1
|
Thill M, Zahn MO, Welt A, Stickeler E, Nusch A, Fietz T, Rauh J, Wetzel N, Kruggel L, Jänicke M, Marschner N, Harbeck N, Wöckel A, Decker T. Treatment and outcome in metastatic lobular breast cancer in the prospective German research platform OPAL. Breast Cancer Res Treat 2023; 198:545-553. [PMID: 36807725 PMCID: PMC10036409 DOI: 10.1007/s10549-023-06882-7] [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: 12/07/2022] [Accepted: 02/01/2023] [Indexed: 02/20/2023]
Abstract
PURPOSE Evidence about routine treatment and outcome of patients with invasive lobular cancer (ILC) is limited, especially regarding metastatic disease. Here we present prospective real-world data of patients with metastatic ILC (mILC) as compared to patients with metastatic invasive ductal cancer (mIDC) receiving systemic therapy in routine care in Germany. METHODS Prospective data on patient and tumor characteristics, treatments, and outcomes of patients with mILC (n = 466) and mIDC (n = 2100), recruited between 2007 and 2021 into the Tumor Registry Breast Cancer/OPAL were analyzed. RESULTS Compared to mIDCs, patients with mILC were older at start of first-line treatment (median 69 vs. 63 years) and had more often lower grade (G1/G2: 72.8% vs. 51.2%), hormone receptor (HR)-positive (83.7% vs. 73.2%) and less often HER2-positive (14.2% vs. 28.6%) tumors, which metastasized more frequently to the bone (19.7% vs. 14.5%) or peritoneum (9.9% vs. 2.0%), and less frequently to the lungs (0.9% vs. 4.0%). Median OS of patients with mILC (n = 209) and mIDC (n = 1158) was 30.2 months [95% confidence interval (CI) 25.3, 36.0] and 33.7 months [95% CI 30.3, 37.9], respectively. Multivariate survival analysis did not show a significant prognostic impact of the histological subtype [HR mILC vs. mIDC 1.18 (95% CI 0.97-1.42)]. CONCLUSION Overall, our real-world data confirm clinicopathological differences between mILC and mIDC breast cancer patients. Despite patients with mILC presenting with some favorable prognostic factors, ILC histopathology was not associated with a better clinical outcome in multivariate analysis, suggesting the need for more tailored treatment strategies for patients with the lobular subtype.
Collapse
Affiliation(s)
- M Thill
- Agaplesion Markus Krankenhaus, Frankfurt, Germany
| | - M-O Zahn
- MVZ Onkologische Kooperation Harz, Goslar, Germany
| | - A Welt
- Universitätsklinikum Essen, Essen, Germany
| | - E Stickeler
- Universitätsklinikum Aachen, Aachen, Germany
| | - A Nusch
- Praxis für Hämatologie und internistische Onkologie, Ratingen, Germany
| | - T Fietz
- Schwerpunktpraxis für Hämatologie und internistische Onkologie, Singen, Germany
| | - J Rauh
- Gemeinschaftspraxis Innere Medizin, Witten, Germany
| | | | | | | | - N Marschner
- Praxis für interdisziplinäre Onkologie und Hämatologie, Freiburg, Germany
| | - N Harbeck
- Brustzentrum, Frauenklinik LMU Klinikum, Munich, Germany
| | - A Wöckel
- Universitätsklinikum Würzburg, Würzburg, Germany
| | - T Decker
- Onkologie Ravensburg, Praxis für Hämatologie und Onkologie GbR, Ravensburg, Germany.
| | | |
Collapse
|
2
|
Schick J, Altunay M, Lacorcia M, Marschner N, Westermann S, Schluckebier J, Schubart C, Bodendorfer B, Christensen D, Alexander C, Wirtz S, Voehringer D, da Costa CP, Lang R. IL-4 and helminth infection downregulate MINCLE-dependent macrophage response to mycobacteria and Th17 adjuvanticity. eLife 2023; 12:72923. [PMID: 36753434 PMCID: PMC9908076 DOI: 10.7554/elife.72923] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
The myeloid C-type lectin receptor (CLR) MINCLE senses the mycobacterial cell wall component trehalose-6,6'-dimycolate (TDM). Recently, we found that IL-4 downregulates MINCLE expression in macrophages. IL-4 is a hallmark cytokine in helminth infections, which appear to increase the risk for mycobacterial infection and active tuberculosis. Here, we investigated functional consequences of IL-4 and helminth infection on MINCLE-driven macrophage activation and Th1/Th17 adjuvanticity. IL-4 inhibited MINCLE and cytokine induction after macrophage infection with Mycobacterium bovis bacille Calmette-Guerin (BCG). Infection of mice with BCG upregulated MINCLE on myeloid cells, which was inhibited by IL-4 plasmid injection and by infection with the nematode Nippostrongylus brasiliensis in monocytes. To determine the impact of helminth infection on MINCLE-dependent immune responses, we vaccinated mice with a recombinant protein together with the MINCLE ligand trehalose-6,6-dibehenate (TDB) as adjuvant. Concurrent infection with N. brasiliensis or with Schistosoma mansoni promoted T cell-derived IL-4 production and suppressed Th1/Th17 differentiation in the spleen. In contrast, helminth infection did not reduce Th1/Th17 induction by TDB in draining peripheral lymph nodes, where IL-4 levels were unaltered. Upon use of the TLR4-dependent adjuvant G3D6A, N. brasiliensis infection impaired selectively the induction of splenic antigen-specific Th1 but not of Th17 cells. Inhibition of MINCLE-dependent Th1/Th17 responses in mice infected with N. brasiliensis was dependent on IL-4/IL-13. Thus, helminth infection attenuated the Th17 response to MINCLE-dependent immunization in an organ- and adjuvant-specific manner via the Th2 cytokines IL-4/IL-13. Taken together, our results demonstrate downregulation of MINCLE expression on monocytes and macrophages by IL-4 as a possible mechanism of thwarted Th17 vaccination responses by underlying helminth infection.
Collapse
Affiliation(s)
- Judith Schick
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-NürnbergErlangenGermany
| | - Meltem Altunay
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-NürnbergErlangenGermany
| | - Matthew Lacorcia
- Institut für Medizinische Mikrobiologie, Immunologie und Hygiene, Center for Global Health, Technische Universität MünchenMunichGermany,Center for Global Health, Technical University MunichMunichGermany
| | - Nathalie Marschner
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-NürnbergErlangenGermany
| | - Stefanie Westermann
- Infektionsbiologische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-NürnbergErlangenGermany
| | - Julia Schluckebier
- Institut für Medizinische Mikrobiologie, Immunologie und Hygiene, Center for Global Health, Technische Universität MünchenMunichGermany,Center for Global Health, Technical University MunichMunichGermany
| | - Christoph Schubart
- Infektionsbiologische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-NürnbergErlangenGermany
| | - Barbara Bodendorfer
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-NürnbergErlangenGermany
| | - Dennis Christensen
- Adjuvant Research, Department of Infectious Disease Immunology, Statens Serum InstitutCopenhagenDenmark
| | - Christian Alexander
- Cellular Microbiology, Forschungszentrum Borstel, Leibniz Lung Center BorstelBorstelGermany
| | - Stefan Wirtz
- Medizinische Klinik 1, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-NürnbergErlangenGermany
| | - David Voehringer
- Infektionsbiologische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-NürnbergErlangenGermany
| | - Clarissa Prazeres da Costa
- Institut für Medizinische Mikrobiologie, Immunologie und Hygiene, Center for Global Health, Technische Universität MünchenMunichGermany,Center for Global Health, Technical University MunichMunichGermany
| | - Roland Lang
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-NürnbergErlangenGermany
| |
Collapse
|
3
|
Semsek D, Kröning H, Göhler T, Decker T, Kojouharoff G, Lipke J, Moorahrend E, Hartmann F, Reisländer T, de Buhr R, Frank M, Hogrefe C, Marschner N, Potthoff K, Schwaner I. P-55 Efficacy and safety data from patients with pre-treated metastatic colorectal cancer receiving trifluridine/tipiracil: Real-world data from the non-interventional TACTIC study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
4
|
Marschner N, Frank M, Vach W, Ladda E, Karcher A, Winter S, Jänicke M, Trarbach T. Development and validation of a novel prognostic score to predict survival in patients with metastatic colorectal cancer: the metastatic colorectal cancer score (mCCS). Colorectal Dis 2019; 21:816-826. [PMID: 30834622 PMCID: PMC6850201 DOI: 10.1111/codi.14600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 02/02/2019] [Indexed: 12/20/2022]
Abstract
AIM Published prognostic scores for metastatic colorectal cancer (mCRC) are based on data from highly selected patient subgroups with specified first-line treatments and may not be applicable to routine practice. We have therefore developed and validated the metastatic colorectal cancer score (mCCS) to predict overall survival (OS) for patients with mCRC. METHOD A total of 1704 patients from the prospective, multicentre cohort study Tumour Registry Colorectal Cancer were separated into learning (n = 796) and validation (n = 908) samples. Using a multivariate Cox regression model, the six-factor mCCS was established. RESULTS The six independent prognostic factors for survival are as follows: two or more metastatic sites at the start of first-line treatment, tumour grading ≥ G3 at primary diagnosis, residual tumour classification ≥ R1/unknown, lymph node ratio (of primary tumour) ≥ 0.4, tumour stage ≥ III/unknown at primary diagnosis and KRAS status mutated/unknown. The mCCS clearly separated the learning sample into three risk groups: zero to two factors (low risk), three factors (intermediate risk) and four to six factors (high risk). The prognostic performance of the mCCS was confirmed in the validation sample and additionally stratified a large sample of patients with known (K)RAS mutation status. CONCLUSION The novel prognostic score, mCCS, clearly defines three prognostic groups for OS at start of first-line therapy. For oncologists, the mCCS represents a simple and easy-to-apply tool for routine clinical use, as it is based on objective tumour characteristics and can assist with treatment decision-making and communication of the prognosis to patients.
