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Gunjur A, Shao Y, Rozday T, Klein O, Mu A, Haak BW, Markman B, Kee D, Carlino MS, Underhill C, Frentzas S, Michael M, Gao B, Palmer J, Cebon J, Behren A, Adams DJ, Lawley TD. A gut microbial signature for combination immune checkpoint blockade across cancer types. Nat Med 2024; 30:797-809. [PMID: 38429524 PMCID: PMC10957475 DOI: 10.1038/s41591-024-02823-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/12/2024] [Indexed: 03/03/2024]
Abstract
Immune checkpoint blockade (ICB) targeting programmed cell death protein 1 (PD-1) and cytotoxic T lymphocyte protein 4 (CTLA-4) can induce remarkable, yet unpredictable, responses across a variety of cancers. Studies suggest that there is a relationship between a cancer patient's gut microbiota composition and clinical response to ICB; however, defining microbiome-based biomarkers that generalize across cohorts has been challenging. This may relate to previous efforts quantifying microbiota to species (or higher taxonomic rank) abundances, whereas microbial functions are often strain specific. Here, we performed deep shotgun metagenomic sequencing of baseline fecal samples from a unique, richly annotated phase 2 trial cohort of patients with diverse rare cancers treated with combination ICB (n = 106 discovery cohort). We demonstrate that strain-resolved microbial abundances improve machine learning predictions of ICB response and 12-month progression-free survival relative to models built using species-rank quantifications or comprehensive pretreatment clinical factors. Through a meta-analysis of gut metagenomes from a further six comparable studies (n = 364 validation cohort), we found cross-cancer (and cross-country) validity of strain-response signatures, but only when the training and test cohorts used concordant ICB regimens (anti-PD-1 monotherapy or combination anti-PD-1 plus anti-CTLA-4). This suggests that future development of gut microbiome diagnostics or therapeutics should be tailored according to ICB treatment regimen rather than according to cancer type.
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Affiliation(s)
- Ashray Gunjur
- Host-Microbiota Interactions Laboratory, Wellcome Sanger Institute, Hinxton, UK.
- Experimental Cancer Genetics, Wellcome Sanger Institute, Hinxton, UK.
| | - Yan Shao
- Host-Microbiota Interactions Laboratory, Wellcome Sanger Institute, Hinxton, UK
| | - Timothy Rozday
- Host-Microbiota Interactions Laboratory, Wellcome Sanger Institute, Hinxton, UK
| | - Oliver Klein
- Olivia Newton-John Cancer Research Institute, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia
- Department of Medical Oncology, Austin Health, Melbourne, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Andre Mu
- Host-Microbiota Interactions Laboratory, Wellcome Sanger Institute, Hinxton, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK
| | - Bastiaan W Haak
- Host-Microbiota Interactions Laboratory, Wellcome Sanger Institute, Hinxton, UK
- Center for Experimental and Molecular Medicine, Amsterdam UMC, Amsterdam, Netherlands
| | - Ben Markman
- Department of Medical Oncology, Monash Health, Melbourne, Victoria, Australia
- Department of Medical Oncology, Alfred Health, Melbourne, Victoria, Australia
- School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
| | - Damien Kee
- Department of Medical Oncology, Austin Health, Melbourne, Victoria, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Rare Cancer Laboratory, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Matteo S Carlino
- Department of Medical Oncology, Blacktown and Westmead Hospitals, Sydney, New South Wales, Australia
- Melanoma Institute of Australia, University of Sydney, Sydney, New South Wales, Australia
| | - Craig Underhill
- Border Medical Oncology and Haematology Research Unit, Albury-Wodonga Regional Cancer Centre, Albury-Wodonga, New South Wales, Australia
- Rural Medical School, University of New South Wales, Albury, New South Wales, Australia
| | - Sophia Frentzas
- Department of Medical Oncology, Monash Health, Melbourne, Victoria, Australia
| | - Michael Michael
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Bo Gao
- Department of Medical Oncology, Blacktown and Westmead Hospitals, Sydney, New South Wales, Australia
| | - Jodie Palmer
- Olivia Newton-John Cancer Research Institute, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia
- Department of Medical Oncology, Austin Health, Melbourne, Victoria, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia
| | - David J Adams
- Experimental Cancer Genetics, Wellcome Sanger Institute, Hinxton, UK
| | - Trevor D Lawley
- Host-Microbiota Interactions Laboratory, Wellcome Sanger Institute, Hinxton, UK.
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Klein O, Palmer J, Behren A, Cebon J, Kee D. Durable response to combination immunotherapy using nivolumab and ipilimumab in metastatic succinate dehydrogenase (SDH)-deficient gastrointestinal stroma tumour. Eur J Cancer 2023; 194:113351. [PMID: 37827066 DOI: 10.1016/j.ejca.2023.113351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/04/2023] [Accepted: 09/10/2023] [Indexed: 10/14/2023]
Affiliation(s)
- Oliver Klein
- Department of Medical Oncology, Austin Health, Melbourne, Victoria, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia.
| | - Jodie Palmer
- Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia
| | - Jonathan Cebon
- Department of Medical Oncology, Austin Health, Melbourne, Victoria, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia
| | - Damien Kee
- Department of Medical Oncology, Austin Health, Melbourne, Victoria, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Klein O, Kee D, Nagrial A, Markman B, Underhill C, Michael M, Behren A, Palmer J, Tebbutt NC, Carlino MS, Cebon J. Is there a role for combined anti-PD-1/CTLA-4 checkpoint blockade in the management of advanced biliary tract cancers? Cancer 2023; 129:1129-1130. [PMID: 36692958 DOI: 10.1002/cncr.34660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Oliver Klein
- Department of Medical Oncology, Austin Health, Heidelberg, Victoria, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
| | - Damien Kee
- Department of Medical Oncology, Austin Health, Heidelberg, Victoria, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Adnan Nagrial
- Blacktown Hospital, Blacktown, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia
| | - Ben Markman
- Department of Medical Oncology, Alfred Health, Prahran, Victoria, Australia.,Monash University, Melbourne, Victoria, Australia
| | - Craig Underhill
- Albury-Wodonga Regional Cancer Centre, Albury-Wodonga, New South Wales, Australia
| | - Michael Michael
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia
| | - Jodie Palmer
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia
| | - Niall C Tebbutt
- Department of Medical Oncology, Austin Health, Heidelberg, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia
| | - Matteo S Carlino
- Blacktown Hospital, Blacktown, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia
| | - Jonathan Cebon
- Department of Medical Oncology, Austin Health, Heidelberg, Victoria, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia
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Gerstung M, Jolly C, Leshchiner I, Dentro SC, Gonzalez S, Rosebrock D, Mitchell TJ, Rubanova Y, Anur P, Yu K, Tarabichi M, Deshwar A, Wintersinger J, Kleinheinz K, Vázquez-García I, Haase K, Jerman L, Sengupta S, Macintyre G, Malikic S, Donmez N, Livitz DG, Cmero M, Demeulemeester J, Schumacher S, Fan Y, Yao X, Lee J, Schlesner M, Boutros PC, Bowtell DD, Zhu H, Getz G, Imielinski M, Beroukhim R, Sahinalp SC, Ji Y, Peifer M, Markowetz F, Mustonen V, Yuan K, Wang W, Morris QD, Spellman PT, Wedge DC, Van Loo P, Tarabichi M, Wintersinger J, Deshwar AG, Yu K, Gonzalez S, Rubanova Y, Macintyre G, Adams DJ, Anur P, Beroukhim R, Boutros PC, Bowtell DD, Campbell PJ, Cao S, Christie EL, Cmero M, Cun Y, Dawson KJ, Demeulemeester J, Donmez N, Drews RM, Eils R, Fan Y, Fittall M, Garsed DW, Getz G, Ha G, Imielinski M, Jerman L, Ji Y, Kleinheinz K, Lee J, Lee-Six H, Livitz DG, Malikic S, Markowetz F, Martincorena I, Mitchell TJ, Mustonen V, Oesper L, Peifer M, Peto M, Raphael BJ, Rosebrock D, Sahinalp SC, Salcedo A, Schlesner M, Schumacher S, Sengupta S, Shi R, Shin SJ, Spiro O, Pitkänen E, Pivot X, Piñeiro-Yáñez E, Planko L, Plass C, Polak P, Pons T, Popescu I, Potapova O, Prasad A, Stein LD, Preston SR, Prinz M, Pritchard AL, Prokopec SD, Provenzano E, Puente XS, Puig S, Puiggròs M, Pulido-Tamayo S, Pupo GM, Vázquez-García I, Purdie CA, Quinn MC, Rabionet R, Rader JS, Radlwimmer B, Radovic P, Raeder B, Raine KM, Ramakrishna M, Ramakrishnan K, Vembu S, Ramalingam S, Raphael BJ, Rathmell WK, Rausch T, Reifenberger G, Reimand J, Reis-Filho J, Reuter V, Reyes-Salazar I, Reyna MA, Wheeler DA, Reynolds SM, Rheinbay E, Riazalhosseini Y, Richardson AL, Richter J, Ringel M, Ringnér M, Rino Y, Rippe K, Roach J, Yang TP, Roberts LR, Roberts ND, Roberts SA, Robertson AG, Robertson AJ, Rodriguez JB, Rodriguez-Martin B, Rodríguez-González FG, Roehrl MHA, Rohde M, Yao X, Rokutan H, Romieu G, Rooman I, Roques T, Rosebrock D, Rosenberg M, Rosenstiel PC, Rosenwald A, Rowe EW, Royo R, Yuan K, Rozen SG, Rubanova Y, Rubin MA, Rubio-Perez C, Rudneva VA, Rusev BC, Ruzzenente A, Rätsch G, Sabarinathan R, Sabelnykova VY, Zhu H, Sadeghi S, Sahinalp SC, Saini N, Saito-Adachi M, Saksena G, Salcedo A, Salgado R, Salichos L, Sallari R, Saller C, Wang W, Salvia R, Sam M, Samra JS, Sanchez-Vega F, Sander C, Sanders G, Sarin R, Sarrafi I, Sasaki-Oku A, Sauer T, Morris QD, Sauter G, Saw RPM, Scardoni M, Scarlett CJ, Scarpa A, Scelo G, Schadendorf D, Schein JE, Schilhabel MB, Schlesner M, Spellman PT, Schlomm T, Schmidt HK, Schramm SJ, Schreiber S, Schultz N, Schumacher SE, Schwarz RF, Scolyer RA, Scott D, Scully R, Wedge DC, Seethala R, Segre AV, Selander I, Semple CA, Senbabaoglu Y, Sengupta S, Sereni E, Serra S, Sgroi DC, Shackleton M, Van Loo P, Shah NC, Shahabi S, Shang CA, Shang P, Shapira O, Shelton T, Shen C, Shen H, Shepherd R, Shi R, Spellman PT, Shi Y, Shiah YJ, Shibata T, Shih J, Shimizu E, Shimizu K, Shin SJ, Shiraishi Y, Shmaya T, Shmulevich I, Wedge DC, Shorser SI, Short C, Shrestha R, Shringarpure SS, Shriver C, Shuai S, Sidiropoulos N, Siebert R, Sieuwerts AM, Sieverling L, Van Loo P, Signoretti S, Sikora KO, Simbolo M, Simon R, Simons JV, Simpson JT, Simpson PT, Singer S, Sinnott-Armstrong N, Sipahimalani P, Aaltonen LA, Skelly TJ, Smid M, Smith J, Smith-McCune K, Socci ND, Sofia HJ, Soloway MG, Song L, Sood AK, Sothi S, Abascal F, Sotiriou C, Soulette CM, Span PN, Spellman PT, Sperandio N, Spillane AJ, Spiro O, Spring J, Staaf J, Stadler PF, Abeshouse A, Staib P, Stark SG, Stebbings L, Stefánsson ÓA, Stegle O, Stein LD, Stenhouse A, Stewart C, Stilgenbauer S, Stobbe MD, Aburatani H, Stratton MR, Stretch JR, Struck AJ, Stuart JM, Stunnenberg HG, Su H, Su X, Sun RX, Sungalee S, Susak H, Adams DJ, Suzuki A, Sweep F, Szczepanowski M, Sültmann H, Yugawa T, Tam A, Tamborero D, Tan BKT, Tan D, Tan P, Agrawal N, Tanaka H, Taniguchi H, Tanskanen TJ, Tarabichi M, Tarnuzzer R, Tarpey P, Taschuk ML, Tatsuno K, Tavaré S, Taylor DF, Ahn KS, Taylor-Weiner A, Teague JW, Teh BT, Tembe V, Temes J, Thai K, Thayer SP, Thiessen N, Thomas G, Thomas S, Ahn SM, Thompson A, Thompson AM, Thompson JFF, Thompson RH, Thorne H, Thorne LB, Thorogood A, Tiao G, Tijanic N, Timms LE, Aikata H, Tirabosco R, Tojo M, Tommasi S, Toon CW, Toprak UH, Torrents D, Tortora G, Tost J, Totoki Y, Townend D, Akbani R, Traficante N, Treilleux I, Trotta JR, Trümper LHP, Tsao M, Tsunoda T, Tubio JMC, Tucker O, Turkington R, Turner DJ, Akdemir KC, Tutt A, Ueno M, Ueno NT, Umbricht C, Umer HM, Underwood TJ, Urban L, Urushidate T, Ushiku T, Uusküla-Reimand L, Al-Ahmadie H, Valencia A, Van Den Berg DJ, Van Laere S, Van Loo P, Van Meir EG, Van den Eynden GG, Van der Kwast T, Vasudev N, Vazquez M, Vedururu R, Al-Sedairy ST, Veluvolu U, Vembu S, Verbeke LPC, Vermeulen P, Verrill C, Viari A, Vicente D, Vicentini C, VijayRaghavan K, Viksna J, Al-Shahrour F, Vilain RE, Villasante I, Vincent-Salomon A, Visakorpi T, Voet D, Vyas P, Vázquez-García I, Waddell NM, Waddell N, Wadelius C, Alawi M, Wadi L, Wagener R, Wala JA, Wang J, Wang J, Wang L, Wang Q, Wang W, Wang Y, Wang Z, Albert M, Waring PM, Warnatz HJ, Warrell J, Warren AY, Waszak SM, Wedge DC, Weichenhan D, Weinberger P, Weinstein JN, Weischenfeldt J, Aldape K, Weisenberger DJ, Welch I, Wendl MC, Werner J, Whalley JP, Wheeler DA, Whitaker HC, Wigle D, Wilkerson MD, Williams A, Alexandrov LB, Wilmott JS, Wilson GW, Wilson JM, Wilson RK, Winterhoff B, Wintersinger JA, Wiznerowicz M, Wolf S, Wong BH, Wong T, Ally A, Wong W, Woo Y, Wood S, Wouters BG, Wright AJ, Wright DW, Wright MH, Wu CL, Wu DY, Wu G, Alsop K, Wu J, Wu K, Wu Y, Wu Z, Xi L, Xia T, Xiang Q, Xiao X, Xing R, Xiong H, Alvarez EG, Xu Q, Xu Y, Xue H, Yachida S, Yakneen S, Yamaguchi R, Yamaguchi TN, Yamamoto M, Yamamoto S, Yamaue H, Amary F, Yang F, Yang H, Yang JY, Yang L, Yang L, Yang S, Yang TP, Yang Y, Yao X, Yaspo ML, Amin SB, Yates L, Yau C, Ye C, Ye K, Yellapantula VD, Yoon CJ, Yoon SS, Yousif F, Yu J, Yu K, Aminou B, Yu W, Yu Y, Yuan K, Yuan Y, Yuen D, Yung CK, Zaikova O, Zamora J, Zapatka M, Zenklusen JC, Ammerpohl O, Zenz T, Zeps N, Zhang CZ, Zhang F, Zhang H, Zhang H, Zhang H, Zhang J, Zhang J, Zhang J, Anderson MJ, Zhang X, Zhang X, Zhang Y, Zhang Z, Zhao Z, Zheng L, Zheng X, Zhou W, Zhou Y, Zhu B, Ang Y, Zhu H, Zhu J, Zhu S, Zou L, Zou X, deFazio A, van As N, van Deurzen CHM, van de Vijver MJ, van’t Veer L, Antonello D, von Mering C, Anur P, Aparicio S, Appelbaum EL, Arai Y, Aretz A, Arihiro K, Ariizumi SI, Armenia J, Arnould L, Asa S, Assenov Y, Atwal G, Aukema S, Auman JT, Aure MRR, Awadalla P, Aymerich M, Bader GD, Baez-Ortega A, Bailey MH, Bailey PJ, Balasundaram M, Balu S, Bandopadhayay P, Banks RE, Barbi S, Barbour AP, Barenboim J, Barnholtz-Sloan J, Barr H, Barrera E, Bartlett J, Bartolome J, Bassi C, Bathe OF, Baumhoer D, Bavi P, Baylin SB, Bazant W, Beardsmore D, Beck TA, Behjati S, Behren A, Niu B, Bell C, Beltran S, Benz C, Berchuck A, Bergmann AK, Bergstrom EN, Berman BP, Berney DM, Bernhart SH, Beroukhim R, Berrios M, Bersani S, Bertl J, Betancourt M, Bhandari V, Bhosle SG, Biankin AV, Bieg M, Bigner D, Binder H, Birney E, Birrer M, Biswas NK, Bjerkehagen B, Bodenheimer T, Boice L, Bonizzato G, De Bono JS, Boot A, Bootwalla MS, Borg A, Borkhardt A, Boroevich KA, Borozan I, Borst C, Bosenberg M, Bosio M, Boultwood J, Bourque G, Boutros PC, Bova GS, Bowen DT, Bowlby R, Bowtell DDL, Boyault S, Boyce R, Boyd J, Brazma A, Brennan P, Brewer DS, Brinkman AB, Bristow RG, Broaddus RR, Brock JE, Brock M, Broeks A, Brooks AN, Brooks D, Brors B, Brunak S, Bruxner TJC, Bruzos AL, Buchanan A, Buchhalter I, Buchholz C, Bullman S, Burke H, Burkhardt B, Burns KH, Busanovich J, Bustamante CD, Butler AP, Butte AJ, Byrne NJ, Børresen-Dale AL, Caesar-Johnson SJ, Cafferkey A, Cahill D, Calabrese C, Caldas C, Calvo F, Camacho N, Campbell PJ, Campo E, Cantù C, Cao S, Carey TE, Carlevaro-Fita J, Carlsen R, Cataldo I, Cazzola M, Cebon J, Cerfolio R, Chadwick DE, Chakravarty D, Chalmers D, Chan CWY, Chan K, Chan-Seng-Yue M, Chandan VS, Chang DK, Chanock SJ, Chantrill LA, Chateigner A, Chatterjee N, Chayama K, Chen HW, Chen J, Chen K, Chen Y, Chen Z, Cherniack AD, Chien J, Chiew YE, Chin SF, Cho J, Cho S, Choi JK, Choi W, Chomienne C, Chong Z, Choo SP, Chou A, Christ AN, Christie EL, Chuah E, Cibulskis C, Cibulskis K, Cingarlini S, Clapham P, Claviez A, Cleary S, Cloonan N, Cmero M, Collins CC, Connor AA, Cooke SL, Cooper CS, Cope L, Corbo V, Cordes MG, Cordner SM, Cortés-Ciriano I, Covington K, Cowin PA, Craft B, Craft D, Creighton CJ, Cun Y, Curley E, Cutcutache I, Czajka K, Czerniak B, Dagg RA, Danilova L, Davi MV, Davidson NR, Davies H, Davis IJ, Davis-Dusenbery BN, Dawson KJ, De La Vega FM, De Paoli-Iseppi R, Defreitas T, Tos APD, Delaneau O, Demchok JA, Demeulemeester J, Demidov GM, Demircioğlu D, Dennis NM, Denroche RE, Dentro SC, Desai N, Deshpande V, Deshwar AG, Desmedt C, Deu-Pons J, Dhalla N, Dhani NC, Dhingra P, Dhir R, DiBiase A, Diamanti K, Ding L, Ding S, Dinh HQ, Dirix L, Doddapaneni H, Donmez N, Dow MT, Drapkin R, Drechsel O, Drews RM, Serge S, Dudderidge T, Dueso-Barroso A, Dunford AJ, Dunn M, Dursi LJ, Duthie FR, Dutton-Regester K, Eagles J, Easton DF, Edmonds S, Edwards PA, Edwards SE, Eeles RA, Ehinger A, Eils J, Eils R, El-Naggar A, Eldridge M, Ellrott K, Erkek S, Escaramis G, Espiritu SMG, Estivill X, Etemadmoghadam D, Eyfjord JE, Faltas BM, Fan D, Fan Y, Faquin WC, Farcas C, Fassan M, Fatima A, Favero F, Fayzullaev N, Felau I, Fereday S, Ferguson ML, Ferretti V, Feuerbach L, Field MA, Fink JL, Finocchiaro G, Fisher C, Fittall MW, Fitzgerald A, Fitzgerald RC, Flanagan AM, Fleshner NE, Flicek P, Foekens JA, Fong KM, Fonseca NA, Foster CS, Fox NS, Fraser M, Frazer S, Frenkel-Morgenstern M, Friedman W, Frigola J, Fronick CC, Fujimoto A, Fujita M, Fukayama M, Fulton LA, Fulton RS, Furuta M, Futreal PA, Füllgrabe A, Gabriel SB, Gallinger S, Gambacorti-Passerini C, Gao J, Gao S, Garraway L, Garred Ø, Garrison E, Garsed DW, Gehlenborg N, Gelpi JLL, George J, Gerhard DS, Gerhauser C, Gershenwald JE, Gerstein M, Gerstung M, Getz G, Ghori M, Ghossein R, Giama NH, Gibbs RA, Gibson B, Gill AJ, Gill P, Giri DD, Glodzik D, Gnanapragasam VJ, Goebler ME, Goldman MJ, Gomez C, Gonzalez S, Gonzalez-Perez A, Gordenin DA, Gossage J, Gotoh K, Govindan R, Grabau D, Graham JS, Grant RC, Green AR, Green E, Greger L, Grehan N, Grimaldi S, Grimmond SM, Grossman RL, Grundhoff A, Gundem G, Guo Q, Gupta M, Gupta S, Gut IG, Gut M, Göke J, Ha G, Haake A, Haan D, Haas S, Haase K, Haber JE, Habermann N, Hach F, Haider S, Hama N, Hamdy FC, Hamilton A, Hamilton MP, Han L, Hanna GB, Hansmann M, Haradhvala NJ, Harismendy O, Harliwong I, Harmanci AO, Harrington E, Hasegawa T, Haussler D, Hawkins S, Hayami S, Hayashi S, Hayes DN, Hayes SJ, Hayward NK, Hazell S, He Y, Heath AP, Heath SC, Hedley D, Hegde AM, Heiman DI, Heinold MC, Heins Z, Heisler LE, Hellstrom-Lindberg E, Helmy M, Heo SG, Hepperla AJ, Heredia-Genestar JM, Herrmann C, Hersey P, Hess JM, Hilmarsdottir H, Hinton J, Hirano S, Hiraoka N, Hoadley KA, Hobolth A, Hodzic E, Hoell JI, Hoffmann S, Hofmann O, Holbrook A, Holik AZ, Hollingsworth MA, Holmes O, Holt RA, Hong C, Hong EP, Hong JH, Hooijer GK, Hornshøj H, Hosoda F, Hou Y, Hovestadt V, Howat W, Hoyle AP, Hruban RH, Hu J, Hu T, Hua X, Huang KL, Huang M, Huang MN, Huang V, Huang Y, Huber W, Hudson TJ, Hummel M, Hung JA, Huntsman D, Hupp TR, Huse J, Huska MR, Hutter B, Hutter CM, Hübschmann D, Iacobuzio-Donahue CA, Imbusch CD, Imielinski M, Imoto S, Isaacs WB, Isaev K, Ishikawa S, Iskar M, Islam SMA, Ittmann M, Ivkovic S, Izarzugaza JMG, Jacquemier J, Jakrot V, Jamieson NB, Jang GH, Jang SJ, Jayaseelan JC, Jayasinghe R, Jefferys SR, Jegalian K, Jennings JL, Jeon SH, Jerman L, Ji Y, Jiao W, Johansson PA, Johns AL, Johns J, Johnson R, Johnson TA, Jolly C, Joly Y, Jonasson JG, Jones CD, Jones DR, Jones DTW, Jones N, Jones SJM, Jonkers J, Ju YS, Juhl H, Jung J, Juul M, Juul RI, Juul S, Jäger N, Kabbe R, Kahles A, Kahraman A, Kaiser VB, Kakavand H, Kalimuthu S, von Kalle C, Kang KJ, Karaszi K, Karlan B, Karlić R, Karsch D, Kasaian K, Kassahn KS, Katai H, Kato M, Katoh H, Kawakami Y, Kay JD, Kazakoff SH, Kazanov MD, Keays M, Kebebew E, Kefford RF, Kellis M, Kench JG, Kennedy CJ, Kerssemakers JNA, Khoo D, Khoo V, Khuntikeo N, Khurana E, Kilpinen H, Kim HK, Kim HL, Kim HY, Kim H, Kim J, Kim J, Kim JK, Kim Y, King TA, Klapper W, Kleinheinz K, Klimczak LJ, Knappskog S, Kneba M, Knoppers BM, Koh Y, Komorowski J, Komura D, Komura M, Kong G, Kool M, Korbel JO, Korchina V, Korshunov A, Koscher M, Koster R, Kote-Jarai Z, Koures A, Kovacevic M, Kremeyer B, Kretzmer H, Kreuz M, Krishnamurthy S, Kube D, Kumar K, Kumar P, Kumar S, Kumar Y, Kundra R, Kübler K, Küppers R, Lagergren J, Lai PH, Laird PW, Lakhani SR, Lalansingh CM, Lalonde E, Lamaze FC, Lambert A, Lander E, Landgraf P, Landoni L, Langerød A, Lanzós A, Larsimont D, Larsson E, Lathrop M, Lau LMS, Lawerenz C, Lawlor RT, Lawrence MS, Lazar AJ, Lazic AM, Le X, Lee D, Lee D, Lee EA, Lee HJ, Lee JJK, Lee JY, Lee J, Lee MTM, Lee-Six H, Lehmann KV, Lehrach H, Lenze D, Leonard CR, Leongamornlert DA, Leshchiner I, Letourneau L, Letunic I, Levine DA, Lewis L, Ley T, Li C, Li CH, Li HI, Li J, Li L, Li S, Li S, Li X, Li X, Li X, Li Y, Liang H, Liang SB, Lichter P, Lin P, Lin Z, Linehan WM, Lingjærde OC, Liu D, Liu EM, Liu FFF, Liu F, Liu J, Liu X, Livingstone J, Livitz D, Livni N, Lochovsky L, Loeffler M, Long GV, Lopez-Guillermo A, Lou S, Louis DN, Lovat LB, Lu Y, Lu YJ, Lu Y, Luchini C, Lungu I, Luo X, Luxton HJ, Lynch AG, Lype L, López C, López-Otín C, Ma EZ, Ma Y, MacGrogan G, MacRae S, Macintyre G, Madsen T, Maejima K, Mafficini A, Maglinte DT, Maitra A, Majumder PP, Malcovati L, Malikic S, Malleo G, Mann GJ, Mantovani-Löffler L, Marchal K, Marchegiani G, Mardis ER, Margolin AA, Marin MG, Markowetz F, Markowski J, Marks J, Marques-Bonet T, Marra MA, Marsden L, Martens JWM, Martin S, Martin-Subero JI, Martincorena I, Martinez-Fundichely A, Maruvka YE, Mashl RJ, Massie CE, Matthew TJ, Matthews L, Mayer E, Mayes S, Mayo M, Mbabaali F, McCune K, McDermott U, McGillivray PD, McLellan MD, McPherson JD, McPherson JR, McPherson TA, Meier SR, Meng A, Meng S, Menzies A, Merrett ND, Merson S, Meyerson M, Meyerson W, Mieczkowski PA, Mihaiescu GL, Mijalkovic S, Mikkelsen T, Milella M, Mileshkin L, Miller CA, Miller DK, Miller JK, Mills GB, Milovanovic A, Minner S, Miotto M, Arnau GM, Mirabello L, Mitchell C, Mitchell TJ, Miyano S, Miyoshi N, Mizuno S, Molnár-Gábor F, Moore MJ, Moore RA, Morganella S, Morris QD, Morrison C, Mose LE, Moser CD, Muiños F, Mularoni L, Mungall AJ, Mungall K, Musgrove EA, Mustonen V, Mutch D, Muyas F, Muzny DM, Muñoz A, Myers J, Myklebost O, Möller P, Nagae G, Nagrial AM, Nahal-Bose HK, Nakagama H, Nakagawa H, Nakamura H, Nakamura T, Nakano K, Nandi T, Nangalia J, Nastic M, Navarro A, Navarro FCP, Neal DE, Nettekoven G, Newell F, Newhouse SJ, Newton Y, Ng AWT, Ng A, Nicholson J, Nicol D, Nie Y, Nielsen GP, Nielsen MM, Nik-Zainal S, Noble MS, Nones K, Northcott PA, Notta F, O’Connor BD, O’Donnell P, O’Donovan M, O’Meara S, O’Neill BP, O’Neill JR, Ocana D, Ochoa A, Oesper L, Ogden C, Ohdan H, Ohi K, Ohno-Machado L, Oien KA, Ojesina AI, Ojima H, Okusaka T, Omberg L, Ong CK, Ossowski S, Ott G, Ouellette BFF, P’ng C, Paczkowska M, Paiella S, Pairojkul C, Pajic M, Pan-Hammarström Q, Papaemmanuil E, Papatheodorou I, Paramasivam N, Park JW, Park JW, Park K, Park K, Park PJ, Parker JS, Parsons SL, Pass H, Pasternack D, Pastore A, Patch AM, Pauporté I, Pea A, Pearson JV, Pedamallu CS, Pedersen JS, Pederzoli P, Peifer M, Pennell NA, Perou CM, Perry MD, Petersen GM, Peto M, Petrelli N, Petryszak R, Pfister SM, Phillips M, Pich O, Pickett HA, Pihl TD, Pillay N, Pinder S, Pinese M, Pinho AV. Author Correction: The evolutionary history of 2,658 cancers. Nature 2023; 614:E42. [PMID: 36697833 PMCID: PMC9931577 DOI: 10.1038/s41586-022-05601-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Moritz Gerstung
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, UK. .,European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany. .,Wellcome Sanger Institute, Cambridge, UK.
