1
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Goetz MP, Toi M, Huober J, Sohn J, Trédan O, Park IH, Campone M, Chen SC, Manso LM, Paluch-Shimon S, Freedman OC, O'Shaughnessy J, Pivot X, Tolaney SM, Hurvitz S, Llombart-Cussac A, André V, Saha A, van Hal G, Shahir A, Iwata H, Johnston SRD. Abemaciclib plus a nonsteroidal aromatase inhibitor as initial therapy for HR+, HER2- advanced breast cancer: Final overall survival results of MONARCH 3. Ann Oncol 2024:S0923-7534(24)00139-X. [PMID: 38729566 DOI: 10.1016/j.annonc.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND In MONARCH 2, the addition of abemaciclib to fulvestrant significantly improved both progression-free survival (PFS) and overall survival (OS) in patients with HR+, HER2- advanced breast cancer (ABC) with disease progression on prior endocrine therapy (ET). In MONARCH 3, the addition of abemaciclib to a nonsteroidal aromatase inhibitor (NSAI) as initial therapy for HR+, HER2- ABC significantly improved PFS. Here, we present the prespecified final OS results for MONARCH 3. PATIENTS AND METHODS MONARCH 3 is a randomized, double-blind, phase 3 study of abemaciclib plus NSAI (anastrozole or letrozole) versus placebo plus NSAI in postmenopausal women with HR+, HER2- ABC without prior systemic therapy in the advanced setting. The primary objective was investigator-assessed PFS; OS was a gated secondary endpoint, and chemotherapy-free survival (CFS) was an exploratory endpoint. RESULTS A total of 493 women were randomized 2:1 to receive abemaciclib plus NSAI (n = 328) or placebo plus NSAI (n = 165). After a median follow-up of 8.1 years, there were 198 OS events (60.4%) in the abemaciclib arm and 116 (70.3%) in the placebo arm (hazard ratio, 0.804; 95% confidence interval [CI], 0.637-1.015; P = 0.0664, non-significant). Median OS was 66.8 versus 53.7 months for abemaciclib versus placebo. In the subgroup with visceral disease (sVD), there were 113 OS events (65.3%) in the abemaciclib arm and 65 (72.2%) in the placebo arm (hazard ratio, 0.758; 95% CI, 0.558-1.030; P = 0.0757, non-significant). Median OS was 63.7 months versus 48.8 months for abemaciclib versus placebo. The previously demonstrated PFS benefit was sustained, and CFS numerically improved with the addition of abemaciclib. No new safety signals were observed. CONCLUSION Abemaciclib combined with an NSAI resulted in clinically meaningful improvement in median OS (ITT: 13.1 months; sVD: 14.9 months) in patients with HR+ HER2- ABC; however, statistical significance was not reached.
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Affiliation(s)
- M P Goetz
- Department of Oncology, Mayo Clinic, Rochester, MN, USA.
| | - M Toi
- Kyoto University, Kyoto, Japan
| | - J Huober
- Breast Center Cantonal Hospital St. Gallen, Switzerland and University of Ulm, Ulm, Germany
| | - J Sohn
- Yonsei Cancer Center, Seoul, Korea
| | - O Trédan
- Centre Léon Bérard, Lyon, France
| | - I H Park
- National Cancer Center, Goyang-si, Korea
| | - M Campone
- Institut de Cancérologie de l'Ouest, Angers, France
| | - S-C Chen
- Chang Gung University Medical College, Taipei, Taiwan
| | - L M Manso
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - S Paluch-Shimon
- Hadassah University Hospital & Faculty of Medicine Hebrew University, Jerusalem, Israel
| | | | - J O'Shaughnessy
- Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX, USA
| | - X Pivot
- Centre Paul Strauss, INSERM 110, Strasbourg, France
| | - S M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - S Hurvitz
- Department of Medicine, UW Medicine, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | | | - V André
- Eli Lilly, Indianapolis, IN, USA
| | - A Saha
- Eli Lilly, Indianapolis, IN, USA
| | | | - A Shahir
- Eli Lilly, Indianapolis, IN, USA
| | - H Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - S R D Johnston
- Breast Unit, The Royal Marsden NHS Foundation Trust, London, UK
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2
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Saura C, Modi S, Krop I, Park YH, Kim SB, Tamura K, Iwata H, Tsurutani J, Sohn J, Mathias E, Liu Y, Cathcart J, Singh J, Yamashita T. Trastuzumab deruxtecan in previously treated patients with HER2-positive metastatic breast cancer: updated survival results from a phase II trial (DESTINY-Breast01). Ann Oncol 2024; 35:302-307. [PMID: 38092229 DOI: 10.1016/j.annonc.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/02/2023] [Accepted: 12/04/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Primary analysis of the multicenter, open-label, single-arm, phase II DESTINY-Breast01 trial (median follow-up 11.1 months) demonstrated durable antitumor activity with trastuzumab deruxtecan (T-DXd) in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (mBC) previously treated with trastuzumab emtansine (T-DM1). We report updated cumulative survival outcomes with a median follow-up of 26.5 months (data cut-off 26 March 2021). PATIENTS AND METHODS Patients with HER2-positive mBC resistant or refractory to T-DM1 received T-DXd 5.4 mg/kg intravenously every 3 weeks until disease progression, unacceptable adverse events, or withdrawal of consent. The primary endpoint was confirmed objective response rate (ORR) by independent central review (ICR). Secondary endpoints included overall survival (OS), duration of response (DoR), progression-free survival (PFS), and safety. RESULTS The ORR by ICR was 62.0% [95% confidence interval (CI) 54.5% to 69.0%] in patients who received T-DXd 5.4 mg/kg every 3 weeks (n = 184). Median OS was 29.1 months (95% CI 24.6-36.1 months). Median PFS and DoR were 19.4 months (95% CI 14.1-25.0 months) and 18.2 months (95% CI 15.0 months-not evaluable), respectively. Drug-related treatment-emergent adverse events (TEAEs) were observed in 183 patients (99.5%), and 99 patients (53.8%) had one or more grade ≥3 TEAEs. Adjudicated drug-related interstitial lung disease/pneumonitis occurred in 15.8% of patients (n = 29), of which 2.7% (n = 5) were grade 5. CONCLUSIONS These updated results provide further evidence of sustained antitumor activity of T-DXd with a consistent safety profile in heavily pretreated patients with HER2-positive mBC.
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Affiliation(s)
- C Saura
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain.
| | - S Modi
- Memorial Sloan Kettering Cancer Center, New York
| | - I Krop
- Yale Cancer Center, New Haven, USA
| | | | - S-B Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - K Tamura
- Shimane University Hospital, Izumo
| | - H Iwata
- Aichi Cancer Center Hospital, Nagoya
| | - J Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan
| | - J Sohn
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | - E Mathias
- Daiichi Sankyo, Inc., Basking Ridge, USA
| | - Y Liu
- Daiichi Sankyo, Inc., Basking Ridge, USA
| | - J Cathcart
- Daiichi Sankyo, Inc., Basking Ridge, USA
| | - J Singh
- Daiichi Sankyo, Inc., Basking Ridge, USA
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3
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Viale G, Basik M, Niikura N, Tokunaga E, Brucker S, Penault-Llorca F, Hayashi N, Sohn J, Teixeira de Sousa R, Brufsky AM, O'Brien CS, Schmitt F, Higgins G, Varghese D, James GD, Moh A, Livingston A, de Giorgio-Miller V. Retrospective study to estimate the prevalence and describe the clinicopathological characteristics, treatments received, and outcomes of HER2-low breast cancer. ESMO Open 2023; 8:101615. [PMID: 37562195 PMCID: PMC10515285 DOI: 10.1016/j.esmoop.2023.101615] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/05/2023] [Accepted: 07/08/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Approximately 80% of all breast cancers (BCs) are currently categorized as human epidermal growth factor receptor 2 (HER2)-negative [immunohistochemistry (IHC) 0, 1+, or 2+/in situ hybridization (ISH) negative]; approximately 60% of BCs traditionally categorized as HER2-negative express low levels of HER2. HER2-low (IHC 1+ or IHC 2+/ISH-) status became clinically actionable with approval of trastuzumab deruxtecan to treat unresectable/metastatic HER2-low BC. Greater understanding of patients with HER2-low disease is urgently needed. PATIENTS AND METHODS This global, multicenter, retrospective study (NCT04807595) included tissue samples from patients with confirmed HER2-negative unresectable/metastatic BC [any hormone receptor (HR) status] diagnosed from 2014 to 2017. Pathologists rescored HER2 IHC-stained slides as HER2-low (IHC 1+ or IHC 2+/ISH-) or HER2 IHC 0 after training on low-end expression scoring using Ventana 4B5 and other assays at local laboratories (13 sites; 10 countries) blinded to historical scores. HER2-low prevalence and concordance between historical scores and rescores were assessed. Demographics, clinicopathological characteristics, treatments, and outcomes were examined. RESULTS In rescored samples from 789 patients with HER2-negative unresectable/metastatic BC, the overall HER2-low prevalence was 67.2% (HR positive, 71.1%; HR negative, 52.8%). Concordance was moderate between historical and rescored HER2 statuses (81.3%; κ = 0.583); positive agreement was numerically higher for HER2-low (87.5%) than HER2 IHC 0 (69.9%). More than 30% of historical IHC 0 cases were rescored as HER2-low overall (all assays) and using Ventana 4B5. There were no notable differences between HER2-low and HER2 IHC 0 in patient characteristics, treatments received, or clinical outcomes. CONCLUSIONS Approximately two-thirds of patients with historically HER2-negative unresectable/metastatic BC may benefit from HER2-low-directed treatments. Our data suggest that HER2 reassessment in patients with historical IHC 0 scores may be considered to help optimize selection of patients for treatment. Further, accurate identification of patients with HER2-low BC may be achieved with standardized pathologist training.
