1
|
Kostecki KL, Iida M, Wiley AL, Kimani S, Mehall B, Tetreault K, Alexandridis R, Yu M, Hong S, Salgia R, Bruce JY, Birge RB, Harari P, Wheeler DL. Dual Axl/MerTK inhibitor INCB081776 creates a proinflammatory tumor immune microenvironment and enhances anti-PDL1 efficacy in head and neck cancer. Head Neck 2023; 45:1255-1271. [PMID: 36939040 PMCID: PMC10079616 DOI: 10.1002/hed.27340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/01/2023] [Accepted: 02/22/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND The tyrosine kinase receptors Axl and MerTK are highly overexpressed in head and neck cancer (HNC) cells, where they are critical drivers of survival, proliferation, metastasis, and therapeutic resistance. METHODS We investigated the role of Axl and MerTK in creating an immunologically "cold" tumor immune microenvironment (TIME) by targeting both receptors simultaneously with a small molecule inhibitor of Axl and MerTK (INCB081776). Effects of INCB081776 and/or anti-PDL1 on mouse oral cancer (MOC) cell growth and on the TIME were evaluated. RESULTS Targeting Axl and MerTK can reduce M2 and induce M1 macrophage polarization. In vivo, INCB081776 treatment alone or with anti-PDL1 appears to slow MOC tumor growth, increase proinflammatory immune infiltration, and decrease anti-inflammatory immune infiltration. CONCLUSIONS This data indicates that simultaneous targeting of Axl and MerTK with INCB081776, either alone or in combination with anti-PDL1, slows tumor growth and creates a proinflammatory TIME in mouse models of HNC.
Collapse
Affiliation(s)
- Kourtney L Kostecki
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Mari Iida
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Anne L Wiley
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Stanley Kimani
- Rutgers Biomedical Health and Sciences, Rutgers University, Newark, NJ, USA
| | - Bridget Mehall
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Kaitlin Tetreault
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Roxana Alexandridis
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Menggang Yu
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Seungpyo Hong
- Pharmaceutical Sciences Division, University of Wisconsin School of Pharmacy, Madison, WI, USA
- Yonsei Frontier Lab and Department of Pharmacy, Yonsei University, Seoul, Korea
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Ravi Salgia
- Department of Medical Oncology and Experimental Therapeutics, Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - Justine Y Bruce
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Raymond B Birge
- Rutgers Biomedical Health and Sciences, Rutgers University, Newark, NJ, USA
| | - Paul Harari
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Deric L Wheeler
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| |
Collapse
|
2
|
Burr A, Harari P, Wieland A, Kimple R, Hartig G, Witek M. Patterns of failure for hypopharynx cancer patients treated with limited high-dose radiotherapy treatment volumes. Radiat Oncol J 2022; 40:225-231. [PMID: 36456541 PMCID: PMC9830040 DOI: 10.3857/roj.2022.00311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/20/2022] [Indexed: 12/05/2022] Open
Abstract
PURPOSE Optimal radiotherapy treatment volumes for patients with locally advanced hypopharynx squamous cell carcinoma should ensure maximal tumor coverage with minimal inclusion of normal surrounding structures. Here we evaluated the effectiveness of a direct 3-mm high-dose gross tumor volume to planning target volume expansion on clinical outcomes for hypopharynx cancers. MATERIALS AND METHODS We performed a retrospective analysis of patients with hypopharynx carcinoma treated between 2004 and 2018 with primary radiotherapy using a direct high-dose gross tumor volume to planning target volume expansion and with or without concurrent systemic therapy. Diagnostic imaging of recurrences was co-registered with the planning CT. Spatial and volumetric analyses of contoured recurrences were compared with planned isodose lines. Failures were initially defined as in field, marginal, elective nodal, and out of field. Each failure was further classified as central high-dose, peripheral high-dose, central intermediate/low-dose, peripheral intermediate/low-dose, and extraneous. Clinical outcomes were analyzed by Kaplan-Meier estimation. RESULTS Thirty-six patients were identified. At a median follow-up at 52.4 months, estimated 5-year overall survival was 59.3% (95% confidence interval [CI], 36.3%-74.1%), 5-year local and nodal control was 71.7% (95% CI, 47.1%-86.3%) and 69.9% (95% CI, 57.0%-82.6%), respectively. The most common failure was in the high-dose primary target volume. The gastrostomy tube retention rate at 1 year among patients without recurrence was 13.0% (95% CI, 3.2%-29.7%). CONCLUSION Minimal high-dose target volume expansions for hypopharynx cancers were associated with favorable locoregional control. This approach may enable therapy intensification to improve clinical outcomes.