| | - Clemency Jolly
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Ignaty Leshchiner
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Stefan C. Dentro
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK ,grid.4991.50000 0004 1936 8948Big Data Institute, University of Oxford, Oxford, UK
| | - Santiago Gonzalez
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, UK
| | - Daniel Rosebrock
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Thomas J. Mitchell
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.5335.00000000121885934University of Cambridge, Cambridge, UK
| | - Yulia Rubanova
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | - Pavana Anur
- grid.5288.70000 0000 9758 5690Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR USA
| | - Kaixian Yu
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Maxime Tarabichi
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Amit Deshwar
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | - Jeff Wintersinger
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | - Kortine Kleinheinz
- grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Heidelberg University, Heidelberg, Germany
| | - Ignacio Vázquez-García
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.5335.00000000121885934University of Cambridge, Cambridge, UK
| | - Kerstin Haase
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Lara Jerman
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, UK ,grid.8954.00000 0001 0721 6013University of Ljubljana, Ljubljana, Slovenia
| | - Subhajit Sengupta
- grid.240372.00000 0004 0400 4439NorthShore University HealthSystem, Evanston, IL USA
| | - Geoff Macintyre
- grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Salem Malikic
- grid.61971.380000 0004 1936 7494Simon Fraser University, Burnaby, British Columbia Canada ,grid.412541.70000 0001 0684 7796Vancouver Prostate Centre, Vancouver, British Columbia Canada
| | - Nilgun Donmez
- grid.61971.380000 0004 1936 7494Simon Fraser University, Burnaby, British Columbia Canada ,grid.412541.70000 0001 0684 7796Vancouver Prostate Centre, Vancouver, British Columbia Canada
| | - Dimitri G. Livitz
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Marek Cmero
- grid.1008.90000 0001 2179 088XUniversity of Melbourne, Melbourne, Victoria Australia ,grid.1042.70000 0004 0432 4889Walter and Eliza Hall Institute, Melbourne, Victoria Australia
| | - Jonas Demeulemeester
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK ,grid.5596.f0000 0001 0668 7884University of Leuven, Leuven, Belgium
| | - Steven Schumacher
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Yu Fan
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Xiaotong Yao
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA ,grid.429884.b0000 0004 1791 0895New York Genome Center, New York, NY USA
| | - Juhee Lee
- grid.205975.c0000 0001 0740 6917University of California Santa Cruz, Santa Cruz, CA USA
| | - Matthias Schlesner
- grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paul C. Boutros
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.419890.d0000 0004 0626 690XOntario Institute for Cancer Research, Toronto, Ontario Canada ,grid.19006.3e0000 0000 9632 6718University of California, Los Angeles, CA USA
| | - David D. Bowtell
- grid.1055.10000000403978434Peter MacCallum Cancer Centre, Melbourne, Victoria Australia
| | - Hongtu Zhu
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Gad Getz
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA ,grid.32224.350000 0004 0386 9924Center for Cancer Research, Massachusetts General Hospital, Charlestown, MA USA ,grid.32224.350000 0004 0386 9924Department of Pathology, Massachusetts General Hospital, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Marcin Imielinski
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA ,grid.429884.b0000 0004 1791 0895New York Genome Center, New York, NY USA
| | - Rameen Beroukhim
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA ,grid.65499.370000 0001 2106 9910Dana-Farber Cancer Institute, Boston, MA USA
| | - S. Cenk Sahinalp
- grid.412541.70000 0001 0684 7796Vancouver Prostate Centre, Vancouver, British Columbia Canada ,grid.411377.70000 0001 0790 959XIndiana University, Bloomington, IN USA
| | - Yuan Ji
- grid.240372.00000 0004 0400 4439NorthShore University HealthSystem, Evanston, IL USA ,grid.170205.10000 0004 1936 7822The University of Chicago, Chicago, IL USA
| | - Martin Peifer
- grid.6190.e0000 0000 8580 3777University of Cologne, Cologne, Germany
| | - Florian Markowetz
- grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Ville Mustonen
- grid.7737.40000 0004 0410 2071University of Helsinki, Helsinki, Finland
| | - Ke Yuan
- grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK ,grid.8756.c0000 0001 2193 314XUniversity of Glasgow, Glasgow, UK
| | - Wenyi Wang
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Quaid D. Morris
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | | | - Paul T. Spellman
- grid.5288.70000 0000 9758 5690Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR USA
| | - David C. Wedge
- grid.4991.50000 0004 1936 8948Big Data Institute, University of Oxford, Oxford, UK ,grid.454382.c0000 0004 7871 7212Oxford NIHR Biomedical Research Centre, Oxford, UK
| | - Peter Van Loo
- The Francis Crick Institute, London, UK. .,University of Leuven, Leuven, Belgium.
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Calabrese C, Davidson NR, Demircioğlu D, Fonseca NA, He Y, Kahles A, Lehmann KV, Liu F, Shiraishi Y, Soulette CM, Urban L, Greger L, Li S, Liu D, Perry MD, Xiang Q, Zhang F, Zhang J, Bailey P, Erkek S, Hoadley KA, Hou Y, Huska MR, Kilpinen H, Korbel JO, Marin MG, Markowski J, Nandi T, Pan-Hammarström Q, Pedamallu CS, Siebert R, Stark SG, Su H, Tan P, Waszak SM, Yung C, Zhu S, Awadalla P, Creighton CJ, Meyerson M, Ouellette BFF, Wu K, Yang H, Brazma A, Brooks AN, Göke J, Rätsch G, Schwarz RF, Stegle O, Zhang Z, Wu K, Yang H, Fonseca NA, Kahles A, Lehmann KV, Urban L, Soulette CM, Shiraishi Y, Liu F, He Y, Demircioğlu D, Davidson NR, Calabrese C, Zhang J, Perry MD, Xiang Q, Greger L, Li S, Liu D, Stark SG, Zhang F, Amin SB, Bailey P, Chateigner A, Cortés-Ciriano I, Craft B, Erkek S, Frenkel-Morgenstern M, Goldman M, Hoadley KA, Hou Y, Huska MR, Khurana E, Kilpinen H, Korbel JO, Lamaze FC, Li C, Li X, Li X, Liu X, Marin MG, Markowski J, Nandi T, Nielsen MM, Ojesina AI, Pan-Hammarström Q, Park PJ, Pedamallu CS, Pedersen JS, Pederzoli P, Peifer M, Pennell NA, Perou CM, Perry MD, Petersen GM, Peto M, Petrelli N, Pedamallu CS, Petryszak R, Pfister SM, Phillips M, Pich O, Pickett HA, Pihl TD, Pillay N, Pinder S, Pinese M, Pinho AV, Pedersen JS, Pitkänen E, Pivot X, Piñeiro-Yáñez E, Planko L, Plass C, Polak P, Pons T, Popescu I, Potapova O, Prasad A, Siebert R, Preston SR, Prinz M, Pritchard AL, Prokopec SD, Provenzano E, Puente XS, Puig S, Puiggròs M, Pulido-Tamayo S, Pupo GM, Su H, Purdie CA, Quinn MC, Rabionet R, Rader JS, Radlwimmer B, Radovic P, Raeder B, Raine KM, Ramakrishna M, Ramakrishnan K, Tan P, Ramalingam S, Raphael BJ, Rathmell WK, Rausch T, Reifenberger G, Reimand J, Reis-Filho J, Reuter V, Reyes-Salazar I, Reyna MA, Teh BT, Reynolds SM, Rheinbay E, Riazalhosseini Y, Richardson AL, Richter J, Ringel M, Ringnér M, Rino Y, Rippe K, Roach J, Wang J, Roberts LR, Roberts ND, Roberts SA, Robertson AG, Robertson AJ, Rodriguez JB, Rodriguez-Martin B, Rodríguez-González FG, Roehrl MHA, Rohde M, Waszak SM, Rokutan H, Romieu G, Rooman I, Roques T, Rosebrock D, Rosenberg M, Rosenstiel PC, Rosenwald A, Rowe EW, Royo R, Xiong H, Rozen SG, Rubanova Y, Rubin MA, Rubio-Perez C, Rudneva VA, Rusev BC, Ruzzenente A, Rätsch G, Sabarinathan R, Sabelnykova VY, Yakneen S, Sadeghi S, Sahinalp SC, Saini N, Saito-Adachi M, Saksena G, Salcedo A, Salgado R, Salichos L, Sallari R, Saller C, Ye C, Salvia R, Sam M, Samra JS, Sanchez-Vega F, Sander C, Sanders G, Sarin R, Sarrafi I, Sasaki-Oku A, Sauer T, Yung C, Sauter G, Saw RPM, Scardoni M, Scarlett CJ, Scarpa A, Scelo G, Schadendorf D, Schein JE, Schilhabel MB, Schlesner M, Zhang X, Schlomm T, Schmidt HK, Schramm SJ, Schreiber S, Schultz N, Schumacher SE, Schwarz RF, Scolyer RA, Scott D, Scully R, Zheng L, Seethala R, Segre AV, Selander I, Semple CA, Senbabaoglu Y, Sengupta S, Sereni E, Serra S, Sgroi DC, Shackleton M, Zhu J, Shah NC, Shahabi S, Shang CA, Shang P, Shapira O, Shelton T, Shen C, Shen H, Shepherd R, Shi R, Zhu S, Shi Y, Shiah YJ, Shibata T, Shih J, Shimizu E, Shimizu K, Shin SJ, Shiraishi Y, Shmaya T, Shmulevich I, Awadalla P, Shorser SI, Short C, Shrestha R, Shringarpure SS, Shriver C, Shuai S, Sidiropoulos N, Siebert R, Sieuwerts AM, Sieverling L, Creighton CJ, Signoretti S, Sikora KO, Simbolo M, Simon R, Simons JV, Simpson JT, Simpson PT, Singer S, Sinnott-Armstrong N, Sipahimalani P, Meyerson M, Skelly TJ, Smid M, Smith J, Smith-McCune K, Socci ND, Sofia HJ, Soloway MG, Song L, Sood AK, Sothi S, Ouellette BFF, Sotiriou C, Soulette CM, Span PN, Spellman PT, Sperandio N, Spillane AJ, Spiro O, Spring J, Staaf J, Stadler PF, Wu K, Staib P, Stark SG, Stebbings L, Stefánsson ÓA, Stegle O, Stein LD, Stenhouse A, Stewart C, Stilgenbauer S, Stobbe MD, Yang H, Stratton MR, Stretch JR, Struck AJ, Stuart JM, Stunnenberg HG, Su H, Su X, Sun RX, Sungalee S, Susak H, Göke J, Suzuki A, Sweep F, Szczepanowski M, Sültmann H, Yugawa T, Tam A, Tamborero D, Tan BKT, Tan D, Tan P, Schwarz RF, Tanaka H, Taniguchi H, Tanskanen TJ, Tarabichi M, Tarnuzzer R, Tarpey P, Taschuk ML, Tatsuno K, Tavaré S, Taylor DF, Stegle O, Taylor-Weiner A, Teague JW, Teh BT, Tembe V, Temes J, Thai K, Thayer SP, Thiessen N, Thomas G, Thomas S, Zhang Z, Thompson A, Thompson AM, Thompson JFF, Thompson RH, Thorne H, Thorne LB, Thorogood A, Tiao G, Tijanic N, Timms LE, Brazma A, Tirabosco R, Tojo M, Tommasi S, Toon CW, Toprak UH, Torrents D, Tortora G, Tost J, Totoki Y, Townend D, Rätsch G, Traficante N, Treilleux I, Trotta JR, Trümper LHP, Tsao M, Tsunoda T, Tubio JMC, Tucker O, Turkington R, Turner DJ, Brooks AN, Tutt A, Ueno M, Ueno NT, Umbricht C, Umer HM, Underwood TJ, Urban L, Urushidate T, Ushiku T, Uusküla-Reimand L, Brazma A, Valencia A, Van Den Berg DJ, Van Laere S, Van Loo P, Van Meir EG, Van den Eynden GG, Van der Kwast T, Vasudev N, Vazquez M, Vedururu R, Brooks AN, Veluvolu U, Vembu S, Verbeke LPC, Vermeulen P, Verrill C, Viari A, Vicente D, Vicentini C, VijayRaghavan K, Viksna J, Göke J, Vilain RE, Villasante I, Vincent-Salomon A, Visakorpi T, Voet D, Vyas P, Vázquez-García I, Waddell NM, Waddell N, Wadelius C, Rätsch G, Wadi L, Wagener R, Wala JA, Wang J, Wang J, Wang L, Wang Q, Wang W, Wang Y, Wang Z, Schwarz RF, Waring PM, Warnatz HJ, Warrell J, Warren AY, Waszak SM, Wedge DC, Weichenhan D, Weinberger P, Weinstein JN, Weischenfeldt J, Stegle O, Weisenberger DJ, Welch I, Wendl MC, Werner J, Whalley JP, Wheeler DA, Whitaker HC, Wigle D, Wilkerson MD, Williams A, Zhang Z, Wilmott JS, Wilson GW, Wilson JM, Wilson RK, Winterhoff B, Wintersinger JA, Wiznerowicz M, Wolf S, Wong BH, Wong T, Aaltonen LA, Wong W, Woo Y, Wood S, Wouters BG, Wright AJ, Wright DW, Wright MH, Wu CL, Wu DY, Wu G, Abascal F, Wu J, Wu K, Wu Y, Wu Z, Xi L, Xia T, Xiang Q, Xiao X, Xing R, Xiong H, Abeshouse A, Xu Q, Xu Y, Xue H, Yachida S, Yakneen S, Yamaguchi R, Yamaguchi TN, Yamamoto M, Yamamoto S, Yamaue H, Aburatani H, Yang F, Yang H, Yang JY, Yang L, Yang L, Yang S, Yang TP, 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S, Bandopadhayay P, Banks RE, Barbi S, Barbour AP, Barenboim J, Barnholtz-Sloan J, Barr H, Barrera E, Bartlett J, Bartolome J, Bassi C, Bathe OF, Baumhoer D, Bavi P, Baylin SB, Bazant W, Beardsmore D, Beck TA, Behjati S, Behren A, Niu B, Bell C, Beltran S, Benz C, Berchuck A, Bergmann AK, Bergstrom EN, Berman BP, Berney DM, Bernhart SH, Beroukhim R, Berrios M, Bersani S, Bertl J, Betancourt M, Bhandari V, Bhosle SG, Biankin AV, Bieg M, Bigner D, Binder H, Birney E, Birrer M, Biswas NK, Bjerkehagen B, Bodenheimer T, Boice L, Bonizzato G, De Bono JS, Boot A, Bootwalla MS, Borg A, Borkhardt A, Boroevich KA, Borozan I, Borst C, Bosenberg M, Bosio M, Boultwood J, Bourque G, Boutros PC, Bova GS, Bowen DT, Bowlby R, Bowtell DDL, Boyault S, Boyce R, Boyd J, Brazma A, Brennan P, Brewer DS, Brinkman AB, Bristow RG, Broaddus RR, Brock JE, Brock M, Broeks A, Brooks AN, Brooks D, Brors B, Brunak S, Bruxner TJC, Bruzos AL, Buchanan A, Buchhalter I, Buchholz C, Bullman S, Burke H, Burkhardt B, Burns KH, Busanovich J, Bustamante CD, Butler AP, Butte AJ, Byrne NJ, Børresen-Dale AL, Caesar-Johnson SJ, Cafferkey A, Cahill D, Calabrese C, Caldas C, Calvo F, Camacho N, Campbell PJ, Campo E, Cantù C, Cao S, Carey TE, Carlevaro-Fita J, Carlsen R, Cataldo I, Cazzola M, Cebon J, Cerfolio R, Chadwick DE, Chakravarty D, Chalmers D, Chan CWY, Chan K, Chan-Seng-Yue M, Chandan VS, Chang DK, Chanock SJ, Chantrill LA, Chateigner A, Chatterjee N, Chayama K, Chen HW, Chen J, Chen K, Chen Y, Chen Z, Cherniack AD, Chien J, Chiew YE, Chin SF, Cho J, Cho S, Choi JK, Choi W, Chomienne C, Chong Z, Choo SP, Chou A, Christ AN, Christie EL, Chuah E, Cibulskis C, Cibulskis K, Cingarlini S, Clapham P, Claviez A, Cleary S, Cloonan N, Cmero M, Collins CC, Connor AA, Cooke SL, Cooper CS, Cope L, Corbo V, Cordes MG, Cordner SM, Cortés-Ciriano I, Covington K, Cowin PA, Craft B, Craft D, Creighton CJ, Cun Y, Curley E, Cutcutache I, Czajka K, Czerniak B, Dagg RA, Danilova L, Davi MV, Davidson NR, Davies H, Davis IJ, 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Harliwong I, Harmanci AO, Harrington E, Hasegawa T, Haussler D, Hawkins S, Hayami S, Hayashi S, Hayes DN, Hayes SJ, Hayward NK, Hazell S, He Y, Heath AP, Heath SC, Hedley D, Hegde AM, Heiman DI, Heinold MC, Heins Z, Heisler LE, Hellstrom-Lindberg E, Helmy M, Heo SG, Hepperla AJ, Heredia-Genestar JM, Herrmann C, Hersey P, Hess JM, Hilmarsdottir H, Hinton J, Hirano S, Hiraoka N, Hoadley KA, Hobolth A, Hodzic E, Hoell JI, Hoffmann S, Hofmann O, Holbrook A, Holik AZ, Hollingsworth MA, Holmes O, Holt RA, Hong C, Hong EP, Hong JH, Hooijer GK, Hornshøj H, Hosoda F, Hou Y, Hovestadt V, Howat W, Hoyle AP, Hruban RH, Hu J, Hu T, Hua X, Huang KL, Huang M, Huang MN, Huang V, Huang Y, Huber W, Hudson TJ, Hummel M, Hung JA, Huntsman D, Hupp TR, Huse J, Huska MR, Hutter B, Hutter CM, Hübschmann D, Iacobuzio-Donahue CA, Imbusch CD, Imielinski M, Imoto S, Isaacs WB, Isaev K, Ishikawa S, Iskar M, Islam SMA, Ittmann M, Ivkovic S, Izarzugaza JMG, Jacquemier J, Jakrot V, Jamieson NB, Jang GH, Jang SJ, Jayaseelan JC, Jayasinghe R, Jefferys SR, Jegalian K, Jennings JL, Jeon SH, Jerman L, Ji Y, Jiao W, Johansson PA, Johns AL, Johns J, Johnson R, Johnson TA, Jolly C, Joly Y, Jonasson JG, Jones CD, Jones DR, Jones DTW, Jones N, Jones SJM, Jonkers J, Ju YS, Juhl H, Jung J, Juul M, Juul RI, Juul S, Jäger N, Kabbe R, Kahles A, Kahraman A, Kaiser VB, Kakavand H, Kalimuthu S, von Kalle C, Kang KJ, Karaszi K, Karlan B, Karlić R, Karsch D, Kasaian K, Kassahn KS, Katai H, Kato M, Katoh H, Kawakami Y, Kay JD, Kazakoff SH, Kazanov MD, Keays M, Kebebew E, Kefford RF, Kellis M, Kench JG, Kennedy CJ, Kerssemakers JNA, Khoo D, Khoo V, Khuntikeo N, Khurana E, Kilpinen H, Kim HK, Kim HL, Kim HY, Kim H, Kim J, Kim J, Kim JK, Kim Y, King TA, Klapper W, Kleinheinz K, Klimczak LJ, Knappskog S, Kneba M, Knoppers BM, Koh Y, Komorowski J, Komura D, Komura M, Kong G, Kool M, Korbel JO, Korchina V, Korshunov A, Koscher M, Koster R, Kote-Jarai Z, Koures A, Kovacevic M, Kremeyer B, Kretzmer H, Kreuz M, 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Author Correction: Genomic basis for RNA alterations in cancer. Nature 2023; 614:E37. [PMID: 36697831 PMCID: PMC9931574 DOI: 10.1038/s41586-022-05596-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
| | - Claudia Calabrese
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK
| | - Natalie R. Davidson
- grid.5801.c0000 0001 2156 2780ETH Zurich, Zurich, Switzerland ,grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medical College, New York, NY USA ,grid.419765.80000 0001 2223 3006SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland ,grid.412004.30000 0004 0478 9977University Hospital Zurich, Zurich, Switzerland
| | - Deniz Demircioğlu
- grid.4280.e0000 0001 2180 6431National University of Singapore, Singapore, Singapore ,grid.418377.e0000 0004 0620 715XGenome Institute of Singapore, Singapore, Singapore
| | - Nuno A. Fonseca
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK
| | - Yao He
- grid.11135.370000 0001 2256 9319Peking University, Beijing, China
| | - André Kahles
- grid.5801.c0000 0001 2156 2780ETH Zurich, Zurich, Switzerland ,grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center, New York, NY USA ,grid.419765.80000 0001 2223 3006SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland ,grid.412004.30000 0004 0478 9977University Hospital Zurich, Zurich, Switzerland
| | - Kjong-Van Lehmann
- grid.5801.c0000 0001 2156 2780ETH Zurich, Zurich, Switzerland ,grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center, New York, NY USA ,grid.419765.80000 0001 2223 3006SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland ,grid.412004.30000 0004 0478 9977University Hospital Zurich, Zurich, Switzerland
| | - Fenglin Liu
- grid.11135.370000 0001 2256 9319Peking University, Beijing, China
| | - Yuichi Shiraishi
- grid.26999.3d0000 0001 2151 536XThe University of Tokyo, Minato-ku, Japan
| | - Cameron M. Soulette
- grid.205975.c0000 0001 0740 6917University of California, Santa Cruz, Santa Cruz, CA USA
| | - Lara Urban
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK
| | - Liliana Greger
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK
| | - Siliang Li
- grid.21155.320000 0001 2034 1839BGI-Shenzhen, Shenzhen, China ,grid.507779.b0000 0004 4910 5858China National GeneBank-Shenzhen, Shenzhen, China
| | - Dongbing Liu
- grid.21155.320000 0001 2034 1839BGI-Shenzhen, Shenzhen, China ,grid.507779.b0000 0004 4910 5858China National GeneBank-Shenzhen, Shenzhen, China
| | - Marc D. Perry
- grid.17063.330000 0001 2157 2938Ontario Institute for Cancer Research, Toronto, Ontario, Canada ,grid.266102.10000 0001 2297 6811University of California, San Francisco, San Francisco, CA USA
| | - Qian Xiang
- grid.17063.330000 0001 2157 2938Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Fan Zhang
- grid.11135.370000 0001 2256 9319Peking University, Beijing, China
| | - Junjun Zhang
- grid.17063.330000 0001 2157 2938Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Peter Bailey
- grid.8756.c0000 0001 2193 314XUniversity of Glasgow, Glasgow, UK
| | - Serap Erkek
- grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany
| | - Katherine A. Hoadley
- grid.10698.360000000122483208The University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Yong Hou
- grid.21155.320000 0001 2034 1839BGI-Shenzhen, Shenzhen, China ,grid.507779.b0000 0004 4910 5858China National GeneBank-Shenzhen, Shenzhen, China
| | - Matthew R. Huska
- grid.419491.00000 0001 1014 0849Berlin Institute for Medical Systems Biology, Max Delbruck Center for Molecular Medicine, Berlin, Germany
| | - Helena Kilpinen
- grid.83440.3b0000000121901201University College London, London, UK
| | - Jan O. Korbel
- grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany
| | - Maximillian G. Marin
- grid.205975.c0000 0001 0740 6917University of California, Santa Cruz, Santa Cruz, CA USA
| | - Julia Markowski
- grid.419491.00000 0001 1014 0849Berlin Institute for Medical Systems Biology, Max Delbruck Center for Molecular Medicine, Berlin, Germany
| | - Tannistha Nandi
- grid.418377.e0000 0004 0620 715XGenome Institute of Singapore, Singapore, Singapore
| | - Qiang Pan-Hammarström
- grid.21155.320000 0001 2034 1839BGI-Shenzhen, Shenzhen, China ,grid.4714.60000 0004 1937 0626Karolinska Institutet, Stockholm, Sweden
| | - Chandra Sekhar Pedamallu
- grid.66859.340000 0004 0546 1623Broad Institute, Cambridge, MA USA ,grid.65499.370000 0001 2106 9910Dana-Farber Cancer Institute, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Reiner Siebert
- grid.410712.10000 0004 0473 882XUlm University and Ulm University Medical Center, Ulm, Germany
| | - Stefan G. Stark
- grid.5801.c0000 0001 2156 2780ETH Zurich, Zurich, Switzerland ,grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center, New York, NY USA ,grid.419765.80000 0001 2223 3006SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland ,grid.412004.30000 0004 0478 9977University Hospital Zurich, Zurich, Switzerland
| | - Hong Su
- grid.21155.320000 0001 2034 1839BGI-Shenzhen, Shenzhen, China ,grid.507779.b0000 0004 4910 5858China National GeneBank-Shenzhen, Shenzhen, China
| | - Patrick Tan
- grid.418377.e0000 0004 0620 715XGenome Institute of Singapore, Singapore, Singapore ,grid.428397.30000 0004 0385 0924Duke-NUS Medical School, Singapore, Singapore
| | - Sebastian M. Waszak
- grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany
| | - Christina Yung
- grid.17063.330000 0001 2157 2938Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Shida Zhu
- grid.21155.320000 0001 2034 1839BGI-Shenzhen, Shenzhen, China ,grid.507779.b0000 0004 4910 5858China National GeneBank-Shenzhen, Shenzhen, China
| | - Philip Awadalla
- grid.17063.330000 0001 2157 2938Ontario Institute for Cancer Research, Toronto, Ontario, Canada ,grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada
| | - Chad J. Creighton
- grid.39382.330000 0001 2160 926XBaylor College of Medicine, Houston, TX USA
| | - Matthew Meyerson
- grid.66859.340000 0004 0546 1623Broad Institute, Cambridge, MA USA ,grid.65499.370000 0001 2106 9910Dana-Farber Cancer Institute, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | | | - Kui Wu
- grid.21155.320000 0001 2034 1839BGI-Shenzhen, Shenzhen, China ,grid.507779.b0000 0004 4910 5858China National GeneBank-Shenzhen, Shenzhen, China
| | - Huanming Yang
- grid.21155.320000 0001 2034 1839BGI-Shenzhen, Shenzhen, China
| | | | - Alvis Brazma
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK.