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Affiliation(s)
- G Viale
- Department of Pathology and Laboratory Medicine, IEO European Institute of Oncology IRCCS, Milan, Italy.
| | - M Basik
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - N Niikura
- Tokai University School of Medicine, Isehara, Kanagawa Prefecture, Japan
| | - E Tokunaga
- National Hospital Organization Kyushu Cancer Center, Fukuoka, Fukuoka Prefecture, Japan
| | - S Brucker
- Research Institute for Women's Health, University of Tübingen, Tübingen, Germany
| | - F Penault-Llorca
- Centre Jean Perrin, Université Clermont Auvergne, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont Ferrand, France
| | - N Hayashi
- St Luke's International Hospital, Tokyo, Tokyo Prefecture, Japan
| | - J Sohn
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | | | - A M Brufsky
- University of Pittsburgh Medical Center, Magee-Womens Hospital, Pittsburgh, USA
| | - C S O'Brien
- The Christie NHS Foundation Trust, Manchester, UK
| | - F Schmitt
- Medical Faculty of the University of Porto, CINTESIS@RISE (Health Research Network), Molecular Pathology Unit, Ipatimup, Porto, Portugal
| | - G Higgins
- Victorian Cancer Biobank, Melbourne, Australia
| | - D Varghese
- Epidemiology, Global Real World Evidence Generation, OBU Medical, AstraZeneca, Gaithersburg, USA
| | - G D James
- Medical Statistics Consultancy Ltd, London, UK
| | - A Moh
- Daiichi Sankyo, Inc., Basking Ridge, USA
| | - A Livingston
- Global Medical Affairs, Medical Breast, OBU Medical, AstraZeneca, City House, Cambridge, UK
| | - V de Giorgio-Miller
- Global Medical Affairs, Medical Breast, OBU Medical, AstraZeneca, City House, Cambridge, UK
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4
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Ueno N, Jacot W, Yamashita T, Sohn J, Tokunaga E, Prat A, Tsurutani J, Park Y, Rugo H, Xu B, Cardoso F, Mitri Z, Mahtani R, Dunton K, Wang Y, Gambhire D, Cottone F, Harbeck N, Cameron D, Modi S. 217O Patient-reported outcomes (PROs) from DESTINY-Breast04, a randomized phase III study of trastuzumab deruxtecan (T-DXd) vs treatment of physician's choice (TPC) in patients (pts) with HER2-low metastatic breast cancer (MBC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.256] [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: 11/01/2022] Open
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5
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Kim J, Kook Y, Jang J, Bae S, Chae B, Shin D, Ryu J, Sohn J, Jeong J, Ahn S. 166P Adjuvant trastuzumab plus pertuzumab (TP) versus trastuzumab (T) alone in patients achieving pathologic complete response after chemotherapy with TP. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.201] [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: 11/01/2022] Open
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6
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Martin Jimenez M, Lim E, Chavez Mac Gregor M, Bardia A, Wu J, Zhang Q, Nowecki Z, Cruz F, Safin R, Kim SB, Schem C, Montero A, Khan S, Bandyopadhyay R, Shivhare M, Patre M, Martinalbo J, Roncoroni L, Pérez-Moreno P, Sohn J. 211MO Giredestrant (GDC-9545) vs physician choice of endocrine monotherapy (PCET) in patients (pts) with ER+, HER2– locally advanced/metastatic breast cancer (LA/mBC): Primary analysis of the phase II, randomised, open-label acelERA BC study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.250] [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: 11/01/2022] Open
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7
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Balmana J, Fasching P, Delaloge S, Park Y, Eisen A, Bourgeois H, Kemp Z, Jankowski T, Sohn J, Aksoy S, Timcheva C, Park-Simon TW, Anton Torres A, John E, Baria K, Walker G, Gelmon K. 174P Clinical effectiveness and safety of olaparib in BRCA-mutated, HER2-negative metastatic breast cancer in a real-world setting: Phase IIIb LUCY final analysis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.193] [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: 11/01/2022] Open
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8
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Dieras V, Martin Jimenez M, O'Sullivan C, Sohn J, Tryfonidis K, Santarpia L, Yang S, Hamilton E. 207TiP Phase III study of tucatinib or placebo in combination with trastuzumab and pertuzumab as maintenance therapy for HER2+ metastatic breast cancer (HER2CLIMB-05, trial in progress). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.226] [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: 11/01/2022] Open
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9
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Park Y, Jung K, Sohn J, Lee K, Kim J, Yang Y, Baek E, Han H, Im SA. 176P Poziotinib for HER2-positive metastatic breast cancer (MBC): Final clinical efficacy and safety results for long-term follow-up of the phase II NOV120101-203 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.195] [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: 11/28/2022] Open
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Abstract
Although there is a clear relationship between the degree of obesity and periodontal disease incidence, the mechanisms that underpin the links between these conditions are not completely understood. Understanding that myeloid-derived suppressor cells (MDSCs) are expanded during obesity and operate in a context-defined manner, we addressed the potential role of MDSCs to contribute toward obesity-associated periodontal disease. Flow cytometry revealed that in the spleen of mice fed a high-fat diet (HFD), expansion in monocytic MDSCs (M-MDSCs) significantly increased when compared with mice fed a low-fat diet (LFD). In the osteoclast differentiation assay, M-MDSCs isolated from the bone marrow of HFD-fed mice showed a larger number and area of osteoclasts with a greater number of nuclei. In the M-MDSCs of HFD-fed mice, several osteoclast-related genes were significantly elevated when compared with LFD-fed mice according to a focused transcriptomic platform. In experimental periodontitis, the number and percentage of M-MDSCs were greater, with a significantly larger increase in HFD-fed mice versus LFD-fed mice. In the spleen, the percentage of M-MDSCs was significantly higher in HFD-fed periodontitis-induced (PI) mice than in LFD-PI mice. Alveolar bone volume fraction was significantly reduced in experimental periodontitis and was further decreased in HFD-PI mice as compared with LFD-PI mice. The inflammation score was significantly higher in HFD-PI mice versus LFD-PI mice, with a concomitant increase in TRAP staining for osteoclast number and area in HFD-PI mice over LFD-PI mice. These data support the concept that M-MDSC expansion during obesity to become osteoclasts during periodontitis is related to increased alveolar bone destruction, providing a more detailed mechanistic appreciation of the interconnection between obesity and periodontitis.
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Affiliation(s)
- K.H. Kwack
- Department of Oral Biology,
University at Buffalo, Buffalo, NY, USA
| | - L. Zhang
- Department of Oral Biology,
University at Buffalo, Buffalo, NY, USA
| | - J. Sohn
- Department of Oral Biology,
University at Buffalo, Buffalo, NY, USA,Department of Medicine,
University at Buffalo, Buffalo, NY, USA,Department of Genetics, Genomics,
and Bioinformatics Program, University at Buffalo, Buffalo, NY, USA
| | - V. Maglaras
- Department of Oral Biology,
University at Buffalo, Buffalo, NY, USA
| | - R. Thiyagarajan
- Department of Medicine,
University at Buffalo, Buffalo, NY, USA,Research Service, Western New
York Veterans Affairs Healthcare Service, Buffalo, NY, USA
| | - K.L. Kirkwood
- Department of Oral Biology,
University at Buffalo, Buffalo, NY, USA,Department of Head and
Neck/Plastic and Reconstructive Surgery, Roswell Park Comprehensive Cancer
Center, Buffalo, NY, USA,K.L. Kirkwood, Department of Oral
Biology, School of Dental Medicine, University at Buffalo, The State
University of New York, 645 Biomedical Research Building, 3435 Main
St, Buffalo, NY 14214-8006, USA.
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11
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Geyer CE, Sikov WM, Huober J, Rugo HS, Wolmark N, O'Shaughnessy J, Maag D, Untch M, Golshan M, Ponce Lorenzo J, Metzger O, Dunbar M, Symmans WF, Rastogi P, Sohn J, Young R, Wright GS, Harkness C, McIntyre K, Yardley D, Loibl S. Long-term efficacy and safety of addition of carboplatin with or without veliparib to standard neoadjuvant chemotherapy in triple-negative breast cancer: 4-year follow-up data from BrighTNess, a randomized phase 3 trial. Ann Oncol 2022; 33:384-394. [PMID: 35093516 DOI: 10.1016/j.annonc.2022.01.009] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [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: 09/07/2021] [Revised: 01/14/2022] [Accepted: 01/20/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Primary analyses of the phase 3 BrighTNess trial showed addition of carboplatin with/without veliparib to neoadjuvant chemotherapy significantly improved pathological complete response (pCR) rates with manageable acute toxicity in patients with triple-negative breast cancer (TNBC). Here, we report 4.5-year follow-up data from the trial. DESIGN Women with untreated stage II-III TNBC were randomized (2:1:1) to paclitaxel (weekly for 12 doses) plus either: (a) carboplatin (every 3 weeks for four cycles) plus veliparib (twice daily); (b) carboplatin plus veliparib placebo; or (c) carboplatin placebo plus veliparib placebo. All patients then received doxorubicin and cyclophosphamide (AC) every 2‒3 weeks for four cycles. The primary endpoint was pCR. Secondary endpoints included event-free survival (EFS), overall survival (OS), and safety. Since the co-primary endpoint of increased pCR with carboplatin plus veliparib with paclitaxel versus carboplatin with paclitaxel was not met, secondary analyses are descriptive. RESULTS Of 634 patients, 316 were randomized to carboplatin plus veliparib with paclitaxel, 160 to carboplatin with paclitaxel, and 158 to paclitaxel. With median follow-up of 4.5 years, the hazard ratio [HR] for EFS for carboplatin plus veliparib with paclitaxel versus paclitaxel was 0.63 (95% confidence interval [CI] 0.43‒0.92, P=0.02), but 1.12 (95% CI 0.72‒1.72, P=0.62) for carboplatin plus veliparib with paclitaxel versus carboplatin with paclitaxel. In post hoc analysis, HR for EFS was 0.57 (95% CI 0.36‒0.91, P=0.02) for carboplatin with paclitaxel versus paclitaxel. OS did not differ significantly between treatment arms, nor did rates of myelodysplastic syndromes, acute myeloid leukemia, or other secondary malignancies. CONCLUSION Improvement in pCR with addition of carboplatin was associated with long-term EFS benefit with a manageable safety profile, and without increasing the risk of second malignancies, while adding veliparib did not impact EFS. These findings support the addition of carboplatin to weekly paclitaxel followed by AC neoadjuvant chemotherapy for early stage TNBC.
