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Kramer N, Müller G, Zierold S, Röckel M, Fröhlich W, Schefzyk M, Kumbrink J, Hassel JC, Berking C, Ziemer M, Nashan D, French LE, Vera J, Kerl-French KE, Gutzmer R, Heinzerling L. Checkpoint inhibitor-induced bullous pemphigoid differs from spontaneous bullous pemphigoid. J Eur Acad Dermatol Venereol 2024. [PMID: 38400651 DOI: 10.1111/jdv.19860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Affiliation(s)
- N Kramer
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - G Müller
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - S Zierold
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - M Röckel
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - W Fröhlich
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - M Schefzyk
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - J Kumbrink
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - J C Hassel
- Department of Dermatology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
| | - C Berking
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - M Ziemer
- Department of Dermatology, Allergology and Venerology, University Medical Center, Leipzig, Germany
| | - D Nashan
- Department of Dermatology, Hospital Dortmund, Dortmund, Germany
| | - L E French
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - J Vera
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - K E Kerl-French
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - R Gutzmer
- Department of Dermatology, Johannes Wesling Medical Center, Ruhr University Bochum Campus Minden, Minden, Germany
| | - L Heinzerling
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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Kähler KC, Hüning S, Nashan D, Meiss F, Rafei-Shamsabadi DA, Rissmann H, Colapietro C, Livingstone E, Maul LV, Heppt M, Hassel JC, Gutzmer R, Loquai C, Heinzerling L, Sachse MM, Bohne AS, Moysig L, Peters W, Rusch J, Blome C. Preferences of German and Swiss melanoma patients for toxicities versus melanoma recurrence during adjuvant treatment (GERMELATOX-A-trial). J Cancer Res Clin Oncol 2023; 149:11705-11718. [PMID: 37405475 PMCID: PMC10465664 DOI: 10.1007/s00432-023-05027-z] [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: 05/31/2023] [Accepted: 06/26/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE Adjuvant treatment with immune checkpoint inhibitors like PD1-antibodies (ICI) ± CTLA4-antibodies (cICI) or targeted therapy with BRAF/MEK inhibitors (TT) in high-risk melanoma patients demonstrate a significant improvement in disease-free survival (DFS). Due to specific side effects, the choice of treatment is very often driven by the risk for toxicity. This study addressed for the first time in a multicenter setting the attitudes and preferences of melanoma patients for adjuvant treatment with (c)ICI and TT. METHODS In this study ("GERMELATOX-A"), 136 low-risk melanoma patients from 11 skin cancer centers were asked to rate side effect scenarios typical for each (c)ICI and TT with mild-to-moderate or severe toxicity and melanoma recurrence leading to cancer death. We asked patients about the reduction in melanoma relapse and the survival increase at 5 years they would require to tolerate defined side-effects. RESULTS By VAS, patients on average valued melanoma relapse worse than all scenarios of side-effects during treatment with (c)ICI or TT. In case of severe side effects, patients required a 15% higher rate of DFS at 5 years for (c)ICI (80%) compared to TT (65%). For survival, patients required an increase of 5-10% for melanoma survival during (c)ICI (85%/80%) compared to TT (75%). CONCLUSION Our study demonstrated a pronounced variation of patient preferences for toxicity and outcomes and a clear preference for TT. As adjuvant melanoma treatment with (c)ICI and TT will be increasingly implemented in earlier stages, precise knowledge of the patient perspective can be helpful for decision making.
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Affiliation(s)
- Katharina C Kähler
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany.
| | - S Hüning
- Department of Dermatology, Dortmund, Germany
| | - D Nashan
- Department of Dermatology, Dortmund, Germany
| | - F Meiss
- Department of Dermatology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - D A Rafei-Shamsabadi
- Department of Dermatology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - H Rissmann
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - C Colapietro
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - E Livingstone
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - L V Maul
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - M Heppt
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
| | - J C Hassel
- Department of Dermatology and National Center for Tumor Therapy (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - R Gutzmer
- Department of Dermatology, Johannes Wesling Medical Center Minden, Ruhr University Bochum Medical School, Bochum, Germany
| | - C Loquai
- Department of Dermatology, Klinikum Bremen-Ost, Gesundheitnord gGmbH, Bremen, Germany
| | - L Heinzerling
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - M M Sachse
- Department of Dermatology, Bremerhaven, Germany
| | - A S Bohne
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - L Moysig
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - W Peters
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - J Rusch
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg, Hamburg, Germany
| | - C Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg, Hamburg, Germany
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3
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Livingstone E, Gogas H, Kandolf-Sekulovic L, Meier F, Eigentler TK, Ziemer M, Terheyden PAM, Gesierich AH, Herbst RA, Kähler KC, Ziogas DC, Mijuskovic Z, Garzarolli M, Garbe C, Roesch A, Ugurel S, Gutzmer R, Grob JJ, Kiecker F, Utikal J, Windemuth-Kieselbach C, Eckhardt S, Zimmer L, Schadendorf D. Early switch from run-in treatment with vemurafenib plus cobimetinib to atezolizumab after 3 months leads to rapid loss of tumour control in patients with advanced BRAFV600-positive melanoma: The ImmunoCobiVem phase 2 randomised trial. Eur J Cancer 2023; 190:112941. [PMID: 37482012 DOI: 10.1016/j.ejca.2023.112941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023]
Abstract
AIM ImmunoCobiVem investigated whether a planned switch to atezolizumab after achieving tumour control during run-in with vemurafenib + cobimetinib improves progression-free survival (PFS) and overall survival (OS) compared to continuous targeted therapy (TT) in patients with previously untreated advanced BRAFV600-mutated melanoma. METHODS In this multicenter phase 2 study, patients received vemurafenib plus cobimetinib. After 3months, patients without progressive disease (PD) were randomly assigned (1:1) to continue vemurafenib + cobimetinib (Arm A) or switch to atezolizumab (Arm B) until first documented PD (PD1). Primary outcome was PFS1 (time from start of run-in until PD1 or death). OS and safety were also assessed. RESULTS Of 185 patients enroled between November 2016 and December 2019, 135 were randomly assigned after the run-in period (Arm A, n = 69; Arm B, n = 66). Median PFS1 was significantly longer in Arm A versus Arm B (13.9 versus 5.9months; hazard ratio [HR] 0.55; 95% confidence interval [CI], 0.37-0.84; PStratified=0.001). Median OS was not reached in either arm (HR 1.22; 95%CI, 0.69-2.16; PStratified=0.389); 2-year OS was higher in Arm B versus Arm A (67%; 95%CI, 53-78 versus 58%; 95%CI, 45-70). Grade 3/4 AEs occurred in 55% of patients in Arm A and 64% in Arm B; treatment-related AEs led to discontinuation of any drug in 7% and 9% of patients, respectively. CONCLUSION In patients with BRAFV600-mutated advanced melanoma who achieve tumour control with TT, early switch at 3months to atezolizumab led to rapid loss of tumour control but provided a numerical OS benefit at 2years compared with continued TT.
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Affiliation(s)
- E Livingstone
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - H Gogas
- First Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - L Kandolf-Sekulovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - F Meier
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Skin Cancer Center at the University Cancer Centre and National Center for Tumor Diseases, Dresden, Germany
| | - T K Eigentler
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - M Ziemer
- Department of Dermatology, University of Leipzig Medical Center, Leipzig, Germany
| | | | - A H Gesierich
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | | | - K C Kähler
- Department of Dermatology, Venerology, and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - D C Ziogas
- First Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Z Mijuskovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - M Garzarolli
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - A Roesch
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - S Ugurel
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - R Gutzmer
- Department of Dermatology, Skin Cancer Center Hannover, Hannover Medical School, Hannover, Germany; Department of Dermatology, Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany
| | - J J Grob
- Aix-Marseille University, Timone Hospital (APHM), Marseille, France
| | - F Kiecker
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Dermatology and Venereology, Vivantes Hospital Neukölln, Berlin, Germany
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany; DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
| | | | | | - L Zimmer
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany.
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Thiem A, Mashhadiakbar P, Cussigh C, Hassel JC, Grimmelmann I, Gutzmer R, Schlaak M, Heppt MV, Dücker P, Hüning S, Schulmeyer L, Schilling B, Haferkamp S, Ziemer M, Moritz RKC, Hagelstein V, Terheyden P, Posch C, Gaiser MR, Kropp P, Emmert S, Müller B, Tietze JK. Immune checkpoint inhibition and targeted therapy for melanoma: A patient‐oriented cross‐sectional comparative multicenter study. J Eur Acad Dermatol Venereol 2022; 37:884-893. [PMID: 36433671 DOI: 10.1111/jdv.18778] [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] [Received: 05/03/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Choosing the adequate systemic treatment for melanoma is driven by clinical parameters and personal preferences. OBJECTIVE Evaluation of the impact of disease and treatment on the daily life of patients receiving systemic therapy for melanoma. METHODS A German-wide, cross-sectional comparative study was conducted at 13 specialized skin cancer centres from 08/2020 to 03/2021. A questionnaire was distributed to assess patients' perception of disease and symptoms, the impact of their current treatment on quality of life (QOL) and activities, adverse events (AEs), therapeutic visits, as well as believe in and satisfaction with their current systemic melanoma treatment. Patient-reported outcomes (PROs) were rated on a continuous numerical rating scale or selected from a given list. RESULTS Four hundred and fourteen patients with systemic melanoma therapy were included. 359 (87%) received immune checkpoint inhibition (ICI) and 55 (13%) targeted therapy (TT). About 1/3 of patients were adjuvantly treated, the remaining because of unresectable/metastatic melanoma. In subgroup analyses, only in the adjuvant setting, TT patients reported a significant decrease in their treatment associated QOL compared to patients with ICI (p = 0.02). Patients with TT were 1.9 times more likely to report AEs than patients with ICI, a difference being significant just for the adjuvant setting (p = 0.01). ICI treatment intervals differed significantly between adjuvant and unresectable/metastatic setting (p = 0.04), though all patients, regardless of their specific ICI drug, evaluated their treatment frequency as adequate. TT patients with dabrafenib/trametinib (n = 37) or encorafenib/binimetinib (n = 15) did not differ regarding the strain of daily pill intake. Patients older than 63 years rated various PROs better than younger patients. CONCLUSIONS Patients evaluated their treatment mainly positively. ICI might be preferred over TT regarding QOL and patient-reported AEs in the adjuvant setting. Older melanoma patients appeared to be less impacted by their disease and more satisfied with their treatment.
