1
|
Gambardella V, Lombardi P, Carbonell-Asins JA, Tarazona N, Cejalvo JM, González-Barrallo I, Martín-Arana J, Tébar-Martínez R, Viala A, Bruixola G, Hernando C, Blasco I, Papaccio F, Martínez-Ciarpaglini C, Alfaro-Cervelló C, Seda-García E, Blesa S, Chirivella I, Castillo J, Montón-Bueno JV, Roselló S, Huerta M, Pérez-Fidalgo A, Martín-Martorell P, Insa-Mollá A, Fleitas T, Rentero-Garrido P, Zúñiga-Trejos S, Cervantes A, Roda D. Molecular profiling of advanced solid tumours. The impact of experimental molecular-matched therapies on cancer patient outcomes in early-phase trials: the MAST study. Br J Cancer 2021; 125:1261-1269. [PMID: 34493820 PMCID: PMC8548537 DOI: 10.1038/s41416-021-01502-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/14/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Molecular-matched therapies have revolutionized cancer treatment. We evaluated the improvement in clinical outcomes of applying an in-house customized Next Generation Sequencing panel in a single institution. METHODS Patients with advanced solid tumors were molecularly selected to receive a molecular-matched treatment into early phase clinical trials versus best investigators choice, according to the evaluation of a multidisciplinary molecular tumor board. The primary endpoint was progression-free survival (PFS) assessed by the ratio of patients presenting 1.3-fold longer PFS on matched therapy (PFS2) than with prior therapy (PFS1). RESULTS Of a total of 231 molecularly screened patients, 87 were eligible for analysis. Patients who received matched therapy had a higher median PFS2 (6.47 months; 95% CI, 2.24-14.43) compared to those who received standard therapy (2.76 months; 95% CI, 2.14-3.91, Log-rank p = 0.022). The proportion of patients with a PFS2/PFS1 ratio over 1.3 was significantly higher in the experimental arm (0.33 vs 0.08; p = 0.008). DISCUSSION We demonstrate the pivotal role of the institutional molecular tumor board in evaluating the results of a customized NGS panel. This process optimizes the selection of available therapies, improving disease control. Prospective randomized trials are needed to confirm this approach and open the door to expanded drug access.
Collapse
Affiliation(s)
- Valentina Gambardella
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Pasquale Lombardi
- Division of Medical Oncology, Institute for Cancer Research and Treatment, IRCCS Candiolo, Candiolo, Italy
| | | | - Noelia Tarazona
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Miguel Cejalvo
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Inés González-Barrallo
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Jorge Martín-Arana
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.,Bioinformatic and Biostatistic Unit, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Roberto Tébar-Martínez
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain.,Precision Medicine Unit, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain.,Translational Oncology Unit, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Alba Viala
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Gema Bruixola
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Cristina Hernando
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Inma Blasco
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Federica Papaccio
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy
| | - Carolina Martínez-Ciarpaglini
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.,Department of Pathology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Clara Alfaro-Cervelló
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.,Department of Pathology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Enrique Seda-García
- Precision Medicine Unit, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain.,Translational Oncology Unit, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Sebastián Blesa
- Precision Medicine Unit, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain.,Translational Oncology Unit, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Isabel Chirivella
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Josefa Castillo
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.,Department of Biochemistry and Molecular Biology, University of Valencia, Valencia, Spain
| | - José Vicente Montón-Bueno
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Susana Roselló
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Marisol Huerta
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Alejandro Pérez-Fidalgo
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Paloma Martín-Martorell
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Amelia Insa-Mollá
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Tania Fleitas
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Pilar Rentero-Garrido
- Precision Medicine Unit, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Sheila Zúñiga-Trejos
- Bioinformatic and Biostatistic Unit, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Andrés Cervantes
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain. .,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.
| | - Desamparados Roda
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain. .,Division of Medical Oncology, Institute for Cancer Research and Treatment, IRCCS Candiolo, Candiolo, Italy.