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Affiliation(s)
- C E Geyer
- National Surgical Adjuvant Breast and Bowel Project Foundation, Pittsburgh, PA, USA; Houston Methodist Cancer Center, Houston, TX, USA.
| | - W M Sikov
- Women, Infants Hospital of Rhode Island, Providence, RI, USA
| | - J Huober
- Breast Center Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - H S Rugo
- University of California San Francisco Hellen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - N Wolmark
- National Surgical Adjuvant Breast and Bowel Project Foundation, Pittsburgh, PA, USA; University of Pittsburgh, Pittsburgh, PA, USA
| | - J O'Shaughnessy
- Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX, USA; Baylor University Medical Center, Dallas, TX, USA
| | - D Maag
- AbbVie Inc., North Chicago, IL, USA
| | - M Untch
- HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - M Golshan
- Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - J Ponce Lorenzo
- University General Hospital of Alicante, ISABIAL, Alicante, Spain
| | - O Metzger
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - M Dunbar
- AbbVie Inc., North Chicago, IL, USA
| | | | - P Rastogi
- National Surgical Adjuvant Breast and Bowel Project Foundation, Pittsburgh, PA, USA; UPMC Hillman Cancer Center/University of Pittsburgh, Pittsburgh, PA, USA
| | - J Sohn
- Yonsei University College of Medicine, Seoul, Korea
| | - R Young
- Division of Breast Oncology, The Center for Cancer and Blood Disorders, Fort Worth, USA
| | - G S Wright
- Florida Cancer Specialists and Sarah Cannon Research Institute, New Port Richey, FL, USA
| | - C Harkness
- Hope Women's Cancer Centers, Asheville, NC, USA
| | - K McIntyre
- Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX, USA
| | - D Yardley
- Sarah Cannon Research Institute, Tennessee Oncology, Nashville, TN, USA
| | - S Loibl
- German Breast Group, c/o GBG Forschungs GmbH, Neu-Isenburg, Germany; Centre for Haematology and Oncology Bethanien, Frankfurt, Germany
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12
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O'Shaughnessy J, Rastogi P, Harbeck N, Toi M, Hegg R, Sohn J, Guarneri V, Cortes J, Hamilton E, Wei R, Shahir A, San Antonio B, Nabinger S, Tolaney S, Martin M, Johnston S. VP8-2021: Adjuvant abemaciclib combined with endocrine therapy (ET): Updated results from monarchE. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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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13
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Harbeck N, Rastogi P, Martin M, Tolaney SM, Shao ZM, Fasching PA, Huang CS, Jaliffe GG, Tryakin A, Goetz MP, Rugo HS, Senkus E, Testa L, Andersson M, Tamura K, Del Mastro L, Steger GG, Kreipe H, Hegg R, Sohn J, Guarneri V, Cortés J, Hamilton E, André V, Wei R, Barriga S, Sherwood S, Forrester T, Munoz M, Shahir A, San Antonio B, Nabinger SC, Toi M, Johnston SRD, O'Shaughnessy J. Adjuvant abemaciclib combined with endocrine therapy for high-risk early breast cancer: updated efficacy and Ki-67 analysis from the monarchE study. Ann Oncol 2021; 32:1571-1581. [PMID: 34656740 DOI: 10.1016/j.annonc.2021.09.015] [Citation(s) in RCA: 185] [Impact Index Per Article: 61.7] [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: 07/15/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Adjuvant abemaciclib combined with endocrine therapy (ET) previously demonstrated clinically meaningful improvement in invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS) in hormone receptor-positive, human epidermal growth factor receptor 2-negative, node-positive, high-risk early breast cancer at the second interim analysis, however follow-up was limited. Here, we present results of the prespecified primary outcome analysis and an additional follow-up analysis. PATIENTS AND METHODS This global, phase III, open-label trial randomized (1 : 1) 5637 patients to adjuvant ET for ≥5 years ± abemaciclib for 2 years. Cohort 1 enrolled patients with ≥4 positive axillary lymph nodes (ALNs), or 1-3 positive ALNs and either grade 3 disease or tumor ≥5 cm. Cohort 2 enrolled patients with 1-3 positive ALNs and centrally determined high Ki-67 index (≥20%). The primary endpoint was IDFS in the intent-to-treat population (cohorts 1 and 2). Secondary endpoints were IDFS in patients with high Ki-67, DRFS, overall survival, and safety. RESULTS At the primary outcome analysis, with 19 months median follow-up time, abemaciclib + ET resulted in a 29% reduction in the risk of developing an IDFS event [hazard ratio (HR) = 0.71, 95% confidence interval (CI) 0.58-0.87; nominal P = 0.0009]. At the additional follow-up analysis, with 27 months median follow-up and 90% of patients off treatment, IDFS (HR = 0.70, 95% CI 0.59-0.82; nominal P < 0.0001) and DRFS (HR = 0.69, 95% CI 0.57-0.83; nominal P < 0.0001) benefit was maintained. The absolute improvements in 3-year IDFS and DRFS rates were 5.4% and 4.2%, respectively. Whereas Ki-67 index was prognostic, abemaciclib benefit was consistent regardless of Ki-67 index. Safety data were consistent with the known abemaciclib risk profile. CONCLUSION Abemaciclib + ET significantly improved IDFS in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative, node-positive, high-risk early breast cancer, with an acceptable safety profile. Ki-67 index was prognostic, but abemaciclib benefit was observed regardless of Ki-67 index. Overall, the robust treatment benefit of abemaciclib extended beyond the 2-year treatment period.
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Affiliation(s)
- N Harbeck
- Breast Center, Department of OB & GYN and CCC Munich, LMU University Hospital, Munich, Germany.