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Affiliation(s)
- A. Thiem
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
| | - P. Mashhadiakbar
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
| | - C. Cussigh
- Department of Dermatology and National Center for Tumor Diseases (NCT) Heidelberg University Hospital Heidelberg Germany
| | - J. C. Hassel
- Department of Dermatology and National Center for Tumor Diseases (NCT) Heidelberg University Hospital Heidelberg Germany
| | - I. Grimmelmann
- Skin Cancer Center Hannover, Department of Dermatology Hannover Medical School Hannover Germany
| | - R. Gutzmer
- Skin Cancer Center Hannover, Department of Dermatology Hannover Medical School Hannover Germany
- Skin Cancer Center Minden, Department of Dermatology, Johannes‐Wesling‐Klinikum Minden/Ruhr‐University, Bochum Minden Germany
| | - M. Schlaak
- Department of Dermatology and Allergy University Hospital of Munich (LMU) Munich Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin, Department of Dermatology, Venereology and Allergology Berlin Germany
| | - M. V. Heppt
- Department of Dermatology and Comprehensive Cancer Center Erlangen‐European Metropolitan Area of Nuremberg (CCC ER‐EMN), Universitätsklinikum Erlangen, Friedrich‐Alexander‐University Erlangen‐Nürnberg Erlangen Germany
| | - P. Dücker
- Department of Dermatology, Hospital of Dortmund Dortmund Germany
| | - S. Hüning
- Department of Dermatology, Hospital of Dortmund Dortmund Germany
| | - L. Schulmeyer
- Department of Dermatology, Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - B. Schilling
- Department of Dermatology, Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - S. Haferkamp
- Department of Dermatology University Hospital Regensburg Regensburg Germany
| | - M. Ziemer
- Department of Dermatology, Venereology and Allergology University Medical Center Leipzig Leipzig Germany
| | - R. K. C. Moritz
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin, Department of Dermatology, Venereology and Allergology Berlin Germany
- Department of Dermatology and Venereology, Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - V. Hagelstein
- Department of Dermatology, Allergology, and Venereology University of Lübeck Germany
| | - P. Terheyden
- Department of Dermatology, Allergology, and Venereology University of Lübeck Germany
| | - C. Posch
- Department of Dermatology, Venereology and Allergology, Clinic Hietzing Vienna Healthcare Group Vienna Austria
- Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK) Technical University of Munich Munich Germany
- Faculty of Medicine Sigmund Freud University Vienna Vienna Austria
| | - M. R. Gaiser
- Department of Dermatology, Venerology and Allergology, Medical Faculty Mannheim, University Medical Center Mannheim Heidelberg University Mannheim Germany
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg Germany
| | - P. Kropp
- Institute of Medical Psychology and Medical Sociology University Medical Center Rostock Rostock Germany
| | - S. Emmert
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
| | - B. Müller
- Institute of Medical Psychology and Medical Sociology University Medical Center Rostock Rostock Germany
| | - J. K. Tietze
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
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Dummer R, Pathan N, Deng S, Robert C, Arance Fernandez A, de Groot J, Garbe C, Gogas H, Gutzmer R, Krajsova I, Liszkay G, Loquai C, Mandala M, Schadendorf D, Yamazaki N, di Pietro A, Xie T, Ascierto P, Flaherty K. 786O Tumor biomarker analysis from COLUMBUS part 1: Encorafenib + binimetinib for BRAF V600E/K-mutant advanced or metastatic melanoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.912] [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
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Berking C, Livingstone E, Weichenthal M, Leiter-Stoppke U, Remy J, Eigentler T, Mohr P, Kiecker F, Loquai C, Debus D, Gutzmer R. 828P Effectiveness and safety of dabrafenib and trametinib in patients with BRAFV600 mutated metastatic melanoma in the real-world setting: Final results of the non-interventional COMBI-r study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Becker J, Ugurel S, Leiter-Stoppke U, Meier F, Gutzmer R, Haferkamp S, Zimmer L, Livingstone E, Eigentler T, Hauschild A, Kiecker F, Hassel J, Mohr P, Fluck M, Thomas I, Garzarolli M, Grimmelmann I, Drexler K, Eckhardt S, Schadendorf D. 787O Adjuvant immunotherapy with nivolumab (NIVO) versus observation in completely resected Merkel cell carcinoma (MCC): Disease-free survival (DFS) results from ADMEC-O, a randomized, open-label phase II trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Lewis K, Robert C, Ramella Munhoz R, Liszkay G, de la Cruz Merino L, Olah J, Queirolo P, Mackiewicz J, Li H, Zhu Q, Hertig C, Paranthaman N, McKenna E, Gutzmer R, McArthur G, Ascierto P. 813P Time to development of central nervous system (CNS) metastases (mets) with atezolizumab (A) or placebo (P) combined with vemurafenib (V) + cobimetinib (C): Updated results from the phase III IMspire150 study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gosmann JG, Bielefeld A, Schaper-Gerhardt K, Gutzmer R, Stadler R. The effect of mogamulizumab on the malignant T cell population: a monocentric retrospective analysis. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00602-5] [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: 11/03/2022]
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Hughes BGM, Munoz-Couselo E, Mortier L, Bratland Å, Gutzmer R, Roshdy O, González Mendoza R, Schachter J, Arance A, Grange F, Meyer N, Joshi A, Billan S, Zhang P, Gumuscu B, Swaby RF, Grob JJ. Corrigendum to 'Pembrolizumab for locally advanced and recurrent/metastatic cutaneous squamous cell carcinoma (KEYNOTE-629 study): an open-label, nonrandomized, multicenter, phase II trial: [Annals of Oncology Volume 32, Issue 10, October 2021, Pages 1276-1285]. Ann Oncol 2022; 33:853. [PMID: 35690517 DOI: 10.1016/j.annonc.2022.05.517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- B G M Hughes
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston; University of Queensland, Brisbane, Australia.
| | - E Munoz-Couselo
- Hospital Vall D Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - L Mortier
- University of Lille, Inserm U 1189, CHU Lille, Lille, France
| | | | - R Gutzmer
- Department of Dermatology and Allergy, Skin Cancer Center Hannover, Medizinische Hochschule Hannover, Hanover; Mühlenkreiskliniken, Ruhr University Bochum Campus Minden, Minden, Germany
| | - O Roshdy
- Jewish General Hospital, Montreal, Canada
| | | | - J Schachter
- Chaim Sheba Medical Center at Tel HaShomer, Ramat Gan, Israel
| | - A Arance
- Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - F Grange
- Dermatology Department, Center Hospitalier Universitaire de Reims-Hôpital Robert Debre, Reims
| | - N Meyer
- Dermatology, Institut Universitaire du Cancer and CHU de Toulouse, Toulouse, France
| | - A Joshi
- Department of Medical Oncology, Townsville University Hospital, Townsville, Australia
| | - S Billan
- The Head and Neck Center, Oncology Department, Rambam Health Care Campus, Haifa, Israel
| | - P Zhang
- Merck & Co., Inc., Kenilworth, USA
| | | | | | - J-J Grob
- Service de Dermatologie et Cancérologie Cutanée, Aix-Marseille University, Marseille, France
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Munoz Couselo E, Hughes B, Bratland Å, Gutzmer R, Roshdy O, González Mendoza R, Schachter J, Arance Fernandez A, Grange F, Meyer N, Joshi A, Billan S, Grob J, Zhang P, Gumuscu B, Swaby R, Mortier L. 149P KEYNOTE-629: Efficacy of pembrolizumab (Pembro) per immune-related RECIST (irRECIST) in locally advanced (LA) and recurrent or metastatic (R/M) cutaneous squamous cell carcinoma (cSCC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.168] [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: 10/19/2022] Open
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Dummer R, Flaherty K, Robert C, Arance A, de Groot J, Garbe C, Gogas H, Gutzmer R, Krajsová I, Liszkay G, Loquai C, Mandala M, Schadendorf D, Yamazaki N, Zohren F, Edwards M, Ascierto P. 1041MO 5-year update on COLUMBUS: A randomized phase III trial of encorafenib (enco) + binimetinib (bini) versus enco or vemurafenib (vem) in patients (pts) with BRAF V600-mutant melanoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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13
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Gutzmer R, Eigentler T, Mohr P, Weichenthal M, Dücker P, Gebhardt C, Göppner D, Grimmelmann I, Haferkamp S, Kähler K, Meier F, Pföhler C, Sickmann T, Sindrilaru A, Terheyden P, Ugurel S, Ulrich J, Utikal J, Weishaupt C, Schadendorf D. 1079P Comparison of effectiveness and safety of nivolumab monotherapy or in combination therapy with ipilimumab in therapy-naïve and pretreated patients with advanced melanoma within the German noninterventional study NICO. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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14
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Ribas A, Chesney J, Long G, Kirkwood J, Dummer R, Puzanov I, Hoeller C, Gajewski T, Gutzmer R, Rutkowski P, Demidov L, Arenberger P, Shin S, Ferrucci P, Diede S, Anderson J, Treichel S, Chan E, Hodi F, Gogas H. 1037O MASTERKEY-265: A phase III, randomized, placebo (Pbo)-controlled study of talimogene laherparepvec (T) plus pembrolizumab (P) for unresectable stage IIIB–IVM1c melanoma (MEL). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1422] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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15
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Gutzmer R, Sibaud V, Hassel JC. Corrigendum to 'IgE blockade in the management of eosinophil-associated recalcitrant pruritus due to medical tumor therapy': Annals of Oncology 2021; volume 32: 696-697. Ann Oncol 2021; 32:1310. [PMID: 34373158 DOI: 10.1016/j.annonc.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- R Gutzmer
- Skin Cancer Center Minden, Department of Dermatology, Johannes-Wesling-Klinikum Minden/Ruhr-University, Bochum, Minden, Germany.
