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Deycmar S, Johnson BJ, Ray K, Schaaf GW, Ryan DP, Cullin C, Dozier BL, Ferguson B, Bimber BN, Olson JD, Caudell DL, Whitlow CT, Solingapuram Sai KK, Romero EC, Villinger FJ, Burgos AG, Ainsworth HC, Miller LD, Hawkins GA, Chou JW, Gomes B, Hettich M, Ceppi M, Charo J, Cline JM. Epigenetic MLH1 silencing concurs with mismatch repair deficiency in sporadic, naturally occurring colorectal cancer in rhesus macaques. J Transl Med 2024; 22:292. [PMID: 38504345 PMCID: PMC10953092 DOI: 10.1186/s12967-024-04869-6] [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: 08/25/2023] [Accepted: 01/08/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Naturally occurring colorectal cancers (CRC) in rhesus macaques share many features with their human counterparts and are useful models for cancer immunotherapy; but mechanistic data are lacking regarding the comparative molecular pathogenesis of these cancers. METHODS We conducted state-of-the-art imaging including CT and PET, clinical assessments, and pathological review of 24 rhesus macaques with naturally occurring CRC. Additionally, we molecularly characterized these tumors utilizing immunohistochemistry (IHC), microsatellite instability assays, DNAseq, transcriptomics, and developed a DNA methylation-specific qPCR assay for MLH1, CACNA1G, CDKN2A, CRABP1, and NEUROG1, human markers for CpG island methylator phenotype (CIMP). We furthermore employed Monte-Carlo simulations to in-silico model alterations in DNA topology in transcription-factor binding site-rich promoter regions upon experimentally demonstrated DNA methylation. RESULTS Similar cancer histology, progression patterns, and co-morbidities could be observed in rhesus as reported for human CRC patients. IHC identified loss of MLH1 and PMS2 in all cases, with functional microsatellite instability. DNA sequencing revealed the close genetic relatedness to human CRCs, including a similar mutational signature, chromosomal instability, and functionally-relevant mutations affecting KRAS (G12D), TP53 (R175H, R273*), APC, AMER1, ALK, and ARID1A. Interestingly, MLH1 mutations were rarely identified on a somatic or germline level. Transcriptomics not only corroborated the similarities of rhesus and human CRCs, but also demonstrated the significant downregulation of MLH1 but not MSH2, MSH6, or PMS2 in rhesus CRCs. Methylation-specific qPCR suggested CIMP-positivity in 9/16 rhesus CRCs, but all 16/16 exhibited significant MLH1 promoter hypermethylation. DNA hypermethylation was modelled to affect DNA topology, particularly propeller twist and roll profiles. Modelling the DNA topology of a transcription factor binding motif (TFAP2A) in the MLH1 promoter that overlapped with a methylation-specific probe, we observed significant differences in DNA topology upon experimentally shown DNA methylation. This suggests a role of transcription factor binding interference in epigenetic silencing of MLH1 in rhesus CRCs. CONCLUSIONS These data indicate that epigenetic silencing suppresses MLH1 transcription, induces the loss of MLH1 protein, abrogates mismatch repair, and drives genomic instability in naturally occurring CRC in rhesus macaques. We consider this spontaneous, uninduced CRC in immunocompetent, treatment-naïve rhesus macaques to be a uniquely informative model for human CRC.
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Affiliation(s)
- Simon Deycmar
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Roche Postdoctoral Fellowship (RPF) Program, Basel, Switzerland
| | - Brendan J Johnson
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Karina Ray
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR, USA
| | - George W Schaaf
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Declan Patrick Ryan
- School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Cassandra Cullin
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR, USA
| | - Brandy L Dozier
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR, USA
| | - Betsy Ferguson
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR, USA
| | - Benjamin N Bimber
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR, USA
| | - John D Olson
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - David L Caudell
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Christopher T Whitlow
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | - Emily C Romero
- New Iberia Research Center, University of Louisiana-Lafayette, New Iberia, LA, USA
| | - Francois J Villinger
- New Iberia Research Center, University of Louisiana-Lafayette, New Iberia, LA, USA
| | - Armando G Burgos
- Caribbean Primate Research Center, University of Puerto Rico, Toa Baja, PR, USA
| | - Hannah C Ainsworth
- Department of Biostatistics and Data Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Lance D Miller
- Department of Cancer Biology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Center for Cancer Genomics and Precision Oncology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Gregory A Hawkins
- Center for Cancer Genomics and Precision Oncology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Biochemistry, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jeff W Chou
- Center for Cancer Genomics and Precision Oncology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Bruno Gomes
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Michael Hettich
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Maurizio Ceppi
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
- iTeos Therapeutics, Translational Medicine, Gosselies, Belgium
| | - Jehad Charo
- Roche Pharma Research and Early Development, Roche Innovation Center Zurich, Zurich, Switzerland
| | - J Mark Cline
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
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Dziadek S, Kraxner A, Cheng WY, Ou Yang TH, Flores M, Theiss N, Tsao TS, Andersson E, Harring SV, Bröske AME, Ceppi M, Teichgräber V, Charo J. Comprehensive analysis of fibroblast activation protein expression across 23 tumor indications: insights for biomarker development in cancer immunotherapies. Front Immunol 2024; 15:1352615. [PMID: 38558814 PMCID: PMC10981271 DOI: 10.3389/fimmu.2024.1352615] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/25/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Fibroblast activation protein (FAP) is predominantly upregulated in various tumor microenvironments and scarcely expressed in normal tissues. Methods We analyzed FAP across 1216 tissue samples covering 23 tumor types and 70 subtypes. Results Elevated FAP levels were notable in breast, pancreatic, esophageal, and lung cancers. Using immunohistochemistry and RNAseq, a correlation between FAP gene and protein expression was found. Evaluating FAP's clinical significance, we assessed 29 cohorts from 12 clinical trials, including both mono and combination therapies with the PD-L1 inhibitor atezolizumab and chemotherapy. A trend links higher FAP expression to poorer prognosis, particularly in RCC, across both treatment arms. However, four cohorts showed improved survival with high FAP, while in four others, FAP had no apparent survival impact. Conclusions Our results emphasize FAP's multifaceted role in therapy response, suggesting its potential as a cancer immunotherapy biomarker.
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Affiliation(s)
- Sebastian Dziadek
- Roche Pharma Research and Early Development, Oncology, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Anton Kraxner
- Roche Pharma Research and Early Development, Oncology, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Wei-Yi Cheng
- Roche Pharma Research and Early Development, Data and Analytics, Roche Translational & Clinical Research Center, F. Hoffmann-La Roche Ltd, Little Falls, NJ, United States
| | - Tai-Hsien Ou Yang
- Roche Pharma Research and Early Development, Data and Analytics, Roche Translational & Clinical Research Center, F. Hoffmann-La Roche Ltd, Little Falls, NJ, United States
| | - Mike Flores
- Roche Tissue Diagnostics, Tucson, AZ, United States
| | - Noah Theiss
- Roche Tissue Diagnostics, Tucson, AZ, United States
| | | | - Emilia Andersson
- Roche Pharma Research and Early Development, Oncology, Roche Innovation Center Munich, Roche Diagnostics GmbH, Penzberg, Germany
| | - Suzana Vega Harring
- Roche Pharma Research and Early Development, Oncology, Roche Innovation Center Munich, Roche Diagnostics GmbH, Penzberg, Germany
| | - Ann-Marie E. Bröske
- Roche Pharma Research and Early Development, Oncology, Roche Innovation Center Munich, Roche Diagnostics GmbH, Penzberg, Germany
| | - Maurizio Ceppi
- Roche Pharma Research and Early Development, Oncology, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Volker Teichgräber
- Roche Pharma Research and Early Development, Oncology, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Jehad Charo
- Roche Pharma Research and Early Development, Oncology, Roche Innovation Center Zurich, Roche Glycart AG, Schlieren, Switzerland
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3
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Molinelli C, Jacobs F, Agostinetto E, Nader-Marta G, Ceppi M, Bruzzone M, Blondeaux E, Schettini F, Prat A, Viale G, Del Mastro L, Lambertini M, de Azambuja E. Prognostic value of HER2-low status in breast cancer: a systematic review and meta-analysis. ESMO Open 2023; 8:101592. [PMID: 37413762 PMCID: PMC10485402 DOI: 10.1016/j.esmoop.2023.101592] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Human epidermal growth factor receptor 2 (HER2)-low expression in breast cancer has been recently identified as a new therapeutic target. However, it is unclear if HER2-low status has an independent impact on prognosis. MATERIALS AND METHODS A systematic literature research was carried out to identify studies comparing survival outcomes of patients affected by HER2-low versus HER2-zero breast cancer. Using random-effects models, pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for progression-free survival (PFS) and overall survival (OS) in the metastatic setting as well as disease-free survival (DFS), OS and pathological complete response (pCR) in the early setting. Subgroup analyses by hormone receptor (HoR) status were carried out. The study protocol is registered on PROSPERO (n.CRD42023390777). RESULTS Among 1916 identified records, 42 studies including 1 797 175 patients were eligible. In the early setting, HER2-low status was associated with significant improved DFS (HR 0.86, 95% CI 0.79-0.92, P < 0.001) and OS (HR 0.90, 95% CI 0.85-0.95, P < 0.001) when compared to HER2-zero status. Improved OS was observed for both HoR-positive and HoR-negative HER2-low populations, while DFS improvement was observed only in the HoR-positive subgroup. HER2-low status was significantly associated with a lower rate of pCR as compared to HER2-zero status both in the overall population (OR 0.74, 95% CI 0.62-0.88, P = 0.001) and in the HoR-positive subgroup (OR 0.77, 95% CI 0.65-0.90, P = 0.001). In the metastatic setting, patients with HER2-low breast cancers showed better OS when compared with those with HER2-zero tumours in the overall population (HR 0.94, 95% CI 0.89-0.98, P = 0.008), regardless of HoR status. No significant PFS differences were found. CONCLUSIONS Compared with HER2-zero status, HER2-low status appears to be associated with a slightly increased OS both in the advanced and early settings, regardless of HoR expression. In the early setting, HER2-low tumours seem to be associated to lower pCR rates, especially if HoR-positive.
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Affiliation(s)
- C Molinelli
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa. https://twitter.com/ChiaraMolinelli
| | - F Jacobs
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium; Department of Biomedical Sciences, Humanitas University, Milan. https://twitter.com/FlaviaJacobs_
| | - E Agostinetto
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium. https://twitter.com/ElisaAgostinett
| | - G Nader-Marta
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium. https://twitter.com/Nader_Guilherme
| | - M Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - M Bruzzone
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - E Blondeaux
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. https://twitter.com/BlondeauxEva
| | - F Schettini
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona; Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona. https://twitter.com/FrancescoSche20
| | - A Prat
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona; Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona; Reveal Genomics, Barcelona, Spain. https://twitter.com/prat_aleix
| | - G Viale
- Department of Pathology, IEO European Institute of Oncology IRCCS, Milan
| | - L Del Mastro
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. https://twitter.com/delmastro_lucia
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. https://twitter.com/matteolambe
| | - E de Azambuja
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium; Medical Oncology Department, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium.
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4
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Melero I, Tanos T, Bustamante M, Sanmamed MF, Calvo E, Moreno I, Moreno V, Hernandez T, Martinez Garcia M, Rodriguez-Vida A, Tabernero J, Azaro A, Ponz-Sarvisé M, Spanggaard I, Rohrberg K, Guarin E, Nüesch E, Davydov II, Ooi C, Duarte J, Chesne E, McIntyre C, Ceppi M, Cañamero M, Krieter O. A first-in-human study of the fibroblast activation protein-targeted, 4-1BB agonist RO7122290 in patients with advanced solid tumors. Sci Transl Med 2023; 15:eabp9229. [PMID: 37163618 DOI: 10.1126/scitranslmed.abp9229] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This first-in-human study evaluated RO7122290, a bispecific fusion protein carrying a split trimeric 4-1BB (CD137) ligand and a fibroblast activation protein α (FAP) binding site that costimulates T cells for improved tumor cell killing in FAP-expressing tumors. Patients with advanced or metastatic solid tumors received escalating weekly intravenous doses of RO7122290 as a single agent (n = 65) or in combination with a 1200-milligram fixed dose of the anti-programmed death-ligand 1 (anti-PD-L1) antibody atezolizumab given every 3 weeks (n = 50), across a tested RO7122290 dose range of 5 to 2000 milligrams and 45 to 2000 milligrams, respectively. Three dose-limiting toxicities were reported, two at different RO7122290 single-agent doses (grade 3 febrile neutropenia and grade 3 cytokine release syndrome) and one for the combination (grade 3 pneumonitis). No maximum tolerated dose was identified. The pharmacokinetic profile of RO7122290 suggested nonlinearity in elimination. The observed changes in peripheral and tissue pharmacodynamic (PD) biomarkers were consistent with the postulated mechanism of action. Treatment-induced PD changes included an increase in proliferating and activated T cells in peripheral blood both in the single-agent and combination arms. Increased infiltration of intratumoral CD8+ and Ki67+CD8+ T cells was observed for both treatment regimens, accompanied by the up-regulation of T cell activation genes and gene signatures. Eleven patients experienced a complete or partial response, six of whom were confirmed to be immune checkpoint inhibitor naive. These results support further evaluation of RO7122290 in combination with atezolizumab or other immune-oncology agents for the treatment of solid tumors.
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Affiliation(s)
- Ignacio Melero
- Department of Immunology and Immunotherapy, Clinica Universidad de Navarra and CIMA, 31008 Pamplona, Spain
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Tamara Tanos
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Mariana Bustamante
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Miguel F Sanmamed
- Department of Immunology and Immunotherapy, Clinica Universidad de Navarra and CIMA, 31008 Pamplona, Spain
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medical Oncology, Clinica Universidad de Navarra, 31008 Pamplona, Spain
| | - Emiliano Calvo
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, 28050 Madrid, Spain
| | - Irene Moreno
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, 28050 Madrid, Spain
| | - Victor Moreno
- START Madrid-FJD, Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Tatiana Hernandez
- START Madrid-FJD, Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain
| | | | - Alejo Rodriguez-Vida
- Department of Medical Oncology, Hospital del Mar-CIBERONC, 08003 Barcelona, Spain
| | - Josep Tabernero
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Analia Azaro
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Mariano Ponz-Sarvisé
- CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medical Oncology, Clinica Universidad de Navarra, 31008 Pamplona, Spain
| | - Iben Spanggaard
- Department of Oncology, Rigshospitalet University Hospital of Copenhagen, 2100 Copenhagen, Denmark
| | - Kristoffer Rohrberg
- Department of Oncology, Rigshospitalet University Hospital of Copenhagen, 2100 Copenhagen, Denmark
| | - Ernesto Guarin
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Eveline Nüesch
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Iakov I Davydov
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Chiahuey Ooi
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - José Duarte
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Evelyne Chesne
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Christine McIntyre
- Roche Pharma Research and Early Development, Roche Innovation Center Welwyn, AL7 1TW Welwyn Garden City, UK
| | - Maurizio Ceppi
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Marta Cañamero
- Roche Pharma Research and Early Development, Roche Innovation Center Munich, 82377 Penzberg, Germany
| | - Oliver Krieter
- Roche Pharma Research and Early Development, Roche Innovation Center Munich, 82377 Penzberg, Germany
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Martinoli C, Tieppo P, Mercier M, Shehade H, Wald N, Vezzu A, Hermant A, Pirlot B, Ma S, Ceppi M, McGrath Y, Rossetti M. Abstract 4135: A novel plasma cell-based mechanism of action of adenosine immunomodulation and A2AR antagonism. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-4135] [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: 04/07/2023]
Abstract
Abstract
High levels of extracellular adenosine, often found in the tumor microenvironment (TME), promote immune suppression mainly through the A2A receptor (A2AR) expressed by tumor-infiltrating immune cells. Inupadenant (formerly known as EOS100850) is an oral, non-brain penetrant, potent and highly selective small molecule antagonist of A2AR. In a Phase I/Ib clinical trial (NCT02740985), inupadenant as monotherapy showed initial evidence of clinical benefit in subjects with advanced solid tumors. In this study, tumor biopsies with a high number of A2AR-expressing immune cells at baseline were associated with response or stable disease.We now report that infiltration of A2AR+ cells was strongly correlated with the expression of B- and, more specifically, antibody-secreting cell (ASC)-related genes, as assessed by gene expression (Nanostring) and immunohistochemistry (IHC), hinting at a potential novel role for A2AR in B cell biology. Therefore, we explored the expression and function of A2AR in human B cells. Immunocytochemistry staining of A2AR on sorted tonsillar B cell subsets showed that A2AR was predominantly expressed on ASCs, including plasma cells and plasma blasts versus naïve or memory B cells. The preferential expression of A2AR by ASCs was confirmed on NSCLC tissues by multiplex immunofluorescence. In addition to A2AR, ASCs expressed other adenosine pathway markers such as CD39, suggesting that the adenosine pathway is a key mechanism through which ASC functions may be modulated. Using B cells derived from peripheral blood, the A2AR agonist CGS-21680 was shown to inhibit the maturation of B cells into plasma cells, and that maturation could be fully restored by inupadenant. CGS-21680 did not affect B cell or plasma cell viability, indicating that the effect of A2AR signaling on plasma cell differentiation is not due to preferential plasma cell death in culture. Importantly, baseline expression of B cell- and ASC-related markers measured by Nanostring and IHC was associated with response or stable disease to inupadenant monotherapy, supporting the notion that these cells may be a novel target of inupadenant. This is in line with recent reports showing that B cells, plasma cells and tertiary lymphoid structures are associated with favorable responses to cancer immunotherapy. Interestingly, four out of the five non-progressors treated with inupadenant as monotherapy and with available biomarker data showed a reduction in ASC infiltration after inupadenant treatment, suggesting that inupadenant may promote terminal plasma cell differentiation and migration out of the tumor tissue and to the bone marrow.Altogether, these data support a novel plasma cell-centric mechanism of action of inupadenant, which may complement its reported T cell-mediated anti-tumor activity.