Collapse
Affiliation(s)
- Adam Burr
- Department of Human Oncology, Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Paul Harari
- Department of Human Oncology, Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Aaron Wieland
- Division of Otolaryngology and Head and Neck Surgery, Department of Surgery, Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Randall Kimple
- Department of Human Oncology, Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Gregory Hartig
- Division of Otolaryngology and Head and Neck Surgery, Department of Surgery, Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Matthew Witek
- Department of Human Oncology, Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA,Correspondence: Matthew E. Witek Department of Human Oncology, University of Wisconsin – Madison, 600 Highland Avenue, K4/B100-0600, Madison, WI 53792, USA. Tel: +1-608-263-8500 E-mail:
| |
Collapse
|
3
|
Burr A, Harari P, Griffith A, Kimple R, Witek M. Treatment Outcomes for Advanced Stage Hypopharyngeal Cancer Treated without a GTV to CTV Expansion. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.02.574] [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]
|
4
|
Burr A, Harari P, Griffith A, Haasl A, Kimple R, Glazer T, Hartig G, McCulloch T, Witek M. Clinical Outcomes for Larynx Cancer Patients Treated with Refinement of High-Dose Radiation Treatment Volumes. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.02.567] [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: 11/29/2022]
|
5
|
Witek M, Harari P, Burr A, Chandereng T, Bruce J, Kimple R, Avey G. Intra-Treatment PET/MRI Separates Intermediate Risk p16-Positive Oropharynx Cancer Patients into Favorable and Unfavorable Cohorts. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.02.562] [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]
|
6
|
Abbariki M, Toulany M, Iida M, Morgan A, Nickel K, McDaniel N, Kang G, Li C, Harari P, Wheeler D. Abstract 846: Co-targeting of Axl and MerTK improves radiation response in HNSCC. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Axl and MerTK are members of the TAM family (Tyro, Axl and MerTK) of receptor tyrosine kinases and have been reported to be altered in several types of cancer including Head and Neck Squamous Carcinoma (HNSCC). It is well known that aberrant expression or activity of Axl is associated with resistance to various therapies. Therefore, the translational potential of targeting AXL in HNSCC is worthy, however poorly defined. We recently identified an adaptive feedback mechanism of resistance to AXL-targeting agents mediated by upregulation of MerTK that reveals a direct role for MerTK in resistance to Axl inhibition. In this study, we investigated potential radiosensitization by dual targeting of Axl and MerTK in combination with radiation in human HNSCC cell lines and xenografts (SCC47 and TU138). Immunoblot analysis demonstrated that endogenous levels of Axl or MerTK expression were distinct between these two cell lines. SCC47 cells expressed higher endogenous levels of Axl compared to Tu138. Tu138 expressed higher levels of MerTK compared to SCC47 cells. Radiation induced Axl phosphorylation in SCC47 cells but not in Tu138 cells in vitro. Next, inhibitors of Axl (R428) and/or MerTK (UNC2025) were utilized in combination with single dose radiation in vitro. Clonogenic assays showed that the Axl inhibitor alone acted as a potent radiosensitizer in SCC47 cells. To better define Axl's role in radiation response in HNSCC, we developed HN30-Vector and HN30-Axl stable cells and exposed them to radiation. Phosphorylation of Axl was increased 1 hour post-radiation in Axl overexpressed HN30 compared to parental HN30-Vector which expresses low endogenous levels of Axl. We also found that the HN30-Axl cell line was associated with radioresistance by clonogenic assays. Tumor xenograft studies demonstrated that the combination of R428 and UNC2025 inhibitors improved the efficacy of radiation in Tu138 but not in SCC47. Interestingly, radiation therapy alone was more effective in SCC47 tumors than TU138 tumors. These results reveal that the co-targeting of Axl and MerTK enhanced tumor growth delay in TU138 xenograft mouse models in vivo. Mechanisms of radiosensitization are currently under investigation.
Citation Format: Mahyar Abbariki, Mahmoud Toulany, Mari Iida, Alecia Morgan, Kwang Nickel, Nellie McDaniel, Grace Kang, Chunrong Li, Paul Harari, Deric Wheeler. Co-targeting of Axl and MerTK improves radiation response in HNSCC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 846.
Collapse
Affiliation(s)
| | | | - Mari Iida
- 1University of Wisconsin-Madison, Madison, WI
| | | | | | | | - Grace Kang
- 1University of Wisconsin-Madison, Madison, WI
| | - Chunrong Li
- 1University of Wisconsin-Madison, Madison, WI
| | - Paul Harari
- 1University of Wisconsin-Madison, Madison, WI
| | | |
Collapse
|
7
|
Bonner J, Giralt J, Harari P, Spencer S, Schulten J, Hossain A, Chang SC, Chin S, Baselga J. Cetuximab and Radiotherapy in Laryngeal Preservation for Cancers of the Larynx and Hypopharynx: A Secondary Analysis of a Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2017; 142:842-9. [PMID: 27389475 DOI: 10.1001/jamaoto.2016.1228] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE The appropriate use of surgery or radiotherapy-based approaches for organ preservation has been the subject of much debate. Unfortunately, there has been a lack of improvement in overall survival for patients with laryngeal carcinoma in the last 30 years. OBJECTIVE To assess the rates of laryngeal preservation and laryngectomy-free survival in patients receiving cetuximab and radiotherapy (CRT) and patients receiving radiotherapy alone. DESIGN, SETTING, AND PARTICIPANTS Patients were enrolled in a multicenter, open-label, stratified, randomized, phase 3 study from April 1, 1999, through March 31, 2002, from 73 centers in the United States and 14 other countries. A secondary subgroup analysis of patients with hypopharyngeal and laryngeal carcinoma was undertaken. Rates of laryngeal preservation and laryngectomy-free survival were estimated by the Kaplan-Meier method. The hazard ratios (HRs) were calculated using a Cox proportional hazards regression model. Quality of life was evaluated using the European Organization for Research and Treatment of Cancer core questionnaire and head and neck module. MAIN OUTCOMES AND MEASURES Laryngeal preservation and laryngectomy-free survival. RESULTS Of the 424 patients included in the trial, 168 treated patients with cancer of the larynx or hypopharynx were included in this analysis (90 in the CRT group and 78 in the radiotherapy alone group). The median (range) age of the patients was 59 (40-80) years in the CRT group and 61 (35-81) years in the radiotherapy alone group. In the CRT group, 72 patients (80.0%) were male and 18 (20.0%) were female. In the radiotherapy alone group, 62 (79.5%) were male and 16 (20.5%) were female. The rates of laryngeal preservation at 2 years were 87.9% for CRT vs 85.7% for radiotherapy alone, with an HR of 0.57 (95% CI, 0.23-1.42; P = .22). Similarly, the HR for laryngectomy-free survival comparing CRT vs radiotherapy alone was 0.78 (95% CI, 0.54-1.11; P = .17). This study was not powered to assess organ preservation. Median overall survival was 27 (95% CI, 20-45) vs 21 (95% CI, 17-35) months for the CRT and radiotherapy alone groups, respectively, with an HR of 0.87 (95% CI, 0.60-1.27). No differences between treatments were reported regarding overall quality of life, need for a feeding tube, or speech. CONCLUSIONS AND RELEVANCE The results of a possible cetuximab-related laryngeal preservation benefit for patients with hypopharyngeal or laryngeal cancer are intriguing; these results need to be interpreted in the context of a retrospective subset analysis with limited sample size. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00004227.
