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Oh DY, He AR, Qin S, Chen LT, Okusaka T, Vogel A, Kim JW, Suksombooncharoen T, Lee MA, Kitano M, Burris H, Bouattour M, Tanasanvimon S, McNamara MG, Zaucha R, Avallone A, Tan B, Cundom J, Lee CK, Takahashi H, Ikeda M, Chen JS, Wang J, Makowsky M, Rokutanda N, Żotkiewicz M, Kurland JF, Cohen G, Valle JW. Plain language summary of the TOPAZ-1 study: durvalumab and chemotherapy for advanced biliary tract cancer. Future Oncol 2023; 19:2277-2289. [PMID: 37746835 DOI: 10.2217/fon-2023-0468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
WHAT IS THIS SUMMARY ABOUT? This is a summary describing the results of a Phase III study called TOPAZ-1. The study looked at treatment with durvalumab (a type of immunotherapy) and chemotherapy to treat participants with advanced biliary tract cancer (BTC). Advanced BTC is usually diagnosed at late stages of disease, when it cannot be cured by surgery. This study included participants with advanced BTC who had not received previous treatment, or had their cancer come back at least 6 months after receiving treatment or surgery that aimed to cure their disease. Participants received treatment with durvalumab and chemotherapy or placebo and chemotherapy. The aim of this study was to find out if treatment with durvalumab and chemotherapy could increase the length of time that participants with advanced BTC lived, compared with placebo and chemotherapy. WHAT WERE THE RESULTS OF THE STUDY? Participants who took durvalumab and chemotherapy had a 20% lower chance of experiencing death at any point in the study compared with participants who received placebo and chemotherapy. The side effects experienced by participants were similar across treatment groups, and less than 12% of participants in either treatment group had to stop treatment due to treatment-related side effects. WHAT DO THE RESULTS OF THE STUDY MEAN? Overall, these results support durvalumab and chemotherapy as a new treatment option for people with advanced BTCs. Based on the results of this study, durvalumab is now approved for the treatment of adults with advanced BTCs in combination with chemotherapy by government organizations in Europe, the United States and several other countries.
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Affiliation(s)
- Do-Youn Oh
- Division of Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Aiwu Ruth He
- Division of Hematology & Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Shukui Qin
- Cancer Center of Nanjing, Jinling Hospital, Nanjing, China
| | - Li-Tzong Chen
- Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, & National Institute of Cancer Research, Tainan, & National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Takuji Okusaka
- Department of Hepatobiliary & Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Arndt Vogel
- Gastroenterology, Hepatology & Endocrinology, Hannover Medical School, Hannover, Germany
| | - Jin Won Kim
- Division of Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | | | - Myung Ah Lee
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University, Seoul, South Korea
| | - Masayuki Kitano
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Howard Burris
- Sarah Cannon Research Institute, Tennessee Oncology, Nashville, TN, USA
| | - Mohamed Bouattour
- Department of Liver Cancer Unit, AP-HP Hopital Beaujon, Paris, France
| | - Suebpong Tanasanvimon
- Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Mairead G McNamara
- Division of Cancer Sciences, The University of Manchester/The Christie NHS Foundation Trust, Manchester, UK
| | - Renata Zaucha
- Department of Oncology & Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Antonio Avallone
- Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale, Naples, Italy
| | - Benjamin Tan
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Juan Cundom
- Instituto de Investigaciones Metabolicas, Buenos Aires, Argentina
| | - Choong-Kun Lee
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Hidenori Takahashi
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Masafumi Ikeda
- Department of Hepatobiliary & Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Jen-Shi Chen
- Department of Hematology-Oncology, Linkou Chang-Gung MemorialHospital & Chang-Gung University, Tao-yuan City, Taiwan
| | | | | | | | | | | | | | - Juan W Valle
- Division of Cancer Sciences, The University of Manchester/The Christie NHS Foundation Trust, Manchester, UK
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Oh DY, Ruth He A, Qin S, Chen LT, Okusaka T, Vogel A, Kim JW, Suksombooncharoen T, Ah Lee M, Kitano M, Burris H, Bouattour M, Tanasanvimon S, McNamara MG, Zaucha R, Avallone A, Tan B, Cundom J, Lee CK, Takahashi H, Ikeda M, Chen JS, Wang J, Makowsky M, Rokutanda N, He P, Kurland JF, Cohen G, Valle JW. Durvalumab plus Gemcitabine and Cisplatin in Advanced Biliary Tract Cancer. NEJM Evid 2022; 1:EVIDoa2200015. [PMID: 38319896 DOI: 10.1056/evidoa2200015] [Citation(s) in RCA: 225] [Impact Index Per Article: 112.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Durvalumab Combination for Biliary Tract CancerThis trial randomly assigned patients with previously untreated locally advanced or metastatic biliary tract cancer to receive durvalumab or placebo in combination with gemcitabine plus cisplatin. Median overall survival (95% Cl) was 12.8 (11.1-14.0) months in the durvalumab group. Rates of grade 3 or 4 adverse events were similar between groups.