Citation Format: Chiara Martinoli, Paola Tieppo, Marjorie Mercier, Hussein Shehade, Noemie Wald, Anais Vezzu, Annelise Hermant, Boris Pirlot, Stephanie Ma, Maurizio Ceppi, Yvonne McGrath, Maura Rossetti. A novel plasma cell-based mechanism of action of adenosine immunomodulation and A2AR antagonism. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4135.
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Deycmar S, Gomes B, Charo J, Ceppi M, Cline JM. Spontaneous, naturally occurring cancers in non-human primates as a translational model for cancer immunotherapy. J Immunother Cancer 2023; 11:jitc-2022-005514. [PMID: 36593067 PMCID: PMC9808758 DOI: 10.1136/jitc-2022-005514] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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] [Accepted: 12/05/2022] [Indexed: 01/03/2023] Open
Abstract
The complexity of cancer immunotherapy (CIT) demands reliable preclinical models to successfully translate study findings to the clinics. Non-human primates (NHPs; here referring to rhesus and cynomolgus macaques) share broad similarities with humans including physiology, genetic homology, and importantly also immune cell populations, immune regulatory mechanisms, and protein targets for CIT. Furthermore, NHP naturally develop cancers such as colorectal and breast cancer with an incidence, pathology, and age pattern comparable to humans. Thus, these tumor-bearing monkeys (TBMs) have the potential to bridge the experimental gap between early preclinical cancer models and patients with human cancer.This review presents our current knowledge of NHP immunology, the incidence and features of naturally-occurring cancers in NHP, and recent TBM trials investigating CIT to provide a scientific rationale for this unique model for human cancer.
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Affiliation(s)
- Simon Deycmar
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Bruno Gomes
- Roche Pharmaceutical Research and Early Development Oncology, Roche Innovation Center Basel, Basel, Switzerland
| | - Jehad Charo
- Roche Pharmaceutical Research and Early Development Oncology, Roche Innovation Center Zurich, Schlieren, Switzerland
| | - Maurizio Ceppi
- Roche Pharmaceutical Research and Early Development Oncology, Roche Innovation Center Basel, Basel, Switzerland,iTeos Therapeutics Inc, Watertown, Massachusetts, USA
| | - J Mark Cline
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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A. Boutros, Tanda E, Croce E, Catalano F, Ceppi M, Bruzzone M, Cecchi F, Arecco L, Fraguglia M, Pronzato P, Del Mastro L, Lambertini M, Spagnolo F. 63P Activity and safety of first-line treatments for advanced melanoma: A network meta-analysis. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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8
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Deycmar S, Johnson B, Ray K, Caudell DC, Olson J, Dugan G, Sills WS, Ryan D, Whitlow C, Sai KKS, Ferguson B, Bimber B, Cullin C, Dozier B, Romero E, Villinger F, Burgos A, Chou J, Gomes B, Hettich M, Ceppi M, Charo J, Cline JM. Abstract A021: Clinical and molecular characterization of naturally-occurring colorectal cancer in rhesus macaques reveals mismatch repair deficiency driven by epigenetic silencing of MLH1. Cancer Res 2022. [DOI: 10.1158/1538-7445.crc22-a021] [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: 12/04/2022]
Abstract
Abstract
Naturally occurring colorectal cancers (CRC) in rhesus macaques share many features with their human counterparts and emerge at similar life stages as in human patients, but the carcinogenesis and molecular background remain elusive, limiting the value of the model for human disease and cancer therapy. In order to better understand this naturally occurring model, we established a diagnostic and staging pipeline including imaging (18F-FDG PET, plain and contrast-enhanced CT), histopathology, and clinical assessments. We observed cancer symptoms and co-morbidities in our cohort (n=16, all Indian-origin, 11 females, mean age at arrival 20.2y) such as hypoalbuminemia, fecal occult blood, and microcytic anemia, as frequently described in human CRC patients. Pathologically, all cancers were right-sided, involving the proximal colon and/or ileocecocolic junction, and most were densely fibrotic, restricting the colonic lumen. Most cancers appeared with glandular morphology and some (18.8%) had mucinous components. Immunohistochemistry revealed loss of MLH1 and PMS2 in 100% of investigated CRCs, indicating mismatch repair deficiency which furthermore resulted in microsatellite instability (PCR & fragment analysis). Whole exome sequencing revealed the close genetic relatedness to human CRCs, particularly exemplified by mutations affecting KRAS (37.5%, e.g., p.G12D), APC (31.3%), TP53 (18.8%, e.g. p.R175H), ARID1A (56.3%), and ALK (43.8%), as similarly annotated in the human COSMIC database. Nonetheless, somatic mutations do not explain the loss of MLH1 in the entire CRC cohort. Transcriptomics on the other hand revealed the transcriptional suppression of MLH1 but not MSH2, MSH6, or PMS2 in rhesus CRC in comparison to adjacent healthy colon. Moreover, comparison of differentially expressed gene sets of rhesus CRC with a human annotated database (IPA) confirmed the disease similarities observed clinically, genetically, and histopathologically. Subsequently, we investigated DNA methylation of the promoter region of MLH1 and retranslated markers for the CpG island methylator phenotype (CIMP) as described in human CRC. While only 56.3% of CRCs were considered CIMP positive (≥3/5 markers hypermethylated), 100% of investigated CRCs exhibited MLH1 promoter hypermethylation. As a result, epigenetic silencing is suggested to suppress MLH1 transcription, cause the loss of MLH1 protein, and drive mismatch repair deficiency and genomic instability in naturally occurring CRC in rhesus macaques. We therefore consider spontaneous, uninduced CRC in rhesus macaques, their treatment-naïve nature, and their unaltered immune competence an outstanding model for human disease and in particular for human cancer immunotherapy.
Citation Format: Simon Deycmar, Brendan Johnson, Karina Ray, David Caudell Caudell, John Olson, Greg Dugan, W. Shane Sills, Declan Ryan, Christopher Whitlow, Kiran K. Solingapuram Sai, Betsy Ferguson, Benjamin Bimber, Cassandra Cullin, Brandy Dozier, Emily Romero, Francois Villinger, Armando Burgos, Jeff Chou, Bruno Gomes, Michael Hettich, Maurizio Ceppi, Jehad Charo, J. Mark Cline. Clinical and molecular characterization of naturally-occurring colorectal cancer in rhesus macaques reveals mismatch repair deficiency driven by epigenetic silencing of MLH1 [abstract]. In: Proceedings of the AACR Special Conference on Colorectal Cancer; 2022 Oct 1-4; Portland, OR. Philadelphia (PA): AACR; Cancer Res 2022;82(23 Suppl_1):Abstract nr A021.
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Affiliation(s)
| | | | - Karina Ray
- 2Oregon Health and Science University Beaverton, Oregon National Primate Research Center, Beaverton, OR,
| | | | - John Olson
- 1Wake Forest University, Winston-Salem, NC,
| | - Greg Dugan
- 1Wake Forest University, Winston-Salem, NC,
| | | | - Declan Ryan
- 3University of California Davis, School of Veterinary Medicine, Davis, CA,
| | | | | | - Betsy Ferguson
- 2Oregon Health and Science University Beaverton, Oregon National Primate Research Center, Beaverton, OR,
| | - Benjamin Bimber
- 2Oregon Health and Science University Beaverton, Oregon National Primate Research Center, Beaverton, OR,
| | - Cassandra Cullin
- 2Oregon Health and Science University Beaverton, Oregon National Primate Research Center, Beaverton, OR,
| | - Brandy Dozier
- 2Oregon Health and Science University Beaverton, Oregon National Primate Research Center, Beaverton, OR,
| | - Emily Romero
- 4University of Louisiana - Lafayette, New Iberia Research Center, New Iberia, LA,
| | - Francois Villinger
- 4University of Louisiana - Lafayette, New Iberia Research Center, New Iberia, LA,
| | - Armando Burgos
- 5University of Puerto Rico, Caribbean Primate Research Center, Toa Baja, United States Territories and Minor Outlying Islands,
| | - Jeff Chou
- 1Wake Forest University, Winston-Salem, NC,
| | - Bruno Gomes
- 7Roche Innovation Center Basel, Basel, Switzerland
| | | | | | - Jehad Charo
- 7Roche Innovation Center Basel, Basel, Switzerland
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9
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Marić T, Wójcik I, Katušić Bojanac A, Matijević A, Ceppi M, Bruzzone M, Evgeni E, Petrović T, Trbojević-Akmačić I, Lauc G, Ježek D, Fučić A. Seminal plasma N-glycome as a new biomarker of environmental exposure associated with semen quality. Reprod Toxicol 2022; 113:96-102. [PMID: 35961531 DOI: 10.1016/j.reprotox.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/27/2022] [Accepted: 08/07/2022] [Indexed: 11/25/2022]
Abstract
Male infertility, a condition that has during the last decade raised significant concern, is a diagnostically demanding and socially sensitive topic. The number of unsolved issues on infertility etiology, especially potential environmental causes, in couples demonstrates the need for further investigations into infertility biomarkers. Semen parameters are often insufficient for reliable profiling of male infertility. Thus, this study aims to evaluate for the first time seminal plasma N-glycosylation as a biomarker of environmental exposure in semen samples from 82 normozoospermic men and 84 men with abnormal semen parameters and compare it with genome damage measured by DNA fragmentation. We obtained information about chronic exposure to environmental factors from the self-reported questionnaire, and determined sperm DNA fragmentation by sperm chromatin dispersion, while N-glycans were characterized with liquid chromatography-mass spectrometry (LC-MS). Based on previously published results, ten N-glycans were selected. Results show that the selected seminal plasma N-glycans were significantly associated with smoking, exposure to pesticides, air pollution, agents emitted during photocopying, alcohol consumption, and obesity. Some N-glycans showed a simultaneous association with DNA fragmentation, semen parameters, and environmental stressors. These subgroups of N-glycans are new potential candidates for biomonitoring of exposure to different environmental factors in men with semen abnormalities.
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Affiliation(s)
- T Marić
- Scientific Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10 000 Zagreb, Croatia; University of Zagreb School of Medicine, 10 000 Zagreb, Croatia.
| | - I Wójcik
- Genos Glycoscience Research Laboratory, 10 000 Zagreb, Croatia
| | - A Katušić Bojanac
- Scientific Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10 000 Zagreb, Croatia; University of Zagreb School of Medicine, 10 000 Zagreb, Croatia
| | - A Matijević
- University Hospital Centre Zagreb, Department of Laboratory Diagnostics, 10 000 Zagreb, Croatia
| | - M Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16 132 Genova, Italy
| | - M Bruzzone
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16 132 Genova, Italy
| | - E Evgeni
- Cryogonia Cryopreservation Bank, 11 526 Athens, Greece
| | - T Petrović
- Genos Glycoscience Research Laboratory, 10 000 Zagreb, Croatia
| | | | - G Lauc
- Genos Glycoscience Research Laboratory, 10 000 Zagreb, Croatia; University of Zagreb, Faculty of Pharmacy and Biochemistry, 10 000 Zagreb, Croatia
| | - D Ježek
- Scientific Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10 000 Zagreb, Croatia; University of Zagreb School of Medicine, 10 000 Zagreb, Croatia
| | - A Fučić
- Scientific Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10 000 Zagreb, Croatia; Institute for Medical Research and Occupational Health, 10 000 Zagreb, Croatia
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Deycmar S, Johnson B, Ryan D, Sills S, Caudell D, Dugan G, Schaaf G, Whitlow C, Sai KKS, Ferguson B, Bimber B, Ray K, Cullin C, Dozier B, Burgos A, Hettich M, Gomes B, Charo J, Ceppi M, Cline M. Abstract 1325: Naturally occurring colorectal cancer in nonhuman primates used to study human immunotherapeutic agents confirms a link between DNA methylation and mismatch repair deficiency. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1325] [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 Non-human primates (NHP) such as rhesus macaques with naturally occurring cancers are a proposed model for translational cancer immunotherapy (CIT) research and have generated relevant proof-of-mechanism evidence for 3 different CIT agents. NHP spontaneously develop cancers with progression patterns, histology, and clinical symptoms similar to humans. Gene suppression by DNA hypermethylation in the promoter region is the major characteristics of the CpG-island-methylator-phenotype (CIMP) described in human CRC patients but information in rhesus macaques is scarce. To further validate these animals as translational models for CIT, we conducted a deep molecular characterization of NHP colorectal cancers and established novel qPCR panels to assess DNA methylation of marker genes published for humans.
Methods Our cohort (n=16) consisted of Indian-origin rhesus macaques (Macaca mulatta) with naturally occurring CRC (n=16, female=11). Clinical examination, imaging (contrast-enhanced CT, FDG-PET) and biopsy to confirm cancer histology were performed. Molecular characterization was done by IHC for CRC-associated mismatch repair proteins MLH1, MSH2, MSH6, and PMS2 and by PCR/electrophoresis for microsatellite instability. Ultimately, we designed DNA methylation- and rhesus-specific qPCR probes (Methylight) targeting corresponding regions as published in human patients, including CACNA1G, CDKN2A, CRABP1, MLH1, and NEUROG1 as parts of the CIMP panel and BMP3, NDRG4, and SEPTIN9 as probed for human CRC-screening.
Results MLH1 deficiency by IHC, in conjunction with PMS2 absence, is observed in all NHP CRC cases, clearly exceeding frequencies reported in human CRCs (ranging from 2-15%). Moreover, we have documented microsatellite instable cases in some NHP CRCs, analog to human CRCs. DNA methylation of the MLH1 promoter region was significantly elevated in CRCs (100% of CRCs >2-fold, p<0.0001) compared to healthy colon. We hypothesized that this elevation would suppress MLH1 mRNA expression. This hypothesis of epigenetic suppression is corroborated by both qPCR and RNA sequencing which demonstrate significantly downregulated levels of MLH1 mRNA. DNA methylation of the other markers is less consistent but revealed CIMP positive and CIMP negative cases in our NHP CRC cohort.
Conclusions Transcriptional suppression of MLH1 by promoter hypermethylation is a major and widespread driver of genetic instability and carcinogenesis in rhesus macaque colorectal cancer. Differential DNA methylation in the promoter regions as observed in NHP CRCs can provide a screening target for liquid biopsies. This work highlights the possible translatability of naturally occurring NHP cancers for human cancer immunotherapy research and can be further explored in future tumor-bearing monkey trials.
Citation Format: Simon Deycmar, Brendan Johnson, Declan Ryan, Shane Sills, David Caudell, Greg Dugan, George Schaaf, Christopher Whitlow, Kiran Kumar Solingapuram Sai, Betsy Ferguson, Benjamin Bimber, Karina Ray, Cassandra Cullin, Brandy Dozier, Armando Burgos, Michael Hettich, Bruno Gomes, Jehad Charo, Maurizio Ceppi, Mark Cline. Naturally occurring colorectal cancer in nonhuman primates used to study human immunotherapeutic agents confirms a link between DNA methylation and mismatch repair deficiency [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1325.
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Affiliation(s)
| | | | | | | | | | - Greg Dugan
- 1Wake Forest University, Winston-Salem, NC
| | | | | | | | | | | | - Karina Ray
- 3Oregon Health and Science University, Beaverton, OR
| | | | - Brandy Dozier
- 3Oregon Health and Science University, Beaverton, OR
| | | | | | - Bruno Gomes
- 5Roche Innovation Center Basel, Basel, Switzerland
| | - Jehad Charo
- 6Roche Innovation Center Zurich, Zurich, Switzerland
| | | | - Mark Cline
- 1Wake Forest University, Winston-Salem, NC
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Nader-Marta G, Martins-Branco D, Agostinetto E, Bruzzone M, Ceppi M, Danielli L, Lambertini M, Kotecki N, Awada A, de Azambuja E. Efficacy of tyrosine kinase inhibitors for the treatment of patients with HER2-positive breast cancer with brain metastases: a systematic review and meta-analysis. ESMO Open 2022; 7:100501. [PMID: 35653982 PMCID: PMC9160675 DOI: 10.1016/j.esmoop.2022.100501] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/09/2022] [Indexed: 12/03/2022] Open
Abstract
Background Brain metastases (BMs) are frequent events in patients with HER2-positive metastatic breast cancer (MBC) and are associated with poor prognosis. Small-molecule anti-HER2 tyrosine kinase inhibitors (TKIs) are promising agents for the treatment of BM. In this study, we assess the clinical outcomes of patients with HER2-positive MBC and BM treated with TKI-containing regimens compared with those treated with non-TKI-containing regimens. Materials and methods PubMed, Embase, Cochrane Library, and conference proceedings (ASCO, SABCS, ESMO, and ESMO Breast) were searched up to June 2021. The primary endpoint was progression-free survival (PFS) in patients with BM. Secondary endpoints included PFS in patients without BM and overall survival (OS). The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Overall effects were pooled using random-effects models. Results This systematic review and meta-analysis included data from 2437 patients (490 with and 1947 without BM at baseline) enrolled in five trials assessing tucatinib-, lapatinib-, pyrotinib-, or afatinib-based combinations. A nonstatistically significant PFS benefit favoring TKI-containing regimens was observed in both patients with BM [hazard ratio (HR) 0.67, 95% confidence interval (CI) 0.41-1.12; P = 0.13] and without BM (HR 0.55, 95% CI 0.24-1.26; P = 0.16). Sensitivity analysis, excluding each study singly, demonstrated a significant PFS benefit favoring TKI-containing regimens in patients with BM after the exclusion of afatinib from the analysis (HR 0.56, 95% CI 0.35-0.90; P = 0.016). No statistically significant differences in OS were observed between the comparison groups. Conclusions A trend in PFS favoring TKI-containing regimens was observed in patients with BM. Sensitivity analysis including only trials that evaluated regimens containing tucatinib, lapatinib, or pyrotinib demonstrated a significant PFS benefit favoring TKI-containing regimens in patients with BM. The optimal therapy for HER2+ BC BMs remains unknown. Anti-HER2 TKIs are effective for treating MBC. This study examined the efficacy of TKI for the treatment of patients with BM. A trend toward improved PFS favoring TKIs was observed in patients with BM. There was no significant difference in OS between TKIs versus non-TKI regimens.