| |
Collapse
|
2
|
Calvo V, Domine M, Sullivan I, Gonzalez-Larriba JL, Ortega AL, Bernabé R, Sala MA, Campos B, De Castro J, Martín-Martorell P, Bosch-Barrera J, Mielgo X, Vilà L, Casal J, Ros S, Martinez Aguillo M, Padilla A, Sandiego S, Aires Machado J, Provencio-Pulla M. A phase III clinical trial of adjuvant chemotherapy versus chemoimmunotherapy for stage IB-IIIA completely resected non-small cell lung cancer (NSCLC) patients nadim-adjuvant: New adjuvant trial of chemotherapy versus chemoimmunotherapy. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps8581] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
TPS8581 Background: The results of current studies are considered acceptable evidence to support the hypothesis of efficacy of the proposed combination of immunotherapy with chemotherapy (CT-IO) in patients with NSCLC stages Ib-IIIA candidates for adjuvant treatment. Methods: This is an open-label, randomised, two-arm, phase III, multi-centre clinical trial. Primary objective and endpoint: The primary objective is disease free survival (DFS) defined time from randomization to the earliest event defined as disease recurrence, any new lung cancer (even in the opposite lung), or death from any cause at any known point in time Sample size: 210 patients NSCLC stages Ib-IIIA (Experimental Arm (Adjuvant Chemotherapy-Inmunotherapy + maintenance adjuvant Inmunotherapy): 105 patients, Control Arm (Adjuvant Chemotherapy): 105 patients Treatment Patients randomised to the experimental arm will receive Nivolumab 360mg + Paclitaxel 200mg/m2 + Carboplatin AUC5 for 4 cycles every 21 days (+/- 3 days) as adjuvant treatment followed by maintenance adjuvant treatment for 6 cycles with Nivolumab 480 mg Q4W (+/- 3 days). Patients randomized to the control arm will receive Paclitaxel 200mg/m2 + Carboplatin AUC5 for 4 cycles every 21 days (+/- 3 days) followed by 2 observation visits. Total trial duration: 6.5 years, 3.5 years of recruitment, 1 year of adjuvant treatment or observation and 2 years of follow up. The start date was January 2021. The estimated primary completion date is June 2027. Clinical trial information: NCT04564157.
Collapse
Affiliation(s)
- Virginia Calvo
- Instituto Investigacion Sanitaria Puerta de Hierro-Segovia de Arana, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Manuel Domine
- Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Ivana Sullivan
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Reyes Bernabé
- Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | | | - Javier De Castro
- Translational Oncology Unit at Medical Oncology Division, Hospital Universitario La Paz, IdipAZ, Madrid, Spain
| | | | | | - Xabier Mielgo
- Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - Laia Vilà
- Parc Taulí University Hospital, Parc Taulí Institute of Research and Innovation I3PT, Barcelona Autonomous University, Spain, Sabadell, Spain
| | | | - Silver Ros
- Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | - Airam Padilla
- Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | | | - Jonathan Aires Machado
- Department of Clinical Oncology, University Hospital San Pedro de Alcántara, Cáceres, Spain
| | - Mariano Provencio-Pulla
- Instituto Investigacion Sanitaria Puerta de Hierro-Segovia de Arana, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| |
Collapse
|
3
|
Martín-Martorell P, Gonzalez-Barrallo I, Gambardella V, Cejalvo JM, Cervantes A. In the literature: April 2021. ESMO Open 2021; 6:100116. [PMID: 33887688 PMCID: PMC8086009 DOI: 10.1016/j.esmoop.2021.100116] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- P Martín-Martorell
- Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - I Gonzalez-Barrallo
- Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - V Gambardella
- Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - J M Cejalvo
- Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - A Cervantes
- Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.
