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Lai Y, Cappellini MD, Aydinok Y, Porter J, Karakas Z, Viprakasit V, Siritanaratkul N, Kattamis A, Liu R, Izquierdo M, Lasher J, Govindaraju S, Taher A. An open-label, multicenter, efficacy, and safety study of deferasirox in iron-overloaded patients with non-transfusion-dependent thalassemia (THETIS): 5-year results. Am J Hematol 2022; 97:E281-E284. [PMID: 35560253 DOI: 10.1002/ajh.26592] [Citation(s) in RCA: 2] [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] [Received: 02/15/2022] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Yong‐Rong Lai
- Department of Hematology Guangxi Medical University Nanning China
| | | | - Yesim Aydinok
- Department of Pediatric Hematology Ege University Medical School Izmir Turkey
| | - John Porter
- Department of Haematology University College Hospital London UK
| | - Zeynep Karakas
- Istanbul Medical Faculty Istanbul University Istanbul Turkey
| | - Vip Viprakasit
- Department of Pediatrics and Internal Medicine Siriraj Hospital Bangkok Thailand
| | | | - Antonis Kattamis
- First Department of Pediatrics National and Kapodistrian University of Athens Athens Greece
| | - Rongrong Liu
- Department of Hematology Guangxi Medical University Nanning China
| | | | - Janet Lasher
- Novartis Pharmaceuticals Corporation East Hanover New Jersey USA
| | | | - Ali Taher
- Division of Hematology and Oncology, Department of Internal Medicine American University of Beirut Medical Center Beirut Lebanon
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Rummel MJ, Janssens A, MacDonald D, Keating MM, Zaucha JM, Davis J, Lasher J, Babanrao Pisal C, Izquierdo M, Friedberg JW. A phase 3, randomized study of ofatumumab combined with bendamustine in rituximab-refractory iNHL (COMPLEMENT A + B study). Br J Haematol 2021; 193:1123-1133. [PMID: 33973233 DOI: 10.1111/bjh.17420] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/28/2021] [Indexed: 01/22/2023]
Abstract
The standard of care for indolent non-Hodgkin lymphoma (iNHL) is rituximab, an anti-CD20 antibody, with/without chemotherapy. However, multiple relapses are common in these patients. This phase 3, randomized study compared outcomes of a combination of ofatumumab (a second-generation anti-CD20 antibody) and bendamustine, with bendamustine alone in patients unresponsive to prior rituximab-based treatment. Overall, 346 patients were randomized to receive either the combination or bendamustine alone. Bendamustine was given for ≤8 cycles and ofatumumab for ≤12 cycles. The primary end-point was progression-free survival (PFS) after 215 protocol-defined events assessed by independent review committee (IRC). Median IRC-assessed PFS was 16·7 and 13·8 months in the combination and monotherapy arms respectively [hazard ratio (HR) = 0·82; P = 0·1390]. Median overall survival (OS) was 58·2 and 51·8 months in the combination and monotherapy arms respectively (HR = 0·89, P = 0·4968). The safety profile was consistent with previous reports. Overall, 73% and 80% of patients in the combination and monotherapy arms, respectively, experienced a ≥grade 3 adverse event. The study did not meet its primary end-point. No significant improvement in PFS and OS was seen with the combination of ofatumumab and bendamustine as compared with bendamustine alone in rituximab-refractory iNHL (NCT01077518).