Collapse
Affiliation(s)
- James Bonner
- Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham
| | - Jordi Giralt
- Hospital General Vall d'Hebron, Barcelona, Spain
| | - Paul Harari
- Department of Human Oncology, University of Wisconsin at Madison, Madison
| | - Sharon Spencer
- Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham
| | | | | | - Shao-Chun Chang
- Eli Lilly and Company, Indianapolis, Indiana6currently with AstraZeneca, Gaithersburg, Maryland
| | - Steve Chin
- Eli Lilly and Company, Indianapolis, Indiana
| | - José Baselga
- Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
8
|
Javaid A, Swick AD, Werner L, Prabakaran P, Hu R, Nickel KP, Ong I, Sampene E, Bruce J, Hartig G, Wieland A, Canon J, Harari P, Kimple R. Abstract 5187: Potent radiosensitization of adenoid cystic carcinoma in a patient derived xenograft model using the MDM2 inhibitor AMG 232. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-5187] [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
Purpose: Adenoid cystic carcinoma (ACC) is a relatively rare cancer that typically arises in major or minor salivary gland tissues of the head and neck. There are currently no approved systemic agents for ACC and no established data supporting the delivery of chemoradiation for ACC patients. The scarcity of validated preclinical model systems has hampered research efforts. We report the successful establishment and propagation of an ACC patient derived xenograft (PDX), genomic evaluation of cancer associated mutations, and in vivo response to MDM2 inhibition combined with radiotherapy. Because TP53 mutations are seen in <5% of ACCs, we investigated the role of a small molecule MDM2 inhibitor, AMG 232.
Methods: An ACC PDX was established and assessed for common cancer-associated mutations using the Illumina TruSeq Amplicon Cancer panel. Xenografts were treated with focal radiation with or without AMG 232. Focal radiation was delivered at 0, 2, 5, or 8 Gy x 8 fractions delivered twice weekly, with AMG 232 (50mg/kg) delivered daily by oral gavage. Tumor size was measured by caliper and comparisons between treatment groups made using a repeated measures ANOVA. A TCD50 was calculated by fitting log-transformed data to a dose-response curve and compared using the extra-sum-of-squares f test. Target inhibition and anti-cancer effect was confirmed via immuno-blotting of tumor lysates, and IHC staining or in situ hybridization of relevant targets within FFPE sections of tumors harvested 2 and 48 hrs post treatment.
Results: The histologic characteristics of the primary human tumor are maintained in subsequent murine passages of this ACC PDX. Mutational profiling determined that the PDX was wildtype for TP53. AMG 232 alone resulted in modest slowing of tumor growth. Radiation alone produced a tumor growth delay in a dose dependent manner but did not result in sustained local tumor control. Strikingly, the combination of AMG 232 with RT (including low dose radiation of 2 Gy) produced dramatic tumor shrinkage and potent tumor control three months after the end of treatment. Target inhibition of MDM2 was confirmed by western blot of tumor lysates and IHC of FFPE samples taken 2 hrs post treatment. Antiproliferative and apoptotic effects were confirmed by western blot of tumor lysates and IHC of FFPE samples taken at 48 hrs post treatment.
Conclusions: This study suggests that MDM2 inhibition may provide potent radiosensitization in TP53 WT ACC. While additional translational models are warranted, the powerful response profile observed suggests that phase I clinical trial evaluation of this combination is worthy for this challenging malignancy.
Citation Format: Amal Javaid, Adam D. Swick, Lauryn Werner, Prashanth Prabakaran, Rong Hu, Kwangok P. Nickel, Irene Ong, Emmanuel Sampene, Justine Bruce, Gregory Hartig, Aaron Wieland, Jude Canon, Paul Harari, Randall Kimple. Potent radiosensitization of adenoid cystic carcinoma in a patient derived xenograft model using the MDM2 inhibitor AMG 232 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5187. doi:10.1158/1538-7445.AM2017-5187
Collapse
|
9
|
Mittauer K, Geurts M, Toya R, Bassetti M, Harari P, Paliwal B, Bayouth J. TH-CD-202-11: Implications for Online Adaptive and Non-Adaptive Radiotherapy of Gastic and Gastroesophageal Junction Cancers Using MRI-Guided Radiotherapy. Med Phys 2016. [DOI: 10.1118/1.4958168] [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: 11/07/2022] Open
|
10
|
Mittauer K, Rosenberg S, Geurts M, Bassetti M, Chen I, Henke L, Olsen J, Kashani R, Wojcieszynski A, Harari P, Labby Z, Hill P, Paliwal B, Parikh P, Bayouth J. TU-AB-BRA-11: Indications for Online Adaptive Radiotherapy Based On Dosimetric Consequences of Interfractional Pancreas-To-Duodenum Motion in MRI-Guided Pancreatic Radiotherapy. Med Phys 2016. [DOI: 10.1118/1.4957421] [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: 11/07/2022] Open
|
11
|
Abstract
This study investigated the dosimetric differences in treatment plans from flattened and flattening filter-free (FFF) beams from the TrueBeam System. A total of 104 treatment plans with static (sliding window) intensity-modulated radiotherapy beams and volumetric-modulated arc therapy (VMAT) beams were generated for 15 patients involving three cancer sites. In general, the FFF beam provides similar target coverage as the flattened beam with improved dose sparing to organ-at-risk (OAR). Among all three cancer sites, the head and neck showed more important differences between the flattened beam and FFF beam. The maximum reduction of the FFF beam in the mean dose reached up to 2.82 Gy for larynx in head and neck case. Compared to the 6 MV flattened beam, the 10 MV FFF beam provided improved dose sparing to certain OARs, especially for VMAT cases. Thus, 10 MV FFF beam could be used to improve the treatment plan.