Collapse
Affiliation(s)
- N Marschner
- Praxis für interdisziplinäre Onkologie und Hämatologie, Freiburg, Germany
| | - M Frank
- Biostatistics, iOMEDICO, Freiburg, Germany
| | - W Vach
- Department of Orthopaedics and Traumatology, Universitätsspital Basel, Basel, Switzerland
| | - E Ladda
- Onkologische Schwerpunktpraxis Neumarkt, Neumarkt in der Oberpfalz, Germany
| | - A Karcher
- Onkologische Schwerpunktpraxis, Heidelberg, Germany
| | - S Winter
- Clinical Epidemiology and Health Economics, iOMEDICO, Freiburg, Germany
| | - M Jänicke
- Clinical Epidemiology and Health Economics, iOMEDICO, Freiburg, Germany
| | - T Trarbach
- MVZ des Klinikums Wilhelmshaven, Wilhelmshaven, Germany
| |
Collapse
|
5
|
Welslau M, Marschner N, Wolff T, Otremba B, Topaly J, Bittencourt da Silva L. SANDOZ RITUXIMAB FOR TREATMENT OF DIFFUSE LARGE B-CELL LYMPHOMA: INTERIM SAFETY RESULTS OF THE NON-INTERVENTIONAL, OBSERVATIONAL, MULTICENTER, OPEN-LABEL REFLECT STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.120_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M. Welslau
- Onkologie Aschaffenburg; Aschaffenburg Germany
| | | | - T. Wolff
- Onkologie Lerchenfeld; Hamburg Germany
| | - B. Otremba
- Onkologische Praxis Oldenburg/Delmenhorst; Oldenburg Germany
| | - J. Topaly
- MVZ Klinikum Osnabrück GmbH; Osnabrück Germany
| | | |
Collapse
|
6
|
Welt A, Welslau M, Lüftner D, Deryal M, Liersch R, Sahlmann J, Houet L, Vannier C, Marschner N, Potthoff K. Palbociclib plus fulvestrant as first-line therapy for patients with locally advanced, inoperable or metastatic HR+/HER2- breast cancer in Germany: Interim results of the INGE-B phase II study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz100.007] [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
|
7
|
Decker T, Mündlein A, Marschner N, Welt A, Riedt T, Hagen V, Rauh J, Klein D, Potthoff K, Jähnig P, Schröder H, Hegewisch-Becker S, Lerchenmüller C. Exploratory biomarker analysis in patients treated with vinorelbine plus everolimus or vinorelbine monotherapy as second-line treatment for HER2-negative advanced breast cancer: Final results from the randomized phase II trial VicTORia. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.285] [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
|
8
|
Ammon A, Weber MH, Wallner I, Marschner N, Droese M, Gröne HJ, Hiddemann W. Expression of the Tumor-Associated Glycoproteins Mca, Ca 125 and Bw 495/36-P in Epithelial Tumors of the Kidney and the Urinary Bladder. Int J Biol Markers 2018; 9:224-30. [PMID: 7836800 DOI: 10.1177/172460089400900404] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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
The differential expression of the tumor-associated glycoproteins MCA, CA 125 and BW 495/36-P was investigated in 11 renal cell carcinomas and 11 urinary bladder carcinomas and compared with their expression in non-neoplastic tissue preparations from the kidney (n = 9) and urinary bladder (n = 12). The glycoproteins were demonstrated immunohistologically in frozen sections and additionally, in some cases, in paraffin sections. MCA and BW 495/36-P positive cells were present in all preparations except for a grade I transitional cell carcinoma of the bladder, in which no MCA-expression could be detected. In the non-neoplastic renal tissue mainly the cells of the distal tubuli were stained by the antibodies against these two glycoproteins. Carcinoma cells of the kidney and of the urinary bladder showed an increased expression of both epitopes. CA 125, in comparison, was strongly expressed in 3 of the 11 urinary bladder carcinomas investigated but could only be shown in a few cells of a single renal cell carcinoma. Normal renal tissue showed no and the urinary bladder only very isolated CA 125 positive epithelial cells. Apart from this distribution, strong staining of the connective tissue fibers with CA 125 antibody was seen in all paraffin sections, but not in the frozen sections. This leads to the supposition that in these structures there is a CA 125 cryptantigen. The consistent expression of MCA as well as the virtual lack of CA 125 in the renal cell carcinomas are in contrast with our previous serological results, in which patients with metastatic renal cell carcinomas showed increased CA 125 in approx. 50% of cases whereas only approx. 20% had increased MCA serum levels.
Collapse
Affiliation(s)
- A Ammon
- Department of Hematology and Oncology, University of Göttingen, Germany
| | | | | | | | | | | | | |
Collapse
|
9
|
Ammon A, Weber MH, Wallner I, Marschner N, Droese M, Gröne HJ, Hiddemann W. Immunocytochemical determination of the tumor-associated glycoproteins MCA, CA 125 and BW 495/36-P in urine of patients with epithelial tumors of the kidney and urinary bladder. Int J Biol Markers 2018; 10:17-23. [PMID: 7629422 DOI: 10.1177/172460089501000104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pre-operative and, in some cases, post-operative urine samples from 29 patients with renal cell or urinary bladder carcinoma were compared to samples from 24 healthy persons and 10 patients with nephrolithiasis and 9 patients with other benign disorders of the efferent urinary tract. The specimens were examined for the presence of MCA, CA 125 and BW 495/36-P expressing epithelial cells. The urine concentrations of the soluble antigens MCA and CA 125 were determined simultaneously in urine samples from 35 patients with renal cell or urinary bladder carcinoma, 10 patients with cystitis and 30 healthy individuals. MCA and BW 495/36-P expressing epithelial cells were significantly increased in all pre-operative urine samples of the tumor patients compared to the group of healthy persons. This increase was also seen with CA 125-positive cells in patients with bladder carcinoma, not however in patients with renal cell carcinoma. BW 495/36-P positive cells were also found in both groups of tumor patients in greater numbers than in the patients with nephrolithiasis or other benign urinary tract disorders. Based on a specificity of 97% when compared to the control urine samples, the cytological determination of the antigens MCA, CA 125 and BW 495/36-P in urinary tract cells of all tumor patients revealed a sensitivity of 48%, 33% and 79% as well as a positive predictive value of 92%, 89% and 95%, respectively. The sensitivity of CA 125 increased to 67% upon isolated analysis of patients with bladder carcinoma. The majority of labelled cells were not identifiable as tumor cells morphologically and appeared as normal transitional epithelial cells. The urinary concentration of soluble MCA was greatest in healthy patients whereas the concentration of CA 125 was increased in patients with bladder carcinoma. Our results indicate that especially the determination of BW 495/36-P expressing epithelial cells could be a helpful supplement to the cytological examination of urinary epithelium with regard to renal cell and bladder carcinoma. Determination of CA 125-positive cells appears to be of diagnostic relevance only in cases of suspected bladder carcinoma.
Collapse
Affiliation(s)
- A Ammon
- Department of Hematology and Oncology, Urbachtal-Klinik, Neukirchen, Germany
| | | | | | | | | | | | | |
Collapse
|
10
|
Griesinger F, Eberhardt WEE, Nusch A, Reiser M, Losem C, Marschner N, Jänicke M, Fleitz A, Spring L, Karatas A, Hipper A, de Wit M, Metzenmacher M, Waller C, Weichert W, Sebastian M, Thomas M. Molecular testing, frequency of molecular alteraions and first-line treatment of patients with non-small cell lung carcinoma (NSCLC) in Germany. First results from the prospective German Registry CRISP (AIO-TRK-0315). Pneumologie 2018. [DOI: 10.1055/s-0037-1619267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- F Griesinger
- Department of Hematology and Oncology, Pius-Hospital Oldenburg, University Hospital
| | - WEE Eberhardt
- Innere Klinik (Tumorforschung), Universitätsklinikum Essen
| | - A Nusch
- Praxis für Hämatologie und Internistische Onkologie, Ratingen
| | - M Reiser
- PIOH, Praxis Internistische Onkologie, Köln
| | - C Losem
- MVZ für Onkologie und Hämatologie Im Rhein-Kreis Neuss
| | - N Marschner
- Praxis für Interdisziplinäre Onkologie und Hämatologie, Freiburg
| | | | | | | | | | | | - M de Wit
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Vivantes Klinikum Neukölln
| | - M Metzenmacher
- Innere Klinik (Tumorforschung), Universitätsklinikum Essen
| | - C Waller
- Abteilung Hämatologie/Onkologie, Medizinische Universitätsklinik Freiburg
| | - W Weichert
- Institute of Pathology; Technical University of Munich
| | | | - M Thomas
- Department of Thoracic Oncology, University Hospital Heidelberg; Thoraxklinik Heidelberg
| |
Collapse
|
11
|
Hortobagyi GN, Stemmer S, Campone M, Sonke GS, Arteaga CL, Paluch-Shimon S, Petrakova K, Villanueva C, Nusch A, Grischke EM, Chan A, Jakobsen E, Marschner N, Hart LL, Alba E, Ohnstand HO, Blau S, Yardley DA, Solovieff N, Su F, Germa C, Yap YS. Abstract PD4-06: First-line ribociclib + letrozole in hormone receptor-positive, HER2-negative advanced breast cancer: Efficacy by baseline circulating tumor DNA alterations in MONALEESA-2. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd4-06] [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
Background: The addition of first-line ribociclib (RIB; cyclin-dependent kinase 4/6 inhibitor) to letrozole (LET) significantly improved progression-free survival (PFS) compared with placebo (PBO) + LET in patients (pts) with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) advanced breast cancer (ABC) in the Phase III MONALEESA-2 study. Identifying biomarkers that predict response to treatment remains a key challenge in pts with HR+ ABC. Here we analyze results from MONALEESA-2 by molecular alterations detected in circulating tumor DNA (ctDNA) at baseline, including PIK3CA mutations and other alterations considered to be important in HR+ ABC.
Methods: Postmenopausal women (N=668) with HR+, HER2– ABC who had not received any prior therapy for ABC were randomized 1:1 to RIB (600 mg/day; 3-weeks-on/1-week-off) + LET (2.5 mg/day; continuous) or PBO + LET. The primary endpoint was PFS. Biomarker analysis of the ctDNA mutation profile was an exploratory endpoint. Plasma samples for ctDNA analysis were collected at baseline and end of treatment. ctDNA was analyzed using next-generation sequencing with a targeted panel of ˜550 genes.
Results: Baseline ctDNA was successfully sequenced in 494 pts (RIB + LET: n=212; PBO + LET: n=215); 67 (14%) of 494 pts were removed from the analysis due to limited tumor DNA in circulation. 427 (86%) pts had ≥1 alteration, including 1,573 mutations, 513 short insertions/deletions, 166 amplifications, and 8 translocations. Alterations (frequency) were commonly observed in the following genes: PIK3CA (33%), TP53 (12%), ZNF703/FGFR1 (5%), and ESR1 (4%), and in genes involved in receptor tyrosine kinase (RTK) signaling (12%). RIB + LET treatment benefit was consistent in pts with wild-type (WT) and altered PIK3CA, and in pts with WT and altered TP53 (Table). RIB + LET improved PFS regardless of RTK or ZNF703/FGFR1 alterations. However, there was a weak trend for increased benefit in pts with WT vs altered RTK genes and in pts with WT vs altered ZNF703/FGFR1 genes. These results should be interpreted with caution due to the small number of pts with these alterations. There were too few ESR1 alterations for firm conclusions to be drawn.
Events, n/NMedian PFS, months Gene(s)RIB + LETPBO + LETRIB + LETPBO + LETHazard ratio (95% confidence interval)PIK3CAWT54/14393/14229.614.70.44 (0.31–0.62)Altered40/6955/7319.212.70.53 (0.35–0.81)TP53WT72/180129/19427.614.70.44 (0.33–0.59)Altered22/3219/2110.25.50.43 (0.23–0.83)ZNF703/FGFR1WT88/202139/20524.814.60.47 (0.36–0.62)Altered6/109/1010.611.40.73 (0.23–2.29)RTKWT81/189128/18724.814.40.46 (0.35–0.61)Altered13/2320/2821.311.40.72 (0.34–1.53)
Conclusions: Consistent RIB + LET treatment benefit was observed compared with PBO + LET, irrespective of the status of baseline ctDNA biomarkers.
Citation Format: Hortobagyi GN, Stemmer S, Campone M, Sonke GS, Arteaga CL, Paluch-Shimon S, Petrakova K, Villanueva C, Nusch A, Grischke E-M, Chan A, Jakobsen E, Marschner N, Hart LL, Alba E, Ohnstand HO, Blau S, Yardley DA, Solovieff N, Su F, Germa C, Yap Y-S. First-line ribociclib + letrozole in hormone receptor-positive, HER2-negative advanced breast cancer: Efficacy by baseline circulating tumor DNA alterations in MONALEESA-2 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD4-06.