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Affiliation(s)
- Mathias J Rummel
- Department for Haematology, Clinic for Haematology and Medical Oncology, Justus-Liebig University-Hospital, Gießen, Germany
| | - Ann Janssens
- Department of Haematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - David MacDonald
- Division of Haematology, Dalhousie University, Halifax, NS, Canada
| | | | - Jan M Zaucha
- Department of Haematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | | | | | - Jonathan W Friedberg
- Wilmot Cancer Institute, University of Rochester Medical Centre, Rochester, NY, USA
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Chen X, Shen G, Jiang J, Liu H, Hu K, Darstein C, Lasher J, Hu P. Pharmacokinetics and safety of subcutaneous pasireotide and intramuscular pasireotide long-acting release in Chinese male healthy volunteers: a phase I, single-center, open-label, randomized study. Clin Ther 2014; 36:1196-210. [PMID: 25012727 DOI: 10.1016/j.clinthera.2014.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 01/10/2014] [Revised: 04/16/2014] [Accepted: 06/05/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to assess the pharmacokinetic (PK) properties and safety of single and multiple doses of subcutaneous (SC) pasireotide and a single-dose intramuscular (IM) long-acting release (LAR) formulation of pasireotide in Chinese healthy volunteers (HVs) versus the PK properties in Western HVs (pooled from previous PK studies). METHODS In this phase I, single-center, open-label study, 45 Chinese male HVs were evenly randomized to 1 to 9 treatment sequences: each volunteer received a single dose of 300, 600, or 900 μg of pasireotide SC on day 1, followed by administration of the same dose BID from day 15 to the morning of day 19, and then a single IM dose of 20, 40, or 60 mg of pasireotide LAR on day 33. The PK parameters were assessed with noncompartmental analysis. Statistical comparison of PK parameters, including AUC, Cmax, and CL/F from both formulations, was made for Chinese versus Western male HVs. The safety profile was also assessed. Metabolic parameters, including blood glucose, insulin, and glucagon, and measures that reflect the effects of pasireotide LAR on relatively long-term glucose control, lipid metabolism, and systemic concentrations of pancreatic enzymes and thyrotropin were evaluated. FINDINGS Of the 45 randomized HVs, 42 completed the study per protocol, 1 withdrew his informed consent for personal reasons, and 2 prematurely discontinued the study because of adverse events (AEs). Concentration-time and safety profiles of both formulations were similar to those reported in Western HVs. Mean geometric mean ratios (GMRs) of Chinese versus Western HVs ranged from 0.79 to 1.42. For most primary PK parameters, 90% CIs for GMRs were within a predefined ethnic insensitivity interval (90% CI, 0.70-1.43). After considering age and weight as covariates in the statistical model, the GMRs and 90% CIs for other PK parameters were within the predefined interval (Cmax in single-dose SC administration) or significantly decreased (Cmin,ss in multiple BID SC doses and first peak Cmax in the single-dose LAR formulation). No serious AEs were reported. Both formulations were well tolerated; pasireotide SC caused transient changes in glucose metabolism. Owing to the differential binding affinity to the somatostatin receptor subtypes, pasireotide LAR elicited a concentration-dependent increase of fasting blood glucose, substantial reduction in triglyceride, and a mild decrease in cholesterol. The most frequently reported AEs after single-dose and multiple-dose pasireotide SC were injection site reaction, nausea, dizziness, and diarrhea; most HVs developed diarrhea with single-dose pasireotide LAR. IMPLICATIONS The pasireotide formulations had similar PK and safety profiles between Chinese and Western male HVs. Thus, no ethnic sensitivity was found for pasireotide SC or LAR.
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Affiliation(s)
- Xia Chen
- Clinical Pharmacology Research Centre, Peking Union Medical College Hospital, Beijing, China
| | - Guoxiang Shen
- Novartis Pharmaceutical Corporation, Oncology Business Unit, East Hanover, New Jersey
| | - Ji Jiang
- Clinical Pharmacology Research Centre, Peking Union Medical College Hospital, Beijing, China
| | - Hongzhong Liu
- Clinical Pharmacology Research Centre, Peking Union Medical College Hospital, Beijing, China
| | - Ke Hu
- Novartis Pharmaceutical Corporation, Oncology Business Unit, East Hanover, New Jersey
| | | | - Janet Lasher
- Novartis Pharmaceutical Corporation, Oncology Business Unit, East Hanover, New Jersey
| | - Pei Hu
- Clinical Pharmacology Research Centre, Peking Union Medical College Hospital, Beijing, China.
