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Pott C, Jurinovic V, Trotman J, Kehden B, Unterhalt M, Herold M, Jagt RVD, Janssens A, Kneba M, Mayer J, Young M, Schmidt C, Knapp A, Nielsen T, Brown H, Spielewoy N, Harbron C, Bottos A, Mundt K, Marcus R, Hiddemann W, Hoster E. Minimal Residual Disease Status Predicts Outcome in Patients With Previously Untreated Follicular Lymphoma: A Prospective Analysis of the Phase III GALLIUM Study. J Clin Oncol 2024; 42:550-561. [PMID: 38096461 DOI: 10.1200/jco.23.00838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/23/2023] [Accepted: 10/12/2023] [Indexed: 02/09/2024] Open
Abstract
PURPOSE We report an analysis of minimal residual/detectable disease (MRD) as a predictor of outcome in previously untreated patients with follicular lymphoma (FL) from the randomized, multicenter GALLIUM (ClinicalTrials.gov identifier: NCT01332968) trial. PATIENTS AND METHODS Patients received induction with obinutuzumab (G) or rituximab (R) plus bendamustine, or cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) or cyclophosphamide, vincristine, prednisone (CVP) chemotherapy, followed by maintenance with the same antibody in responders. MRD status was assessed at predefined time points (mid-induction [MI], end of induction [EOI], and at 4-6 monthly intervals during maintenance and follow-up). Patients with evaluable biomarker data at diagnosis were included in the survival analysis. RESULTS MRD positivity was associated with inferior progression-free survival (PFS) at MI (hazard ratio [HR], 3.03 [95% CI, 2.07 to 4.45]; P < .0001) and EOI (HR, 2.25 [95% CI, 1.53 to 3.32]; P < .0001). MRD response was higher after G- versus R-chemotherapy at MI (94.2% v 88.9%; P = .013) and at EOI (93.1% v 86.7%; P = .0077). Late responders (MI-positive/EOI-negative) had a significantly poorer PFS than early responders (MI-negative/EOI-negative; HR, 3.11 [95% CI, 1.75 to 5.52]; P = .00011). The smallest proportion of MRD positivity was observed in patients receiving bendamustine at MI (4.8% v 16.0% in those receiving CHOP; P < .0001). G appeared to compensate for less effective chemotherapy regimens, with similar MRD response rates observed across the G-chemo groups. During the maintenance period, more patients treated with R than with G were MRD-positive (R-CHOP, 20.7% v G-CHOP, 7.0%; R-CVP, 21.7% v G-CVP, 9.4%). Throughout maintenance, MRD positivity was associated with clinical relapse. CONCLUSION MRD status can determine outcome after induction and during maintenance, and MRD negativity is a prerequisite for long-term disease control in FL. The higher MRD responses after G- versus R-based treatment confirm more effective tumor cell clearance.
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Affiliation(s)
| | - Vindi Jurinovic
- Department of Internal Medicine III, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Judith Trotman
- Concord Repatriation General Hospital, University of Sydney, Sydney, NSW, Australia
| | - Britta Kehden
- University Hospital Schleswig-Holstein, Kiel, Germany
| | - Michael Unterhalt
- Department of Internal Medicine III, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | | | | | | | - Michael Kneba
- University Hospital Schleswig-Holstein, Kiel, Germany
| | - Jiri Mayer
- University Hospital and Masaryk University, Brno, Czech Republic
| | - Moya Young
- East Kent Hospital, Canterbury, United Kingdom
| | - Christian Schmidt
- Department of Internal Medicine III, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | | | | | - Helen Brown
- Roche Products Ltd, Welwyn Garden City, United Kingdom
| | | | - Chris Harbron
- Roche Products Ltd, Welwyn Garden City, United Kingdom
| | | | | | | | - Wolfgang Hiddemann
- Department of Internal Medicine III, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Eva Hoster
- Department of Internal Medicine III, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
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Townsend W, Hiddemann W, Buske C, Cartron G, Cunningham D, Dyer MJ, Gribben JG, Phillips EH, Dreyling M, Seymour JF, Grigg A, Trotman J, Lin TY, Hong XN, Kingbiel D, Nielsen TG, Knapp A, Herold M, Marcus R. Obinutuzumab Versus Rituximab Immunochemotherapy in Previously Untreated iNHL: Final Results From the GALLIUM Study. Hemasphere 2023; 7:e919. [PMID: 37404773 PMCID: PMC10317485 DOI: 10.1097/hs9.0000000000000919] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/19/2023] [Indexed: 07/06/2023] Open
Abstract
The phase III GALLIUM trial assessed the safety and efficacy of obinutuzumab-based versus rituximab-based immunochemotherapy in patients with previously untreated follicular lymphoma (FL) or marginal zone lymphoma (MZL). At the primary analysis, the trial met its primary end point, demonstrating improvement in investigator-assessed progression-free survival (PFS) with obinutuzumab-based versus rituximab-based immunochemotherapy in patients with FL. We report the results of the final analysis in the FL population, with an additional exploratory analysis in the MZL subgroup. Overall, 1202 patients with FL were randomized 1:1 to obinutuzumab- or rituximab-based immunochemotherapy followed by maintenance with the same antibody for up to 2 years. After a median 7.9 (range, 0.0-9.8) years of follow-up, PFS remained improved with obinutuzumab- versus rituximab-based immunochemotherapy, with 7-year PFS rates of 63.4% versus 55.7% (P = 0.006). Time-to-next antilymphoma treatment was also improved (74.1% versus 65.4% of patients had not started their next antilymphoma treatment at 7 y; P = 0.001). Overall survival was similar between the arms (88.5% versus 87.2%; P = 0.36). Irrespective of the treatment received, PFS and OS were higher in patients with a complete molecular response (CMR) versus those with no CMR (P < 0.001). Serious adverse events were reported in 48.9% and 43.4% of patients in the obinutuzumab and rituximab arms, respectively; there was no difference in the rate of fatal adverse events (4.4% and 4.5%, respectively). No new safety signals were reported. These data demonstrate the long-term benefit of obinutuzumab-based immunochemotherapy and confirm its role as a standard-of-care for the first-line treatment of advanced-stage FL, taking into account patient characteristics and safety considerations.
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Affiliation(s)
- William Townsend
- Cancer Research UK and UCL Cancer Trials Centre, University College Hospitals London, United Kingdom
| | | | | | | | | | - Martin J.S. Dyer
- Ernest and Helen Scott Hematological Research Institute, University of Leicester, United Kingdom
| | - John G. Gribben
- Queen Mary, University of London, St Bartholomew’s Hospital, London, United Kingdom
| | - Elizabeth H. Phillips
- University of Manchester, The Christie Hospital and National Institutes of Health Research Manchester Biomedical Research Centre, Manchester, United Kingdom
| | | | - John F. Seymour
- Peter MacCallum Cancer Centre, the Royal Melbourne Hospital, and University of Melbourne, VIC, Australia
| | | | - Judith Trotman
- Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia
| | - Tong-Yu Lin
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, and Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xiao-Nan Hong
- Fudan University Shanghai Cancer Center, Shanghai, China
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Dixon JG, Çağlayan Ç, Chihara D, Nielsen T, Dimier N, Zheng J, Wall AK, Salles G, Morschhauser F, Marcus R, Herold M, Kimby E, Blum KA, Ghielmini M, Shi Q, Flowers CR. Factors Affecting the Clinical Course of Follicular Lymphoma: A Multistate Survival Analysis Using Individual Patient Data from Eight Multicenter Randomized Clinical Trials. Clin Lymphoma Myeloma Leuk 2022; 22:e1009-e1018. [PMID: 36045021 DOI: 10.1016/j.clml.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/19/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION/BACKGROUND Leveraging the Follicular Lymphoma Analysis of Surrogacy Hypothesis database of individual patient data from first-line clinical trials, we studied the clinical course of follicular lymphoma (FL) and investigated clinical factors associated with FL outcomes. PATIENTS AND METHODS We examined 2428 patients from 8 randomized trials using multistate survival models with 4 states: induction treatment, progression, death from FL, and death from other causes. We utilized Aalen-Johansen estimator and Cox models to assess the likelihood of FL outcomes and quantify predictors' effects. RESULTS Two-year progression, FL-related death, and death from other causes estimates were 26.5%, 3.4% and 1.4%, respectively. FL-associated deaths were the primary cause of mortality within 10 years of follow-up. Male sex (hazard ratio: 1.25; 95% confidence interval: 1.05-1.47), > 4 involved nodal areas (1.51; 1.23-1.86), elevated LDH (1.20; 1.01-1.43), low hemoglobin (1.44; 1.15-1.81), and elevated β-2 levels (1.23; 1.02-1.47) increased risk of progression. CD20-targeting agents reduced risks for progression (0.29; 0.22-0.39), death from FL (0.05; 0.01-0.20), and death from other causes without progression (0.13; 0.05-0.33) and following progression (0.52; 0.30-0.92). Estimated 2-year progression rates were 22.3% and 43.5% with or without CD20-targeting agents, respectively. Two-year FL-associated mortality rate was 8.3% among patients without CD20-targeting agents, 5.4% with B-symptoms, 4.9% with elevated LDH, and 9.1% with low hemoglobin. CONCLUSION This study identified independent contributions of baseline clinical factors to distinct outcomes for patients with FL following first-line therapy on a clinical trial. Similar analytical approaches are needed to increase understanding of factors that influence FL outcomes in other settings.