| | - Angela N. Brooks
- grid.205975.c0000 0001 0740 6917University of California, Santa Cruz, Santa Cruz, CA USA ,grid.66859.340000 0004 0546 1623Broad Institute, Cambridge, MA USA ,grid.65499.370000 0001 2106 9910Dana-Farber Cancer Institute, Boston, MA USA
| | - Jonathan Göke
- grid.418377.e0000 0004 0620 715XGenome Institute of Singapore, Singapore, Singapore ,grid.410724.40000 0004 0620 9745National Cancer Centre Singapore, Singapore, Singapore
| | - Gunnar Rätsch
- ETH Zurich, Zurich, Switzerland. .,Memorial Sloan Kettering Cancer Center, New York, NY, USA. .,Weill Cornell Medical College, New York, NY, USA. .,SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland. .,University Hospital Zurich, Zurich, Switzerland.
| | - Roland F. Schwarz
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK ,grid.419491.00000 0001 1014 0849Berlin Institute for Medical Systems Biology, Max Delbruck Center for Molecular Medicine, Berlin, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Consortium (DKTK), partner site Berlin, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Oliver Stegle
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK ,grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Zemin Zhang
- grid.11135.370000 0001 2256 9319Peking University, Beijing, China
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6
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Goldinger SM, Buder-Bakhaya K, Lo SN, Forschner A, McKean M, Zimmer L, Khoo C, Dummer R, Eroglu Z, Buchbinder EI, Ascierto PA, Gutzmer R, Rozeman EA, Hoeller C, Johnson DB, Gesierich A, Kölblinger P, Bennannoune N, Cohen JV, Kähler KC, Wilson MA, Cebon J, Atkinson V, Smith JL, Michielin O, Long GV, Hassel JC, Weide B, Haydu LE, Schadendorf D, McArthur G, Ott PA, Blank C, Robert C, Sullivan R, Hauschild A, Carlino MS, Garbe C, Davies MA, Menzies AM. Chemotherapy after immune checkpoint inhibitor failure in metastatic melanoma: a retrospective multicentre analysis. Eur J Cancer 2021; 162:22-33. [PMID: 34952480 DOI: 10.1016/j.ejca.2021.11.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 08/23/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Despite remarkably improved outcomes with immune checkpoint inhibition, many patients with metastatic melanoma will eventually require further therapy. Chemotherapy has limited activity when used first-line but can alter the tumour microenvironment and does improve efficacy when used in combination with immunotherapy in lung cancer. Whether chemotherapy after checkpoint inhibitor failure has relevant activity in patients with metastatic melanoma is unknown. METHODS Patients with metastatic melanoma treated with chemotherapy after progression on immunotherapy with checkpoint inhibitors were identified retrospectively from 24 melanoma centres. Objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and safety were examined. RESULTS In total, 463 patients were treated between 2007 and 2017. Fifty-six per cent had received PD-1-based therapy before chemotherapy. Chemotherapy regimens included carboplatin + paclitaxel (32%), dacarbazine (25%), temozolomide (15%), taxanes (9%, nab-paclitaxel 4%), fotemustine (6%) and others (13%). Median duration of therapy was 7.9 weeks (0-108). Responses included 0.4% complete response (CR), 12% partial response (PR), 21% stable disease (SD) and 67% progressive disease (PD). Median PFS was 2.6 months (2.2, 3.0), and median PFS in responders was 8.7 months (6.3, 16.3), respectively. Twelve-month PFS was 12% (95% CI 2-15%). In patients who had received anti-PD-1 before chemotherapy, the ORR was 11%, and median PFS was 2.5 months (2.1, 2.8). The highest activity was achieved with single-agent taxanes (N = 40), with ORR 25% and median PFS 3.9 months (2.1, 6.2). Median OS from chemotherapy start was 7.1 months (6.5, 8.0). Subsequent treatment with checkpoint inhibitors achieved a response rate of 16% with a median PFS of 19.1 months (2.0-43.1 months). No unexpected toxicities were observed. CONCLUSION Chemotherapy has a low response rate and short PFS in patients with metastatic melanoma who have failed checkpoint inhibitor therapy, although activity varied between regimens. Chemotherapy has a limited role in the management of metastatic melanoma.
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Affiliation(s)
- Simone M Goldinger
- University of Zurich, Department of Dermatology, Gloriastrasse 31 Zurich, 8091, Switzerland; Melanoma Institute Australia, The University of Sydney, The Poche Centre, 40 Rocklands Road North Sydney NSW 2060, Australia.
| | - Kristina Buder-Bakhaya
- University Hospital Heidelberg, Department of Dermatology and National Center for Cancer (NCT), Im Neuenheimer Feld 460 Heidelberg, 69120, Germany.
| | - Serigne N Lo
- Melanoma Institute Australia, The University of Sydney, The Poche Centre, 40 Rocklands Road North Sydney NSW 2060, Australia.
| | - Andrea Forschner
- University of Tuebingen, Department of Dermatology, Liebermeisterstrasse 25, Tübingen, 72076, Germany.
| | - Meredith McKean
- University of Texas MD Anderson Cancer Center, Department of Melanoma Medical Oncology and Department of Surgical Oncology, 1400 Pressler Street, Houston, TX 77006 USA.
| | - Lisa Zimmer
- University Hospital Essen, Department of Dermatology, Essen & German Cancer Consortium, Partner Site Essen, Germany.
| | - Chloe Khoo
- Peter MacCallum Cancer Centre, Melbourne, Australia.
| | - Reinhard Dummer
- University of Zurich, Department of Dermatology, Gloriastrasse 31 Zurich, 8091, Switzerland.
| | - Zeynep Eroglu
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33612, USA.
| | | | - Paolo A Ascierto
- Department of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Napoli, Italy.
| | - Ralf Gutzmer
- Skin Cancer Center, Department of Dermatology, Mühlenkreiskliniken, Ruhr University Bochum Campus Minden, Germany.
| | - Elisa A Rozeman
- Antoni van Leeuwenhoek Hospital - The Netherlands Cancer Institute, Department of Medical Oncology and Immunology, Plesmanlaan 121 Amsterdam, 1066 CX, the Netherlands.
| | - Christoph Hoeller
- Medical University of Vienna, Department of Dermatology, Waehringer Guertel 18-20, Vienna, 1090, Austria.
| | - Douglas B Johnson
- Vanderbilt University Medical Center, Department of Medicine, Nashville, TN, USA.
| | - Anja Gesierich
- University Hospital Wuerzburg, Department of Dermatology, Wuerzburg, Germany.
| | - Peter Kölblinger
- Department of Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria.
| | - Naima Bennannoune
- Gustave Roussy and Paris-Saclay University, 114 rue Edouard Vaillant Villejuif Cedex, 94805, France.
| | - Justine V Cohen
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
| | - Katharina C Kähler
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller-Strasse 3, Haus C, Kiel, 24105, Germany.
| | - Melissa A Wilson
- Perlmutter Cancer Center, NYU Langone Health, NYU School of Medicine, 160 E. 34th Street, New York, NY 10016, USA.
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Austin Health, School of Cancer Medicine, La Trobe University, 145 Studley Road, Heidelberg VIC, Melbourne, 3084, Australia.
| | - Victoria Atkinson
- University of QLD, Princess Alexandra Hospital, Greenslopes Private Hospital, 199 Ipswich Rd, Woolloongabba QLD 4102, Australia.
| | - Jessica L Smith
- Crown Princess Mary Cancer Centre Westmead, Sydney, NSW, Australia.
| | - Olivier Michielin
- Lausanne University Hospital, Department of Oncology, Precision Oncology Center, Rue du Bugnon 21, Lausanne, 1011, Switzerland.
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, The Poche Centre, 40 Rocklands Road North Sydney NSW 2060, Australia; Royal North Shore Hospital, Reserve Road St Leonards NSW 2065, Australia; Mater Hospital, 25 Rocklands Road, North Sydney NSW 2060, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Charles Perkins Centre, The University of Sydney, Australia.
| | - Jessica C Hassel
- University Hospital Heidelberg, Department of Dermatology and National Center for Cancer (NCT), Im Neuenheimer Feld 460 Heidelberg, 69120, Germany.
| | - Benjamin Weide
- University of Tuebingen, Department of Dermatology, Liebermeisterstrasse 25, Tübingen, 72076, Germany.
| | - Lauren E Haydu
- University of Texas MD Anderson Cancer Center, Department of Melanoma Medical Oncology and Department of Surgical Oncology, 1400 Pressler Street, Houston, TX 77006 USA.
| | - Dirk Schadendorf
- University Hospital Essen, Department of Dermatology, Essen & German Cancer Consortium, Partner Site Essen, Germany.
| | | | - Patrick A Ott
- Dana Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, USA.
| | - Christian Blank
- Antoni van Leeuwenhoek Hospital - The Netherlands Cancer Institute, Department of Medical Oncology and Immunology, Plesmanlaan 121 Amsterdam, 1066 CX, the Netherlands.
| | - Caroline Robert
- Gustave Roussy and Paris-Saclay University, 114 rue Edouard Vaillant Villejuif Cedex, 94805, France.
| | - Ryan Sullivan
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
| | - Axel Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller-Strasse 3, Haus C, Kiel, 24105, Germany.
| | - Matteo S Carlino
- Crown Princess Mary Cancer Centre Westmead, Sydney, NSW, Australia.
| | - Claus Garbe
- University of Tuebingen, Department of Dermatology, Liebermeisterstrasse 25, Tübingen, 72076, Germany.
| | - Michael A Davies
- University of Texas MD Anderson Cancer Center, Department of Melanoma Medical Oncology and Department of Surgical Oncology, 1400 Pressler Street, Houston, TX 77006 USA.
| | - Alexander M Menzies
- Melanoma Institute Australia, The University of Sydney, The Poche Centre, 40 Rocklands Road North Sydney NSW 2060, Australia; Royal North Shore Hospital, Reserve Road St Leonards NSW 2065, Australia; Mater Hospital, 25 Rocklands Road, North Sydney NSW 2060, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
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7
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Klein O, Kee D, Gao B, Markman B, da Gama Duarte J, Quigley L, Jackett L, Linklater R, Strickland A, Scott C, Mileshkin L, Palmer J, Carlino M, Behren A, Cebon J. Combination immunotherapy with nivolumab and ipilimumab in patients with rare gynecological malignancies: results of the CA209-538 clinical trial. J Immunother Cancer 2021; 9:jitc-2021-003156. [PMID: 34782426 PMCID: PMC8593709 DOI: 10.1136/jitc-2021-003156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Patients with rare cancers represent 55% of all gynecological malignancies and have poor survival outcomes due to limited treatment options. Combination immunotherapy with the anti-programmed cell death protein 1 (anti-PD-1) antibody nivolumab and the anti-cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4) antibody ipilimumab has demonstrated significant clinical efficacy across a range of common malignancies, justifying evaluation of this combination in rare gynecological cancers. METHODS This multicenter phase II study enrolled 43 patients with advanced rare gynecological cancers. Patients received induction treatment with nivolumab and ipilimumab at a dose of 3 mg/kg and 1 mg/kg, respectively, every 3 weeks for four doses. Treatment was continued with nivolumab monotherapy at 3 mg/kg every 2 weeks until disease progression or a maximum of 2 years. The primary endpoint was the proportion of patients with disease control at week 12 (complete response, partial response or stable disease (SD) by Response Evaluation Criteria In Solid Tumor V.1.1). Exploratory evaluations correlated clinical outcomes with tumor programmed death-ligand 1 (PD-L1) expression and tumor mutational burden (TMB). RESULTS The objective response rate in the radiologically evaluable population was 36% (12/33 patients) and in the intention-to-treat population was 28% (12/43 patients), with additional 7 patients obtaining SD leading to a disease control rate of 58% and 44%, respectively. Durable responses were seen across a range of tumor histologies. Thirty-one (72%) patients experienced an immune-related adverse event (irAE) with a grade 3/4 irAE observed in seven (16%) patients. Response rate was higher among those patients with baseline PD-L1 expression (≥1% on tumor cells) but was independent of TMB. CONCLUSIONS Ipilimumab and nivolumab combination treatment has significant clinical activity with a favorable safety profile across a range of advanced rare gynecological malignancies and warrants further investigation in these tumor types.
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Affiliation(s)
- Oliver Klein
- Department of Medical Oncology, Olivia Newton-John Cancer Centre, Austin Health, Melbourne, Victoria, Australia .,Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia
| | - Damien Kee
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Bo Gao
- Blacktown Hospital and the University of Sydney, Sydney, New South Wales, Australia
| | - Ben Markman
- Department of Medical Oncology, Monash Health, Melbourne, Victoria, Australia.,Monash University, Melbourne, Victoria, Australia
| | - Jessica da Gama Duarte
- Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia
| | - Luke Quigley
- Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia
| | - Louise Jackett
- Department of Anatomical Pathology, Austin Health, Melbourne, Victoria, Australia
| | - Richelle Linklater
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Andrew Strickland
- Department of Medical Oncology, Monash Health, Melbourne, Victoria, Australia.,Monash University, Melbourne, Victoria, Australia
| | - Clare Scott
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Linda Mileshkin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Jodie Palmer
- Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia
| | - Matteo Carlino
- Blacktown Hospital and the University of Sydney, Sydney, New South Wales, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia.,Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Jonathan Cebon
- Department of Medical Oncology, Olivia Newton-John Cancer Centre, Austin Health, Melbourne, Victoria, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia.,Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
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8
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Jacquelot N, Seillet C, Wang M, Pizzolla A, Liao Y, Hediyeh-Zadeh S, Grisaru-Tal S, Louis C, Huang Q, Schreuder J, Souza-Fonseca-Guimaraes F, de Graaf CA, Thia K, Macdonald S, Camilleri M, Luong K, Zhang S, Chopin M, Molden-Hauer T, Nutt SL, Umansky V, Ciric B, Groom JR, Foster PS, Hansbro PM, McKenzie ANJ, Gray DHD, Behren A, Cebon J, Vivier E, Wicks IP, Trapani JA, Munitz A, Davis MJ, Shi W, Neeson PJ, Belz GT. Blockade of the co-inhibitory molecule PD-1 unleashes ILC2-dependent antitumor immunity in melanoma. Nat Immunol 2021; 22:851-864. [PMID: 34099918 PMCID: PMC7611091 DOI: 10.1038/s41590-021-00943-z] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 04/26/2021] [Indexed: 01/17/2023]
Abstract
Group 2 innate lymphoid cells (ILC2s) are essential to maintain tissue homeostasis. In cancer, ILC2s can harbor both pro-tumorigenic and anti-tumorigenic functions, but we know little about their underlying mechanisms or whether they could be clinically relevant or targeted to improve patient outcomes. Here, we found that high ILC2 infiltration in human melanoma was associated with a good clinical prognosis. ILC2s are critical producers of the cytokine granulocyte-macrophage colony-stimulating factor, which coordinates the recruitment and activation of eosinophils to enhance antitumor responses. Tumor-infiltrating ILC2s expressed programmed cell death protein-1, which limited their intratumoral accumulation, proliferation and antitumor effector functions. This inhibition could be overcome in vivo by combining interleukin-33-driven ILC2 activation with programmed cell death protein-1 blockade to significantly increase antitumor responses. Together, our results identified ILC2s as a critical immune cell type involved in melanoma immunity and revealed a potential synergistic approach to harness ILC2 function for antitumor immunotherapies.
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Affiliation(s)
- Nicolas Jacquelot
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia.
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia.
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
| | - Cyril Seillet
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Minyu Wang
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Angela Pizzolla
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Yang Liao
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
- School of Cancer Medicine, La Trobe University, Heidelberg, Victoria, Australia
| | - Soroor Hediyeh-Zadeh
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Sharon Grisaru-Tal
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Cynthia Louis
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Qiutong Huang
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
- The University of Queensland Diamantina Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Jaring Schreuder
- The University of Queensland Diamantina Institute, University of Queensland, Brisbane, Queensland, Australia
| | | | - Carolyn A de Graaf
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Kevin Thia
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sean Macdonald
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Mary Camilleri
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Kylie Luong
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Shengbo Zhang
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Michael Chopin
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Tristan Molden-Hauer
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Stephen L Nutt
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Viktor Umansky
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
| | - Bogoljub Ciric
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joanna R Groom
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Paul S Foster
- Priority Research Centres for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, New South Wales, Australia
| | - Philip M Hansbro
- Priority Research Centres for Healthy Lungs, Hunter Medical Research Institute and The University of Newcastle, Newcastle, New South Wales, Australia
- Centre for Inflammation, Centenary Institute, Sydney, New South Wales, Australia
- School of Life Sciences, University of Technology Sydney, Sydney, New South Wales, Australia
| | | | - Daniel H D Gray
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
- School of Cancer Medicine, La Trobe University, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
- School of Cancer Medicine, La Trobe University, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, Victoria, Australia
| | - Eric Vivier
- Innate Pharma Research Labs, Marseille, France
- Aix Marseille University, CNRS, INSERM, CIML, Marseille, France
- Service d'Immunologie, Marseille Immunopole, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Ian P Wicks
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
- Rheumatology Unit, Royal Melbourne Hospital, Melbourne, Australia
| | - Joseph A Trapani
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Ariel Munitz
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Melissa J Davis
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Computing and Information Systems, University of Melbourne, Melbourne, Victoria, Australia
| | - Wei Shi
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
- School of Cancer Medicine, La Trobe University, Heidelberg, Victoria, Australia
- Department of Computing and Information Systems, University of Melbourne, Melbourne, Victoria, Australia
| | - Paul J Neeson
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabrielle T Belz
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia.
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia.
- The University of Queensland Diamantina Institute, University of Queensland, Brisbane, Queensland, Australia.
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9
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Parakh S, Musafer A, Paessler S, Witkowski T, Suen CSNLW, Tutuka CSA, Carlino MS, Menzies AM, Scolyer RA, Cebon J, Dobrovic A, Long GV, Klein O, Behren A. PDCD1 Polymorphisms May Predict Response to Anti-PD-1 Blockade in Patients With Metastatic Melanoma. Front Immunol 2021; 12:672521. [PMID: 34177913 PMCID: PMC8220213 DOI: 10.3389/fimmu.2021.672521] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/21/2021] [Indexed: 01/06/2023] Open
Abstract
A significant number of patients (pts) with metastatic melanoma do not respond to anti-programmed cell death 1 (PD1) therapies. Identifying predictive biomarkers therefore remains an urgent need. We retrospectively analyzed plasma DNA of pts with advanced melanoma treated with PD-1 antibodies, nivolumab or pembrolizumab, for five PD-1 genotype single nucleotide polymorphisms (SNPs): PD1.1 (rs36084323, G>A), PD1.3 (rs11568821, G>A), PD1.5 (rs2227981, C>T) PD1.6 (rs10204225, G>A) and PD1.9 (rs2227982, C>T). Clinico-pathological and treatment parameters were collected, and presence of SNPs correlated with response, progression free survival (PFS) and overall survival (OS). 115 patients were identified with a median follow up of 18.7 months (range 0.26 – 52.0 months). All were Caucasian; 27% BRAF V600 mutation positive. At PD-1 antibody commencement, 36% were treatment-naïve and 52% had prior ipilimumab. The overall response rate was 43%, 19% achieving a complete response. Overall median PFS was 11.0 months (95% CI 5.4 - 17.3) and median OS was 31.1 months (95% CI 23.2 - NA). Patients with the G/G genotype had more complete responses than with A/G genotype (16.5% vs. 2.6% respectively) and the G allele of PD1.3 rs11568821 was significantly associated with a longer median PFS than the AG allele, 14.1 vs. 7.0 months compared to the A allele (p=0.04; 95% CI 0.14 – 0.94). No significant association between the remaining SNPs and responses, PFS or OS were observed. Despite limitations in sample size, this is the first study to demonstrate an association of a germline PD-1 polymorphism and PFS in response to anti-PD-1 therapy in pts with metastatic melanoma. Extrinsic factors like host germline polymorphisms should be considered with tumor intrinsic factors as predictive biomarkers for immune checkpoint regulators.