| | - V Sibaud
- Cancer University Institute, Toulouse Oncopole, Toulouse, France
| | - J C Hassel
- Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
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16
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Gutzmer R, Schulze HJ, Hauschild A, Leiter U, Meier F, Haferkamp S, Ulrich C, Wahl RU, Berking C, Herbst R, Häckl M, Schadendorf D. Effectiveness, safety and utilization of vismodegib in locally advanced basal cell carcinoma under real-world conditions in Germany - The non-interventional study NIELS. J Eur Acad Dermatol Venereol 2021; 35:1678-1685. [PMID: 33931910 DOI: 10.1111/jdv.17332] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) can arise by the uncontrolled proliferation of cells from multiple epidermal compartments due to aberrant activation of the Hedgehog (Hh) signalling pathway. Vismodegib, a small-molecule inhibitor of this pathway, is approved for treatment of patients with locally advanced (la) BCC inappropriate for surgery or radiotherapy or patients with symptomatic metastatic (m) BCC. OBJECTIVES The aim of this non-interventional study was to assess effectiveness with a special focus on duration of response (DOR), safety and utilization of vismodegib for treatment of laBCC in daily practice in Germany. METHODS This non-interventional study (NIS) observed treatment of laBCC with vismodegib according to the German label in clinical practice. All available patients who had received at least one dose of vismodegib between commercial availability of vismodegib in Germany (02 August 2013) and 3 years before end of study (31 March 2016) could be included and were documented retrospectively and/or prospectively for up to 3 years. Primary effectiveness variable was DOR. Assessment of tumour response was carried out by the treating physicians. Exploratory variables included utilization of vismodegib, decision makers for therapy and method of tumour response evaluation. All statistical analyses were descriptive. RESULTS Between September 2015 and March 2019, 66 patients were observed at 26 German centres. The objective response rate (ORR) was 74.2% and the disease control rate (DCR) was 90.9%. The median DOR was 15.9 months (95% CI: 9.2; 25.7; n = 49 patients with response). The median progression-free survival (PFS) was 19.1 months and the median time to response (TTR) 2.7 months. A total of 340 adverse events were reported in 63 (95.5%) patients; no new safety signals were identified. CONCLUSIONS The NIS NIELS shows effectiveness and safety of vismodegib in patients with laBCC. It confirms the transferability of the results of the pivotal trial into routine clinical practice.
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Affiliation(s)
- R Gutzmer
- Klinik für Dermatologie, Mühlenkreiskliniken Minden, Akademisches der Universität Bochum, Minden, Germany
| | - H-J Schulze
- Hauttumorzentrum Hornheide-Münster, Münster, Germany
| | - A Hauschild
- Klinik für Dermatologie, UKSH Campus Kiel, Kiel, Germany
| | - U Leiter
- Zentrum für Dermatoonkologie, Universitätsklinikum Tübingen, Tübingen, Germany
| | - F Meier
- Hautkrebszentrum am Universitäts-Krebscentrum Dresden und Nationales Centrum für Tumorerkrankungen, Dresden, Germany.,Abteilung für Dermatologie, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - S Haferkamp
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Regensburg, Regensburg, Germany
| | - C Ulrich
- Klinik für Dermatologie, Venerologie u. Allergologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - R U Wahl
- Klinik für Dermatologie und Allergologie, Universitätsklinikum der RWTH Aachen, Aachen, Germany
| | - C Berking
- Hautklinik, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), CCC Erlangen EMN, Erlangen, Germany
| | - R Herbst
- Hauttumorzentrum, Erfurt, Germany
| | - M Häckl
- Roche Pharma AG, Grenzach-Wyhlen, Germany
| | - D Schadendorf
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site, Essen, Germany
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17
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Gutzmer R, Sibaud V, Hassel JC. IgE blockade in the management of eosinophil-associated recalcitrant pruritus due to medical tumor therapy. Ann Oncol 2021; 32:696-697. [PMID: 33882330 DOI: 10.1016/j.annonc.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- R Gutzmer
- Skin Cancer Center Minden, Department of Dermatology, Johannes-Wesling-Klinikum Minden/Ruhr-University Bochum, Minden, Germany.
| | - V Sibaud
- Cancer University Institute, Toulouse Oncopole, Toulouse, France
| | - J C Hassel
- Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
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18
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Gutzmer R, Dummer R, Loquai C, Squittieri N, Lewis K, Migden M. Les effets de la réduction de la posologie ou du retard du sonidégib sur les carcinomes basocellulaires localement avancés : données à 42 mois, issues de BOLT. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.107] [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]
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19
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Lewis K, Robert C, Ascierto P, Munhoz R, Liszkay G, Merino LDLC, Olah J, Queirolo P, Mackiewicz J, Li H, Zhu Q, McKenna E, McNally V, Gutzmer R, McArthur G. 1137P Incidence and time course of adverse events (AEs) with atezolizumab (A) in combination with vemurafenib (V) and cobimetinib (C) in the phase III IMspire150 study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1260] [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
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20
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Gutzmer R, Eigentler T, Mohr P, Weichenthal M, Dücker P, Gebhardt C, Göppner D, Haferkamp S, Kähler K, Meier F, Pföhler C, Satzger I, Sickmann T, Sindrilaru A, Terheyden P, Ugurel S, Ulrich J, Utikal J, Weishaupt C, Schadendorf D. 1104P Nivolumab (NIVO) monotherapy or combination therapy with ipilimumab (NIVO+IPI) in advanced melanoma patients with brain metastases: Real-world evidence from the German non-interventional study NICO. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1227] [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
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21
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Robert C, Flaherty K, Gogas H, Fernandez AA, Mandala M, Liszkay G, Garbe C, Schadendorf D, Krajsova I, Gutzmer R, de Groot J, Dutriaux C, Loquai C, Harney A, Kiprilov E, Pickard M, Cantey-Kiser J, Dummer R, Ascierto P. 1127P Correlation of BRAF mutation status in circulating tumour DNA (ctDNA) with tumour biopsy and clinical outcomes in COLUMBUS. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1250] [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
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22
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Ascierto P, Robert C, Lewis K, Gutzmer R, Stroyakovskiy D, Gogas H, Protsenko S, Pereira R, Eigentler T, Rutkowski P, Demidov L, Manikhas GM, McNally V, Forbes H, Shah K, Yan Y, McArthur G. 1102P Clinical benefit in BRAFV600 mutation-positive melanoma defined by programmed death ligand 1 (PD-L1) and/or lactate dehydrogenase (LDH) status: Exploratory analyses from the IMspire150 study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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23
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Leiter U, Gutzmer R, Alter M, Ulrich C, Meiwes A, Heppt MV, Steeb T, Berking C, Lonsdorf AS, Sachse MM, Garbe C, Hillen U. [Cutaneous squamous cell carcinoma]. Hautarzt 2020; 71:597-606. [PMID: 32583034 DOI: 10.1007/s00105-020-04620-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers of the Caucasian population and accounts for 20% of all skin tumours. An S3 guideline of the German Guideline Program in Oncology has been available since 2019. The diagnosis is based on the clinical examination. Excision and histological confirmation is required for all clinically suspicious lesions to allow prognostic assessment and correct treatment. The therapy of first choice is complete excision with histological control of the surgical margin. In cSCC with risk factors such as tumor thickness >6 mm, sentinel lymph node biopsy may be discussed, but there is currently no clear evidence of its prognostic and therapeutic relevance. Adjuvant radiation therapy may be considered in cases of high risk of recurrence and should be tested in cases of inoperable tumors. The indication for electrochemotherapy should also be considered in the treatment of local or locoregional recurrence. The immune checkpoint inhibitor cemiplimab is approved for the treatment of inoperable or metastasized cSCC. In case of contraindications, chemotherapeutic agents, epidermal growth factor receptor (EGFR) inhibitors or palliative radiotherapy can be used. Since the evidence is low in these cases, a systemic therapy should be used preferentially within clinical studies. Follow-up care should be risk-adapted and includes a dermatological control, supplemented by ultrasound examinations in high-risk patients.