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Affiliation(s)
- Do-Youn Oh
- Division of Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Aiwu Ruth He
- Division of Hematology and Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Shukui Qin
- Cancer Center of Nanjing, Jinling Hospital, Nanjing, China
| | - Li-Tzong Chen
- Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- National Institute of Cancer Research, Tainan, Taiwan
- National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Arndt Vogel
- Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Jin Won Kim
- Division of Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | | | - Myung Ah Lee
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University, Seoul, South Korea
| | - Masayuki Kitano
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Howard Burris
- Sarah Cannon Research Institute, Tennessee Oncology, Nashville, TN
| | - Mohamed Bouattour
- Department of Liver Cancer Unit, Assistance Publique-Hôpitaux de Paris Hôpital Beaujon, Paris, France
| | - Suebpong Tanasanvimon
- Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Mairéad G McNamara
- Division of Cancer Sciences, The University of Manchester/The Christie NHS Foundation Trust, Manchester, UK
| | - Renata Zaucha
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Antonio Avallone
- Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale, Naples, Italy
| | - Benjamin Tan
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Juan Cundom
- Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
| | - Choong-Kun Lee
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Hidenori Takahashi
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Masafumi Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Jen-Shi Chen
- Department of Hematology-Oncology, Linkou Chang-Gung Memorial Hospital and Chang-Gung University, Taoyuan City, Taiwan
| | | | | | | | | | | | | | - Juan W Valle
- Division of Cancer Sciences, The University of Manchester/The Christie NHS Foundation Trust, Manchester, UK
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He A, Valle J, Lee C, Ikeda M, Potemski P, Morizane C, Cundom J, Tougeron D, Dayyani F, Rokutanda N, Xiong J, Cohen G, Oh D. O-1 Outcomes by primary tumour location in patients with advanced biliary tract cancer treated with durvalumab or placebo plus gemcitabine and cisplatin in the phase 3 TOPAZ-1 study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Oh DY, He AR, Qin S, Chen LT, Okusaka T, Vogel A, Kim JW, Suksombooncharoen T, Lee MA, Kitano M, Burris III HA, Bouattour M, Tanasanvimon S, Zaucha R, Avallone A, Cundom J, Rokutanda N, Xiong J, Cohen G, Valle JW. A phase 3 randomized, double-blind, placebo-controlled study of durvalumab in combination with gemcitabine plus cisplatin (GemCis) in patients (pts) with advanced biliary tract cancer (BTC): TOPAZ-1. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.4_suppl.378] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
378 Background: BTC is a rare, heterogenous cancer with poor prognosis. Reports on immunogenic features of BTC suggest checkpoint inhibition may result in antitumor immune responses, and limited clinical activity has been seen with single agents in advanced settings. Durvalumab (PD-L1 inhibitor) + GemCis showed promising antitumor activity in advanced BTC in a phase 2 study. TOPAZ-1 (NCT03875235) is the first global phase 3 study to evaluate first-line immunotherapy + GemCis in advanced BTC. Methods: In this double-blind study, pts previously untreated for unresectable locally advanced, recurrent, or metastatic BTC were randomized 1:1 to receive durvalumab (1500 mg every 3 weeks [Q3W]) or placebo + GemCis (Gem 1000 mg/m2 and Cis 25 mg/m2 on Days 1 and 8 Q3W) for up to 8 cycles, followed by durvalumab (1500 mg Q4W) or placebo until disease progression or unacceptable toxicity. Randomization was stratified by disease status (initially unresectable, recurrent) and primary tumor location (intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, gallbladder cancer). The primary objective was to assess overall survival (OS). Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), and safety. Results: At data cutoff for this interim analysis (11 August 2021), 685 pts were randomized to durvalumab + GemCis (n=341) or placebo + GemCis (n=344; Table). The primary objective was met: durvalumab + GemCis significantly improved OS vs placebo + GemCis (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.66–0.97; p=0.021). PFS was also significantly improved with durvalumab vs placebo (HR, 0.75; 95% CI, 0.64–0.89; p=0.001). ORR was 26.7% with durvalumab and 18.7% with placebo. Grade 3/4 treatment-related adverse events (TRAEs) occurred in 62.7% of pts receiving durvalumab and 64.9% of pts receiving placebo. TRAEs led to discontinuation of any study medication in 8.9% of pts receiving durvalumab and 11.4% of pts receiving placebo. Conclusions: In pts with advanced BTC, durvalumab + GemCis significantly improved OS and PFS vs placebo + GemCis with manageable safety, indicating durvalumab + GemCis may be a new first-line standard of care regimen. Clinical trial information: NCT03875235. [Table: see text]
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Affiliation(s)
- Do-Youn Oh
- Division of Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | | | - Shukui Qin
- Cancer Center of Nanjing, Jinling Hospital, Nanjing, China
| | - Li-Tzong Chen
- National Institute of Cancer Research, Tainan, Taiwan
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Jin Won Kim