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Affiliation(s)
- Sagun Parakh
- Medical Oncology Unit, Austin Health, Melbourne, VIC, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia.,La Trobe University School of Cancer Medicine, Melbourne, VIC, Australia
| | - Ashan Musafer
- Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia.,La Trobe University School of Cancer Medicine, Melbourne, VIC, Australia
| | - Sabrina Paessler
- Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia
| | - Tom Witkowski
- Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia.,La Trobe University School of Cancer Medicine, Melbourne, VIC, Australia
| | - Connie S N Li Wai Suen
- Department of Mathematics and Statistics, La Trobe University, Melbourne, VIC, Australia
| | | | - Matteo S Carlino
- Department of Medical Oncology, Westmead and Blacktown Hospitals, Sydney, NSW, Australia.,Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
| | - Alexander M Menzies
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia.,Department of Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jonathan Cebon
- Medical Oncology Unit, Austin Health, Melbourne, VIC, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia.,La Trobe University School of Cancer Medicine, Melbourne, VIC, Australia
| | - Alexander Dobrovic
- Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia.,La Trobe University School of Cancer Medicine, Melbourne, VIC, Australia
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia.,Department of Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia.,Department of Clinical Medicine, Macquarie University, Sydney, NSW, Australia
| | - Oliver Klein
- Medical Oncology Unit, Austin Health, Melbourne, VIC, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia.,La Trobe University School of Cancer Medicine, Melbourne, VIC, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
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10
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Liew D, Poon A, Mcmaster C, Owen C, Leung J, Frauman A, Cebon J, Scott A, Buchanan R. OP0194 GENERALIZED IMMUNE ACTIVATION IN STRUCTURES RELATED TO PMR OR GCA ON PET/CT ASSESSMENT DOES NOT OCCUR IN IMMUNE CHECKPOINT INHIBITOR-TREATED PATIENTS WHO DO NOT GO ON TO DEVELOP RHEUMATIC IMMUNE-RELATED ADVERSE EVENTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The pathogenesis of rheumatic immune-related adverse events (irAEs) from checkpoint inhibitor cancer immunotherapy directed against programmed cell death protein 1 (PD-1) and programmed death ligand 1 (PD-L1) remains unknown, even though they are a consequence of pharmacologic inhibition of a specific immune mechanism. Given that some irAEs resemble polymyalgia rheumatica (PMR) or giant cell arteritis (GCA), a disease whose pathogenesis is poorly understood, observations regarding the pathogenesis of PMR-like or GCA-like irAEs are of significant interest. One proposed pathogenic mechanism involves generalized immune activation leading to a spectrum of subclinical disease. Interrogation of this hypothesis may be aided by PET/CT, which is frequently utilized for oncological staging purposes but is also useful in classical PMR or GCA diagnosis. If PMR or GCA irAEs merely represent a spectrum of generalized immune activation, low-grade subclinical PMR or GCA-related changes on PET/CT might be expected to be seen in patients who receive immunotherapy, irrespective of whether they develop clinically evident rheumatic irAEs.Objectives:This study investigated whether such changes occurred in patients receiving immunotherapy who did not develop clinically evident rheumatic irAEs.Methods:Consecutive patients exposed to PD-1 or PD-L1 inhibitor immunotherapy at a single center had scintigraphic uptake calculated by a nuclear medicine physician experienced in assessment of vasculitis. Patients were included if they had had 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging both within the two weeks prior to immunotherapy initiation and after at least eleven weeks of immunotherapy. Patients who went on to develop a rheumatic irAE were excluded, as were patients with scintigraphic evidence of liver metastases owing to their potential influence on scoring of uptake. Quantification of 18F-FDG uptake by maximum standardized uptake values (maximum standard unit value, SUVmax) was performed at sites relevant to PMR or GCA (17 sites relevant to PMR, 17 sites relevant to GCA) in paired scans, and the difference calculated.Results:Twenty-four patients receiving nivolumab, pembrolizumab or avelumab met the inclusion criteria, primarily for melanoma, non-small cell lung cancer, or lymphoma. The mean age was 67 at the time of the first scan, 71% were male, and 66% had a complete or partial oncological response at best response. No statistically or clinically significant difference in SUVmax was noted at any PMR or GCA-relevant anatomical site interrogated. Latent class analysis did not reveal clusters identifiable by cancer type, best response, or presence of combination therapy.Conclusion:Patients treated with PD-1/PD-L1 inhibitors without clinically evident rheumatic irAEs do not develop subclinical PMR or GCA-like changes on PET/CT. This supports the proposition that PMR-like and GCA-like irAEs are a distinct entity with stochastic onset, and do not simply represent generalized immune activation induced by immunotherapy.Acknowledgements:David Liew is the recipient of the Ronald John Gleghorn Bursary from the University of Melbourne.Disclosure of Interests:David Liew: None declared, Aurora Poon: None declared, Christopher McMaster: None declared, Claire Owen Speakers bureau: Roche, Jessica Leung Speakers bureau: GIlead, Novartis, Albert Frauman: None declared, Jonathan Cebon: None declared, Andrew Scott: None declared, Russell Buchanan: None declared
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11
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Klein O, Kee D, Markman B, Carlino MS, Underhill C, Palmer J, Power D, Cebon J, Behren A. Evaluation of TMB as a predictive biomarker in patients with solid cancers treated with anti-PD-1/CTLA-4 combination immunotherapy. Cancer Cell 2021; 39:592-593. [PMID: 33930312 DOI: 10.1016/j.ccell.2021.04.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Oliver Klein
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia; Department of Medical Oncology, Austin Health, Melbourne, Australia.
| | - Damien Kee
- Department of Medical Oncology, Austin Health, Melbourne, Australia; Department of Medical Oncology, Peter McCallum Cancer Centre, Melbourne, Australia
| | - Ben Markman
- Department of Medical Oncology, Alfred Health, Melbourne, Australia; Monash University, Melbourne, Australia
| | - Matteo S Carlino
- Blacktown Hospital and the University of Sydney, Sydney, Australia
| | - Craig Underhill
- Albury-Wodonga Regional Cancer Centre, Albury-Wodonga, Australia
| | - Jodie Palmer
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia; School of Cancer Medicine, La Trobe University, Australia
| | | | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia; Department of Medical Oncology, Austin Health, Melbourne, Australia; School of Cancer Medicine, La Trobe University, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia; School of Cancer Medicine, La Trobe University, Australia
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12
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Klein O, Senko C, Carlino MS, Markman B, Jackett L, Gao B, Lum C, Kee D, Behren A, Palmer J, Cebon J. Combination immunotherapy with ipilimumab and nivolumab in patients with advanced adrenocortical carcinoma: a subgroup analysis of CA209-538. Oncoimmunology 2021; 10:1908771. [PMID: 33889439 PMCID: PMC8043165 DOI: 10.1080/2162402x.2021.1908771] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: Adrenocortical carcinoma is a rare malignancy, with poor prognosis and limited treatment options for patients with advanced disease. Chemotherapy is the current standard first-line treatment, providing only a modest survival benefit. There is only limited treatment experience with immunotherapy using single-agent anti-PD-1/PD-L1 therapy. To date no clinical trials have been reported using combination immunotherapy with anti-CTLA-4 and anti-PD-1 blockade in this patient population. Methods: CA209-538 is a prospective multicentre clinical trial in patients with advanced rare cancers. Participants received the anti-PD-1 antibody nivolumab (3 mg/kg IV) and the anti-CTLA-4 antibody ipilimumab (1 mg/kg IV) every three weeks for four doses, followed by nivolumab (3 mg/kg IV) every two weeks and continued for up to 96 weeks, until disease progression or unacceptable toxicity. Response was assessed every 12 weeks by RECIST version 1.1. Primary endpoint was clinical benefit rate (complete response, partial response, stable disease at 12 weeks). Results: Six patients with adrenocortical carcinoma were enrolled and received treatment. Two patients (33%) have an ongoing partial response (10 and 25 months +) and two patients (33%) stable disease leading to a disease control rate of 66%. Both responders had tumors with a microsatellite instable phenotype. One patient rapidly progressed shortly after enrollment into the trial and did not undergo restaging. Immunotherapy-related toxicity was reported in all patients, with four patients (67%) experiencing grade 3/4 hepatitis leading to discontinuation of treatment. Conclusions: This is the first treatment experience using ipilimumab and nivolumab combination immunotherapy in patients with advanced adrenocortical carcinoma. Durable responses have been observed in a subset of patients suggesting that this treatment regimen should be further investigated in this patient population.
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Affiliation(s)
- Oliver Klein
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | - Clare Senko
- Department of Medical Oncology, Austin Health, Melbourne, Australia
| | - Matteo S Carlino
- Blacktown Hospital and the University of Sydney, Sydney, Australia
| | - Ben Markman
- Department of Medical Oncology, Alfred Health, Melbourne Australia.,School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Louise Jackett
- Department of Anatomical Pathology, Austin Health, Melbourne Australia
| | - Bo Gao
- Blacktown Hospital and the University of Sydney, Sydney, Australia
| | - Caroline Lum
- Department of Medical Oncology, Monash Health, Melbourne, Australia
| | - Damien Kee
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Australia
| | - Jodie Palmer
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Australia
| | - Jonathan Cebon
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Australia
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13
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Da Gama Duarte J, Woods K, Quigley LT, Deceneux C, Tutuka C, Witkowski T, Ostrouska S, Hudson C, Tsao SCH, Pasam A, Dobrovic A, Blackburn JM, Cebon J, Behren A. Ropporin-1 and 1B Are Widely Expressed in Human Melanoma and Evoke Strong Humoral Immune Responses. Cancers (Basel) 2021; 13:1805. [PMID: 33918976 PMCID: PMC8069442 DOI: 10.3390/cancers13081805] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022] Open
Abstract
Antibodies that block immune regulatory checkpoints (programmed cell death 1, PD-1 and cytotoxic T-lymphocyte-associated antigen 4, CTLA-4) to mobilise immunity have shown unprecedented clinical efficacy against cancer, demonstrating the importance of antigen-specific tumour recognition. Despite this, many patients still fail to benefit from these treatments and additional approaches are being sought. These include mechanisms that boost antigen-specific immunity either by vaccination or adoptive transfer of effector cells. Other than neoantigens, epigenetically regulated and shared antigens such as NY-ESO-1 are attractive targets; however, tissue expression is often heterogeneous and weak. Therefore, peptide-specific therapies combining multiple antigens rationally selected to give additive anti-cancer benefits are necessary to achieve optimal outcomes. Here, we show that Ropporin-1 (ROPN1) and 1B (ROPN1B), cancer restricted antigens, are highly expressed and immunogenic, inducing humoral immunity in patients with advanced metastatic melanoma. By multispectral immunohistochemistry, 88.5% of melanoma patients tested (n = 54/61) showed ROPN1B expression in at least 1 of 2/3 tumour cores in tissue microarrays. Antibody responses against ROPN1A and ROPN1B were detected in 71.2% of melanoma patients tested (n = 74/104), with increased reactivity seen with more advanced disease stages. Thus, ROPN1A and ROPN1B may indeed be viable targets for cancer immunotherapy, alone or in combination with other cancer antigens, and could be combined with additional therapies such as immune checkpoint blockade.
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Affiliation(s)
- Jessica Da Gama Duarte
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Katherine Woods
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Luke T. Quigley
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Cyril Deceneux
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Candani Tutuka
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Tom Witkowski
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Simone Ostrouska
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Chris Hudson
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Simon Chang-Hao Tsao
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Anupama Pasam
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Alexander Dobrovic
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
- Department of Clinical Pathology, Melbourne Medical School, University of Melbourne, Parkville, VIC 3010, Australia
| | - Jonathan M. Blackburn
- Department of Integrative Biomedical Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
- Institute for Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
- Medical Oncology Unit, Austin Health, Heidelberg, VIC 3084, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
- Department of Medicine—Austin, Melbourne Medical School, University of Melbourne, Parkville, VIC 3010, Australia
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14
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Klein O, Kee D, Nagrial A, Markman B, Underhill C, Michael M, Jackett L, Lum C, Behren A, Palmer J, Tebbutt NC, Carlino MS, Cebon J. Evaluation of Combination Nivolumab and Ipilimumab Immunotherapy in Patients With Advanced Biliary Tract Cancers: Subgroup Analysis of a Phase 2 Nonrandomized Clinical Trial. JAMA Oncol 2021; 6:1405-1409. [PMID: 32729929 DOI: 10.1001/jamaoncol.2020.2814] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Importance Biliary tract cancers represent a rare group of malignant conditions with very limited treatment options. Patients with advanced disease have a poor outcome with current therapies. Objective To evaluate the efficacy and safety of combination immunotherapy with nivolumab and ipilimumab in patients with advanced biliary tract cancers. Design, Setting, and Participants The CA209-538 prospective multicenter phase 2 nonrandomized clinical trial included patients with advanced rare cancers including patients with biliary tract cancers. This subgroup analysis evaluated 39 patients from CA209-538 with biliary tract cancers who were enrolled from December 2017 to December 2019. Most of the patients (n = 33) had experienced disease progression after 1 or more lines of therapy and had tumor tissue available for biomarker research. Interventions Patients received treatment with nivolumab at a dose of 3 mg/kg and ipilimumab at 1 mg/kg every 3 weeks for 4 doses, followed by nivolumab 3 mg/kg every 2 weeks and continued for up to 96 weeks until disease progression or the development of unacceptable toxic events. Main Outcomes and Measures The primary end point was disease control rate (complete remission, partial remission, or stable disease) as assessed by RECIST 1.1. Results Among the 39 patients included in this subgroup analysis of a phase 2 clinical trial (20 men, 19 women; mean [range] age, 65 [37-81] years), the objective response rate was 23% (n = 9) with a disease control rate of 44% (n = 17); all responders had received prior chemotherapy, and none had a microsatellite unstable tumor. Responses were exclusively observed in patients with intrahepatic cholangiocarcinoma and gallbladder carcinoma. The median duration of response was not reached (range, 2.5 to ≥23 months). The median progression-free survival was 2.9 months (95% CI, 2.2-4.6 months), and overall survival was 5.7 months (95% CI, 2.7-11.9 months). Immune-related toxic events were reported in 49% of patients (n = 19), with 15% (n = 6) experiencing grade 3 or 4 events. Conclusions and Relevance This subgroup analysis of a phase 2 clinical trial found that combination immunotherapy with nivolumab and ipilimumab was associated with substantial positive outcomes patients with advanced biliary tract cancers. This treatment compares favorably to single-agent anti-programmed cell death protein 1 (anti-PD-1) therapy and warrants further investigation. Ongoing translational research is focused on identifying biomarkers that can predict treatment response. Trial Registration ClinicalTrials.gov Identifier: NCT02923934.
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Affiliation(s)
- Oliver Klein
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | - Damien Kee
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Adnan Nagrial
- Blacktown Hospital and the University of Sydney, Sydney, Australia
| | - Ben Markman
- Department of Medical Oncology, Monash Health, Melbourne, Australia.,Monash University, Melbourne, Australia
| | - Craig Underhill
- Albury-Wodonga Regional Cancer Centre, Albury-Wodonga, Australia
| | - Michael Michael
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Louise Jackett
- Department of Anatomical Pathology, Austin Health, Melbourne, Australia
| | - Caroline Lum
- Department of Medical Oncology, Monash Health, Melbourne, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Australia
| | - Jodie Palmer
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Australia
| | - Niall C Tebbutt
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Matteo S Carlino
- Blacktown Hospital and the University of Sydney, Sydney, Australia
| | - Jonathan Cebon
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Australia
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15
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Arulananda S, O'Brien M, Evangelista M, Harris TJ, Steinohrt NS, Jenkins LJ, Walkiewicz M, O'Donoghue RJJ, Poh AR, Thapa B, Williams DS, Leong T, Mariadason JM, Li X, Cebon J, Lee EF, John T, Fairlie WD. BCL-XL is an actionable target for treatment of malignant pleural mesothelioma. Cell Death Discov 2020; 6:114. [PMID: 33298868 PMCID: PMC7603509 DOI: 10.1038/s41420-020-00348-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 09/20/2020] [Indexed: 12/29/2022] Open
Abstract
Despite having one of the lowest survival rates of all cancers, there have been no new approved treatments for malignant pleural mesothelioma (MPM) in over a decade. Standard-of-care treatment relies on Cisplatin plus Pemetrexed chemotherapy. Here, we tested a suite of BH3-mimetic drugs targeting BCL-2 pro-survival proteins of the intrinsic apoptotic pathway. We found BCL-XL is the dominant pro-survival protein in a panel of cell lines in vitro, though potent, synergistic cell killing occurred with MCL-1 co-targeting. This correlates with high-level expression of BCL-XL and MCL-1 in cell lines and a large cohort of patient tumour samples. BCL-XL inhibition combined with Cisplatin also enhanced cell killing. In vivo BCL-XL inhibition was as effective as Cisplatin, and the combination enhanced tumour growth control and survival. Genetic ablation of MCL-1 also enhanced the effects of BCL-XL inhibitors, in vivo. Combined, these data provide a compelling rationale for the clinical investigation of BH3-mimetics targeting BCL-XL in MPM.
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Affiliation(s)
- Surein Arulananda
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia.,Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia
| | - Megan O'Brien
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Marco Evangelista
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Tiffany J Harris
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Nikita S Steinohrt
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Laura J Jenkins
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia
| | - Marzena Walkiewicz
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Robert J J O'Donoghue
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,Department of Pharmacology and Therapeutics, University of Melbourne, Melbourne, VIC, Australia
| | - Ashleigh R Poh
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia
| | - Bibhusal Thapa
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - David S Williams
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia.,Department of Clinical Pathology, University of Melbourne, Melbourne, VIC, Australia.,Department of Pathology, Austin Health, Heidelberg, VIC, Australia
| | - Trishe Leong
- Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia.,Department of Clinical Pathology, University of Melbourne, Melbourne, VIC, Australia.,Department of Pathology, Austin Health, Heidelberg, VIC, Australia
| | - John M Mariadason
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Bundoora, VIC, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia.,Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia
| | - Erinna F Lee
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia. .,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia. .,Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, VIC, Australia.
| | - Thomas John
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia. .,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia. .,Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia. .,Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
| | - W D Fairlie
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia. .,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia. .,Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, VIC, Australia.
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16
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Park SM, Brooks AE, Chen CJJ, Sheppard HM, Loef EJ, McIntosh JD, Angel CE, Mansell CJ, Bartlett A, Cebon J, Birch NP, Dunbar PR. Migratory cues controlling B-lymphocyte trafficking in human lymph nodes. Immunol Cell Biol 2020; 99:49-64. [PMID: 32740978 DOI: 10.1111/imcb.12386] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 12/14/2022]
Abstract
B-cell migration within lymph nodes (LNs) is crucial to adaptive immune responses. Chemotactic gradients are proposed to drive migration of B cells into follicles, followed by their relocation to specific zones of the follicle during activation, and ultimately egress. However, the molecular drivers of these processes and the cells generating chemotactic signals that affect B cells in human LNs are not well understood. We used immunofluorescence microscopy, flow cytometry and functional assays to study molecular mechanisms of B-cell migration within human LNs, and found subtle but important differences to previous murine models. In human LNs we find CXCL13 is prominently expressed at the follicular edge, often associated with fibroblastic reticular cells located in these areas, whereas follicular dendritic cells show minimal contribution to CXCL13 expression. Human B cells rapidly downregulate CXCR5 on encountering CXCL13, but recover CXCR5 expression in the CXCL13-low environment. These data suggest that the CXCL13 gradient in human LNs is likely to be different from that proposed in mice. We also identify CD68+ CD11c+ PU.1+ tingible body macrophages within both primary and secondary follicles as likely drivers of the sphingosine-1-phosphate (S1P) gradient that mediates B-cell egress from LNs, through their expression of the S1P-degrading enzyme, S1P lyase. Based on our findings, we present a model of B-cell migration within human LNs, which has both similarities and interesting differences to that proposed for mice.
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Affiliation(s)
- Saem Mul Park
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Anna Es Brooks
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Chun-Jen J Chen
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Hilary M Sheppard
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Evert Jan Loef
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Julie D McIntosh
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Catherine E Angel
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Claudia J Mansell
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand
| | - Adam Bartlett
- School of Medicine, The University of Auckland, Auckland, New Zealand
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, La Trobe University School of Cancer Medicine, Heidelberg, Australia
| | - Nigel P Birch
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand
| | - P Rod Dunbar
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
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17
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Hultin S, Nahar K, Menzies AM, Long GV, Fernando SL, Atkinson V, Cebon J, Wong MG. Histological diagnosis of immune checkpoint inhibitor induced acute renal injury in patients with metastatic melanoma: a retrospective case series report. BMC Nephrol 2020; 21:391. [PMID: 32894101 PMCID: PMC7487459 DOI: 10.1186/s12882-020-02044-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/23/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI) have become the standard of care in many oncological conditions but are associated with a spectrum of renal immune-related adverse events (IrAEs). We aimed to describe the spectrum, histology, management and outcomes of renal IrAE in patients with metastatic melanoma undergoing ICI therapy. METHODS We conducted a retrospective review of 23 patients with a diagnosis of metastatic melanoma treated with ICI between January 2017 and April 2019 who developed a renal IrAE. Baseline demographic data, biochemical and histopathological results, management and outcomes were analyzed. RESULTS The majority of patients who developed renal irAE were male and received combination immunotherapy. The median time of onset from initiation of ICI therapy to renal IrAE was 4 months. 52% of the treated renal IrAE had histopathologically confirmed renal IrAE. The most common histological pattern of injury was acute tubulo-interstitial nephritis (92%). One patient developed anti-GBM disease with non-dialysis dependent stage 5 CKD. In tubulointerstitial injury, there was no association between peak creatinine, renal recovery and histologically reported inflammation or fibrosis. Patients with renal IrAE demonstrated persisting renal dysfunction at 3, 6 and 12 months with a mean baseline, 3 and 12 month creatinine of 90.0 μmol/L, 127.0 μmol/L and 107.5 μmol/L respectively. CONCLUSION Renal IrAE is most commonly attributable to steroid responsive acute tubulointerstitial nephritis. The outcome of rarer pathologies such as anti-GBM disease may be adversely affected by a delayed diagnosis. There is persisting renal dysfunction following an episode of renal IrAE that may have impact on future renal and overall survival outcomes.
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Affiliation(s)
- Sebastian Hultin
- Department of Renal Medicine Royal North Shore Hospital, Sydney, Australia. .,Sydney Medical School, The University of Sydney, Sydney, Australia. .,Westmead Institute of Medical Research, 176 Hawkesbury Road, Westmead, NSW2145, Australia.
| | - Kazi Nahar
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - Alexander M Menzies
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia.,Department of Medical Oncology, Royal North Shore Hospital and Mater Hospital, Sydney, Australia
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia.,Department of Medical Oncology, Royal North Shore Hospital and Mater Hospital, Sydney, Australia
| | - Suran L Fernando
- Sydney Medical School, The University of Sydney, Sydney, Australia.,Department of Immunopathology, NSW Health Pathology North, Sydney, Australia
| | - Victoria Atkinson
- Princess Alexandra Hospital, Brisbane, Australia.,University of Queensland, Brisbane, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute at Austin Health, Heidelberg, Australia
| | - Muh Geot Wong
- Department of Renal Medicine Royal North Shore Hospital, Sydney, Australia.,The George Institute for Global Health, Sydney, Australia
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18
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Arulananda S, Parakh S, Palmer J, Goodwin M, Andrews MC, Cebon J. A pilot study of intrahepatic yttrium-90 microsphere radioembolization in combination with intravenous cisplatin for uveal melanoma liver-only metastases. Cancer Rep (Hoboken) 2020; 2:e1183. [PMID: 32721131 DOI: 10.1002/cnr2.1183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/22/2019] [Accepted: 04/03/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Metastatic uveal melanoma is a highly aggressive disease with no standard of care treatment option. A large proportion of patients have liver-only metastatic disease which raises the question if liver-directed therapy can be efficacious in this subpopulation. AIMS The study aims to evaluate the safety and efficacy of radiosensitizing chemotherapy in combination with yttrium-90 microspheres in patients with uveal melanoma with liver-only metastases. METHODS AND RESULTS This single arm, open labeled, non-randomized study enrolled 10 patients with liver-only metastatic uveal melanoma between November 2012 and January 2018. Eligible patients received intrahepatic yttrium-90 microspheres followed by intravenous cisplatin (20 mg/m2) for 5 days. Ten patients were enrolled, but nine patients received treatment who were included in the final analysis with a median follow-up of 30 months (range 7 to 44). Five (50%) were female, five (50%) had an elevated lactate dehydrogenase (LDH), and one (10%) had prior anti-PD-1 therapy. The combination was well tolerated with no greater than or equal to grade 3 toxicity observed. The liver objective response rate (ORR) was 33% (3/9), the median progression-free survival (PFS) in the liver was 3 months (95% CI, 3-NA), and the extrahepatic PFS was 3 months (95% CI, 3-NA). Seventy-eight percent (7/9) received an immune checkpoint inhibitor on disease progression, with no responses seen. The median overall survival (OS) was 10 months (95% CI, 7-NA). CONCLUSION The combination of cisplatin with yttrium-90 microspheres was well tolerated; however, it was associated with intrahepatic disease control of relatively short duration. No responses were seen in patients treated with immune checkpoint inhibitors post radioembolization.
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Affiliation(s)
- Surein Arulananda
- Medical Oncology Unit, Austin Health, Heidelberg, Victoria, Australia.,Cancer Immuno-Biology Laboratory, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, Victoria, Australia
| | - Sagun Parakh
- Medical Oncology Unit, Austin Health, Heidelberg, Victoria, Australia.,Cancer Immuno-Biology Laboratory, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, Victoria, Australia
| | - Jodie Palmer
- Cancer Immuno-Biology Laboratory, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
| | - Mark Goodwin
- Department of Radiology, Austin Hospital, Heidelberg, Victoria, Australia
| | - Miles C Andrews
- Medical Oncology Unit, Austin Health, Heidelberg, Victoria, Australia.,Cancer Immuno-Biology Laboratory, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, Victoria, Australia.,Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Jonathan Cebon
- Medical Oncology Unit, Austin Health, Heidelberg, Victoria, Australia.,Cancer Immuno-Biology Laboratory, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, Victoria, Australia
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19
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Klein O, Kee D, Markman B, Michael M, Underhill C, Carlino MS, Jackett L, Lum C, Scott C, Nagrial A, Behren A, So JY, Palmer J, Cebon J. Immunotherapy of Ipilimumab and Nivolumab in Patients with Advanced Neuroendocrine Tumors: A Subgroup Analysis of the CA209-538 Clinical Trial for Rare Cancers. Clin Cancer Res 2020; 26:4454-4459. [PMID: 32532787 DOI: 10.1158/1078-0432.ccr-20-0621] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/24/2020] [Accepted: 06/09/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Combination immunotherapy with anti-CTLA-4 and anti-PD-1 blockade has demonstrated significant clinical activity across several tumor types. Neuroendocrine tumors (NET) are a heterogeneous group of rare tumors with limited treatment options. CA209-538 is a clinical trial of combination immunotherapy with ipilimumab and nivolumab in rare cancers, including advanced NETs. PATIENTS AND METHODS CA209-538 is a prospective multicenter clinical trial in patients with advanced rare cancers. Patients received treatment with nivolumab at a dose of 3 mg/kg and ipilimumab at 1 mg/kg every three weeks for four doses, followed by nivolumab 3 mg/kg every two weeks and continued for up to 96 weeks, until disease progression or the development of unacceptable toxicity. Response was assessed every 12 weeks by RECIST 1.1. The primary endpoint was clinical benefit rate (CBR; complete remission + partial remission + stable disease). RESULTS Twenty-nine patients with advanced NETs received treatment. Three (10%) patients had low-, 13 (45%) had intermediate-, and 13 (45%) had high-grade tumors; lung was the most common primary site (39%). The objective response rate was 24% with a CBR of 72%; 43% of patients with pancreatic neuroendocrine neoplasms (NEN), and 33% of patients with atypical bronchial carcinoid achieved an objective response. The median progression-free survival was 4.8 months [95% confidence interval (CI): 2.7-10.5] and overall survival was 14.8 months (95% CI: 4.1-21.3). Immune-related toxicity was reported in 66% of patients with 34% experiencing grade 3/4 events. CONCLUSIONS Combination immunotherapy with ipilimumab and nivolumab demonstrated significant clinical activity in subgroups of patients with advanced NETs including patients with atypical bronchial carcinoid and high-grade pancreatic NENs.
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Affiliation(s)
- Oliver Klein
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Australia
| | - Damien Kee
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Ben Markman
- Department of Medical Oncology, Alfred Health, Melbourne Australia.,School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Michael Michael
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Craig Underhill
- Albury-Wodonga Regional Cancer Centre, Albury-Wodonga, Australia
| | - Matteo S Carlino
- Blacktown Hospital and the University of Sydney, Sydney, Australia
| | - Louise Jackett
- Department of Anatomical Pathology, Austin Health, Melbourne, Australia
| | - Caroline Lum
- Department of Medical Oncology, Monash Health, Melbourne, Australia
| | - Clare Scott
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Adnan Nagrial
- Blacktown Hospital and the University of Sydney, Sydney, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Jane Y So
- Department of Medical Oncology, Monash Health, Melbourne, Australia
| | - Jodie Palmer
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Jonathan Cebon
- Department of Medical Oncology, Austin Health, Melbourne, Australia. .,Olivia Newton-John Cancer Research Institute, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Australia
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20
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Rigau M, Ostrouska S, Fulford T, Johnson DN, Woods K, Ruan Z, McWilliam H, Hudson C, Tutuka C, Wheatley AK, Kent SJ, Villadangos JA, Pal B, Kurts C, Simmonds J, Pelzing M, Hammet AD, Verhagen AM, Vairo G, Maraskovsky E, Panousis C, Gherardin NA, Cebon J, Godfrey DI, Behren A, Uldrich AP. Butyrophilin molecules govern γδ T cell reactivity against phosphoantigens. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.140.12] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Humans have a minor lymphocyte population of gamma-delta (γδ) T cells. The majority of these express a recombined Vγ9Vδ2 T cell receptor (TCR) attractive to immunotherapy. This distinct TCR conveys reactivity to phosphorylated antigens (pAg) that derive from pathogens or accumulate inside tumour cells. Such T cell responses are regulated by butyrophilin (BTN) 3A1 and other membrane-related proteins present on antigen-presenting cells. However, the activation mechanism and direct molecular ligand recognised by the γδ TCR remain a crucial unresolved question. Herein, we used pAg-reactive TCR probes in a whole-genome screen to identify BTN2A1 as an essential ligand. In further investigation, we elucidated its functionality working in cis with BTN3A1. Also, a mutational analysis unveiled critical regions of the γδ TCR are positioned at opposite sides. We locate germ-line encoded residues of the Vγ9 chain were responsible for BTN2A1 binding, whereas two amino-acids of the Vδ2 chain were necessary for a complete response to pAg. In conclusion, we propose a dual-ligand complex model that senses pAg to evoke immune responses, wherein BTN2A1 sets the framework to develop new opportunities on γδ T cell-based immunotherapies.