Collapse
Affiliation(s)
- GN Hortobagyi
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - S Stemmer
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - M Campone
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - GS Sonke
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - CL Arteaga
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - S Paluch-Shimon
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - K Petrakova
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - C Villanueva
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - A Nusch
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - E-M Grischke
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - A Chan
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - E Jakobsen
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - N Marschner
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - LL Hart
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - E Alba
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - HO Ohnstand
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - S Blau
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - DA Yardley
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - N Solovieff
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - F Su
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - C Germa
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| | - Y-S Yap
- The University of Texas MD Anderson Cancer Center, Houston, TX; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel; Institut de Cancérologie de l'Ouest – René Gauducheau Centre de Recherche en Cancérologie, Nates, France; Netherlands Cancer Institute and BOOG Study Center, Amsterdam, Netherlands; Vanderbilt-Ingram Cancer Center, Nashville, TN; Sheba Medical Center, Ramat Gan, Israel; Masaryk Memorial Cancer Institute, Brno, Czech Republic; University Hospital of Besançon, Hospital Jean-Minjoz, Besançon, France; Onkologische Praxis Velbert, Velbert, Germany; University of Tübingen, Tübingen, Germany; Breast Cancer Research Centre–Western Australia and Curtin University, Perth, Australia; Vejle Hospital, Vejle, Denmark; Joint Practice for Interdisciplinary Oncology and Hematology, Freiburg, Germany; Florida Cancer Specialists–Sarah Cannon Research Institute, Fort Myers, FL; Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Norwegian Radium Hospital, Oslo University H
| |
Collapse
|
12
|
Griesinger F, Eberhardt W, Nusch A, Reiser M, Losem C, Ketzler-Henkel S, Zahn M, Marschner N, Jänicke M, Fleitz A, Spring L, Sahlmann J, Karatas A, Hipper A, De Wit M, Metzenmacher M, Waller C, Kern J, Weichert W, Sebastian M, Thomas M. P3.01-088 Molecular Testing and First-Line Treatment of Patients with NSCLC. First Results from the German CRISP Study (AIO-TRK-0315). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1529] [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: 10/18/2022]
|
13
|
Griesinger F, Eberhardt W, Marschner N, Jänicke M, Fleitz A, Spring L, Sahlmann J, Karatas A, Hipper A, Weichert W, Sebastian M, Thomas M. Clinical Research platform Into molecular testing, treatment and outcome of non-Small cell lung carcinoma Patients (CRISP): a prospective German Registry in stage IV NSCLC AIO-TRK-0315). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.086] [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
|
14
|
Goebell P, Müller L, Staehler M, Müller M, Frank M, Kruggel L, Jänicke M, Marschner N. Prognostic factors for overall survival of patients with advanced renal cell carcinoma – data from the German prospective RCC-Registry. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371.056] [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
|
15
|
Marschner N, von Verschuer U, Schnell R, Zahn MO, Eggert J, Binninger A, Spring L, Jänicke M. Comparison of platinum agents cisplatin and carboplatin in routine treatment of advanced NSCLC: Results from prospective German TLK cohort study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.071] [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
|
16
|
Staehler M, Müller L, Goebell P, Overkamp F, Frank M, Kruggel L, Jänicke M, Marschner N. Treatment reality and outcome data of patients with advanced papillary renal cell carcinoma: Data from the German prospective RCC-Registry. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
17
|
Potthoff K, Nusch A, Söling U, Hansen R, Salat C, Grebhardt S, Harde J, Marschner N. Overall survival and quality of life in patients with metastatic breast cancer treated with nab-paclitaxel: Final results of the non-interventional study NABUCCO. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.056] [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
|
18
|
Campone M, Marschner N, Villanueva C, Sonke G, Alba E, Jakobsen E, Su F, He W, Germa C, André F. First-line ribociclib + letrozole in HR+, HER2– ABC: Efficacy by baseline tumor markers. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
19
|
Griesinger F, Eberhardt W, Marschner N, Jänicke M, Fleitz A, Sahlmann J, Karatas A, Hipper A, Sebastian M, Thomas M. Clinical research platform into molecular testing, treatment and outcome of non-small cell lung carcinoma Patients (CRISP): A prospective German registry in stage IV NSCLC, AIO-TRK-0315. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx091.045] [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
|
20
|
Quidde J, Hegewisch-Becker S, Graeven U, Lerchenmüller CA, Killing B, Depenbusch R, Steffens CC, Lange T, Dietrich G, Stoehlmacher J, Reinacher A, Tannapfel A, Trarbach T, Marschner N, Schmoll HJ, Hinke A, Al-Batran SE, Arnold D. Quality of life assessment in patients with metastatic colorectal cancer receiving maintenance therapy after first-line induction treatment: a preplanned analysis of the phase III AIO KRK 0207 trial. Ann Oncol 2016; 27:2203-2210. [PMID: 27753609 DOI: 10.1093/annonc/mdw425] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 08/25/2016] [Accepted: 08/26/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND First-line maintenance strategies are a current matter of debate in the management of mCRC. Their impact on patient's health-related quality of life (HRQOL) has not yet been evaluated. The objective of this study was to assess whether differences in HRQOL during any active maintenance treatment compared with no maintenance treatment exist. PATIENT AND METHODS Eight hundred and thirty-seven patients were enrolled in the AIO KRK 0207 trial. Four hundred and seventy-two underwent randomization (after 24 weeks of induction treatment) into one of the maintenance arms: FP plus Bev (arm A), Bev alone (arm B), or no active treatment (arm C). HRQOL were assessed every 6 weeks during induction and maintenance treatment independent from treatment stop, delay, or modification, and also continued after progression, using the EORTC QLQ-C30, QLQ-CR29. The mean value of the global quality of life dimension (GHS/QoL) of the EORTC QLQ-C30, calculated as the average of all available time points after randomization was considered as pre-specified main endpoint. Additionally, EORTC QLQ-C30 response scores were analyzed. RESULTS For HRQOL analysis, 413 patients were eligible (arm A: 136; arm B: 142, arm C: 135). Compliance rate with the HRQOL questionnaires was 95% at time of randomization and remained high during maintenance (98%, 99%, 97% and 97% at week 6, 12, 18 and 24). No significant differences between treatment arms in the mean GHS/QoL scores were observed at any time point. Also, rates of GHS/QoL score deterioration were similar (20.5%; 17.2% and 20.7% of patients), whereas a score improvement occurred in 36.1%; 43.8% and 42.1% (arms A, B and C). CONCLUSION Continuation of an active maintenance treatment with FP/Bev after induction treatment was neither associated with a detrimental effect on GHS/QoL scores when compared with both, less active treatment with Bev alone or no active treatment. CLINICAL TRIALS NUMBER NCT00973609 (ClinicalTrials.gov).
Collapse
Affiliation(s)
- J Quidde
- Department of Oncology, Haematology, Bone Marrow Transplantation with Section Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg
| | | | - U Graeven
- Department of Hematology, Oncology and Gastroenterology, Kliniken Maria Hilf GmbH, Mönchengladbach
| | | | - B Killing
- Department of Hematology/Oncology, Lahn-Dill-Kliniken, Wetzlar
| | | | | | - T Lange
- Department for Hematology/Oncology, Asklepios Klinikum Weissenfels, Weissenfels
| | - G Dietrich
- Department of Gastroenterology/Hematology/Oncology, Klinikum Bietigheim, Bietigheim-Bissingen
| | | | | | - A Tannapfel
- Institute for Pathology, Ruhr-University, Bochum
| | | | | | - H-J Schmoll
- Department of Hematology and Oncology, University Hospital Halle (Saale), Halle
| | - A Hinke
- Department of Cancer Research, CCRC, Düsseldorf
| | - S-E Al-Batran
- UCT University Cancer Center, Krankenhaus Nordwest, Frankfurt, Germany
| | - D Arnold
- Department, Oncology, Instituto CUF de Oncologia (ICO), Lisbon, Portugal
| |
Collapse
|
21
|
Grischke EM, Nusch A, Marschner N, Abenhardt W, Wilke J, Decker T, Just M, Kümmel S, Kurbacher C, Marmé F, Overkamp F, Xuan F, Miller M, Janni W. Ribociclib + letrozole for postmenopausal women with hormone receptor-positive (HR+), HER2-negative advanced breast cancer (ABC) who received no prior therapy for advanced disease. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592812] [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: 10/20/2022] Open
|
22
|
Potthoff K, Nusch A, Söling U, Hansen R, Salat C, Grebhardt S, Marschner N. Efficacy and safety of nab-paclitaxel in patients with metastatic breast cancer: final results of the non-interventional study NABUCCO. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
23
|
Zielinski C, Gligorov J, Marschner N, Puglisi F, Vrdoljak E, Castan JC, de Ducla S, Deurloo R, Easton V, von Minckwitz G. Exploratory analyses of candidate predictive and prognostic tissue biomarkers (BMs) in the open-label randomised phase III TANIA trial of bevacizumab (BEV) in HER2-negative locally recurrent/metastatic breast cancer (LR/mBC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw392.24] [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
|
24
|
Quidde J, Becker SH, Graeven U, Lerchenmueller C, Killing B, Depenbusch R, Steffens CC, Lange T, Dietrich G, Stoehlmacher J, Reinacher A, Tannapfel A, Trarbach T, Marschner N, Schmoll H, Hinke A, Al-Batran SE, Arnold D. Quality of life in patients with metastatic colorectal cancer receiving maintenance therapy after first-line inductive treatment: A quality of life sub-analysis of the AIO KRK 0207 phase III trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
25
|
Vrdoljak E, Marschner N, Zielinski C, Gligorov J, Cortes J, Puglisi F, Aapro M, Fallowfield L, Fontana A, Inbar M, Kahan Z, Welt A, Lévy C, Brain E, Pivot X, Putzu C, González Martín A, de Ducla S, Easton V, von Minckwitz G. Final results of the TANIA randomised phase III trial of bevacizumab after progression on first-line bevacizumab therapy for HER2-negative locally recurrent/metastatic breast cancer. Ann Oncol 2016; 27:2046-2052. [PMID: 27502725 DOI: 10.1093/annonc/mdw316] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 07/28/2016] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The randomised phase III TANIA trial demonstrated that continuing bevacizumab with second-line chemotherapy for locally recurrent/metastatic breast cancer (LR/mBC) after progression on first-line bevacizumab-containing therapy significantly improved progression-free survival (PFS) compared with chemotherapy alone [hazard ratio (HR) = 0.75, 95% confidence interval (CI) 0.61-0.93]. We report final results from the TANIA trial, including overall survival (OS) and health-related quality of life (HRQoL). PATIENTS AND METHODS Patients with HER2-negative LR/mBC that had progressed on or after first-line bevacizumab plus chemotherapy were randomised to receive standard second-line chemotherapy either alone or with bevacizumab. At second progression, patients initially randomised to bevacizumab continued bevacizumab with their third-line chemotherapy, but those randomised to chemotherapy alone were not allowed to cross over to receive third-line bevacizumab. The primary end point was second-line PFS; secondary end points included third-line PFS, combined second- and third-line PFS, OS, HRQoL and safety. RESULTS Of the 494 patients randomised, 483 received second-line therapy; 234 patients (47% of the randomised population) continued to third-line study treatment. The median duration of follow-up at the final analysis was 32.1 months in the chemotherapy-alone arm and 30.9 months in the bevacizumab plus chemotherapy arm. There was no statistically significant difference between treatment arms in third-line PFS (HR = 0.79, 95% CI 0.59-1.06), combined second- and third-line PFS (HR = 0.85, 95% CI 0.68-1.05) or OS (HR = 0.96, 95% CI 0.76-1.21). Third-line safety results showed increased incidences of proteinuria and hypertension with bevacizumab, consistent with safety results for the second-line treatment phase. No differences in HRQoL were detected. CONCLUSIONS In this trial, continuing bevacizumab beyond first and second progression of LR/mBC improved second-line PFS, but no improvement in longer term efficacy was observed. The second-line PFS benefit appears to be achieved without detrimentally affecting quality of life. CLINICALTRIALSGOV NCT01250379.