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Petersenn S, Bollerslev J, Arafat AM, Schopohl J, Serri O, Katznelson L, Lasher J, Hughes G, Hu K, Shen G, Reséndiz KH, Giannone V, Beckers A. Pharmacokinetics, pharmacodynamics, and safety of pasireotide LAR in patients with acromegaly: A randomized, multicenter, open-label, phase I study. J Clin Pharmacol 2014; 54:1308-17. [DOI: 10.1002/jcph.326] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/02/2014] [Indexed: 12/16/2022]
Affiliation(s)
| | - Jens Bollerslev
- Oslo University Hospital; Section of Specialized Endocrinology, Medical Clinic B and Faculty of Medicine, University of Oslo; Oslo Norway
| | - Ayman M. Arafat
- Department of Endocrinology; Diabetes and Nutrition, Charité-University Medicine Berlin, Campus Benjamin Franklin; Berlin Germany
| | - Jochen Schopohl
- Medizinische Klinik IV; Campus Innenstadt, University of Munich; Munich Germany
| | - Omar Serri
- CHUM, Notre-Dame Hospital; Montreal Quebec Canada
| | - Laurence Katznelson
- Division of Endocrinology and Metabolism; Stanford University School of Medicine; Stanford CA USA
| | - Janet Lasher
- Novartis Pharmaceuticals Corporation; East Hanover NJ USA
| | - Gareth Hughes
- Novartis Pharmaceuticals Corporation; East Hanover NJ USA
| | - Ke Hu
- Novartis Pharmaceuticals Corporation; East Hanover NJ USA
| | - George Shen
- Novartis Pharmaceuticals Corporation; East Hanover NJ USA
| | | | | | - Albert Beckers
- CHU de Liège; Domaine Universitaire du Sart-Tilman Liège; Liège Belgium
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Petersenn S, Hu K, Maldonado M, Zhang Y, Lasher J, Bouillaud E, Wang Y, Mann K, Unger N. Tolerability and Dose Proportional Pharmacokinetics of Pasireotide Administered as a Single Dose or Two Divided Doses in Healthy Male Volunteers: A Single-Center, Open-Label, Ascending-Dose Study. Clin Ther 2012; 34:677-88. [DOI: 10.1016/j.clinthera.2012.01.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2012] [Indexed: 11/24/2022]
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Valkema R, Pauwels SA, Kvols LK, Kwekkeboom DJ, Jamar F, de Jong M, Barone R, Walrand S, Kooij PPM, Bakker WH, Lasher J, Krenning EP. Long-term follow-up of renal function after peptide receptor radiation therapy with (90)Y-DOTA(0),Tyr(3)-octreotide and (177)Lu-DOTA(0), Tyr(3)-octreotate. J Nucl Med 2005; 46 Suppl 1:83S-91S. [PMID: 15653656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
UNLABELLED The kidneys are critical organs in peptide receptor radiation therapy (PRRT). Renal function loss may become apparent many years after PRRT. We analyzed the time course of decline in creatinine clearance (CLR) in patients during a follow-up of at least 18 mo after the start of PRRT with (90)Y-1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid (DOTA),Tyr(3)-octreotide ((90)Y-DOTATOC) or (177)Lu-DOTA(0),Tyr(3)-octreotate ((177)Lu-DOTATATE). METHODS Twenty-eight patients with metastasized neuroendocrine tumors received 1-5 cycles of (90)Y-DOTATOC, leading to renal radiation doses of 5.9-26.9 Gy per cycle and a total of 18.3-38.7 Gy. Median follow-up was 2.9 y (range, 1.5-5.4 y), with a median of 16 measurements (range, 5-53) per patient. Thirty-seven patients with metastasized neuroendocrine tumors received 3-7 cycles of (177)Lu-DOTATATE, leading to renal radiation doses of 1.8-7.8 Gy per cycle and a total of 7.3-26.7 Gy. Median follow-up was 2.4 y (range, 1.7-4.0 y), with a median of 10 (range, 6-27) measurements per patient. All renal dose estimates were calculated with the MIRDOSE3 model. All patients were infused with renoprotective amino acids during the administration of the radioactive peptides. The time trend of CLR was determined by fitting a monoexponential function through the data of individual patients, yielding the decline in CLR in terms of percentage change per year. RESULTS The median decline in CLR was 7.3% per y in patients treated with (90)Y-DOTATOC and 3.8% per y in patients treated with (177)Lu-DOTATATE (P = 0.06). The time trend of decline in CLR was sustained during the follow-up period. Eleven patients had a >15% per y decline in CLR. Cumulative renal radiation dose, per-cycle renal radiation dose, age, hypertension, and diabetes are probable contributing factors to the rate of decline in CLR after PRRT. CONCLUSION This study showed that the time course of CLR after PRRT was compatible with the pattern of sustained CLR loss in progressive chronic kidney disease.