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Affiliation(s)
- Marc Rigau
- 1Univ. of Melbourne, Australia
- 2Univ. of Bonn, Germany
- 3Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Australia
| | - Simone Ostrouska
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
| | | | | | - Katherine Woods
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
- 6Ludwig Institute for Cancer Research, Australia
| | | | | | | | - Candani Tutuka
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
| | - Adam K Wheatley
- 1Univ. of Melbourne, Australia
- 7Australian Research Council Centre of Excellence for Convergent Bio-Nano Science and Technology at the Univ. of Melbourne, Australia
| | - Stephen J Kent
- 1Univ. of Melbourne, Australia
- 7Australian Research Council Centre of Excellence for Convergent Bio-Nano Science and Technology at the Univ. of Melbourne, Australia
| | | | - Bhupinder Pal
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
| | | | | | | | | | | | | | | | | | | | - Jonathan Cebon
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
| | - Dale Ian Godfrey
- 1Univ. of Melbourne, Australia
- 3Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Australia
| | - Andreas Behren
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
- 6Ludwig Institute for Cancer Research, Australia
| | - Adam Peter Uldrich
- 1Univ. of Melbourne, Australia
- 3Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Australia
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Wang J, Wuethrich A, Sina AAI, Lane RE, Lin LL, Wang Y, Cebon J, Behren A, Trau M. Tracking extracellular vesicle phenotypic changes enables treatment monitoring in melanoma. Sci Adv 2020; 6:eaax3223. [PMID: 32133394 PMCID: PMC7043913 DOI: 10.1126/sciadv.aax3223] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 12/10/2019] [Indexed: 05/13/2023]
Abstract
Monitoring targeted therapy in real time for cancer patients could provide vital information about the development of drug resistance and improve therapeutic outcomes. Extracellular vesicles (EVs) have recently emerged as a promising cancer biomarker, and EV phenotyping shows high potential for monitoring treatment responses. Here, we demonstrate the feasibility of monitoring patient treatment responses based on the plasma EV phenotypic evolution using a multiplex EV phenotype analyzer chip (EPAC). EPAC incorporates the nanomixing-enhanced microchip and the multiplex surface-enhanced Raman scattering (SERS) nanotag system for direct EV phenotyping without EV enrichment. In a preclinical model, we observe the EV phenotypic heterogeneity and different phenotypic responses to the treatment. Furthermore, we successfully detect cancer-specific EV phenotypes from melanoma patient plasma. We longitudinally monitor the EV phenotypic evolution of eight melanoma patients receiving targeted therapy and find specific EV profiles involved in the development of drug resistance, reflecting the potential of EV phenotyping for monitoring treatment responses.
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Affiliation(s)
- Jing Wang
- Centre for Personalized Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD 4072, Australia
| | - Alain Wuethrich
- Centre for Personalized Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD 4072, Australia
| | - Abu Ali Ibn Sina
- Centre for Personalized Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD 4072, Australia
| | - Rebecca E. Lane
- Centre for Personalized Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD 4072, Australia
| | - Lynlee L. Lin
- Centre for Personalized Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD 4072, Australia
- Dermatology Research Centre, University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD 4102, Australia
| | - Yuling Wang
- Department of Molecular Sciences, ARC Centre of Excellence for Nanoscale BioPhotonics, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Heidelberg, VIC 3084, Australia
- Department of Medicine, University of Melbourne, Heidelberg, VIC 3084, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Heidelberg, VIC 3084, Australia
- Department of Medicine, University of Melbourne, Heidelberg, VIC 3084, Australia
| | - Matt Trau
- Centre for Personalized Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD 4072, Australia
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia
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Aaltonen LA, Abascal F, Abeshouse A, Aburatani H, Adams DJ, Agrawal N, Ahn KS, Ahn SM, Aikata H, Akbani R, Akdemir KC, Al-Ahmadie H, Al-Sedairy ST, Al-Shahrour F, Alawi M, Albert M, Aldape K, Alexandrov LB, Ally A, Alsop K, Alvarez EG, Amary F, Amin SB, Aminou B, Ammerpohl O, Anderson MJ, Ang Y, Antonello D, Anur P, Aparicio S, Appelbaum EL, Arai Y, Aretz A, Arihiro K, Ariizumi SI, Armenia J, Arnould L, Asa S, Assenov Y, Atwal G, Aukema S, Auman JT, Aure MRR, Awadalla P, Aymerich M, Bader GD, Baez-Ortega A, Bailey MH, Bailey PJ, Balasundaram M, Balu S, Bandopadhayay P, Banks RE, Barbi S, Barbour AP, Barenboim J, Barnholtz-Sloan J, Barr H, Barrera E, Bartlett J, Bartolome J, Bassi C, Bathe OF, Baumhoer D, Bavi P, Baylin SB, Bazant W, Beardsmore D, Beck TA, Behjati S, Behren A, Niu B, Bell C, Beltran S, Benz C, Berchuck A, Bergmann AK, Bergstrom EN, Berman BP, Berney DM, Bernhart SH, Beroukhim R, Berrios M, Bersani S, Bertl J, Betancourt M, Bhandari V, Bhosle SG, Biankin AV, Bieg M, Bigner D, Binder H, Birney E, Birrer M, Biswas NK, Bjerkehagen B, Bodenheimer T, Boice L, Bonizzato G, De Bono JS, Boot A, Bootwalla MS, Borg A, Borkhardt A, Boroevich KA, Borozan I, Borst C, Bosenberg M, Bosio M, Boultwood J, Bourque G, Boutros PC, Bova GS, Bowen DT, Bowlby R, Bowtell DDL, Boyault S, Boyce R, Boyd J, Brazma A, Brennan P, Brewer DS, Brinkman AB, Bristow RG, Broaddus RR, Brock JE, Brock M, Broeks A, Brooks AN, Brooks D, Brors B, Brunak S, Bruxner TJC, Bruzos AL, Buchanan A, Buchhalter I, Buchholz C, Bullman S, Burke H, Burkhardt B, Burns KH, Busanovich J, Bustamante CD, Butler AP, Butte AJ, Byrne NJ, Børresen-Dale AL, Caesar-Johnson SJ, Cafferkey A, Cahill D, Calabrese C, Caldas C, Calvo F, Camacho N, Campbell PJ, Campo E, Cantù C, Cao S, Carey TE, Carlevaro-Fita J, Carlsen R, Cataldo I, Cazzola M, Cebon J, Cerfolio R, Chadwick DE, Chakravarty D, Chalmers D, Chan CWY, Chan K, Chan-Seng-Yue M, Chandan VS, Chang DK, Chanock SJ, Chantrill LA, Chateigner A, Chatterjee N, Chayama K, Chen HW, Chen J, Chen K, Chen Y, Chen Z, Cherniack AD, Chien J, Chiew YE, Chin SF, Cho J, Cho S, Choi JK, Choi W, Chomienne C, Chong Z, Choo SP, Chou A, Christ AN, Christie EL, Chuah E, Cibulskis C, Cibulskis K, Cingarlini S, Clapham P, Claviez A, Cleary S, Cloonan N, Cmero M, Collins CC, Connor AA, Cooke SL, Cooper CS, Cope L, Corbo V, Cordes MG, Cordner SM, Cortés-Ciriano I, Covington K, Cowin PA, Craft B, Craft D, Creighton CJ, Cun Y, Curley E, Cutcutache I, Czajka K, Czerniak B, Dagg RA, Danilova L, Davi MV, Davidson NR, Davies H, Davis IJ, Davis-Dusenbery BN, Dawson KJ, De La Vega FM, De Paoli-Iseppi R, Defreitas T, Tos APD, Delaneau O, Demchok JA, Demeulemeester J, Demidov GM, Demircioğlu D, Dennis NM, Denroche RE, Dentro SC, Desai N, Deshpande V, Deshwar AG, Desmedt C, Deu-Pons J, Dhalla N, Dhani NC, Dhingra P, Dhir R, DiBiase A, Diamanti K, Ding L, Ding S, Dinh HQ, Dirix L, Doddapaneni H, Donmez N, Dow MT, Drapkin R, Drechsel O, Drews RM, Serge S, Dudderidge T, Dueso-Barroso A, Dunford AJ, Dunn M, Dursi LJ, Duthie FR, Dutton-Regester K, Eagles J, Easton DF, Edmonds S, Edwards PA, Edwards SE, Eeles RA, Ehinger A, Eils J, Eils R, El-Naggar A, Eldridge M, Ellrott K, Erkek S, Escaramis G, Espiritu SMG, Estivill X, Etemadmoghadam D, Eyfjord JE, Faltas BM, Fan D, Fan Y, Faquin WC, Farcas C, Fassan M, Fatima A, Favero F, Fayzullaev N, Felau I, Fereday S, Ferguson ML, Ferretti V, Feuerbach L, Field MA, Fink JL, Finocchiaro G, Fisher C, Fittall MW, Fitzgerald A, Fitzgerald RC, Flanagan AM, Fleshner NE, Flicek P, Foekens JA, Fong KM, Fonseca NA, Foster CS, Fox NS, Fraser M, Frazer S, Frenkel-Morgenstern M, Friedman W, Frigola J, Fronick CC, Fujimoto A, Fujita M, Fukayama M, Fulton LA, Fulton RS, Furuta M, Futreal PA, Füllgrabe A, Gabriel SB, Gallinger S, Gambacorti-Passerini C, Gao J, Gao S, Garraway L, Garred Ø, Garrison E, Garsed DW, Gehlenborg N, Gelpi JLL, George J, Gerhard DS, Gerhauser C, Gershenwald JE, Gerstein M, Gerstung M, Getz G, Ghori M, Ghossein R, Giama NH, Gibbs RA, Gibson B, Gill AJ, Gill P, Giri DD, Glodzik D, Gnanapragasam VJ, Goebler ME, Goldman MJ, Gomez C, Gonzalez S, Gonzalez-Perez A, Gordenin DA, Gossage J, Gotoh K, Govindan R, Grabau D, Graham JS, Grant RC, Green AR, Green E, Greger L, Grehan N, Grimaldi S, Grimmond SM, Grossman RL, Grundhoff A, Gundem G, Guo Q, Gupta M, Gupta S, Gut IG, Gut M, Göke J, Ha G, Haake A, Haan D, Haas S, Haase K, Haber JE, Habermann N, Hach F, Haider S, Hama N, Hamdy FC, Hamilton A, Hamilton MP, Han L, Hanna GB, Hansmann M, Haradhvala NJ, Harismendy O, Harliwong I, Harmanci AO, Harrington E, Hasegawa T, Haussler D, Hawkins S, Hayami S, Hayashi S, Hayes DN, Hayes SJ, Hayward NK, Hazell S, He Y, Heath AP, Heath SC, Hedley D, Hegde AM, Heiman DI, Heinold MC, Heins Z, Heisler LE, Hellstrom-Lindberg E, Helmy M, Heo SG, Hepperla AJ, Heredia-Genestar JM, Herrmann C, Hersey P, Hess JM, Hilmarsdottir H, Hinton J, Hirano S, Hiraoka N, Hoadley KA, Hobolth A, Hodzic E, Hoell JI, Hoffmann S, Hofmann O, Holbrook A, Holik AZ, Hollingsworth MA, Holmes O, Holt RA, Hong C, Hong EP, Hong JH, Hooijer GK, Hornshøj H, Hosoda F, Hou Y, Hovestadt V, Howat W, Hoyle AP, Hruban RH, Hu J, Hu T, Hua X, Huang KL, Huang M, Huang MN, Huang V, Huang Y, Huber W, Hudson TJ, Hummel M, Hung JA, Huntsman D, Hupp TR, Huse J, Huska MR, Hutter B, Hutter CM, Hübschmann D, Iacobuzio-Donahue CA, Imbusch CD, Imielinski M, Imoto S, Isaacs WB, Isaev K, Ishikawa S, Iskar M, Islam SMA, Ittmann M, Ivkovic S, Izarzugaza JMG, Jacquemier J, Jakrot V, Jamieson NB, Jang GH, Jang SJ, Jayaseelan JC, Jayasinghe R, Jefferys SR, Jegalian K, Jennings JL, Jeon SH, Jerman L, Ji Y, Jiao W, Johansson PA, Johns AL, Johns J, Johnson R, Johnson TA, Jolly C, Joly Y, Jonasson JG, Jones CD, Jones DR, Jones DTW, Jones N, Jones SJM, Jonkers J, Ju YS, Juhl H, Jung J, Juul M, Juul RI, Juul S, Jäger N, Kabbe R, Kahles A, Kahraman A, Kaiser VB, Kakavand H, Kalimuthu S, von Kalle C, Kang KJ, Karaszi K, Karlan B, Karlić R, Karsch D, Kasaian K, Kassahn KS, Katai H, Kato M, Katoh H, Kawakami Y, Kay JD, Kazakoff SH, Kazanov MD, Keays M, Kebebew E, Kefford RF, Kellis M, Kench JG, Kennedy CJ, Kerssemakers JNA, Khoo D, Khoo V, Khuntikeo N, Khurana E, Kilpinen H, Kim HK, Kim HL, Kim HY, Kim H, Kim J, Kim J, Kim JK, Kim Y, King TA, Klapper W, Kleinheinz K, Klimczak LJ, Knappskog S, Kneba M, Knoppers BM, Koh Y, Komorowski J, Komura D, Komura M, Kong G, Kool M, Korbel JO, Korchina V, Korshunov A, Koscher M, Koster R, Kote-Jarai Z, Koures A, Kovacevic M, Kremeyer B, Kretzmer H, Kreuz M, Krishnamurthy S, Kube D, Kumar K, Kumar P, Kumar S, Kumar Y, Kundra R, Kübler K, Küppers R, Lagergren J, Lai PH, Laird PW, Lakhani SR, Lalansingh CM, Lalonde E, Lamaze FC, Lambert A, Lander E, Landgraf P, Landoni L, Langerød A, Lanzós A, Larsimont D, Larsson E, Lathrop M, Lau LMS, Lawerenz C, Lawlor RT, Lawrence MS, Lazar AJ, Lazic AM, Le X, Lee D, Lee D, Lee EA, Lee HJ, Lee JJK, Lee JY, Lee J, Lee MTM, Lee-Six H, Lehmann KV, Lehrach H, Lenze D, Leonard CR, Leongamornlert DA, Leshchiner I, Letourneau L, Letunic I, Levine DA, Lewis L, Ley T, Li C, Li CH, Li HI, Li J, Li L, Li S, Li S, Li X, Li X, Li X, Li Y, Liang H, Liang SB, Lichter P, Lin P, Lin Z, Linehan WM, Lingjærde OC, Liu D, Liu EM, Liu FFF, Liu F, Liu J, Liu X, Livingstone J, Livitz D, Livni N, Lochovsky L, Loeffler M, Long GV, Lopez-Guillermo A, Lou S, Louis DN, Lovat LB, Lu Y, Lu YJ, Lu Y, Luchini C, Lungu I, Luo X, Luxton HJ, Lynch AG, Lype L, López C, López-Otín C, Ma EZ, Ma Y, MacGrogan G, MacRae S, Macintyre G, Madsen T, Maejima K, Mafficini A, Maglinte DT, Maitra A, Majumder PP, Malcovati L, Malikic S, Malleo G, Mann GJ, Mantovani-Löffler L, Marchal K, Marchegiani G, Mardis ER, Margolin AA, Marin MG, Markowetz F, Markowski J, Marks J, Marques-Bonet T, Marra MA, Marsden L, Martens JWM, Martin S, Martin-Subero JI, Martincorena I, Martinez-Fundichely A, Maruvka YE, Mashl RJ, Massie CE, Matthew TJ, Matthews L, Mayer E, Mayes S, Mayo M, Mbabaali F, McCune K, McDermott U, McGillivray PD, McLellan MD, McPherson JD, McPherson JR, McPherson TA, Meier SR, Meng A, Meng S, Menzies A, Merrett ND, Merson S, Meyerson M, Meyerson W, Mieczkowski PA, Mihaiescu GL, Mijalkovic S, Mikkelsen T, Milella M, Mileshkin L, Miller CA, Miller DK, Miller JK, Mills GB, Milovanovic A, Minner S, Miotto M, Arnau GM, Mirabello L, Mitchell C, Mitchell TJ, Miyano S, Miyoshi N, Mizuno S, Molnár-Gábor F, Moore MJ, Moore RA, Morganella S, Morris QD, Morrison C, Mose LE, Moser CD, Muiños F, Mularoni L, Mungall AJ, Mungall K, Musgrove EA, Mustonen V, Mutch D, Muyas F, Muzny DM, Muñoz A, Myers J, Myklebost O, Möller P, Nagae G, Nagrial AM, Nahal-Bose HK, Nakagama H, Nakagawa H, Nakamura H, Nakamura T, Nakano K, Nandi T, Nangalia J, Nastic M, Navarro A, Navarro FCP, Neal DE, Nettekoven G, Newell F, Newhouse SJ, Newton Y, Ng AWT, Ng A, Nicholson J, Nicol D, Nie Y, Nielsen GP, Nielsen MM, Nik-Zainal S, Noble MS, Nones K, Northcott PA, Notta F, O’Connor BD, O’Donnell P, O’Donovan M, O’Meara S, O’Neill BP, O’Neill JR, Ocana D, Ochoa A, Oesper L, Ogden C, Ohdan H, Ohi K, Ohno-Machado L, Oien KA, Ojesina AI, Ojima H, Okusaka T, Omberg L, Ong CK, Ossowski S, Ott G, Ouellette BFF, P’ng C, Paczkowska M, Paiella S, Pairojkul C, Pajic M, Pan-Hammarström Q, Papaemmanuil E, Papatheodorou I, Paramasivam N, Park JW, Park JW, Park K, Park K, Park PJ, Parker JS, Parsons SL, Pass H, Pasternack D, Pastore A, Patch AM, Pauporté I, Pea A, Pearson JV, Pedamallu CS, Pedersen JS, Pederzoli P, Peifer M, Pennell NA, Perou CM, Perry MD, Petersen GM, Peto M, Petrelli N, Petryszak R, Pfister SM, Phillips M, Pich O, Pickett HA, Pihl TD, Pillay N, Pinder S, Pinese M, Pinho AV, Pitkänen E, Pivot X, Piñeiro-Yáñez E, Planko L, Plass C, Polak P, Pons T, Popescu I, Potapova O, Prasad A, Preston SR, Prinz M, Pritchard AL, Prokopec SD, Provenzano E, Puente XS, Puig S, Puiggròs M, Pulido-Tamayo S, Pupo GM, Purdie CA, Quinn MC, Rabionet R, Rader JS, Radlwimmer B, Radovic P, Raeder B, Raine KM, Ramakrishna M, Ramakrishnan K, Ramalingam S, Raphael BJ, Rathmell WK, Rausch T, Reifenberger G, Reimand J, Reis-Filho J, Reuter V, Reyes-Salazar I, Reyna MA, Reynolds SM, Rheinbay E, Riazalhosseini Y, Richardson AL, Richter J, Ringel M, Ringnér M, Rino Y, Rippe K, Roach J, Roberts LR, Roberts ND, Roberts SA, Robertson AG, Robertson AJ, Rodriguez JB, Rodriguez-Martin B, Rodríguez-González FG, Roehrl MHA, Rohde M, Rokutan H, Romieu G, Rooman I, Roques T, Rosebrock D, Rosenberg M, Rosenstiel PC, Rosenwald A, Rowe EW, Royo R, Rozen SG, Rubanova Y, Rubin MA, Rubio-Perez C, Rudneva VA, Rusev BC, Ruzzenente A, Rätsch G, Sabarinathan R, Sabelnykova VY, Sadeghi S, Sahinalp SC, Saini N, Saito-Adachi M, Saksena G, Salcedo A, Salgado R, Salichos L, Sallari R, Saller C, Salvia R, Sam M, Samra JS, Sanchez-Vega F, Sander C, Sanders G, Sarin R, Sarrafi I, Sasaki-Oku A, Sauer T, Sauter G, Saw RPM, Scardoni M, Scarlett CJ, Scarpa A, Scelo G, Schadendorf D, Schein JE, Schilhabel MB, Schlesner M, Schlomm T, Schmidt HK, Schramm SJ, Schreiber S, Schultz N, Schumacher SE, Schwarz RF, Scolyer RA, Scott D, Scully R, Seethala R, Segre AV, Selander I, Semple CA, Senbabaoglu Y, Sengupta S, Sereni E, Serra S, Sgroi DC, Shackleton M, Shah NC, Shahabi S, Shang CA, Shang P, Shapira O, Shelton T, Shen C, Shen H, Shepherd R, Shi R, Shi Y, Shiah YJ, Shibata T, Shih J, Shimizu E, Shimizu K, Shin SJ, Shiraishi Y, Shmaya T, Shmulevich I, Shorser SI, Short C, Shrestha R, Shringarpure SS, Shriver C, Shuai S, Sidiropoulos N, Siebert R, Sieuwerts AM, Sieverling L, Signoretti S, Sikora KO, Simbolo M, Simon R, Simons JV, Simpson JT, Simpson PT, Singer S, Sinnott-Armstrong N, Sipahimalani P, Skelly TJ, Smid M, Smith J, Smith-McCune K, Socci ND, Sofia HJ, Soloway MG, Song L, Sood AK, Sothi S, Sotiriou C, Soulette CM, Span PN, Spellman PT, Sperandio N, Spillane AJ, Spiro O, Spring J, Staaf J, Stadler PF, Staib P, Stark SG, Stebbings L, Stefánsson ÓA, Stegle O, Stein LD, Stenhouse A, Stewart C, Stilgenbauer S, Stobbe MD, Stratton MR, Stretch JR, Struck AJ, Stuart JM, Stunnenberg HG, Su H, Su X, Sun RX, Sungalee S, Susak H, Suzuki A, Sweep F, Szczepanowski M, Sültmann H, Yugawa T, Tam A, Tamborero D, Tan BKT, Tan D, Tan P, Tanaka H, Taniguchi H, Tanskanen TJ, Tarabichi M, Tarnuzzer R, Tarpey P, Taschuk ML, Tatsuno K, Tavaré S, Taylor DF, Taylor-Weiner A, Teague JW, Teh BT, Tembe V, Temes J, Thai K, Thayer SP, Thiessen N, Thomas G, Thomas S, Thompson A, Thompson AM, Thompson JFF, Thompson RH, Thorne H, Thorne LB, Thorogood A, Tiao G, Tijanic N, Timms LE, Tirabosco R, Tojo M, Tommasi S, Toon CW, Toprak UH, Torrents D, Tortora G, Tost J, Totoki Y, Townend D, Traficante N, Treilleux I, Trotta JR, Trümper LHP, Tsao M, Tsunoda T, Tubio JMC, Tucker O, Turkington R, Turner DJ, Tutt A, Ueno M, Ueno NT, Umbricht C, Umer HM, Underwood TJ, Urban L, Urushidate T, Ushiku T, Uusküla-Reimand L, Valencia A, Van Den Berg DJ, Van Laere S, Van Loo P, Van Meir EG, Van den Eynden GG, Van der Kwast T, Vasudev N, Vazquez M, Vedururu R, Veluvolu U, Vembu S, Verbeke LPC, Vermeulen P, Verrill C, Viari A, Vicente D, Vicentini C, VijayRaghavan K, Viksna J, Vilain RE, Villasante I, Vincent-Salomon A, Visakorpi T, Voet D, Vyas P, Vázquez-García I, Waddell NM, Waddell N, Wadelius C, Wadi L, Wagener R, Wala JA, Wang J, Wang J, Wang L, Wang Q, Wang W, Wang Y, Wang Z, Waring PM, Warnatz HJ, Warrell J, Warren AY, Waszak SM, Wedge DC, Weichenhan D, Weinberger P, Weinstein JN, Weischenfeldt J, Weisenberger DJ, Welch I, Wendl MC, Werner J, Whalley JP, Wheeler DA, Whitaker HC, Wigle D, Wilkerson MD, Williams A, Wilmott JS, Wilson GW, Wilson JM, Wilson RK, Winterhoff B, Wintersinger JA, Wiznerowicz M, Wolf S, Wong BH, Wong T, Wong W, Woo Y, Wood S, Wouters BG, Wright AJ, Wright DW, Wright MH, Wu CL, Wu DY, Wu G, Wu J, Wu K, Wu Y, Wu Z, Xi L, Xia T, Xiang Q, Xiao X, Xing R, Xiong H, Xu Q, Xu Y, Xue H, Yachida S, Yakneen S, Yamaguchi R, Yamaguchi TN, Yamamoto M, Yamamoto S, Yamaue H, Yang F, Yang H, Yang JY, Yang L, Yang L, Yang S, Yang TP, Yang Y, Yao X, Yaspo ML, Yates L, Yau C, Ye C, Ye K, Yellapantula VD, Yoon CJ, Yoon SS, Yousif F, Yu J, Yu K, Yu W, Yu Y, Yuan K, Yuan Y, Yuen D, Yung CK, Zaikova O, Zamora J, Zapatka M, Zenklusen JC, Zenz T, Zeps N, Zhang CZ, Zhang F, Zhang H, Zhang H, Zhang H, Zhang J, Zhang J, Zhang J, Zhang X, Zhang X, Zhang Y, Zhang Z, Zhao Z, Zheng L, Zheng X, Zhou W, Zhou Y, Zhu B, Zhu H, Zhu J, Zhu S, Zou L, Zou X, deFazio A, van As N, van Deurzen CHM, van de Vijver MJ, van’t Veer L, von Mering C. Pan-cancer analysis of whole genomes. Nature 2020; 578:82-93. [PMID: 32025007 PMCID: PMC7025898 DOI: 10.1038/s41586-020-1969-6] [Citation(s) in RCA: 1435] [Impact Index Per Article: 358.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 12/11/2019] [Indexed: 02/07/2023]
Abstract
Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale1-3. Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4-5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter4; identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation5,6; analyses timings and patterns of tumour evolution7; describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity8,9; and evaluates a range of more-specialized features of cancer genomes8,10-18.