Collapse
Affiliation(s)
- E Vrdoljak
- Department of Oncology, University Hospital Split, Split, Croatia
| | | | - C Zielinski
- Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria.,Central European Cooperative Oncology Group (CECOG)
| | - J Gligorov
- Assistance Publique Hôpitaux de Paris-Tenon, IUC-UPMC, Sorbonne University, Paris, France
| | - J Cortes
- Ramon y Cajal University Hospital, Madrid.,Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - F Puglisi
- Department of Medical and Biological Sciences, University of Udine, Udine.,Department of Oncology, University Hospital of Udine, Udine, Italy
| | - M Aapro
- Multidisciplinary Institute of Oncology, Clinique de Genolier, Genolier, Switzerland
| | - L Fallowfield
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Falmer, UK
| | - A Fontana
- Medical Oncology Unit 2, Pisa Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - M Inbar
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Z Kahan
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - A Welt
- West German Cancer Center, University Duisburg-Essen, Essen.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - C Lévy
- Oncology Department, Centre François Baclesse, Caen
| | - E Brain
- Institut Curie-Hôpital René Huguenin, Saint-Cloud
| | - X Pivot
- Oncology Department, Jean Minjoz University Hospital, Besançon, France
| | - C Putzu
- Oncology Unit, University Hospital of Sassari, Sassari, Italy
| | | | | | - V Easton
- Stamford Consultants AG, on behalf of F Hoffmann-La Roche Ltd, Basel, Switzerland
| | | |
Collapse
|
26
|
Vrdoljak E, Marschner N, Zielinski C, Gligorov J, Cortes J, Puglisi F, Aapro M, Fallowfield L, Fontana A, Inbar M, Kahan Z, Welt A, Lévy C, Brain E, Pivot X, Putzu C, Gonzalez-Martin A, Ebel K, Easton V, von Minckwitz G. Abstract P6-14-01: Final results of the TANIA randomized phase III trial of bevacizumab (BEV) after progression on 1st-line BEV therapy for HER2-negative locally recurrent/metastatic breast cancer (LR/mBC). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-14-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: The open-label randomized phase III TANIA trial (NCT01250379) evaluated 2nd-line BEV-containing therapy in BEV-pretreated LR/mBC. The primary objective was met: 2nd-line PFS was statistically significantly improved in patients (pts) receiving further BEV (hazard ratio [HR] 0.75, 95% CI 0.61–0.93; p=0.0068) [von Minckwitz, Lancet Oncol 2014]. We report final efficacy, safety, and health-related quality of life (HRQoL) results.
METHODS: Eligible pts had HER2-negative LR/mBC that had progressed on/after 1st-line BEV plus chemotherapy (CT). Pts were randomized to receive 2nd-line CT (investigator's choice) either alone or combined with BEV (15 mg/kg q3w or 10 mg/kg q2w) until disease progression (PD), unacceptable toxicity, or consent withdrawal. At 2nd PD, pts in the CT arm received 3rd-line CT without BEV (no crossover); pts initially randomized to BEV–CT received 3rd-line BEV–CT. Secondary endpoints included 3rd-line PFS, 2nd- and 3rd-line PFS (from randomization to 3rd PD/death), overall survival (OS), HRQoL, and safety. HRQoL was assessed using FACT-B at baseline, every 8/9 weeks (depending on treatment schedule) during 2nd-line therapy, and at the time of 2nd PD. Prespecified HRQoL analyses included differences between treatment arms in mean change from baseline for each FACT-B subscale.
RESULTS: At the time of data cut-off for the prespecified final analysis (April 30, 2015, 24 months after the last pt was randomized), median follow-up was 32.1 vs 30.9 months in the CT vs BEV–CT arms, respectively. All pts had stopped study treatment. Of the 494 pts randomized to 2nd-line therapy, 234 began 3rd-line therapy (105 initially randomized to CT; 129 from the BEV–CT arm, of whom 17 received CT without BEV). The most commonly selected 3rd-line CT was vinorelbine (33% of CT pts vs 31% of BEV–CT pts).
EndpointNo. of events/pts (%)Median, months (95% CI)Stratified HR (95% CI)p-value CTBEV–CTCTBEV–CT 3rd-line PFS99/105 (94)124/129 (96)2.9 (2.2-3.9)3.8 (2.4-5.1)0.79 (0.59-1.06)0.10802nd- and 3rd-line PFS177/247 (72)206/247 (83)10.7 (9.2-12.5)12.8 (10.7-14.5)0.85 (0.68-1.05)0.1349OS156/247 (63)163/247 (66)18.7 (15.4-21.2)19.7 (17.6-21.0)0.96 (0.76-1.21)0.7253
Subgroup analyses of 3rd-line PFS and OS according to stratification factors were consistent with the overall ITT result. Before study closure, 68% and 61% of pts in the 3rd-line ITT population CT and BEV–CT arms, respectively, received further CT. 3rd-line safety results showed no new safety signals. At week 8/9, mean change from baseline for all FACT-B subscales was <1.5 points in either direction in both treatment arms, representing no significant difference. Similarly, exploratory HRQoL analyses of the physical and functional wellbeing subscales using mixed-model repeated measures and responder analyses revealed no meaningful significant differences between treatment arms.
CONCLUSIONS: Although BEV given after PD on 1st-line BEV-containing therapy showed improvement in 2nd-line PFS, no OS benefit was demonstrated. No new safety signals were observed. There were no differences in HRQoL between treatment arms, suggesting that the PFS benefit with BEV is achieved with maintained HRQoL.
Citation Format: Vrdoljak E, Marschner N, Zielinski C, Gligorov J, Cortes J, Puglisi F, Aapro M, Fallowfield L, Fontana A, Inbar M, Kahan Z, Welt A, Lévy C, Brain E, Pivot X, Putzu C, Gonzalez-Martin A, Ebel K, Easton V, von Minckwitz G. Final results of the TANIA randomized phase III trial of bevacizumab (BEV) after progression on 1st-line BEV therapy for HER2-negative locally recurrent/metastatic breast cancer (LR/mBC). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-14-01.
Collapse
Affiliation(s)
- E Vrdoljak
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - N Marschner
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - C Zielinski
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - J Gligorov
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - J Cortes
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - F Puglisi
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - M Aapro
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - L Fallowfield
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - A Fontana
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - M Inbar
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - Z Kahan
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - A Welt
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - C Lévy
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - E Brain
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - X Pivot
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - C Putzu
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - A Gonzalez-Martin
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - K Ebel
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - V Easton
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| | - G von Minckwitz
- Center of Oncology, Split, Croatia; Outpatient Cancer Center, Freiburg, Germany; Comprehensive Cancer Center, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Vienna, Austria; Hôpital Tenon, Paris, France; Vall d'Hebron University Hospital, Barcelona, Spain; University Hospital of Udine, Udine, Italy; Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland; Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom; University Hospital of Pisa, Istituto Toscana Tumori, Pisa, Italy; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; University of Szeged, Szeged, Hungary; West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Centre François Baclesse, Caen, France; Institut Curie – Hôpital René Huguenin, Saint-Cloud, France; University Hospital Jean Minjoz, Besançon, France; University Hospital of Sassari, Sassari, Italy
| |
Collapse
|
27
|
Untch M, Augustin D, Ettl J, Haidinger R, Harbeck N, Lück HJ, Lüftner D, Marmé F, Müller L, Overkamp F, Ruckhäberle E, Thill M, Thomssen C, Wuerstlein R, Marschner N. ABC3 Consensus Commented from the Perspective of the German Guidelines: Third International Consensus Conference for Advanced Breast Cancer (ABC3), Lisbon, 07. 11. 2015. Geburtshilfe Frauenheilkd 2016; 76:156-163. [PMID: 26941448 PMCID: PMC4771501 DOI: 10.1055/s-0042-101168] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 12/29/2015] [Accepted: 01/19/2016] [Indexed: 12/17/2022] Open
Abstract
The Third International Consensus Conference for Advanced Breast Cancer ABC3 on the diagnosis and treatment of advanced breast cancer was held in Lisbon from 5 to 7 November 2015. This year the focus was the treatment of metastatic breast cancer (stage IV) - including the patient perspectives. Important topics were questions relating to quality of life, the care for long-term survivors as well as the management of disease-related symptoms and treatment-based side effects. The use of standardised tools to assess individual treatment success and the benefits of new substances were important points for discussion. The diagnosis and treatment of inoperable locally advanced breast cancer were discussed two years ago during the ABC2 consensus 1. A working group of German breast cancer experts commented on the results of the ABC panellists, paying particular attention to the German guidelines (AGO, S3, DGHO) on the diagnosis and treatment of breast cancer 2, 3, 4, 5 in Germany.
Collapse
Affiliation(s)
- M. Untch
- Klinik für Gynäkologie und Geburtshilfe, Interdisziplinäres Brustzentrum, HELIOS Klinikum Berlin-Buch, Berlin; Writing Committee
| | - D. Augustin
- Mammazentrum Ostbayern, DONAUISAR Klinikum Deggendorf, Deggendorf
| | - J. Ettl
- Frauenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich
| | - R. Haidinger
- Brustkrebs Deutschland e. V. (patient representative)
| | - N. Harbeck
- Brustzentrum, Klinikum der Universität München, München; Writing Committee, ABC Panel Member
| | - H.-J. Lück
- Gynäkologisch-Onkologische Praxis, Hannover
| | - D. Lüftner
- Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, Charité Berlin, Campus Benjamin Franklin, Berlin; Writing Committee
| | - F. Marmé
- Sektion Gynäkologische Onkologie, Nationales Centrum für Tumorerkrankungen (NCT), Heidelberg
| | - L. Müller
- Onkologie UnterEms, Leer-Emden-Papenburg
| | - F. Overkamp
- Medizinischer Onkologe, OncoConsult.Hamburg GmbH, Hamburg
| | - E. Ruckhäberle
- Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf
| | - M. Thill
- Klinik für Gynäkologie und Geburtshilfe, Interdisziplinäres Brustzentrum, Agaplesion Markus Krankenhaus, Frankfurt am Main
| | - C. Thomssen
- Universitätsklinik und Poliklinik für Gynäkologie, Martin-Luther-Universität, Halle an der Saale; Writing Committee, ABC Panel Member
| | - R. Wuerstlein
- Brustzentrum, Klinikum der Universität München, Munich; Writing Committee
| | - N. Marschner
- Gemeinschaftspraxis für interdisziplinäre Onkologie und Hämatologie, Freiburg; Writing Committee
| |
Collapse
|
28
|
Untch M, Harbeck N, Huober J, von Minckwitz G, Gerber B, Kreipe HH, Liedtke C, Marschner N, Möbus V, Scheithauer H, Schneeweiss A, Thomssen C, Jackisch C, Beckmann MW, Blohmer JU, Costa SD, Decker T, Diel I, Fasching PA, Fehm T, Janni W, Lück HJ, Maass N, Scharl A, Loibl S. Primary Therapy of Patients with Early Breast Cancer: Evidence, Controversies, Consensus: Opinions of German Specialists to the 14th St. Gallen International Breast Cancer Conference 2015 (Vienna 2015). Geburtshilfe Frauenheilkd 2015; 75:556-565. [PMID: 26166836 DOI: 10.1055/s-0035-1546120] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 05/17/2015] [Accepted: 05/17/2015] [Indexed: 01/30/2023] Open
Abstract
For the first time, this year's St. Gallen International Consensus Conference on the treatment of patients with primary breast cancer, which takes place every two years, was held not in St. Gallen (Switzerland) but - for logistical reasons - in Vienna (Austria) under its usual name. The 2015 St. Gallen International Consensus Conference was the 14th of its kind. As the international panel of the St. Gallen conference consists of experts from different countries, the consensus mirrors an international cross-section of opinions. From a German perspective, it was considered useful to translate the results of the votes of the St. Gallen conference into practical suggestions, particularly in light of the recently updated treatment guideline of the Gynecologic Oncology Group (AGO-Mamma 2015) in Germany. A German group consisting of 14 breast cancer experts, three of whom are members of the international St. Gallen panel, has therefore provided comments on the results of this year's votes at the 2015 St. Gallen Consensus Conference and their impact on clinical care in Germany. The 14th St. Gallen conference once again focused on surgery of the breast and the axilla, radio-oncologic and systemic treatment options for primary breast cancer depending on tumor biology, and the clinical use of multigene assays. The conference also considered targeted therapies for older and for younger patients, including the diagnosis/treatment of breast cancer during and after pregnancy and the preservation of fertility.