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Affiliation(s)
- Roelf Valkema
- Department of Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
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Valkema R, Kvols LK, Pauwels S, Jamar F, Barone R, Lasher J, Krenning EP. Peptide receptor radiotherapy (PRRT) with [Y-90-DOTA,Tyr3]octreotide: Toxicity and efficacy of 4-cycle and single-cycle regimens. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3046] [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)
- R. Valkema
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - L. K. Kvols
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - S. Pauwels
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - F. Jamar
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - R. Barone
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - J. Lasher
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - E. P. Krenning
- Erasmus MC, Rotterdam, Netherlands; H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL; Cliniques Universitaires Saint-Luc, Brussels, Belgium; Novartis Pharmaceuticals Corporation, East Hanover, NJ
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Macklis R, Lasher J. Palliative radiotherapy for skeletal metastases: cost-substitution analyses and economic impact. J Oncol Manag 1999; 8:17-22. [PMID: 10387551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- R Macklis
- Department of Radiation Oncology, Cleveland Clinic Foundation, OH, USA
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Macklis RM, Cornelli H, Lasher J. Brief courses of palliative radiotherapy for metastatic bone pain: a pilot cost-minimization comparison with narcotic analgesics. Am J Clin Oncol 1998; 21:617-22. [PMID: 9856668 DOI: 10.1097/00000421-199812000-00019] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The use of radiotherapy to treat metastatic bone pain is being challenged by claims of high cost and by more readily available, noninvasive treatment approaches. The authors assessed the effectiveness of brief courses of radiotherapy in reducing pain and estimated cost data for a pilot comparison between radiotherapy and narcotic analgesics in patients with cancer. A representative group of outpatients undergoing brief courses of radiotherapy with Karnofsky scores above 70 and without serious comorbidities were recruited from 1995 through 1996. Patients indicated their pain at rest and with movement on a scale of from 1 to 10 both before and up to 12 months after radiotherapy. Radiotherapy costs were estimated from Medicare-allowable charges. Narcotic analgesia costs were estimated from published values. In 66 patients with 131 individually treated sites, median at rest pain score decreased by about 4 points after treatment (5.58 [-/+3.28] before treatment vs. 1.55 [-/+1.8] after treatment; p < 0.05). Median with movement pain score was about 5 points lower after treatment (7.32 [-/+2.72] before treatment vs. 1.94 [-/+2.07] after treatment; p < 0.05). No differences were found when stratifying by type of pain, tumor histologic type, or skeletal site. The estimated cost per patient ranged from $1,200 to $2,500 for radiotherapy. This compares with an estimated cost of $9,000 to $36,000 for 9 months of narcotics. In this pilot study, a brief course of radiotherapy significantly reduced pain and appeared to be cost effective when compared with narcotic analgesia. A full economic evaluation is warranted.
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Affiliation(s)
- R M Macklis
- Department of Radiation Oncology, The Cleveland Clinic Foundation, Ohio 44195, USA
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Macklis RM, Cornelli H, Lasher J. Brief courses of palliative radiotherapy for metastatic bone pain: A pilot cost-minimization comparison with narcotic analgesics. Int J Radiat Oncol Biol Phys 1998. [DOI: 10.1016/s0360-3016(98)80175-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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