| | - P Rastogi
- University of Pittsburgh/UPMC, NSABP Foundation, Pittsburgh, USA
| | - M Martin
- Hospital General Universitario Gregorio Marañon, Universidad Complutense, CIBERONC, GEICAM, Madrid, Spain
| | | | - Z M Shao
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - P A Fasching
- University Hospital Erlangen, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - C S Huang
- National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - G G Jaliffe
- Grupo Medico Camino S.C., Mexico City, Mexico
| | - A Tryakin
- N.N.Blokhin Russian Cancer Research Center, Moscow, Russia
| | | | - H S Rugo
- Department of Medicine (Hematology/Oncology), University of California San Francisco, San Francisco, USA
| | - E Senkus
- Department of Oncology & Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - L Testa
- Instituto D'Or de Pesquisa e Ensino (IDOR), Sao Paulo, Brazil
| | | | - K Tamura
- National Cancer Center Hospital, Tokyo, Japan
| | - L Del Mastro
- IRCSS Ospedale Policlinico San Martino, UO Breast Unit, Genoa, Italy; Università di Genova, Department of Internal Medicine and Medical Specialties (DIM), Genoa, Italy
| | - G G Steger
- Medical University of Vienna, Vienna, Austria
| | - H Kreipe
- Medizinische Hochschule Hannover, Hannover, Germany
| | - R Hegg
- Clin. Pesq. e Centro São Paulo, São Paulo, Brazil
| | - J Sohn
- Yonsei Cancer Center, Seoul, Korea
| | - V Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy; Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy
| | - J Cortés
- International Breast Cancer Center (IBCC), Madrid & Barcelona, and Vall d'Hebron Institute of Oncology, Barcelona, Spain; Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Medicine, Madrid, Spain
| | - E Hamilton
- Sarah Cannon Research Institute/Tennessee Oncology, Nashville, USA
| | - V André
- Eli Lilly and Company, Indianapolis, USA
| | - R Wei
- Eli Lilly and Company, Indianapolis, USA
| | - S Barriga
- Eli Lilly and Company, Indianapolis, USA
| | - S Sherwood
- Eli Lilly and Company, Indianapolis, USA
| | | | - M Munoz
- Eli Lilly and Company, Indianapolis, USA
| | - A Shahir
- Eli Lilly and Company, Indianapolis, USA
| | | | | | - M Toi
- Kyoto University Hospital, Kyoto, Japan
| | | | - J O'Shaughnessy
- Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, USA
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Saji S, Mittendorf E, Harbeck N, Zhang H, Barrios C, Hegg R, Koehler A, Sohn J, Iwata H, Telli M, Ferrario C, Punie K, Llorca FP, Patel S, Duc AN, Hermoso ML, Maiya V, Molinero L, Chui S, Jung K. 3MO IMpassion031: Results from a phase III study of neoadjuvant (neoadj) atezolizumab + chemo in early triple-negative breast cancer (TNBC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Johnston S, Harbeck N, Hegg R, Toi M, Martin M, Shao Z, Campone M, Hamilton E, Sohn J, Guarneri V, Cortes J, Neven P, Boyle F, Smith I, Frenzel M, Headley D, Wei R, Cox J, O'Shaughnessy J, Rastogi P. 2MO Abemaciclib in high risk early breast cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Huang CS, Toi M, Im YH, Iwata H, Sohn J, Wang HC, Masuda N, Im SA, Lu Y, Haddad N, Sakaguchi S, Hurt K, Neven P, Llombart-Cussac A, Sledge G. 45O Abemaciclib plus fulvestrant in East Asian women with HR+, HER2- advanced breast cancer: Overall survival from MONARCH 2. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.065] [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: 10/22/2022] Open
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Lu YS, Sohn J, Lee K, Jung K, Babu G, Liu MC, Srimuninnimit V, Yap Y, Chow L, Gaur A, Wang Y, Gao M, Im SA. 47MO Efficacy and quality of life (QOL) in premenopausal Asian patients (pts) with hormone receptor–positive (HR+), HER2-negative (HER2-) advanced breast cancer (ABC) treated in the MONALEESA (ML)-7 study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.067] [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: 10/22/2022] Open
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Ledermann J, Colombo N, Oza A, Fujiwara K, Birrer M, Randall L, Poddubskaya E, Scambia G, Shparyk Y, Lim M, Bhoola S, Sohn J, Yonemori K, Stewart R, Zhang X, Zohren F, Linn C, Monk B. Avelumab in combination with and/or following chemotherapy vs chemotherapy alone in patients with previously untreated epithelial ovarian cancer: Results from the phase 3 javelin ovarian 100 trial. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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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Johnston S, Harbeck N, Hegg R, Toi M, Martin M, Shao Z, Campone M, Hamilton E, Sohn J, Guarneri V, Cortés J, Neven P, Boyle F, Smith I, Headley D, Wei R, Frenzel M, Cox J, O'Shaughnessy J, Rastogi P. LBA5_PR Abemaciclib in high risk early breast cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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De Laurentiis M, Merino LDLC, Hart L, Bardia A, Im SA, Sohn J, Neven P, Martin M, Ji Y, Yang S, Hu H, Lteif A, Tripathy D. 331P Impact of ribociclib (RIB) dose reduction on overall survival (OS) in patients (pts) with HR+/HER2− advanced breast cancer (ABC) in MONALEESA (ML) -3 and -7. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lim S, Sohn J, Kim G, Moon Y, Kim J. Prognosis and effect of adjuvant treatment in small, node(-), HER2(+) breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz416.009] [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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Im SA, Yap YS, Sohn J, Lee K, Jung K, Tseng L, Lee S, Babu K, Park Y, Gounaris I, Sondhi M, Ridolfi A, Zarate J, Lu YS. Pooled analysis of efficacy and safety in Asian patients (pts) in the MONALEESA-2, MONALEESA-3, and MONALEESA-7 trials of ribociclib (RIB) plus endocrine therapy (ET). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz418.002] [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: 11/13/2022] Open
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Lee KH, Kim SB, Sohn J, Goodwin A, Usari T, Lanzalone S, Im YH. Talazoparib (TALA) vs physician’s choice of chemotherapy (PCT) in Asian patients (Pts) with HER2- advanced breast cancer (ABC) and a germline BRCA1/2 mutation (gBRCA1/2mut): Data from phase III EMBRACA. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz418.001] [Citation(s) in RCA: 2] [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: 11/13/2022] Open
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Iwata H, Im SA, Sohn J, Jung K, Im YH, Lee K, Inoue K, Tamura K, Wong A, Emens L, Barrios C, Adams S, Schneeweiss A, Diéras V, Winer E, Chui S, Henschel V, Rugo H, Loi S, Schmid P. Subgroup analysis of IMpassion130: Atezolizumab + nab-paclitaxel (nab-P) in patients (pts) with advanced triple-negative breast cancer (TNBC) in Asian countries. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz418] [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: 11/13/2022] Open
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Ahn JH, Lee K, Lee KH, Seo J, KANG S, Sohn J, Yang Y, Park K, Moon Y, Lim S, Yoon K, Cho H, Kim SB. Phase II study of DHP107 oral paclitaxel in first-line, HER2 negative recurrent/metastatic breast cancer (OPTIMAL study, NCT03315364). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.041] [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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Martín M, Johnston S, Huober J, Di Leo A, Sohn J, Andre V, Martin H, Hardebeck M, Goetz M. MONARCH 3: Updated time to chemotherapy and disease progression following abemaciclib plus aromatase inhibitor (AI) in HR+, HER2- advanced breast cancer (ABC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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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Jeong J, Kim J, Ahn JH, Jung K, Koh SJ, Cheon J, Sohn J, Kim G, Lee K, Park I, Sim S, Kim SB. Leuprorelin (LEUP) combined with Letrozole (LET) with/without everolimus (EVE) in ovarian suppressed premenopausal women with hormone receptor (HR) positive, HER2-negative metastatic breast cancer (MBC): Primary analysis of LEO Trial (NCT02344550). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.006] [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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Sledge G, Toi M, Neven P, Sohn J, Inoue K, Pivot X, Burdaeva O, Okera M, Masuda N, Kaufman P, Koh H, Grischke EM, Conte P, Lu Y, Barriga S, Hurt K, Frenzel M, Johnston S, Llombart-Cussac A. MONARCH 2: Overall survival of abemaciclib plus fulvestrant in patients with HR+, HER2- advanced breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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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Lee H, Lee K, Lee J, Yoon K, Mohammad A, Park H, Park J, Lee ST, Sohn J. Development of a hereditary cancer panel testing for patients with triple negative breast cancer. Breast 2019. [DOI: 10.1016/s0960-9776(19)30165-1] [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: 10/27/2022] Open
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Noguchi E, Hata T, Nakamura K, Kuchiba A, Hayashi M, Hamada A, Yonemori K, Sohn J, Lu YS, Yap YS, Fujiwara Y, Tamura K. Abstract OT3-02-02: PATHWAY: Asian, multicenter, phase 3 trial of tamoxifen with or without palbociclib ± goserelin in women with hormone receptor-positive, HER2-negative advanced or metastatic breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot3-02-02] [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:
The incidence rates of breast cancer (BC) in Asian counties have been rising rapidly. The age-specific female BC incidence rates peak before menopause (around 40-50 years of age) in Asia, however treatment options for pre/perimenopausal patients are limited. Palbociclib (P) is an oral novel cyclin-dependent kinase 4/6 (CDK4/6) inhibitor. The addition of P to endocrine therapy (ET) such as aromatase inhibitor or fulvestrant has been demonstrated improved progression-free survival (PFS) in phase 3 studies PALOMA-2 and PALOMA-3. This study is designed to evaluate efficacy and safety of P plus tamoxifen (TAM) in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic BC regardless of menopausal status. This study is conducted as a Clinical Research Collaboration by National Cancer Center Hospital with research funding from Pfizer.
TRIAL DESIGN:
PATHWAY/NCCH1607 is a double-blind, placebo-controlled, randomized, phase 3 study. Patients will be randomized 1:1 to receive either P (125 mg once daily, days1-21 of a 28-day cycle) or placebo in combination with TAM (20 mg once daily, continuously). Pre/perimenopausal women should receive concurrent ovarian function suppression with goserelin. Randomization will be stratified by prior ET for advanced/metastatic BC (1st line ET vs. 2nd line ET) and menopausal status (pre/perimenopausal vs. postmenopausal).
KEY ELIGIBILITY CRITERIA:
Eligible patients include women of any menopausal status with HR-positive, HER2-negative advanced or metastatic BC; candidates to receive TAM as 1st line or 2nd line ET for advanced/metastatic disease; ≥18 years of age; measurable or non-measurable disease (RECIST v.1.1); ECOG performance status 0-1; adequate organ function; have not received treatment with TAM (except for patients who have had more than 12 months from completion of adjuvant therapy with TAM); and have not received any CDK4/6 or phosphoinositide 3-kinase (PI3K) - mammalian target of rapamycin (mTOR) inhibitors.
SPECIFIC AIMS:
The primary endpoint is PFS as assessed by the investigator. Secondary endpoints include overall survival (OS), 1, 2, and 3-year survival probabilities, objective response (OR), duration of response, clinical benefit rate (CBR), pharmacokinetics, safety, and patient-reported outcomes.
STATISTICAL METHODS:
The sample size was determined to detect a 38% reduction in the hazard of disease progression or death in P plus TAM arm with a 1-sided significance level of 2.5% and power of 80%. A stratified log rank test will be used to compare PFS between the 2 treatment arms.
PRESENT ACCRUAL AND TARGET ACCRUAL:
Target accrual of 180 patients will be enrolled within 23 sites among Japan, Korea, Taiwan, and Singapore. As of June 2018, 46 patients have been enrolled.
CONTACT INFORMATION:
This trial is registered at ClinicalTrials.gov NCT03423199 and UMIN000030816. For more information, email NCCH1607_office@ml.res.ncc.go.jp
Citation Format: Noguchi E, Hata T, Nakamura K, Kuchiba A, Hayashi M, Hamada A, Yonemori K, Sohn J, Lu Y-S, Yap Y-S, Fujiwara Y, Tamura K. PATHWAY: Asian, multicenter, phase 3 trial of tamoxifen with or without palbociclib ± goserelin in women with hormone receptor-positive, HER2-negative advanced or metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-02-02.