Collapse
Affiliation(s)
- Yue Yan
- Department of Medical Physics, University of Wisconsin, Madison, USA; Department of Human Oncology, University of Wisconsin, Madison, USA
| | - Poonam Yadav
- Department of Human Oncology, University of Wisconsin, Madison, USA; Riverview Cancer Center, University of Wisconsin, Wisconsin Rapids, Wisconsin, USA
| | - Michael Bassetti
- Riverview Cancer Center, University of Wisconsin, Wisconsin Rapids, Wisconsin, USA
| | - Kaifang Du
- Riverview Cancer Center, University of Wisconsin, Wisconsin Rapids, Wisconsin, USA
| | - Daniel Saenz
- Department of Medical Physics, University of Wisconsin, Madison, USA; Department of Human Oncology, University of Wisconsin, Madison, USA
| | - Paul Harari
- Riverview Cancer Center, University of Wisconsin, Wisconsin Rapids, Wisconsin, USA
| | - Bhudatt R Paliwal
- Department of Medical Physics, University of Wisconsin, Madison, USA; Department of Human Oncology, University of Wisconsin, Madison, USA
| |
Collapse
|
12
|
Harari P. SP-0603: Interaction of radiotherapy with molecular targeting agents. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31853-9] [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: 10/21/2022]
|
13
|
Schwartz DL, Harris J, Yao M, Rosenthal DI, Opanowski A, Levering A, Ang KK, Trotti AM, Garden AS, Jones CU, Harari P, Foote R, Holland J, Zhang Q, Le QT. Metabolic tumor volume as a prognostic imaging-based biomarker for head-and-neck cancer: pilot results from Radiation Therapy Oncology Group protocol 0522. Int J Radiat Oncol Biol Phys 2015; 91:721-9. [PMID: 25752384 DOI: 10.1016/j.ijrobp.2014.12.023] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 12/03/2014] [Accepted: 12/09/2014] [Indexed: 01/06/2023]
Abstract
PURPOSE To evaluate candidate fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging biomarkers for head-and-neck chemoradiotherapy outcomes in the cooperative group trial setting. METHODS AND MATERIALS Radiation Therapy Oncology Group (RTOG) protocol 0522 patients consenting to a secondary FDG-PET/CT substudy were serially imaged at baseline and 8 weeks after radiation. Maximum standardized uptake value (SUVmax), SUV peak (mean SUV within a 1-cm sphere centered on SUVmax), and metabolic tumor volume (MTV) using 40% of SUVmax as threshold were obtained from primary tumor and involved nodes. RESULTS Of 940 patients entered onto RTOG 0522, 74 were analyzable for this substudy. Neither high baseline SUVmax nor SUVpeak from primary or nodal disease were associated with poor treatment outcomes. However, primary tumor MTV above the cohort median was associated with worse local-regional control (hazard ratio 4.01, 95% confidence interval 1.28-12.52, P=.02) and progression-free survival (hazard ratio 2.34, 95% confidence interval 1.02-5.37, P=.05). Although MTV and T stage seemed to correlate (mean MTV 6.4, 13.2, and 26.8 for T2, T3, and T4 tumors, respectively), MTV remained a strong independent prognostic factor for progression-free survival in bivariate analysis that included T stage. Primary MTV remained prognostic in p16-associated oropharyngeal cancer cases, although sample size was limited. CONCLUSION High baseline primary tumor MTV was associated with worse treatment outcomes in this limited patient subset of RTOG 0522. Additional confirmatory work will be required to validate primary tumor MTV as a prognostic imaging biomarker for patient stratification in future trials.
Collapse
Affiliation(s)
- David L Schwartz
- Department of Radiation Oncology, University of Texas Southwestern School of Medicine, Dallas, Texas.
| | - Jonathan Harris
- Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania
| | - Min Yao
- Department of Radiation Oncology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - David I Rosenthal
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adam Opanowski
- American College of Radiology Imaging Network, Philadelphia, Pennsylvania
| | - Anthony Levering
- American College of Radiology Imaging Network, Philadelphia, Pennsylvania
| | - K Kian Ang
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Andy M Trotti
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Adam S Garden
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Paul Harari
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Robert Foote
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - John Holland
- Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon
| | - Qiang Zhang
- Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania
| | - Quynh-Thu Le
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, California
| |
Collapse
|
14
|
Morris ZS, Guy E, Francis D, Gressett M, Yang R, Rakhmilevich A, Hank J, Gillies S, Harari P, Sondel P. In vivo synergy of radiation and hu14.18-IL2 immunocytokine results in a memory T cell response in a syngeneic murine melanoma model. J Immunother Cancer 2014. [PMCID: PMC4288538 DOI: 10.1186/2051-1426-2-s3-p160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
15
|
Fayette J, Wirth L, Oprean C, Hitt R, Udrea A, Jimeno A, Rischin D, Nutting C, Harari P, Cso˝szi T, Cernea D, Wang X, Kapp A, Anderson M, Penuel E, McCall B, Pirzkall A, Vermorken J. Randomized Phase Ii Study of Mehd7945A (Mehd) Vs Cetuximab (Cet) in >= 2Nd-Line Recurrent/Metastatic Squamous Cell Carcinoma of the Head & Neck (Rmscchn) Progressive On/After Platinum-Based Chemotherapy (Ptct). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu340.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
16
|
Magnuson W, Morris Z, Mohindra P, Geye H, Harari P. Potential Influence of ACE Inhibitors and Angiotensin Receptor Blockers on Outcome in Patients With Oropharynx Cancer Treated With Radiation Therapy. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1581] [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: 11/24/2022]
|
17
|
|
18
|
Abstract
In this review, key aspects of epidermal growth factor receptor (EGFR) biology and the fruitful translation of these fundamental findings into recent treatment advances in head and neck squamous cell cancer (HNSCC) are highlighted. In contrast to a number of contemporary reviews of the EGFR, many of which focus on colorectal and nonsmall cell lung cancer, this review discusses the EGFR as a validated therapeutic target in HNSCC. Recent data confirm a survival advantage for the addition of the anti-EGFR monoclonal antibody cetuximab to definitive radiation therapy in locoregionally advanced HNSCC patients, as well as palliative benefits for patients with incurable recurrent and metastatic HNSCC. Small-molecule EGFR tyrosine kinase inhibitors also show considerable promise in this disease, both alone and in combination with radiation and chemotherapy. Both classes of anti-EGFR agent are generally well tolerated, with side effects (notably skin rash) that are distinct from the toxicities of conventional chemotherapy. Ongoing clinical trials will more clearly define the role for EGFR inhibitors in all treatment phases of HNSCC.