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Affiliation(s)
- Jesse G Dixon
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
| | - Çağlar Çağlayan
- Asymmetric Operations Sector, Johns Hopkins University Applied Physics Laboratory, Laurel, MD
| | - Dai Chihara
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Tina Nielsen
- Department of Biostatistics, Roche Products Ltd, Welwyn Garden City, Hertfordshire, United Kingdom
| | - Natalie Dimier
- Department of Biostatistics, Roche Products Ltd, Welwyn Garden City, Hertfordshire, United Kingdom
| | | | - Anna K Wall
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Gilles Salles
- Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Franck Morschhauser
- Department of Hematology, University of Lille, Lille, Hauts-de-France, France
| | - Robert Marcus
- Department of Haematology, Addenbrookes Hospital, Cambridge, Cambridgeshire, United Kingdom
| | - Michael Herold
- Helios Klinikum Erfurt, Onkologisches Zentrum, Erfurt, Thuringia, Germany
| | - Eva Kimby
- Unit for Hematology Karolinska University Hospital, Stockholm, Sweden
| | - Kristie A Blum
- Department of Hematology and Medical Oncology, Emory University, Atlanta, GA
| | - Michele Ghielmini
- Department of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Ticino, Switzerland
| | - Qian Shi
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Christopher R Flowers
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, University of Texas, Houston, TX
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Dixon JG, Dimier N, Nielsen T, Zheng J, Marcus R, Morschhauser F, Evens AM, Federico M, Blum KA, Shi Q. End of induction positron emission tomography complete response (PET-CR) as a surrogate for progression-free survival in previously untreated follicular lymphoma. Br J Haematol 2022; 198:333-337. [PMID: 35491747 DOI: 10.1111/bjh.18217] [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: 02/23/2022] [Revised: 04/07/2022] [Accepted: 04/13/2022] [Indexed: 11/28/2022]
Abstract
Progression-free survival (PFS) has been the regulatory primary end-point for recent phase III trials in first-line follicular lymphoma (FL), but requires prolonged follow-up. Complete response (CR) at 30 months after initiation of induction treatment was validated as surrogate end-point for PFS. Our objective was to further evaluate surrogacy of CR measured by [18 F] fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging at the end of induction (EoI). Individual patient data were analysed from 1505 patients from five randomized trials. Trial-level surrogacy examining the association between treatment effects on EoI-PET-CR and PFS was evaluated using linear regression ( R WLS 2 $$ {R}_{\mathrm{WLS}}^2 $$ ) and bivariate Copula ( R Copula 2 $$ {R}_{\mathrm{Copula}}^2 $$ ) models. Although EoI-PET-CR strongly predicted PFS at a prognostic level, the trial-level assessment did not show strong correlation ( R WLS 2 = 0.56 $$ {R}_{\mathrm{WLS}}^2=0.56 $$ , confidence interval [CI]: 0.20-0.88; R Copula 2 = 0.35 $$ {R}_{\mathrm{Copula}}^2=0.35 $$ , CI: 0.0-0.82). The high uncertainty in estimation was possibly due to the small number of trials and the population of patients with available PET data. Maintenance therapy affecting PFS beyond induction treatment, but not EoI-PET-CR end-point, may have distorted the association between treatment effects. However, there will probably be a number of additional trials approaching completion with available PET response data. Refined evaluation of PET-CR based surrogate end-points is still warranted.
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Affiliation(s)
- Jesse G Dixon
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Natalie Dimier
- Biostatistics, Roche Products Ltd, Welwyn Garden City, UK
| | - Tina Nielsen
- Biostatistics, Roche Products Ltd, Welwyn Garden City, UK
| | - Jamie Zheng
- Worldwide Medical Affairs Hematology/Lymphoma/CLL, Bristol-Myers Squibb, Plainsboro, New Jersey, USA
| | - Robert Marcus
- Department of Haematology, King's College Hospital, London, UK
| | - Franck Morschhauser
- Groupe de Recherche sur les formes Injectables et les Technologies Associees, University of Lille, CHU Lille, Lille, France
| | - Andrew M Evens
- Department of Biomedical and Health Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Massimo Federico
- Dipartimento di Oncologia ed Ematologia, Centro Oncologico Modenese, Universita di Modena e Reggio Emilia, Modena, Italy
| | - Kristie A Blum
- Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia, USA
| | - Qian Shi
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
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Opat S, Tedeschi A, Linton K, McKay P, Hu B, Chan H, Jin J, Sobieraj-Teague M, Zinzani PL, Coleman M, Thieblemont C, Browett P, Ke X, Sun M, Marcus R, Portell CA, Ardeshna K, Bijou F, Walker P, Hawkes EA, Mapp S, Ho SJ, Talaulikar D, Zhou KS, Co M, Li X, Zhou W, Cappellini M, Tankersley C, Huang J, Trotman J. The MAGNOLIA Trial: Zanubrutinib, a Next-Generation Bruton Tyrosine Kinase Inhibitor, Demonstrates Safety and Efficacy in Relapsed/Refractory Marginal Zone Lymphoma. Clin Cancer Res 2021; 27:6323-6332. [PMID: 34526366 PMCID: PMC9401507 DOI: 10.1158/1078-0432.ccr-21-1704] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [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: 06/01/2021] [Revised: 07/29/2021] [Accepted: 09/10/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE Marginal zone lymphoma (MZL) is an uncommon non-Hodgkin lymphoma with malignant cells that exhibit a consistent dependency on B-cell receptor signaling. We evaluated the efficacy and safety of zanubrutinib, a next-generation selective Bruton tyrosine kinase inhibitor, in patients with relapsed/refractory (R/R) MZL. PATIENTS AND METHODS Patients with R/R MZL were enrolled in the phase II MAGNOLIA (BGB-3111-214) study. The primary endpoint was overall response rate (ORR) as determined by an independent review committee (IRC) based on the Lugano 2014 classification. RESULTS Sixty-eight patients were enrolled. After a median follow-up of 15.7 months (range, 1.6 to 21.9 months), the IRC-assessed ORR was 68.2% and complete response (CR) was 25.8%. The ORR by investigator assessment was 74.2%, and the CR rate was 25.8%. The median duration of response (DOR) and median progression-free survival (PFS) by independent review was not reached. The IRC-assessed DOR rate at 12 months was 93.0%, and IRC-assessed PFS rate was 82.5% at both 12 and 15 months. Treatment was well tolerated with the majority of adverse events (AE) being grade 1 or 2. The most common AEs were diarrhea (22.1%), contusion (20.6%), and constipation (14.7%). Atrial fibrillation/flutter was reported in 2 patients; 1 patient had grade 3 hypertension. No patient experienced major hemorrhage. In total, 4 patients discontinued treatment due to AEs, none of which were considered treatment-related by the investigators. CONCLUSIONS Zanubrutinib demonstrated high ORR and CR rate with durable disease control and a favorable safety profile in patients with R/R MZL.