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Rigau M, Ostrouska S, Fulford TS, Johnson DN, Woods K, Ruan Z, McWilliam HEG, Hudson C, Tutuka C, Wheatley AK, Kent SJ, Villadangos JA, Pal B, Kurts C, Simmonds J, Pelzing M, Nash AD, Hammet A, Verhagen AM, Vairo G, Maraskovsky E, Panousis C, Gherardin NA, Cebon J, Godfrey DI, Behren A, Uldrich AP. Butyrophilin 2A1 is essential for phosphoantigen reactivity by γδ T cells. Science 2020; 367:science.aay5516. [PMID: 31919129 DOI: 10.1126/science.aay5516] [Citation(s) in RCA: 232] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/14/2019] [Accepted: 12/23/2019] [Indexed: 12/21/2022]
Abstract
Gamma delta (γδ) T cells are essential to protective immunity. In humans, most γδ T cells express Vγ9Vδ2+ T cell receptors (TCRs) that respond to phosphoantigens (pAgs) produced by cellular pathogens and overexpressed by cancers. However, the molecular targets recognized by these γδTCRs are unknown. Here, we identify butyrophilin 2A1 (BTN2A1) as a key ligand that binds to the Vγ9+ TCR γ chain. BTN2A1 associates with another butyrophilin, BTN3A1, and these act together to initiate responses to pAg. Furthermore, binding of a second ligand, possibly BTN3A1, to a separate TCR domain incorporating Vδ2 is also required. This distinctive mode of Ag-dependent T cell activation advances our understanding of diseases involving pAg recognition and creates opportunities for the development of γδ T cell-based immunotherapies.
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Affiliation(s)
- Marc Rigau
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,University of Bonn, Bonn, Germany.,Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Victoria 3010, Australia
| | - Simone Ostrouska
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia
| | - Thomas S Fulford
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Darryl N Johnson
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Victoria 3010, Australia
| | - Katherine Woods
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia.,Ludwig Institute for Cancer Research, Melbourne -Austin Branch, Victoria 3084, Australia
| | - Zheng Ruan
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Victoria 3010, Australia
| | - Hamish E G McWilliam
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Department of Biochemistry and Molecular Biology at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Christopher Hudson
- Ludwig Institute for Cancer Research, Melbourne -Austin Branch, Victoria 3084, Australia
| | - Candani Tutuka
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia
| | - Adam K Wheatley
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Australian Research Council Centre of Excellence for Convergent Bio-Nano Science and Technology at the University of Melbourne, Victoria 3010, Australia
| | - Stephen J Kent
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Australian Research Council Centre of Excellence for Convergent Bio-Nano Science and Technology at the University of Melbourne, Victoria 3010, Australia
| | - Jose A Villadangos
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Department of Biochemistry and Molecular Biology at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Bhupinder Pal
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia
| | | | - Jason Simmonds
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Matthias Pelzing
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Andrew D Nash
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Andrew Hammet
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Anne M Verhagen
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Gino Vairo
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Eugene Maraskovsky
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Con Panousis
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Nicholas A Gherardin
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia.,Ludwig Institute for Cancer Research, Melbourne -Austin Branch, Victoria 3084, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Victoria 3010, Australia.,Austin Health, Heidelberg, Victoria 3084, Australia
| | - Dale I Godfrey
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia. .,Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Victoria 3010, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia. .,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia.,Ludwig Institute for Cancer Research, Melbourne -Austin Branch, Victoria 3084, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Adam P Uldrich
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia. .,Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Victoria 3010, Australia
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24
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Gunjur A, Klein O, Kee D, Cebon J. Anti-programmed cell death protein 1 (anti-PD1) immunotherapy induced autoimmune polyendocrine syndrome type II (APS-2): a case report and review of the literature. J Immunother Cancer 2019; 7:241. [PMID: 31488221 PMCID: PMC6729071 DOI: 10.1186/s40425-019-0713-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/21/2019] [Indexed: 12/18/2022] Open
Abstract
Background Autoimmune polyendocrine syndrome type II (APS-2) is a rare constellation of autoimmune hypoadrenalism, thyroid dysfunction and/or type 1 diabetes (T1DM), usually occurring in the 3rd or 4th decades and associated with a human leukocyte antigen (HLA) DR3 or DR4 serotype. We detail the first report of an elderly woman developing the full triad of APS-2 shortly after commencing anti-programmed cell death protein 1 (anti-PD1) immune checkpoint inhibition for unresectable melanoma and review the literature for similar presentations secondary to anti-PD1 axis therapy. Case A 78-year-old female with advanced unresectable BRAF wild-type melanoma was treated with pembrolizumab (2 mg/kg 3-weekly). Three weeks following the first dose she developed fulminant autoimmune diabetes, with an initially low C-peptide denoting rapid destruction of ß-islet cells. Following stabilisation of her diabetes, two further doses of pembrolizumab was administered. She then represented with symptomatic hypoadrenalism and hypothyroidism, consistent with APS-2. Her HLA class II genotype was HLA-DRB1*04.16 (DR4 serotype), a recognised association with this syndrome. Her melanoma responded rapidly to anti-PD1 therapy, and a complete response (CR) was attained after four doses of pembrolizumab. Treatment was discontinued and her CR is ongoing. Conclusion This is the first report of the full triad of APS-2 developing in a genetically susceptible individual at the age of 78 after treatment with an anti-PD1 agent. Although scarcely reported, a literature review of similar reports seems to indicate a predilection for this syndrome in patients with HLA-DR4 serotypes. HLA Class II typing is not routinely recommended, but may provide useful predictive information for patients at risk of poly-endocrinopathy even in patients without a relevant personal or family history. Additional studies are required to determine if such testing would be useful and/or cost effective. Electronic supplementary material The online version of this article (10.1186/s40425-019-0713-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ashray Gunjur
- Department of Medical Oncology, Austin Health, Melbourne, Australia.
| | - Oliver Klein
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Damien Kee
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Jonathan Cebon
- Department of Medical Oncology, Austin Health, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Australia
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25
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Lee EF, Harris TJ, Tran S, Evangelista M, Arulananda S, John T, Ramnac C, Hobbs C, Zhu H, Gunasingh G, Segal D, Behren A, Cebon J, Dobrovic A, Mariadason JM, Strasser A, Rohrbeck L, Haass NK, Herold MJ, Fairlie WD. BCL-XL and MCL-1 are the key BCL-2 family proteins in melanoma cell survival. Cell Death Dis 2019; 10:342. [PMID: 31019203 PMCID: PMC6482196 DOI: 10.1038/s41419-019-1568-3] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/28/2019] [Accepted: 04/02/2019] [Indexed: 12/17/2022]
Abstract
Malignant melanoma is one of the most difficult cancers to treat due to its resistance to chemotherapy. Despite recent successes with BRAF inhibitors and immune checkpoint inhibitors, many patients do not respond or become resistant to these drugs. Hence, alternative treatments are still required. Due to the importance of the BCL-2-regulated apoptosis pathway in cancer development and drug resistance, it is of interest to establish which proteins are most important for melanoma cell survival, though the outcomes of previous studies have been conflicting. To conclusively address this question, we tested a panel of established and early passage patient-derived cell lines against several BH3-mimetic drugs designed to target individual or subsets of pro-survival BCL-2 proteins, alone and in combination, in both 2D and 3D cell cultures. None of the drugs demonstrated significant activity as single agents, though combinations targeting MCL-1 plus BCL-XL, and to a lesser extent BCL-2, showed considerable synergistic killing activity that was elicited via both BAX and BAK. Genetic deletion of BFL-1 in cell lines that express it at relatively high levels only had minor impact on BH3-mimetic drug sensitivity, suggesting it is not a critical pro-survival protein in melanoma. Combinations of MCL-1 inhibitors with BRAF inhibitors also caused only minimal additional melanoma cell killing over each drug alone, whilst combinations with the proteasome inhibitor bortezomib was more effective in multiple cell lines. Our data show for the first time that therapies targeting specific combinations of BCL-2 pro-survival proteins, namely MCL-1 plus BCL-XL and MCL-1 plus BCL-2, could have significant benefit for the treatment of melanoma.
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Affiliation(s)
- Erinna F Lee
- La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, 3086, Australia. .,Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia. .,School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia.
| | - Tiffany J Harris
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia
| | - Sharon Tran
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Marco Evangelista
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia
| | - Surein Arulananda
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Thomas John
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Celeste Ramnac
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Chloe Hobbs
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Haoran Zhu
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - Gency Gunasingh
- The University of Queensland, The University of Queensland Diamantina Institute, Translational Research Institute, Woolloongabba, Brisbane, QLD, 4102, Australia
| | - David Segal
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Alexander Dobrovic
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia
| | - John M Mariadason
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Andreas Strasser
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Leona Rohrbeck
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Karolinska Institute, Stockholm, Sweden
| | - Nikolas K Haass
- The University of Queensland, The University of Queensland Diamantina Institute, Translational Research Institute, Woolloongabba, Brisbane, QLD, 4102, Australia
| | - Marco J Herold
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - W Douglas Fairlie
- La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, 3086, Australia. .,Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia. .,School of Cancer Medicine, La Trobe University, Melbourne, VIC, 3086, Australia.
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26
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Liew DFL, Leung JLY, Liu B, Cebon J, Frauman AG, Buchanan RRC. Association of good oncological response to therapy with the development of rheumatic immune-related adverse events following PD-1 inhibitor therapy. Int J Rheum Dis 2018; 22:297-302. [PMID: 30549256 DOI: 10.1111/1756-185x.13444] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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: 04/22/2018] [Revised: 10/03/2018] [Accepted: 10/19/2018] [Indexed: 01/19/2023]
Abstract
AIM To investigate whether any patient or treatment characteristics are associated with the development of rheumatic immune-related adverse events (irAEs) following programmed cell death protein 1 (PD-1) inhibitor therapy for cancer. METHOD This was a retrospective chart review of all patients who were dispensed nivolumab or pembrolizumab at a single center before 1 January, 2017, with follow-up until 1 July, 2017. Patients with any diagnosis of a non-cutaneous irAE were identified, regardless of severity, and rheumatic irAEs were characterized. RESULTS Of 244 episodes of therapy, a non-cutaneous irAE occurred in 72 (29.5%). Rheumatic irAEs were diagnosed in 19 episodes of therapy (7.8%), with 12 de novo diagnoses (5.1% of episodes without a pre-existing autoimmune rheumatic disease) and 7 exacerbations of existing disease. Review by a rheumatologist occurred in only 11 of these. Rheumatic irAEs were more common in patients with a good oncological response to therapy (relative risk [RR] 11.16), those being treated for melanoma (RR 2.94) and those who developed another non-cutaneous irAE (RR 2.64). CONCLUSION Rheumatic irAEs are relatively common with PD-1 inhibitor therapy, and appear to be associated with a good oncological response to therapy. Many rheumatic irAEs were not referred to rheumatological services. Prospective systematic investigation would be of benefit to explore these characteristics.
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Affiliation(s)
- David F L Liew
- Department of Rheumatology, Austin Health, Melbourne, VIC, Australia.,Department of Clinical Pharmacology and Therapeutics, Austin Health, Melbourne, VIC, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Jessica L Y Leung
- Department of Rheumatology, Austin Health, Melbourne, VIC, Australia
| | - Bonnia Liu
- Department of Rheumatology, Austin Health, Melbourne, VIC, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Wellness & Research Centre, Melbourne, VIC, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia
| | - Albert G Frauman
- Department of Clinical Pharmacology and Therapeutics, Austin Health, Melbourne, VIC, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Russell R C Buchanan
- Department of Rheumatology, Austin Health, Melbourne, VIC, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
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27
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Parakh S, Randhawa M, Nguyen B, Warburton L, Hussain MA, Cebon J, Millward M, Yip D, Ali S. Real-world efficacy and toxicity of combined nivolumab and ipilimumab in patients with metastatic melanoma. Asia Pac J Clin Oncol 2018; 15:26-30. [PMID: 30426665 DOI: 10.1111/ajco.13100] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 05/18/2018] [Accepted: 09/29/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is limited real-world data on the efficacy and safety of combination programmed cell death protein-1 (PD-1) inhibitor, nivolumab and the cytotoxic T-lymphocyte antigen (CTLA-4) inhibitor ipilimumab. METHOD We retrospectively identified patients (pts) with metastatic melanoma treated with three-weekly nivolumab (1 mg/kg) in combination with ipilimumab (3 mg/kg) for four cycles followed by nivolumab monotherapy (3 mg/kg) fortnightly. Patient demographics and treatment parameters were collected and outcomes determined. RESULTS A total of 45 pts received combination treatment with a median follow up of 8.7 months (range 0.33-25.9 months). A total of 67% were male, and BRAF V600 mutations detected in 38%. At treatment commencement, 14 (31%) pts had brain metastases, 51% had an elevated LDH and 18 (40%) were treatment-naive. Almost a third (30%) required corticosteroids for symptom control or management of prior toxicities. Nineteen (42%) patients had prior anti-PD-1 therapy. The disease control rate (DCR) was 54% and objective response rate (ORR) was 29%. Of pts treated with prior immune checkpoint inhibitors, the DCR and ORR were 50% and 33%, respectively. Intracranial responses were observed in 18% (n = 2). The median progression-free survival (PFS) was 5.8 months (95% Confidence interval (CI), 2.9-14.1 months). PFS was higher in treatment naïve patients compared to those who had prior immunotherapy (6.2 months vs 4.9 months, P = 0.59). The median OS was 17.4 months (95% CI, 7.1-NR). pts requiring corticosteroids had a shorter PFS (4.9 months vs 6.8 months) and OS (7.1 months vs NR, P = 0.01).Treatment-related adverse events of any grade were experienced by 88% of pts, with 54% having grade 3-4 adverse events. Treatment discontinuation due to adverse events occurred in 44% of pts. CONCLUSION In this study, responses to combination immunotherapy were lower than reported. Patients treated with prior immunotherapy had similar responses as treatment-naïve pts. The toxicity profile seen in this study is similar to those reported in clinical trials.
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Affiliation(s)
- Sagun Parakh
- Department of Medical Oncology, Austin Health, Melbourne, Victoria, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia.,La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia
| | - Manreet Randhawa
- Department of Medical Oncology, Canberra Region Cancer Centre, The Canberra Hospital, ACT, Australia
| | - Bella Nguyen
- Department of Medical Oncology, Sir Charles Gairdner Hospital, WA, Australia
| | - Lydia Warburton
- Department of Medical Oncology, Sir Charles Gairdner Hospital, WA, Australia
| | - Mohammad Akhtar Hussain
- Western Australia Centre for Rural Health, University of Western Australia, WA, Australia.,School of Population and Global Health, University of Western Australia, WA, Australia
| | - Jonathan Cebon
- Department of Medical Oncology, Austin Health, Melbourne, Victoria, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia.,La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia
| | - Michael Millward
- Department of Medical Oncology, Sir Charles Gairdner Hospital, WA, Australia
| | - Desmond Yip
- Department of Medical Oncology, Canberra Region Cancer Centre, The Canberra Hospital, ACT, Australia.,ANU Medical School, Australian National University, ACT, Australia
| | - Sayed Ali
- Department of Medical Oncology, Canberra Region Cancer Centre, The Canberra Hospital, ACT, Australia.,ANU Medical School, Australian National University, ACT, Australia
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28
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Arulananda S, Parakh S, Goodwin M, Andrews M, Cebon J. A pilot study of intrahepatic Yttrium-90 microsphere radioembolisation in combination with intravenous cisplatin for uveal melanoma liver-only metastases. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy439.002] [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: 11/12/2022] Open
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29
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Barnet M, Jackson K, Gao B, Nagrial A, Boyer M, Cooper W, Hui R, Linton A, Tattersall M, Russell A, Gibson G, Cebon J, Long G, Menzies A, Scolyer R, Lacaze P, Brink R, Peters T, Cowley M, Gayevskiy V, Thomas D, Pinese M, Blinman P, Kao S, Goodnow C. P1.04-11 Exploring the Germ-Line Contribution to Exceptional Response to PD-1/PD-L1 Inhibition in Patients with NSCLC by Whole Genome Sequencing. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Ribas A, Dummer R, Puzanov I, VanderWalde A, Andtbacka RHI, Michielin O, Olszanski AJ, Malvehy J, Cebon J, Fernandez E, Kirkwood JM, Gajewski TF, Chen L, Gorski KS, Anderson AA, Diede SJ, Lassman ME, Gansert J, Hodi FS, Long GV. Oncolytic Virotherapy Promotes Intratumoral T Cell Infiltration and Improves Anti-PD-1 Immunotherapy. Cell 2018; 174:1031-1032. [PMID: 30096300 DOI: 10.1016/j.cell.2018.07.035] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Halse H, Colebatch AJ, Petrone P, Henderson MA, Mills JK, Snow H, Westwood JA, Sandhu S, Raleigh JM, Behren A, Cebon J, Darcy PK, Kershaw MH, McArthur GA, Gyorki DE, Neeson PJ. Multiplex immunohistochemistry accurately defines the immune context of metastatic melanoma. Sci Rep 2018; 8:11158. [PMID: 30042403 PMCID: PMC6057961 DOI: 10.1038/s41598-018-28944-3] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/02/2018] [Indexed: 01/01/2023] Open
Abstract
A prospective study explored the heterogeneous nature of metastatic melanoma using Multiplex immunohistochemistry (IHC) and flow cytometry (FACS). Multiplex IHC data quantitated immune subset number present intra-tumoral (IT) vs the tumor stroma, plus distance of immune subsets from the tumor margin (TM). In addition, mIHC showed a close association between the presence of IT CD8+ T cells and PDL1 expression in melanoma, which was more prevalent on macrophages than on melanoma cells. In contrast, FACS provided more detailed information regarding the T cell subset differentiation, their activation status and expression of immune checkpoint molecules. Interestingly, mIHC detected significantly higher Treg numbers than FACS and showed preferential CD4+ T cell distribution in the tumor stroma. Based on the mIHC and FACS data, we provide a model which defines metastatic melanoma immune context into four categories using the presence or absence of PDL1+ melanoma cells and/or macrophages, and their location within the tumor or on the periphery, combined with the presence or absence of IT CD8+ T cells. This model interprets melanoma immune context as a spectrum of tumor escape from immune control, and provides a snapshot upon which interpretation of checkpoint blockade inhibitor (CBI) therapy responses can be built.
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Affiliation(s)
- H Halse
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - A J Colebatch
- Division of Cancer Medicine Melanoma Program, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - P Petrone
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - M A Henderson
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - J K Mills
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - H Snow
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - J A Westwood
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - S Sandhu
- Division of Cancer Medicine Melanoma Program, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, 3052, Australia
| | - J M Raleigh
- Division of Cancer Medicine Melanoma Program, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - A Behren
- Olivia Newton John Cancer Research Institute, Heidelberg, Victoria, 3084, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, 3086, Australia
| | - J Cebon
- Olivia Newton John Cancer Research Institute, Heidelberg, Victoria, 3084, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, 3086, Australia
| | - P K Darcy
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, 3052, Australia
| | - M H Kershaw
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, 3052, Australia
| | - G A McArthur
- Division of Cancer Medicine Melanoma Program, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - D E Gyorki
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Department of Surgery, University of Melbourne, Parkville, Victoria, 3052, Australia
| | - P J Neeson
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia. .,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, 3052, Australia.
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32
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Parakh S, Cebon J, Klein O. Delayed Autoimmune Toxicity Occurring Several Months After Cessation of Anti-PD-1 Therapy. Oncologist 2018; 23:849-851. [PMID: 29666298 DOI: 10.1634/theoncologist.2017-0531] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/12/2018] [Indexed: 01/03/2023] Open
Abstract
Treatment with anti-programmed cell death protein 1 (PD-1) antibodies has demonstrated clinical efficacy in a whole range of malignancies including advanced melanoma, renal cell cancer, bladder cancer, and non-small cell lung cancer. Immune-related adverse events are a unique side effect of checkpoint regulator therapy including anti-PD-1 antibodies. Treatment-related autoimmunity can occur in any organ system, with the median onset usually within 5-15 weeks from the commencement of therapy, depending on the organ system involved. This study describes for the first time a case of delayed autoimmunity occurring 8 months after discontinuing treatment with the anti-PD-1 antibody nivolumab in a patient with metastatic melanoma. The case highlights the need for ongoing surveillance of patients treated with immune checkpoint inhibitors even after cessation of therapy, especially as patients increasingly stop treatment after achieving durable responses.
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Affiliation(s)
- Sagun Parakh
- Medical Oncology Unit, Austin Health, Melbourne, Victoria, Australia
- Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia
- La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia
| | - Jonathan Cebon
- Medical Oncology Unit, Austin Health, Melbourne, Victoria, Australia
- Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia
- La Trobe University School of Cancer Medicine, Melbourne, Victoria, Australia
| | - Oliver Klein
- Medical Oncology Unit, Austin Health, Melbourne, Victoria, Australia
- Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia
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Tsao SCH, Wang J, Wang Y, Behren A, Cebon J, Trau M. Characterising the phenotypic evolution of circulating tumour cells during treatment. Nat Commun 2018; 9:1482. [PMID: 29662054 PMCID: PMC5902511 DOI: 10.1038/s41467-018-03725-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 03/08/2018] [Indexed: 12/30/2022] Open
Abstract
Real-time monitoring of cancer cells' phenotypic evolution during therapy can provide vital tumour biology information for treatment management. Circulating tumour cell (CTC) analysis has emerged as a useful monitoring tool, but its routine usage is restricted by either limited multiplexing capability or sensitivity. Here, we demonstrate the use of antibody-conjugated and Raman reporter-coated gold nanoparticles for simultaneous labelling and monitoring of multiple CTC surface markers (named as "cell signature"), without the need for isolating individual CTCs. We observe cell heterogeneity and phenotypic changes of melanoma cell lines during molecular targeted treatment. Furthermore, we follow the CTC signature changes of 10 stage-IV melanoma patients receiving immunological or molecular targeted therapies. Our technique maps the phenotypic evolution of patient CTCs sensitively and rapidly, and shows drug-resistant clones having different CTC signatures of potential clinical value. We believe our proposed method is of general interest in the CTC relevant research and translation fields.
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Affiliation(s)
- Simon Chang-Hao Tsao
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane, QLD, 4072, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,Department of Surgery, University of Melbourne, Austin Health, Heidelberg, VIC, 3084, Australia
| | - Jing Wang
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane, QLD, 4072, Australia
| | - Yuling Wang
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane, QLD, 4072, Australia. .,Department of Molecular Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, 2109, Australia.
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,Department of Surgery, University of Melbourne, Austin Health, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Matt Trau
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane, QLD, 4072, Australia. .,School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, QLD, 4072, Australia.
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Da Gama Duarte J, Parakh S, Andrews MC, Woods K, Pasam A, Tutuka C, Ostrouska S, Blackburn JM, Behren A, Cebon J. Autoantibodies May Predict Immune-Related Toxicity: Results from a Phase I Study of Intralesional Bacillus Calmette-Guérin followed by Ipilimumab in Patients with Advanced Metastatic Melanoma. Front Immunol 2018; 9:411. [PMID: 29552014 PMCID: PMC5840202 DOI: 10.3389/fimmu.2018.00411] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/14/2018] [Indexed: 11/13/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced melanoma. The first ICI to demonstrate clinical benefit, ipilimumab, targets cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4); however, the long-term overall survival is just 22%. More than 40 years ago intralesional (IL) bacillus Calmette-Guérin (BCG), a living attenuated strain of Mycobacterium bovis, was found to induce tumor regression by stimulating cell-mediated immunity following a localized and self-limiting infection. We evaluated these two immune stimulants in combination with melanoma with the aim of developing a more effective immunotherapy and to assess toxicity. In this phase I study, patients with histologically confirmed stage III/IV metastatic melanoma received IL BCG injection followed by up to four cycles of intravenous ipilimumab (anti-CTLA-4) (ClinicalTrials.gov number NCT01838200). The trial was discontinued following treatment of the first five patients as the two patients receiving the escalation dose of BCG developed high-grade immune-related adverse events (irAEs) typical of ipilimumab monotherapy. These irAEs were characterized in both patients by profound increases in the repertoire of autoantibodies directed against both self- and cancer antigens. Interestingly, the induced autoantibodies were detected at time points that preceded the development of symptomatic toxicity. There was no overlap in the antigen specificity between patients and no evidence of clinical responses. Efforts to increase response rates through the use of novel immunotherapeutic combinations may be associated with higher rates of irAEs, thus the imperative to identify biomarkers of toxicity remains strong. While the small patient numbers in this trial do not allow for any conclusive evidence of predictive biomarkers, the observed changes warrant further examination of autoantibody repertoires in larger patient cohorts at risk of developing irAEs during their course of treatment. In summary, dose escalation of IL BCG followed by ipilimumab therapy was not well tolerated in advanced melanoma patients and showed no evidence of clinical benefit. Measuring autoantibody responses may provide early means for identifying patients at risk from developing severe irAEs during cancer immunotherapy.
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Affiliation(s)
- Jessica Da Gama Duarte
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Sagun Parakh
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Miles C Andrews
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia.,MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Katherine Woods
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Anupama Pasam
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Candani Tutuka
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Simone Ostrouska
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia
| | - Jonathan M Blackburn
- Department of Integrative Biomedical Sciences and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.,Sengenics Corporation, Singapore, Singapore
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
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Long GV, Eroglu Z, Infante J, Patel S, Daud A, Johnson DB, Gonzalez R, Kefford R, Hamid O, Schuchter L, Cebon J, Sharfman W, McWilliams R, Sznol M, Redhu S, Gasal E, Mookerjee B, Weber J, Flaherty KT. Long-Term Outcomes in Patients With BRAF V600-Mutant Metastatic Melanoma Who Received Dabrafenib Combined With Trametinib. J Clin Oncol 2018; 36:667-673. [PMID: 28991513 PMCID: PMC10466457 DOI: 10.1200/jco.2017.74.1025] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To report 5-year landmark analysis efficacy and safety outcomes in patients with BRAF V600-mutant metastatic melanoma (MM) who received BRAF inhibitor dabrafenib (D) and MEK inhibitor trametinib (T) combination therapy versus D monotherapy in the randomized phase II BRF113220 study part C. Patients and Methods BRAF inhibitor-naive patients with BRAF V600-mutant MM were randomly assigned 1:1:1 to receive D 150 mg twice a day, D 150 mg twice a day plus T 1 mg once daily, or D 150 mg twice a day plus T 2 mg once daily (D + T 150/2). Patients who received D monotherapy could cross over to D + T 150/2 postprogression. Efficacy and safety were analyzed 4 and 5 years after initiation in patients with ≥ 5 years of follow-up. Results As of October 13, 2016, 18 patients who received D + T 150/2 remained in the study (13 [24%] of 54 enrolled at this dose plus five [11%] of 45 initially administered D who crossed over to D + T). With D + T 150/2, overall survival (OS; 4 years, 30%; 5 years, 28%) and progression-free survival (4 and 5 years, both 13%) appeared to stabilize with extended follow-up. Increased OS was observed in patients who received D + T with baseline normal lactate dehydrogenase (5 years, 45%) and normal lactate dehydrogenase with fewer than three organ sites with metastasis (5 years, 51%). With extended follow-up, one additional patient who received D + T 150/2 improved from a partial to a complete response. No new safety signals were observed. Conclusion This 5-year analysis represents the longest follow-up to date with BRAF + MEK inhibitor combination therapy in BRAF V600-mutant MM. Consistent with trends observed in landmark analyses with shorter follow-up, this therapy elicits durable plateaus of long-term OS and progression-free survival that last ≥ 5 years in some patients with MM.