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Affiliation(s)
- E Noguchi
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
| | - T Hata
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
| | - K Nakamura
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
| | - A Kuchiba
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
| | - M Hayashi
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
| | - A Hamada
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
| | - K Yonemori
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
| | - J Sohn
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
| | - Y-S Lu
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
| | - Y-S Yap
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
| | - Y Fujiwara
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
| | - K Tamura
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Research Institute, Tokyo, Japan; Yonsei University Severance Hospital, Seoul, Korea; National Taiwan University Hospital, Taipei, Taiwan; National Cancer Center Singapore, Singapore, Singapore
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Loi S, Schmid P, Cortés J, Park YH, Muñoz-Couselo E, Kim SB, Sohn J, Im SA, Holgado E, Foukakis T, Kuemmel S, Dent R, Wang A, Aktan G, Karantza V, Salgado R. Abstract P3-10-09: Relationship between tumor infiltrating lymphocytes (TILs) and response to pembrolizumab (Pembro)+chemotherapy (Chemo) as neoadjuvant treatment (NAT) for triple-negative breast cancer (TNBC): phase Ib KEYNOTE-173 trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-10-09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Abstract
Background:Increasing quantities of stromal TILs (sTILs) are associated with higher pathologic complete response (pCR) rates with conventional chemo in early-stage TNBC. We evaluated the association between sTILs and PD-L1 expression with response to pembro+chemo as NAT for TNBC in the KEYNOTE-173 trial (NCT02622074).
Methods: sTILs were quantified using light microscopy of H&E-stained slides from pretreatment and on-treatment (during first 3 weeks of pembro monotherapy) tumor biopsies by a pathologist blind to response data. Pretreatment PD-L1 expression was assessed using the PD-L1 IHC 22C3 pharmDx assay and reported as combined positive score (CPS). Endpoints were pCR rate by ypT0 ypN0 and ypT0/Tis ypN0 and objective response rate (ORR; RECIST v1.1) after the first 4 cycles of NAT (taxane±carboplatin+pembro) by MRI. sTILs and PD-L1 CPS were evaluated as continuous variables. Association between sTILs and PD-L1 CPS with response was assessed using logistic regression and area under the reciever operating curve (AUROC) analyses, with a 1-sided alpha level of 0.10. Correlation between PD-L1 and sTILs was assessed by Spearman's rank correlation coefficient. Multivariate analysis included sTILs (pretreatment and on-treatment) and PD-L1 CPS. Likelihood ratio tests were used to evaluate the added value of factors in predicting pCR rate.
Results: Of 60 total pts, 34 had tumors evaluated for pretreatment sTILs, 52 for PD-L1 CPS, and 33 for both sTILs and CPS. On-treatment sTILs were evaluated in 31 pts. Overall pCR rates were 56.7% and 60% by ypT0 ypN0 and ypT0/Tis ypN0, respectively; ORR was 78.3%. In pts evaluated for sTILs and CPS (individually), pCR rates and ORR were comparable with overall pCR rates and ORR. There was a significant correlation between pretreatment sTILs and PD-L1 CPS (ρ=0.65, P<0.001).Higher pretreatment sTILs were significantly associated with response: ypT0 ypN0 P= 0.011; ypT0/Tis ypN0 P=0.006; ORR P=0.061. On-treatment sTILs were also significantly associated with response: ypT0 ypN0 P=0.061; ypT0/Tis ypN0 P=0.041; ORR P=0.031. Pretreatment PD-L1 CPS was significantly associated with response: ypT0 ypN0 P=0.073; ypT0/is ypN0 P=0.030; and ORR P=0.021. AUROC of pretreatment sTIL association with pCR was numerically higher than with on-treatment sTILs and PD-L1 CPS (0.69 vs 0.61 vs 0.56 for ypT0ypN0 and 0.72 vs 0.67 vs 0.62 for ypT0/Tis ypN0). Responders had higher median pretreatment sTIL levels vs nonresponders: 45% [10, 75] vs 10% [5, 20] for pCR rate by ypT0 ypN0 and 52.5% [10, 73.8] vs 10% [5, 20] for pCR rate by ypT0/Tis ypN0; 25% [5, 70] vs 10% [6.3, 27.5] for ORR. In multivariate analysis, only pretreatment sTILs were significant for both pCR endpoints (ypT0 ypN0 P=0.031; ypT0/Tis ypN0 P=0.034). Likelihood ratio tests demonstrated that for both pCR endpoints, PD-L1 CPS (P=0.683/P=0.422) and on-treatment sTILs (P=0.984/P=0.568) did not add significantly more value to pretreatment sTILs when predicting pCR.
Conclusions:Higher quantities of pretreatment sTILs and PD-L1 CPS and on-treatment sTILs were significantly associated with higher pCR rates and ORR in primary TNBC treated with pembro and NAT.
Citation Format: Loi S, Schmid P, Cortés J, Park YH, Muñoz-Couselo E, Kim S-B, Sohn J, Im S-A, Holgado E, Foukakis T, Kuemmel S, Dent R, Wang A, Aktan G, Karantza V, Salgado R. Relationship between tumor infiltrating lymphocytes (TILs) and response to pembrolizumab (Pembro)+chemotherapy (Chemo) as neoadjuvant treatment (NAT) for triple-negative breast cancer (TNBC): phase Ib KEYNOTE-173 trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-10-09.
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Affiliation(s)
- S Loi
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - P Schmid
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - J Cortés
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - YH Park
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - E Muñoz-Couselo
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S-B Kim
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - J Sohn
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S-A Im
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - E Holgado
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - T Foukakis
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S Kuemmel
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - R Dent
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - A Wang
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - G Aktan
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - V Karantza
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - R Salgado
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
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Beck JT, Neven P, Sohn J, Chan A, Sonke GS, Bachelot T, Campos-Gomez S, Martin M, Bardia A, Alam J, Miller M, Diaz-Padilla I, Kong O, Hart L. Abstract P6-18-06: Ribociclib treatment benefit in patients with advanced breast cancer with ≥1 dose reduction: Data from the MONALEESA-2, -3, and -7 trials. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-06] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: In the MONALEESA (ML) trials, addition of ribociclib (RIB; cyclin-dependent kinase 4/6 inhibitor) to endocrine therapy (ET) prolonged progression-free survival (PFS) in patients (pts) with hormone receptor-positive (HR+), HER2-negative (HER2–) advanced breast cancer (ABC). RIB was generally well tolerated, with adverse events (AEs) managed effectively by dose modifications. Here we present efficacy data for RIB-based regimens of interest for the proposed indication (i.e. with a non-steroidal aromatase inhibitor [NSAI] or fulvestrant [FUL]) from ML-2, -3, and -7 in pts who received no prior ET for ABC and who had ≥1 RIB dose reduction, to explore the efficacy of RIB in pts who need to dose reduce.
Methods: Pts included in this analysis were: postmenopausal women with HR+, HER2– ABC and no prior ET for ABC who received RIB (600 mg; 3-weeks-on/1-week-off) with letrozole (2.5 mg/day; ML-2 [NCT01958021]), or FUL (500 mg per label; ML-3 [NCT02422615]); and premenopausal women with no prior ET and ≤1 line of chemotherapy for ABC who received RIB with an NSAI (anastrozole: 1 mg/day; letrozole: 2.5 mg/day; ML-7 [NCT02278120]) plus goserelin (3.6 mg every 28 days). Dose reductions for RIB (600 to 400 to 200 mg) were permitted. Primary endpoint was PFS. Secondary endpoints included overall response rate (ORR), clinical benefit rate (CBR), and safety.
Results: In ML-2, -3, and -7, ≥1 RIB dose reduction occurred (n/N) in 169/334 (51%), 92/238 (39%), and 91/246 (37%) pts assigned to RIB, respectively. AEs were the main reason for dose reduction, with all-grade neutropenia the most common AE leading to dose reduction (ML-2 69%, ML-3 80%, ML-7 82%). Median PFS (months) was prolonged with RIB vs placebo in pts without a RIB dose reduction (ML-2: 27.7 vs 16.0; ML-3: not reached [NR] vs 18.3; ML-7: 23.8 vs 13.8); median PFS in pts with ≥1 RIB dose reduction was: ML-2 25.3, ML-3 NR, and ML-7 27.5 months. In pts with measurable disease and without a RIB dose reduction, ORR was 46% (ML-2), 43% (ML-3), and 48% (ML-7); CBR was 70%, 68%, and 79%, respectively. In pts with measurable disease and ≥1 RIB dose reduction, ORR was 62% (ML-2), 57% (ML-3), and 55% (ML-7); CBR was 88%, 85%, and 88%, respectively. The most common Grade 3/4 AEs in the RIB vs placebo groups (≥5% of pts in either ML trial, irrespective of causality or dose reduction) were neutropenia (ML-2: 62% vs 1%; ML-3: 55% vs 0; ML-7: 65% vs 4%), leukopenia (ML-2: 21% vs 1%; ML-3: 12% vs 0; ML-7: 16% vs 1%), hypertension (ML-2: 13% vs 13%; ML-3: 5% vs 5%; ML-7: 2% vs 3%), increased alanine aminotransferase (ML-2: 10% vs 1%; ML-3: 10% vs 0; ML-7: 5% vs 1%), and increased aspartate aminotransferase (ML-2: 6% vs 1%; ML-3: 6% vs 0; ML-7: 4% vs 1%).
Conclusions: Results from the ML-2, -3, and -7 trials suggest that pts who start on 600 mg of RIB and require dose reduction for the management of their AEs, or for other reasons, continue to derive clinical benefit.