| |
Collapse
|
4
|
Lombardi P, Gambardella V, Tarazona N, Carbonell-Asins J, Martín-Arana J, Rentero-Garrido P, Montón-Bueno J, Gonzalez-Barrallo I, Bruixola G, Cejalvo J, Martín-Martorell P, Tébar-Martínez R, Blesa S, Seda E, Pérez-Fidalgo J, Insa Mollá A, Fleitas T, Zúñiga-Trejos S, Cervantes A, Roda D. 1201P The role of a mini tumour mutational burden (TMB) score generated with a customized NGS panel to predict benefit from immunotherapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.095] [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: 10/23/2022] Open
|
5
|
Di Liello R, Cimmino F, Simón S, Giunta EF, De Falco V, Martín-Martorell P. Role of liquid biopsy for thoracic cancers immunotherapy. Explor Target Antitumor Ther 2020; 1:183-199. [PMID: 36046196 PMCID: PMC9400760 DOI: 10.37349/etat.2020.00012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/11/2020] [Indexed: 01/09/2023] Open
Abstract
Immunotherapy has shifted the therapeutic landscape in thoracic cancers. However, assessment of biomarkers for patient selection and disease monitoring remain challenging, especially considering the lack of tissue sample availability for clinical and research purposes. In this scenario, liquid biopsy (LB), defined as the study and characterization of biomarkers in body fluids, represents a useful alternative strategy. In other malignancies such as colorectal cancer, breast cancer or melanoma, the potential of LB has been more extensively explored for monitoring minimal residual disease or response to treatment, and to investigate mechanisms of resistance to targeted agents. Even if various experiences have already been published about the applications of LB in immunotherapy in thoracic cancers, the standardization of methodology and assessment of its clinical utility is still pending. In this review, the authors will focus on the applications of LB in immunotherapy in non-small cell lung cancer, small cell lung cancer, and malignant pleural mesothelioma, describing available data and future perspectives.
Collapse
Affiliation(s)
- Raimondo Di Liello
- Medical Oncology, Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80131 Naples, Italy,Medical Oncology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain,Correspondence: Raimondo Di Liello, Medical Oncology, Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80131 Naples, Italy.
| | | | - Soraya Simón
- Medical Oncology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Emilio Francesco Giunta
- Medical Oncology, Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Vincenzo De Falco
- Medical Oncology, Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Paloma Martín-Martorell
- Medical Oncology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| |
Collapse
|
6
|
Becker JH, Gao Y, Soucheray M, Pulido I, Kikuchi E, Rodríguez ML, Gandhi R, Lafuente-Sanchis A, Aupí M, Alcácer Fernández-Coronado J, Martín-Martorell P, Cremades A, Galbis-Caravajal JM, Alcácer J, Christensen CL, Simms P, Hess A, Asahina H, Kahle MP, Al-Shahrour F, Borgia JA, Lahoz A, Insa A, Juan O, Jänne PA, Wong KK, Carretero J, Shimamura T. CXCR7 Reactivates ERK Signaling to Promote Resistance to EGFR Kinase Inhibitors in NSCLC. Cancer Res 2019; 79:4439-4452. [PMID: 31273063 DOI: 10.1158/0008-5472.can-19-0024] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/10/2019] [Accepted: 06/27/2019] [Indexed: 12/16/2022]
Abstract
Although EGFR mutant-selective tyrosine kinase inhibitors (TKI) are clinically effective, acquired resistance can occur by reactivating ERK. We show using in vitro models of acquired EGFR TKI resistance with a mesenchymal phenotype that CXCR7, an atypical G protein-coupled receptor, activates the MAPK-ERK pathway via β-arrestin. Depletion of CXCR7 inhibited the MAPK pathway, significantly attenuated EGFR TKI resistance, and resulted in mesenchymal-to-epithelial transition. CXCR7 overexpression was essential in reactivation of ERK1/2 for the generation of EGFR TKI-resistant persister cells. Many patients with non-small cell lung cancer (NSCLC) harboring an EGFR kinase domain mutation, who progressed on EGFR inhibitors, demonstrated increased CXCR7 expression. These data suggest that CXCR7 inhibition could considerably delay and prevent the emergence of acquired EGFR TKI resistance in EGFR-mutant NSCLC. SIGNIFICANCE: Increased expression of the chemokine receptor CXCR7 constitutes a mechanism of resistance to EGFR TKI in patients with non-small cell lung cancer through reactivation of ERK signaling.