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Affiliation(s)
- G Nader-Marta
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.
| | - D Martins-Branco
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - E Agostinetto
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - M Bruzzone
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, School of Medicine, University of Genova, Genova, Italy
| | - M Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, School of Medicine, University of Genova, Genova, Italy
| | - L Danielli
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - N Kotecki
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - A Awada
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - E de Azambuja
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
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12
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Arecco L, Blondeaux E, Bruzzone M, Ceppi M, Latocca MM, Marrocco C, Boutros A, Spagnolo F, Razeti MG, Favero D, Spinaci S, Condorelli M, Massarotti C, Goldrat O, Del Mastro L, Demeestere I, Lambertini M. Safety of fertility preservation techniques before and after anticancer treatments in young women with breast cancer: a systematic review and meta-analysis. Hum Reprod 2022; 37:954-968. [PMID: 35220429 PMCID: PMC9071231 DOI: 10.1093/humrep/deac035] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/19/2022] [Indexed: 11/25/2022] Open
Abstract
STUDY QUESTION Is it safe to perform controlled ovarian stimulation (COS) for fertility preservation before starting anticancer therapies or ART after treatments in young breast cancer patients? SUMMARY ANSWER Performing COS before, or ART following anticancer treatment in young women with breast cancer does not seem to be associated with detrimental prognostic effect in terms of breast cancer recurrence, mortality or event-free survival (EFS). WHAT IS KNOWN ALREADY COS for oocyte/embryo cryopreservation before starting chemotherapy is standard of care for young women with breast cancer wishing to preserve fertility. However, some oncologists remain concerned on the safety of COS, particularly in patients with hormone-sensitive tumors, even when associated with aromatase inhibitors. Moreover, limited evidence exists on the safety of ART in breast cancer survivors for achieving pregnancy after the completion of anticancer treatments. STUDY DESIGN, SIZE, DURATION The present systematic review and meta-analysis was carried out by three blinded investigators using the keywords 'breast cancer' and 'fertility preservation'; keywords were combined with Boolean operators. Eligible studies were identified by a systematic literature search of Medline, Web of Science, Embase and Cochrane library with no language or date restriction up to 30 June 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS To be included in this meta-analysis, eligible studies had to be case-control or cohort studies comparing survival outcomes of women who underwent COS or ART before or after breast cancer treatments compared to breast cancer patients not exposed to these strategies. Survival outcomes of interest were cancer recurrence rate, relapse rate, overall survival and number of deaths. Adjusted relative risk (RR) and hazard ratio (HR) with 95% CI were extracted. When the number of events for each group were available but the above measures were not reported, HRs were estimated using the Watkins and Bennett method. We excluded case reports or case series with <10 patients and studies without a control group of breast cancer patients who did not pursue COS or ART. Quality of data and risk of bias were assessed using the Newcastle-Ottawa Assessment Scale. MAIN RESULTS AND THE ROLE OF CHANCE A total of 1835 records were retrieved. After excluding ineligible publications, 15 studies were finally included in the present meta-analysis (n = 4643). Among them, 11 reported the outcomes of breast cancer patients who underwent COS for fertility preservation before starting chemotherapy, and 4 the safety of ART following anticancer treatment completion. Compared to women who did not receive fertility preservation at diagnosis (n = 2386), those who underwent COS (n = 1594) had reduced risk of recurrence (RR 0.58, 95% CI 0.46-0.73) and mortality (RR 0.54, 95% CI 0.38-0.76). No detrimental effect of COS on EFS was observed (HR 0.76, 95% CI 0.55-1.06). A similar trend of better outcomes in terms of EFS was observed in women with hormone-receptor-positive disease who underwent COS (HR 0.36, 95% CI 0.20-0.65). A reduced risk of recurrence was also observed in patients undergoing COS before neoadjuvant chemotherapy (RR 0.22, 95% CI 0.06-0.80). Compared to women not exposed to ART following completion of anticancer treatments (n = 540), those exposed to ART (n = 123) showed a tendency for better outcomes in terms of recurrence ratio (RR 0.34, 95% CI 0.17-0.70) and EFS (HR 0.43, 95% CI 0.17-1.11). LIMITATIONS, REASONS FOR CAUTION This meta-analysis is based on abstracted data and most of the studies included are retrospective cohort studies. Not all studies had matching criteria between the study population and the controls, and these criteria often differed between the studies. Moreover, rate of recurrence is reported as a punctual event and it is not possible to establish when recurrences occurred and whether follow-up, which was shorter than 5 years in some of the included studies, is adequate to capture late recurrences. WIDER IMPLICATIONS OF THE FINDINGS Our results demonstrate that performing COS at diagnosis or ART following treatment completion does not seem to be associated with detrimental prognostic effect in young women with breast cancer, including among patients with hormone receptor-positive disease and those receiving neoadjuvant chemotherapy. STUDY FUNDING/COMPETING INTEREST(S) Partially supported by the Associazione Italiana per la Ricerca sul Cancro (AIRC; grant number MFAG 2020 ID 24698) and the Italian Ministry of Health-5 × 1000 funds 2017 (no grant number). M.L. acted as consultant for Roche, Pfizer, Novartis, Lilly, AstraZeneca, MSD, Exact Sciences, Gilead, Seagen and received speaker honoraria from Roche, Pfizer, Novartis, Lilly, Ipsen, Takeda, Libbs, Knight, Sandoz outside the submitted work. F.S. acted as consultant for Novartis, MSD, Sun Pharma, Philogen and Pierre Fabre and received speaker honoraria from Roche, Novartis, BMS, MSD, Merck, Sun Pharma, Sanofi and Pierre Fabre outside the submitted work. I.D. has acted as a consultant for Roche, has received research grants from Roche and Ferring, has received reagents for academic clinical trial from Roche diagnostics, speaker's fees from Novartis, and support for congresses from Theramex and Ferring outside the submitted work. L.D.M. reported honoraria from Roche, Novartis, Eli Lilly, MSD, Pfizer, Ipsen, Novartis and had an advisory role for Roche, Eli Lilly, Novartis, MSD, Genomic Health, Pierre Fabre, Daiichi Sankyo, Seagen, AstraZeneca, Eisai outside the submitted work. The other authors declare no conflict of interest. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript and decision to submit the manuscript for publication. REGISTRATION NUMBER N/A.
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Affiliation(s)
- L Arecco
- U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Sciences (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - E Blondeaux
- Department of Internal Medicine and Medical Sciences (DiMI), School of Medicine, University of Genova, Genova, Italy
- U.O.S.D. Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - M Bruzzone
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - M Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - M M Latocca
- U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Sciences (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - C Marrocco
- U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - A Boutros
- Department of Internal Medicine and Medical Sciences (DiMI), School of Medicine, University of Genova, Genova, Italy
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - F Spagnolo
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - M G Razeti
- U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Sciences (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - D Favero
- Department of Internal Medicine and Medical Sciences (DiMI), School of Medicine, University of Genova, Genova, Italy
- U.O.S.D. Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - S Spinaci
- Breast Unit, Ospedale Villa Scassi, Genova, Italy
| | - M Condorelli
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
- Research Laboratory on Human Reproduction, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - C Massarotti
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), School of Medicine, University of Genova, Genova, Italy
| | - O Goldrat
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
- Research Laboratory on Human Reproduction, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - L Del Mastro
- Department of Internal Medicine and Medical Sciences (DiMI), School of Medicine, University of Genova, Genova, Italy
- U.O.S.D. Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - I Demeestere
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
- Research Laboratory on Human Reproduction, Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - M Lambertini
- U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Sciences (DiMI), School of Medicine, University of Genova, Genova, Italy
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Condorelli M, Bruzzone M, Ceppi M, Ferrari A, Grinshpun A, Hamy AS, de Azambuja E, Carrasco E, Peccatori FA, Di Meglio A, Paluch-Shimon S, Poorvu PD, Venturelli M, Rousset-Jablonski C, Senechal C, Livraghi L, Ponzone R, De Marchis L, Pogoda K, Sonnenblick A, Villarreal-Garza C, Córdoba O, Teixeira L, Clatot F, Punie K, Graffeo R, Dieci MV, Pérez-Fidalgo JA, Duhoux FP, Puglisi F, Ferreira AR, Blondeaux E, Peretz-Yablonski T, Caron O, Saule C, Ameye L, Balmaña J, Partridge AH, Azim HA, Demeestere I, Lambertini M. Safety of assisted reproductive techniques in young women harboring germline pathogenic variants in BRCA1/2 with a pregnancy after prior history of breast cancer. ESMO Open 2021; 6:100300. [PMID: 34775302 PMCID: PMC8593447 DOI: 10.1016/j.esmoop.2021.100300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 09/16/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Knowledge is growing on the safety of assisted reproductive techniques (ART) in cancer survivors. No data exist, however, for the specific population of breast cancer patients harboring germline BRCA1/2 pathogenic variants. PATIENTS AND METHODS This is a multicenter retrospective cohort study across 30 centers worldwide including women diagnosed at ≤40 years with stage I-III breast cancer, between January 2000 and December 2012, harboring known germline BRCA1/2 pathogenic variants. Patients included in this analysis had a post-treatment pregnancy either achieved through use of ART (ART group) or naturally (non-ART group). ART procedures included ovulation induction, ovarian stimulation for in vitro fertilization or intracytoplasmic sperm injection, and embryo transfer under hormonal replacement therapy. RESULTS Among the 1424 patients registered in the study, 168 were eligible for inclusion in the present analysis, of whom 22 were in the ART group and 146 in the non-ART group. Survivors in the ART group conceived at an older age compared with those in the non-ART group (median age: 39.7 versus 35.4 years, respectively). Women in the ART group experienced more delivery complications compared with those in the non-ART group (22.1% versus 4.1%, respectively). No other apparent differences in obstetrical outcomes were observed between cohorts. The median follow-up from pregnancy was 3.4 years (range: 0.8-8.6 years) in the ART group and 5.0 years (range: 0.8-17.6 years) in the non-ART group. Two patients (9.1%) in the ART group experienced a disease-free survival event (specifically, a locoregional recurrence) compared with 40 patients (27.4%) in the non-ART group. In the ART group, no patients deceased compared with 10 patients (6.9%) in the non-ART group. CONCLUSION This study provides encouraging safety data on the use of ART in breast cancer survivors harboring germline pathogenic variants in BRCA1/2, when natural conception fails or when they opt for ART in order to carry out preimplantation genetic testing.
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Affiliation(s)
- M Condorelli
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles (U.L.B.), Fertility Clinic, Brussels, Belgium; Research Laboratory on Human Reproduction, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - M Bruzzone
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - M Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - A Ferrari
- Department of Surgical Sciences, General Surgery III-Breast Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical Surgical Sciences, University of Pavia, Pavia, Italy
| | - A Grinshpun
- Breast Oncology Unit Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - A S Hamy
- Department of Medical Oncology, Institut Curie, Paris, France
| | - E de Azambuja
- Department of Medicine, Institut Jules Bordet and Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - E Carrasco
- Hereditary Cancer Genetics Group, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - F A Peccatori
- Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy
| | - A Di Meglio
- Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - S Paluch-Shimon
- Breast Oncology Unit Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - P D Poorvu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - M Venturelli
- Department of Oncology and Haematology, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - C Rousset-Jablonski
- Department of Surgery, Centre Léon Bérard and INSERM U1290 RESHAPE, Université Claude Bernard Lyon 1, Lyon, France
| | - C Senechal
- Cancer Genetics Unit, Bergonie Institute, Bordeaux, France
| | - L Livraghi
- Medical Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy; University of Siena, Siena, Italy
| | - R Ponzone
- Gynecological Oncology, Candiolo Cancer Institute, FPO - IRCCS, Candiolo, Turin, Italy
| | - L De Marchis
- Division of Medical Oncology, Department of Radiological, Oncological and Pathological Sciences, "La Sapienza" University of Rome, Rome, Italy
| | - K Pogoda
- Department of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - A Sonnenblick
- Oncology Division, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv, Israel
| | - C Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
| | - O Córdoba
- Obstetrics and Gynecology Department, Hospital Universitari Son Espases, Palma, Spain
| | - L Teixeira
- Breast Disease Unit, Saint-Louis Hospital, APHP, Université de Paris, INSERM U976, Paris, France
| | - F Clatot
- Department of Medical Oncology, Centre Henri Becquerel, Rouen, France
| | - K Punie
- Department of General Medical Oncology and Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - R Graffeo
- Breast Unit of Southern Switzerland (CSSI), Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - M V Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Medical Oncology 2, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - J A Pérez-Fidalgo
- Department of Medical Oncology, INCLIVA University Hospital of Valencia, CIBERONC, Valencia, Spain
| | - F P Duhoux
- Department of Medical Oncology, Breast Clinic, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - F Puglisi
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; Department of Medicine, University of Udine, Udine, Italy
| | - A R Ferreira
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
| | - E Blondeaux
- Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - T Peretz-Yablonski
- Breast Oncology Unit Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - O Caron
- Department of Medical Oncology, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - C Saule
- Department of Genetics, Institut Curie, Paris, France
| | - L Ameye
- Data Centre, Institut Jules Bordet and Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - J Balmaña
- Hereditary Cancer Genetics Group, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - A H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - H A Azim
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
| | - I Demeestere
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles (U.L.B.), Fertility Clinic, Brussels, Belgium; Research Laboratory on Human Reproduction, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genova, Italy; Department of Medical Oncology, Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
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Dziadek S, Kraxner A, Cheng WY, Flores M, Theiss N, Tsao TS, Andersson E, Harring SV, Hoelzlwimmer GG, Broeske AM, Ceppi M, Charo J. 86 Extensive FAP expression analysis in 23 tumor indications and potential application in defining the patient population in FAP-targeting cancer immunotherapies. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.086] [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: 11/04/2022] Open
Abstract
BackgroundFibroblast activation protein alpha (FAP) is frequently over-expressed in the tumor microenvironment (TME) while exhibiting limited expression in normal tissues. FAP expression was reported to be immunosuppressive in tumor mouse models and generally associated with worse prognosis in clinical studies. Therefore, it is important to understand the context in which FAP both exhibits immunosuppressive characteristics and be a useful target for immunotherapy.MethodsComprehensive immunohistochemistry (IHC) analyses on formalin-fixed paraffin-embedded tissue specimens with emphasis on lymph nodes and primary and metastatic tumor lesions spanning a wide range of indications were undertaken in this study. FAP staining of tumor tissues was performed with an optimized IHC robust-prototype-assay (RPA) and manually scored. The area (normal stroma & neoplastic) staining positively relative to the total tumor area at each intensity level was recorded and an H-score calculated (FAP-intensity score).These were supplemented by gene expression analysis using public as well as Roche phase 1, 2 and 3 cancer immunotherapy (CIT) clinical trial data sets.ResultsAnalysing FAP expression on normal tissue confirmed the general absence of FAP apart from a subset of pancreatic islet cells. Unlike the more homogenous expression of typical protein targets on tumor cells, FAP expression in the TME is heterogeneous in both pattern and intensity, requiring the analysis of a large sample set. Therefore, we evaluated 1216 samples from 23 tumor indications and 70 sub-indications. FAP expression exhibited a significant spread ranging from indications with highly abundant expression to those with low coverage.Using data from matching IHC and gene expression samples we confirmed FAP mRNA expression to significantly correlate with RPA H-scores (Spearman correlation: 0.62) (N=289, P=1.2E-31). Gene expression data from 12 atezolizumab clinical studies, including standard of care (SOC) randomized studies, with more than 6000 samples from 4 major indications were interrogated for the association between FAP expression and clinical response as evaluated by overall and progression free survival. This analysis suggests that FAP expression is generally associated with higher hazard ratios across all atezolizumab-treated samples (OS: 95% CI 1.04–1.09; PFS: 1.04–1.08), with the highest effect observed in Renal Cell Carcinoma (OS: 95% CI 1.08–1.31; PFS: 1.05–1.21), indicating a potential role of FAP in limiting CIT.ConclusionsData from these analyses can tailor indication and patient enrichment strategies for achieving optimal FAP-targeting. We propose to select indications with FAP-levels that are high enough to enable drug accumulation, yet low enough to reduce immunosuppressive effects that can hamper successful immunotherapy.