Collapse
Affiliation(s)
- M Untch
- Klinik für Gynäkologie und Geburtshilfe, interdisziplinäres Brustzentrum, HELIOS Klinikum Berlin Buch, Berlin
| | - N Harbeck
- Brustzentrum, Frauenklinik der Universität München (LMU), Munich
| | - J Huober
- Universitätsfrauenklinik Ulm, Brustzentrum, Ulm
| | - G von Minckwitz
- German Breast Group, Neu-Isenburg; Universitäts-Klinikum Frankfurt; Senologische Onkologie, Düsseldorf
| | - B Gerber
- Universitätsfrauenklinik Rostock, Rostock
| | - H-H Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Hanover
| | - C Liedtke
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - N Marschner
- Gemeinschaftspraxis für interdisziplinäre Onkologie und Hämatologie, Freiburg
| | - V Möbus
- Klinik für Gynäkologie und Geburtshilfe, Klinikum Frankfurt-Höchst, Frankfurt/Main
| | - H Scheithauer
- Klinik und Poliklinik für Strahlentherapie und Radioonkologie, LMU München, Munich
| | - A Schneeweiss
- Nationales Centrum für Tumorerkrankungen (NCT) und Universitätsfrauenklinik Heidelberg, Heidelberg
| | - C Thomssen
- Universitätsklinik und Poliklinik für Gynäkologie, Halle (Saale)
| | - C Jackisch
- Klinik für Gynäkologie und Geburtshilfe, Sana-Klinikum Offenbach, Offenbach
| | - M W Beckmann
- Frauenklinik des Universitätsklinikums Erlangen (Direktor), Comprehensive Cancer Center Erlangen, Erlangen
| | - J-U Blohmer
- Klinik für Gynäkologie und Brustzentrum, Charité Berlin
| | - S-D Costa
- Universitätsfrauenklinik Magdeburg, Magdeburg
| | - T Decker
- Gemeinschaftspraxis Onkologie, Ravensburg, Ravensburg
| | - I Diel
- Gemeinschaftspraxis Gynäkologie und Geburtshilfe, Mannheim
| | - P A Fasching
- Frauenklinik des Universitätsklinikums Erlangen, Comprehensive Cancer Center Erlangen-Nürnberg, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen
| | - T Fehm
- Universitätsfrauenklinik Düsseldorf, Düsseldorf
| | - W Janni
- Universitätsfrauenklinik Ulm, Ulm
| | - H-J Lück
- Gynäkologisch-onkologische Praxis, Hannover, Hanover
| | - N Maass
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - A Scharl
- Frauenklinik, Klinikum St. Marien, Amberg
| | - S Loibl
- German Breast Group, Neu-Isenburg; Klinik für Gynäkologie und Geburtshilfe, Sana-Klinikum Offenbach, Offenbach
| |
Collapse
|
29
|
Goebell P, Müller L, Staehler M, Nusch A, Münz M, Koska M, Jänicke M, Marschner N. 6 Survival data from patients with advanced or metastatic renal cell carcinoma in routine practice differs significantly compared to clinical trial data – analyses from the German clinical RCC Registry. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/s1569-9056(15)60009-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
30
|
von Minckwitz G, Puglisi F, Cortes J, Vrdoljak E, Marschner N, Zielinski C, Villanueva C, Romieu G, Láng I, Ciruelos E, De Laurentiis M, Veyret C, De Ducla S, Freudensprung U, Srock S, Gligorov J. Efficacy and Safety in Tania, a Randomised Phase III Trial of Continued or Reintroduced Bevacizumab (Bev) After 1St-Line Bev for Her2-Negative Locally Recurrent/Metastatic Breast Cancer (Lr/Mbc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu329.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
31
|
Welt A, Marschner N, Lerchenmüller C, Decker T, Salat C, Busies S, Hegewisch-Becker S. Final Efficacy and Safety Analysis of the Carin Phase III Trial: Capecitabine (Cap) and Bevacizumab (Bev) with or Without Vinorelbine (Vin) in 1St Line Metastatic Breast Cancer (Mbc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu329.9] [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
|
32
|
Quidde J, Arnold D, Hegewisch-Becker S, Graeven U, Lerchenmüller C, Killing B, Depenbusch R, Steffens C, Lange T, Marschner N, Dietrich G, Al-Batran S. Quality of Life (Qol) in Patients with Metastatic Colorectal Cancer (Mcrc) Receiving Maintenance Therapy After First-Line Inductive Treatment: a Qol Sub-Analysis of the Aio Krk 0207 Phase III Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
33
|
Welt A, Lerchenmüller C, Decker T, Marschner N, Salat C, Hegewisch-Becker S. Abstract P3-13-01: Primary efficacy endpoint analysis of the CARIN trial: Capecitabine (Cap) and bevacizumab (Bev) with or without vinorelbine (Vin) in first line metastatic breast cancer (MBC). Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-13-01] [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 RIBBON-1, the combination of Bev with Cap as 1st-line therapy for MBC significantly improved progression-free survival (PFS) compared with Cap alone, with limited impact on tolerability. Vin and Cap are active agents with few overlapping toxicities. The combination of both cytotoxic drugs in phase I/II trials showed good tolerability and promising clinical activity. The CARIN trial aims to further improve efficacy by adding Vin to Cap/Bev to establish a less toxic alternative to taxane-based 1st line therapy.
Patients and Methods:
CARIN is a multicenter randomized study comparing the efficacy of Cap plus Bev versus the same regimen combined with Vin. From 04/2009 until 10/2012 598 pts in 61 participating centers were randomized (1:1) to receive Cap 1000 mg/m2 bid days 1–14 + Bev 15 mg/kg q3w (Arm A) or Cap/Bev combined with Vin 25 mg/m2 days 1+8 (Arm B). Randomization was stratified by prior therapy with anthracycline and/or taxane (yes/no) and hormone receptor status (ER/PR +/-). Treatment was continued until progression or unacceptable toxicity. Key eligibility criteria included Her-2 negative metastatic or locally recurrent disease, no prior palliative chemotherapy for MBC, ECOG ≤2, and absence of brain metastases. Primary endpoint was progression-free survival (PFS); secondary endpoints included objective response rate, overall survival, and safety & tolerability. Baseline demographics, prior therapy and disease characteristics were well balanced. 21.5% of pts had triple negative BC, 10.6% had bone metastases only. Progression free survival data for the two treatment arms will be compared using a log-rank test. The influence of pretreatment, hormone receptor status and predictive variables on progression free survival will be analyzed within a cox regression model.
Results:
Data Cleaning and analysis will be complete by October 2013 and results for the primary endpoint PFS and secondary endpoints will be presented at the meeting.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-13-01.
Collapse
Affiliation(s)
- A Welt
- West German Cancer Center, University Hospital, Essen, Germany; Onkologische Schwerpunktpraxis, Münster, Germany; Onkologische Schwerpunktpraxis, Ravensburg, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Onkologische Schwerpunktpraxis, München, Germany; Onkologische Schwerpunktpraxis, Hamburg, Germany
| | - C Lerchenmüller
- West German Cancer Center, University Hospital, Essen, Germany; Onkologische Schwerpunktpraxis, Münster, Germany; Onkologische Schwerpunktpraxis, Ravensburg, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Onkologische Schwerpunktpraxis, München, Germany; Onkologische Schwerpunktpraxis, Hamburg, Germany
| | - T Decker
- West German Cancer Center, University Hospital, Essen, Germany; Onkologische Schwerpunktpraxis, Münster, Germany; Onkologische Schwerpunktpraxis, Ravensburg, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Onkologische Schwerpunktpraxis, München, Germany; Onkologische Schwerpunktpraxis, Hamburg, Germany
| | - N Marschner
- West German Cancer Center, University Hospital, Essen, Germany; Onkologische Schwerpunktpraxis, Münster, Germany; Onkologische Schwerpunktpraxis, Ravensburg, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Onkologische Schwerpunktpraxis, München, Germany; Onkologische Schwerpunktpraxis, Hamburg, Germany
| | - C Salat
- West German Cancer Center, University Hospital, Essen, Germany; Onkologische Schwerpunktpraxis, Münster, Germany; Onkologische Schwerpunktpraxis, Ravensburg, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Onkologische Schwerpunktpraxis, München, Germany; Onkologische Schwerpunktpraxis, Hamburg, Germany
| | - S Hegewisch-Becker
- West German Cancer Center, University Hospital, Essen, Germany; Onkologische Schwerpunktpraxis, Münster, Germany; Onkologische Schwerpunktpraxis, Ravensburg, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Onkologische Schwerpunktpraxis, München, Germany; Onkologische Schwerpunktpraxis, Hamburg, Germany
| |
Collapse
|
34
|
Ramalingam S, Crawford J, Chang A, Manegold C, Perez-Soler R, Douillard JY, Thatcher N, Barlesi F, Owonikoko T, Wang Y, Pultar P, Zhu J, Malik R, Giaccone G, Della-Fiorentina S, Begbie S, Jennens R, Dass J, Pittman K, Ivanova N, Koynova T, Petrov P, Tomova A, Tzekova V, Couture F, Hirsh V, Burkes R, Sangha R, Ambrus M, Janaskova T, Musil J, Novotny J, Zatloukal P, Jakesova J, Klenha K, Roubec J, Vanasek J, Fayette J, Barlesi F, Bennouna-Louridi J, Chouaid C, Mazières J, Vallerand H, Robinet G, Souquet PJ, Spaeth D, Schott R, Lena H, Martinet Y, El Kouri C, Baize N, Scherpereel A, Molinier O, Fuchs F, Josten K, Manegold C, Marschner N, Schneller F, Overbeck T, Thomas M, von Pawel J, Reck M, Schuette W, Hagen V, Schneider CP, Georgoulias V, Varthalitis I, Zarogoulidis K, Syrigos K, Papandreou C, Bocskei C, Csanky E, Juhasz E, Losonczy G, Mark Z, Molnar I, Papai-Szekely Z, Tehenes S, Vinkler I, Almel S, Bakshi A, Bondarde S, Maru A, Pathak A, Pedapenki R, Prasad K, Prasad S, Kilara N, Gorijavolu D, Deshmukh C, John S, Sharma L, Amoroso D, Bajetta E, Bidoli P, Bonetti A, De Marinis F, Maio M, Passalacqua R, Cascinu S, Bearz A, Bitina M, Brize A, Purkalne G, Skrodele M, Baba A, Ratnavelu K, Saw M, Samson-Fernando M, Ladrera G, Jassem J, Koralewski P, Serwatowski P, Krzakowski M, Cebotaru C, Filip D, Ganea-Motan D, Ianuli C, Manolescu I, Udrea A, Burdaeva O, Byakhov M, Filippov A, Lazarev S, Mosin I, Orlov S, Udovitsa D, Khorinko A, Protsenko S, Chang A, Lim H, Tan Y, Tan E, Bastus Piulats R, Garcia-Foncillas J, Valdivia J, de Castro J, Domine Gomez M, Kim S, Lee JS, Kim H, Lee J, Shin S, Kim DW, Kim YC, Park K, Chang CS, Chang GC, Goan YG, Su WC, Tsai CM, Kuo HP, Benekli M, Demir G, Gokmen E, Sevinc A, Crawford J, Giaccone G, Haigentz M, Owonikoko T, Agarwal M, Pandit S, Araujo R, Vrindavanam N, Bonomi P, Berg A, Wade J, Bloom R, Amin B, Camidge R, Hill D, Rarick M, Flynn P, Klein L, Lo Russo K, Neubauer M, Richards P, Ruxer R, Savin M, Weckstein D, Rosenberg R, Whittaker T, Richards D, Berry W, Ottensmeier C, Dangoor A, Steele N, Summers Y, Rankin E, Rowley K, Giridharan S, Kristeleit H, Humber C, Taylor P. Talactoferrin alfa versus placebo in patients with refractory advanced non-small-cell lung cancer (FORTIS-M trial). Ann Oncol 2013; 24:2875-80. [DOI: 10.1093/annonc/mdt371] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
35
|
Steinmetz T, Tschechne B, Harlin O, Klement B, Franzem M, Wamhoff J, Tesch H, Rohrberg R, Marschner N. Clinical experience with ferric carboxymaltose in the treatment of cancer- and chemotherapy-associated anaemia. Ann Oncol 2013; 24:475-482. [PMID: 23071262 PMCID: PMC3551483 DOI: 10.1093/annonc/mds338] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [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: 04/16/2012] [Revised: 07/05/2012] [Accepted: 07/12/2012] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Intravenous (i.v.) iron can improve anaemia of chronic disease and response to erythropoiesis-stimulating agents (ESAs), but data on its use in practice and without ESAs are limited. This study evaluated effectiveness and tolerability of ferric carboxymaltose (FCM) in routine treatment of anaemic cancer patients. PATIENTS AND METHODS Of 639 patients enrolled in 68 haematology/oncology practices in Germany, 619 received FCM at the oncologist's discretion, 420 had eligible baseline haemoglobin (Hb) measurements, and 364 at least one follow-up Hb measurement. Data of transfused patients were censored from analysis before transfusion. RESULTS The median total iron dose was 1000 mg per patient (interquartile range 600-1500 mg). The median Hb increase was comparable in patients receiving FCM alone (1.4 g/dl [0.2-2.3 g/dl; N = 233]) or FCM + ESA (1.6 g/dl [0.7-2.4 g/dl; N = 46]). Patients with baseline Hb up to 11.0 g/dl and serum ferritin up to 500 ng/ml benefited from FCM treatment (stable Hb ≥ 11.0 g/dl). Also patients with ferritin >500 ng/ml but low transferrin saturation benefited from FCM treatment. FCM was well tolerated, 2.3% of patients reported putative drug-related adverse events. CONCLUSIONS The substantial Hb increase and stabilisation at 11-12 g/dl in FCM-treated patients suggest a role for i.v. iron alone in anaemia correction in cancer patients.