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Affiliation(s)
- U Leiter
- Zentrum für Dermato-Onkologie, Südwestdeutsches Tumorzentrum, Universitäts-Hautklinik, Eberhard-Karls-Universität, Liebermeisterstr. 25, 72076, Tübingen, Deutschland.
| | - R Gutzmer
- Hauttumorzentrum Hannover, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - M Alter
- Universitätshautklinik, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - C Ulrich
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - A Meiwes
- Zentrum für Dermato-Onkologie, Südwestdeutsches Tumorzentrum, Universitäts-Hautklinik, Eberhard-Karls-Universität, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| | - M V Heppt
- Hautklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - T Steeb
- Hautklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - C Berking
- Hautklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - A S Lonsdorf
- Universitäts-Hautklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Deutschland
| | - M M Sachse
- Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven, Bremerhaven, Deutschland
| | - C Garbe
- Zentrum für Dermato-Onkologie, Südwestdeutsches Tumorzentrum, Universitäts-Hautklinik, Eberhard-Karls-Universität, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| | - U Hillen
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
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24
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Gellrich FF, Hüning S, Beissert S, Eigentler T, Stockfleth E, Gutzmer R, Meier F. Medical treatment of advanced cutaneous squamous-cell carcinoma. J Eur Acad Dermatol Venereol 2020; 33 Suppl 8:38-43. [PMID: 31833610 DOI: 10.1111/jdv.16024] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/21/2019] [Indexed: 01/23/2023]
Abstract
Considering the rising incidence, cutaneous squamous-cell carcinoma (cSCC) has a high clinical relevance. In patients with localized cSCC, complete surgical resection is indicated. Radiotherapy should be performed in patients with non-resectable tumours or in patients who are not suitable for surgery. Systemic therapy is reserved for cSCC that are neither surgically nor radiotherapeutically curable due to their extensive local spread and/or local or distant metastasis. In the absence of prospective randomized phase 3 trials to evaluate and compare the efficacy and safety of chemotherapeutics, epidermal growth factor receptor (EGFR) inhibitors and anti-PD-1 antibodies, no final recommendation for systemic therapy can be given for patients with locally advanced or metastatic cSCC. Anti-PD-1 antibodies currently show promising results with response rates of up to 50% in both locally advanced and metastatic cSCC. Anti-PD-1 antibodies appear to achieve higher response rates compared with EGFR inhibitors, and the duration of response appears to be superior to both chemotherapy and EGFR inhibitors. Compared with chemotherapy, the side effect profile of anti-PD-1 antibodies appears to be favourable. Altogether, PD-1 inhibitors are expected to become the new standard of care for patients with locally advanced and metastatic cSCC. Currently, placebo-controlled clinical trials are investigating the adjuvant use of cemiplimab and pembrolizumab in patients undergoing resection and radiotherapy of high-risk cSCC. Patients not eligible for anti-PD-1 treatment, e.g. in organ transplant recipients, or in patients refractory to anti-PD-1 may be offered EGFR inhibitors and/or chemotherapies. Chemotherapies appear to be superior to EGFR inhibitors in terms of response rates, whereas EGFR inhibitors have a more favourable toxicity profile. EGFR inhibitors are therefore more suitable for multimorbid and/or frail elderly patients. By combining EGFR inhibitors with local therapy such as surgery or radiotherapy, response rates and duration of response may be improved.
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Affiliation(s)
- F F Gellrich
- Dermatology, National Center for Tumor Diseases, University Hospital Carl Gustav Carus, Dresden, Germany
| | - S Hüning
- Dermatology, Klinikum Dortmund gGmbH, Dortmund, Germany
| | - S Beissert
- Dermatology, National Center for Tumor Diseases, University Hospital Carl Gustav Carus, Dresden, Germany
| | - T Eigentler
- Dermatology, Universitätsklinikum Tübingen, Tübingen, Germany
| | - E Stockfleth
- Dermatology and Allergology, University of Bochum, Bochum, Germany
| | - R Gutzmer
- Department of Dermatology and Allergy, Skin Cancer Center, Hannover Medical School, Hannover, Germany
| | - F Meier
- Dermatology, National Center for Tumor Diseases, University Hospital Carl Gustav Carus, Dresden, Germany
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25
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Livingstone E, Zaremba A, Horn S, Ugurel S, Casalini B, Schlaak M, Hassel JC, Herbst R, Utikal JS, Weide B, Gutzmer R, Meier F, Koelsche C, Hadaschik E, Sucker A, Reis H, Merkelbach-Bruse S, Siewert M, Sahm F, von Deimling A, Cosgarea I, Zimmer L, Schadendorf D, Schilling B, Griewank KG. GNAQ and GNA11 mutant nonuveal melanoma: a subtype distinct from both cutaneous and uveal melanoma. Br J Dermatol 2020; 183:928-939. [PMID: 32064597 DOI: 10.1111/bjd.18947] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND GNAQ and GNA11 mutant nonuveal melanoma represent a poorly characterized rare subgroup of melanoma with a gene mutation profile similar to uveal melanoma. OBJECTIVES To characterize these tumours in terms of clinical behaviour and genetic characteristics. METHODS Patients with nonuveal GNAQ/11 mutated melanoma were identified from the prospective multicentre tumour tissue registry ADOREG, Tissue Registry in Melanoma (TRIM) and additional cooperating skin cancer centres. Extensive data on patient, tumour and treatment characteristics were collected retrospectively. Targeted sequencing was used to determine tumour mutational burden. Immunohistochemistry staining was performed for programmed death-ligand 1 and BRCA1-associated protein (BAP)1. Existing whole-exome cutaneous and uveal melanoma data were analysed for mutation type and burden. RESULTS We identified 18 patients with metastatic GNAQ/11 mutant nonuveal melanoma. Tumours had a lower tumour mutational burden and fewer ultraviolet signature mutations than cutaneous melanomas. In addition to GNAQ and GNA11 mutations (nine each), six splicing factor 3b subunit 1 (SF3B1), three eukaryotic translation initiation factor 1A X-linked (EIF1AX) and four BAP1 mutations were detected. In contrast to uveal melanoma, GNAQ/11 mutant nonuveal melanomas frequently metastasized lymphatically and concurrent EIF1AX, SF3B1 and BAP1 mutations showed no apparent association with patient prognosis. Objective response to immunotherapy was poor with only one partial response observed in 10 treated patients (10%). CONCLUSIONS Our findings suggest that GNAQ/11 mutant nonuveal melanomas are a subtype of melanoma that is both clinically and genetically distinct from cutaneous and uveal melanoma. As they respond poorly to available treatment regimens, novel effective therapeutic approaches for affected patients are urgently needed. What is already known about this topic? The rare occurrence of GNAQ/11 mutations in nonuveal melanoma has been documented. GNAQ/11 mutant nonuveal melanomas also harbour genetic alterations in EIF1AX, SF3B1 and BAP1 that are of prognostic relevance in uveal melanoma. What does this study add? GNAQ/11 mutant nonuveal melanomas show metastatic spread reminiscent of cutaneous melanoma, but not uveal melanoma. GNAQ/11 mutant nonuveal melanomas have a low tumour mutational burden that is higher than uveal melanoma, but lower than cutaneous melanoma. What is the translational message? Primary GNAQ/11 mutant nonuveal melanomas are a subtype of melanoma that is clinically and genetically distinct from both cutaneous and uveal melanoma. As metastatic GNAQ/11 mutant nonuveal melanomas respond poorly to available systemic therapies, including immune checkpoint inhibition, novel therapeutic approaches for these tumours are urgently needed. Linked Comment: Rafei-Shamsabadi. Br J Dermatol 2020; 183:806-807.
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Affiliation(s)
- E Livingstone
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - A Zaremba
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - S Horn
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany.,Medical Faculty of the University Leipzig, Rudolf-Schönheimer-Institute of Biochemistry, Johannisallee 30, 04103, Leipzig, Germany
| | - S Ugurel
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - B Casalini
- Department of Neuropathology, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology and DKTK, DKFZ, Heidelberg, Germany
| | - M Schlaak
- Department of Dermatology, LMU München, Frauenlobstraße 9-11, 80337, Munich, Germany
| | - J C Hassel
- Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - R Herbst
- Department of Dermatology, Helios Klinikum Erfurt, Nordhäuserstr. 74, 99089, Erfurt, Germany
| | - J S Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
| | - B Weide
- Department of Dermatology, University of Tübingen, Liebermeisterstraße 25, 72076, Tübingen, Germany
| | - R Gutzmer
- Department of Dermatology, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - F Meier
- Department of Dermatology, Carl-Gustav-Carus University Hospital, Fetscherstr. 74, 01307, Dresden, Germany
| | - C Koelsche
- Department of General Pathology, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - E Hadaschik
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - A Sucker
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - H Reis
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - S Merkelbach-Bruse
- Institute of Pathology, University Hospital Cologne, Kerpener Str. 62, 50924, Cologne, Germany
| | - M Siewert
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - F Sahm
- Department of Neuropathology, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology and DKTK, DKFZ, Heidelberg, Germany
| | - A von Deimling
- Department of Neuropathology, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology and DKTK, DKFZ, Heidelberg, Germany
| | - I Cosgarea
- Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - B Schilling
- Deptartment of Dermatology, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany
| | - K G Griewank
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany.,Dermatopathologie bei Mainz, Bahnhofstr. 2B, 55268, Nieder-Olm, Germany
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26
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Dummer R, Ascierto P, Basset‐Seguin N, Dréno B, Garbe C, Gutzmer R, Hauschild A, Krattinger R, Lear J, Malvehy J, Schadendorf D, Grob J. Sonidegib and vismodegib in the treatment of patients with locally advanced basal cell carcinoma: a joint expert opinion. J Eur Acad Dermatol Venereol 2020; 34:1944-1956. [DOI: 10.1111/jdv.16230] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/17/2019] [Indexed: 12/23/2022]
Affiliation(s)
- R. Dummer
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - P.A. Ascierto
- Melanoma Cancer Immunotherapy and Development Therapeutics Unit Istituto Nazionale Tumori IRCCS Fondazione G. Pascale Naples Italy
| | | | - B. Dréno
- Department of Dermato Oncology University Hospital Nantes Nantes France
| | - C. Garbe
- Division of Dermato‐oncology University of Tübingen Tübingen Germany
| | - R. Gutzmer
- Skin Cancer Center Hannover Department of Dermatology Hannover Medical School Hannover Germany
| | - A. Hauschild
- Department of Dermatology University Hospital Schleswig‐Holstein Kiel Germany
| | - R. Krattinger
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - J.T. Lear
- Department of Dermatology Manchester Academic Health Science Centre Manchester University and Salford Royal NHS Trust Manchester UK
| | - J. Malvehy
- Dermatology Department Hospital Clinic of Barcelona IDIBAPS University of Barcelona Barcelona Spain
| | - D. Schadendorf
- Department of Dermatology University Hospital Essen Essen & German Cancer Consortium Heidelberg Germany
| | - J.J. Grob
- Dermatology and Oncology Service Aix Marseille University and Timone Hospital Marseille France
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Dummer R, Guminksi A, Gutzmer R, Lear JT, Lewis KD, Chang ALS, Combemale P, Dirix L, Kaatz M, Kudchadkar R, Loquai C, Plummer R, Schulze HJ, Stratigos AJ, Trefzer U, Squittieri N, Migden MR. Long-term efficacy and safety of sonidegib in patients with advanced basal cell carcinoma: 42-month analysis of the phase II randomized, double-blind BOLT study. Br J Dermatol 2019; 182:1369-1378. [PMID: 31545507 PMCID: PMC7318253 DOI: 10.1111/bjd.18552] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [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] [Accepted: 09/18/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Basal cell carcinomas (BCCs) exhibit aberrant activation of the hedgehog pathway. Sonidegib is a hedgehog pathway inhibitor approved for the treatment of locally advanced BCC (laBCC) and metastatic BCC (mBCC) based on primary results of the BOLT study [Basal Cell Carcinoma Outcomes with LDE225 (sonidegib) Treatment]. OBJECTIVES This is the final 42-month analysis of the BOLT study, evaluating the efficacy and safety of sonidegib. METHODS Adults with no prior hedgehog pathway inhibitor therapy were randomized in a 1 : 2 ratio to sonidegib 200 mg or 800 mg once daily. Treatment continued for up to 42 months or until disease progression, unacceptable toxicity, death, study termination or withdrawal of consent. The primary efficacy end point was the objective response rate (ORR) by central review, assessed at baseline; weeks 5, 9 and 17; then subsequently every 8 or 12 weeks during years 1 or 2, respectively. Safety end points included adverse event monitoring and reporting. RESULTS The study enrolled 230 patients, 79 and 151 in the 200-mg and 800-mg groups, respectively, of whom 8% and 3.3% remained on treatment by the 42-month cutoff, respectively. The ORRs by central review were 56% [95% confidence interval (CI) 43-68] for laBCC and 8% (95% CI 0·2-36) for mBCC in the 200-mg group and 46·1% (95% CI 37·2-55·1) for laBCC and 17% (95% CI 5-39) for mBCC in the 800-mg group. No new safety concerns emerged. CONCLUSIONS Sonidegib demonstrated sustained efficacy and a manageable safety profile. The final BOLT results support sonidegib as a viable treatment option for laBCC and mBCC. What's already known about this topic? Basal cell carcinoma (BCC) is usually treatable with surgery or radiation therapy, but there are limited treatment options for patients with advanced BCC. Sonidegib, a hedgehog pathway inhibitor approved for the treatment of advanced BCC, demonstrated clinically relevant efficacy and manageable safety in prior analyses of the phase II randomized, double-blind BOLT study [Basal Cell Carcinoma Outcomes with LDE225 (sonidegib) Treatment]. What does this study add? This final 42-month analysis of BOLT is the longest follow-up available for a hedgehog pathway inhibitor. Clinically relevant efficacy results were sustained from prior analyses, with objective response rates by central review of the approved 200-mg daily dose of 56% in locally advanced BCC and 8% in metastatic BCC. No new safety concerns were raised. The results confirmed sonidegib as a viable long-term treatment option for patients with advanced BCC.