Collapse
Affiliation(s)
- Igor Astsaturov
- Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA
| | | | | |
Collapse
|
19
|
Schwartz D, Harris J, Yao M, Trotti A, Garden A, Jones C, Harari P, Foote R, Holland J, Ang K. Metabolic Tumor Volume as a Predictive Imaging Biomarker in Head-and-Neck Cancer: Pilot Results From RTOG 0522. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.496] [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: 01/31/2023]
|
20
|
Lippert DC, Dang P, Cannon D, Harari P, McCulloch TM, Hartig GK. Impact of Radiation on Lymph Node Counts and Incidence of Extracapsular-Spread in Neck Dissection Specimens. Otolaryngol Head Neck Surg 2013. [DOI: 10.1177/0194599813496044a102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: 1) Analyze the impact of preoperative radiotherapy on total lymph node yield in neck dissection specimens. 2) Analyze the impact of preoperative radiotherapy on the presence of extracapsular-spread in neck dissection specimens. Methods: Historical cohort study. Setting: Academic medical center. Patients: 525 subjects who underwent neck dissection for a diagnosis of squamous cell carcinoma from 1990 to 2010 were analyzed. Subjects were divided into 2 groups; those who underwent neck dissection alone or had neck dissection before radiation (surgery first group), versus subjects who received radiation therapy before neck dissection (radiation first group). Outcome Measures: The total number of lymph nodes harvested as well as the incidence of extracapsular-spread was examined between these two groups. Results: A total of 366 patients in the surgery first group and 159 in the radiation first group were analyzed. The mean number of lymph nodes harvested in the surgery first group was 29.4, compared to 20.9 lymph nodes in the radiation first group ( P < 0.001). Of 461 patients with available extracapsular-spread data, 106 (23.0%) had extracapsular-spread identified in their pathology report. Preoperative radiation significantly decreased the incidence of extracapsular-spread (OR=0.296, P < 0.001). The incidence of extracapsular-spread was 26.9% (84/312) in the surgery first group, and 14.8% (22/149) in the radiation first group. Conclusions: We identified a significantly decreased number of lymph nodes harvested and a decreased frequency of extracapsular-spread in the neck dissection specimens from patients who had undergone prior neck irradiation as compared to those without prior neck irradiation.
Collapse
|
21
|
Saker J, Armstrong E, Bednarz B, Farhoud M, Besemer A, Weichert J, Harari P. Abstract 4536: Combination external beam and internal radiation via 131I-CLR1404 in the treatment of head and neck squamous cell carcinoma xenografts. Cancer Res 2013. [DOI: 10.1158/1538-7445.am2013-4536] [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
Radiotherapy (RT) is a central treatment modality for head and neck cancer (HNC). However, optimal outcome is commonly limited by the radiation tolerance of adjacent normal tissue structures. Radiation is sometimes valuable in the setting of locoregional tumor recurrence, however the risk of significant normal tissue toxicity is substantial with repeat irradiation and can have a profound adverse impact on patient quality of life. Although technical advances including intensity modulated radiotherapy (IMRT) can reduce normal tissue effects, the problem of repeat exposure of normal tissues to radiation is frequently limiting. The radiolabeled drug 124/131I-CLR1404 is a phospholipid ether analogue (PLE) that accumulates preferentially within malignant tumors and enables internal delivery of radiation. This allows a combination of external and internal radiotherapy delivery with a goal of improving treatment outcome without enhanced normal tissue toxicities.
In this study, we characterized the ability of 131I-CLR1404 to augment RT response using xenografted mice harboring human squamous cell carcinomas (SCC). We determined tumor growth delay as well as tumor and normal tissue dose distribution of 131I-CLR-1404 via Monte Carlo simulation using PET data generated with 124I-CLR1404 imaging. Tumor growth delay was extended by 15.5 days using combined 3.7MBq 131I-CLR1404 and RT compared to RT or 131I-CLR1404 alone. In combination therapy, single dose administration of 7.4 MBq 131I-CLR1404 as well as split dosing with 2 x 3.7 MBq separated by one week showed the same additional growth delay of 27 days compared to single dose of 3.7 MBq. Monitoring drug distribution via PET/CT showed high tumor selectivity with a tumor-to-liver ratio of 6.2±0.65 and a tumor-to-muscle ratio of 6.7±0.21.
These data illustrate the tumor selectivity of the CLR1404 PLE delivery platform as well as augmentation of tumor response with combined RT and 131I-CLR1404 treatment. De-intensification of external beam radiation dose, with attendant reduction in normal tissue toxicities so common in HNC patients represents a central objective to be tested in controlled clinical trials with the ultimate goal of improving treatment outcome and quality of life for HNC patients.
Citation Format: Jarob Saker, Eric Armstrong, Bryan Bednarz, Mohammed Farhoud, Abigail Besemer, Jamey Weichert, Paul Harari. Combination external beam and internal radiation via 131I-CLR1404 in the treatment of head and neck squamous cell carcinoma xenografts. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4536. doi:10.1158/1538-7445.AM2013-4536
Collapse
Affiliation(s)
- Jarob Saker
- University of Wisconsin, Madison, Madison, WI
| | | | | | | | | | | | - Paul Harari
- University of Wisconsin, Madison, Madison, WI
| |
Collapse
|
22
|
Harari P. SP-052: Against the Motion. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)34671-5] [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]
|
23
|
Mohindra P, Barasch S, Yang D, Patel V, Khuntia D, Hoang T, Speer T, McCulloch T, Hartig G, Harari P. PO-125: Primary Radiation-Based Management of Oropharyngeal Cancer: A Comprehensive 20-Year Single Institution Review. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)34744-7] [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: 11/28/2022]
|
24
|
Speer T, Bernhardt P, Bednarz B, Harari P, Saker J, Thomadsen B. Feasibility of the Systemic Cure of Cancer With Targeted Radionuclide Therapy (TRT). Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1898] [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: 11/26/2022]
|
25
|
Magnuson W, Urban E, Bayliss A, Harari P. Impact of Node Negative (N0) Target Volume on Parotid Gland Dose Sparing in HNSCC. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1409] [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: 11/29/2022]