Collapse
Affiliation(s)
- T Steinmetz
- Outpatient Clinic for Oncology and Haematology, Cologne.
| | - B Tschechne
- Klinikum Neustadt am Rübenberge, Neustadt am Rübenberge
| | | | - B Klement
- Vifor Pharma, Glattbrugg, Switzerland
| | | | | | - H Tesch
- Outpatient Clinic, Im Pruefling, Frankfurt
| | | | - N Marschner
- Practice for Oncology and Hematology, Freiburg, German
| |
Collapse
|
36
|
Schmidt M, Rüttinger D, Sebastian M, Hanusch CA, Marschner N, Baeuerle PA, Wolf A, Göppel G, Oruzio D, Schlimok G, Steger GG, Wolf C, Eiermann W, Lang A, Schuler M. Phase IB study of the EpCAM antibody adecatumumab combined with docetaxel in patients with EpCAM-positive relapsed or refractory advanced-stage breast cancer. Ann Oncol 2012; 23:2306-2313. [PMID: 22357251 DOI: 10.1093/annonc/mdr625] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [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: 10/06/2023] Open
Abstract
BACKGROUND Targeted therapy options in HER2-negative breast cancer are limited. This open-label, multicenter phase IB dose-escalation trial was conducted to determine safety, tolerability, and antitumor activity of a combination of docetaxel (Taxotere) and increasing doses of adecatumumab, a human IgG1 antibody targeting epithelial cell adhesion molecule (EpCAM), in EpCAM-positive relapsed or primary refractory advanced-stage breast cancer. PATIENTS AND METHODS Patients pretreated with up to four prior chemotherapy regimens received increasing adecatumumab doses either every 3 weeks (q3w) or weekly (qw) combined with docetaxel (100 mg/m(2) q3w). Primary end points were safety and tolerability. Antitumor activity was evaluated according to RECIST. Clinical benefit was defined as complete or partial response or stable disease for ≥24 weeks. RESULTS Thirty-one evaluable patients were treated. Most adverse events were mild to moderate in severity. Neutropenia, leukocytopenia, lymphopenia, and diarrhea (dose-limiting) were the most frequent toxic effects. Maximum tolerated doses of adecatumumab given in combination with docetaxel were 550 mg/m(2) q3w and 360 mg/m(2) qw. Clinical benefit was observed in 44% of patients treated with q3w adecatumumab and docetaxel, increasing to 63% in patients with high EpCAM-expressing tumors. CONCLUSION Combination therapy of adecatumumab and docetaxel is safe, feasible, and potentially active in heavily pretreated advanced-stage breast cancer.
Collapse
Affiliation(s)
- M Schmidt
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - D Rüttinger
- Micromet, Inc., Bethesda, USA; Micromet AG, Munich
| | - M Sebastian
- Department of Internal Medicine III, University Medical Center of the Johannes Gutenberg University Mainz, Mainz
| | | | - N Marschner
- Practice for Oncology and Hematology, Freiburg
| | - P A Baeuerle
- Micromet, Inc., Bethesda, USA; Micromet AG, Munich
| | - A Wolf
- Micromet, Inc., Bethesda, USA; Micromet AG, Munich
| | - G Göppel
- Micromet, Inc., Bethesda, USA; Micromet AG, Munich
| | - D Oruzio
- Hospital Augsburg, II. Medical Center, Augsburg, Germany
| | - G Schlimok
- Hospital Augsburg, II. Medical Center, Augsburg, Germany
| | - G G Steger
- Medical University Vienna, Department of Oncology, Vienna, Austria
| | - C Wolf
- Cooperative Breast Center, Ulm, Germany
| | - W Eiermann
- Gynecological Hospital Red Cross, Munich
| | - A Lang
- State Hospital Feldkirch at State Hospital Rankweil, Rankweil, Austria
| | - M Schuler
- Department of Medical Oncology, West German Cancer Center, University Duisburg-Essen, Essen, Germany.
| |
Collapse
|
37
|
Steinmetz H, Tschechne B, Virgin G, Klement B, Rzychon B, Franzem M, Wamhoff J, Tesch H, Rohrberg R, Marschner N. 3000 POSTER DISCUSSION Effectiveness and Tolerability of Ferric Carboxymaltose in the Correction of Cancer – and Chemotherapy-associated Anaemia – a Multicenter Observational Study. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71073-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
38
|
Untch M, Gerber B, Möbus V, Schneeweiss A, Thomssen C, Minckwitz GV, Beckmann M, Blohmer JU, Costa SD, Diedrich K, Diel I, Eiermann W, Friese K, Harbeck N, Hilfrich J, Jackisch C, Janni W, Jänicke F, Jonat W, Kaufmann M, Kiechle M, Köhler U, Kreienberg R, Maass N, Marschner N, Nitz U, Scharl A, Wallwiener D. St.-Gallen-Konferenz 2011 zum primären Mammakarzinom. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0030-1271133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
39
|
Hegewisch-Becker S, Lerchenmuller CA, Welt A, Decker T, Just M, Steffens C, Hipper A, Marschner N. Capecitabine (Cap) combined with bevacizumab (Bev) with or without vinorelbine (Vin) in first-line metastatic breast cancer (MBC): First safety results from the randomized CARIN trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
40
|
Steinmetz T, Tschechne B, Virgin G, Felder M, Wamhoff J, Tesch H, Rohrberg R, Marschner N. Clinical experience with ferric carboxymaltose as treatment of cancer-associated anemia. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19561] [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: 11/20/2022] Open
|
41
|
Herrmann E, Marschner N, Grimm M, Ohlmann CH, Hutzschenreuther U, Overkamp F, Groschek M, Blumenstengel K, Steiner T. Sequential therapies with sorafenib and sunitinib in advanced or metastatic renal cell carcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15061] [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: 11/20/2022] Open
|
42
|
Herrmann E, Marschner N, Grimm MO, Ohlmann CH, Hutzschenreuter U, Overkamp F, Groschek M, Blumenstengel K, Pühse G, Steiner T. Sequential therapies with sorafenib and sunitinib in advanced or metastatic renal cell carcinoma. World J Urol 2011; 29:361-6. [PMID: 21461939 DOI: 10.1007/s00345-011-0673-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Accepted: 03/08/2011] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To investigate whether patients with metastatic renal cell carcinoma benefit from sequential therapies with the tyrosine kinase inhibitors (TKIs) sorafenib and sunitinib. PATIENTS AND METHODS A total of 89 patients were treated in nine German centres between 2002 and 2009. The TKI sequence started as first-, second- or third-line therapy after prior chemo- or immunotherapy. When progression was diagnosed, treatment was switched to the second TKI until further progression. RESULTS Overall progression-free survival (PFS) of patients receiving sunitinib followed by sorafenib shows no statistically significant difference to patients receiving sorafenib followed by sunitinib (15.4 months vs. 12.1 months). The secondary use of sorafenib resulted in a median PFS of 3.8 months if the TKI sequence had been started as a first-line treatment and of 3.5 months if the TKI sequence had been started second-line treatment. The secondary use of sunitinib resulted in a median PFS of 3.4 and 4.0 months, respectively. OS was 28.8 months for all patients, without a statistically significant difference between the two groups. CONCLUSIONS This study endorses the notion of a clinical benefit of the sequential use of sorafenib and sunitinib and supports observations from previous studies. In terms of the optimal succession of the two TKIs, the study does not allow a definite answer.