Collapse
Affiliation(s)
- Jeffrey H Becker
- Department of Surgery, Division of Cardiothoracic Surgery, University of Illinois at Chicago, Chicago, Illinois.,University of Illinois Hospital & Health Sciences System Cancer Center, University of Illinois at Chicago, Chicago, Illinois.,Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois
| | - Yandi Gao
- Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois
| | - Margaret Soucheray
- Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois
| | - Ines Pulido
- Departament de Fisiologia, Facultat de Farmacia, Universitat de València, Burjassot, Spain
| | - Eiki Kikuchi
- First department of Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - María L Rodríguez
- Departament de Fisiologia, Facultat de Farmacia, Universitat de València, Burjassot, Spain
| | - Rutu Gandhi
- Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois
| | | | - Miguel Aupí
- Departament de Fisiologia, Facultat de Farmacia, Universitat de València, Burjassot, Spain
| | | | | | - Antonio Cremades
- Department of Pathology, Hospital Universitario de la Ribera, Alzira, Valencia, Spain
| | - José M Galbis-Caravajal
- Department of Thoracic Surgery, Hospital Universitario de la Ribera, Alzira, Valencia, Spain
| | - Javier Alcácer
- Department of Pathology, Hospital Quirónsalud Valencia, Valencia, Spain
| | - Camilla L Christensen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Belfer Institute for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts.,Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Ludwig Center, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Patricia Simms
- Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois
| | - Ashley Hess
- Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois
| | - Hajime Asahina
- First department of Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Michael P Kahle
- Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois
| | - Fatima Al-Shahrour
- Bioinformatics Unit, Spanish National Cancer Research Centre, Madrid, Spain
| | - Jeffrey A Borgia
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, Illinois
| | - Agustín Lahoz
- Biomarkers and Precision Medicine Unit, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Amelia Insa
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Oscar Juan
- Biomarkers and Precision Medicine Unit, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Department of Medical Oncology, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Pasi A Jänne
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Belfer Institute for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts.,Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Bioinformatics Unit, Spanish National Cancer Research Centre, Madrid, Spain
| | - Kwok-Kin Wong
- Laura and Isaac Perlmutter Cancer Center, Division of Hematology and Medical Oncology, New York University, New York, New York
| | - Julian Carretero
- Departament de Fisiologia, Facultat de Farmacia, Universitat de València, Burjassot, Spain.
| | - Takeshi Shimamura
- Department of Surgery, Division of Cardiothoracic Surgery, University of Illinois at Chicago, Chicago, Illinois. .,University of Illinois Hospital & Health Sciences System Cancer Center, University of Illinois at Chicago, Chicago, Illinois.,Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois
| |
Collapse
|
7
|
Farinas-Madrid L, Estévez-García P, Perez-Fidalgo JA, Bosch-Barrera J, Moran T, Nadal E, Rodriguez Freixinos V, Calvo E, Falcon A, Martín-Martorell P, Huerta Alvaro M, Barretina-Ginesta MP, Romeo M, Gil-Martin M, Garralda E, Rodon J, Lizcano JM, Domenech C, Alfon JA, Oaknin A. Phase 1 of ABTL0812, a proautophagic drug, in combination with paclitaxel and carboplatin at first-line in advanced endometrial cancer and squamous cell lung carcinoma. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.3089] [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
3089 Background: ABTL0812 is a novel anti-cancer agent that induces a strong autophagy-mediated cell death by a dual mechanism. It inhibits the Akt/mTOR axis by upregulating TRIB3, an endogenous Akt inhibitor, and induces reticular (ER)-stress. Preclinical data in squamous non-small cell lung carcinoma (Sq-NSCLC) and endometrial cancer (EC) has indicated drug efficacy as a single agent and potentiation of chemotherapy. Methods: A phase 1 clinical study was designed where ABTL0812 was administered orally in combination with 175 mg/m2 paclitaxel/carboplatin AUC5 D1 every 3 weeks (P/C), and posterior ABTL0812 as a maintenance therapy until disease progression or unacceptable toxicity. The study included first-line patients (pts) with advanced Sq-NSCLC or advanced/recurrent EC. The design included a 3+3 de-escalation trial followed by an expansion cohort, where the starting dose of ABTL0812 was 1300 mg tid and if at least 2 pts experienced a DLT, the dose level would be de-escalated to 1000 mg tid. Safety and tolerability were the primary endpoints and preliminary efficacy according to RECIST v1.1 criteria and pharmacodynamic biomarkers (TRIB3 and CHOP an ER-stress biomarker, by qPCR in whole blood) were the secondary endpoints. Results: 16 EC and 5 Sq-NSCLC pts were enrolled. One DLT, a grade 4 neutropenia, appeared in the first cohort of 6 pts and no de-escalation was applied. Fourteen pts were included in an expansion cohort with the same dose level (1300 mg tid), and 1 DLT, a grade 3 febrile neutropenia, was observed. Therefore, the dose of 1300 mg tid was selected as RP2D in combination with P/C. Most frequent grades 2-4 AEs were neutrophil count decreased (n = 9, 43%), nausea (n = 5, 24%), fatigue (n = 4, 19%), followed by anemia, vomiting, dyspepsia, platelet count decreased, arthralgia and neurotoxicity (n = 2, 10% each). Seventeen pts (13 EC and 4 Sq-NSCLC) who completed at least two treatment cycles were evaluable for efficacy; 1 CR (EC), 8 PR (7 EC and 1 Sq-NSCLC), 7 SD (5 EC and 2 Sq-NSCLC) and 1 PD (Sq-NSCLC) were observed. Pharmacodynamic biomarkers showed increased TRIB3 and CHOP levels. Conclusions: The combination of ABTL0812+P/C was safe and tolerated, efficacy signals were observed, and biomarker modulation confirmed drug activity. The triple combination is currently being evaluated in both indications in a Phase 2 study. Clinical trial information: NCT03366480.