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Affiliation(s)
- R Dummer
- Department of Dermatology, University of Zürich, Skin Cancer Center, University Hospital, Zürich, Switzerland
| | - A Guminksi
- Department of Medical Oncology, Royal North Shore Hospital, Sydney, Australia.,Melanoma Institute Australia, The University of Sydney, Sydney, Australia.,Mater Hospital, Sydney, Australia
| | - R Gutzmer
- Skin Cancer Center Hannover, Department of Dermatology, Hannover Medical School, Hannover, Germany
| | - J T Lear
- Manchester Academic Health Science Centre, Manchester University and Salford Royal NHS Trust, Manchester, U.K
| | - K D Lewis
- University of Colorado Cancer Center, Anschutz, Aurora, CO, U.S.A
| | - A L S Chang
- Department of Dermatology, Stanford University School of Medicine, Redwood City, CA, U.S.A
| | - P Combemale
- Department of Dermatology, Hôpitaux Universitaires de Lyon, Université de Lyon, Lyon, France.,Centre de Référence des Neurofibromatoses, Créteil, France
| | - L Dirix
- Saint-Augustinus Hospital, Antwerp, Belgium
| | - M Kaatz
- Department of Dermatology, SRH Waldklinikum, Gera, Germany
| | | | - C Loquai
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | - R Plummer
- Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, U.K
| | - H-J Schulze
- Department of Dermatology, Fachklinik Hornheide, Münster, Germany
| | - A J Stratigos
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - U Trefzer
- Department of Dermatology, University Hospital Charite, Berlin, Germany
| | - N Squittieri
- Sun Pharmaceutical Industries, Inc., Princeton, NJ, U.S.A
| | - M R Migden
- Departments of Dermatology and Head and Neck Surgery, The University of Texas-MD Anderson Cancer Center, Houston, TX, U.S.A
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Drakaki A, Luhn P, Wakelee H, Dhillon P, Kent M, Shim J, Degaonkar V, Hoang T, McNally V, Chui S, Gutzmer R. Association of systemic corticosteroids with overall survival in patients receiving cancer immunotherapy for advanced melanoma, non-small cell lung cancer or urothelial cancer in routine clinical practice. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz449.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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29
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Hassel J, Berking C, Eigentler T, Gutzmer R, Ascierto P, Schilling B, Hermann F, Bartz R, Schadendorf D. Phase Ib/II study (SENSITIZE) assessing safety, pharmacokinetics (PK), pharmacodynamics (PD), and clinical outcome of domatinostat in combination with pembrolizumab in patients with advanced melanoma refractory/non-responding to prior checkpoint inhibitor therapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Knispel S, Gassenmaier M, Menzies A, Loquai C, Johnson D, Franklin C, Gutzmer R, Hassel J, Weishaupt C, Eigentler T, Schummer P, Kiecker F, Owen C, Schmidgen M, Kähler K, Cann C, Niebel D, Mohr P, Schadendorf D, Zimmer L. Outcome of patients with elevated LDH treated with first-line targeted therapy (TT) or PD-1 based immune checkpoint inhibitors (ICI). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Krauss J, Eigentler T, Schreiber J, Weishaupt C, Terheyden P, Heinzerling L, Mohr P, Weide B, Ochsenreither S, Gutzmer R, Becker J, Kiecker F, Funkner F, Heidenreich R, Kays SK, Klinkhardt U, Gnad-Vogt U, Scheel B, Schönborn-Kellenberger O, Seibel T. A phase I dose-escalation and expansion trial of intratumorally administered CV8102, alone and in combination with anti-PD-1 in patients with advanced solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Berking C, Livingstone E, Weichenthal M, Leiter U, Wittmann K, Eigentler T, Mohr P, Kiecker F, Loquai C, Debus D, Gutzmer R. Efficacy and safety of dabrafenib and trametinib in patients with metastatic BRAFV600 mutation-positive melanoma in the real-world setting: Interim results of the non-interventional COMBI-r study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Schadendorf D, Hassel J, Fluck M, Eigentler T, Loquai C, Berneburg M, Gutzmer R, Meier F, Mohr P, Hauschild A, Becker J, Menzer C, Kiecker F, Dippel E, Simon JC, Conrad B, Garbe C, Körner S, Livingstone E, Zimmer L. Adjuvant immunotherapy with nivolumab (NIVO) alone or in combination with ipilimumab (IPI) versus placebo in stage IV melanoma patients with no evidence of disease (NED): A randomized, double-blind phase II trial (IMMUNED). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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34
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Dalle S, Mortier L, Corrie P, Lotem M, Board R, Arance A, Meiss F, Terheyden P, Gutzmer R, Brokaw J, Le T, Mathias S, Scotto J, Lord-Bessen J, Moshyk A, Kotapati S, Middleton M. Long-term real-world (RW) outcomes in patients with advanced melanoma (MEL) treated with ipilimumab (IPI) and non-IPI therapies: IMAGE study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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Shannan B, Matschke J, Chauvistré H, Vogel F, Klein D, Meier F, Westphal D, Bruns J, Rauschenberg R, Utikal J, Forschner A, Berking C, Terheyden P, Dabrowski E, Gutzmer R, Rafei-Shamsabadi D, Meiss F, Heinzerling L, Zimmer L, Livingstone E, Váraljai R, Hoewner A, Horn S, Klode J, Stuschke M, Scheffler B, Marchetto A, Sannino G, Grünewald TGP, Schadendorf D, Jendrossek V, Roesch A. Sequence-dependent cross-resistance of combined radiotherapy plus BRAF V600E inhibition in melanoma. Eur J Cancer 2019; 109:137-153. [PMID: 30721788 DOI: 10.1016/j.ejca.2018.12.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/22/2018] [Accepted: 12/29/2018] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Treatment of patients with metastatic melanoma is hampered by drug-resistance and often requires combination with radiotherapy as last-resort option. However, also after radiotherapy, clinical relapses are common. METHODS & RESULTS Our preclinical models indicated a higher rate of tumour relapse when melanoma cells were first treated with BRAFV600E inhibition (BRAFi) followed by radiotherapy as compared to the reverse sequence. Accordingly, retrospective follow-up data from 65 stage-IV melanoma patients with irradiated melanoma brain metastases confirmed a shortened duration of local response of mitogen-activated protein kinase (MAPK)-inhibitor-pretreated compared with MAPK-inhibitor-naïve intracranial metastases. On the molecular level, we identified JARID1B/KDM5B as a cellular marker for cross-resistance between BRAFi and radiotherapy. JARID1Bhigh cells appeared more frequently under upfront BRAFi as compared with upfront radiation. JARID1B favours cell survival by transcriptional regulation of genes controlling cell cycle, DNA repair and cell death. CONCLUSION The level of cross-resistance between combined MAPK inhibition and radiotherapy is dependent on the treatment sequence. JARID1B may represent a novel therapy-overarching resistance marker.