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Affiliation(s)
- Stephen Opat
- Monash Health, Monash University, Clayton, Victoria, Australia
| | | | - Kim Linton
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Cancer Research Centre, Manchester, United Kingdom
| | - Pamela McKay
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Bei Hu
- Levine Cancer Institute University City, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina
| | - Henry Chan
- North Shore Hospital, Auckland, New Zealand
| | - Jie Jin
- The First Affiliated Hospital, School of Medicine, Zhejiang University Hangzhou, Zhejiang, China
| | | | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
- Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Morton Coleman
- WCM Research Alliance, Weill Cornell Medicine, Lake Success, New York
| | - Catherine Thieblemont
- Service d'Hématologie-Oncologie, Hôpital Saint-Louis, APHP, Paris, France
- Paris University, Paris, France
| | - Peter Browett
- Auckland City Hospital, University of Auckland, Grafton, Auckland, New Zealand
| | - Xiaoyan Ke
- Peking University Third Hospital, Beijing, China
| | - Mingyuan Sun
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Robert Marcus
- Sarah Cannon Research Institute, London, United Kingdom
| | - Craig A Portell
- University of Virginia Cancer Center, Charlottesville, Virginia
| | - Kirit Ardeshna
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- UCLH NIHR Biomedical Research Centre, London, United Kingdom
| | | | - Patricia Walker
- Peninsula Private Hospital, Ramsay Health Care, Frankston, Australia
| | - Eliza A Hawkes
- Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, Victoria, Australia
- Eastern Health, Box Hill, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | - Sally Mapp
- Haematology Service, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Shir-Jing Ho
- Haematology Clinical Services, St George Hospital, Sydney, New South Wales, Australia
| | - Dipti Talaulikar
- The Canberra Hospital, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | - Ke-Shu Zhou
- Henan Cancer Hospital, Zhengzhou, Henan, China
| | | | | | | | | | | | | | - Judith Trotman
- Concord Repatriation General Hospital, Sydney Medical School, University of Sydney, Concord, New South Wales, Australia.
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Caceres S, Sanders L, Rysavy N, Poch K, Jones C, Pickard K, Fingerlin T, Marcus R, Malcolm K, Taylor-Cousar J, Nichols D, Nick J, Strand M, Saavedra M. 527: Blood mRNA biomarkers identify inflammatory phenotypes before inhaled antibiotic therapy. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01951-2] [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]
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7
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Trotman J, Tedeschi A, Linton K, McKay P, Hu B, Chan H, Jin J, Sobieraj‐Teague M, Zinzani PL, Coleman M, Browett P, Ke X, Sun M, Marcus R, Portell C, Thieblemont C, Zhou K, Liberati AM, Bachy E, Cavallo F, Costello R, Iyengar S, Marasca R, Mociková H, Kim JS, Talaulikar D, Co M, Zhou W, Huang J, Opat S. SAFETY AND EFFICACY OF ZANUBRUTINIB IN PATIENTS WITH RELAPSED/REFRACTORY MARGINAL ZONE LYMPHOMA (MAGNOLIA PHASE 2 STUDY). Hematol Oncol 2021. [DOI: 10.1002/hon.19_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J. Trotman
- Concord Repatriation General Hospital University of Sydney Oncology Concord Australia
| | - A. Tedeschi
- ASST Grande Ospedale Metropolitano Niguarda Hematology Milan Italy
| | - K. Linton
- The Christie Hematology Manchester UK
| | - P. McKay
- Beatson West of Scotland Cancer Centre Oncology Glasgow UK
| | - B. Hu
- Levine Cancer Institute/Atrium Health Oncology Charlotte USA
| | - H. Chan
- North Shore Hospital Haematology Auckland New Zealand
| | - J. Jin
- The First Affiliated Hospital Zhejiang University Hematology Hangzhou China
| | | | - P. L. Zinzani
- Institute of Hematology “Seràgnoli” University of Bologna Hematology Bologna Italy
| | - M. Coleman
- Clinical Research Alliance Hematology Lake Success USA
| | - P. Browett
- Auckland City Hospital Haematology Grafton New Zealand
| | - X. Ke
- Peking University Third Hospital Hematology Beijing China
| | - M. Sun
- Institute of Hematology & Blood Diseases Hospital Chinese Academy of Medical Sciences Peking Union Medical College Hematology Tianjin China
| | - R. Marcus
- Sarah Cannon Research Institute UK Oncology London UK
| | - C. Portell
- University of Virginia Health System Hematology/Oncology Charlottesville USA
| | - C. Thieblemont
- APHP, Hôpital Saint‐Louis, Hemato‐oncology Paris University Diderot Hematology/Oncology Paris France
| | - K. Zhou
- Henan Cancer Hospital Oncology Zhengzhou China
| | - A. M. Liberati
- Azienda Ospedaliera Santa Maria Di Terni Oncology Terni Italy
| | - E. Bachy
- Centre Hospitalier Lyon Sud Pierre Bénite Hematology Rhone Italy
| | - F. Cavallo
- Azienda Ospedaliera Città della Salute e della Scienza di Torino Hematology Torino Italy
| | - Rég. Costello
- Hôpital de la Conception – APHM Hematology Marseille France
| | - S. Iyengar
- Royal Marsden Hospital Haematology London UK
| | - R. Marasca
- AOU Policlinico di Modena Hematology Modena Italy
| | - H. Mociková
- Fakultní nemocnice Královské Vinohrady Hematology Praha 10 Czech Republic
| | - J. S. Kim
- Severance Hospital Hematology Seoul Korea
| | - D. Talaulikar
- The Canberra Hospital Haematology Canberra Australia
| | - M. Co
- BeiGene (Beijing) Co., Ltd. Beijing, China and BeiGene USA, Inc Hematology San Mateo USA
| | - W. Zhou
- BeiGene (Beijing) Co., Ltd. Beijing, China and BeiGene USA, Inc Hematology San Mateo USA
| | - J. Huang
- BeiGene (Beijing) Co., Ltd. Beijing, China and BeiGene USA, Inc Hematology San Mateo USA
| | - S. Opat
- Monash Health Monash University Haematology Clayton Australia
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Brown Y, Saldaña A, Patino Nava D, Bayangos T, Evans D, Detoy K, Marcus R, Bern C, Gilman R, Talaat K. Challenges in the diagnosis of chronic Chagas disease in the U.S.: Experience from a community-based study in the Washington Metropolitan area. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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9
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Gill K, Johnson L, Dietrich J, Myer L, Marcus R, Wallace M, Pidwell T, Mendel E, Fynn L, Jones K, Wiesner L, Slack C, Strode A, Spiegel H, Hosek S, Rooney J, Gray G, Bekker LG. Acceptability, safety, and patterns of use of oral tenofovir disoproxil fumarate and emtricitabine for HIV pre-exposure prophylaxis in South African adolescents: an open-label single-arm phase 2 trial. Lancet Child Adolesc Health 2020; 4:875-883. [PMID: 33222803 PMCID: PMC9832157 DOI: 10.1016/s2352-4642(20)30248-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/22/2020] [Accepted: 07/14/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND HIV incidence among adolescents in southern Africa remains unacceptably high. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention but there are few data on its implementation among adolescents. We aimed to investigate the safety, feasibility, and acceptability of PrEP with oral tenofovir disoproxil fumarate and emtricitabine as part of a comprehensive HIV prevention package in an adolescent population in South Africa. METHODS This open-label single-arm phase 2 study (PlusPills) was done in two research clinics in Cape Town and Johannesburg, South Africa. Adolescents aged 15-19 years were recruited into the study through recruitment events and outreach in the community. Potential participants were eligible for enrolment if they reported being sexually active. Exclusion criteria were a positive test for HIV or pregnancy at enrolment, breastfeeding, or any relevant co-morbidities. Participants were given oral tenofovir disoproxil fumarate and emtricitabine for PrEP to take daily for the first 12 weeks and were then given the choice to opt in or out of PrEP use at three monthly intervals during scheduled clinic visits. Participants were invited to monthly visits for adherence counselling and HIV testing during the study period. The primary outcomes were acceptability, use, and safety of PrEP. Acceptability was measured by the proportion of participants who reported willingness to take up PrEP and remain on PrEP at each study timepoint. Use was defined as the number of participants who continued to use PrEP after the initial 12-week period until the end of the study (week 48). Safety was measured by grade 2, 3, and 4 laboratory and clinical adverse events using the Division of AIDS table for grading the severity of adult and paediatric adverse events, version 1.0. Dried blood spot samples were collected at each study time-point to measure tenofovir diphosphate concentrations. This trial is registered with ClinicalTrials.gov, NCT02213328. FINDINGS Between April 28, 2015, and Nov 11, 2016, 244 participants were screened, and 148 participants were enrolled (median age was 18 years; 99 participants [67%] were female) and initiated PrEP. PrEP was stopped by 26 of the 148 (18%) participants at 12 weeks. Cumulative PrEP opt-out, from the total cohort, was 41% (60 of 148 participants) at week 24 and 43% (63 of 148 participants) at week 36. PrEP was well tolerated with only minor adverse events (grade 2) thought to be related to study drug, which included headache (n=4, 3%), gastrointestinal upset (n=8, 5%), and skin rash (n=2, 1%). Two participants (1%) experienced grade 3 weight loss, which was deemed related to the study drug and resolved fully when PrEP was discontinued. Tenofovir diphosphate concentrations were detectable (>16 fmol/punch) in dried blood spot samples in 108 (92%) of 118 participants who reported PrEP use at week 12, in 74 (74%) of 100 participants at week 24, and in 22 (59%) of 37 participants by the study end at week 48. INTERPRETATION In this cohort of self-selected South African adolescents at risk of HIV acquisition, PrEP appears safe and tolerable in those who continued use. PrEP use decreased throughout the course of the study as the number of planned study visits declined. Adolescents in southern Africa needs access to PrEP with tailored adherence support and possibly the option for more frequent and flexible visit schedules. FUNDING National Institute of Allergy and Infectious Diseases of the US National Institutes of Health.