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Deycmar S, Johnson B, Ryan D, Sills W, Caudell D, Dugan G, Sai KS, Hettich M, Gomes B, Ceppi M, Cline M. 11 Molecular characterization of naturally occurring colorectal and breast cancer in non-human primates to model human immunotherapeutic agents. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.011] [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] Open
Abstract
BackgroundNon-human primates (NHP) with naturally occurring cancers (also called tumor-bearing monkeys or TBM) are a proposed model for translational cancer immunotherapy (CIT) research.1 TBM spontaneously develop cancers with progression patterns similar to humans, potentially bridging the gap between preclinical models and cancers in patients. Interventional CIT trials recently conducted in colorectal (CRC) and breast cancer (BC)-bearing NHP, have generated relevant proof-of-mechanism evidence for three different CIT agents.1–3 To further validate these animals as translational models for CIT, we conducted a deep molecular characterization of tumors at baseline and reverse translated biomarker assays employed in human patients.MethodsOur cohort (n=19) consisted of Indian-origin rhesus macaques (Macaca mulatta) with naturally occurring CRC (n=14, female=9, male=5) and BC (n=5, female=5). Clinical examination, imaging (contrast-enhanced CT, PET) and biopsy to confirm cancer histology were performed. Molecular characterization was done by IHC for CRC-associated mismatch repair (MMR) proteins MLH1, MSH2, MSH6, and PMS2 and BC markers ER, PR, and HER2. We assessed microsatellite instability (MSI) by PCR and electrophoresis, and for selected cases somatic tumor mutations and tumor mutational burden (TMB) by whole exome sequencing.ResultsDeficiency in MMR proteins determines eligibility for PD-1 blockade therapy, is observed in approximately 15% of human CRCs, and surprisingly in 100% (14/14) of our NHP CRCs. The absence of MLH1 (14/14), MSH2 (1/14), MSH6 (0/14) and PMS2 (14/14) observed in NHP CRCs clearly exceeds the frequencies reported in human CRCs ranging from 2–15% for each individual MMR protein.4 5 Moreover, we have documented MSI cases in some NHP CRCs, as described in human CRCs. We sequenced 3 CRCs and observed mutations in KRAS (G12D & A59T), WNT7A (V238M), IDH2 (R362Q), AKT3 (R388H), and TMB of 4.27, 22.95, and 29.3 mut/Mbp. Regarding breast, we found hormone receptor positive (Luminal A), HER2 positive, and TNBC, as in human BC patients. Sequencing of 2 BCs revealed mutations in PTEN (G251V), TGFBR2 (L162P), and ERBB4 (R1250Q), and TMB of 2.32 and 17.22 mut/Mbp.ConclusionsNHP cancers can be similarly characterized as human cancers, both macroscopically and molecularly. In this study we demonstrated an overrepresentation of MMR deficiency in NHP CRCs. Receptor expression in NHP BCs revealed similar subtypes as in human BCs. Cancer-associated mutations described in humans are also evident in TBM. This work highlights the possible translatability of naturally occurring NHP cancers for human cancer immunotherapy research, and can be further explored in future TBM trials.ReferencesCeppi M, Hettich M, Teichgraeber V, Driessen W, Tuerck D, et al. Tumor-bearing non-human primates: an unrivaled model for translational cancer immunology research. Proceedings: AACR Annual Meeting 2020.Claus C, Ferrara C, Xu W, Sam J, Lang S, Uhlenbrock F, et al. Tumor-targeted 4-1BB agonists for combination with T cell bispecific antibodies as off-the-shelf therapy. Sci Transl Med 2019;11(496).Waldhauer I, Gonzalez-Nicolini V, Freimoser-Grundschober A, Nayak TK, Fahrni L, et al. Simlukasfusp alfa (FAP-IL2v) immunocytokine is a versatile combination partner for cancer immunotherapy. MAbs 2021;13(1).Parc Y, Gueroult S, Mourra N, Serfaty L, Flejou J-F, Tiret E, Parc R. Prognostic significance of microsatellite instability determined by immunohistochemical staining of MSH2 and MLH1 in sporadic T3N0M0 colon cancer. Gut 2004;53.Chen L, Chen G, Zheng X, Chen Y. Expression status of four mismatch repair proteins in patients with colorectal cancer: clinical significance in 1238 cases. Int J Clin Exp Pathol 2019;12(10).Ethics ApprovalWake Forest University is accredited by the Association for the Assessment and Accreditation of Laboratory Animal Care, International (AAALAC) and registered with the United States Department of Agriculture (USDA) to conduct research in laboratory animals. The protocols and any subsequent amendments are reviewed and approved by the Wake Forest Institutional Animal Care and Use Committee (IACUC) and in compliance with the U.S. Animal Welfare Act, the Guide for the Care and Use of Laboratory Animals, the Office of Laboratory Animal Welfare, and public health service regulations.
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Kraxner A, Braun F, Cheng WY, Canamero M, Andersson E, Harring SV, Dziadek S, Broeske AM, Ceppi M, Teichgraeber V, Charo J. 930 Fibroblast activation protein alpha expression in tumor stroma and its association with immuno-regulatory circuits across epithelial tumors. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.930] [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: 11/04/2022] Open
Abstract
BackgroundCarcinoma associated fibroblasts (CAFs) play important roles in modulating tumor development and prognosis through biochemical and biomechanical signals, but also through their immuno-modulatory characteristics. Fibroblast activation protein alpha (FAP), a serine protease with selectively high expression on CAFs, may be an ideal target for therapeutic intervention, including cancer immunotherapy. Therefore, a thorough understanding of FAP expression, but also immune cell composition and especially their interaction is key to optimally inform drug development and patient enrichment strategies.MethodsFormalin-fixed paraffin embedded tissue specimens comprising 253 primary tumors and 277 metastatic lesions were included in this study. Tumor sections were analyzed by digital immunohistochemistry (IHC) to assess tumor-stroma composition, FAP content and immune cell infiltration, complemented by transcriptomic analyses.ResultsAcross different types of epithelial tumors, FAP was detected by digital IHC in the tumor-associated stroma at a low to moderate proportion and with heterogeneous distribution patterns. Primary tumors in breast and lung cancer demonstrated a higher median FAP content (6.5% and 6.6% area coverage, respectively) compared to renal cell carcinoma (0.2% area coverage), which was confirmed on mRNA expression level. Median FAP levels were similar between primary and metastatic lesions in most tumor types except for renal cancer, for which FAP levels were significantly increased in metastasis lesions (3.3% area coverage). FAP content positively correlated with the density of FoxP3 positive regulatory T cells, but indication and tissue type specific differences were observed. Transcriptomic analysis revealed that both stroma-richness as well as higher FAP content were positively correlated with macrophage and dendritic cell gene signatures. However, while a higher stromal content was associated with signatures related to endothelial cells and preadipocytes, higher FAP content showed a stronger correlation with regulatory T cells. These findings are suggestive of a distinct biological role of FAP positive stroma in human tumors.ConclusionsFAP-targeted therapy is a promising strategy to optimize accumulation and action of anti-cancer drugs in the tumor microenvironment, potentially leading to more specific and effective therapies. Our study further elucidates the role of FAP by providing a comprehensive and granular landscape of FAP content in primary and metastatic tumor lesions derived from the same patient population and its association with immune cell composition. Future studies aim to elucidate the complex and dynamic interplay between malignant, stromal and immune cell populations in both temporal and spatial contexts and how that contributes to outcome in cancer immunotherapy.
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Tanos T, Heichinger C, Wilson S, Canamero M, Bustamante M, Ooi C, Klaman I, Gomes B, Ceppi M, Ceppi M. 527 Digital spatial profiling of paired tumor biopsies reveals indoleamine 2,3-dioxygenase (IDO)1 as a potential resistance mechanism for a tumor-targeted 4–1BB agonist in patients with solid tumors. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.527] [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] Open
Abstract
BackgroundWe previously described the capacity of RO7122290 (RO) - a FAP-targeted 4-1BB bispecific antibody - to induce CD8+ T cell infiltration and activation in the tumor (Moreno V. et al, SITC 2020). Aiming to compare pharmacodynamic (PD) changes in tumor nests and stroma, paired tumor biopsies from patients treated with RO (Part A) and RO + atezolizumab (Part B) were analysed by digital spatial profiling (DSP, Nanostring).MethodsSeven paired (baseline and on-treatment) FFPE tumor tissue biopsies (three from Part A, four from Part B) obtained from an ongoing Phase 1/1b trial (EUDRACT 2017-003961-83) were assessed for mRNA and protein expression. Biopsies were taken from six different tumor types at different RO doses. Up to twelve Regions of Interest (ROIs) were collected per slide and the morphology markers PanCK, CD8, CD3 and DAPI were applied. The ROIs were further annotated in tumor nests and stroma segments based on PanCK staining. The immune-oncology 58-plex protein and 78-plex mRNA expression panels (Nanostring) were used to profile all samples. Data were normalized according to Nanostring guidelines and filtered based on relevance (absolute log2 fold change > 1) and significance (FDR < 0.05, p-value).ResultsThe level of CD8+ T cell infiltration measured by spatial profiling correlated with the level measured by IHC, in both tumor nests and stroma. The activation markers 4-1BB and PD-1 were upregulated, confirming the PD effect already measured by mRNA sequencing. We also identified novel protein markers - CD40, PD-L1 and IDO1 - being upregulated after treatment. Spatial regulation differed among the markers with 4-1BB, PD-1 and CD40 upregulated only in the stroma, PD-L1 and IDO1 upregulated in the tumor nests and in the stroma. IDO1 induction is particularly relevant, since this protein is known to attenuate 4-1BB-mediated effector responses. Conventional IHC analysis performed on 14 paired biopsies confirmed IDO1 being upregulated in 11 out of 14 cases and revealed dendritic cells, macrophages and stromal cells to express IDO1. Importantly, IDO1 upregulation was observed in both Part A (3 out of 3) and Part B (8 out of 11).ConclusionsSpatial profiling allowed us to identify key markers that are spatially regulated after treatment and to gain new insights on the MoA of RO. The induction of IDO1 by RO confirms the dual immunoregulatory nature of 4-1BB signaling and highlights IDO1 as a potential resistance mechanism for RO in the clinical setting, both as single agent and in combination with atezolizumab.Trial RegistrationEUDRACT Number: 2017-003961-83; Protocol Number: BP40087ReferencesMoreno V. et al, Pharmacodynamic assessment of a novel FAP-targeted 4–1BB agonist, administered as single agent and in combination with atezolizumab to patients with advanced solid tumors, Nov 1 2020, Journal for ImmunoTherapy of Cancer, presented at SITC 2020
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Caputo SM, Telly D, Briaux A, Sesen J, Ceppi M, Bonnet F, Bourdon V, Coulet F, Castera L, Delnatte C, Hardouin A, Mazoyer S, Schultz I, Sevenet N, Uhrhammer N, Bonnet C, Tilkin-Mariamé AF, Houdayer C, Moncoutier V, Andrieu C, Bièche I, Stern MH, Stoppa-Lyonnet D, Lidereau R, Toulas C, Rouleau E. 5' Region Large Genomic Rearrangements in the BRCA1 Gene in French Families: Identification of a Tandem Triplication and Nine Distinct Deletions with Five Recurrent Breakpoints. Cancers (Basel) 2021; 13:cancers13133171. [PMID: 34202044 PMCID: PMC8268747 DOI: 10.3390/cancers13133171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/30/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 12/28/2022] Open
Abstract
Simple Summary Large genomic rearrangements in BRCA1 consisting of deletions/duplications of one or several exons are complex events, often occurring in the 5′ region. We characterized 10 events in 20 families: one large triplication classified as benign and nine large deletions classified as pathogenic. The breakpoint localization will certainly help to further understand the chromatin structure in regions sensitive to rearrangement. Abstract Background: Large genomic rearrangements (LGR) in BRCA1 consisting of deletions/duplications of one or several exons have been found throughout the gene with a large proportion occurring in the 5′ region from the promoter to exon 2. The aim of this study was to better characterize those LGR in French high-risk breast/ovarian cancer families. Methods: DNA from 20 families with one apparent duplication and nine deletions was analyzed with a dedicated comparative genomic hybridization (CGH) array, high-resolution BRCA1 Genomic Morse Codes analysis and Sanger sequencing. Results: The apparent duplication was in fact a tandem triplication of exons 1 and 2 and part of intron 2 of BRCA1, fully characterized here for the first time. We calculated a causality score with the multifactorial model from data obtained from six families, classifying this variant as benign. Among the nine deletions detected in this region, eight have never been identified. The breakpoints fell in six recurrent regions and could confirm some specific conformation of the chromatin. Conclusions: Taken together, our results firmly establish that the BRCA1 5′ region is a frequent site of different LGRs and highlight the importance of the segmental duplication and Alu sequences, particularly the very high homologous region, in the mechanism of a recombination event. This also confirmed that those events are not systematically deleterious.
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Affiliation(s)
- Sandrine M. Caputo
- Department of Genetics, Institut Curie, F-75248 Paris, France; (S.M.C.); (A.B.); (V.M.); (C.A.); (I.B.); (M.-H.S.); (D.S.-L.); (R.L.)
- Institut Curie, PSL Research University, F-75005 Paris, France
| | - Dominique Telly
- Laboratoire d’Oncogénétique, Institut Claudius Regaud, IUCT-O, F-31059 Toulouse, France;
| | - Adrien Briaux
- Department of Genetics, Institut Curie, F-75248 Paris, France; (S.M.C.); (A.B.); (V.M.); (C.A.); (I.B.); (M.-H.S.); (D.S.-L.); (R.L.)
- Institut Curie, PSL Research University, F-75005 Paris, France
| | - Julie Sesen
- Department of Neurosurgery, Boston Children’s Hospital, Boston, MA 02115, USA;
| | - Maurizio Ceppi
- Roche Innovation Center Basel (RICB), Roche Pharma Research and Early Development, CH-4052 Basel, Switzerland;
| | - Françoise Bonnet
- Laboratoire de Génétique Constitutionnelle et INSERM U916 VINCO, Institut Bergonié, CEDEX, F-33076 Bordeaux, France; (F.B.); (N.S.)
| | - Violaine Bourdon
- Laboratoire d’Oncogénétique Moléculaire, Département de Biologie du Cancer, Institut Paoli-Calmettes, F-13273 Marseille, France;
| | - Florence Coulet
- Department of Genetics, Pitié-Salpêtriere Hospital, Assistance Publique-Hopitaux de Paris, Sorbonne University, F-75013 Paris, France;
| | - Laurent Castera
- Laboratoire de Biologie et de Génétique du Cancer, CLCC François Baclesse, INSERM 1079 Centre Normand de Génomique et de Médecine Personnalisée, F-14076 Caen, France; (L.C.); (A.H.)
| | - Capucine Delnatte
- Service de Génétique Médicale, Unité de Génétique Moléculaire, CHU Nantes, F-44093 Nantes, France;
| | - Agnès Hardouin
- Laboratoire de Biologie et de Génétique du Cancer, CLCC François Baclesse, INSERM 1079 Centre Normand de Génomique et de Médecine Personnalisée, F-14076 Caen, France; (L.C.); (A.H.)
| | - Sylvie Mazoyer
- Centre de Recherche en Neurosciences de Lyon, INSERM, U1028, CNRS, UMR5292, Université de Lyon, F-69008 Lyon, France;
| | - Inès Schultz
- Centre Paul Strauss, Laboratoire de Biologie Tumorale—Oncogénétique, F-67000 Strasbourg, France;
| | - Nicolas Sevenet
- Laboratoire de Génétique Constitutionnelle et INSERM U916 VINCO, Institut Bergonié, CEDEX, F-33076 Bordeaux, France; (F.B.); (N.S.)
| | - Nancy Uhrhammer
- Biologie Clinique et Oncologique, Biologie Moléculaire—Centre Jean Perrin, F-63000 Clermont-Ferrand, France;
| | - Céline Bonnet
- Institut de Cancérologie, 6 Avenue de Bourgogne, F-54519 Vandœuvre-lès-Nancy, France;
| | - Anne-Françoise Tilkin-Mariamé
- Cancer Research Center of Toulouse (CRCT), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1037, F-31000 Toulouse, France;
| | - Claude Houdayer
- Inserm U1245, UNIROUEN, Normandie University, Normandy Centre for Genomic and Personalized Medicine, F-76183 Rouen, France;
- Normandy Centre for Genomic and 41 Personalized Medicine, Department of Genetics, University Hospital, F-76183 Rouen, France
| | - Virginie Moncoutier
- Department of Genetics, Institut Curie, F-75248 Paris, France; (S.M.C.); (A.B.); (V.M.); (C.A.); (I.B.); (M.-H.S.); (D.S.-L.); (R.L.)
- Institut Curie, PSL Research University, F-75005 Paris, France
| | - Catherine Andrieu
- Department of Genetics, Institut Curie, F-75248 Paris, France; (S.M.C.); (A.B.); (V.M.); (C.A.); (I.B.); (M.-H.S.); (D.S.-L.); (R.L.)
- Institut Curie, PSL Research University, F-75005 Paris, France
| | | | - Ivan Bièche
- Department of Genetics, Institut Curie, F-75248 Paris, France; (S.M.C.); (A.B.); (V.M.); (C.A.); (I.B.); (M.-H.S.); (D.S.-L.); (R.L.)
- Faculty of Pharmaceutical and Biological Sciences, University of Paris, F-75006 Paris, France
| | - Marc-Henri Stern
- Department of Genetics, Institut Curie, F-75248 Paris, France; (S.M.C.); (A.B.); (V.M.); (C.A.); (I.B.); (M.-H.S.); (D.S.-L.); (R.L.)
- Institut Curie, INSERM U830, DNA Repair and Uveal Melanoma (D.R.U.M.), PSL Research University, F-75005 Paris, France
| | - Dominique Stoppa-Lyonnet
- Department of Genetics, Institut Curie, F-75248 Paris, France; (S.M.C.); (A.B.); (V.M.); (C.A.); (I.B.); (M.-H.S.); (D.S.-L.); (R.L.)
- Institut Curie, INSERM U830, DNA Repair and Uveal Melanoma (D.R.U.M.), PSL Research University, F-75005 Paris, France
- Faculty of Medicine, University of Paris, F-75005 Paris, France
| | - Rosette Lidereau
- Department of Genetics, Institut Curie, F-75248 Paris, France; (S.M.C.); (A.B.); (V.M.); (C.A.); (I.B.); (M.-H.S.); (D.S.-L.); (R.L.)