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Affiliation(s)
- B Shannan
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - J Matschke
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Germany
| | - H Chauvistré
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - F Vogel
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - D Klein
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Germany
| | - F Meier
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - D Westphal
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - J Bruns
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - R Rauschenberg
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - J Utikal
- Skin Cancer Unit German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Dermatology, Venereology and Allergology University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - A Forschner
- Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Germany
| | - C Berking
- Department of Dermatology and Allergy, University Hospital of Munich, Munich, Germany
| | - P Terheyden
- Department of Dermatology, University of Luebeck, Luebeck, Germany
| | - E Dabrowski
- Department of Dermatology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - R Gutzmer
- Skin Cancer Centre, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - D Rafei-Shamsabadi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - F Meiss
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - L Heinzerling
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - Elisabeth Livingstone
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - Renáta Váraljai
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - A Hoewner
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - S Horn
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - J Klode
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - M Stuschke
- Department of Radiotherapy, West German Cancer Center, University Hospital, University of Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Essen, Germany
| | - B Scheffler
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - A Marchetto
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Germany
| | - G Sannino
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Germany
| | - T G P Grünewald
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - V Jendrossek
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Germany
| | - A Roesch
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany.
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Robert C, Dummer R, Ascierto P, Gogas H, Arance A, Mandala M, Liszkay G, Garbe C, Schadendorf D, Krajsova I, Gutzmer R, Chiarion Sileni V, Dutriaux C, de Groot J, Yamazaki N, Loquai C, Moutouh-de Parseval L, Pickard M, Sandor V, Flaherty K. Données de survie globale de l’étude COLUMBUS, étude de phase III avec encorafénib (ENCO) plus binimétinib (BINI) versus vémurafénib (VEM) ou encorafénib (ENCO) dans le mélanome métastatique BRAF muté. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.103] [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: 10/27/2022]
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Gogas H, Gutzmer R, Malvehy J, Mehnert J, Liu K, Pickett C, Snyder W, Chesney J. Response rates with talimogene laherparepvec (T-VEC) monotherapy in patients (pts) with stage IIIB–IVM1c melanoma previously treated with checkpoint inhibitor (CPI) therapy: Retrospective analysis of two clinical trials. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy486.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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38
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Gogas H, Samoylenko I, Schadendorf D, Gutzmer R, Grob J, Sacco J, Gorski K, Anderson A, Liu C, Malvehy J. Talimogene laherparepvec (T-VEC) treatment increases intratumoral effector T-cell and natural killer (NK) cell density in noninjected tumors in patients (pts) with stage IIIB–IVM1c melanoma: Evidence for systemic effects in a phase II, single-arm study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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39
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Lear J, Migden M, Lewis K, Chang A, Guminski A, Gutzmer R, Dirix L, Combemale P, Stratigos A, Plummer R, Castro H, Yi T, Mone M, Zhou J, Trefzer U, Kaatz M, Loquai C, Kudchadkar R, Sellami D, Dummer R. Long-term efficacy and safety of sonidegib in patients with locally advanced and metastatic basal cell carcinoma: 30-month analysis of the randomized phase 2 BOLT study. J Eur Acad Dermatol Venereol 2018; 32:372-381. [PMID: 28846163 PMCID: PMC5873455 DOI: 10.1111/jdv.14542] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 08/07/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients with locally advanced basal cell carcinoma (laBCC) or metastatic BCC (mBCC), two difficult-to-treat populations, have had limited treatment options. Sonidegib, a hedgehog pathway inhibitor (HPI), was approved in laBCC based on results from the BOLT trial. OBJECTIVE To evaluate long-term efficacy and safety of sonidegib in laBCC and mBCC in the BOLT 18- and 30-month analyses. METHODS BOLT (NCT01327053, ClinicalTrials.gov), a double-blind phase 2 study, enrolled patients from July 2011 until January 2013. Eligible HPI-treatment-naïve patients with laBCC not amenable to curative surgery/radiotherapy or mBCC were randomized 1 : 2 to sonidegib 200 mg (laBCC, n = 66; mBCC, n = 13) or 800 mg (laBCC, n = 128; mBCC, n = 23). Tumour response was assessed per central and investigator review. RESULTS With 30 months of follow-up, among patients treated with sonidegib 200 mg (approved dose), objective response rates were 56.1% (central) and 71.2% (investigator) in laBCC and 7.7% (central) and 23.1% (investigator) in mBCC. Tumour responses were durable as follows: median duration of response was 26.1 months (central) and 15.7 months (investigator) in laBCC and 24.0 months (central) and 18.1 months (investigator) in mBCC. Five patients with laBCC and three with mBCC in the 200-mg arm died. Median overall survival was not reached in either population; 2-year overall survival rates were 93.2% (laBCC) and 69.3% (mBCC). In laBCC, efficacy was similar regardless of aggressive or non-aggressive histology. Sonidegib 200 mg continued to have a better safety profile than 800 mg, with lower rates of grade 3/4 adverse events (43.0% vs. 64.0%) and adverse events leading to discontinuation (30.4% vs. 40.0%). CONCLUSION Sonidegib continued to demonstrate long-term efficacy and safety in these populations. These data support the use of sonidegib 200 mg per local treatment guidelines.
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Affiliation(s)
- J.T. Lear
- Manchester Academic Health Science CentreUniversity of ManchesterManchesterUK
| | - M.R. Migden
- Departments of Dermatology and Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - K.D. Lewis
- Division of Medical OncologyUniversity of Colorado School of MedicineAuroraCOUSA
| | - A.L.S. Chang
- Stanford University School of MedicineRedwood CityCAUSA
| | - A. Guminski
- Royal North Shore HospitalSt LeonardsNSWAustralia
| | - R. Gutzmer
- Medizinische Hochschule HannoverHannoverGermany
| | - L. Dirix
- Sint‐Augustinus ZiekenhuisAntwerpBelgium
| | | | - A. Stratigos
- Andreas Syggros HospitalUniversity of AthensAthensGreece
| | - R. Plummer
- Northern Centre for Cancer CareFreeman HospitalNewcastle upon TyneUK
| | | | - T. Yi
- Novartis Pharmaceuticals CorporationEast HanoverNJUSA
| | - M. Mone
- Novartis Pharmaceuticals CorporationEast HanoverNJUSA
| | - J. Zhou
- Novartis Pharmaceuticals CorporationEast HanoverNJUSA
| | | | - M. Kaatz
- University Hospital JenaJenaGermany
| | - C. Loquai
- University Medical Center MainzMainzGermany
| | - R. Kudchadkar
- Winship Cancer Institute of Emory UniversityAtlantaGAUSA
| | - D. Sellami
- Novartis Pharmaceuticals CorporationEast HanoverNJUSA
| | - R. Dummer
- UniversitätsSpital Zürich‐Skin Cancer CenterUniversity HospitalZürichSwitzerland
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Teramoto Y, Keim U, Gesierich A, Schuler G, Fiedler E, Tüting T, Ulrich C, Wollina U, Hassel JC, Gutzmer R, Goerdt S, Zouboulis C, Leiter U, Eigentler TK, Garbe C. Acral lentiginous melanoma: a skin cancer with unfavourable prognostic features. A study of the German central malignant melanoma registry (CMMR) in 2050 patients. Br J Dermatol 2018; 178:443-451. [PMID: 28707317 DOI: 10.1111/bjd.15803] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acral lentiginous melanoma (ALM) is one of the four major subtypes in cutaneous melanoma (CM). Although ALM has a poorer prognosis than other CM subtypes, the prognostic factors associated with ALM have only been verified in small-sized cohorts because of the low incidence of ALM worldwide. OBJECTIVES To investigate the clinical characteristics of ALM and to evaluate their prognostic values based on a large dataset from the Central Malignant Melanoma Registry (CMMR) of the German Dermatologic Society. METHODS The Kaplan-Meier method was used to estimate the potential influence of clinical and histological parameters on ALM disease-specific survival (DSS) curves, which were compared using the log-rank test. A Cox proportional hazards model was used to identify independent prognostic factors for DSS. RESULTS In total, 2050 patients with ALM were identified from 58 949 patients with CM recorded by the CMMR with follow-up data. In multivariate analyses, age (P = 0·006), ulceration (P = 0·013), tumour thickness (P < 0·001) and tumour spread (P < 0·001) turned out to be significant prognostic factors for DSS in ALM whereas sex, nevus association and level of invasion were not independent factors. CONCLUSIONS ALM has the same prognostic factors as other subtypes of melanoma. Unfavourable prognosis probably derives from the delay in diagnosis in comparison with other melanoma subtypes.