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Affiliation(s)
- K Gill
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
| | - L Johnson
- Centre for Infectious Diseases Epidemiology and Research, University of Cape Town, South Africa
| | - J Dietrich
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - L Myer
- Health Systems Research Unit, South African Medical Research Council, Western Cape, South Africa
| | - R Marcus
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
| | - M Wallace
- Cancer Association of South Africa (CANSA)
| | - T Pidwell
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
| | - E Mendel
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
| | - L Fynn
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
| | - K Jones
- Vagelos College of Physicians and Surgeons, Columbia University, New York, USA
| | - L Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, South Africa
| | - C Slack
- HIV AIDS Vaccines Ethics Group, University of KwaZulu- Natal, South Africa
| | - A Strode
- School of Socio Legal Studies, School of Law, Pietermaritzburg, University of KwaZulu-Natal, Private Bag X01, Scottsville
| | - H Spiegel
- Kelly Government Solutions, Contractor to National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, Rockville, USA
| | - S Hosek
- Stroger Hospital of Cook County, Chicago, USA
| | - J Rooney
- Gilead Sciences, 333 Lakeside Drive, Building 300, Foster City, USA
| | - G Gray
- Office of the President, South African Medical Research Council, Western Cape, South Africa
| | - LG Bekker
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
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Mir F, Mattiello F, Grigg A, Herold M, Hiddemann W, Marcus R, Seymour JF, Bolen CR, Knapp A, Nielsen T, Casulo C. Follicular Lymphoma Evaluation Index (FLEX): A new clinical prognostic model that is superior to existing risk scores for predicting progression-free survival and early treatment failure after frontline immunochemotherapy. Am J Hematol 2020; 95:1503-1510. [PMID: 32815559 PMCID: PMC7756469 DOI: 10.1002/ajh.25973] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 12/28/2022]
Abstract
Patients with advanced‐stage follicular lymphoma (FL) who progress early after receiving first‐line therapy have poor overall survival (OS). Currently applied clinical prognostic models such as FL International Prognostic Index [FLIPI], FLIPI‐2 and PRIMA‐Prognostic Index [PRIMA‐PI] have suboptimal sensitivity and specificity to predict this poor prognosis subgroup. The primary objective was to develop a novel prognostic model, the FL Evaluation Index (FLEX) score, to identify high‐risk patients and compare its performance with FLIPI, FLIPI‐2 and PRIMA‐PI. Progression‐free survival (PFS) after first‐line immunochemotherapy was the key endpoint, while OS and progression of disease within 24 months (POD24) were also assessed. The model, which includes nine clinical variables, was developed using a cohort of patients with previously untreated advanced‐stage FL from the phase 3 GALLIUM trial (NCT01332968). The performance of the model was validated using data from the SABRINA trial (NCT01200758). In GALLIUM (n = 1004; 127 with and 877 without POD24), FLEX increased the intergroup (low‐risk/high‐risk) difference in 2‐year and 3‐year PFS rates and demonstrated superior intergroup differences in 2‐year and 3‐year OS rates compared with FLIPI, FLIPI‐2 and PRIMA‐PI. Sensitivity for a high‐risk score to predict POD24 was 60% using FLEX compared with 53% for FLIPI and FLIPI‐2, and 69% for PRIMA‐PI, while specificity was 68% for FLEX compared with 58% for FLIPI, 59% for FLIPI‐2 and 48% for PRIMA‐PI. The prognostic value of FLEX in SABRINA was similar to FLIPI. Therefore, FLEX appears to perform better than existing prognostic models in previously untreated FL, in particular for the newer treatment regimens.
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Affiliation(s)
- Farheen Mir
- The Royal Marsden NHS Trust Foundation London UK
| | | | | | | | | | | | - John F. Seymour
- Peter MacCallum Cancer Centre Royal Melbourne Hospital and University of Melbourne Melbourne Victoria Australia
| | | | | | | | - Carla Casulo
- Wilmot Cancer Institute University of Rochester New York New York USA
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11
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Townsend W, Pasikowska M, Yallop D, Phillips EH, Patten PEM, Salisbury JR, Marcus R, Pepper A, Devereux S. The architecture of neoplastic follicles in follicular lymphoma; analysis of the relationship between the tumor and follicular helper T cells. Haematologica 2020; 105:1593-1603. [PMID: 31537685 PMCID: PMC7271595 DOI: 10.3324/haematol.2019.220160] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 09/18/2019] [Indexed: 12/15/2022] Open
Abstract
CD4+ T-follicular helper cells are essential for the survival, proliferation, and differentiation of germinal center B cells and have been implicated in the pathogenesis of follicular lymphoma (FL). To further define the role of these cells in FL, we used multiparameter confocal microscopy to compare the architecture of normal and neoplastic follicles and next generation sequencing to analyze the T-cell receptor repertoire in FL lymph nodes (LN). Multiparameter analysis of LN showed that the proportion of T-follic-ular helper cells (TFH) in normal and neoplastic follicles is the same and that the previously reported increase in TFH numbers in FL is thus due to an increase in the number and not content of follicles. As in normal germinal centers, TFH were shown to have a close spatial correlation with proliferating B cells in neoplastic follicles, where features of immunological synapse formation were observed. The number of TFH in FL correlate with the rate of B-cell proliferation and TFH co-localized to activation induced cytidine deaminase expressing proliferating B cells. T-cell receptor repertoire analysis of FL LN revealed that follicular areas are significantly more clonal when compared to the rest of the LN. These novel findings show that neoplastic follicles and germinal centers share important structural features and provide further evidence that TFH may play a role in driving B-cell proliferation and genomic evolution in TFH Our results also suggest that targeting this interaction would be an attractive therapeutic option.