|
26
|
Bavan B, Krakow T, Pinto H, Harari P, Brizel D, Amdur R, Hu K, Le Q. Interim Report of a Phase II Study of Lapatinib and Concurrent Radiotherapy in Patients With Locally Advanced Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.831] [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: 12/01/2022]
|
27
|
Nyflot M, Simoncic U, Harari P, Perlman S, Jeraj R. SU-D-BRC-06: Multimodality Assessment of Response to Combined Chemoradiation and Anti-Angiogenic Therapy with CuATSM-PET, FLT-PET, and Contrast-Enhanced CT Imaging. Med Phys 2011. [DOI: 10.1118/1.3611530] [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: 11/07/2022] Open
|
28
|
Nyflot M, Harari P, Perlman S, Jeraj R. MO-D-204B-03: Correlation of PET Images of Metabolism, Proliferation and Hypoxia to Characterize Tumor Phenotype in Patients with HNSCC. Med Phys 2010. [DOI: 10.1118/1.3469064] [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: 11/07/2022] Open
|
29
|
Song C, Nyflot M, Harari P, Perlman S, Jeraj R. MO-D-204B-08: Classification and Characterization of Tumor Subpopulations Using Molecular Imaging. Med Phys 2010. [DOI: 10.1118/1.3469069] [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: 11/07/2022] Open
|
30
|
Harari P. 18 Combining EGFR inhibitors with radiation. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70025-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
31
|
Nyflot M, Harari P, Perlman S, Nickles R, Jeraj R. SU-FF-J-135: Quantification of Tumor Proliferation and Hypoxia with PET/CT Imaging of HNSCC Patients Receiving VEGF-Targeted Therapy. Med Phys 2009. [DOI: 10.1118/1.3181427] [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: 11/07/2022] Open
|
32
|
Hatakeyama H, Parker J, Wheeler D, Harari P, Levy S, Chung CH. Effect of insulin-like growth factor 1 receptor inhibitor on sensitization of head and neck cancer cells to cetuximab and methotrexate. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6079] [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
6079 Background: Insulin-like growth factor 1 receptor (IGF1R) is highly expressed in head and neck squamous cell carcinoma (HNSCC) and IGF1R inhibitors have been shown to modulate sensitivity to selected chemotherapeutic agents and radiation. The combination effects of an IGF1R inhibitor, MK-0646, with cetuximab or cytotoxic agents that are commonly used in the treatment of recurrent and/or metastatic HNSCC were examined in cetuximab resistant and sensitive HNSCC cell lines. Methods: The cell lines, SCC1 and its cetuximab-resistant clone 1Cc8, were treated with MK-0646, cetuximab or methotrexate, and a combination of MK-0646 and each anti-cancer drug (MK-0646 was supplied by Merck & Co., Inc.). The effect of treatments on cell proliferation and anti-tumor activity was determined using MTS assay in vitro and in vivo using mouse xenografts generated from the cell lines. Overall changes in the gene and protein expressions with the treatments were determined by DNA microarrays and western blots. Results: The IGF1R inhibitor, MK-0646, showed high-sensitivity in vitro xenograft model in SCC1 as monotherapy and increased sensitivity to cetuximab in SCC1 and to methotrexate in 1Cc8 in combination. However, MK-0646 did not inhibit cell proliferation in vitro and in vivo in 1Cc8. The gene expression array and western blot analyses showed that MK-0646 decreased expression of AKT and dihydrofolate reductase (DHFR), a target of methotrexate. Increased expressions of AKT and DHFR have been shown to associate with cetuximab and methotrexate resistance as well as radiation resistance. Conclusions: The development of tolerance in response to the IGF1R inhibitor and cetuximab is common. Whereas IGF1R inhibitors may have little therapeutic impact in cetuximab resistant, the IGF1R inhibitor may modulate response to selected chemotherapeutic agents and to radiation. The IGF1R inhibitor appears to enhance cetuximab and methotrexate response, and modulates genes associated with radiation resistance thereby providing alternative regimens for recurrent and refractory HNSCC patients who have developed resistance to initial therapies. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- H. Hatakeyama
- Vanderbilt University, Nashville, TN; Expression Analysis, Durham, NC; University of Wisconsin Medical School, Madison, WI
| | - J. Parker
- Vanderbilt University, Nashville, TN; Expression Analysis, Durham, NC; University of Wisconsin Medical School, Madison, WI
| | - D. Wheeler
- Vanderbilt University, Nashville, TN; Expression Analysis, Durham, NC; University of Wisconsin Medical School, Madison, WI
| | - P. Harari
- Vanderbilt University, Nashville, TN; Expression Analysis, Durham, NC; University of Wisconsin Medical School, Madison, WI
| | - S. Levy
- Vanderbilt University, Nashville, TN; Expression Analysis, Durham, NC; University of Wisconsin Medical School, Madison, WI
| | - C. H. Chung
- Vanderbilt University, Nashville, TN; Expression Analysis, Durham, NC; University of Wisconsin Medical School, Madison, WI
| |
Collapse
|
33
|
Curran WJ, Chen AY, Garden AS, Harari P, Murphy BA, Wong S, Bellm LA, Schwartz M, Dawson D, Ang KK. Longitudinal oncology registry of head and neck carcinoma (LORHAN): First report of outcomes. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6071] [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
6071 Background: Registries can be invaluable for describing patterns of care and outcomes for a population of patients (pts). We report the initial survival findings from LORHAN, a prospective, longitudinal, observational national registry of head and neck carcinoma (HNC) pts. Methods: Pts are eligible for LORHAN if they have newly diagnosed HNC, are scheduled to receive radiotherapy (RT) or drug therapy, are ≥18 years of age and have provided written informed consent. Data are entered in the registry electronically and transferred via Secure HTTP protocols. Patient confidentiality is strictly maintained. Pts are followed from time of initial diagnosis and for a minimum of 2 and up to 10 years. When information is complete and has been verified and signed off by the investigator, a record is locked. Only locked records are summarized and reported. Results: 2,354 pts have been enrolled in LORHAN since Dec. 2005. Of these, 1,326 pts have completed initial cancer treatment and have locked records. 1- and 2-year follow-up data are available for 583 and 56 pts, respectively. Baseline characteristics were similar between settings, except that pts treated at academic centers were significantly younger (58 vs. 62 years of age), had poorer performance status (mean Zubrod: 0.9 vs. 0.7), had fewer laryngeal tumors (17% vs. 27% of pts) but more oropharyngeal tumors (42% vs. 37% of pts) and presented with more advanced disease (stage IV: 70% vs. 48% of pts) compared to pts treated in community. Treatment did not differ by setting. Treatment and survival data are shown below. Conclusions: LORHAN demonstrates it is feasible to collect more detailed information about patient and tumor features and treatment other than surgery. Changes in the pattern of care and survival findings are expected to emerge as newer regimens, including IC and targeted agents, are incorporated more broadly into clinical practice, and data in LORHAN matures. [Table: see text] [Table: see text]