Citation Format: Beck JT, Neven P, Sohn J, Chan A, Sonke GS, Bachelot T, Campos-Gomez S, Martin M, Bardia A, Alam J, Miller M, Diaz-Padilla I, Kong O, Hart L. Ribociclib treatment benefit in patients with advanced breast cancer with ≥1 dose reduction: Data from the MONALEESA-2, -3, and -7 trials [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-06.
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Affiliation(s)
- JT Beck
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - P Neven
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - J Sohn
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - A Chan
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - GS Sonke
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - T Bachelot
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - S Campos-Gomez
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - M Martin
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - A Bardia
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - J Alam
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - M Miller
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - I Diaz-Padilla
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - O Kong
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
| | - L Hart
- Highlands Oncology Group, Fayetteville, AR; Multidisciplinary Breast Centre, Universitair Ziekenhuis Leuven, Leuven, Belgium; Severance Hospital, Yonsei University Health System, Seoul, Korea; Breast Cancer Research Centre, Nedlands, Western Australia, Australia; Netherlands Cancer Institute/BOOG Study Center, Amsterdam, Netherlands; Centre Léon Bérard, Lyon, France; Centro Oncológico Estatal, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico; Instituto de Investigación Sanitaria Gregorio Marañon, Ciberonc, Geicam, Universidad Complutense de Madrid, Madrid, Spain; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Novartis Pharma AG, Basel, Switzerland; Florida Cancer Specialists, Sarah Cannon Research Institute, Fort Myers, FL
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Choi E, Lee K, Jung J, Kim H, Kim C, Sohn J, So B. Systemic mucormycosis caused by Lichtheimia ramosa in a pregnant cow. J Comp Pathol 2019. [DOI: 10.1016/j.jcpa.2018.10.114] [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: 10/27/2022]
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Im SA, Sohn J, Tripathy D, Chow L, Lee K, Jung K, Babu G, Im YH, El Saghir N, Liu MC, Diaz-Padilla I, Alam J, Kong O, Miller M, Lu YS. Ribociclib (RIB) + non-steroidal aromatase inhibitor (NSAI) + goserelin in premenopausal Asian women with hormone-receptor-positive (HR+), HER2-negative (HER2–) advanced breast cancer (ABC): Results from the randomized phase III MONALEESA-7 study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy428] [Citation(s) in RCA: 2] [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: 11/13/2022] Open
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Sohn J, Keet C, McGowan E. SELF-REPORTED ASTHMA AND FOOD ALLERGY, BUT NOT SENSITIZATION, ARE INCREASED IN CHILDREN WITH DEVELOPMENTAL DELAY. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.164] [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: 10/27/2022]
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Kwon J, Kang JH, Lee YG, Park K, An H, Sohn J, Seol Y, Lee H, Yun HJ, Ahn J, Kim H. Ramosetron versus palonosetron in combination with aprepitant and dexamethasone for the control of highly emetogenic chemotherapy-induced nausea and vomiting. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.022] [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: 11/13/2022] Open
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Kim G, Koh H, Kim J, Park BW, Cho Y, Kim S, Park H, Kim J, Kim M, Jeong J, Sohn J. Baseline lymphocyte counts predict distant recurrence in early breast cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.191] [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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Sohn J, Lim SM, Kim E, Kim S, Koo JS, Kim SI, Park S, Park HS, Kwon NJ, Kim GM, Kim S. Abstract P2-05-07: Whole exome sequencing of extreme responders reveals low mutation burden in metastatic breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-05-07] [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: Extreme responders to anticancer therapy are rarely encountered in the treatment of advanced breast cancer patients, but their treatment response have not been investigated on the whole exome level. We performed whole exome analysis to characterize genomic landscape of extreme responders in metastatic breast cancer patients.
Methods: Clinical samples were obtained from patients who showed exceptional response to anti-HER2 therapy or hormonal therapy. Non-responders were selected among those who did not respond. Matched breast tumor tissue (somatic DNA) and blood samples (germline DNA) were collected from a total of 18 responders (12 ER+, 6 HER2+) and 8 non-responders (6 ER+, 1 HER2+, 1 TNBC). Whole exome sequencing using Illumina HiSeq2500 was performed on the 26 patients (52 samples). Somatic single nucleotide variants (SNVs), indels and copy number variants (CNVs) were identified for each patient genome. Group specific somatic variants and mutation burden were statistically analyzed.
Findings: Cancer exomes were characterized by 1,455 somatic single-nucleotide variants (1,327 missense, 80 nonsense, 36 splice-site, 12 start/stop-lost), 149 insertions/deletions (108 frameshift, 41 inframe), with a median of 1 mutations per Mb (0.2 to 2.7 mutations per Mb) in all patients. Responders harbored a significantly lower non-synonymous mutation burden than non-responders (median, 27 vs. 90.5, P=0.01), and copy number variation burden was also lower (median 23 vs. 31, P=0.14). Multivariate analyses of factors influencing progression-free survival showed that high mutation burden and visceral metastases were significantly related with progression.
Interpretation: Extreme responders of metastatic breast cancer are characterized by low nonsynonymous mutational burden.
Citation Format: Sohn J, Lim SM, Kim E, Kim S, Koo JS, Kim SI, Park S, Park HS, Kwon N-J, Kim GM, Kim S. Whole exome sequencing of extreme responders reveals low mutation burden in metastatic breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-05-07.
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Affiliation(s)
- J Sohn
- Yonsei University College of Medicine; CHA Bundang Medical Center; Macrogen
| | - SM Lim
- Yonsei University College of Medicine; CHA Bundang Medical Center; Macrogen
| | - E Kim
- Yonsei University College of Medicine; CHA Bundang Medical Center; Macrogen
| | - S Kim
- Yonsei University College of Medicine; CHA Bundang Medical Center; Macrogen
| | - JS Koo
- Yonsei University College of Medicine; CHA Bundang Medical Center; Macrogen
| | - SI Kim
- Yonsei University College of Medicine; CHA Bundang Medical Center; Macrogen
| | - S Park
- Yonsei University College of Medicine; CHA Bundang Medical Center; Macrogen
| | - HS Park
- Yonsei University College of Medicine; CHA Bundang Medical Center; Macrogen
| | - N-J Kwon
- Yonsei University College of Medicine; CHA Bundang Medical Center; Macrogen
| | - GM Kim
- Yonsei University College of Medicine; CHA Bundang Medical Center; Macrogen
| | - S Kim
- Yonsei University College of Medicine; CHA Bundang Medical Center; Macrogen
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Schmid P, Dent R, Sohn J, Park YH, Muñoz-Couselo E, Kim SB, Im SA, Holgado E, Chen E, Dang T, Aktan G, Cortés J. Abstract PD6-12: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd6-12] [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
This abstract was withdrawn by the authors.
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Affiliation(s)
- P Schmid
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - R Dent
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - J Sohn
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - YH Park
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - E Muñoz-Couselo
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - S-B Kim
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - S-A Im
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - E Holgado
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - E Chen
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - T Dang
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - G Aktan
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - J Cortés
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
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Sohn J, Sharma P, Dirix L, Allison J, Ben Y, Kataria R, Ferro S, Asubonteng K, Oh DY. Abstract P1-08-03: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-08-03] [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
This abstract was withdrawn by the authors.