- Institut Curie, PSL Research University, F-75005 Paris, France
| | - Christine Toulas
- Laboratoire d’Oncogénétique, Institut Claudius Regaud, IUCT-O, F-31059 Toulouse, France;
- Correspondence: (C.T.); (E.R.)
| | - Etienne Rouleau
- Department of Biology, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
- Correspondence: (C.T.); (E.R.)
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Caparica R, Bruzzone M, Agostinetto E, De Angelis C, Fêde Â, Ceppi M, de Azambuja E. Beta-blockers in early-stage breast cancer: a systematic review and meta-analysis. ESMO Open 2021; 6:100066. [PMID: 33639601 PMCID: PMC7921512 DOI: 10.1016/j.esmoop.2021.100066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/27/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Preclinical and retrospective studies suggest that beta-blockers are active against breast cancer. We carried out a systematic review and meta-analysis to assess the impact of beta-blockers on the outcomes of patients with early-stage breast cancer. METHODS A systematic literature search was performed to identify studies comparing outcomes of patients with early-stage breast cancer according to beta-blocker use (yes versus no). The primary endpoint was recurrence-free survival (RFS), defined as the occurrence of breast cancer recurrence or death. Secondary objectives were pathologic complete response (pCR), breast cancer recurrence, breast cancer-specific mortality and overall survival (OS). Hazard ratios (HRs) or odds ratios (ORs) and 95% confidence intervals (CIs) were extracted from each study and a pooled analysis with the random-effect model was conducted. The Higgins' I-squared test was used to quantify heterogeneity. Egger's test was applied to assess publication bias. All P values were two-sided and considered significant if ≤0.05. RESULTS Overall, 13 studies were included as follows: RFS (6), pCR (2), breast cancer recurrence (6), breast cancer-specific mortality (7) and OS (5). The use of beta-blockers was associated with a significant RFS improvement in the overall population (N = 21 570; HR 0.73; 95% CI, 0.56-0.96; P = 0.025) and in patients with triple-negative disease (N = 1212; HR 0.53; 95% CI, 0.35-0.81; P = 0.003). No significant differences in terms of pCR (N = 1554; OR 0.77; 95% CI, 0.44-1.36; P = 0.371), breast cancer recurrence (N = 37 957; OR 0.66; 95% CI, 0.42-1.03; P = 0.065), breast cancer-specific mortality (N = 64 830; HR 0.77; 95% CI, 0.56-1.08; P = 0.130) or OS (N = 103 065; HR 1.03; 95% CI, 0.87-1.23; P = 0.692) were observed according to beta-blocker use. DISCUSSION In this meta-analysis, beta-blocker use was associated with a longer RFS in patients with early-stage breast cancer, with a more pronounced effect observed in those with triple-negative disease. Beta-blockers arise as an interesting option to be explored in prospective studies for patients with early-stage breast cancer.
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Affiliation(s)
- R Caparica
- Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.
| | - M Bruzzone
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - E Agostinetto
- Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium; Humanitas Clinical and Research Center - IRCCS, Humanitas Cancer Center, Rozzano, Milan, Italy
| | - C De Angelis
- Azienda Ospedaliera-Universitaria, Pisana, Pisa, Italy
| | - Â Fêde
- AC Camargo Cancer Center, São Paulo, Brazil
| | - M Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - E de Azambuja
- Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
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Melero I, Sanmamed M, Calvo E, Moreno I, Moreno V, Guerrero TH, Martinez-Garcia M, Rodriguez-Vida A, Tabernero J, Pedrazzoli AA, Spanggaard I, Rohrberg K, Guarin E, Nueesch E, Chesne E, Ceppi M, Sweere U, McIntyre C, Lichtenegger F, Krieter O. 1025MO First-in-human (FIH) phase I study of RO7122290 (RO), a novel FAP-targeted 4-1BB agonist, administered as single agent and in combination with atezolizumab (ATZ) to patients with advanced solid tumours. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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21
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Ceppi M, Hettich M, Teichgräber V, Driessen W, Tuerck D, Marrer-Berger E, Evers S, Crameri F, Gomes B, Bachl J, Klein C, Claus C, Amann M, Krieter O, Dugan G, Caudell D, Grayson J, Kiran SKS, Cline M. Abstract 6135: Tumor-bearing non-human primates: An unrivaled model for translational cancer immunology research. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-6135] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The translatability of mouse models for the clinical development of cancer immunotherapies remains limited because of substantial differences between the murine and the human immune systems, as well as dissimilarities in the tumor biology. Non-human primates (NHPs) display good homologies towards the human immune system, based on the development of vaccines to several human pathogens. Tumor-bearing monkeys (TBMs) are NHPs that spontaneously developed cancer with progression patterns similar to humans, potentially bridging the experimental gap between early preclinical models and cancer patients treated with immunotherapeutic agents.
TBMs are prevalently rhesus macaques (Macaca mulata) and the most common cancer types are of gastrointestinal, urogenital and endocrine origin. Rhesus macaques are genetically similar to humans and share many characteristics of aging. In both, humans and rhesus macaques, cancer incidence increases with age with the greatest incidence in those over 60 years of age and 20 years, respectively.
TBMs were recently employed to assess the tumor targeting and the pharmacodynamics of the FAP-expressing tumor stroma-targeted immunocytokine FAP-IL2v (Evers et al, AACR 2014, Abstract 2592) and costimulatory agonist FAP-4-1BBL (Claus et al, Science translational Medicine, 2019). In the latter study, we could show targeting of FAP-4-1BBL to FAP-expressing tumor stroma and lymph nodes in a colorectal cancer-bearing rhesus monkey. These data were the basis to investigate tumor targeting of FAP-4-1BBL in an on-going clinical imaging study.
In the present work, we validated further TBMs as translational models for cancer immunotherapy, by performing an imaging/biomarker study in animals exposed to a second FAP-targeted TNFRSF agonist. Two breast cancer-bearing rhesus monkeys (one triple-negative and one Luminal A) were first pre-immunized with a diphtheria/pertussis/tetanus (DTP) vaccine, and then exposed to a single injection of the TNFRSF agonist. In both animals, we could measure a strong systemic immune activation, induction of the TNFRSF agonist in T cells and also tumor regression. These observations validated the applied pre-immunization strategy to induce the TNFRSF protein expression, and confirmed the target to be pursued in the clinical setting.
In conclusion, we consider TBMs as valuable translational animal models to generate proof-of-mechanism evidence in small “signal-seeking” preclinical studies. Tumor targeting, biodistribution, peripheral and intra-tumoral pharmacodynamic activity, pharmacokinetics, immunogenicity, intra-tumoral metabolic activity and tumor regression can all be assessed in TBMs. Because of the similar tumor stroma biology shared between humans and rhesus macaques, TBMs are particularly well suited to test FAP-targeting agents. We anticipate that testing cancer immunotherapy compounds in TBMs could be of high predictability for clinical behavior.
Citation Format: Maurizio Ceppi, Michael Hettich, Volker Teichgräber, Wouter Driessen, Dietrich Tuerck, Estelle Marrer-Berger, Stefan Evers, Flavio Crameri, Bruno Gomes, Jürgen Bachl, Christian Klein, Christina Claus, Maria Amann, Oliver Krieter, Greg Dugan, David Caudell, Jason Grayson, Sai Kumar Solingapuram Kiran, Mark Cline. Tumor-bearing non-human primates: An unrivaled model for translational cancer immunology research [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 6135.
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Affiliation(s)
| | | | | | | | | | | | - Stefan Evers
- 1Roche Innovation Center Basel (RICB), Switzerland
| | | | - Bruno Gomes
- 1Roche Innovation Center Basel (RICB), Switzerland
| | - Jürgen Bachl
- 1Roche Innovation Center Basel (RICB), Switzerland
| | | | | | - Maria Amann
- 2Roche Innovation Center Zürich (RICZ), Switzerland
| | | | - Greg Dugan
- 4Wake Forest School of Medicine - Wake Forest University Health Sciences, Winston-Salem, NC
| | - David Caudell
- 4Wake Forest School of Medicine - Wake Forest University Health Sciences, Winston-Salem, NC
| | - Jason Grayson
- 4Wake Forest School of Medicine - Wake Forest University Health Sciences, Winston-Salem, NC
| | | | - Mark Cline
- 4Wake Forest School of Medicine - Wake Forest University Health Sciences, Winston-Salem, NC
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Claus C, Ferrara C, Xu W, Sam J, Lang S, Uhlenbrock F, Albrecht R, Herter S, Schlenker R, Hüsser T, Diggelmann S, Challier J, Mössner E, Hosse RJ, Hofer T, Brünker P, Joseph C, Benz J, Ringler P, Stahlberg H, Lauer M, Perro M, Chen S, Küttel C, Bhavani Mohan PL, Nicolini V, Birk MC, Ongaro A, Prince C, Gianotti R, Dugan G, Whitlow CT, Solingapuram Sai KK, Caudell DL, Burgos-Rodriguez AG, Cline JM, Hettich M, Ceppi M, Giusti AM, Crameri F, Driessen W, Morcos PN, Freimoser-Grundschober A, Levitsky V, Amann M, Grau-Richards S, von Hirschheydt T, Tournaviti S, Mølhøj M, Fauti T, Heinzelmann-Schwarz V, Teichgräber V, Colombetti S, Bacac M, Zippelius A, Klein C, Umaña P. Tumor-targeted 4-1BB agonists for combination with T cell bispecific antibodies as off-the-shelf therapy. Sci Transl Med 2020; 11:11/496/eaav5989. [PMID: 31189721 DOI: 10.1126/scitranslmed.aav5989] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 05/16/2019] [Indexed: 01/08/2023]
Abstract
Endogenous costimulatory molecules on T cells such as 4-1BB (CD137) can be leveraged for cancer immunotherapy. Systemic administration of agonistic anti-4-1BB antibodies, although effective preclinically, has not advanced to phase 3 trials because they have been hampered by both dependency on Fcγ receptor-mediated hyperclustering and hepatotoxicity. To overcome these issues, we engineered proteins simultaneously targeting 4-1BB and a tumor stroma or tumor antigen: FAP-4-1BBL (RG7826) and CD19-4-1BBL. In the presence of a T cell receptor signal, they provide potent T cell costimulation strictly dependent on tumor antigen-mediated hyperclustering without systemic activation by FcγR binding. We could show targeting of FAP-4-1BBL to FAP-expressing tumor stroma and lymph nodes in a colorectal cancer-bearing rhesus monkey. Combination of FAP-4-1BBL with tumor antigen-targeted T cell bispecific (TCB) molecules in human tumor samples led to increased IFN-γ and granzyme B secretion. Further, combination of FAP- or CD19-4-1BBL with CEA-TCB (RG7802) or CD20-TCB (RG6026), respectively, resulted in tumor remission in mouse models, accompanied by intratumoral accumulation of activated effector CD8+ T cells. FAP- and CD19-4-1BBL thus represent an off-the-shelf combination immunotherapy without requiring genetic modification of effector cells for the treatment of solid and hematological malignancies.
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Affiliation(s)
- Christina Claus
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Claudia Ferrara
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Wei Xu
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Johannes Sam
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Sabine Lang
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Franziska Uhlenbrock
- University of Basel, Department of Biomedicine, Hebelstrasse 20, 4031 Basel, Switzerland
| | - Rosmarie Albrecht
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Sylvia Herter
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Ramona Schlenker
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Tamara Hüsser
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Sarah Diggelmann
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - John Challier
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Ekkehard Mössner
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Ralf J Hosse
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Thomas Hofer
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Peter Brünker
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Catherine Joseph
- Roche Innovation Center Basel, pRED, Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Jörg Benz
- Roche Innovation Center Basel, pRED, Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Philippe Ringler
- University of Basel, Center for Cellular Imaging and NanoAnalytics (C-CINA), Biozentrum, Klingelbergstrasse 70, 4056 Basel, Switzerland
| | - Henning Stahlberg
- University of Basel, Center for Cellular Imaging and NanoAnalytics (C-CINA), Biozentrum, Klingelbergstrasse 70, 4056 Basel, Switzerland
| | - Matthias Lauer
- Roche Innovation Center Basel, pRED, Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Mario Perro
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Stanford Chen
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Christine Küttel
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Preethi L Bhavani Mohan
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Valeria Nicolini
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Martina Carola Birk
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Amandine Ongaro
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Christophe Prince
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Reto Gianotti
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Gregory Dugan
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Christopher T Whitlow
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | | | - David L Caudell
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | | | - J Mark Cline
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Michael Hettich
- Roche Innovation Center Basel, pRED, Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Maurizio Ceppi
- Roche Innovation Center Basel, pRED, Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Anna Maria Giusti
- Roche Innovation Center Basel, pRED, Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Flavio Crameri
- Roche Innovation Center Basel, pRED, Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Wouter Driessen
- Roche Innovation Center Basel, pRED, Grenzacherstrasse 124, 4070 Basel, Switzerland
| | - Peter N Morcos
- Roche Innovation Center New York, pRED, 430 E 29th St, New York, NY 10016, USA
| | - Anne Freimoser-Grundschober
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Victor Levitsky
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Maria Amann
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Sandra Grau-Richards
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | | | - Stella Tournaviti
- Roche Innovation Center Munich, pRED, Nonnenwald 2, 82377 Penzberg, Germany
| | - Michael Mølhøj
- Roche Innovation Center Munich, pRED, Nonnenwald 2, 82377 Penzberg, Germany
| | - Tanja Fauti
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | | | - Volker Teichgräber
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Sara Colombetti
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Marina Bacac
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Alfred Zippelius
- University of Basel, Department of Biomedicine, Hebelstrasse 20, 4031 Basel, Switzerland
| | - Christian Klein
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland
| | - Pablo Umaña
- Roche Innovation Center Zurich, Roche Pharmaceutical Research and Early Development (pRED), Wagistrasse 10, 8952 Schlieren, Switzerland.
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Brandão M, Bruzzone M, Franzoi M, de Angelis C, Eiger D, Caparica R, Dauby N, Ceppi M, Piccart M, Carrilho C, Lunet N, Buisseret L, de Azambuja E, Lambertini M. 188P Impact of HIV infection (HIV+) on baseline characteristics and survival of breast cancer (BC) patients (pts): A systematic review and meta-analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Poggio F, Bruzzone M, Ceppi M, Pondé NF, La Valle G, Del Mastro L, de Azambuja E, Lambertini M. Platinum-based neoadjuvant chemotherapy in triple-negative breast cancer: a systematic review and meta-analysis. Ann Oncol 2019; 29:1497-1508. [PMID: 29873695 DOI: 10.1093/annonc/mdy127] [Citation(s) in RCA: 249] [Impact Index Per Article: 49.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background The role of platinum-based neoadjuvant chemotherapy in triple-negative breast cancer (TNBC) patients is highly controversial and it is not endorsed by current guidelines. Our meta-analysis aimed to better elucidate its activity, efficacy and safety. Material and methods A systematic search of Medline, Web of Science and conferences proceedings up to 30 October 2017 was carried out to identify randomized controlled trials (RCTs) investigating platinum-based versus platinum-free neoadjuvant chemotherapy in TNBC patients. Using the fixed and random effects models, pooled odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CI) were calculated for pathological complete response (pCR, defined as ypT0/is pN0), event-free survival (EFS), overall survival (OS) and grade 3 and 4 adverse events (AEs: neutropenia, anemia, thrombocytopenia and neuropathy). Results Nine RCTs (N = 2109) were included. Overall, platinum-based neoadjuvant chemotherapy significantly increased pCR rate from 37.0% to 52.1% (OR 1.96, 95% CI 1.46-2.62, P < 0.001). Platinum-based neoadjuvant chemotherapy remained significantly associated with increased pCR rate also after restricting the analysis to the three RCTs (N = 611) that used the same standard regimen in both groups of weekly paclitaxel (with or without carboplatin) followed by anthracycline and cyclophosphamide (OR 2.53, 95% CI 1.37-4.66, P = 0.003). Conversely, among the 96 BRCA-mutated patients included in two RCTs, the addition of carboplatin was not associated with significantly increased pCR rate (OR 1.17, 95% CI 0.51-2.67, P = 0.711). Two RCTs (N = 748) reported survival outcomes: no significant difference in EFS (HR 0.72, 95% CI 0.49-1.06, P = 0.094) and OS (HR 0.86, 95% CI 0.46-1.63, P = 0.651) was observed. A significant higher risk of grade 3 and 4 hematological AEs, with no increased risk of grade 3 and 4 neuropathy was observed with platinum-based neoadjuvant chemotherapy. Conclusion In TNBC patients, platinum-based neoadjuvant chemotherapy is associated with significantly increased pCR rates at the cost of worse hematological toxicities. Platinum-based neoadjuvant chemotherapy may be considered an option in TNBC patients. PROSPERO registration number CRD42018080042.
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Affiliation(s)
- F Poggio
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium; Department of Medical Oncology, Oncologia Medica 2, School of Medicine, University of Genova, Genova, Italy
| | - M Bruzzone
- Unit of Clinical Epidemiology, School of Medicine, University of Genova, Genova, Italy
| | - M Ceppi
- Unit of Clinical Epidemiology, School of Medicine, University of Genova, Genova, Italy
| | - N F Pondé
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - G La Valle
- Health Direction, School of Medicine, University of Genova, Genova, Italy
| | - L Del Mastro
- Department of Medical Oncology, U.O. Sviluppo Terapie Innovative, Ospedale Policlinico San Martino IRCCS per l'Oncologia, School of Medicine, University of Genova, Genova, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genova, Italy
| | - E de Azambuja
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - M Lambertini
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium; Breast Cancer Translational Research Laboratory, Institute Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.