Collapse
Affiliation(s)
- W. J. Curran
- Emory University, Atlanta, GA; UT M. D. Anderson Cancer Center, Houston, TX; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minnetonka, MN; ImClone Systems, Branchburg, NJ
| | - A. Y. Chen
- Emory University, Atlanta, GA; UT M. D. Anderson Cancer Center, Houston, TX; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minnetonka, MN; ImClone Systems, Branchburg, NJ
| | - A. S. Garden
- Emory University, Atlanta, GA; UT M. D. Anderson Cancer Center, Houston, TX; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minnetonka, MN; ImClone Systems, Branchburg, NJ
| | - P. Harari
- Emory University, Atlanta, GA; UT M. D. Anderson Cancer Center, Houston, TX; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minnetonka, MN; ImClone Systems, Branchburg, NJ
| | - B. A. Murphy
- Emory University, Atlanta, GA; UT M. D. Anderson Cancer Center, Houston, TX; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minnetonka, MN; ImClone Systems, Branchburg, NJ
| | - S. Wong
- Emory University, Atlanta, GA; UT M. D. Anderson Cancer Center, Houston, TX; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minnetonka, MN; ImClone Systems, Branchburg, NJ
| | - L. A. Bellm
- Emory University, Atlanta, GA; UT M. D. Anderson Cancer Center, Houston, TX; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minnetonka, MN; ImClone Systems, Branchburg, NJ
| | - M. Schwartz
- Emory University, Atlanta, GA; UT M. D. Anderson Cancer Center, Houston, TX; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minnetonka, MN; ImClone Systems, Branchburg, NJ
| | - D. Dawson
- Emory University, Atlanta, GA; UT M. D. Anderson Cancer Center, Houston, TX; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minnetonka, MN; ImClone Systems, Branchburg, NJ
| | - K. K. Ang
- Emory University, Atlanta, GA; UT M. D. Anderson Cancer Center, Houston, TX; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minnetonka, MN; ImClone Systems, Branchburg, NJ
| |
Collapse
|
34
|
Sonis S, Jacquin P, Randolph-Jackson P, Harari P, Grunberg S, Liao Z, Bolek T, Elting L, Keefe D. Prevalence of Mouth and Throat Soreness (MTS) in Patients undergoing Lung Cancer Treatment, with Adverse Impact on Functional and Quality of Life Outcomes. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.395] [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: 11/27/2022]
|
35
|
Garden A, Chen A, Curran W, Harari P, Murphy B, Wong S, Schwartz M, Dawson D, Dempsey C, Ang K. Longitudinal Oncology Registry of Head and Neck Carcinoma (LORHAN): Preliminary Report Regarding Radiation Patterns of Care. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1305] [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: 11/28/2022]
|
36
|
Keefe D, Elting L, Sonis S, Garden A, Spijkervet F, Barasch A, Jacquin P, Randolph P, Harari P. Treatment for Head and Neck Cancer and for Lung Cancer Causes Significant Diarrhea. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1432] [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: 11/28/2022]
|
37
|
Jeraj R, Simoncic U, McCall K, Harari P, Mehta M, Nickles R, Perlman S. MO-E-AUD C-03: Use of FLT-PET Imaging to Assess Tumor and Normal Tissue Response to Radiotherapy. Med Phys 2008. [DOI: 10.1118/1.2962392] [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: 11/07/2022] Open
|
38
|
Nyflot M, Grudzinski J, Titz B, Armstrong E, Wheeler D, Harari P, Jeraj R. TH-C-351-04: 18F-FLT PET Imaging of Proliferative Response to An EGFR Inhibitor in HNSCC Xenograft Mouse Models. Med Phys 2008. [DOI: 10.1118/1.2962860] [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: 11/07/2022] Open
|
39
|
Curran WJ, Chen A, Garden A, Harari P, Murphy BA, Wong SJ, Bellm L, Schwartz M, Dawson D, Ang K. Longitudinal oncology registry of head and neck carcinoma (LORHAN): Initial treatment findings. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.6054] [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
|
Abstract
The epidermal growth factor (EGFR) and its receptor were discovered nearly 40 years ago. Over the past decade interruption of this pathway has been exploited in the treatment of various solid tumors. Antibodies that interfere with ligand binding to and dimerization of the EGFR (and small molecules that inhibit the EGFR tyrosine kinase) are anti-proliferative, profoundly radiosensitizing, and synergistic with DNA-damaging cytotoxic agents. Proposed mechanisms of radio- and chemosensitization include enhanced apoptosis, interference with DNA repair and angiogenesis, receptor depletion from the cell surface and antibody-dependent cell-mediated cytotoxicity. This article provides a reader with a comprehensive review of EGFR-targeting antibodies under development for the treatment of head and neck squamous cell cancer (HNSCC) and also summarizes relevant clinical data in this disease with small molecule EGFR inhibitors. One of the monoclonal antibodies, cetuximab, recently received full FDA approval for the treatment of patients with locally advanced (with radiation) or metastatic HNSCC (as a single agent). Regulatory approval followed reporting of a large international study in which the addition of cetuximab to definitive radiation therapy in HNSCC resulted in statistically significant improvements in locoregional control and overall survival. Results of the pivotal trial, other clinical data supporting the regulatory approval, and a preview of the next generation of clinical trials are presented. Considerable work remains to be done, particularly to enhance our understanding of factors that may predict for favorable response to EGFR inhibitor therapy and to evaluate the impact of integrating anti-EGFR therapies into complex chemoradiation programs delivered with curative intent.