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Affiliation(s)
- William Townsend
- Department of Haematological Medicine, Rayne Institute, King's College London, London
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London
| | - Marta Pasikowska
- Department of Haematological Medicine, Rayne Institute, King's College London, London
| | - Deborah Yallop
- Department of Haematological Medicine, Rayne Institute, King's College London, London
- Department of Haematology, King's College Hospital, London
| | - Elizabeth H Phillips
- Department of Haematological Medicine, Rayne Institute, King's College London, London
| | - Piers E M Patten
- Department of Haematological Medicine, Rayne Institute, King's College London, London
- Department of Haematology, King's College Hospital, London
| | | | - Robert Marcus
- Department of Haematology, King's College Hospital, London
| | - Andrea Pepper
- Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Brighton, UK
| | - Stephen Devereux
- Department of Haematological Medicine, Rayne Institute, King's College London, London
- Department of Haematology, King's College Hospital, London
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12
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Townsend W, Buske C, Cartron G, Cunningham D, Dyer MJ, Gribben JG, Zhang Z, Rufibach K, Nielsen T, Herold M, Hiddemann W, Marcus R. Comparison of efficacy and safety with obinutuzumab plus chemotherapy versus rituximab plus chemotherapy in patients with previously untreated follicular lymphoma: Updated results from the phase III Gallium Study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.8023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8023 Background: Immunochemotherapy is standard of care for patients (pts) with previously untreated advanced stage follicular lymphoma (FL). Four-year data from the Phase III GALLIUM study (NCT01332968) have previously demonstrated an improvement in the primary endpoint of investigator-assessed progression-free survival (PFS) for obinutuzumab (GA101, G) plus chemotherapy (G-chemo) versus rituximab plus chemotherapy (R-chemo) (Townsend et al. ASH 2018). Here, we report efficacy and safety results from an updated analysis. Methods: Eligibility criteria: ≥18 years; advanced stage, previously untreated grade 1–3a FL; requiring treatment according to Groupe d’Etude des Lymphomes Folliculaires criteria. Pts were randomized 1:1 to receive G 1000mg IV (day [D] 1, 8 and 15 of Cycle 1; D1 of each subsequent cycle) or R 375mg/m2 IV (D1 of each cycle) with CHOP, CVP, or bendamustine for 6 or 8 cycles. Responders received maintenance therapy with the same monoclonal antibody every 2 months for 2 years. Results: 1202 pts (median age 59 years) were enrolled (n = 601 per treatment arm). Median duration of follow-up was 76.5 months. Pts receiving G- vs R-chemo demonstrated improved PFS (5-year PFS: hazard ratio [HR] 0.76; 95% CI: 0.62–0.92; p = 0.0043; 70.5% [95% CI: 66.4–74.1] vs 63.2% [95% CI: 59.0–67.1]). There was no notable difference in 5-year overall survival (OS), with few events in either arm (HR 0.87; 95% CI: 0.62–1.22; p = 0.41; G-chemo: 90.2% [95% CI: 87.5–92.4]; R-chemo: 89.4% [95% CI: 86.6–91.6]). Time-to-next-treatment (TTNT) was greater in the G- vs R-chemo arm (5-year TTNT rate: HR 0.72; 95% CI: 0.57–0.90; p = 0.0039; 79.7% [95% CI: 76.1–82.7] vs 72.9% [95% CI: 69.1–76.4]). Incidence of grade 3–5 adverse events was 79.3% in the G-chemo arm and 71.2% in the R-chemo arm, and consistent with those reported in the primary analysis (Marcus et al. N Engl J Med 2017). Conclusions: These data further demonstrate the clinically meaningful and durable benefit of treatment with G-chemo relative to R-chemo in previously untreated FL pts. Acknowledgement: GALLIUM was sponsored by F. Hoffmann-La Roche Ltd. Third-party medical writing assistance, under the direction of William Townsend, was provided by Louise Profit and Stephanie Lacey of Gardiner-Caldwell Communications, and was funded by F. Hoffmann-La Roche Ltd. Clinical trial information: NCT01332968 .
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Affiliation(s)
- William Townsend
- Cancer Research UK and UCL Cancer Trials Centre, London, United Kingdom
| | | | | | | | - Martin J.S. Dyer
- Ernest and Helen Scott Haematological Research Institute, University of Leicester, Leicester, United Kingdom
| | | | - Zilu Zhang
- F. Hoffmann-La Roche Ltd., Shanghai, China
| | | | | | | | - Wolfgang Hiddemann
- Department of Medicine III, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
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13
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Nielsen T, Barrington S, Meignan M, Sahin D, Knapp A, Kinkolykh A, Herold M, Hiddemann W, Marcus R, Trotman J. First-line immunochemotherapy for follicular lymphoma in the GALLIUM study: Prognostic value of PET-CT status after long-term follow-up. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.8025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8025 Background: The prognostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) response assessment following first-line immunochemotherapy for advanced-stage symptomatic follicular lymphoma (FL) was previously demonstrated for patients (pts) enrolled in the Phase III GALLIUM study (NCT01332968; Trotman et al. ICML 2017). Here, we evaluated the association between PET complete metabolic response (CMR) and survival after longer follow-up in this patient population. Methods: In the GALLIUM study, 1202 pts with previously untreated FL were randomized 1:1 to induction therapy of 1000mg obinutuzumab (G; Days 1, 8, 15 of Cycle 1 then Day 1 of subsequent cycles) or 375mg/m2 rituximab (R; Day 1 of each cycle), in combination with chemotherapy (CHOP, CVP, or bendamustine) (Marcus et al. New Engl J Med 2017). PET-CT scans were mandatory, where available, at baseline and end-of-induction (EOI) for the first 170 pts enrolled, and optional thereafter. For this response analysis, the Lugano 2014 criteria were applied by an independent review committee (IRC) (Cheson et al. J Clin Oncol 2014). Associations between EOI PET complete metabolic response (PET-CMR) status and progression-free survival (PFS) and overall survival (OS) were evaluated, with hazard ratios (HR) stratified according to chemotherapy regimen and FL International Prognostic Index. Results: Of the 609 pts with a baseline PET scan, 595 (98%) had detectable lesions. Of these, 519 pts had an EOI PET evaluable by Lugano 2014 criteria. At EOI, per IRC assessment, 450/595 (76%) pts had achieved CMR. Pts with non-available scans were considered as non-responders and were excluded from the landmark (LM) analyses. Pts who died or progressed (CT-based progression assessment) before or at EOI were excluded from the PFS LM analysis; pts who died before EOI were excluded from the OS LM analysis. After a median follow-up of 76.5 months, EOI PET status was highly prognostic for both longer investigator-assessed PFS (non-CMR vs CMR: HR 3.40; 95% CI: 2.33–4.97; p < 0.0001) and longer OS (HR 3.34; 95% CI: 1.81–6.17; p < 0.0001). Six-year investigator-assessed PFS from EOI was 62.6% (95% CI: 57.0–67.6) for CMR pts compared with 23.4% (95% CI: 12.2–36.7) for non-CMR pts; the corresponding OS was 91.3% (95% CI: 88.1–93.6) vs 79.6% (95% CI: 68.0–87.4). Conclusions: With more than 6 years of follow-up, this analysis confirms that after first-line chemoimmunotherapy for FL, achieving CMR on PET-CT is an early and strong predictor of increased PFS and OS. Clinical trial information: NCT01332968 .
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Affiliation(s)
| | - Sally Barrington
- King’s College London and Guys’ & St Thomas PET Imaging Centre, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Michel Meignan
- Service de Médecine Nucléaire, Hôpital Henri Mondor and Université Paris Est Créteil, Créteil, France
| | - Deniz Sahin
- F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | | | - Anastasiia Kinkolykh
- Consultant to F. Hoffmann-La Roche Ltd., via GCE Solutions-an IQVIA business, Basel, Switzerland
| | | | - Wolfgang Hiddemann
- Department of Medicine III, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | | | - Judith Trotman
- Hematology Department, Concord Repatriation General Hospital, University of Sydney, Concord, Australia
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Seymour JF, Marcus R, Davies A, Gallop-Evans E, Grigg A, Haynes A, Herold M, Illmer T, Nilsson-Ehle H, Sökler M, Dünzinger U, Nielsen T, Launonen A, Hiddemann W. Association of early disease progression and very poor survival in the GALLIUM study in follicular lymphoma: benefit of obinutuzumab in reducing the rate of early progression. Haematologica 2020; 105:1465. [PMID: 32358081 DOI: 10.3324/haematol.2020.246991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- John F Seymour
- Peter MacCallum Cancer Centre, Royal Melbourne Hospital and University of Melbourne, Victoria, NSW, Australia
| | | | - Andrew Davies
- Cancer Research UK Centre, University of Southampton, Southampton, UK
| | | | - Andrew Grigg
- Austin Hospital, Melbourne, Victoria, NSW, Australia
| | - Andrew Haynes
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Thomas Illmer
- BAG Freiberg-Richter, Jacobasch, Illmer and Wolf, Dresden, Germany
| | - Herman Nilsson-Ehle
- Section of Hematology and Coagulation, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martin Sökler
- Eberhard-Karls-University Tübingen, Tübingen, Germany
| | | | | | | | - Wolfgang Hiddemann
- Department of Medicine III, Ludwig-Maximilians-University, München, Germany
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Abbar M, Khan A, Rollin L, Sanchez R, Carson W, Morris B, Timko K, Marcus R. Efficacy of adjunctive aripiprazole to lithium or valproate in the long-term treatment of mania in subjects with bipolar i disorder (CN138–189). Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(11)71897-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
ObjectivesTo evaluate the long-term safety and efficacy of adjunctive aripiprazole (ARI) to lithium (LI) or valproate (VAL) in delaying time to relapse in bipolar I disorder.MethodsBipolar I disorder subjects with a current manic or mixed episode received LI or VAL for at least 2 weeks; inadequate responders (YMRS score ≥ 16 and ≤35% decrease from baseline at 2 weeks) received adjunctive ARI. Subjects maintaining mood stability (YMRS and MADRS ≤ 12 for 12 consecutive weeks) were randomised 1:1 to double-blind ARI (10 to 30 mg/day) or placebo (PBO) plus LI or VAL. Relapse was monitored up to 52 weeks.Results337 subjects were randomised to continuation of mood stabiliser plus adjunctive ARI or PBO; 61.3% and 52.7%, respectively, completed the study. Adjunctive ARI significantly delayed the time to any relapse, hazard ratio = 0.544 (95% CI: 0.33, 0.89, log-rank p = 0.014). Overall relapse rates at 52 weeks were 14.9% and 25.4% in ARI vs PBO subjects. A superior reduction in CGI-BP Mania Severity of Illness from baseline at 52 weeks was also observed (0.3 vs. 0.0, respectively, p = 0.01). Adverse events generally were as expected per known drug and illness profiles with no significant difference in mean change in body weight between adjunctive PBO (0.60 kg) and adjunctive ARI (1.07 kg) (p = 0.49 Week 52, LOCF).ConclusionContinuation of aripiprazole treatment increased time to relapse to any mood episode compared with placebo plus LI/VAL over 1 year, indicating a long-term benefit in continuing adjunctive aripiprazole to a mood stabiliser after sustained remission is achieved.