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Affiliation(s)
- Georgina V. Long
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Zeynep Eroglu
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Jeffrey Infante
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Sapna Patel
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Adil Daud
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Douglas B. Johnson
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Rene Gonzalez
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Richard Kefford
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Omid Hamid
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Lynn Schuchter
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Jonathan Cebon
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - William Sharfman
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Robert McWilliams
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Mario Sznol
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Suman Redhu
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Eduard Gasal
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Bijoyesh Mookerjee
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Jeffrey Weber
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
| | - Keith T. Flaherty
- Georgina V. Long, University of Sydney, and Royal North Shore Hospital; Richard Kefford, Macquarie University, Sydney, and Westmead Hospital, Westmead, New South Wales; Jonathan Cebon, Ludwig Institute for Cancer Research, Melbourne, Victoria, Australia; Zeynep Eroglu, Moffitt Cancer Center, Tampa, FL; Jeffrey Infante, Tennessee Oncology; Douglas B. Johnson, Vanderbilt-Ingram Cancer Center, Nashville, TN; Sapna Patel, The University of Texas MD Anderson Cancer Center, Houston, TX; Adil Daud, University of California, San Francisco, San Francisco; Omid Hamid, The Angeles Clinic and Research Institute, Los Angeles, CA; Rene Gonzalez, University of Colorado, Denver, CO; Lynn Schuchter, University of Pennsylvania, Philadelphia, PA; William Sharfman, Sidney Kimmel Cancer Center, Baltimore, MD; Robert McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University, New Haven, CT; Suman Redhu, Eduard Gasal, and Bijoyesh Mookerjee, Novartis, East Hanover, NJ; Jeffrey Weber, New York University Langone Medical Center, New York, NY; and Keith T. Flaherty, Dana-Farber/Harvard Cancer Center, Boston, MA
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Jayachandran A, Prithviraj P, Lo PH, Walkiewicz M, Anaka M, Woods BL, Tan B, Behren A, Cebon J, McKeown SJ. Identifying and targeting determinants of melanoma cellular invasion. Oncotarget 2018; 7:41186-41202. [PMID: 27172792 PMCID: PMC5173051 DOI: 10.18632/oncotarget.9227] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 04/22/2016] [Indexed: 01/04/2023] Open
Abstract
Epithelial-to-mesenchymal transition is a critical process that increases the malignant potential of melanoma by facilitating invasion and dissemination of tumor cells. This study identified genes involved in the regulation of cellular invasion and evaluated whether they can be targeted to inhibit melanoma invasion. We identified Peroxidasin (PXDN), Netrin 4 (NTN4) and GLIS Family Zinc Finger 3 (GLIS3) genes consistently elevated in invasive mesenchymal-like melanoma cells. These genes and proteins were highly expressed in metastatic melanoma tumors, and gene silencing led to reduced melanoma invasion in vitro. Furthermore, migration of PXDN, NTN4 or GLIS3 siRNA transfected melanoma cells was inhibited following transplantation into the embryonic chicken neural tube compared to control siRNA transfected melanoma cells. Our study suggests that PXDN, NTN4 and GLIS3 play a functional role in promoting melanoma cellular invasion, and therapeutic approaches directed toward inhibiting the action of these proteins may reduce the incidence or progression of metastasis in melanoma patients.
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Affiliation(s)
- Aparna Jayachandran
- Olivia Newton-John Cancer Research Institute, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Victoria, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Victoria, Australia.,Department of Medicine, University of Melbourne, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Victoria, Australia.,The University of Queensland School of Medicine and the Gallipoli Medical Research Institute, Greenslopes Private Hospital, Brisbane, Queensland, Australia
| | - Prashanth Prithviraj
- Olivia Newton-John Cancer Research Institute, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Victoria, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Victoria, Australia.,Department of Medicine, University of Melbourne, Victoria, Australia
| | - Pu-Han Lo
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Victoria, Australia
| | - Marzena Walkiewicz
- Olivia Newton-John Cancer Research Institute, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Victoria, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Victoria, Australia
| | - Matthew Anaka
- Olivia Newton-John Cancer Research Institute, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Victoria, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Victoria, Australia.,Department of Medicine, University of Melbourne, Victoria, Australia
| | - Briannyn L Woods
- Department of Anatomy and Neuroscience, University of Melbourne, Victoria, Australia
| | - BeeShin Tan
- Olivia Newton-John Cancer Research Institute, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Victoria, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Victoria, Australia.,Department of Medicine, University of Melbourne, Victoria, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Victoria, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Victoria, Australia.,Department of Medicine, University of Melbourne, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Victoria, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Victoria, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Victoria, Australia.,Department of Medicine, University of Melbourne, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Victoria, Australia
| | - Sonja J McKeown
- Department of Anatomy and Neuroscience, University of Melbourne, Victoria, Australia
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Petrella TM, Robert C, Richtig E, Miller WH, Masucci GV, Walpole E, Lebbe C, Steven N, Middleton MR, Hille D, Zhou W, Ibrahim N, Cebon J. Patient-reported outcomes in KEYNOTE-006, a randomised study of pembrolizumab versus ipilimumab in patients with advanced melanoma. Eur J Cancer 2017; 86:115-124. [DOI: 10.1016/j.ejca.2017.08.032] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/28/2017] [Accepted: 08/28/2017] [Indexed: 12/19/2022]
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Wolchok JD, Chiarion-Sileni V, Gonzalez R, Rutkowski P, Grob JJ, Cowey CL, Lao CD, Wagstaff J, Schadendorf D, Ferrucci PF, Smylie M, Dummer R, Hill A, Hogg D, Haanen J, Carlino MS, Bechter O, Maio M, Marquez-Rodas I, Guidoboni M, McArthur G, Lebbé C, Ascierto PA, Long GV, Cebon J, Sosman J, Postow MA, Callahan MK, Walker D, Rollin L, Bhore R, Hodi FS, Larkin J. Overall Survival with Combined Nivolumab and Ipilimumab in Advanced Melanoma. N Engl J Med 2017; 377:1345-1356. [PMID: 28889792 PMCID: PMC5706778 DOI: 10.1056/nejmoa1709684] [Citation(s) in RCA: 2482] [Impact Index Per Article: 354.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Nivolumab combined with ipilimumab resulted in longer progression-free survival and a higher objective response rate than ipilimumab alone in a phase 3 trial involving patients with advanced melanoma. We now report 3-year overall survival outcomes in this trial. METHODS We randomly assigned, in a 1:1:1 ratio, patients with previously untreated advanced melanoma to receive nivolumab at a dose of 1 mg per kilogram of body weight plus ipilimumab at a dose of 3 mg per kilogram every 3 weeks for four doses, followed by nivolumab at a dose of 3 mg per kilogram every 2 weeks; nivolumab at a dose of 3 mg per kilogram every 2 weeks plus placebo; or ipilimumab at a dose of 3 mg per kilogram every 3 weeks for four doses plus placebo, until progression, the occurrence of unacceptable toxic effects, or withdrawal of consent. Randomization was stratified according to programmed death ligand 1 (PD-L1) status, BRAF mutation status, and metastasis stage. The two primary end points were progression-free survival and overall survival in the nivolumab-plus-ipilimumab group and in the nivolumab group versus the ipilimumab group. RESULTS At a minimum follow-up of 36 months, the median overall survival had not been reached in the nivolumab-plus-ipilimumab group and was 37.6 months in the nivolumab group, as compared with 19.9 months in the ipilimumab group (hazard ratio for death with nivolumab plus ipilimumab vs. ipilimumab, 0.55 [P<0.001]; hazard ratio for death with nivolumab vs. ipilimumab, 0.65 [P<0.001]). The overall survival rate at 3 years was 58% in the nivolumab-plus-ipilimumab group and 52% in the nivolumab group, as compared with 34% in the ipilimumab group. The safety profile was unchanged from the initial report. Treatment-related adverse events of grade 3 or 4 occurred in 59% of the patients in the nivolumab-plus-ipilimumab group, in 21% of those in the nivolumab group, and in 28% of those in the ipilimumab group. CONCLUSIONS Among patients with advanced melanoma, significantly longer overall survival occurred with combination therapy with nivolumab plus ipilimumab or with nivolumab alone than with ipilimumab alone. (Funded by Bristol-Myers Squibb and others; CheckMate 067 ClinicalTrials.gov number, NCT01844505 .).
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Affiliation(s)
- Jedd D Wolchok
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Vanna Chiarion-Sileni
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Rene Gonzalez
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Piotr Rutkowski
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Jean-Jacques Grob
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - C Lance Cowey
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Christopher D Lao
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - John Wagstaff
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Dirk Schadendorf
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Pier F Ferrucci
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Michael Smylie
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Reinhard Dummer
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Andrew Hill
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - David Hogg
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - John Haanen
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Matteo S Carlino
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Oliver Bechter
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Michele Maio
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Ivan Marquez-Rodas
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Massimo Guidoboni
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Grant McArthur
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Celeste Lebbé
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Paolo A Ascierto
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Georgina V Long
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Jonathan Cebon
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Jeffrey Sosman
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Michael A Postow
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Margaret K Callahan
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Dana Walker
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Linda Rollin
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - Rafia Bhore
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - F Stephen Hodi
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
| | - James Larkin
- From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (J.D.W., M.A.P., M.K.C.); Oncology Institute of Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua (V.C.-S.), European Institute of Oncology, Milan (P.F.F.), Center for Immuno-Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena (M.M.), the Immunotherapy and Somatic Cell Therapy Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (M.G.), and Istituto Nazionale Tumori Fondazione Pascale, Naples (P.A.A.) - all in Italy; University of Colorado, Denver (R.G.); Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.); Aix-Marseille University, Hôpital de la Timone, Marseille (J.-J.G.), and Assistance Publique-Hôpitaux de Paris, Dermatology and Centres d'Investigation Clinique, INSERM Unité 976, Hôpital Saint-Louis, Université Paris Diderot, Paris (C.L.) - both in France; Texas Oncology-Baylor Cancer Center, Dallas (C.L.C.); University of Michigan, Ann Arbor (C.D.L.); the College of Medicine, Swansea University, Swansea (J.W.), and Royal Marsden NHS Foundation Trust, London (J.L.) - both in the United Kingdom; the Department of Dermatology, University of Essen, Essen, and the German Cancer Consortium, Heidelberg - both in Germany (D.S.); Cross Cancer Institute, Edmonton, AB (M.S.), and Princess Margaret Cancer Centre, Toronto (D.H.) - both in Canada; Universitäts Spital, Zurich, Switzerland (R.D.); Tasman Oncology Research, Southport Gold Coast, QLD (A.H.), Crown Princess Mary Cancer Centre, Melanoma Institute Australia, University of Sydney (M.S.C.), and Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals (G.V.L.), Sydney, and Peter MacCallum Cancer Centre (G.M.) and the Olivia Newton-John Cancer Research Institute, University of Melbourne (J.C.), Melbourne, VIC - all in Australia; Netherlands Cancer Institute, Amsterdam (J.H.); University Hospitals Leuven, KU Leuven, Leuven, Belgium (O.B.); General University Hospital Gregorio Marañón, Madrid (I.M.-R.); Northwestern University, Chicago (J.S.); Bristol-Myers Squibb, Princeton, NJ (D.W., L.R., R.B.); and the Dana-Farber Cancer Institute, Boston (F.S.H.)
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Ribas A, Dummer R, Puzanov I, VanderWalde A, Andtbacka RHI, Michielin O, Olszanski AJ, Malvehy J, Cebon J, Fernandez E, Kirkwood JM, Gajewski TF, Chen L, Gorski KS, Anderson AA, Diede SJ, Lassman ME, Gansert J, Hodi FS, Long GV. Oncolytic Virotherapy Promotes Intratumoral T Cell Infiltration and Improves Anti-PD-1 Immunotherapy. Cell 2017; 170:1109-1119.e10. [PMID: 28886381 DOI: 10.1016/j.cell.2017.08.027] [Citation(s) in RCA: 958] [Impact Index Per Article: 136.9] [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: 04/10/2017] [Revised: 07/11/2017] [Accepted: 08/15/2017] [Indexed: 12/27/2022]
Abstract
Here we report a phase 1b clinical trial testing the impact of oncolytic virotherapy with talimogene laherparepvec on cytotoxic T cell infiltration and therapeutic efficacy of the anti-PD-1 antibody pembrolizumab. Twenty-one patients with advanced melanoma were treated with talimogene laherparepvec followed by combination therapy with pembrolizumab. Therapy was generally well tolerated, with fatigue, fevers, and chills as the most common adverse events. No dose-limiting toxicities occurred. Confirmed objective response rate was 62%, with a complete response rate of 33% per immune-related response criteria. Patients who responded to combination therapy had increased CD8+ T cells, elevated PD-L1 protein expression, as well as IFN-γ gene expression on several cell subsets in tumors after talimogene laherparepvec treatment. Response to combination therapy did not appear to be associated with baseline CD8+ T cell infiltration or baseline IFN-γ signature. These findings suggest that oncolytic virotherapy may improve the efficacy of anti-PD-1 therapy by changing the tumor microenvironment. VIDEO ABSTRACT.
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Affiliation(s)
- Antoni Ribas
- University of California at Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.
| | | | | | | | | | | | | | - Josep Malvehy
- Hospital Clinic i Provincial de Barcelona, Barcelona, Spain
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Austin Health, School of Cancer Medicine, LaTrobe University, Heidelberg, VIC, Australia
| | | | - John M Kirkwood
- University of Pittsburgh Cancer Institute and Hillman UPMC Cancer Center, Pittsburgh, PA, USA
| | | | | | | | | | | | | | | | | | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney and Royal North Shore and Mater Hospitals, Sydney, NSW, Australia
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40
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Sznol M, Ferrucci PF, Hogg D, Atkins MB, Wolter P, Guidoboni M, Lebbé C, Kirkwood JM, Schachter J, Daniels GA, Hassel J, Cebon J, Gerritsen W, Atkinson V, Thomas L, McCaffrey J, Power D, Walker D, Bhore R, Jiang J, Hodi FS, Wolchok JD. Pooled Analysis Safety Profile of Nivolumab and Ipilimumab Combination Therapy in Patients With Advanced Melanoma. J Clin Oncol 2017; 35:3815-3822. [PMID: 28915085 DOI: 10.1200/jco.2016.72.1167] [Citation(s) in RCA: 212] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose The addition of nivolumab (anti-programmed death-1 antibody) to ipilimumab (anti-cytotoxic T-cell lymphocyte-associated 4 antibody) in patients with advanced melanoma improves antitumor response and progression-free survival but with a higher frequency of adverse events (AEs). This cross-melanoma study describes the safety profile of the approved nivolumab plus ipilimumab regimen. Methods This retrospective safety review on data from three trials (phase I, II, and III) included patients with advanced melanoma who received at least one dose of nivolumab 1 mg/kg plus ipilimumab 3 mg/kg every 3 weeks × 4 and then nivolumab 3 mg/kg every 2 weeks until disease progression or unacceptable toxicity while following established guidelines for AE management. Analyses were of all treatment-related AEs, select (immune-related) AEs, time to onset and resolution, and use of immune-modulating agents and their effects on outcome. Results Among 448 patients, median duration of follow-up was 13.2 months. Treatment-related grade 3/4 AEs occurred in 55.5% of patients; 35.7% had treatment-related AEs that led to discontinuation. The most frequent treatment-related select AEs of any grade were skin (64.3%) and GI (46.7%) and of grade 3/4, hepatic (17.0%) and GI (16.3%); 30.1% developed a grade 2 to 4 select AE in more than one organ category. Median time to onset of grade 3/4 treatment-related select AEs ranged from 3.1 (skin) to 16.3 (renal) weeks, and with the exclusion of endocrine AEs, median time to resolution from onset ranged from 1.9 (renal) to 4.5 (pulmonary) weeks, with resolution rates between 79% and 100% while using immune-modulating agents. Four (< 1%) on-study deaths were attributed to therapy. Conclusion Frequency of grade 3/4 treatment-related AEs was higher with nivolumab plus ipilimumab and occurred earlier than historical experience with either agent alone, but resolution rates were similar.
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Affiliation(s)
- Mario Sznol
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Pier Francesco Ferrucci
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - David Hogg
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michael B Atkins
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Pascal Wolter
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Massimo Guidoboni
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Celeste Lebbé
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - John M Kirkwood
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jacob Schachter
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Gregory A Daniels
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jessica Hassel
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jonathan Cebon
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Winald Gerritsen
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Victoria Atkinson
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Luc Thomas
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - John McCaffrey
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Derek Power
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Dana Walker
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rafia Bhore
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joel Jiang
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - F Stephen Hodi
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jedd D Wolchok
- Mario Sznol, Yale Comprehensive Cancer Center, New Haven, CT; Pier Francesco Ferrucci, Istituto Europeo di Oncologia, Milan; Massimo Guidoboni, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; David Hogg, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Michael B. Atkins, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC; Pascal Wolter, University Hospitals Leuven, Leuven, Belgium; Celeste Lebbé, Université Paris Diderot, Paris; Luc Thomas, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France; John M. Kirkwood, Hillman Cancer Center, Pittsburgh, PA; Jacob Schachter, Sheba Medical Center, Ramat Gan, Israel; Gregory A. Daniels, University of California San Diego, Moores Cancer Center, La Jolla, CA; Jessica Hassel, University Hospital, Heidelberg, Germany; Jonathan Cebon, Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria; Winald Gerritsen, University of Queensland, St Lucia; Victoria Atkinson, Gallipoli Medical Research Foundation, Greenslopes; Victoria Atkinson, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Winald Gerritsen, Radboud University Medical Center, Nijmegen, the Netherlands; John McCaffrey, Irish Clinical Oncology Research Group, Dublin; Derek Power, Irish Clinical Oncology Research Group, Cork, Ireland; Dana Walker, Rafia Bhore, and Joel Jiang, Bristol-Myers Squibb, Princeton, NJ; F. Stephen Hodi, Dana-Farber Cancer Institute, Boston, MA; and Jedd D. Wolchok, Parker Institute and Ludwig Center at Memorial Sloan Kettering Cancer Center, New York, NY
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Burr ML, Sparbier CE, Chan YC, Williamson JC, Woods K, Beavis PA, Lam EYN, Henderson MA, Bell CC, Stolzenburg S, Gilan O, Bloor S, Noori T, Morgens DW, Bassik MC, Neeson PJ, Behren A, Darcy PK, Dawson SJ, Voskoboinik I, Trapani JA, Cebon J, Lehner PJ, Dawson MA. CMTM6 maintains the expression of PD-L1 and regulates anti-tumour immunity. Nature 2017; 549:101-105. [PMID: 28813417 PMCID: PMC5706633 DOI: 10.1038/nature23643] [Citation(s) in RCA: 559] [Impact Index Per Article: 79.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 07/17/2017] [Indexed: 12/13/2022]
Abstract
Cancer cells exploit the expression of the programmed death-1 (PD-1) ligand 1 (PD-L1) to subvert T-cell-mediated immunosurveillance. The success of therapies that disrupt PD-L1-mediated tumour tolerance has highlighted the need to understand the molecular regulation of PD-L1 expression. Here we identify the uncharacterized protein CMTM6 as a critical regulator of PD-L1 in a broad range of cancer cells, by using a genome-wide CRISPR-Cas9 screen. CMTM6 is a ubiquitously expressed protein that binds PD-L1 and maintains its cell surface expression. CMTM6 is not required for PD-L1 maturation but co-localizes with PD-L1 at the plasma membrane and in recycling endosomes, where it prevents PD-L1 from being targeted for lysosome-mediated degradation. Using a quantitative approach to profile the entire plasma membrane proteome, we find that CMTM6 displays specificity for PD-L1. Notably, CMTM6 depletion decreases PD-L1 without compromising cell surface expression of MHC class I. CMTM6 depletion, via the reduction of PD-L1, significantly alleviates the suppression of tumour-specific T cell activity in vitro and in vivo. These findings provide insights into the biology of PD-L1 regulation, identify a previously unrecognized master regulator of this critical immune checkpoint and highlight a potential therapeutic target to overcome immune evasion by tumour cells.
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Affiliation(s)
- Marian L. Burr
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Rd, Cambridge CB2 0XY, UK
| | - Christina E. Sparbier
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
| | - Yih-Chih Chan
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
| | - James C. Williamson
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Rd, Cambridge CB2 0XY, UK
| | - Katherine Woods
- School of Cancer Medicine, La Trobe University, Melbourne, Victoria 3086, Australia
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia
| | - Paul A. Beavis
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
| | - Enid Y. N. Lam
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
| | - Melissa A. Henderson
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
| | - Charles C. Bell
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
| | - Sabine Stolzenburg
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
| | - Omer Gilan
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
| | - Stuart Bloor
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Rd, Cambridge CB2 0XY, UK
| | - Tahereh Noori
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
| | - David W. Morgens
- Department of Genetics, Stanford University, Stanford, California, USA
| | - Michael C. Bassik
- Department of Genetics, Stanford University, Stanford, California, USA
| | - Paul J. Neeson
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
| | - Andreas Behren
- School of Cancer Medicine, La Trobe University, Melbourne, Victoria 3086, Australia
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia
| | - Phillip K. Darcy
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
| | - Sarah-Jane Dawson
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Ilia Voskoboinik
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
| | - Joseph A. Trapani
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
| | - Jonathan Cebon
- School of Cancer Medicine, La Trobe University, Melbourne, Victoria 3086, Australia
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia
| | - Paul J Lehner
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Rd, Cambridge CB2 0XY, UK
| | - Mark A. Dawson
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne Victoria 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria 3052, Australia
- Centre for Cancer Research, University of Melbourne, Melbourne, Australia
- Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Australia
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Duarte J, Woods K, Behren A, Cebon J. Abstract CT099: A phase I study of intralesional Bacillus Calmette-Guerin (BCG) followed by ipilimumab therapy in patients with advanced metastatic melanoma. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-ct099] [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: Immunotherapies with checkpoint inhibitors have revolutionized the treatment of advanced melanomas. Nonetheless, a subset of patients fail to benefit clinically from these immunotherapeutics, and thus strategies aimed at inducing a favorable inflammatory tumor microenvironment prior to immunotherapy are currently being investigated by means of combination therapies. Bacillus Calmette-Guerin (BCG) is a living attenuated strain of Mycobacterium bovis that stimulates cell-mediated immunity by producing a localized and self-limiting infection. This immunostimulatory agent has shown evidence of anti-tumor activity in several clinical studies with suggested induction of non-specific immune responses, thereby warranting further investigation in a combination therapy setting.
Methods: This phase I study aimed to determine the safety, clinical efficacy and immunogenicity of the administration of intralesional BCG followed by up to four intravenous infusions of ipilimumab (anti-CTLA4) (NCT01838200). Patients with histologically confirmed stage III/IV metastatic melanoma with at least one injectable lesion, and no prior immunotherapy or autoimmune disease were recruited for this study. Patients received up to four 3 mg/kg ipilimumab infusions every 3 weeks from 36 days after intralesion BCG injection containing 0.16 - 0.64 x 106 colony-forming units. Serum samples were collected prior to each therapeutic intervention as a means of investigating immunogenicity. Humoral immune responses were investigated using the Immunome protein array, a high-content array with 1627 full-length, correctly folded, and fully functional immobilized proteins that enables the interrogation of the depth and breadth of the immune response.
Results: 5 patients were enrolled in this study, with 2 displaying high grade immune-related adverse events (irAEs) (grade 3 hepatitis and grade 4 colitis), which led to the early discontinuation of this trial. These irAEs were in accordance with ipilimumab-related reported toxicities. Furthermore, all patients displayed evidence of clinically progressive disease, with no evident therapeutic benefit. Patients displaying irAEs were characterized by drastic increases in their antibody repertoire towards tumor and self-antigens, when compared to those with no reported irAEs (42% vs. 3% of array content, respectively). This high order of de novo and induced antibodies was detected in time points preceding clinical detection of these high-grade toxicities. However, these antibody profiles did not overlap between patients, with unique antigen targets detected in each patient, suggesting evidence of a systemic B-cell deregulation, rather than an induced specific anti-tumor response.
Conclusions: Intralesional BCG followed by ipilimumab therapy was not well tolerated in advanced melanoma patients, and showed no evidence of clinical benefit. Investigating humoral immunity may offer a means to detect the early onset of irAEs in an immunotherapeutic clinical trial setting.
Citation Format: Jessica Duarte, Katherine Woods, Andreas Behren, Jonathan Cebon. A phase I study of intralesional Bacillus Calmette-Guerin (BCG) followed by ipilimumab therapy in patients with advanced metastatic melanoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr CT099. doi:10.1158/1538-7445.AM2017-CT099
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Affiliation(s)
- Jessica Duarte
- Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
| | - Katherine Woods
- Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
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Tutuka CSA, Andrews MC, Mariadason JM, Ioannidis P, Hudson C, Cebon J, Behren A. PLX8394, a new generation BRAF inhibitor, selectively inhibits BRAF in colonic adenocarcinoma cells and prevents paradoxical MAPK pathway activation. Mol Cancer 2017; 16:112. [PMID: 28659148 PMCID: PMC5490236 DOI: 10.1186/s12943-017-0684-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 06/21/2017] [Indexed: 01/07/2023] Open
Abstract
BRAF inhibitors (BRAFi) are standard of care for the treatment of BRAF V600 mutation-driven metastatic melanoma, but can lead to paradoxical activation of the mitogen-activated protein kinase (MAPK) signalling pathway. This can result in the promotion of precancerous lesions and secondary neoplasms, mainly (but not exclusively) associated with pre-existing mutations in RAS genes. We previously reported a patient with synchronous BRAF-mutated metastatic melanoma and BRAFwt/KRASG12D-metastatic colorectal cancer (CRC), whose CRC relapsed and progressed when treated with the BRAF inhibitor dabrafenib (GSK2118436). We used tissue from the resected CRC metastasis to derive a cell line, LM-COL-1, which directly and reliably mimicked the clinical scenario including paradoxical activation of the MAPK signalling pathway resulting in increased cell proliferation upon dabrafenib treatment. Novel BRAF inhibitors (PLX8394 and PLX7904), dubbed as “paradox breakers”, were developed to inhibit V600 mutated oncogenic BRAF without causing paradoxical MAPK pathway activation. In this study we used our LM-COL-1 model alongside multiple other CRC cell lines with varying mutational backgrounds to demonstrate and confirm that the paradox breaker PLX8394 retains on-target inhibition of mutated BRAF V600 without paradoxically promoting MAPK signalling.