Collapse
Affiliation(s)
| | - Purificación Estévez-García
- Unidad de Tumores Ginecológicos y Genitourinarios, Servicio de Oncologia Médica, Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | | | - Teresa Moran
- Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Ernest Nadal
- Institut Català d’Oncologia, L’Hospitalet, Barcelona, Spain
| | | | - Elisa Calvo
- Servicio de Oncologia Médica, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Alejandro Falcon
- Medical Oncology Department. Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | | | | | - Margarita Romeo
- Medical Oncology Department, Institut Català d’Oncologia (ICO) Badalona, B-ARGO, Badalona, Spain
| | | | - Elena Garralda
- Hospital Universitari Vall d’Hebron, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Jordi Rodon
- Vall d’Hebron University Hospital Institute of Oncology (VHIO), Barcelona, Spain
| | - Jose M. Lizcano
- Institut de Neurociencies, Universitat Autonoma de Barcelona, Bellaterra, Barcelona, Spain
| | | | | | - Ana Oaknin
- Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| |
Collapse
|
8
|
Provencio M, Nadal E, Insa A, Garcia-Campelo R, Casal Rubio J, Domine M, Majem M, Rodriguez-Abreu D, Martinez Marti A, Cobo M, Lopez-Vivanco G, del Barco E, Bernabé R, Vinolas N, Barneto I, Viteri S, Martín-Martorell P, Jove M, Franco F, Massuti B. Neoadjuvant chemo-immunotherapy for the treatment of stage IIIA resectable non-small-cell lung cancer (NSCLC): A phase II multicenter exploratory study—Final data of patients who underwent surgical assessment. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.8509] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [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
8509 Background: Patients with stage IIIA (N2 or T4N0) are potentially curable but median overall survival is only around 15 months and complete pathologic response with conventional chemotherapy (CT) is no more than 9%. Methods: A Phase II, single-arm, open-label multicenter study of resectable stage IIIA N2-NSCLC adult patients with CT plus IO as a neoadjuvant treatment: three cycles of Nivolumab (NV) 360mg IV Q3W + paclitaxel 200mg/m2 + carboplatin AUC 6 IV Q3W followed by adjuvant NV treatment for 1 year. After complete neoadjuvant therapy, tumor assessment is performed prior to surgery. Surgery is performed in the 3rd or 4th week after day 21 of the third cycle of neoadjuvant treatment. The study aims to recruit 46 pts. The primary endpoint is Progression-Free Survival (PFS) at 24 months. Efficacy is explored using objective pathologic response criteria. We present final data on all patients included in this study that underwent surgical assessment. Results: At the time of submission, 46 pts had been included and 41 had undergone surgery. CT-IO was well-tolerated and surgery was not delayed in any patient. None of the pts withdrew from the study preoperatively due to progression or toxicity. 41 surgeries had been performed and all tumors were deemed resectable, with R0 resection in all cases. 34 pts (83%) achieved major pathologic response (MPR) (CI 95% 71-95%), and 24 (71%) of them had a complete pathologic response (CPR) (CI 95% 54-87%). Downstaging was seen in 90% (CI 95% 81-100%) of cases. By RECIST, 29 pts (71%) (CI 95% 56-85%) had partial response and 3 (7%) (CI 95% 0-16%) complete response. Conclusions: This is the first multicentric study to CT-IO in the neoadjuvant setting in stage IIIA. Neoadjuvant CT-IO with nivolumab in resectable IIIA NSCLC yields a high complete pathologic response rate that has never been seen previously and unsuspected by RECIST criteria. Preliminary correlative analyses in blood samples are included in a separate abstract. EudraCT Number: 2016-003732-20. Clinical trial information: NCT 03081689.
