H J Mackay
- CRC Department of Medical Oncology Beatson Oncology Centre, Western Infirmary, Glasgow, UK.
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