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Affiliation(s)
- Candani S A Tutuka
- Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Miles C Andrews
- Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,Austin Medical Oncology Unit, Austin Health, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia
| | - John M Mariadason
- Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia
| | - Paul Ioannidis
- Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Christopher Hudson
- Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,Austin Medical Oncology Unit, Austin Health, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia.,Department of Medicine, University of Melbourne, Parkville, VIC, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia. .,School of Cancer Medicine, La Trobe University, Bundoora, VIC, Australia.
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Abou-Alfa GK, Blanc JF, Miles S, Ganten T, Trojan J, Cebon J, Liem AK, Lipton L, Gupta C, Wu B, Bass M, Hollywood E, Ma J, Bradley M, Litten J, Saltz LB. Phase II Study of First-Line Trebananib Plus Sorafenib in Patients with Advanced Hepatocellular Carcinoma. Oncologist 2017; 22:780-e65. [PMID: 28592620 PMCID: PMC5507650 DOI: 10.1634/theoncologist.2017-0058] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 04/05/2017] [Indexed: 12/22/2022] Open
Abstract
Lessons Learned. Trebananib leveraging anti‐angiogenic mechanism that is distinct from the classic sorafenib anti‐vascular endothelial growth factor inhibition did not demonstrate improved progression‐free survival at 4 months in patients with advanced hepatocellular carcinoma (HCC). In support of previously reported high Ang‐2 levels’ association with poor outcome in HCC for patients, trebananib treatment with lower baseline Ang‐2 at study entry was associated with improved overall survival to 22 months and may suggest future studies to be performed within the context of low baseline Ang‐2.
Background. Ang‐1 and Ang‐2 are angiopoietins thought to promote neovascularization via activation of the Tie‐2 angiopoietin receptor. Trebananib sequesters Ang‐1 and Ang‐2, preventing interaction with the Tie‐2 receptor. Trebananib plus sorafenib combination has acceptable toxicity. Elevated Ang‐2 levels are associated with poor prognosis in hepatocellular carcinoma (HCC). Methods. Patients with HCC, Eastern Cooperative Oncology Group ≤2, and Childs‐Pugh A received IV trebananib at 10 mg/kg or 15 mg/kg weekly plus sorafenib 400 mg orally twice daily. The study was planned for ≥78% progression‐free survival (PFS) rate at 4 months relative to 62% for sorafenib historical control (power = 80% α = 0.20). Secondary endpoints included safety, tolerability, overall survival (OS), and multiple biomarkers, including serum Ang‐2. Results. Thirty patients were enrolled sequentially in each of the two nonrandomized cohorts. Demographics were comparable between the two arms and the historical controls. PFS rates at 4 months were 57% and 54% on the 10 mg/kg and 15 mg/kg trebananib cohorts, respectively. Median OS was 17 and 11 months, respectively. Grade 3 and above events noted in ≥10% of patients included fatigue, hypertension, diarrhea, liver failure, palmar‐plantar erythrodysesthesia syndrome, dyspnea, and hypophosphatemia. One death was due to hepatic failure. Serum Ang‐2 dichotomized at the median was associated with improved OS in both cohorts. Conclusion. There was no improvement in PFS rate at 4 months in either cohort, when compared with sorafenib historical control.
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Affiliation(s)
- Ghassan K Abou-Alfa
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | | | - Steven Miles
- Cedars Sinai Hospital, Los Angeles, California, USA
| | - Tom Ganten
- University of Heidelberg, Heidelberg, Germany
| | - Jörg Trojan
- Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Victoria, Australia
| | - Andre K Liem
- Translational Oncology Research International, Long Beach, California, USA
| | - Lara Lipton
- Western Hospital, Footscray, Victoria, Australia
| | | | | | | | - Ellen Hollywood
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jennifer Ma
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | | | - Leonard B Saltz
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Weill Cornell Medical College, New York, New York, USA
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Parakh S, Park JJ, Mendis S, Rai R, Xu W, Lo S, Drummond M, Rowe C, Wong A, McArthur G, Haydon A, Andrews MC, Cebon J, Guminski A, Kefford RF, Long GV, Menzies AM, Klein O, Carlino MS. Efficacy of anti-PD-1 therapy in patients with melanoma brain metastases. Br J Cancer 2017; 116:1558-1563. [PMID: 28524161 PMCID: PMC5518864 DOI: 10.1038/bjc.2017.142] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 04/21/2017] [Accepted: 04/24/2017] [Indexed: 01/09/2023] Open
Abstract
Background: There is limited data on the efficacy of anti-programmed death 1 (PD-1) antibodies in patients (pts) with melanoma brain metastasis (BM), particularly those which are symptomatic. Method: We retrospectively assessed pts with melanoma BM treated with PD-1 antibodies, nivolumab and pembrolizumab. Clinicopathologic and treatment parameters were collected and outcomes determined for intracranial (IC) response rate (RR) using a modified RECIST criteria, with up to five IC target lesions used to determine IC response, disease control rate (DCR) and progression-free survival (PFS). Results: A total of 66 pts were identified with a median follow up of 7.0 months (range 0.8–24.5 months). A total of 68% were male and 45% BRAF V600 mutation positive. At PD-1 antibody commencement, 50% had an elevated LDH; 64% had local therapy to BM prior to commencing anti-PD1, of which 5% had surgical resection, 14% stereotactic radiosurgery (SRS), 18% whole-brain radiotherapy (WBRT), 27% had surgery and radiotherapy. Twenty-one per cent started anti-PD-1 as first line systemic therapy. No pt had prior anti-PD-1 treatment. The IC overall RR was 21 and DCR 56%. Responses occurred in 21% of pts with symptomatic BM. The median OS was 9.9 months (95% CI 6.93–17.74). Pts with symptomatic BM had shorter PFS than those without symptoms (2.7 vs 7.4 months, P=0.035) and numerically shorter OS (5.7 vs 13.0 months, P=0.068). Pts requiring corticosteroids also had a numerically shorter PFS (3.2 vs 7.4 months, P=0.081) and OS (4.8 vs 13.1 months, P=0.039). Conclusions: IC responses to anti-PD-1 antibodies occur in pts with BM, including those with symptomatic BM requiring corticosteroids. Prospective trials evaluating anti-PD-1 therapy in pts with BM are underway.
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Affiliation(s)
- Sagun Parakh
- Medical Oncology Unit, Austin Health, Melbourne, Victoria 3084, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Victoria 3084, Australia.,La Trobe University School of Cancer Medicine, Melbourne, Victoria 3086, Australia
| | - John J Park
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales 2145, Australia.,The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Shehara Mendis
- Medical Oncology Unit, Alfred Hospital, Melbourne, Victoria 3004, Australia
| | - Rajat Rai
- The University of Sydney, Sydney, New South Wales 2006, Australia.,Melanoma Institute Australia, Sydney, New South Wales 2060, Australia
| | - Wen Xu
- Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia
| | - Serigne Lo
- The University of Sydney, Sydney, New South Wales 2006, Australia.,Melanoma Institute Australia, Sydney, New South Wales 2060, Australia
| | - Martin Drummond
- The University of Sydney, Sydney, New South Wales 2006, Australia.,Melanoma Institute Australia, Sydney, New South Wales 2060, Australia
| | - Catherine Rowe
- Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia
| | - Annie Wong
- Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia
| | - Grant McArthur
- Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia
| | - Andrew Haydon
- Medical Oncology Unit, Alfred Hospital, Melbourne, Victoria 3004, Australia
| | - Miles C Andrews
- Medical Oncology Unit, Austin Health, Melbourne, Victoria 3084, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Victoria 3084, Australia
| | - Jonathan Cebon
- Medical Oncology Unit, Austin Health, Melbourne, Victoria 3084, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Victoria 3084, Australia
| | - Alex Guminski
- The University of Sydney, Sydney, New South Wales 2006, Australia.,Melanoma Institute Australia, Sydney, New South Wales 2060, Australia.,Royal North Shore and Mater Hospitals, Sydney, New South Wales 2065, Australia
| | - Richard F Kefford
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales 2145, Australia.,Melanoma Institute Australia, Sydney, New South Wales 2060, Australia.,Department of Clinical Medicine, Macquarie University, New South Wales 2109, Australia
| | - Georgina V Long
- The University of Sydney, Sydney, New South Wales 2006, Australia.,Melanoma Institute Australia, Sydney, New South Wales 2060, Australia.,Royal North Shore and Mater Hospitals, Sydney, New South Wales 2065, Australia
| | - Alexander M Menzies
- The University of Sydney, Sydney, New South Wales 2006, Australia.,Melanoma Institute Australia, Sydney, New South Wales 2060, Australia.,Royal North Shore and Mater Hospitals, Sydney, New South Wales 2065, Australia
| | - Oliver Klein
- Medical Oncology Unit, Austin Health, Melbourne, Victoria 3084, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Victoria 3084, Australia
| | - Matteo S Carlino
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales 2145, Australia.,The University of Sydney, Sydney, New South Wales 2006, Australia.,Melanoma Institute Australia, Sydney, New South Wales 2060, Australia
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Hayward NK, Wilmott JS, Waddell N, Johansson PA, Field MA, Nones K, Patch AM, Kakavand H, Alexandrov LB, Burke H, Jakrot V, Kazakoff S, Holmes O, Leonard C, Sabarinathan R, Mularoni L, Wood S, Xu Q, Waddell N, Tembe V, Pupo GM, De Paoli-Iseppi R, Vilain RE, Shang P, Lau LMS, Dagg RA, Schramm SJ, Pritchard A, Dutton-Regester K, Newell F, Fitzgerald A, Shang CA, Grimmond SM, Pickett HA, Yang JY, Stretch JR, Behren A, Kefford RF, Hersey P, Long GV, Cebon J, Shackleton M, Spillane AJ, Saw RPM, López-Bigas N, Pearson JV, Thompson JF, Scolyer RA, Mann GJ. Whole-genome landscapes of major melanoma subtypes. Nature 2017; 545:175-180. [PMID: 28467829 DOI: 10.1038/nature22071] [Citation(s) in RCA: 871] [Impact Index Per Article: 124.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 03/15/2017] [Indexed: 12/16/2022]
Abstract
Melanoma of the skin is a common cancer only in Europeans, whereas it arises in internal body surfaces (mucosal sites) and on the hands and feet (acral sites) in people throughout the world. Here we report analysis of whole-genome sequences from cutaneous, acral and mucosal subtypes of melanoma. The heavily mutated landscape of coding and non-coding mutations in cutaneous melanoma resolved novel signatures of mutagenesis attributable to ultraviolet radiation. However, acral and mucosal melanomas were dominated by structural changes and mutation signatures of unknown aetiology, not previously identified in melanoma. The number of genes affected by recurrent mutations disrupting non-coding sequences was similar to that affected by recurrent mutations to coding sequences. Significantly mutated genes included BRAF, CDKN2A, NRAS and TP53 in cutaneous melanoma, BRAF, NRAS and NF1 in acral melanoma and SF3B1 in mucosal melanoma. Mutations affecting the TERT promoter were the most frequent of all; however, neither they nor ATRX mutations, which correlate with alternative telomere lengthening, were associated with greater telomere length. Most melanomas had potentially actionable mutations, most in components of the mitogen-activated protein kinase and phosphoinositol kinase pathways. The whole-genome mutation landscape of melanoma reveals diverse carcinogenic processes across its subtypes, some unrelated to sun exposure, and extends potential involvement of the non-coding genome in its pathogenesis.
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Affiliation(s)
- Nicholas K Hayward
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - James S Wilmott
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia.,Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Nicola Waddell
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia.,Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Peter A Johansson
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Matthew A Field
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland 4878, Australia
| | - Katia Nones
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia.,Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Ann-Marie Patch
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia.,Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Hojabr Kakavand
- Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006, Australia
| | | | - Hazel Burke
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia
| | - Valerie Jakrot
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia
| | - Stephen Kazakoff
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia.,Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Oliver Holmes
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia.,Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Conrad Leonard
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia.,Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Radhakrishnan Sabarinathan
- Research Program on Biomedical Informatics, IMIM Hospital del Mar Medical Research Institute, Universitat Pompeu Fabra, 08003 Barcelona, Catalonia, Spain.,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, 08028 Barcelona, Spain
| | - Loris Mularoni
- Research Program on Biomedical Informatics, IMIM Hospital del Mar Medical Research Institute, Universitat Pompeu Fabra, 08003 Barcelona, Catalonia, Spain.,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, 08028 Barcelona, Spain
| | - Scott Wood
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia.,Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Qinying Xu
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia.,Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Nick Waddell
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Varsha Tembe
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, Sydney, New South Wales 2145, Australia
| | - Gulietta M Pupo
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, Sydney, New South Wales 2145, Australia
| | - Ricardo De Paoli-Iseppi
- Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Ricardo E Vilain
- Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Ping Shang
- Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Loretta M S Lau
- Children's Medical Research Institute, The University of Sydney, Westmead, Sydney, New South Wales 2145, Australia
| | - Rebecca A Dagg
- Children's Hospital at Westmead, The University of Sydney, Westmead, New South Wales Sydney, 2145, Australia
| | - Sarah-Jane Schramm
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, Sydney, New South Wales 2145, Australia
| | - Antonia Pritchard
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Ken Dutton-Regester
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Felicity Newell
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Anna Fitzgerald
- Bioplatforms Australia, North Ryde, Sydney, New South Wales 2109, Australia
| | - Catherine A Shang
- Bioplatforms Australia, North Ryde, Sydney, New South Wales 2109, Australia
| | - Sean M Grimmond
- University of Melbourne Centre for Cancer Research, University of Melbourne, Parkville, Melbourne, Victoria 3052, Australia
| | - Hilda A Pickett
- Children's Medical Research Institute, The University of Sydney, Westmead, Sydney, New South Wales 2145, Australia
| | - Jean Y Yang
- School of Mathematics and Statistics, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Jonathan R Stretch
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, La Trobe University, Austin Health, Heidelberg, Melbourne, Victoria 3084, Australia
| | - Richard F Kefford
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia.,Macquarie University, North Ryde, Sydney, New South Wales 2109, Australia
| | - Peter Hersey
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia.,Centenary Institute, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia.,Department of Medical Oncology, Royal North Shore Hospital, St Leonards, Sydney, New South Wales 2065, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, La Trobe University, Austin Health, Heidelberg, Melbourne, Victoria 3084, Australia
| | - Mark Shackleton
- Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Andrew J Spillane
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia
| | - Robyn P M Saw
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia
| | - Núria López-Bigas
- Research Program on Biomedical Informatics, IMIM Hospital del Mar Medical Research Institute, Universitat Pompeu Fabra, 08003 Barcelona, Catalonia, Spain.,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, 08028 Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain
| | - John V Pearson
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia.,Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland 4072, Australia
| | - John F Thompson
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia.,Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, Sydney, New South Wales 2050, Australia
| | - Graham J Mann
- Melanoma Institute Australia, The University of Sydney, North Sydney, Sydney, New South Wales 2065, Australia.,Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, Sydney, New South Wales 2145, Australia
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Duarte J, Peyper J, Woods K, Tsao SCH, Cebon J, Blackburn J. Abstract A78: Antibody profiling of melanoma patients using a custom protein microarray platform. Cancer Immunol Res 2017. [DOI: 10.1158/2326-6074.tumimm16-a78] [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
There is substantial evidence that the mainly tumor-restricted aberrant expression of the highly immunogenic cancer-testis (CT) antigens across several different cancer types makes them attractive cancer diagnostic and predictive biomarkers. Therefore, we aimed to measure differences in CT antigen-specific antibody repertoires between melanoma patient samples, and assess whether these could identify novel diagnostic or prognostic biomarkers, which could aid in the detection and management of cancer. In order to detect and quantify CT-antigen-specific antibodies circulating in the serum or plasma of cancer patients, we co-developed a novel CT antigen microarray platform. This tool represents a high-throughput means of profiling antibody repertoires against over 100 cancer-restricted antigens in a highly reproducible manner with high sensitivity (detection limit: 10-100pg/ml) and specificity. In addition, it provides a significant advantage over tissue-based approaches, due to the ease of sample access without the need for invasive procedures. We carried out a retrospective serological study of antibody titers across a large cohort of eighty-eight mainly advanced malignant melanoma patients (8% unknown stage, 2% stage I, 10% stage II, 40% stage III and 40% stage IV) undergoing a variety of distinct cancer treatments (surgery, chemotherapy, radiotherapy, immunotherapy or none), using our recently developed and validated novel CT antigen microarray platform. We successfully identified abundant antibody titers towards two leading CT antigens, NY-ESO-1 and CTAG2 - a highly homologous pair - expressed across 50% (n = 44/88) and 45% (n = 40/88) of all patients, respectively, with reported diagnostic and clinical efficacy predictive biomarker potential. Furthermore, the overlap in antibody titers of this pair, most likely due to a shared immunogenic epitope, validated our array platform, showing consistency amongst our obtained results across patients. Additional abundant titers were found across fifteen further antigens, including several members of the melanoma antigen (MAGE) family, such as MAGEB1 (n = 30/88, 34%), MAGEB6 (n = 29/88, 33%), MAGEB5 (n = 26/88, 29%), MAGEA3 (n = 26/88, 29%) and MAGEA11 (n = 24/88, 27%). Abundant antibody titers towards at least one of these leading seventeen cancer antigens were detected across 82% of this cohort (n = 72/88), thus emphasizing the potential uses of these as diagnostic or prognostic biomarkers, warranting further larger studies. Furthermore, healthy individuals showed no detectable cancer-antigen-specific antibody titers, therefore highlighting the specificity of this tool in a cancer setting. In conclusion, we showed that our novel protein microarray platform represents a sensitive, high-throughput and customizable means to detect and quantify the presence of large panels of cancer-specific human antibodies in serum, obtaining consistently robust, high quality and reproducible data, and demonstrating its potential feasibility and inferred biological significance.
Citation Format: Jessica Duarte, Janique Peyper, Katherine Woods, Simon Chang-Hao Tsao, Jonathan Cebon, Jonathan Blackburn. Antibody profiling of melanoma patients using a custom protein microarray platform. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2016 Oct 20-23; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2017;5(3 Suppl):Abstract nr A78.
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Affiliation(s)
- Jessica Duarte
- 1Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia,
| | | | - Katherine Woods
- 1Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia,
| | | | - Jonathan Cebon
- 1Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia,
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Davis ID, Quirk J, Morris L, Seddon L, Tai TY, Whitty G, Cavicchiolo T, Ebert L, Jackson H, Browning J, MacGregor D, Wittke F, Winkels G, Alex R, Miloradovic L, Maraskovsky E, Chen W, Cebon J. A pilot study of peripheral blood BDCA-1 (CD1c) positive dendritic cells pulsed with NY-ESO-1 ISCOMATRIX™ adjuvant. Immunotherapy 2017; 9:249-259. [PMID: 28183192 DOI: 10.2217/imt-2016-0132] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
AIM Pilot clinical trial of NY-ESO-1 (ESO) protein in ISCOMATRIX™ adjuvant pulsed onto peripheral blood dendritic cells (PBDC), to ascertain feasibility, evaluate toxicity and assess induction of ESO-specific immune responses. PATIENTS & METHODS Eligible participants had resected cancers expressing ESO or LAGE-1 and were at high risk of relapse. PBDC were produced using CliniMACS®plus, with initial depletion of CD1c+ B cells followed by positive selection of CD1c+ PBDC. Patients received three intradermal vaccinations of ESO/IMX-pulsed PBDC at 4-week intervals. RESULTS The process was feasible and safe. No vaccine-induced immune responses were detected. Assays of immunomodulatory cells did not correlate with outcomes. One patient had a long lasting complete remission. CONCLUSION This method was feasible and safe but was minimally immunogenic.
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Affiliation(s)
- Ian D Davis
- Ludwig Institute for Cancer Research, Victoria, Australia.,Austin Health, Department of Medical Oncology, Victoria, Australia.,Monash University Eastern Health Clinical School, Level 2, 5 Arnold St, Box Hill, Victoria 3128, Australia.,Eastern Health, Victoria, Australia
| | - Juliet Quirk
- Ludwig Institute for Cancer Research, Victoria, Australia
| | - Leone Morris
- Ludwig Institute for Cancer Research, Victoria, Australia
| | - Lauren Seddon
- Ludwig Institute for Cancer Research, Victoria, Australia
| | - Tsin Yee Tai
- Ludwig Institute for Cancer Research, Victoria, Australia
| | | | | | - Lisa Ebert
- Ludwig Institute for Cancer Research, Victoria, Australia
| | | | - Judy Browning
- Austin Health, Department of Anatomical Pathology, Victoria, Australia
| | - Duncan MacGregor
- Austin Health, Department of Anatomical Pathology, Victoria, Australia
| | | | | | | | | | - Eugene Maraskovsky
- Ludwig Institute for Cancer Research, Victoria, Australia.,CSL Limited, Melbourne, Australia
| | - Weisan Chen
- Ludwig Institute for Cancer Research, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Australia
| | - Jonathan Cebon
- Ludwig Institute for Cancer Research, Victoria, Australia.,Austin Health, Department of Medical Oncology, Victoria, Australia.,School of Cancer Medicine, La Trobe University, Australia.,Olivia Newton-John Cancer Research Institute, Victoria, Australia
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Gedye C, Cardwell T, Dimopoulos N, Tan BS, Jackson H, Svobodová S, Anaka M, Behren A, Maher C, Hofmann O, Hide W, Caballero O, Davis ID, Cebon J. Mycoplasma Infection Alters Cancer Stem Cell Properties in Vitro. Stem Cell Rev Rep 2016; 12:156-61. [PMID: 26514153 DOI: 10.1007/s12015-015-9630-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cancer cell lines can be useful to model cancer stem cells. Infection with Mycoplasma species is an insidious problem in mammalian cell culture. While investigating stem-like properties in early passage melanoma cell lines, we noted poorly reproducible results from an aliquot of a cell line that was later found to be infected with Mycoplasma hyorhinis. Deliberate infection of other early passage melanoma cell lines aliquots induced variable and unpredictable effects on expression of putative cancer stem cell markers, clonogenicity, proliferation and global gene expression. Cell lines established in stem cell media (SCM) were equally susceptible. Mycoplasma status is rarely reported in publications using cultured cells to study the cancer stem cell hypothesis. Our work highlights the importance of surveillance for Mycoplasma infection while using any cultured cells to interrogate tumor heterogeneity.
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Affiliation(s)
- Craig Gedye
- Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, VIC, 3084, Australia.,University of Newcastle, School of Biomedical Sciences and Pharmacy, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Tracy Cardwell
- Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, LaTrobe University, Olivia Newton-John Cancer Research Institute, Level 5, Olivia Newton-John Cancer & Wellness Centre, Austin Health, 145-163 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Nektaria Dimopoulos
- Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, VIC, 3084, Australia
| | - Bee Shin Tan
- Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, VIC, 3084, Australia
| | - Heather Jackson
- Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, VIC, 3084, Australia
| | - Suzanne Svobodová
- Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, VIC, 3084, Australia
| | - Matthew Anaka
- Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, VIC, 3084, Australia
| | - Andreas Behren
- Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, LaTrobe University, Olivia Newton-John Cancer Research Institute, Level 5, Olivia Newton-John Cancer & Wellness Centre, Austin Health, 145-163 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Christopher Maher
- South African National Bioinformatics Institute, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa.,Washington University Genome Institute, St. Louis, MO, 63110, USA
| | - Oliver Hofmann
- South African National Bioinformatics Institute, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa.,Department of Biostatistics, Harvard School of Public Health, 655 Huntington Avenue, SPH2, 4th Floor, Boston, MA, 02115, USA
| | - Winston Hide
- South African National Bioinformatics Institute, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa.,Department of Biostatistics, Harvard School of Public Health, 655 Huntington Avenue, SPH2, 4th Floor, Boston, MA, 02115, USA
| | - Otavia Caballero
- Ludwig Institute for Cancer Research, New York Branch at Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10021, USA
| | - Ian D Davis
- Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, VIC, 3084, Australia.,Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, and Eastern Health, Box Hill Hospital, 5 Arnold St, Box Hill, VIC, 3128, Australia
| | - Jonathan Cebon
- Ludwig Institute for Cancer Research, Austin Hospital, Studley Road, Heidelberg, VIC, 3084, Australia. .,School of Cancer Medicine, LaTrobe University, Olivia Newton-John Cancer Research Institute, Level 5, Olivia Newton-John Cancer & Wellness Centre, Austin Health, 145-163 Studley Road, Heidelberg, VIC, 3084, Australia.
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50
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Atkinson V, Long GV, Menzies AM, McArthur G, Carlino MS, Millward M, Roberts-Thomson R, Brady B, Kefford R, Haydon A, Cebon J. Optimizing combination dabrafenib and trametinib therapy in BRAF mutation-positive advanced melanoma patients: Guidelines from Australian melanoma medical oncologists. Asia Pac J Clin Oncol 2016; 12 Suppl 7:5-12. [PMID: 27905182 DOI: 10.1111/ajco.12656] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BRAF mutations occur commonly in metastatic melanomas and inhibition of mutant BRAF and the downstream kinase MEK results in rapid tumor regression and prolonged survival in patients. Combined therapy with BRAF and MEK inhibition improves response rate, progression free survival and overall survival compared with single agent BRAF inhibition, and reduces the skin toxicity that is seen with BRAF inhibitor monotherapy. However, this combination is associated with an increase in other toxicities, particularly drug-related pyrexia, which affects approximately 50% of patients treated with dabrafenib and trametinib (CombiDT). We provide guidance on managing adverse events likely to arise during treatment with combination BRAF and MEK inhibition with CombiDT: pyrexia, skin conditions, fatigue; and discuss management of CombiDT during surgery and radiotherapy. By improving tolerability and in particular preventing unnecessary treatment cessations or reduction in drug exposure, best outcomes can be achieved for patients undergoing CombiDT therapy.
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Affiliation(s)
- Victoria Atkinson
- Princess Alexandra Hospital, Greenslopes Private Hospital and University of Queensland, Brisbane, Queensland, Australia
| | - Georgina V Long
- Melanoma Institute Australia, Royal North Shore and Mater Hospitals, The University of Sydney, Sydney, New South Wales, Australia
| | - Alexander M Menzies
- Melanoma Institute Australia, Royal North Shore and Mater Hospitals, The University of Sydney, Sydney, New South Wales, Australia
| | - Grant McArthur
- Peter MacCallum Cancer Centre and Cabrini Health, Melbourne, Victoria, Australia
| | | | - Michael Millward
- School of Medicine and Pharmacology, University of Western Australia and Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | | | - Benjamin Brady
- Peter MacCallum Cancer Centre and Cabrini Health, Melbourne, Victoria, Australia
| | - Richard Kefford
- Westmead Hospital and Macquarie University, Sydney, New South Wales, Australia
| | | | - Jonathan Cebon
- Olivia Newton John Cancer Wellness & Research Centre, Austin Health Melbourne, Victoria, Australia
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