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Affiliation(s)
- Y Teramoto
- Division for Dermatooncology, Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany
- Department of Skin Oncology/Dermatology, Comprehensive Cancer Centre, Saitama Medical University International Medical Centre, Saitama, Japan
| | - U Keim
- Division for Dermatooncology, Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany
- Central Malignant Melanoma Registry, University Hospital Tuebingen, Tuebingen, Germany
| | - A Gesierich
- Department of Dermatology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - G Schuler
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - E Fiedler
- Skin Cancer Centre, Department of Dermatology, University Hospital Halle, Halle, Germany
| | - T Tüting
- Department of Dermatology, University Hospital Magdeburg, Magdeburg, Germany
| | - C Ulrich
- Skin Cancer Centre, Department of Dermatology, Charité Berlin, Berlin, Germany
| | - U Wollina
- Department of Dermatology and Allergology, Hospital Dresden Friedrichsstadt, Dresden, Germany
| | - J C Hassel
- Department of Dermatology and National Centre for Tumour Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - R Gutzmer
- Skin Cancer Centre, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - S Goerdt
- Department of Dermatology, University Hospital Mannheim, Mannheim, Germany
| | - C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Centre, Medical University of Brandenburg, Dessau, Germany
| | - U Leiter
- Division for Dermatooncology, Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany
| | - T K Eigentler
- Division for Dermatooncology, Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany
| | - C Garbe
- Division for Dermatooncology, Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany
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Mommert S, Schaper J, Schaper K, Gutzmer R, Werfel T. 408 Up-regulation of the production of CCL18, a chemokine related to atopic dermatitis, by Th2 cytokines and by histamine H2- or H4 receptor agonists on human M2c- and M2a macrophages. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Arance A, Dummer R, Ascierto P, Gogas H, Mandala M, Liszkay G, Garbe C, Schadendorf D, Krajsová I, Gutzmer R, Chiarion Sileni V, Dutriaux C, de Groot J, Yamazaki N, Loquai C, de Parseval L, Pickard M, Sandor V, Robert C, Flaherty K. Hospitalization Rates in COLUMBUS Part 1: A Phase 3 Trial of Encorafenib (ENCO) Plus Binimetinib (BINI) Versus Vemurafenib (VEM) or ENCO in BRAF-Mutant Melanoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx377.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dummer R, Ascierto P, Gogas H, Arance A, Mandala M, Liszkay G, Garbe C, Schadendorf D, Krajsová I, Gutzmer R, Chiarion Sileni V, Dutriaux C, de Groot J, Yamazaki N, Loquai C, de Parseval L, Pickard M, Sandor V, Robert C, Flaherty K. Results of COLUMBUS Part 2: A phase 3 trial of encorafenib (ENCO) plus binimetinib (BINI) versus ENCO in BRAF-mutant melanoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx377.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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44
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Gogas H, Dummer R, Ascierto P, Arance A, Mandala M, Liszkay G, Garbe C, Schadendorf D, Krajsová I, Gutzmer R, Chiarion Sileni V, Dutriaux C, de Groot J, Yamazaki N, Loquai C, de Parseval L, Pickard M, Sandor V, Robert C, Flaherty K. Quality-of-life (QoL) in COLUMBUS part 1: A phase 3 trial of encorafenib (ENCO) plus binimetinib (BINI) versus vemurafenib (VEM) or ENCO in braf-mutant melanoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx377.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
Squamous cell carcinoma (SCC) of the skin accounts for 20 % of non-melanoma skin cancer and is one of the most frequent types of cancer in Caucasian populations. Diagnosis is based on the clinical features and should be histopathologically confirmed to adequately address the prognosis and treatment. Complete surgical excision with histopathological control of excision margins is the gold standard in the treatment of primary SCC. Sentinel lymph node biopsies (SLNB) can be considered in SCC with a tumor thickness of >6 mm but there is currently no evidence concerning prognostic and therapeutic effects. Radiotherapy can be discussed as an alternative to surgery for inoperable tumors or as adjuvant therapy for a high risk of recurrence. In SCC with distant metastases various chemotherapeutic agents are used; however, there is no standard regimen. The epidermal growth factor receptor (EGFR) inhibitors and immune checkpoint blockers can be discussed as treatment options, preferentially in clinical trials. There is no standard follow-up schedule for patients with SCC. A risk-adapted follow-up is recommended based on the risk of metastatic spread or development of new lesions primarily by dermatological control and supplemented by ultrasound investigations in high risk patients.
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Affiliation(s)
- U Leiter
- Zentrum für Dermato-Onkologie, Universitäts-Hautklinik, Eberhard-Karls-Universität Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland.
| | - R Gutzmer
- Hauttumorzentrum Hannover, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - M Alter
- Universitätshautklinik, Otto von Guericke Universität Magdeburg, Magdeburg, Deutschland
| | - C Ulrich
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - A S Lonsdorf
- Universitäts-Hautklinik, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Deutschland
| | - M M Sachse
- Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven, Bremerhaven, Deutschland
| | - U Hillen
- Klinik für Dermatologie, Universitätsklinikum Essen, Essen, Deutschland
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Schaper K, Köther B, Hesse K, Satzger I, Gutzmer R. The pattern and clinicopathological correlates of programmed death-ligand 1 expression in cutaneous squamous cell carcinoma. Br J Dermatol 2017; 176:1354-1356. [PMID: 27516151 DOI: 10.1111/bjd.14955] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- K Schaper
- Skin Cancer Center Hannover, Department of Dermatology and Allergy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - B Köther
- Skin Cancer Center Hannover, Department of Dermatology and Allergy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - K Hesse
- Skin Cancer Center Hannover, Department of Dermatology and Allergy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - I Satzger
- Skin Cancer Center Hannover, Department of Dermatology and Allergy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - R Gutzmer
- Skin Cancer Center Hannover, Department of Dermatology and Allergy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
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47
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Saiag P, Gutzmer R, Ascierto PA, Maio M, Grob JJ, Murawa P, Dreno B, Ross M, Weber J, Hauschild A, Rutkowski P, Testori A, Levchenko E, Enk A, Misery L, Vanden Abeele C, Vojtek I, Peeters O, Brichard VG, Therasse P. Prospective assessment of a gene signature potentially predictive of clinical benefit in metastatic melanoma patients following MAGE-A3 immunotherapeutic (PREDICT). Ann Oncol 2016; 27:1947-53. [PMID: 27502712 PMCID: PMC5035794 DOI: 10.1093/annonc/mdw291] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 05/26/2016] [Accepted: 07/20/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Genomic profiling of tumor tissue may aid in identifying predictive or prognostic gene signatures (GS) in some cancers. Retrospective gene expression profiling of melanoma and non-small-cell lung cancer led to the characterization of a GS associated with clinical benefit, including improved overall survival (OS), following immunization with the MAGE-A3 immunotherapeutic. The goal of the present study was to prospectively evaluate the predictive value of the previously characterized GS. PATIENTS AND METHODS An open-label prospective phase II trial ('PREDICT') in patients with MAGE-A3-positive unresectable stage IIIB-C/IV-M1a melanoma. RESULTS Of 123 subjects who received the MAGE-A3 immunotherapeutic, 71 (58.7%) displayed the predictive GS (GS+). The 1-year OS rate was 83.1%/83.3% in the GS+/GS- populations. The rate of progression-free survival at 12 months was 5.8%/4.1% in GS+/GS- patients. The median time-to-treatment failure was 2.7/2.4 months (GS+/GS-). There was one complete response (GS-) and two partial responses (GS+). The MAGE-A3 immunotherapeutic was similarly immunogenic in both populations and had a clinically acceptable safety profile. CONCLUSION Treatment of patients with MAGE-A3-positive unresectable stage IIIB-C/IV-M1a melanoma with the MAGE-A3 immunotherapeutic demonstrated an overall 1-year OS rate of 83.5%. GS- and GS+ patients had similar 1-year OS rates, indicating that in this study, GS was not predictive of outcome. Unexpectedly, the objective response rate was lower in this study than in other studies carried out in the same setting with the MAGE-A3 immunotherapeutic. Investigation of a GS to predict clinical benefit to adjuvant MAGE-A3 immunotherapeutic treatment is ongoing in another melanoma study.This study is registered at www.clinicatrials.gov NCT00942162.
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Affiliation(s)
- P Saiag
- General Dermatology and Oncology Service, Ambroise-Paré Hospital, AP-HP, University of Versailles-Saint-Quentin-en-Yvelines, Boulogne, France
| | - R Gutzmer
- Skin Cancer Center Hannover, Hannover Medical School, Hannover, Germany
| | - P A Ascierto
- National Institute for Tumors Foundation 'G. Pascale', Napoli
| | - M Maio
- Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena, Italy
| | - J-J Grob
- Department of Dermatology and Skin Cancers, La Timone APHM Hospital, Aix-Marseille University, Marseille, France
| | - P Murawa
- Department of Biochemistry and Molecular Biology, Poznań University of Medical Sciences, Poznań, Poland
| | - B Dreno
- Dermatology Clinic, Hôtel-Dieu Hospital, CHU Nantes, Nantes, France
| | - M Ross
- Department of Surgical Oncology, UTMD Anderson Cancer Center, Houston
| | - J Weber
- Moffitt Cancer Center, Tampa, USA
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Center and Institute of Oncology, Warsaw, Poland
| | - A Testori
- Melanoma and Soft Tissue Sarcoma Division, European Institute of Oncology, Milan, Italy
| | - E Levchenko
- Petrov Research Institute of Oncology, St Petersburg, Russian Federation
| | - A Enk
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | | | - I Vojtek
- GSK Vaccines, Rixensart, Belgium
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Mommert S, Kleiner S, Gehring M, Eiz-Vesper B, Stark H, Gutzmer R, Werfel T, Raap U. Human basophil chemotaxis and activation are regulated via the histamine H4 receptor. Allergy 2016; 71:1264-73. [PMID: 26948974 DOI: 10.1111/all.12875] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND IgE-mediated cross-linking of FcεRI results in the release of mediators stored in basophil granules, such as histamine and proteases, and in the de novo synthesis of sulfidoleukotrienes. OBJECTIVE In this study, we investigated the role of the histamine receptors, in particular that of the histamine H4 receptor (H4R), in modulating human basophil function. METHODS The mRNA expression of the histamine receptors was measured by real-time PCR. Migration of basophils was assessed using the modified Boyden chamber technique. The expression levels of CD63 and CD203c on the cell surface and the sulfidoleukotriene release were determined by flow cytometry and ELISA, respectively. RESULTS We could show that highly purified basophils express the H1R, H2R, and H4R but not the H3R mRNA. Human basophils expressed higher H4R mRNA levels as compared to the expression levels of the H1R (P < 0.01). Histamine and the H4R agonist ST-1006 initiated active migration of basophils (P < 0.001). A significant reduction in FcεRI cross-linking-mediated surface expression of CD63 and CD203c was observed on basophils after pre-incubation with histamine or the specific H4R agonist ST-1006 (P < 0.01). The synthesis and release of sulfidoleukotrienes from basophils after activation with different stimuli, by FcεRI cross-linking or by stimulation with hymenoptera venom allergens, were significantly reduced by histamine or the H4R agonist ST-1006 (P < 0.05-0.001). CONCLUSION These data imply that the H4R regulates IgE-dependent processes in human basophils and provides a novel function of the H4R preventing an overwhelming immune reaction by engagement of a negative feedback loop.