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Affiliation(s)
- J Sohn
- Yonsei University Severance Hospital, Seoul, Korea; The University of Texas MD Anderson Cancer Center, Houston, TX; AZ Sint Augustinus, Antwerp, Belgium; AstraZeneca, Gaithersburg, MD; Seoul National University Hospital, Seoul, Korea
| | - P Sharma
- Yonsei University Severance Hospital, Seoul, Korea; The University of Texas MD Anderson Cancer Center, Houston, TX; AZ Sint Augustinus, Antwerp, Belgium; AstraZeneca, Gaithersburg, MD; Seoul National University Hospital, Seoul, Korea
| | - L Dirix
- Yonsei University Severance Hospital, Seoul, Korea; The University of Texas MD Anderson Cancer Center, Houston, TX; AZ Sint Augustinus, Antwerp, Belgium; AstraZeneca, Gaithersburg, MD; Seoul National University Hospital, Seoul, Korea
| | - J Allison
- Yonsei University Severance Hospital, Seoul, Korea; The University of Texas MD Anderson Cancer Center, Houston, TX; AZ Sint Augustinus, Antwerp, Belgium; AstraZeneca, Gaithersburg, MD; Seoul National University Hospital, Seoul, Korea
| | - Y Ben
- Yonsei University Severance Hospital, Seoul, Korea; The University of Texas MD Anderson Cancer Center, Houston, TX; AZ Sint Augustinus, Antwerp, Belgium; AstraZeneca, Gaithersburg, MD; Seoul National University Hospital, Seoul, Korea
| | - R Kataria
- Yonsei University Severance Hospital, Seoul, Korea; The University of Texas MD Anderson Cancer Center, Houston, TX; AZ Sint Augustinus, Antwerp, Belgium; AstraZeneca, Gaithersburg, MD; Seoul National University Hospital, Seoul, Korea
| | - S Ferro
- Yonsei University Severance Hospital, Seoul, Korea; The University of Texas MD Anderson Cancer Center, Houston, TX; AZ Sint Augustinus, Antwerp, Belgium; AstraZeneca, Gaithersburg, MD; Seoul National University Hospital, Seoul, Korea
| | - K Asubonteng
- Yonsei University Severance Hospital, Seoul, Korea; The University of Texas MD Anderson Cancer Center, Houston, TX; AZ Sint Augustinus, Antwerp, Belgium; AstraZeneca, Gaithersburg, MD; Seoul National University Hospital, Seoul, Korea
| | - D-Y Oh
- Yonsei University Severance Hospital, Seoul, Korea; The University of Texas MD Anderson Cancer Center, Houston, TX; AZ Sint Augustinus, Antwerp, Belgium; AstraZeneca, Gaithersburg, MD; Seoul National University Hospital, Seoul, Korea
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Park J, Park D, Sohn J, Shin J. Cardiac diastolic dysfunction correlates with the CTG trinucleotide repeat length in ambulatory myotonic dystrophy 1. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Di Leo A, Toi M, Campone M, Sohn J, Paluch-Shimon S, Huober J, Park I, Tredan O, Chen SC, Manso L, Freedman O, Jaliffe G, Forrester T, Frenzel M, Barriga S, Smith I, Bourayou N, Goetz M. MONARCH 3: Abemaciclib as initial therapy for patients with HR+/HER2- advanced breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.008] [Citation(s) in RCA: 8] [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] [Indexed: 11/14/2022] Open
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Park Y, Lee KH, Sohn J, Lee K, Jung K, Kim J, Lee K, Ahn J, Kim TY, Kim G, Park I, Kim SB, Kim S, Han H, Im YH, Ahn J, Kim JY, Kang J, Im SA. A phase II trial of pan-HER inhibitor Poziotinib, in patients with HER2-positive metastatic breast cancer who have received at least two prior HER2-directed regimens: The results of NOV120101-203 trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.001] [Citation(s) in RCA: 2] [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: 11/13/2022] Open
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Yardley D, Hurvitz S, Jiang ZF, Toi M, Burris H, Buyse M, Slamon D, Makhson A, Elsaid A, Lerzo G, Hellerstedt B, Nuzzo F, Sohn J, Manzyuk L, Cabaribere D, Lincy J, Weimann A, Noel-Baron F, Pacaud L, Andre F. Abstract P4-22-13: Everolimus plus trastuzumab and paclitaxel as first-line therapy in women with HER2+ advanced breast cancer: Overall survival results from BOLERO-1. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-22-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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
Everolimus (EVE), an mTOR inhibitor has shown activity in HER2+ advanced breast cancer (ABC) in both preclinical and clinical studies. In the pivotal BOLERO-1 trial (NCT00876395), the progression-free survival (PFS) was not significantly different between the EVE + trastuzumab (TRAS) + paclitaxel (PAC) combination and placebo (PBO) + TRAS + PAC in the full HER2+ population (EVE, 15.0 mo vs PBO, 14.5 mo; HR=0.89; 95% CI: 0.73-1.08; p=0.1166). Although not reaching protocol defined level for statistical significance, the hormone receptor negative (HR-) subpopulation appeared to benefit from EVE, with a 7.2 mo PFS benefit vs PBO arm (EVE, 20.3 mo vs PBO, 13.1 mo; HR=0.66; 95% CI: 0.48-0.91; p=0.0049). The final exploratory overall survival (OS) analysis from the study is presented here.
Methods
In this phase 3 randomized trial, 719 women with HER2+ ABC without prior TRAS or chemotherapy in the metastatic setting were randomized 2:1 to receive either EVE (10 mg/d) or placebo (PBO) and weekly PAC+TRAS, stratified by visceral metastasis (lung, liver, peritoneal or pleural: yes vs no) and prior adjuvant or neo-adjuvant treatment with TRAS (yes vs no). As the primary objectives (PFS on full population and on HR- subpopulation) of BOLERO-1 were not met, the key secondary endpoint of OS was not formally statistically tested. However, given the results of PFS, in particular in the HR- subpopulation, a change to the OS analysis plan was made by introducing one final exploratory OS analysis at the time of study termination.
Results
At data cutoff (Dec 31, 2015), the median duration of exposure was 40.8 weeks (range: 0.6-320.4) in the EVE arm and 48.1 weeks (range: 1.1-308.0) in the PBO arm. After a median follow-up of 60.3 mo, 350 deaths were recorded in the full population, 238 (49.6%) in the EVE arm and 112 (46.9%) pts in the PBO arm. In the full population, the median OS was comparable in the EVE vs PBO arms (48.6 mo vs 50.0 mo respectively; HR = 1.13; 95% CI: 0.90-1.42). In the HR- subpopulation, 138 deaths were recorded; 88 (42.3%) pts in the EVE arm and 50 (48.5%) pts in the PBO arm. In the HR- subpopulation, the median OS in the EVE arm was longer compared to PBO arm (57.0 mo vs 41.6 mo respectively; HR = 0.83; 95% CI: 0.59-1.18). Stomatitis, diarrhea, alopecia, cough, rash, pyrexia, neutropenia, and fatigue were the most frequent adverse events (AEs) reported in EVE arm (≥35%). AEs leading to dose interruption and/or change were reported in 441 (93.4%) pts in EVE arm and 165 (69.3%) pts in the PBO arm respectively. Overall, AEs leading to treatment discontinuation were reported in 262 (55.5%) pts in EVE arm and 98 (41.2%) pts in PBO arm. Serious AEs were reported in 171 (36.2%) pts in the EVE arm and 40 (16.8%) pts in the PBO arm respectively. On treatment AE related deaths were reported for 3.6% pts in the EVE arm and 0% pts in the PBO arm.
Conclusions
The median OS was similar in the EVE vs PBO arms for overall population. However, a prolongation of 15.4 mo in median OS of HR- subpopulation was observed in the EVE arm vs PBO arm in this exploratory analysis. Pts in the EVE arm had a manageable safety, consistent with the safety profile of EVE and no new safety signals were identified.
Citation Format: Yardley D, Hurvitz S, Jiang Z-f, Toi M, Burris H, Buyse M, Slamon D, Makhson A, Elsaid A, Lerzo G, Hellerstedt B, Nuzzo F, Sohn J, Manzyuk L, Cabaribere D, Lincy J, Weimann A, Noel-Baron F, Pacaud L, Andre F. Everolimus plus trastuzumab and paclitaxel as first-line therapy in women with HER2+ advanced breast cancer: Overall survival results from BOLERO-1 [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-22-13.
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Affiliation(s)
- D Yardley
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - S Hurvitz
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - Z-f Jiang
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - M Toi
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - H Burris
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - M Buyse
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - D Slamon
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - A Makhson
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - A Elsaid
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - G Lerzo
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - B Hellerstedt
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - F Nuzzo
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - J Sohn
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - L Manzyuk
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - D Cabaribere
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - J Lincy
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - A Weimann
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - F Noel-Baron
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - L Pacaud
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
| | - F Andre
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Beijing 307 Hospital of PLA, Beijing, China; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Sarah Cannon Research Institute, Nashville, TN; International Drug Development Institute (IDDI), Louvain La Neuve, Belgium; University of California, Los Angeles (UCLA), Angeles, CA; Moscow Municipal Hospital No. 62, Moscow, Russian Federation; Clinical Research Centre, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Sanatorio de la Providencia, Buenos aires, Argentina; Texas Oncology, Austin, TX; IRCCS Fondazione G. Pascale, Dipartimento di Senologia, Napoli, Italy; Severance Hospital, Yonsei University Health System, Seoul, Korea; Russian Cancer Research Centre, Moscow, Russian Federation; Translational Research in Oncology (TRIO), Paris, France; Novartis Pharma AG, Basel, Switzerland; Institut Gustave Roussy, Université Paris Sud, Villejuif, France
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Ku H, Jung Y, Jo M, Park S, Kim S, Yang D, Rhee K, An EM, Sohn J, Kwon K. Recycling of spent lithium-ion battery cathode materials by ammoniacal leaching. J Hazard Mater 2016; 313:138-146. [PMID: 27060219 DOI: 10.1016/j.jhazmat.2016.03.062] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/03/2016] [Accepted: 03/23/2016] [Indexed: 06/05/2023]
Abstract
As the production and consumption of lithium ion batteries (LIBs) increase, the recycling of spent LIBs appears inevitable from an environmental, economic and health viewpoint. The leaching behavior of Ni, Mn, Co, Al and Cu from treated cathode active materials, which are separated from a commercial LIB pack in hybrid electric vehicles, is investigated with ammoniacal leaching agents based on ammonia, ammonium carbonate and ammonium sulfite. Ammonium sulfite as a reductant is necessary to enhance leaching kinetics particularly in the ammoniacal leaching of Ni and Co. Ammonium carbonate can act as a pH buffer so that the pH of leaching solution changes little during leaching. Co and Cu can be fully leached out whereas Mn and Al are hardly leached and Ni shows a moderate leaching efficiency. It is confirmed that the cathode active materials are a composite of LiMn2O4, LiCoxMnyNizO2, Al2O3 and C while the leach residue is composed of LiNixMnyCozO2, LiMn2O4, Al2O3, MnCO3 and Mn oxides. Co recovery via the ammoniacal leaching is believed to gain a competitive edge on convenitonal acid leaching both by reducing the sodium hydroxide expense for increasing the pH of leaching solution and by removing the separation steps of Mn and Al.