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Bonardi B, Bruzzone M, Goldrat O, De Mastro L, Anserini P, Massarotti C, Mangili G, Ceppi M, Demeestere I, Lambertini M. Efficacy and safety of controlled ovarian stimulation with or without letrozole co-administration for fertility preservation: A systematic review and meta-analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Conte B, Bruzzone M, Lambertini M, Poggio F, Blondeaux E, De Laurentiis M, Valle E, Cognetti F, Nisticò C, De Placido S, Merlano M, Gamucci T, Montemurro F, Ceppi M, Del Mastro L. Efficacy of dose-dense (DD) adjuvant chemotherapy (CT) in hormone receptor positive/HER2-negative early breast cancer (BC) patients (pts) according to immunohistochemically (IHC) defined luminal subtypes: An exploratory analysis of the GIM2 trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cejalvo JM, Jacob W, Fleitas Kanonnikoff T, Felip E, Navarro Mendivil A, Martinez Garcia M, Taus Garcia A, Leighl N, Lassen U, Mau-Soerensen M, Adessi C, Michielin F, James I, Ceppi M, Hasmann M, Weisser M, Cervantes A. A phase Ib/II study of HER3-targeting lumretuzumab in combination with carboplatin and paclitaxel as first-line treatment in patients with advanced or metastatic squamous non-small cell lung cancer. ESMO Open 2019; 4:e000532. [PMID: 31423336 PMCID: PMC6678014 DOI: 10.1136/esmoopen-2019-000532] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 04/25/2019] [Revised: 05/27/2019] [Accepted: 05/29/2019] [Indexed: 12/24/2022] Open
Abstract
Purpose This study investigated the safety and clinical activity of lumretuzumab, a humanised antihuman epidermal growth factor receptor 3 (HER3) monoclonal antibody, in combination with carboplatin and paclitaxel in first-line treatment of patients with squamous non-small cell lung cancer (sqNSCLC). HER3 ligand heregulin and HER3 protein expression were evaluated as potential biomarkers of clinical activity. Patients and methods This open-label, phase Ib/II study enrolled patients receiving lumretuzumab at 800 mg (flat) in combination with carboplatin (area under the curve (AUC) 6 mg/mL×min) and paclitaxel (200 mg/m2) administered intravenously on a every 3-week schedule. Adverse event (AE) rates and tumour responses were determined. Heregulin messenger RNA (mRNA) and HER3 protein expression were investigated in archival tumour biopsies. Results Altogether, 12 patients received lumretuzumab in combination with carboplatin and paclitaxel. The most frequent AEs were gastrointestinal, haematological and nervous system toxicities, which were generally mild and manageable. Partial responses were observed in 3 of 12 patients lasting 81, 177 and 207 days. All responses were achieved in tumours expressing higher heregulin mRNA levels. Conclusion Lumretuzumab in combination with carboplatin and paclitaxel was well tolerated. Objective responses were enriched in tumours expressing higher heregulin mRNA levels.
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Affiliation(s)
- Juan-Miguel Cejalvo
- Department of Medical Oncology, Institute of Health Research INCLIVA, University of Valencia, Valencia and CIBERONC, Institute of Health Carlos III, Madrid, Spain
| | - Wolfgang Jacob
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Tania Fleitas Kanonnikoff
- Department of Medical Oncology, Institute of Health Research INCLIVA, University of Valencia, Valencia and CIBERONC, Institute of Health Carlos III, Madrid, Spain
| | - Enriqueta Felip
- Department of Medical Oncology, University Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | | | - Natasha Leighl
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Ulrik Lassen
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | | | - Celine Adessi
- Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
| | - Francesca Michielin
- Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
| | - Ian James
- A4PConsulting Ltd, Sandwich, United Kingdom
| | - Maurizio Ceppi
- Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
| | - Max Hasmann
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Martin Weisser
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Andrés Cervantes
- Department of Medical Oncology, Institute of Health Research INCLIVA, University of Valencia, Valencia and CIBERONC, Institute of Health Carlos III, Madrid, Spain
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Ducret A, James I, Wilson S, Feilke M, Tebbe A, Dybowski N, Elschenbroich S, Klammer M, Blackler A, Liao WL, Tian Y, Friess T, Bossenmaier B, Dietmann G, Schaab C, Hembrough T, Ceppi M. Translation and evaluation of a pre-clinical 5-protein response prediction signature in a breast cancer phase Ib clinical trial. PLoS One 2019; 14:e0213892. [PMID: 30897176 PMCID: PMC6428264 DOI: 10.1371/journal.pone.0213892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 03/05/2019] [Indexed: 12/21/2022] Open
Abstract
Human protein biomarker discovery relies heavily on pre-clinical models, in particular established cell lines and patient-derived xenografts, but confirmation studies in primary tissue are essential to demonstrate clinical relevance. We describe in this study the process that was followed to clinically translate a 5-protein response signature predictive for the activity of an anti-HER3 monoclonal antibody (lumretuzumab) originally measured in fresh frozen xenograft tissue. We detail the development, qualification, and validation of the multiplexed targeted mass spectrometry assay used to assess the signature performance in formalin-fixed, paraffin-embedded human clinical samples collected in a phase Ib trial designed to evaluate lumretuzumab in patients with metastatic breast cancer. We believe that the strategy delineated here provides a path forward to avoid the time- and cost-consuming step of having to develop immunological reagents against unproven targets. We expect that mass spectrometry-based platforms may become part of a rational process to rapidly test and qualify large number of candidate biomarkers to identify the few that stand a chance for further development and validation.
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Affiliation(s)
- Axel Ducret
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
- * E-mail:
| | - Ian James
- A4P Consulting Ltd, Sandwich, United Kingdom
| | - Sabine Wilson
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Martina Feilke
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | | | | | | | | | - Adele Blackler
- Oncoplex Diagnostics, Rockville, MD, United States of America
| | - Wei-Li Liao
- Oncoplex Diagnostics, Rockville, MD, United States of America
| | - Yuan Tian
- Oncoplex Diagnostics, Rockville, MD, United States of America
| | - Thomas Friess
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Birgit Bossenmaier
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Gabriele Dietmann
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | | | - Todd Hembrough
- Oncoplex Diagnostics, Rockville, MD, United States of America
| | - Maurizio Ceppi
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
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Caparica R, Bruzzone M, Poggio F, Ceppi M, de Azambuja E, Lambertini M. Should anthracyclines always be present in the adjuvant treatment of breast cancer (BC)? A systematic review and meta-analysis of randomized controlled trials (RCTs). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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Kim HS, Han JY, Shin DH, Lim KY, Lee GK, Kim JY, Jacob W, Ceppi M, Weisser M, James I. EGFR and HER3 signaling blockade in invasive mucinous lung adenocarcinoma harboring an NRG1 fusion. Lung Cancer 2018; 124:71-75. [DOI: 10.1016/j.lungcan.2018.07.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/19/2018] [Accepted: 07/19/2018] [Indexed: 12/21/2022]
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31
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Schneeweiss A, Park-Simon TW, Albanell J, Lassen U, Cortés J, Dieras V, May M, Schindler C, Marmé F, Cejalvo JM, Martinez-Garcia M, Gonzalez I, Lopez-Martin J, Welt A, Levy C, Joly F, Michielin F, Jacob W, Adessi C, Moisan A, Meneses-Lorente G, Racek T, James I, Ceppi M, Hasmann M, Weisser M, Cervantes A. Phase Ib study evaluating safety and clinical activity of the anti-HER3 antibody lumretuzumab combined with the anti-HER2 antibody pertuzumab and paclitaxel in HER3-positive, HER2-low metastatic breast cancer. Invest New Drugs 2018; 36:848-859. [PMID: 29349598 PMCID: PMC6153514 DOI: 10.1007/s10637-018-0562-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 01/10/2018] [Indexed: 01/03/2023]
Abstract
Purpose To investigate the safety and clinical activity of comprehensive human epidermal growth factor receptor (HER) family receptor inhibition using lumretuzumab (anti-HER3) and pertuzumab (anti-HER2) in combination with paclitaxel in patients with metastatic breast cancer (MBC). Methods This phase Ib study enrolled 35 MBC patients (first line or higher) with HER3-positive and HER2-low (immunohistochemistry 1+ to 2+ and in-situ hybridization negative) tumors. Patients received lumretuzumab (1000 mg in Cohort 1; 500 mg in Cohorts 2 and 3) plus pertuzumab (840 mg loading dose [LD] followed by 420 mg in Cohorts 1 and 2; 420 mg without LD in Cohort 3) every 3 weeks, plus paclitaxel (80 mg/m2 weekly in all cohorts). Patients in Cohort 3 received prophylactic loperamide treatment. Results Diarrhea grade 3 was a dose-limiting toxicity of Cohort 1 defining the maximum tolerated dose of lumretuzumab when given in combination with pertuzumab and paclitaxel at 500 mg every three weeks. Grade 3 diarrhea decreased from 50% (Cohort 2) to 30.8% (Cohort 3) with prophylactic loperamide administration and omission of the pertuzumab LD, nonetheless, all patients still experienced diarrhea. In first-line MBC patients, the objective response rate in Cohorts 2 and 3 was 55% and 38.5%, respectively. No relationship between HER2 and HER3 expression or somatic mutations and clinical response was observed. Conclusions Combination treatment with lumretuzumab, pertuzumab and paclitaxel was associated with a high incidence of diarrhea. Despite the efforts to alter dosing, the therapeutic window remained too narrow to warrant further clinical development. TRIAL REGISTRATION on ClinicalTrials.gov with the identifier NCT01918254 first registered on 3rd July 2013.
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MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/pharmacokinetics
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/pharmacokinetics
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Breast Neoplasms/drug therapy
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Diarrhea/chemically induced
- Female
- Humans
- Hypokalemia/chemically induced
- Male
- Middle Aged
- Paclitaxel/administration & dosage
- Paclitaxel/adverse effects
- Polymorphism, Single Nucleotide
- Receptor, ErbB-2/antagonists & inhibitors
- Receptor, ErbB-2/genetics
- Receptor, ErbB-2/metabolism
- Receptor, ErbB-3/antagonists & inhibitors
- Receptor, ErbB-3/genetics
- Receptor, ErbB-3/metabolism
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Affiliation(s)
- Andreas Schneeweiss
- National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Tjoung-Won Park-Simon
- Department of Obstetrics and Gynecology, Division of Gynecological Oncology and Clinical Research Center, Hannover Medical School, Hannover, Germany
| | - Joan Albanell
- Department of Medical Oncology, Hospital del Mar, CIBERONC, Barcelona, Spain
| | | | - Javier Cortés
- Ramon y Cajal University Hospital, Madrid, Spain
- Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - Marcus May
- Department of Obstetrics and Gynecology, Division of Gynecological Oncology and Clinical Research Center, Hannover Medical School, Hannover, Germany
| | - Christoph Schindler
- Department of Obstetrics and Gynecology, Division of Gynecological Oncology and Clinical Research Center, Hannover Medical School, Hannover, Germany
| | - Frederik Marmé
- National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Juan Miguel Cejalvo
- Department of Medical Oncology, Biomedical Health Research Institute INCLIVA, University of Valencia, Valencia and CIBERONC, Institute of Health Carlos III, Madrid, Spain
| | | | - Iria Gonzalez
- Department of Medical Oncology, Hospital del Mar, CIBERONC, Barcelona, Spain
| | - Jose Lopez-Martin
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Anja Welt
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Christelle Levy
- Departments of Clinical Research Unit and Medical Oncology, Centre François Baclesse, Caen, France
| | - Florence Joly
- Departments of Clinical Research Unit and Medical Oncology, Centre François Baclesse, Caen, France
| | - Francesca Michielin
- Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
| | - Wolfgang Jacob
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany.
| | - Céline Adessi
- Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
| | - Annie Moisan
- Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
| | - Georgina Meneses-Lorente
- Pharma Research and Early Development (pRED), Roche Innovation Center Welwyn, Welwyn Garden City, UK
| | - Tomas Racek
- Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
| | | | - Maurizio Ceppi
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Max Hasmann
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Martin Weisser
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Andrés Cervantes
- Department of Medical Oncology, Biomedical Health Research Institute INCLIVA, University of Valencia, Valencia and CIBERONC, Institute of Health Carlos III, Madrid, Spain
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32
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Puntoni R, Goldsmith DF, Valerio F, Vercelli M, Bonassi S, Di Giorgio F, Ceppi M, Stagnaro E, Filiberti R, Santi L. A Cohort Study of Workers Employed in a Refractory Brick Plant. Tumori 2018; 74:27-33. [PMID: 2832986 DOI: 10.1177/030089168807400105] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A mortality study was carried out on a cohort of workers who were exposed to silica dust in a refractory brick plant. The cohort was divided into two groups: workers with and without silicosis, and their mortality was contrasted with the death rate of Genova from 1960 to 1979. Results show an increased risk for laryngeal tumors (3 obs., 0.44 exp., SMR = 682), nonmalignant respiratory disease (16 obs., 3.2 exp., SMR = 500), and cardiovascular diseases (19 obs., 11 exp., SMR = 173) among silicotics. The mortality rate for lung cancer showed an increase for the cohort of workers as a whole (11 obs., 6 exp., SMR = 183). The almost double overall mortality observed in silicotic subjects raises some doubts about the validity of other proportional mortality studies that showed no excesses for workers in these industries.
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Affiliation(s)
- R Puntoni
- Dipartimento di Epidemiologia e Biostatistica, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italia
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Bendell J, Blay JY, Cassier P, Bauer T, Terret C, Mueller C, Morel A, Chesne E, Xu ZX, Tessier J, Ceppi M, James I, Wilson S, Quackenbush E, Ochoa de Olza M, Tabernero J, De Miguel M, Calvo E. Abstract A092: Phase 1 trial of RO6874813, a novel bispecific FAP-DR5 antibody, in patients with solid tumors. Mol Cancer Ther 2018. [DOI: 10.1158/1535-7163.targ-17-a092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: FAP-DR5 (RO6874813) is a novel bispecific antibody that binds with high and low affinity to fibroblast activation protein (FAP) and death receptor 5 (DR5), respectively. FAP-driven binding of RO6874813 mediates the high levels of DR5 clustering that are required for triggering cell death. Here, we present ongoing phase 1 data in patients with advanced solid tumors who were treated with escalating doses of single agent RO6874813 and assessed for tolerability. Methods: Study endpoints are safety and tolerability (primary) and antitumor activity (secondary). The study uses a continuous reassessment method (CRM) design for dose escalation. Patients received drug (IV ≤ 90 min) weekly (QW) or every other week (Q2W), starting with a run-in dose on Cycle 0/Day 1 (C0/D1) of 0.5 mg/kg for all cohorts to characterize linear and nonlinear pharmacokinetics (PK) . Doses administered at C1/D1 ranged from 1.0 to 45 mg/kg (3 or more patients per cohort). Dosing continued until progression of disease (PD) or toxicity occurred. Plasma biomarkers (BM) of DR5 binding (TRAIL, the DR5 ligand) and apoptosis (ccCK18) were measured at multiple timepoints. Archival or fresh tumor samples collected prior to RO6874813 treatment were analyzed for target expression by IHC and mRNA (qRT-PCR), cellular infiltrates, and apoptosis. Results: As of 26 April 2017, 32 patients have been treated with RO6874813. Patients had a median of 3.5 prior regimens (range 1-11) and received a median of 4 (range 2-21) doses of RO6874813. One patient (NSCLC) remains on treatment; 31 discontinued treatment (30 for PD; 1 for subject decision). A maximum tolerated dose has not been reached. The most common treatment-related adverse events (TR-AEs) were: fatigue (21.9%); nausea (15.6%), and infusion-related reactions (9.4%). Grade (Gr) ≥3 TR-AEs occurred in 2 patients (6.25%): anemia and asthenia (both Gr 3, occurring in 1 patient each). No Gr 4/5 TR-AEs and no protocol-defined DLTs were reported. No AE led to permanent study drug withdrawal; 5 patients died from PD, one within 30 days of their last dose. Thirty-one patients were evaluated for antitumor activity: using RECIST criteria, 1 PR (NSCLC; time on treatment = 324 days, ongoing) and 6 stable diseases (SD; median duration 42 days) were observed. 28 patients were evaluated by PET, with 2 (7%) FDG partial metabolic responses (EORTC criteria) seen. No difference was found between QW (used with select doses) and Q2W schedules for safety, antitumor activity, and PK/PD parameters. RO6874813 serum concentrations increased linearly with dose and revealed saturation of TMDD at ≥ 5 mg/kg (Q2W). For the single patient with a PR (30 mg/kg; Q2W), the Cmax at C1 exceeded that of other patients and showed accumulation over time, despite two dose interruptions for Gr 2 neutropenia. Blood BM analyses revealed a significant upregulation of TRAIL and ccCK18 after dosing in this and other patients, suggesting apoptotic activity. FAP and DR5 were expressed in tumor tissue of all patients. Conclusions: RO6874813 demonstrated a favorable safety profile in patients with multiple solid tumor types, and dose escalation and regimen optimization continue. Preliminary antitumor activity was observed in a patient with heavily pretreated NSCLC. Analyses required to support the hypothesis that FAP-binding mediates sufficiently high levels of DR5 clustering for apoptosis induction are ongoing.
Citation Format: Johanna Bendell, Jean-Yves Blay, Philippe Cassier, Todd Bauer, Catherine Terret, Claudia Mueller, Anthony Morel, Evelyne Chesne, Zhi-xin Xu, Jean Tessier, Maurizio Ceppi, Ian James, Sabine Wilson, Elizabeth Quackenbush, Maria Ochoa de Olza, Josep Tabernero, Maria De Miguel, Emiliano Calvo. Phase 1 trial of RO6874813, a novel bispecific FAP-DR5 antibody, in patients with solid tumors [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr A092.