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16
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Hanamsagar R, Reizis T, Chamberlain M, Marcus R, Nestle FO, de Rinaldis E, Savova V. Publisher Correction: An optimized workflow for single-cell transcriptomics and repertoire profiling of purified lymphocytes from clinical samples. Sci Rep 2020; 10:6321. [PMID: 32286331 PMCID: PMC7156626 DOI: 10.1038/s41598-020-62066-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Richa Hanamsagar
- Sanofi Immunology and Inflammation Research Therapeutic Area, 270 Albany St, Cambridge, MA, 02139, USA
| | - Timothy Reizis
- New York University College of Arts and Sciences, 32 Waverly Pl, New York, NY, 10003, USA
| | - Mathew Chamberlain
- Sanofi Immunology and Inflammation Research Therapeutic Area, 270 Albany St, Cambridge, MA, 02139, USA
| | - Robert Marcus
- Sanofi Immunology and Inflammation Research Therapeutic Area, 270 Albany St, Cambridge, MA, 02139, USA
| | - Frank O Nestle
- Sanofi Immunology and Inflammation Research Therapeutic Area, 270 Albany St, Cambridge, MA, 02139, USA
| | - Emanuele de Rinaldis
- Sanofi Immunology and Inflammation Research Therapeutic Area, 270 Albany St, Cambridge, MA, 02139, USA
| | - Virginia Savova
- Sanofi Immunology and Inflammation Research Therapeutic Area, 270 Albany St, Cambridge, MA, 02139, USA.
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Pokhrel D, Sanford L, Larkin S, Bhaswanth D, Janelle M, Mark B, Marcus R, Ronald M. Single-Isocenter/Multi-Lesion Synchronous Lung Stereotactic Body Radiation Therapy (SBRT): Plan Quality, Treatment Efficiency and Clinical Outcomes. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Opat S, Marcus R, Portell CA, Reed W, Co M, Huang J, Trotman J. Phase 2 study of zanubrutinib (BGB-3111) in patients with relapsed/refractory marginal zone lymphoma (R/R MZL). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.tps7568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS7568 Background: Bruton tyrosine kinase (BTK) plays a critical role in B-cell receptor signaling, mediating B-cell proliferation, migration, adhesion and survival. BTK inhibition has emerged as a strategy for targeting B-cell malignancies, including MZL. In preclinical studies, zanubrutinib was shown to be a potent, irreversible, highly specific BTK inhibitor with excellent oral bio-availability and favorable pharmacokinetic/pharmacodynamic properties. Clinical data to date have shown that complete and sustained 24-hour BTK occupancy is associated with durable responses and suggested that zanubrutinib is generally well tolerated with low rates of serious adverse events. Preliminary results from the MZL cohort enrolled in the open-label, multicenter, phase 1 study demonstrated responses in 7 of 9 patients for an overall response rate (ORR) of 78%. Cumulative safety data also showed that zanubrutinib monotherapy was associated with infrequent incidence of atrial fibrillation and major hemorrhage and infrequent drug discontinuation due to treatment-related adverse events. This study is designed to evaluate the safety and efficacy of zanubrutinib in patients with R/R MZL. Methods: This ongoing global phase 2, single-arm, open-label study is examining zanubrutinib monotherapy in patients with R/R MZL who have received one or more prior lines of systemic therapy. Patients are treated with oral zanubrutinib at 160 mg twice-daily until progressive disease, unacceptable toxicity, or withdrawal of consent. Eligible patients must have histologically confirmed MZL, have received prior anti-CD20 antibody therapy, and have measurable disease. Disease response is assessed per the 2014 Lugano Classification for non-Hodgkin lymphoma. The primary endpoint is ORR determined by independent review committee (IRC). Key secondary endpoints include ORR by investigator assessment, time to and duration of response, time to treatment discontinuation, progression-free survival (all determined by IRC and investigator assessments), and overall survival and safety. Recruitment is ongoing.
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Affiliation(s)
- Stephen Opat
- Monash Health, Monash University, Clayton, Victoria, Australia
| | - Robert Marcus
- Sarah Cannon Research Institute, London, United Kingdom
| | | | | | | | | | - Judith Trotman
- Concord Repatriation Hospital, The University of Sydney, Sydney, New South Wales, Australia
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19
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Jamois C, Gibiansky E, Gibiansky L, Buchheit V, Sahin D, Cartron G, Marcus R, Hiddemann W, Seymour JF, Strefford JC, Hargreaves CE, Meneses-Lorente G, Frey N, Fingerle-Rowson G. Role of obinutuzumab exposure on clinical outcome of follicular lymphoma treated with first-line immunochemotherapy. Br J Clin Pharmacol 2019; 85:1495-1506. [PMID: 30866056 PMCID: PMC6595360 DOI: 10.1111/bcp.13920] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 10/02/2018] [Revised: 03/06/2019] [Accepted: 03/10/2019] [Indexed: 01/12/2023] Open
Abstract
AIMS Obinutuzumab (G) is a humanized type II, Fc-glycoengineered anti-CD20 monoclonal antibody used in various indications, including patients with previously untreated front-line follicular lymphoma. We investigated sources of variability in G exposure and association of progression-free survival (PFS) with average concentration over induction (CmeanIND ) in front-line follicular lymphoma patients treated with G plus chemotherapy (bendamustine, CHOP, or CVP) in the GALLIUM trial. METHODS Individual exposures (CmeanIND ) were obtained from a previously established population pharmacokinetic model updated with GALLIUM data. Multivariate Cox proportional hazard models and univariate Kaplan-Meier plots investigated relationships of PFS with exposure and other potential prognostic factors. RESULTS Overall, G exposure was lower in high body-weight patients and in males, and slightly lower in patients with high baseline tumour burden. Analysis of clinical outcomes showed that variability in G exposure did not impact PFS in G-bendamustine-treated patients; PFS was inferior in males and patients with FCGR2a/2b T232 T low-affinity receptor variant, and superior in patients with FCGR2a/2b I232T variant. In G-CHOP/CVP arms, PFS improved with increasing CmeanIND (hazard ratio = 1.74 and 0.394 at 5th and 95th percentile compared to median CmeanIND ) and was inferior in patients with high baseline tumour size and B symptoms. CONCLUSIONS It remains unclear whether for G-CHOP/CVP patients lower G exposure is a consequence of adverse disease biology and/or resistance to chemotherapy backbone (higher clearance in nonresponder patients, as demonstrated for rituximab) rather than being the cause of poorer clinical outcome. A study with >1 dose level of G could help resolve this uncertainty.