Collapse
Affiliation(s)
- E Herrmann
- Department of Urology, University of Münster, Albert-Schweitzer Strasse 33, 48149 Münster, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Mueller L, Goebell P, Blumenstengel K, Lueck A, Koska M, Marschner N. Real-life treatment of patients with advanced or metastatic renal cell carcinoma in German oncology and urology outpatient centers (RCC-Registry). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.367] [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: 11/20/2022] Open
Abstract
367 Background: Until 2006, advanced or metastatic renal cell carcinoma (mRCC) patients were treated with immunomodulators such as interleukins and interferons. Multiple new targeted therapeutics, mainly signal transduction inhibitors, have been developed resulting in fundamental changes of therapeutic standards for patients with mRCC. In 2007, recruitment into the registry started in order to survey the treatment of mRCC patients, the course of disease and treatment as well as the therapeutic decision-making processes. Methods: It is intended to enroll 1,000 mRCC patients and collect data for each case for a maximum of 3 years. Over 100 oncology and urology outpatient centers in Germany are participating. Inclusion Criteria: (1) patients with metastatic or locally advanced RCC requiring antineoplastic therapy, (2) start of first palliative therapy within 1 year before enrolment, (3) age at least 18 years, and (4) Informed written consent. Results: By May 2010, 509 patients were enrolled. At the start of systemic therapy mean age were 66.2 years for male and 69.0 years for female patients, respectively. Patients have a Charlson Comorbidity Index of 1.0. More than 94% of patients had metastases at inclusion. 62.8% of the patients received sunitinib as first-line treatment, 12.0% received temsirolimus, 9.6% were treated with bevacizumab/interferon alpha, and 9.1% received sorafenib. Median duration determined using Kaplan-Meier analyses of first-line treatment with: sunitinib: 8.5 months (n=319), temsirolimus: 2.6 months (n=60), bevacizumab/interferon alpha: 4.6 months (n=49), and sorafenib: 6.7 months (n=45) whereby the duration of ongoing therapies was censored as the date of last documentation; thus the final duration might exceed the given values. After first-line treatment with sunitinib most of the patients received either sorafenib (12.4%, n=63) or temsirolimus (7.7%, n=39) in the second line. Conclusions: The registry provides an overview of the current treatment of mRCC patients in German outpatient cancer centers and shows how fast the insights of clinical studies concerning treatment of mRCC patients are transferred into current medical practice. [Table: see text]
Collapse
Affiliation(s)
- L. Mueller
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
| | - P. Goebell
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
| | - K. Blumenstengel
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
| | - A. Lueck
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
| | - M. Koska
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
| | - N. Marschner
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
| |
Collapse
|
44
|
Karthaus M, Karapetis CS, Brown M, Pavlakis N, Trarbach T, Marschner N, Duerk HA, Manzione L. A randomized, double-blind, placebo-controlled trial for prevention of oxaliplatin-induced neuropathy symptoms with pregabalin. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.553] [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: 11/20/2022] Open
Abstract
553 Background: Sensorial peripheral neuropathy (PNP) is a major limitation for pts receiving oxaliplatin-based ctx for CRC. Pregabalin is widely used for treatment of oxaliplatin-induced PNP. We evaluated the efficacy of pregabalin vs. placebo for the prevention of paresthesia from the onset of oxaliplatin-based ctx over each cycle. Methods: Rd, db, placebo-controlled study in adult CRC pts with ECOG 0-2 to undergo a new oxaliplatin/5-FU/FA-based ctx. Pts were excluded if they had neuropathic pain or other of painful paresthesia prior to baseline. Paresthesia, dysesthesia, and pain were rated on a numerical scale (NRS 0-10) every day. Primary endpoint was the time of onset of persistent symptoms (NRS >4). Results: Of the 69 screened pts, 64 were randomized and 61 received study medication (32 pregabalin vs. 29 placebo). Pts were balanced in both arms regarding age, sex, stage, and ctx. There were no differences between both treatment groups for all PNP parameters at any cycle. One pt in both arms developed paresthesia (5.3%) after 9 cycles of ctx, 1 pt had persistent pain (placebo arm). During the follow-up period persistent paresthesic, dysesthesic, and persistent pain developed in 2 vs. 1, 2 vs. 2, and 0 vs. 2 pts, respectively. The study was terminated after a blinded data review found that there were very few events of persistent symptoms, which was then confirmed an interim analysis. Nausea and anorexia were the most frequently reported AE in both groups. Conclusions: The results of this study, which was terminated early at interim analysis, is that too few patients developed persistent symptoms to allow any meaningful treatment difference for prevention of neuropathic pain related to oxaliplatin by pregabalin. There remains an unmet need for oxaliplatin-induced PNP with new trial design issues in this field urgently needed. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- M. Karthaus
- Klinikum Neuperlach, Munich, Germany; Flinders Medical Centre, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia; Royal North Shore Hospital, Sydney University, Sydney, Australia; West German Cancer Center, Essen, Germany; Praxis Onkologie, Freiburg, Germany; St. Marien-Hospital Hamm, Hamm, Germany; Hospitale San Carlo, Potenza, Italy
| | - C. S. Karapetis
- Klinikum Neuperlach, Munich, Germany; Flinders Medical Centre, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia; Royal North Shore Hospital, Sydney University, Sydney, Australia; West German Cancer Center, Essen, Germany; Praxis Onkologie, Freiburg, Germany; St. Marien-Hospital Hamm, Hamm, Germany; Hospitale San Carlo, Potenza, Italy
| | - M. Brown
- Klinikum Neuperlach, Munich, Germany; Flinders Medical Centre, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia; Royal North Shore Hospital, Sydney University, Sydney, Australia; West German Cancer Center, Essen, Germany; Praxis Onkologie, Freiburg, Germany; St. Marien-Hospital Hamm, Hamm, Germany; Hospitale San Carlo, Potenza, Italy
| | - N. Pavlakis
- Klinikum Neuperlach, Munich, Germany; Flinders Medical Centre, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia; Royal North Shore Hospital, Sydney University, Sydney, Australia; West German Cancer Center, Essen, Germany; Praxis Onkologie, Freiburg, Germany; St. Marien-Hospital Hamm, Hamm, Germany; Hospitale San Carlo, Potenza, Italy
| | - T. Trarbach
- Klinikum Neuperlach, Munich, Germany; Flinders Medical Centre, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia; Royal North Shore Hospital, Sydney University, Sydney, Australia; West German Cancer Center, Essen, Germany; Praxis Onkologie, Freiburg, Germany; St. Marien-Hospital Hamm, Hamm, Germany; Hospitale San Carlo, Potenza, Italy
| | - N. Marschner
- Klinikum Neuperlach, Munich, Germany; Flinders Medical Centre, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia; Royal North Shore Hospital, Sydney University, Sydney, Australia; West German Cancer Center, Essen, Germany; Praxis Onkologie, Freiburg, Germany; St. Marien-Hospital Hamm, Hamm, Germany; Hospitale San Carlo, Potenza, Italy
| | - H. A. Duerk
- Klinikum Neuperlach, Munich, Germany; Flinders Medical Centre, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia; Royal North Shore Hospital, Sydney University, Sydney, Australia; West German Cancer Center, Essen, Germany; Praxis Onkologie, Freiburg, Germany; St. Marien-Hospital Hamm, Hamm, Germany; Hospitale San Carlo, Potenza, Italy
| | - L. Manzione
- Klinikum Neuperlach, Munich, Germany; Flinders Medical Centre, Adelaide, Australia; Royal Adelaide Hospital, Adelaide, Australia; Royal North Shore Hospital, Sydney University, Sydney, Australia; West German Cancer Center, Essen, Germany; Praxis Onkologie, Freiburg, Germany; St. Marien-Hospital Hamm, Hamm, Germany; Hospitale San Carlo, Potenza, Italy
| | | |
Collapse
|
45
|
Karthaus M, Karapetis CS, Brown MP, Pavlakis N, Trarbach T, Marschner N, Duerk HA, Barone C, Luigi M. A randomized, double-blind, placebo-controlled trial for prevention of oxalipatin-induced peripheral neuropathy symptoms with pregabalin in patients with advanced colorectal cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
46
|
Schmidt M, Scheulen ME, Dittrich C, Obrist P, Marschner N, Dirix L, Schmidt M, Rüttinger D, Schuler M, Reinhardt C, Awada A. An open-label, randomized phase II study of adecatumumab, a fully human anti-EpCAM antibody, as monotherapy in patients with metastatic breast cancer. Ann Oncol 2009; 21:275-282. [PMID: 19633042 DOI: 10.1093/annonc/mdp314] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND High-level expression of epithelial cell adhesion molecule (EpCAM) is associated with unfavorable prognosis in breast cancer. This study was designed to investigate two doses of the fully human IgG1 anti-EpCAM antibody adecatumumab (MT201) in patients with metastatic breast cancer (MBC). METHODS A total of 109 patients were stratified into high- and low-level EpCAM expression by immunohistochemical staining of primary tumors and subsequently randomly assigned to receive monotherapy with either high- (6 mg/kg every two weeks (q2w)) or low-dose adecatumumab (2 mg/kg/ q2w) until disease progression. RESULTS No complete or partial tumor responses could be confirmed by central RECIST assessment. The probability for tumor progression was significantly lower in patients receiving high-dose adecatumumab and expressing high levels of EpCAM (hazard ratio 0.43; P = 0.0057 versus low dose and low EpCAM). Three of 18 patients with highest EpCAM expression treated with adecatumumab developed new metastases up to week 6, compared with 14 of 29 patients with low EpCAM. Most frequent treatment-related adverse events (high dose/low dose) were chills (59%/20%), nausea (55%/18%), fatigue (39%/23%) and diarrhea (43%/7%). CONCLUSIONS Single-agent adecatumumab shows dose- and target-dependent clinical activity in EpCAM-positive MBC, albeit no objective tumor regression. Further investigation of adecatumumab in patients with EpCAM-overexpressing tumors and lower tumor burden is warranted.
Collapse
Affiliation(s)
- M Schmidt
- Department of Obstetrics and Gynecology, Johannes Gutenberg University, Mainz
| | - M E Scheulen
- Department of Medicine (Cancer Research), West German Cancer Center, University Hospital Essen, Essen, Germany
| | - C Dittrich
- Third Medical Department, Centre for Oncology and Hematology, CEADDP, Applied Cancer Research, Institution for Translational Research Vienna, Vienna; Ludwig Boltzmann-Institute for Applied Cancer Research, Vienna
| | - P Obrist
- Department of Pathology, St Vinzenz Hospital, Zams, Austria
| | - N Marschner
- Practice for Oncology and Hematology, Freiburg, Germany
| | - L Dirix
- Medical Oncology Unit, Oncologisch Centrum Sint-Augustinus, Antwerp, Belgium
| | - M Schmidt
- Clinical Development, Micromet AG, Munich, Germany
| | - D Rüttinger
- Clinical Development, Micromet AG, Munich, Germany
| | - M Schuler
- Department of Medicine (Cancer Research), West German Cancer Center, University Hospital Essen, Essen, Germany
| | - C Reinhardt
- Clinical Development, Micromet AG, Munich, Germany.