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Affiliation(s)
- Johanna Bendell
- 1Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN
| | | | | | - Todd Bauer
- 1Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN
| | | | | | | | | | - Zhi-xin Xu
- 5Roche Innovation Center-New York, New York City, NY
| | - Jean Tessier
- 6Roche Innovation Center-Basel, Basel, Switzerland
| | | | - Ian James
- 7A4P Consulting, LTD, Sandwich, United Kingdom
| | | | | | | | | | - Maria De Miguel
- 10START Madrid - Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - Emiliano Calvo
- 10START Madrid - Centro Integral Oncológico Clara Campal, Madrid, Spain
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Puglisi F, Ceppi M, Gerratana L, Cognetti F, De Placido S, Bruzzi P, De Laurentiis M, Bisagni G, Cavazzini G, Durando A, Turletti A, Valle E, Montemurro F, Barni S, Ardizzoni A, Colantuoni G, Gamucci T, Del Mastro L. Composite index of risk shows that benefit from adjuvant dose dense chemotherapy is not confined to triple negative breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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35
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Martel S, Bruzzone M, Ceppi M, Maurer C, Falbel Ponde N, Ferreira A, Viglietti G, Delmastro L, Prady C, De Azambuja E, Lambertini M. The CAN BEAR study: A systematic review and meta-analysis investigating adverse events (AEs) of targeted agents added to endocrine therapy (ET) in patients (pts) with hormone-receptor positive (HR+) metastatic breast cancer (MBC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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36
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Meulendijks D, Jacob W, Voest EE, Mau-Sorensen M, Martinez-Garcia M, Taus A, Fleitas T, Cervantes A, Lolkema MP, Langenberg MHG, De Jonge MJ, Sleijfer S, Han JY, Calles A, Felip E, Kim SW, Schellens JHM, Wilson S, Thomas M, Ceppi M, Meneses-Lorente G, James I, Vega-Harring S, Dua R, Nguyen M, Steiner L, Adessi C, Michielin F, Bossenmaier B, Weisser M, Lassen UN. Phase Ib Study of Lumretuzumab Plus Cetuximab or Erlotinib in Solid Tumor Patients and Evaluation of HER3 and Heregulin as Potential Biomarkers of Clinical Activity. Clin Cancer Res 2017; 23:5406-5415. [PMID: 28600476 DOI: 10.1158/1078-0432.ccr-17-0812] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 05/03/2017] [Accepted: 06/05/2017] [Indexed: 11/16/2022]
Abstract
Purpose: This study investigated the safety, clinical activity, and target-associated biomarkers of lumretuzumab, a humanized, glycoengineered, anti-HER3 monoclonal antibody (mAb), in combination with the EGFR-blocking agents erlotinib or cetuximab in patients with advanced HER3-positive carcinomas.Experimental Design: The study included two parts: dose escalation and dose extension phases with lumretuzumab in combination with either cetuximab or erlotinib, respectively. In both parts, patients received lumretuzumab doses from 400 to 2,000 mg plus cetuximab or erlotinib according to standard posology, respectively. The effect of HRG mRNA and HER3 mRNA and protein expression were investigated in a dedicated extension cohort of squamous non-small cell lung cancer (sqNSCLC) patients treated with lumretuzumab and erlotinib.Results: Altogether, 120 patients were treated. One dose-limiting toxicity (DLT) in the cetuximab part and two DLTs in the erlotinib part were reported. The most frequent adverse events were gastrointestinal and skin toxicities, which were manageable. The objective response rate (ORR) was 6.1% in the cetuximab part and 4.2% in the erlotinib part. In the sqNSCLC extension cohort of the erlotinib part, higher tumor HRG and HER3 mRNA levels were associated with a numerically higher disease control rate but not ORR.Conclusions: The toxicity profile of lumretuzumab in combination with cetuximab and erlotinib was manageable, but only modest clinical activity was observed across tumor types. In the sqNSCLC cohort, there was no evidence of meaningful clinical benefit despite enriching for tumors with higher HRG mRNA expression levels. Clin Cancer Res; 23(18); 5406-15. ©2017 AACR.
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Affiliation(s)
- Didier Meulendijks
- Department of Clinical Pharmacology, Division of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Wolfgang Jacob
- Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany.
| | - Emile E Voest
- Department of Clinical Pharmacology, Division of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | | | - Alvaro Taus
- Department of Medical Oncology, Hospital del Mar, Barcelona, Spain
| | - Tania Fleitas
- Department of Medical Oncology, CIBERONC, Institute of Health Research INCLIVA, University of Valencia, Valencia, Spain
| | - Andres Cervantes
- Department of Medical Oncology, CIBERONC, Institute of Health Research INCLIVA, University of Valencia, Valencia, Spain
| | - Martijn P Lolkema
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.,Department of Medical Oncology, Erasmus Medical Center Cancer Institute and Cancer Genomics, Rotterdam, the Netherlands
| | - Marlies H G Langenberg
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Maja J De Jonge
- Department of Medical Oncology, Erasmus Medical Center Cancer Institute and Cancer Genomics, Rotterdam, the Netherlands
| | - Stefan Sleijfer
- Department of Medical Oncology, Erasmus Medical Center Cancer Institute and Cancer Genomics, Rotterdam, the Netherlands
| | - Ji-Youn Han
- Center for Lung Cancer, National Cancer Center, Goyang, South Korea
| | - Antonio Calles
- START-Madrid, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - Enriqueta Felip
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Sang-We Kim
- Department of Oncology, Asan Medical Center, Seoul, South Korea
| | - Jan H M Schellens
- Department of Clinical Pharmacology, Division of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Utrecht Institute for Pharmaceutical Sciences (UIPS), University Utrecht, Utrecht, the Netherlands
| | - Sabine Wilson
- Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Marlene Thomas
- Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Maurizio Ceppi
- Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | | | - Ian James
- A4P Consulting Ltd, Discovery Park, Sandwich, United Kingdom
| | - Suzana Vega-Harring
- Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Rajiv Dua
- Roche Molecular Systems Inc., Pleasanton, California
| | | | - Lori Steiner
- Roche Molecular Systems Inc., Pleasanton, California
| | - Celine Adessi
- Pharma Research and Early Development, Roche Innovation Center, Basel, Basel, Switzerland
| | - Francesca Michielin
- Pharma Research and Early Development, Roche Innovation Center, Basel, Basel, Switzerland
| | - Birgit Bossenmaier
- Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Martin Weisser
- Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Ulrik N Lassen
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
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Solinas C, Ceppi M, Lambertini M, Scartozzi M, Buisseret L, Garaud S, Fumagalli D, de Azambuja E, Salgado R, Sotiriou C, Willard-Gallo K, Ignatiadis M. Tumor-infiltrating lymphocytes in patients with HER2-positive breast cancer treated with neoadjuvant chemotherapy plus trastuzumab, lapatinib or their combination: A meta-analysis of randomized controlled trials. Cancer Treat Rev 2017; 57:8-15. [DOI: 10.1016/j.ctrv.2017.04.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 04/21/2017] [Accepted: 04/23/2017] [Indexed: 01/13/2023]
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Collins D, Jacob W, Cejalvo JM, Ceppi M, James I, Hasmann M, Crown J, Cervantes A, Weisser M, Bossenmaier B. Direct estrogen receptor (ER) / HER family crosstalk mediating sensitivity to lumretuzumab and pertuzumab in ER+ breast cancer. PLoS One 2017; 12:e0177331. [PMID: 28493933 PMCID: PMC5426757 DOI: 10.1371/journal.pone.0177331] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [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: 02/01/2017] [Accepted: 04/26/2017] [Indexed: 11/24/2022] Open
Abstract
Bidirectional cross talk between members of the human epidermal growth factor family of receptors (HER) and the estrogen receptor (ER) is believed to underlie resistance mechanisms that develop in response to treatment with anti-HER agents and endocrine therapy. We investigated the interaction between HER2, HER3 and the ER in vitro using human embryonic kidney cells transfected with human HER2, HER3, and ERα. We also investigated the additive efficacy of combination regimens consisting of anti-HER3 (lumretuzumab), anti-HER2 (pertuzumab), and endocrine (fulvestrant) therapy in vivo. Our data show that both HER2 and HER3 can directly complex with the ER and can mediate phosphorylation of the ER. Phosphorylation of the ER was only observed in cells that expressed both HER2 and ERα or in heregulin-stimulated cells that expressed both HER3 and ERα. Using a mouse xenograft model of ER+/HER2-low (HER2 immunohistochemistry 1+ or 2+ without gene amplification) human breast cancer we show that the combination of lumretuzumab and pertuzumab is highly efficacious and induces long-lasting tumor regression in vivo and adding endocrine therapy (fulvestrant) to this combination further improved efficacy. In addition, a prolonged clinical response was observed with the combination of lumretuzumab and pertuzumab in a patient with ER+/HER2-low breast cancer who had failed endocrine therapy. These preclinical data confirm that direct cross talk exists between HER2/HER3 and ER which may explain the resistance mechanisms to endocrine therapy and monoclonal antibodies that target HER2 and HER3. Our data also indicate that the triplet of anti-HER2, anti-HER3, and endocrine therapy might be an efficacious combination for treating patients with ER+/HER2-low breast cancer, which is an area of significant unmet medical need.
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Affiliation(s)
- Denis Collins
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
- * E-mail: (DC); (MW)
| | | | - Juan Miguel Cejalvo
- Department of Medical Oncology, Institute of Health Research INCLIVA, University of Valencia, Valencia, Spain
| | | | - Ian James
- A4P Consulting Ltd, Sandwich, United Kingdom
| | - Max Hasmann
- Roche Innovation Center Munich, Penzberg, Germany
| | - John Crown
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
- Department of Medical Oncology, St. Vincent's University Hospital, Dublin, Ireland
| | - Andrés Cervantes
- Department of Medical Oncology, Institute of Health Research INCLIVA, University of Valencia, Valencia, Spain
| | - Martin Weisser
- Roche Innovation Center Munich, Penzberg, Germany
- * E-mail: (DC); (MW)
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Solinas C, Ceppi M, Lambertini M, Scartozzi M, Garaud S, Fumagalli D, De Azambuja E, Salgado R, Willard-Gallo K, Ignatiadis M. Tumor infiltrating lymphocytes in HER2-positive breast cancer patients treated with neoadjuvant chemotherapy plus trastuzumab, lapatinib or their combination: A meta-analysis of published randomized clinical trials. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx138.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Poggio F, Ceppi M, Lambertini M, Bruzzi P, Ugolini D, Bighin C, Levaggi A, Giraudi S, D'Alonzo A, Vaglica M, Blondeaux E, Sertoli MR, Pronzato P, Del Mastro L. Concurrent versus sequential adjuvant chemo-endocrine therapy in hormone-receptor positive early stage breast cancer patients: a systematic review and meta-analysis. Breast 2017; 33:104-108. [PMID: 28360014 DOI: 10.1016/j.breast.2017.03.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 03/22/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although in clinical practice adjuvant chemotherapy (CT) and endocrine therapy (ET) are administered sequentially in patients with hormone-receptor positive breast cancer, the optimal timing, i.e. concurrent or sequential administration, of these treatments has been scarcely investigated. To better clarify this issue we conducted a systematic review and meta-analysis of randomized studies comparing these two modalities of administrations in terms of disease-free survival (DFS) and overall survival (OS). METHODS Relevant studies were identified by searching PubMed, Web of Knowledge and the proceedings of the major conferences with no date restriction up to March 2016. The summary risk estimates (pooled hazard ratio [HR] and 95% confidence intervals [CI]) for DFS and OS were calculated using random effect models (DerSimonian and Laird method). RESULTS A total of three randomized studies were eligible including 2021 breast cancer patients. Overall, 755 DFS events were observed, 365 in the sequential arm and 390 in the concomitant arm, with a pooled HR of 0.95 (95% CI = 0.76 to 1.18, P = 0.643). No association between timing of treatment and OS was observed (HR = 0.95; 95% CI = 0.80 to 1.12, P = 0.529). CONCLUSION Our pooled analysis showed no association between the timing of administration of adjuvant CT and ET and DFS and OS in breast cancer patients candidates for both adjuvant treatments. Because of the small number of published trials, the lack of data on the timing with modern adjuvant treatments, i.e. taxane-containing CT and aromatase inhibitors, this topic remain still controversial and requires further studies to be clarified.
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Affiliation(s)
- F Poggio
- Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino - IST, Genova, Italy
| | - M Ceppi
- Unit of Clinical Epidemiology, IRCCS AOU San Martino-IST, Genova, Italy
| | - M Lambertini
- BrEAST Data Centre, Department of Medicine, Institut Jules Bordet, and l'Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - P Bruzzi
- Unit of Clinical Epidemiology, IRCCS AOU San Martino-IST, Genova, Italy
| | - D Ugolini
- Department of Internal Medicine, University of Genoa, Unit of Clinical Epidemiology, IRCCS AOU San Martino-IST, Genova, Italy
| | - C Bighin
- Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino - IST, Genova, Italy
| | - A Levaggi
- Department of Medical Oncology, U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino - IST, Genova, Italy
| | - S Giraudi
- Department of Medical Oncology, U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino - IST, Genova, Italy
| | - A D'Alonzo
- Department of Medical Oncology, U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino - IST, Genova, Italy
| | - M Vaglica
- Department of Medical Oncology, U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino - IST, Genova, Italy
| | - E Blondeaux
- Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino - IST, Genova, Italy
| | - M R Sertoli
- Department of Medical Oncology, Clinica di Oncologia Medica, IRCCS AOU San Martino - IST, Genova, Italy
| | - P Pronzato
- Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino - IST, Genova, Italy
| | - L Del Mastro
- Department of Medical Oncology, U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino - IST, Genova, Italy.
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Puglisi F, Ceppi M, Cognetti F, De Placido S, Bruzzi P, De Laurentiis M, Bisagni G, Cavazzini G, Durando A, Turletti A, Valle E, Montemurro F, Barni S, Ardizzoni A, Gamucci T, Colantuoni G, Del Mastro L. Abstract P1-09-12: Dose dense adjuvant chemotherapy in patients with early breast cancer: Differential treatment effects according to composite index of benefit. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-09-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background In patients with node-positive early breast cancer (EBC), dose-dense adjuvant chemotherapy improves disease-free survival (DFS) compared with standard interval chemotherapy. The GIM2 trial supports the value of dose-dense chemotherapy and suggests that the benefit is present in patients with hormone receptor-negative or hormone receptor-positive tumours (Del Mastro et al. Lancet 2015). In order to individualize decision making, there is a need to examine the absolute treatment effects of dose dense chemotherapy according to patient and tumor characteristics.
Patients and Methods The randomized phase III GIM2 trial enrolled 2091 patients. The primary endpoint was DFS. A continuous, composite measure of treatment benefit for each patient was determined from a Cox model incorporating potential predictive factors (age: 25-40/41-55/56-71; histological grade: 1+2/3; hormonal receptor status: positive/negative). Subpopulation treatment effect pattern plot methodology was used to reveal differential treatment effects on DFS according to composite index. The study focused on patients with HER2–negative disease (N=1287).
Results On average, the magnitude of benefit with dose dense chemotherapy versus standard chemotherapy ranged widely across different subpopulations, as quantified by the composite measure of relevant variables. The highest benefit was observed in patients with high grade, hormone receptor-negative disease (hazard ratio for DFS 0.44, 95% CI 0.23-0.83). Of note, a relevant benefit was observed also in patients with high grade, hormone receptor-positive disease (hazard ratio for DFS 0.74, 95% CI 0.50-1.09).
Conclusion The absolute improvement in DFS with dose dense adjuvant chemotherapy is substantial in some patients with node-positive HER2-negative breast cancer, particularly those regarded as having high index risk (hormone receptor-negative, high grade disease). Interestingly, a significant effect of dose dense chemotherapy was observed also in patients with hormone receptor-positive, high grade disease.
Citation Format: Puglisi F, Ceppi M, Cognetti F, De Placido S, Bruzzi P, De Laurentiis M, Bisagni G, Cavazzini G, Durando A, Turletti A, Valle E, Montemurro F, Barni S, Ardizzoni A, Gamucci T, Colantuoni G, Del Mastro L. Dose dense adjuvant chemotherapy in patients with early breast cancer: Differential treatment effects according to composite index of benefit [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-09-12.
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Affiliation(s)
- F Puglisi
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - M Ceppi
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - F Cognetti
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - S De Placido
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - P Bruzzi
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - M De Laurentiis
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - G Bisagni
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - G Cavazzini
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - A Durando
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - A Turletti
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - E Valle
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - F Montemurro
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - S Barni
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - A Ardizzoni
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - T Gamucci
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - G Colantuoni
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - L Del Mastro
- University Hospital of Udine, Udine, Italy; Gruppo Italiano Mammella, Italy; IRCCS AOU San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
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Schneeweiss A, Park-Simon TW, Albanell J, Lassen U, Cortes J, Dieras V, May M, Schindler C, Marmé F, Cejalvo JM, Martinez-Garcia M, Gonzalez I, Lopez-Martin J, Welt A, Joly F, Michielin F, Jacob W, Adessi C, Moisan A, Meneses-Lorente G, James I, Ceppi M, Hasmann M, Weisser M, Cervantes A. Abstract P6-11-13: Phase Ib study evaluating the safety and clinical activity of lumretuzumab combined with pertuzumab and paclitaxel in HER2-low metastatic breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-11-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Inhibition of HER2 and HER3 heterodimerisation is a novel treatment concept in HER2-”low” expressing breast cancer (BC). Lumretuzumab, a glycoengineered monoclonal anti-HER3 antibody, in combination with pertuzumab has demonstrated synergistic anti-tumor activity in preclinical HER2–low expressing preclinical BC models.