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Affiliation(s)
- S. Mommert
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - S. Kleiner
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - M. Gehring
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - B. Eiz-Vesper
- Institute for Transfusion Medicine; Hannover Medical School; Hannover Germany
| | - H. Stark
- Institute of Pharmaceutical and Medicinal Chemistry; Heinrich Heine University; Duesseldorf Germany
| | - R. Gutzmer
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - T. Werfel
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - U. Raap
- Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
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49
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Gutzmer R, Rivoltini L, Levchenko E, Testori A, Utikal J, Ascierto PA, Demidov L, Grob JJ, Ridolfi R, Schadendorf D, Queirolo P, Santoro A, Loquai C, Dreno B, Hauschild A, Schultz E, Lesimple TP, Vanhoutte N, Salaun B, Gillet M, Jarnjak S, De Sousa Alves PM, Louahed J, Brichard VG, Lehmann FF. Safety and immunogenicity of the PRAME cancer immunotherapeutic in metastatic melanoma: results of a phase I dose escalation study. ESMO Open 2016; 1:e000068. [PMID: 27843625 PMCID: PMC5070281 DOI: 10.1136/esmoopen-2016-000068] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [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: 04/21/2016] [Accepted: 04/22/2016] [Indexed: 12/23/2022] Open
Abstract
Purpose The PRAME tumour antigen is expressed in several tumour types but in few normal adult tissues. A dose-escalation phase I/II study (NCT01149343) assessed the safety, immunogenicity and clinical activity of the PRAME immunotherapeutic (recombinant PRAME protein (recPRAME) with the AS15 immunostimulant) in patients with advanced melanoma. Here, we report the phase I dose-escalation study segment. Patients and methods Patients with stage IV PRAME-positive melanoma were enrolled to 3 consecutive cohorts to receive up to 24 intramuscular injections of the PRAME immunotherapeutic. The RecPRAME dose was 20, 100 or 500 µg in cohorts 1, 2 and 3, respectively, with a fixed dose of AS15. Adverse events (AEs), including predefined dose-limiting toxicity (DLT) and the anti-PRAME humoral response (ELISA), were coprimary end points. Cellular immune responses were evaluated using in vitro assays. Results 66 patients were treated (20, 24 and 22 in the respective cohorts). AEs considered by the investigator to be causally related were mostly grade 1 or 2 injection site symptoms, fatigue, chills, fever and headache. Two DLTs (grade 3 brain oedema and proteinuria) were recorded in two patients in two cohorts (cohorts 2 and 3). All patients had detectable anti-PRAME antibodies after four immunisations. Percentages of patients with predefined PRAME-specific-CD4+T-cell responses after four immunisations were similar in each cohort. No CD8+ T-cell responses were detected. Conclusions The PRAME immunotherapeutic had an acceptable safety profile and induced similar anti-PRAME-specific humoral and cellular immune responses in all cohorts. As per protocol, the phase II study segment was initiated to further evaluate the 500 µg PRAME immunotherapeutic dose. Trial registration number NCT01149343, Results.
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Affiliation(s)
- R Gutzmer
- Skin Cancer Center Hannover , Hannover Medical School , Hannover , Germany
| | - L Rivoltini
- Unit of Immunotherapy of Human Tumors , Fondazione RCCS Istituto Nazionale dei Tumori , Milan , Italy
| | - E Levchenko
- Petrov Research Institute of Oncology , St. Petersburg , Russia
| | - A Testori
- Istituto Europeo Di Oncologia , Milano , Italy
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
| | - P A Ascierto
- Melanoma, Cancer Immunotherapy and Innovative Therapies Unit , Istituto Nazionale Tumori Fondazione Pascale , Naples , Italy
| | - L Demidov
- Cancer Research Center , Moscow , Russia
| | - J J Grob
- Aix Marseille University Hôpital de la Timone, Service de Dermatologie , Marseille , France
| | - R Ridolfi
- Immunotherapy Unit , Romagna Cancer Institute IRST- IRCCS , Meldola , Italy
| | - D Schadendorf
- Department of Dermatology , University Hospital Essen , Essen , Germany
| | - P Queirolo
- Istituto Nazionale per la Ricerca sul Cancro Oncologia Medica , Genova , Italy
| | - A Santoro
- Humanitas Cancer Center, Istituto Clinico Humanitas IRCCS , Rozzano , Italy
| | - C Loquai
- Department of Dermatology , University of Mainz , Mainz , Germany
| | - B Dreno
- Dermatology Clinic , Hôpital Hôtel-Dieu, CHU Nantes , Nantes , France
| | - A Hauschild
- Department of Dermatology , Skin Cancer Center, Schleswig-Holstein University Hospital , Kiel , Germany
| | - E Schultz
- Department of Dermatology , Paracelsus Medical University, Klinikum Nuremberg , Nuremberg , Germany
| | - T P Lesimple
- Département d'Oncologie Médicale , Centre Eugène Marquis , Rennes , France
| | | | - B Salaun
- GSK Vaccines , Rixensart , Belgium
| | - M Gillet
- GSK Vaccines , Rixensart , Belgium
| | | | - P M De Sousa Alves
- GSK Vaccines, Rixensart, Belgium; Celyad, Mont-Saint-Guibert, Rixensart, Belgium
| | | | - V G Brichard
- GSK Vaccines, Rixensart, Belgium; Vianova-Biosciences, Lasne, Belgium
| | - F F Lehmann
- GSK Vaccines, Rixensart, Belgium; Celyad, Mont-Saint-Guibert, Rixensart, Belgium
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50
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Eigentler TK, Gutzmer R, Hauschild A, Heinzerling L, Schadendorf D, Nashan D, Hölzle E, Kiecker F, Becker J, Sunderkötter C, Moll I, Richtig E, Pönitzsch I, Pehamberger H, Kaufmann R, Pföhler C, Vogt T, Berking C, Praxmarer M, Garbe C. Adjuvant treatment with pegylated interferon α-2a versus low-dose interferon α-2a in patients with high-risk melanoma: a randomized phase III DeCOG trial. Ann Oncol 2016; 27:1625-32. [PMID: 27287206 DOI: 10.1093/annonc/mdw225] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 05/30/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Adjuvant treatment with interferon (IFN)-α-2a improved disease-free survival (DFS) and showed a trend for improving overall survival (OS) in melanoma. This trial was designed to examine whether PEG-IFN is superior to IFN with regard to distant metastasis-free survival (DMFS), DFS and OS. PATIENTS AND METHODS In this multicenter, open-label, prospective randomized phase III trial, patients with resected cutaneous melanoma stage IIA(T3a)-IIIB (AJCC 2002) were randomized to receive PEG-IFN (180 μg subcutaneously 1×/week; 24 months) or IFN α-2a (3MIU subcutaneously 3×/week; 24 months). Randomization was stratified for stage, number of metastatic nodes, age and previous IFN treatment. The primary end point was DMFS; secondary end points were OS, DFS, quality of life (QoL) and tolerability. RESULTS A total of 909 patients were enrolled (451 PEG-IFN versus 458 IFN). Neither 5-year DMFS [PEG-IFN 61.0% versus IFN 67.3%; hazard ratio (HR) 1.16, P = 0.21] nor 5-year OS (PEG-IFN 73.2% versus IFN 75.2%; HR 1.05, P = 0.70) nor 5-year DFS (PEG-IFN 57.3% versus IFN 60.9%; HR 1.09, P = 0.40) showed significant differences. Subgroup analyses in patients ± ulcerated primaries and of different tumor stages did not find differences in DMFS, OS or DFS between the treatment groups. One hundred and eighteen patients (26.2%) in the PEG-IFN and 61 patients (13.3%) in the IFN population did not receive the full dosage and length of treatment due to adverse events (P < 0.001). Leukopenia and elevation of liver enzymes were more common in the PEG-IFN arm (56% versus 23.5% LCP; 19.1% versus 9.4% AST; 33.0% versus 16.5% ALT). QoL was identical for nearly all domains. CONCLUSION PEG-IFN did not improve the outcome over IFN. A higher percentage of patients under PEG-IFN discontinued treatment due to toxicity. CLINICAL TRIALSGOV IDENTIFIER NCT00204529.
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Affiliation(s)
- T K Eigentler
- Department of Dermatology, Center for Dermatooncology, University Medical Center Tübingen, Tübingen
| | - R Gutzmer
- Department of Dermatology and Allergy, Hannover Medical School, Hannover
| | - A Hauschild
- Department of Dermatology, University Hospital Kiel, Kiel
| | - L Heinzerling
- Department of Dermatology, University Hospital Erlangen, Erlangen
| | - D Schadendorf
- Department of Dermatology, University Essen-Duisburg, Essen
| | - D Nashan
- Department of Dermatology, Hospital Dortmund, Dortmund
| | - E Hölzle
- Department of Dermatology, Hospital Oldenburg, Oldenburg
| | - F Kiecker
- Department of Dermatology, Charité Berlin, Berlin
| | - J Becker
- Department of Dermatology, University Essen-Duisburg, Essen
| | - C Sunderkötter
- Department of Dermatology, University Hospital Münster, Münster
| | - I Moll
- Department of Dermatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E Richtig
- Department of Dermatology, University Hospital Graz, Graz, Austria
| | - I Pönitzsch
- Department of Dermatology, University Hospital Leipzig, Leipzig, Germany
| | - H Pehamberger
- Department of Dermatology, AKH Wien, University Hospital Vienna, Vienna, Austria
| | - R Kaufmann
- Department of Dermatology, University Hospital Frankfurt am Main, Frankfurt/Main
| | - C Pföhler
- Department of Dermatology, Saarland University Medical School, Homburg/Saar
| | - T Vogt
- Department of Dermatology, Saarland University Medical School, Homburg/Saar
| | - C Berking
- Department of Dermatology and Allergy, University Hospital of Munich, Munich, Germany
| | | | - C Garbe
- Department of Dermatology, Center for Dermatooncology, University Medical Center Tübingen, Tübingen
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