| | - A Awada
- Institut Jules Bordet, Unité Chemiothérapie, Université Libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
47
|
Sebastian M, Hanusch C, Schmidt M, Marschner N, Oruzio D, Wolf C, Reinhardt C, Eiermann W, Rüttinger D, Schuler M. Safety and antitumor activity of 3-weekly anti-EpCAM antibody adecatumumab (MT201) in combination with docetaxel for patients with metastatic breast cancer: Results of a multicenter phase Ib trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1009 Background: The fully human IgG1 antibody adecatumumab (MT201) binds to the epithelial cell adhesion molecule (EpCAM), which is expressed in over 90% of breast cancers and has been associated with poor prognosis. Data from a previous phase II study in metastatic breast cancer (MBC) indicated that single agent MT201 could prolong progression-free survival in a subset of patients with high EpCAM expression. This study tested safety and tolerability of MT201 treatment in combination with standard docetaxel. Methods: Relapsed or primary refractory, EpCAM-positive MBC patients were treated with docetaxel (100 mg/m2 q21d) in combination with MT201 (dose levels 180 mg/m2, and 550 mg/m2 q21d). A loading dose of 100 mg/m2 and 300 mg/m2, respectively, was administered on day 1 and 7. Patients were grouped into high- and low-level EpCAM expression. Primary objectives were safety and tolerability; anti-tumor activity according to RECIST was a secondary objective. Results: A total of 22 patients with a median of 3 prior chemotherapy lines were enrolled. Most frequent grade 3/4 adverse events (AE) in all patients were leucopenia (90%), neutropenia (77%), lymphopenia (68%), and diarrhea (23%). No evidence for aggravation of grade 3/4 toxicities typically associated with docetaxel was found. The dose level 550 mg/m2 q21d has been determined as MTD in combination with 100 mg/m2 q21d docetaxel. The overall response rate (CR/PR; RECIST) and clinical benefit rate (CR/PR and SD>24wks) in all evaluable patients was 24% and 41%, respectively. Patients with high EpCAM expression showed a response rate of 43%, whereas patients with low EpCAM expression had a response rate of 10%. Median time-to-progression (TTP) in all evaluable patients was 165 days. Conclusions: Combining MT201 with docetaxel for the treatment of MBC appears to be safe and feasible. The DLT of this combination were short and manageable episodes of grade 3 diarrhea. The response rate and TTP observed in this heavily pre-treated population is encouraging and warrant further development of MT201/chemotherapy combinations in patients with tumors of high EpCAM target level. [Table: see text]
Collapse
Affiliation(s)
- M. Sebastian
- Johannes Gutenberg University, Mainz, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Zentralklinikum Augsburg, Augsburg, Germany; Medizinisches Zentrum Ulm, Ulm, Germany; Micromet AG, Munich, Germany; University Hospital Essen, Essen, Germany
| | - C. Hanusch
- Johannes Gutenberg University, Mainz, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Zentralklinikum Augsburg, Augsburg, Germany; Medizinisches Zentrum Ulm, Ulm, Germany; Micromet AG, Munich, Germany; University Hospital Essen, Essen, Germany
| | - M. Schmidt
- Johannes Gutenberg University, Mainz, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Zentralklinikum Augsburg, Augsburg, Germany; Medizinisches Zentrum Ulm, Ulm, Germany; Micromet AG, Munich, Germany; University Hospital Essen, Essen, Germany
| | - N. Marschner
- Johannes Gutenberg University, Mainz, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Zentralklinikum Augsburg, Augsburg, Germany; Medizinisches Zentrum Ulm, Ulm, Germany; Micromet AG, Munich, Germany; University Hospital Essen, Essen, Germany
| | - D. Oruzio
- Johannes Gutenberg University, Mainz, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Zentralklinikum Augsburg, Augsburg, Germany; Medizinisches Zentrum Ulm, Ulm, Germany; Micromet AG, Munich, Germany; University Hospital Essen, Essen, Germany
| | - C. Wolf
- Johannes Gutenberg University, Mainz, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Zentralklinikum Augsburg, Augsburg, Germany; Medizinisches Zentrum Ulm, Ulm, Germany; Micromet AG, Munich, Germany; University Hospital Essen, Essen, Germany
| | - C. Reinhardt
- Johannes Gutenberg University, Mainz, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Zentralklinikum Augsburg, Augsburg, Germany; Medizinisches Zentrum Ulm, Ulm, Germany; Micromet AG, Munich, Germany; University Hospital Essen, Essen, Germany
| | - W. Eiermann
- Johannes Gutenberg University, Mainz, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Zentralklinikum Augsburg, Augsburg, Germany; Medizinisches Zentrum Ulm, Ulm, Germany; Micromet AG, Munich, Germany; University Hospital Essen, Essen, Germany
| | - D. Rüttinger
- Johannes Gutenberg University, Mainz, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Zentralklinikum Augsburg, Augsburg, Germany; Medizinisches Zentrum Ulm, Ulm, Germany; Micromet AG, Munich, Germany; University Hospital Essen, Essen, Germany
| | - M. Schuler
- Johannes Gutenberg University, Mainz, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; Onkologische Schwerpunktpraxis, Freiburg, Germany; Zentralklinikum Augsburg, Augsburg, Germany; Medizinisches Zentrum Ulm, Ulm, Germany; Micromet AG, Munich, Germany; University Hospital Essen, Essen, Germany
| |
Collapse
|
48
|
Marschner N, Kreienberg R, Balas R, Brandtner M, Schlingensiepen R, Schumann S, Büttner S, Staab H, Rauschning W. Droloxifen bei postmenopausalen Patientinnen mit metastasiertem Mammakarzinom: Doppelblind randomisierte Phase-ll-Studie. Oncol Res Treat 2009. [DOI: 10.1159/000218507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
49
|
Miller K, Bergmann L, Albers P, Jäger E, Jakse G, Geschwend JE, Marschner N. [Interdisciplinary recommendations on targeted therapy in the treatment of renal cell carcinoma]. Aktuelle Urol 2007; 38:328-30. [PMID: 17647172 DOI: 10.1055/s-2007-980093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 10/23/2022]
Abstract
Recently, new data have been published on the treatment of metastasized renal cell cancer using targeted therapies. With the approval of the tyrosine kinase inhibitors Sunitinib and Sorafenib, two of these new therapies are now available in clinical practice. This has raised both new opportunities and new questions for the health care professionals involved. Here we report on a consensus conference addressing these questions with answers based on evidence from the recent literature.
Collapse
Affiliation(s)
- K Miller
- Urologische Klinik, Charité Berlin, Germany.
| | | | | | | | | | | | | |
Collapse
|
50
|
Awada AH, Schmidt M, Scheulen ME, Obrist P, Marschner N, Dirix L, Dittrich C, Reinhardt C, Schuler M. Final results from an open-label, randomised, phase II study of adecatumumab (MT201), a fully human anti-EpCAM antibody, in patients with metastatic breast cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.3588] [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: 11/20/2022] Open
Abstract
3588 Background: High-level expression of the epithelial cell adhesion molecule (EpCAM) has been associated with unfavourable prognosis in various cancers. Adecatumumab was developed as a low-affinity IgG1 antibody targeting EpCAM-positive cancer cells. Methods: EpCAM-positive metastatic breast cancer patients without CNS metastases, with no indication for trastuzumab were eligible; an initial restriction to a maximum of one previous chemotherapy for metastatic disease was subsequently removed. 109 EpCAM- positive patients were enrolled. Patients were stratified into high- and low-level EpCAM expression (n = 74 and 35, respectively) according to immuno-histochemistry testing, and subsequently randomised to receive either high-dose (6 mg/kg/q2w) or low-dose (2 mg/kg/q2w) adecatumumab (n = 54 and 55, respectively). Primary endpoint was clinical benefit rate (CBR = objective response + stable disease) at week 24 with secondary parameters exploring time to progression (TTP) and safety. Results: The primary endpoint (CBR at week 24: >25%) was not met in any of the 4 groups according to central radiological review. Exploratory analyses of the Kaplan-Meier curves, however, showed a lower probability for tumor progression in patients receiving high dose adecatumumab (HR: 0.67 [0.47–0.94]; p=0.047). A similar trend was also observed in patients with high-level EpCAM expression (HR: 0.71 [0.49–1.03]; p=0.116). Further (retrospective) analysis using more stringent criteria for the definition of high-level EpCAM expression indicated an inverse correlation of staining intensity and frequency with probability of progression. An increased incidence of CTC grade 1 and 2 AE was found in the high-dose group with main side effects being gastrointestinal and constitutional symptoms. Conclusions: The observation of dose- and target-dependent activity of adecatumumab warrants further investigation. Definition of the optimum dose and regimen as well as exploration of the predictive value of EpCAM testing will be key in future development. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- A. H. Awada
- Jules Bordet Institute, Brussels, Belgium; Klinikum der Johannes Gutenberg-Universität, Mainz, Germany; Universitätsklinikum Essen, Essen, Germany; Pathologie-Labor, Zams, Austria; Onkologische Schwerpunktpraxis Dr. Marschner, Freiburg, Germany; Algemeen Ziekenhuis St. Augustinus, Wilrijk, Belgium; Sozialmed. Zentrum Süd–Kaiser-Franz-Josef-Spital, Vienna, Austria; Micromet AG, Munich, Germany
| | - M. Schmidt
- Jules Bordet Institute, Brussels, Belgium; Klinikum der Johannes Gutenberg-Universität, Mainz, Germany; Universitätsklinikum Essen, Essen, Germany; Pathologie-Labor, Zams, Austria; Onkologische Schwerpunktpraxis Dr. Marschner, Freiburg, Germany; Algemeen Ziekenhuis St. Augustinus, Wilrijk, Belgium; Sozialmed. Zentrum Süd–Kaiser-Franz-Josef-Spital, Vienna, Austria; Micromet AG, Munich, Germany
| | - M. E. Scheulen
- Jules Bordet Institute, Brussels, Belgium; Klinikum der Johannes Gutenberg-Universität, Mainz, Germany; Universitätsklinikum Essen, Essen, Germany; Pathologie-Labor, Zams, Austria; Onkologische Schwerpunktpraxis Dr. Marschner, Freiburg, Germany; Algemeen Ziekenhuis St. Augustinus, Wilrijk, Belgium; Sozialmed. Zentrum Süd–Kaiser-Franz-Josef-Spital, Vienna, Austria; Micromet AG, Munich, Germany
| | - P. Obrist
- Jules Bordet Institute, Brussels, Belgium; Klinikum der Johannes Gutenberg-Universität, Mainz, Germany; Universitätsklinikum Essen, Essen, Germany; Pathologie-Labor, Zams, Austria; Onkologische Schwerpunktpraxis Dr. Marschner, Freiburg, Germany; Algemeen Ziekenhuis St. Augustinus, Wilrijk, Belgium; Sozialmed. Zentrum Süd–Kaiser-Franz-Josef-Spital, Vienna, Austria; Micromet AG, Munich, Germany
| | - N. Marschner
- Jules Bordet Institute, Brussels, Belgium; Klinikum der Johannes Gutenberg-Universität, Mainz, Germany; Universitätsklinikum Essen, Essen, Germany; Pathologie-Labor, Zams, Austria; Onkologische Schwerpunktpraxis Dr. Marschner, Freiburg, Germany; Algemeen Ziekenhuis St. Augustinus, Wilrijk, Belgium; Sozialmed. Zentrum Süd–Kaiser-Franz-Josef-Spital, Vienna, Austria; Micromet AG, Munich, Germany
| | - L. Dirix
- Jules Bordet Institute, Brussels, Belgium; Klinikum der Johannes Gutenberg-Universität, Mainz, Germany; Universitätsklinikum Essen, Essen, Germany; Pathologie-Labor, Zams, Austria; Onkologische Schwerpunktpraxis Dr. Marschner, Freiburg, Germany; Algemeen Ziekenhuis St. Augustinus, Wilrijk, Belgium; Sozialmed. Zentrum Süd–Kaiser-Franz-Josef-Spital, Vienna, Austria; Micromet AG, Munich, Germany
| | - C. Dittrich
- Jules Bordet Institute, Brussels, Belgium; Klinikum der Johannes Gutenberg-Universität, Mainz, Germany; Universitätsklinikum Essen, Essen, Germany; Pathologie-Labor, Zams, Austria; Onkologische Schwerpunktpraxis Dr. Marschner, Freiburg, Germany; Algemeen Ziekenhuis St. Augustinus, Wilrijk, Belgium; Sozialmed. Zentrum Süd–Kaiser-Franz-Josef-Spital, Vienna, Austria; Micromet AG, Munich, Germany
| | - C. Reinhardt
- Jules Bordet Institute, Brussels, Belgium; Klinikum der Johannes Gutenberg-Universität, Mainz, Germany; Universitätsklinikum Essen, Essen, Germany; Pathologie-Labor, Zams, Austria; Onkologische Schwerpunktpraxis Dr. Marschner, Freiburg, Germany; Algemeen Ziekenhuis St. Augustinus, Wilrijk, Belgium; Sozialmed. Zentrum Süd–Kaiser-Franz-Josef-Spital, Vienna, Austria; Micromet AG, Munich, Germany
| | - M. Schuler
- Jules Bordet Institute, Brussels, Belgium; Klinikum der Johannes Gutenberg-Universität, Mainz, Germany; Universitätsklinikum Essen, Essen, Germany; Pathologie-Labor, Zams, Austria; Onkologische Schwerpunktpraxis Dr. Marschner, Freiburg, Germany; Algemeen Ziekenhuis St. Augustinus, Wilrijk, Belgium; Sozialmed. Zentrum Süd–Kaiser-Franz-Josef-Spital, Vienna, Austria; Micromet AG, Munich, Germany
| |
Collapse
|