- Seoul National University Bundang Hospital, Seongnam, South Korea
| | | | - Myung Ah Lee
- Seoul St. Mary's Hospital, Catholic University, Seoul, South Korea
| | - Masayuki Kitano
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | | | | | - Suebpong Tanasanvimon
- Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | | | - Antonio Avallone
- Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale, Naples, Italy
| | - Juan Cundom
- Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
| | | | | | | | - Juan W. Valle
- University of Manchester and the Christie NHS Foundation Trust, Manchester, United Kingdom
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Martin C, Cuello M, Barajas O, Recondo G, Aruachan S, Perroud H, Sena S, Bonilla C, Orlandi F, Berutti S, Garcia Cocco V, Gomez A, Korbenfeld E, Zapata M, Cundom J, Orellana E, Goncalves S, Reinhold F. Real-world evaluation of molecular testing and treatment patterns for EGFR mutations in non-small cell lung cancer in Latin America. Mol Clin Oncol 2021; 16:6. [PMID: 34881026 PMCID: PMC8647188 DOI: 10.3892/mco.2021.2439] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/08/2021] [Indexed: 12/24/2022] Open
Abstract
Lung cancer is a leading cause of cancer-related deaths in Latin America, with non-small cell lung cancer (NSCLC) being the most prevalent. The current study aimed to report real-world data on epidermal growth factor receptor (EGFR) mutational testing and treatment regimens at diagnosis and progression in patients with metastatic NSCLC across four Latin American countries (Argentina, Chile, Colombia and Uruguay). A retrospective, multicenter, observational study was conducted in patients with NSCLC using medical records from participating countries. The study population was categorized into two cohorts: Cohort 1 comprised of newly diagnosed, treatment-naïve patients with stage IV NSCLC; and cohort 2 comprised of stage IV NSCLC EGFR mutation (EGFRm)-positive patients who had progressed after first- or second-generation EGFR-tyrosine kinase inhibitor (TKI) treatment. Measures included demographic variables, health characteristics, treatment regimen, molecular testing rate and turnaround time at diagnosis and at progression for cohorts 1 and 2, respectively. Descriptive statistics were used to summarize all study measures. Of the 462 patients enrolled, 431 were newly diagnosed or treatment naïve with metastatic NSCLC. In cohort 1, the majority of patients with private health insurance (57.31%) underwent molecular diagnosis while only 41.3% of patients within the public sector had access to testing. The average molecular testing rate in cohort 1 varied across countries, with Argentina having the highest testing rate (79%) and Uruguay the lowest (27.63%). EGFRm was observed in 22% of patients. Cohort 2 comprised 31 patients who had progressed after first- or second-generation EGFR-TKI treatment and of these, only 22 (70.97%) underwent testing after progression. Access to molecular testing is still a challenge impacting the choice of first-line treatment in Latin American patients with NSCLC. These findings underline the unmet needs of ensuring early diagnosis, molecular profiling and use of correct treatment to alleviate NSCLC burden in the region.
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Affiliation(s)
- Claudio Martin
- Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina
| | - Mauricio Cuello
- Department of Oncology, Hospital of Clinics, Montevideo 11600, Uruguay
| | - Olga Barajas
- Department of Medical Oncology, Arturo Lopez Perez Foundation, Santiago 7500000, Chile
| | - Gonzalo Recondo
- Department of Thoracic Oncology, Medical education and Clinical Research Centre, University Institute (CEMIC), Buenos Aires C1431FWO, Argentina
| | - Sandra Aruachan
- Department of Clinical Oncology, High Technology Medical Institute Oncomedica, Monteria 23001, Colombia
| | - Herman Perroud
- Department of Clinical Oncology, Women's Health Centre, Rosario 2000, Argentina
| | - Susana Sena
- Department of Clinical Oncology; German Hospital, Buenos Aires PC C1118AAT, Argentina
| | - Carlos Bonilla
- Clinical Oncology Unit, National Cancer Institute of Colombia, Bogotá 110411, Colombia
| | - Francisco Orlandi
- Department of Clinical Oncology, Orlandi Oncology, Providencia 7500713, Chile
| | - Susana Berutti
- Department of Clinical Oncology, Italian Hospital of La Plata, La Plata B1900AXI, Argentina
| | | | - Alvaro Gomez
- Department of Medical Oncology, Hemato-oncologos SA, Cali 760042, Colombia
| | - Ernesto Korbenfeld
- Department of Medical Oncology, British Hospital of Buenos Aires, Buenos Aires C1280AEB, Argentina
| | - Maycos Zapata
- Department of Medical Oncology, Cancer Institute Las Americas, Antioquia 050025, Colombia
| | - Juan Cundom
- Department of Medical Oncology, Lanari Institute, University of Buenos Aires, Buenos Aires C1427ARN, Argentina
| | - Eric Orellana
- Department of Clinical Oncology, Clinic Santa Maria, Santiago 7500000, Chile
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Tsou F, Angel M, Reinhold F, Gabay C, Bonet M, Bluthgen M, Minatta J, Bustos B, Novas C, Rizzo M, Kowalyszyn R, Cundom J, Richardet E, Ferreira G, Bradley DG, Roa G, Tatangelo M, Caglevic C, Pini A, Paskevicius M, Flores M, Pupareli C, Martin C. P21.13 Durvalumab in Locally-Advanced NSCLC in LATAM: Real World Data from Patients Included in the Early Access Program. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.593] [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: 11/25/2022]
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