Methods: This open-label, multicenter phase I study selectively enrolled metastatic BC patients (pts) expressing HER3 protein and low levels of HER2 (defined as IHC 1+ and 2+ and ISH-negative) in a formalin-fixed paraffin-embedded pretreatment tumor biopsy sample. Eligible pts were treated with a combination of paclitaxel (PA) qw plus lumretuzumab (L) and pertuzumab (P) q3w in three dose cohorts. The safety, antitumor activity and tumor biomarkers including protein expression (IHC, MS) and mutational data (NGS) in association with clinical activity were evaluated.
Results: Overall, 35 pts were included in this study. The median age was 60 (range: 33 to 77) years. The median number of prior treatments for metastatic disease ranged from 0 to 5 with 23 pts (65.7%) without prior chemotherapy for metastatic disease. Cohort 1 was treated with PA at 80 mg/m2, L at 1000 mg and P at 840 mg for Cycle 1 followed by 420 mg for the following cycles. This cohort was stopped after two pts both experienced grade 3 diarrhea within the first treatment cycle which was considered a dose-limiting toxicity (DLT). For Cohort 2 the dose of L was reduced to 500 mg based on PK modelling and simulation data. No DLTs were seen for the first 6 pts. A total of 20 pts were recruited with an objective response rate (ORR) and disease control rate (DCR) of 30% and 75%, respectively, and 56% and 78%, respectively, for 1st-line pts (n=9) in this cohort. Diarrhea (≥G3) and hypokalemia (≥G3) occurred in 50% and 55% of pts, respectively, and all pts experienced chronic diarrhea throughout the course of treatment. For Cohort 3 the dose of L was maintained at 500 mg, PA at 80 mg/m2, and P was administered at 420 mg at all cycles. In addition, a prophylactic loperamide regimen was introduced. Altogether, 13 pts - all 1st-line for metastatic disease - were treated. No DLTs were seen for the first 6 pts. Diarrhea (≥G3) and hypokalemia (≥G3) were reduced to 31% and 15%, respectively, but chronic diarrhea was still observed throughout the treatment in all pts. The ORR and DCR were 31% and 77%, respectively. Preliminary mechanistic safety experiments revealed HER2/HER3-dependent chloride channels in the intestine as likely cause of diarrhea. Biomarker data will be presented along with updated clinical and safety data.
Conclusions: The combination of L, P and PA was associated with high rates of persistent diarrhea. Dose modifications and prophylactic anti-diarrheal medication led to significantly reduced diarrhea intensity but did not change the incidence and persistence of diarrhea overall. Despite encouraging clinical activity especially in 1st line pts, the therapeutic window of this combination is too low to warrant further clinical development.
Citation Format: Schneeweiss A, Park-Simon T-W, Albanell J, Lassen U, Cortes J, Dieras V, May M, Schindler C, Marmé F, Cejalvo JM, Martinez-Garcia M, Gonzalez I, Lopez-Martin J, Welt A, Joly F, Michielin F, Jacob W, Adessi C, Moisan A, Meneses-Lorente G, James I, Ceppi M, Hasmann M, Weisser M, Cervantes A. Phase Ib study evaluating the safety and clinical activity of lumretuzumab combined with pertuzumab and paclitaxel in HER2-low metastatic breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-11-13.
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Affiliation(s)
- A Schneeweiss
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - T-W Park-Simon
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - J Albanell
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - U Lassen
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - J Cortes
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - V Dieras
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M May
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - C Schindler
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - F Marmé
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - JM Cejalvo
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Martinez-Garcia
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - I Gonzalez
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - J Lopez-Martin
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - A Welt
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - F Joly
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - F Michielin
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - W Jacob
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - C Adessi
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - A Moisan
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - G Meneses-Lorente
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - I James
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Ceppi
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Hasmann
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Weisser
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - A Cervantes
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
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Meulendijks D, Lassen U, Cervantes A, Han JY, Calles A, Felip E, Kim SW, Schellens J, Taus A, Sorensen M, Fleitas T, Bossenmaier B, Michielin F, Adessi C, Meneses-Lorente G, Ceppi M, James I, Jacob W, Weisser M, Martinez-Garcia M. Impact of tumor heregulin mRNA expression on outcome of patients with advanced/metastatic squamous NSCLC treated with lumretuzumab, a glycoengineered monoclonal antibody targeting HER3, in combination with erlotinib. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw368.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cejalvo J, Fleitas T, Felip E, Mendivil AN, Martinez-Garcia M, Taus A, Leighl N, Lassen U, Soerensen MM, Adessi C, Michielin F, Jacob W, James I, Ceppi M, Weisser M, Cervantes A. A phase Ib study of lumretuzumab, a glycoengineered monoclonal antibody targeting HER3, in combination with carboplatin and paclitaxel as 1st-line treatment in patients with squamous non-small cell lung cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw368.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Poggio F, Ceppi M, Lambertini M, Bruzzi P, Ugolini D, Bighin C, Levaggi A, Giraudi S, D'alonzo A, Vaglica M, Blondeaux E, Conte B, Sertoli M, Pronzato P. Concurrent versus sequential adjuvant chemo-endocrine therapy in early stage hormone receptor-positive breast cancer patients: a systematic review and meta-analysis. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw337.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Blondeaux E, Lambertini M, Ceppi M, Cognetti F, Cavazzini G, De Laurentiis M, De Placido S, Michelotti A, Bisagni G, Durando A, Valle E, Scotto T, De Censi A, Turletti A, Benasso M, Barni S, Montemurro F, Puglisi F, Bighin C, Bruzzi P, Del Mastro L. Dose-dense adjuvant chemotherapy, treatment-induced amenorrhea and overall survival in premenopausal breast cancer patients: a pooled analysis of the MIG1 and GIM2 phase 3 studies. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw337.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gyulveszi G, Fischer C, Mirolo M, Stern M, Green L, Ceppi M, Wang H, Bürgi B, Staempfli A, Muster W, van Waterschoot R, Gloge A, Sade H, Klaman I, Hoelzlvimmer G, Surya A, Banerjee M, Shrivastava R, Middya S, Yadav D, Basu S, Acuna G. Abstract LB-085: RG70099: A novel, highly potent dual IDO1/TDO inhibitor to reverse metabolic suppression of immune cells in the tumor micro-environment. Immunology 2016. [DOI: 10.1158/1538-7445.am2016-lb-085] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Cheeseman K, Ropars J, Renault P, Dupont J, Gouzy J, Branca A, Abraham AL, Ceppi M, Conseiller E, Debuchy R, Malagnac F, Goarin A, Silar P, Lacoste S, Sallet E, Bensimon A, Giraud T, Brygoo Y. Multiple recent horizontal transfers of a large genomic region in cheese making fungi. Nat Commun 2015; 5:2876. [PMID: 24407037 PMCID: PMC3896755 DOI: 10.1038/ncomms3876] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [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: 06/26/2013] [Accepted: 11/06/2013] [Indexed: 02/01/2023] Open
Abstract
While the extent and impact of horizontal transfers in prokaryotes are widely acknowledged, their importance to the eukaryotic kingdom is unclear and thought by many to be anecdotal. Here we report multiple recent transfers of a huge genomic island between Penicillium spp. found in the food environment. Sequencing of the two leading filamentous fungi used in cheese making, P. roqueforti and P. camemberti, and comparison with the penicillin producer P. rubens reveals a 575 kb long genomic island in P. roqueforti—called Wallaby—present as identical fragments at non-homologous loci in P. camemberti and P. rubens. Wallaby is detected in Penicillium collections exclusively in strains from food environments. Wallaby encompasses about 250 predicted genes, some of which are probably involved in competition with microorganisms. The occurrence of multiple recent eukaryotic transfers in the food environment provides strong evidence for the importance of this understudied and probably underestimated phenomenon in eukaryotes. Horizontal gene transfers are known to play an important role in prokaryote evolution but their impact and prevalence in eukaryotes is less clear. Here, the authors sequence the genomes of cheese making fungi P. roqueforti and P. camemberti, and provide evidence for recent horizontal transfers of a large genomic region.
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Affiliation(s)
- Kevin Cheeseman
- INRA, UMR1319 Micalis, F-78352 Jouy-en-Josas, France; Genomic Vision, 80-84 rue des Meuniers, 92220 Bagneux, France; AgroParisTech, UMR Micalis, F-78352 Jouy-en-Josas, France
| | - Jeanne Ropars
- Origine, Structure, Evolution de la Biodiversité, UMR 7205 CNRS-MNHN, Muséum National d'Histoire Naturelle, CP39, 57 rue Cuvier, 75231 Paris Cedex 05, France; Univ Paris-Sud, Ecologie, Systématique et Evolution, UMR8079, 91405 Orsay, France; CNRS, Ecologie, Systématique et Evolution, UMR8079, 91405 Orsay, France
| | - Pierre Renault
- INRA, UMR1319 Micalis, F-78352 Jouy-en-Josas, France; AgroParisTech, UMR Micalis, F-78352 Jouy-en-Josas, France
| | - Joëlle Dupont
- Origine, Structure, Evolution de la Biodiversité, UMR 7205 CNRS-MNHN, Muséum National d'Histoire Naturelle, CP39, 57 rue Cuvier, 75231 Paris Cedex 05, France
| | - Jérôme Gouzy
- LIMP Toulouse, INRA/CNRS, INRA, 24 Chemin de Borde Rouge-Auzeville, CS 52627, 31326 Castanet-Tolosan Cedex, France; INRA, Laboratoire des Interactions Plantes-Microorganismes (LIPM), UMR441, F-31326 Castanet-Tolosan, France; CNRS, Laboratoire des Interactions Plantes-Microorganismes (LIPM), UMR2594, F-31326 Castanet-Tolosan, France
| | - Antoine Branca
- Univ Paris-Sud, Ecologie, Systématique et Evolution, UMR8079, 91405 Orsay, France; CNRS, Ecologie, Systématique et Evolution, UMR8079, 91405 Orsay, France
| | - Anne-Laure Abraham
- INRA, UMR1319 Micalis, F-78352 Jouy-en-Josas, France; AgroParisTech, UMR Micalis, F-78352 Jouy-en-Josas, France
| | - Maurizio Ceppi
- Genomic Vision, 80-84 rue des Meuniers, 92220 Bagneux, France
| | | | - Robert Debuchy
- Univ Paris-Sud, Institut de Génétique et Microbiologie, UMR8621, 91405 Orsay, France; CNRS, Institut de Génétique et Microbiologie UMR8621, 91405 Orsay, France
| | - Fabienne Malagnac
- Univ Paris-Sud, Institut de Génétique et Microbiologie, UMR8621, 91405 Orsay, France; Univ Paris Diderot, Sorbonne Paris Cité, Institut des Energies de Demain (IED), 75205 Paris, France
| | - Anne Goarin
- Univ Paris-Sud, Institut de Génétique et Microbiologie, UMR8621, 91405 Orsay, France
| | - Philippe Silar
- Univ Paris-Sud, Institut de Génétique et Microbiologie, UMR8621, 91405 Orsay, France; Univ Paris Diderot, Sorbonne Paris Cité, Institut des Energies de Demain (IED), 75205 Paris, France
| | - Sandrine Lacoste
- Origine, Structure, Evolution de la Biodiversité, UMR 7205 CNRS-MNHN, Muséum National d'Histoire Naturelle, CP39, 57 rue Cuvier, 75231 Paris Cedex 05, France
| | - Erika Sallet
- LIMP Toulouse, INRA/CNRS, INRA, 24 Chemin de Borde Rouge-Auzeville, CS 52627, 31326 Castanet-Tolosan Cedex, France; INRA, Laboratoire des Interactions Plantes-Microorganismes (LIPM), UMR441, F-31326 Castanet-Tolosan, France; CNRS, Laboratoire des Interactions Plantes-Microorganismes (LIPM), UMR2594, F-31326 Castanet-Tolosan, France
| | - Aaron Bensimon
- Genomic Vision, 80-84 rue des Meuniers, 92220 Bagneux, France
| | - Tatiana Giraud
- Univ Paris-Sud, Ecologie, Systématique et Evolution, UMR8079, 91405 Orsay, France; CNRS, Ecologie, Systématique et Evolution, UMR8079, 91405 Orsay, France
| | - Yves Brygoo
- 13 ruelle d'Aigrefoin 78470 St Rémy-lès-Chevreuse
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Meulendijks D, Jacob W, Martinez-Garcia M, Taus A, Lolkema MP, Voest EE, Langenberg MHG, Fleitas Kanonnikoff T, Cervantes A, De Jonge MJ, Sleijfer S, Soerensen MM, Thomas M, Ceppi M, Meneses-Lorente G, James I, Adessi C, Michielin F, Abiraj K, Bossenmaier B, Schellens JHM, Weisser M, Lassen UN. First-in-Human Phase I Study of Lumretuzumab, a Glycoengineered Humanized Anti-HER3 Monoclonal Antibody, in Patients with Metastatic or Advanced HER3-Positive Solid Tumors. Clin Cancer Res 2015; 22:877-85. [PMID: 26463709 DOI: 10.1158/1078-0432.ccr-15-1683] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/23/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE A first-in-human phase I study was conducted to characterize safety, efficacy, and pharmacokinetic (PK) and pharmacodynamic (PD) properties of lumretuzumab, a humanized and glycoengineered anti-HER3 monoclonal antibody, in patients with advanced cancer. EXPERIMENTAL DESIGN Twenty-five patients with histologically confirmed HER3-expressing tumors received lumretuzumab (100, 200, 400, 800, 1,600, and 2,000 mg) every two weeks (q2w) in 3+3 dose-escalation phase. In addition, 22 patients were enrolled into an extension cohort at 2,000 mg q2w. RESULTS There were no dose-limiting toxicities. Common adverse events (any grade) included diarrhea (22 patients, 46.8%), fatigue (21 patients, 44.7%), decreased appetite (15 patients, 31.9%), infusion-related reactions (13 patients, 27.7%), and constipation (10 patients, 21.3%). The peak concentration (Cmax) and area under the concentration-time curve up to the last measurable concentration (AUClast) of lumretuzumab increased more than dose proportionally from 100 mg up to 400 mg. Linear PK was observed with doses ≥ 400 mg q2w indicating target-mediated drug disposition saturation. Downregulation of HER3 membranous protein was observed in on-treatment tumor biopsies from 200 mg, and was maximal at and above 400 mg. An ex vivo assay demonstrated increased activation potential of peripheral NK lymphocytes with lumretuzumab compared with a non-glycoengineered anti-HER3 antibody. Ten patients (21.3%) had stable disease and remained on study at a median of 111 days (range, 80-225 days). CONCLUSIONS Lumretuzumab was well tolerated and showed evidence of clinical activity. Linear serum PK properties and plateauing of PD effects in serial tumor biopsies indicate optimal biologically active doses of lumretuzumab from 400 mg onwards.
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Affiliation(s)
- Didier Meulendijks
- Department of Clinical Pharmacology, Division of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Wolfgang Jacob
- Pharma Research and Early Development, Roche Innovation Center Penzberg, Penzberg, Germany.
| | | | - Alvaro Taus
- Department of Medical Oncology, Hospital del Mar, Barcelona, Spain
| | - Martijn P Lolkema
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands. Department of Medical Oncology, Erasmus Medical Center Cancer Institute and Cancer Genomics, Rotterdam, the Netherlands
| | - Emile E Voest
- Department of Clinical Pharmacology, Division of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Marlies H G Langenberg
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tania Fleitas Kanonnikoff
- Department of Hematology and Medical Oncology, Institute of Health Research INCLIVA, University of Valencia, Valencia, Spain
| | - Andres Cervantes
- Department of Hematology and Medical Oncology, Institute of Health Research INCLIVA, University of Valencia, Valencia, Spain
| | - Maja J De Jonge
- Department of Medical Oncology, Erasmus Medical Center Cancer Institute and Cancer Genomics, Rotterdam, the Netherlands
| | - Stefan Sleijfer
- Department of Medical Oncology, Erasmus Medical Center Cancer Institute and Cancer Genomics, Rotterdam, the Netherlands
| | | | - Marlene Thomas
- Pharma Research and Early Development, Roche Innovation Center Penzberg, Penzberg, Germany
| | - Maurizio Ceppi
- Pharma Research and Early Development, Roche Innovation Center Penzberg, Penzberg, Germany
| | | | - Ian James
- Pharma Research and Early Development, Roche Innovation Center Penzberg, Penzberg, Germany
| | - Celine Adessi
- Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Francesca Michielin
- Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Keelara Abiraj
- Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Birgit Bossenmaier
- Pharma Research and Early Development, Roche Innovation Center Penzberg, Penzberg, Germany
| | - Jan H M Schellens
- Department of Clinical Pharmacology, Division of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Martin Weisser
- Pharma Research and Early Development, Roche Innovation Center Penzberg, Penzberg, Germany
| | - Ulrik N Lassen
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
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Bighin C, Poggio F, Dozin B, Ceppi M, Bruzzi P, D'Alonzo A, Giraudi S, Levaggi A, Lambertini M, Miglietta L, Vaglica M, Fontana V, Iacono G, Pronzato P, Del Mastro L. Outcomes of hormone-responsive (HR+) HER2 negative (HER2-) metastatic breast cancer (MBC) patients (P) according to their starting first-line (1st) treatment (T): chemotherapy (CT) or hormonal therapy (HT). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.26] [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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