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Affiliation(s)
- Candice Jamois
- Department of Clinical Pharmacology, F. Hoffmann-La Roche, Roche Innovation Center Basel, Switzerland
| | | | | | - Vincent Buchheit
- Department of Clinical Pharmacology, F. Hoffmann-La Roche, Roche Innovation Center Basel, Switzerland
| | | | | | | | | | - John F Seymour
- Peter MacCallum Cancer Centre, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia
| | - Jonathan C Strefford
- Cancer Genomics, Cancer Sciences, Faculty of Medicine, Group University of Southampton, Southampton, UK
| | - Chantal E Hargreaves
- Cancer Genomics, Cancer Sciences, Faculty of Medicine, Group University of Southampton, Southampton, UK
| | | | - Nicolas Frey
- Department of Clinical Pharmacology, F. Hoffmann-La Roche, Roche Innovation Center Basel, Switzerland
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20
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Klanova M, Oestergaard MZ, Trněný M, Hiddemann W, Marcus R, Sehn LH, Vitolo U, Bazeos A, Goede V, Zeuner H, Knapp A, Sahin D, Spielewoy N, Bolen CR, Cardona A, Klein C, Venstrom JM, Nielsen T, Fingerle-Rowson G. Prognostic Impact of Natural Killer Cell Count in Follicular Lymphoma and Diffuse Large B-cell Lymphoma Patients Treated with Immunochemotherapy. Clin Cancer Res 2019; 25:4634-4643. [PMID: 31053601 DOI: 10.1158/1078-0432.ccr-18-3270] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/06/2019] [Accepted: 04/29/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Natural killer (NK) cells are key effector cells for anti-CD20 monoclonal antibodies (mAb), such as obinutuzumab and rituximab. We assessed whether low pretreatment NK-cell count (NKCC) in peripheral blood or tumor tissue was associated with worse outcome in patients receiving antibody-based therapy. PATIENTS AND METHODS Baseline peripheral blood NKCC was assessed by flow cytometry (CD3-CD56+ and/or CD16+ cells) in 1,064 of 1,202 patients with follicular lymphoma treated with obinutuzumab or rituximab plus chemotherapy in the phase III GALLIUM trial (NCT01332968) and 1,287 of 1,418 patients with diffuse large B-cell lymphoma (DLBCL) treated with obinutuzumab or rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (G-CHOP or R-CHOP) in the phase III GOYA trial (NCT01287741). The prognostic value of tumor NK-cell gene expression, as assessed by whole-transcriptome gene expression using TruSeq RNA sequencing, was also analyzed. The association of baseline variables, such as treatment arm, was evaluated using multivariate Cox regression models using a stepwise approach. RESULTS In this exploratory analysis, low baseline peripheral blood NKCC was associated with shorter progression-free survival (PFS) in both follicular lymphoma [hazard ratio (HR), 1.48; 95% confidence interval (CI), 1.02-2.14; P = 0.04] and DLBCL (HR, 1.36; 95% CI, 1.01-1.83; P = 0.04), and overall survival in follicular lymphoma (HR, 2.20; 95% CI, 1.26-3.86; P = 0.0058). Low tumor NK-cell gene expression was associated with shorter PFS in G-CHOP-treated patients with DLBCL (HR, 1.95; 95% CI, 1.22-3.15; P < 0.01). CONCLUSIONS These findings indicate that the number of NK cells in peripheral blood may affect the outcome of patients with B-cell non-Hodgkin lymphoma receiving anti-CD20-based immunochemotherapy.
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Affiliation(s)
- Magdalena Klanova
- Charles University General Hospital, Prague, Czech Republic. .,Institute of Pathological Physiology, Charles University, Prague, Czech Republic.,F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Marek Trněný
- Charles University General Hospital, Prague, Czech Republic
| | | | | | - Laurie H Sehn
- Centre for Lymphoid Cancer, British Columbia Cancer Agency and the University of British Columbia, Vancouver, Canada
| | - Umberto Vitolo
- A.O.U. Citta' Della Salute e della Scienza, S.C. Ematologia, Turin, Italy
| | | | - Valentin Goede
- Center of Integrated Oncology Cologne-Bonn, University Hospital Cologne, Cologne, Germany
| | | | | | - Deniz Sahin
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
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21
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Hanamsagar R, Marcus R, Chamberlain M, de Rinaldis E, Savova V. Optimum processing conditions for single cell RNA sequencing on frozen human PBMCs. The Journal of Immunology 2019. [DOI: 10.4049/jimmunol.202.supp.131.15] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
The field of single cell RNA sequencing (sc-SEQ) has exploded in the past few years. From picking up single cells manually under a microscope, to droplet-based encapsulation of cells using microfluidics – this technology has improved in leaps and bounds. Common droplet-based technologies include inDrop, Drop-seq and 10X Genomics Chromium. All three technologies utilize microfluidics for encapsulating single cells & uniquely barcoded beads within an oil droplet. They differ in their bead material/manufacturing, barcode design and the range to which their operation can be customized by the end user. However, the performance of each sc-SEQ each technology is dependent on factors such as ability to obtain pure, viable single-cell suspension, and ability to accurately quantify the number of cells before running them through the machine. Here, we compare and contrast different conditions for cell processing that can affect single-cell sequencing results – including cell counting and purifying methods, as well as cell subtype enrichment kits; followed by single cell encapsulation, library preparation and analysis using 10X Genomics Chromium workflow.
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22
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Pearson ADJ, Scobie N, Norga K, Ligas F, Chiodin D, Burke A, Minard-Colin V, Adamson P, Marshall LV, Balakumaran A, Benettaib B, Bhargava P, Bollard CM, Bolotin E, Bomken S, Buechner J, Burkhardt B, Caron H, Copland C, Demolis P, Egorov A, Farhan M, Zugmaier G, Gross T, Horton-Taylor D, Klapper W, Lesa G, Marcus R, Miles RR, Nottage K, Pacaud L, Ricafort R, Schrappe M, Sterba J, Vezan R, Weiner S, Kim SY, Reaman G, Vassal G. ACCELERATE and European Medicine Agency Paediatric Strategy Forum for medicinal product development for mature B-cell malignancies in children. Eur J Cancer 2019; 110:74-85. [PMID: 30772656 DOI: 10.1016/j.ejca.2019.01.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 01/02/2019] [Accepted: 01/18/2019] [Indexed: 11/17/2022]
Abstract
Paediatric Strategy Forums have been created by the multistakeholder organisation, ACCELERATE, and the European Medicines Agency to facilitate dialogue between all relevant stakeholders and suggest strategies in critical areas of paediatric oncology drug development. As there are many medicines being developed for B-cell malignancies in adults but comparatively few in children with these malignancies, a Paediatric Strategy Forum was held to discuss the best approach to develop these products for children. It was concluded that as current frontline therapy is highly successful, despite associated acute toxicity, de-escalation of this or substitution of presently used drugs with new medicines can only be undertaken when there is an effective salvage regimen, which is currently not available. Therefore priority should be given to developing treatment for patients with relapsed and refractory mature B-cell lymphomas. The consensus of the clinicians attending the meeting was that CAR T-cells, T-cell engagers and antibody drug conjugates (excluding those with a vinca alkaloid-like drug) presently have the greatest probability of providing benefit in relapse in view of their mechanism of action. However, as producing autologous CAR T-cells currently takes at least 4 weeks, they are not products which could be quickly employed initially at relapse in rapidly progressing mature B-cell malignancies but only for the consolidation phase of the treatment. Global, industry-supported, academic-sponsored studies testing compounds from different pharmaceutical companies simultaneously should be considered in rare populations, and it was proposed that an international working group be formed to develop an overarching clinical trials strategy for these disease groups. Future Forums are planned for other relevant paediatric oncologic diseases with a high unmet medical need and relevant molecular targets.