Collapse
|
41
|
Murphy B, Chen A, Harari P, Curran W, Wong S, Bellm L, Gamber D, Dawson D, Garden A, Ang K. Longitudinal Oncology Registry of Head and Neck Carcinoma (LORHAN), A New National Cancer Registry. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.06.008] [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: 11/29/2022]
|
42
|
Harari P. 136 INVITED Clinical integration of EGFR inhibitors with radiation. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70250-1] [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: 10/22/2022] Open
|
43
|
Jeraj R, McCall K, Bentzen S, Harari P, Ritter M, Mehta M, Tome W. TH-E-M100J-05: Early Assessment of Radiotherapy Efficacy with FLT-PET Imaging. Med Phys 2007. [DOI: 10.1118/1.2761758] [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: 11/07/2022] Open
|
44
|
Allen G, Saba C, Armstrong E, Huang S, Ludwig D, Hicklin D, Harari P. 2613. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
45
|
Curran W, Chen A, Harari P, Murphy B, Wong S, Bellm L, Gamber D, Dawson D, Ang K. Longitudinal Oncology Registry of Head and Neck Carcinoma (LORHAN), a new national cancer registry. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.5583] [Citation(s) in RCA: 1] [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
5583 Background: Registries can be invaluable for describing patterns of care for a population of patients (pts). Most cancer registries, however, do not possess sufficient breadth or depth to provide a complete and reliable picture of clinical practice. We report the launch of LORHAN, a new national registry of head and neck carcinoma (HNC) pts. LORHAN is designed to extend current cancer registries by providing detailed data on radiation and/or cancer drugs delivered to HNC pts in all practice settings. Methods: This is a prospective, multi-center, longitudinal, observational registry. Pts with newly diagnosed HNC, scheduled to receive radiotherapy or drug therapy, ≥18 years of age and providing written informed consent are being enrolled. Patients participating in clinical trials are eligible for LORHAN. The primary objective of the registry is to describe, in detail, patterns of care for HNC pts. The secondary objectives are to document outcome by treatment regimen, determine the incidence and severity of major toxicities and to identify supportive care received for managing treatment-related complications. Pts are entered in the registry from the time of initial diagnosis and are followed for at least 2 years and up to 10 years. Detailed information on initial treatment and re-treatment is collected. Data entry is electronic and incorporates encrypted point-to-point data transfer via secure HTTP protocols. Physician and patient confidentiality are strictly maintained. Participating practitioners can review and compare their data on a real-time basis to the database. Registry pts may be linked to the NDI to minimize lost to follow-up. Analyses of data are primarily descriptive. Results: LORHAN was launched in Oct. 2005, and as of Dec., 7 sites have received IRB approval and 3 pts have been enrolled. Of the 7 sites, 1 is an academic site and the remaining are community-based practices. An additional 21 sites (17 academic, 4 community) are at various stages of participation. More than 100 medical oncologists and radiation oncologists are anticipated to participate and approximately 26,000 pts will be eligible each year. Accrual status will be updated. Conclusions: LORHAN is a new national initiative that may further the understanding of the care of HNC pts across practice settings. [Table: see text]
Collapse
Affiliation(s)
- W. Curran
- Thomas Jefferson University, Philadelphia, PA; Emory University, Atlanta, GA; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minneapolis, MN; ImClone Systems, Branchburg, NJ; UT M. D. Anderson Cancer Center, Houston, TX
| | - A. Chen
- Thomas Jefferson University, Philadelphia, PA; Emory University, Atlanta, GA; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minneapolis, MN; ImClone Systems, Branchburg, NJ; UT M. D. Anderson Cancer Center, Houston, TX
| | - P. Harari
- Thomas Jefferson University, Philadelphia, PA; Emory University, Atlanta, GA; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minneapolis, MN; ImClone Systems, Branchburg, NJ; UT M. D. Anderson Cancer Center, Houston, TX
| | - B. Murphy
- Thomas Jefferson University, Philadelphia, PA; Emory University, Atlanta, GA; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minneapolis, MN; ImClone Systems, Branchburg, NJ; UT M. D. Anderson Cancer Center, Houston, TX
| | - S. Wong
- Thomas Jefferson University, Philadelphia, PA; Emory University, Atlanta, GA; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minneapolis, MN; ImClone Systems, Branchburg, NJ; UT M. D. Anderson Cancer Center, Houston, TX
| | - L. Bellm
- Thomas Jefferson University, Philadelphia, PA; Emory University, Atlanta, GA; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minneapolis, MN; ImClone Systems, Branchburg, NJ; UT M. D. Anderson Cancer Center, Houston, TX
| | - D. Gamber
- Thomas Jefferson University, Philadelphia, PA; Emory University, Atlanta, GA; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minneapolis, MN; ImClone Systems, Branchburg, NJ; UT M. D. Anderson Cancer Center, Houston, TX
| | - D. Dawson
- Thomas Jefferson University, Philadelphia, PA; Emory University, Atlanta, GA; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minneapolis, MN; ImClone Systems, Branchburg, NJ; UT M. D. Anderson Cancer Center, Houston, TX
| | - K. Ang
- Thomas Jefferson University, Philadelphia, PA; Emory University, Atlanta, GA; University of Wisconsin, Madison, WI; Vanderbilt University, Nashville, TN; Medical College of Wisconsin, Milwaukee, WI; MedNet Solutions, Minneapolis, MN; ImClone Systems, Branchburg, NJ; UT M. D. Anderson Cancer Center, Houston, TX
| |
Collapse
|
46
|
Allen G, Modhia F, Armstrong E, Huang S, Harari P. Insulin-Like Growth Factor-1 Receptor Signaling Blockade Modulates Cellular Proliferation, Angiogenesis, Xenograft Growth and Radiation-Induced Apoptosis. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.200] [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: 12/01/2022]
|
47
|
Hoang T, Huang S, Armstrong E, Harari P. P-953 Enhancement of radiation response in upper aero-digestive tracttumors with bevacizumab (Avastine®). Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81446-1] [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: 10/25/2022]
|
48
|
Hoang T, Huang S, Armstrong E, Harari P. 179 Augmentation of radiation response in upper aero-digestive tract tumors with the vascular targeting agent ZD6126. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)80187-3] [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: 10/26/2022] Open
|
49
|
Chinnaiyan P, Vallabhaneni G, Armstrong E, Huang S, Harari P. Modulating radiation response with the histone deacetylase (HDAC) inhibitor SAHA in human carcinomas. Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.07.178] [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: 10/26/2022]
|
50
|
|