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Affiliation(s)
- Heesuk Ku
- Department of Energy & Mineral Resources Engineering, Sejong University, Seoul 05006, Republic of Korea
| | - Yeojin Jung
- Department of Energy & Mineral Resources Engineering, Sejong University, Seoul 05006, Republic of Korea
| | - Minsang Jo
- Department of Energy & Mineral Resources Engineering, Sejong University, Seoul 05006, Republic of Korea
| | - Sanghyuk Park
- Department of Energy & Mineral Resources Engineering, Sejong University, Seoul 05006, Republic of Korea
| | - Sookyung Kim
- Urban Mine Department, Korea Institute of Geoscience and Mineral Resources, 124 Gwahang-no, Yuseong-gu, Daejeon, Republic of Korea
| | - Donghyo Yang
- Urban Mine Department, Korea Institute of Geoscience and Mineral Resources, 124 Gwahang-no, Yuseong-gu, Daejeon, Republic of Korea.
| | - Kangin Rhee
- Urban Mine Department, Korea Institute of Geoscience and Mineral Resources, 124 Gwahang-no, Yuseong-gu, Daejeon, Republic of Korea
| | - Eung-Mo An
- Urban Mine Department, Korea Institute of Geoscience and Mineral Resources, 124 Gwahang-no, Yuseong-gu, Daejeon, Republic of Korea
| | - Jeongsoo Sohn
- Urban Mine Department, Korea Institute of Geoscience and Mineral Resources, 124 Gwahang-no, Yuseong-gu, Daejeon, Republic of Korea
| | - Kyungjung Kwon
- Department of Energy & Mineral Resources Engineering, Sejong University, Seoul 05006, Republic of Korea.
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46
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Monroe J, Boparai K, Xiao Y, Followill D, Galvin J, Sohn J. SU-F-P-13: NRG Oncology Medical Physics Manpower Survey Quantifying Support Demands for Multi Institutional Clinical Trials. Med Phys 2016. [DOI: 10.1118/1.4955720] [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: 11/07/2022] Open
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Kim S, Kim H, Lee S, Awan M, Rangaraj D, Zheng Y, Monroe J, Partel R, Lo S, Machtay M, Sloan A, Sohn J. SU-F-T-599: Volume-Independent Conformity Index for Stereotactic Brain Tumors. Med Phys 2016. [DOI: 10.1118/1.4956784] [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: 11/07/2022] Open
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Lee S, Zheng Y, Albani D, Colussi V, Dorth J, Sohn J. SU-F-J-121: Dosimetric Evaluation of Active Breathing Coordinator-Response Gating System Linked to Linear Accelerator in Volumetric Modulated Arc Therapy. Med Phys 2016. [DOI: 10.1118/1.4956029] [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: 11/07/2022] Open
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Kim HJ, Lee MH, Lee JE, Park SH, Lee ES, Kang YJ, Lee JH, Shin HN, Kim SI, Im SA, Ahn SH, Lee KS, Sohn J, Han W, Nam SJ. Abstract P1-12-09: The oncologic effect of a gonadotropin releasing hormone (GnRH) agonist for ovarian protection during breast cancer chemotherapy. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-12-09] [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: Recently, chemotherapy with a GnRH agonist was reported to protect against ovarian failure. This study was aimed at determining the oncologic effect of a GnRH agonist concurrent with chemotherapy for breast cancer patients.
Patients and Methods: A total of 1189 patients aged 20 to 40 years with stage I to III breast cancer who received (neo or adjuvant) chemotherapy from five hospitals in Korea from 2002 to 2012 were reviewed. A gonadotropin releasing hormone (GnRH) agonist was given to 410 patients for ovarian protection during chemotherapy (GnRH agonist group), and 779 patients received chemotherapy without ovarian protection (Chemotherapy alone group). A matching strategy was used to create matched sets of two groups by age, stage, hormone receptor status, Her2/neu status, neo or adjuvant chemotherapy, and institute.
Results: Survival analysis using Cox regression showed that the GnRH agonist group had better distant metastatic-free survival (HR=0.65, 95%CI 0.44-0.97) outcomes but similar disease free survival (HR=0.78, 95% CI 0.57-1.08) compared with the chemotherapy alone group. The survival benefit was significant for hormone receptor positive, Her2/neu negative breast cancer on distant metastasis (HR=0.44, 95% CI 0.20-0.99) and disease free survival (HR0.47 95% CI 0.23-0.93).
Conclusion: Ovarian protection using a GnRH agonist can be safely considered for premenopausal breast cancer patients for whom chemotherapy is planned.
Citation Format: Kim HJ, Lee MH, Lee JE, Park SH, Lee ES, Kang Y-J, Lee JH, Shin HN, Kim SI, Im SA, Ahn SH, Lee KS, Sohn J, Han W, Nam SJ. The oncologic effect of a gonadotropin releasing hormone (GnRH) agonist for ovarian protection during breast cancer chemotherapy. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-12-09.
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Affiliation(s)
- HJ Kim
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - MH Lee
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - JE Lee
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - SH Park
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - ES Lee
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - Y-J Kang
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - JH Lee
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - HN Shin
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - SI Kim
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - SA Im
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - SH Ahn
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - KS Lee
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - J Sohn
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - W Han
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
| | - SJ Nam
- Division of Breast and Endocrine, College of Medicine, University of Ulsan, Asan Medical Center; Seoul National University College of Medicine, Seoul; Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea; Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, Research Institute and Hospital, National Cancer Center, Goyang, Korea; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea; Seoul National University College of Medicine; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Medical Oncology, Yonsei University College of Medicine
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Im YH, Uslu R, Lee KS, Nagarkar R, Sohn J, Sevinc A, Altundag K, Chang YC, Abdel-Razeq H, Im SA, Jeong J, Park HY, Arpornwirat W, Bastick P, Le TH, Ocak Arikan O, Xue HL, Canatar A, Valenti R, Kim SB. Abstract P4-13-09: Clinical effectiveness of everolimus and exemestane in advanced breast cancer patients from Asia and Africa: First efficacy and updated safety results from the phase IIIb EVEREXES study. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
BOLERO-2 phase III trial established the efficacy of everolimus (EVE) plus exemestane (EXE) for the treatment of postmenopausal patients with hormone receptor (HR)-positive, HER2-negative, advanced breast cancer (aBC). However, in this study only a minority (<10%) of patients were recruited from African and Asia Pacific countries. Considering the potential effects of ethnic and cultural differences on treatment effectiveness, it remains compelling to confirm the safety and efficacy profile of EVE+EXE in these populations.
Methods
EVEREXES is an open-label phase IIIb, single arm, multi-center trial, which from March 2013 to October 2014 enrolled 232 post-menopausal, HR-positive and HER2-negative, aBC patients previously treated with aromatase inhibitors, across 13 countries in Asia Pacific, Middle East, North and South Africa, with a significant majority of patients being of Asian ethnicity (196, 84.5%). Its primary objective was to investigate the safety and tolerability profile of EVE+EXE. Secondary objectives were the evaluation of efficacy (assessed by PFS, ORR, and CBR based on RECIST 1.1 criteria) and change in ECOG performance status.
Results
At data cut off of 31st of January 2015, at a median follow up of 11.7 months, median PFS for the ITT population was 9.5 months [9.2-11.6 months], based on local assessment, with the observation of 1 (0.4%) CR and 35 (15.4%) PR. Regarding safety and tolerability, a majority (81.1%) of grade (G) 1/2 adverse events (AEs) was reported. In particular, the following pattern was observed in terms of % of patients who developed G1/G2/G3 mTOR-inhibition induced AEs: stomatitis (36.1, 13.7, 10.6), rash (21.6/6.2/0), fatigue (10.6, 4.4, 2.2), hyperglycemia (6.2, 11.5, 7.0), weight decrease (7.5, 7, 0.9), pneumonitis (5.7, 7, 0.9). No Grade 4 AEs related to EVE+EXE treatment were observed, with exception of one case of non infectious pneumonitis (0.4%). Median dose intensity of everolimus was 9.2 mg/day.
Conclusions
Efficacy and safety results from EVEREXES trial further confirm the role of EVE+EXE for the treatment of HR+/Her2- advanced BC patients in Eastern countries. Results were consistent with data previously reported in BOLERO-2 trial.
Citation Format: Im Y-H, Uslu R, Lee KS, Nagarkar R, Sohn J, Sevinc A, Altundag K, Chang Y-C, Abdel-Razeq H, Im S-A, Jeong J, Park HY, Arpornwirat W, Bastick P, Le TH, Ocak Arikan O, Xue HL, Canatar A, Valenti R, Kim S-B. Clinical effectiveness of everolimus and exemestane in advanced breast cancer patients from Asia and Africa: First efficacy and updated safety results from the phase IIIb EVEREXES study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-09.
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Affiliation(s)
- Y-H Im
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - R Uslu
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - KS Lee
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - R Nagarkar
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Sohn
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - A Sevinc
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - K Altundag
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Y-C Chang
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H Abdel-Razeq
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S-A Im
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Jeong
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - HY Park
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - W Arpornwirat
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - P Bastick
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - TH Le
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - O Ocak Arikan
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - HL Xue
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - A Canatar
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - R Valenti
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S-B Kim
- Samsung Medical Center, Seoul, Korea; Ege University Medical Faculty, Izmir, Turkey; National Cancer Center, Gyeonggi-do, Korea; Curie Manavata Cancer Centre, Nashik, India; Severance Hospital, Yonsei University Health System, Soul, Korea; Gaziantep University Gaziantep Oncology Hospital, Gaziantep, Turkey; Hacettepe University Medical Faculty, Ankara, Turkey; Mackay Memorial Hospital, Taipei, Taiwan; King Hussein Cancer Center, Amman, Jordan; Seoul National University Hospital, Seoul, Korea; Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea; Kyungpook National University Medical Center, Daegu, Korea; National Cancer Institute, Bangkok, Thailand; Sutherland Hospital, Caringbah, Australia; Cho Ray Hospital, Ho Chí Minh, Viet Nam; Novartis Pharma AG, Basel, Switzerland; 1Novartis Asia Pacific Pharmaceuticals Pte. Ltd, Singapore, Singapore; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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