Collapse
Affiliation(s)
| | - Ernest Nadal
- Institut Català d’Oncologia, L’Hospitalet, Barcelona, Spain
| | - Amelia Insa
- Hospital Clinico Universitario de Valencia, Valencia, Spain
| | | | | | - Manuel Domine
- Oncology Department and Translational Oncology Division, University Hospital Fundacion Jimenez Diaz, Madrid, Spain
| | | | | | - Alex Martinez Marti
- Vall d´Hebron University Hospital /Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Manuel Cobo
- Hospital Regional Universitario de Malaga, Málaga, Spain
| | | | - Elvira del Barco
- Medical Oncology Department, Salamanca University Hospital, Salamanca, Spain
| | | | | | | | | | | | - Maria Jove
- Medical Oncology Department, Institut Català d’Oncologia, l’Hospitalet de Llobregat, Barcelona, Spain
| | - Fabio Franco
- Hospital Universitario Puerta de Hierro, Majadahonda-Madrid, Spain
| | | |
Collapse
|
9
|
de Graaff LCG, Martín-Martorell P, Baan J, Ballieux B, Smit JWA, Radder JK. Long-term follow-up of organ-specific antibodies and related organ dysfunction in type 1 diabetes mellitus. Neth J Med 2011; 69:66-71. [PMID: 21411842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Diabetes mellitus type 1 (DM1) is associated with other autoimmune disorders. To our knowledge, there are no longitudinal data considering the long-term clinical relevance of organ-specific antibodies (OS-Ab) in DM1 patients. We performed a long-term retrospective longitudinal study in order to investigate the presence and diagnostic accuracy (positive predictive value: PPV and negative predictive value: NPV) of OS-Ab in DM1 patients. RESEARCH DESIGN AND METHODS In a retrospective longitudinal study, the presence of OS-Ab and related organ function were analysed in 396 DM1 patients (184 F/212 M, age 44 ± 13 years, age at onset of DM1 21 ± 13 years), with a median follow-up time of 23 ± 10 years. RESULTS OS-Ab frequencies at baseline were: antibodies against thyroglobulin (Tg-Ab) 4.3%, antibodies against thyroid peroxidase (TPO-Ab) 8.1%, Tg- and/or TPO-Ab 10.4%, antibodies against parietal cells (PCA) 5.8% and antibodies against adrenal cortex (ACA) 0.5%. The occurrence of (sub)clinical hypothyroidism was higher in patients with Tg-Ab (47%) or TPO-Ab (42%) than in those without these antibodies (6.2 and 5.1%, respectively, p<0.001). PPV and NPV for Tg-Ab were 0.60 and 0.88, respectively, for TPO -Ab 0.54 and 0.91. Also in patients with PCA, organ dysfunction occurred more often (61%) than in patients without PCA (9.7%, p<0.001). PPV for PCA was 0.61 and NPV 0.90. NPV and PPV for ACA could not be calculated because of the low prevalence. CONCLUSION Long-term follow-up of 396 DM1 patients shows that the presence of thyroid antibodies and/ or parietal cell antibodies is clearly associated with dysfunction of the corresponding organ.
Collapse
Affiliation(s)
- L C G de Graaff
- Department of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands.
| | | | | | | | | | | |
Collapse
|
10
|
Pérez-Fidalgo JA, Roselló S, García-Garré E, Jordá E, Martín-Martorell P, Bermejo B, Chirivella I, Guzman C, Lluch A. Incidence of chemotherapy-induced amenorrhea in hormone-sensitive breast cancer patients: the impact of addition of taxanes to anthracycline-based regimens. Breast Cancer Res Treat 2009; 120:245-51. [DOI: 10.1007/s10549-009-0426-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2009] [Accepted: 05/21/2009] [Indexed: 11/25/2022]
|