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Affiliation(s)
| | | | | | - Franca Ligas
- Paediatric Medicines Office, Product Development Scientific Support Department, European Medicines Agency, London, UK
| | | | - Amos Burke
- Department of Paediatric Haematology and Oncology, Addenbrooke's Hospital Cambridge, UK
| | | | | | - Lynley V Marshall
- Paediatric Drug Development, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust, London, UK; Divisions of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | | | | | | | - Catherine M Bollard
- Centre for Cancer and Immunology Research, Children's National Health System, The George Washington University, Washington DC, USA
| | | | - Simon Bomken
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, UK
| | - Jochen Buechner
- Department of Paediatric Hematology and Oncology, Oslo University Hospital, Norway
| | - Birgit Burkhardt
- Pediatric Hematology, Oncology and BMT, University Hospital Münster, Germany
| | | | | | | | - Anton Egorov
- Centre for Therapeutic Innovation in Oncology, Servier, France
| | - Mahdi Farhan
- Debiopharm International SA, Lausanne, Switzerland
| | | | | | | | | | - Giovanni Lesa
- Paediatric Medicines Office, Product Development Scientific Support Department, European Medicines Agency, London, UK
| | | | - Rodney R Miles
- University of Utah, Department of Pathology, Salt Lake City, UT, USA
| | | | | | - Rosanna Ricafort
- Oncology Clinical Development, Bristol-Myers Squibb Pharma EEIG, NJ, USA
| | | | - Jaroslav Sterba
- Pediatric Oncology Department, University Hospital Brno, School of Medicine Masaryk University, Brno, Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, ICRC Brno, St. Anna University Hospital Brno, Czech Republic
| | | | - Susan Weiner
- Children's Cause for Cancer Advocacy, Washington DC, USA
| | | | - Gregory Reaman
- Office of Hematology and Oncology Products, U.S. Food and Drug Administration, MD, USA
| | - Gilles Vassal
- Department of Clinical Research, Gustave Roussy, Paris-Sud University, Paris, France
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23
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Seymour JF, Marcus R, Davies A, Gallop-Evans E, Grigg A, Haynes A, Herold M, Illmer T, Nilsson-Ehle H, Sökler M, Dünzinger U, Nielsen T, Launonen A, Hiddemann W. Association of early disease progression and very poor survival in the GALLIUM study in follicular lymphoma: benefit of obinutuzumab in reducing the rate of early progression. Haematologica 2018; 104:1202-1208. [PMID: 30573503 PMCID: PMC6545851 DOI: 10.3324/haematol.2018.209015] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 12/17/2018] [Indexed: 12/26/2022] Open
Abstract
We evaluated early disease progression and its impact on overall survival (OS) in previously untreated follicular lymphoma patients in GALLIUM (clinicaltrials.gov identifier: 01332968), and investigated the effect on early disease progression of the two randomization arms: obinutuzumab-based versus rituximab-based immunochemotherapy. Cause-specific Cox regression was used to estimate the effect of treatment on the risk of disease progression or death due to disease progression within 24 months of randomization and to analyze OS in patients with or without disease progression after 24 months. Mortality in both groups was analyzed 6, 12, and 18 months post randomization (median follow up, 41 months). Fewer early disease progression events occurred in obinutuzumab (57 out of 601) versus rituximab (98 out of 601) immunochemotherapy patients, with an average risk reduction of 46.0% (95%CI: 25.0-61.1%; cumulative incidence rate 10.1% vs. 17.4%). At a median post-progression follow up of 22.6 months, risk of mortality increased markedly following a progression event [HR of time-varying progression status, 25.5 (95%CI: 16.2-40.3)]. Mortality risk was higher the earlier patients progressed within the first 24 months. Age-adjusted HR for OS after 24 months in surviving patients with disease progression versus those without was 12.2 (95%CI: 5.6-26.5). Post-progression survival was similar by treatment arm. In conclusion, obinutuzumab plus chemotherapy was associated with a marked reduction in the rate of early disease progression events relative to rituximab plus chemotherapy. Early disease progression in patients with follicular lymphoma was associated with poor prognosis, with mortality risk higher after earlier progression. Survival post progression did not seem to be influenced by treatment arm.
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Affiliation(s)
- John F Seymour
- Peter MacCallum Cancer Centre, Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
| | | | - Andrew Davies
- Cancer Research UK Centre, University of Southampton, UK
| | | | | | | | | | - Thomas Illmer
- BAG Freiberg-Richter, Jacobasch, Illmer and Wolf, Dresden, Germany
| | - Herman Nilsson-Ehle
- Section of Hematology and Coagulation, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | | | | | - Wolfgang Hiddemann
- Department of Medicine III, Ludwig-Maximilians-University, Munich, Germany
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24
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Hübel K, Salles G, Marcus R, Zinzani PL, Dreyling M. New Treatment Options in Advanced Stage Follicular Lymphoma. Hemasphere 2018; 2:e156. [PMID: 31723794 PMCID: PMC6745966 DOI: 10.1097/hs9.0000000000000156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 10/04/2018] [Indexed: 11/26/2022] Open
Abstract
Follicular lymphoma is one of the most common non-Hodgkin's lymphomas with an expected survival of more than 20 years for the majority of patients. This impressive outcome has been achieved with the introduction of immunochemotherapy, as first line treatment with remissions lasting over 8 years, followed by other treatment options at first or subsequent relapse. However, certain groups of patients still have a poor prognosis. In recent years the efficacy of chemotherapy regimens has been augmented by new compounds selectively targeting the cell surface, intracellular pathways, and/or the microenvironment. Some of these are beginning to change the therapeutic landscape. This review summarizes prognostic factors in follicular lymphoma in order to identify patients with greatest medical need for these new treatment options and reviews recent data from prospective clinical studies testing new agents in first-line and relapsed follicular lymphoma. Finally, we assess the current role of immunochemotherapy and discuss the requirements for future clinical trials.
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Affiliation(s)
- Kai Hübel
- University Hospital of Cologne, Cologne, Germany
| | - Gilles Salles
- Hématologie, Hospices Civils de Lyon and Université de Lyon, Pierre-Bénite, Lyon, France
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25
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Trotman J, Davies A, Hiddemann W, Hoster E, Marcus R, Schmidt C, Harbron C, Mundt K, Nielsen T, Pott C. Relationship between MRD and PET responses and PFS in previously untreated follicular lymphoma in the GALLIUM trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.7557] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Judith Trotman
- Concord Repatriation General Hospital, University of Sydney, Sydney, Australia
| | - Andrew Davies
- Cancer Research UK Centre, Cancer Sciences Division, University of Southampton, Southampton, United Kingdom
| | - Wolfgang Hiddemann
- Department of Internal Medicine III, University Hospital of Munich, Munich, Germany
| | - Eva Hoster
- University Hospital of Munich, Munich, Germany
| | | | | | - Chris Harbron
- Roche Products Ltd., Welwyn Garden City, United Kingdom
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26
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Barredo JC, Hastings C, Lu X, Devidas M, Chen Y, Armstrong D, Winick N, Wood BL, Yanofsky R, Loh M, Gastier-Foster JM, Jorstad DT, Marcus R, Ritchey K, Carrol WL, Hunger SP. Isolated late testicular relapse of B-cell acute lymphoblastic leukemia treated with intensive systemic chemotherapy and response-based testicular radiation: A Children's Oncology Group study. Pediatr Blood Cancer 2018; 65:e26928. [PMID: 29286562 PMCID: PMC6136835 DOI: 10.1002/pbc.26928] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/07/2017] [Accepted: 11/17/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND The incidence of isolated testicular relapse (ITR) of acute lymphoblastic leukemia (ALL) has decreased with contemporary treatment strategies, but outcomes are suboptimal with a 58% 5-year overall survival (OS). This study aimed to improve outcome in patients with ITR of B-cell ALL (B-ALL) occurring after 18 months of first clinical remission using intensive systemic chemotherapy and to decrease long-term sequelae by limiting use of testicular radiation. PROCEDURE Forty patients in first ITR of B-ALL were enrolled. Induction (dexamethasone, vincristine, daunorubicin, and intrathecal triple therapy) was preceded by one dose of high-dose methotrexate (MTX, 5 g/m2 ). Following induction, 25 of 26 patients who had persistent testicular enlargement underwent testicular biopsy. Eleven had biopsy-proven disease and received bilateral testicular radiation (24 Gy), whereas twenty-nine did not. RESULTS Overall 5-year event-free survival (EFS)/OS was 65.0 ± 8.8%/73.1 ± 8.3%, with 5-year EFS 62.1 ± 11.0% vs. 72.7 ± 14.4% for patients who did not receive radiation therapy (XRT) (n = 29) compared with those who did (n = 11), respectively (P = 0.64). There were six second bone marrow relapses and six second ITRs. The proportion of second relapses was similar in the patients that received testicular radiation and those who did not. However, the 5-year OS was similar for patients who did not receive XRT (72.6 ± 10.2%) compared with those who did (72.7 ± 14.4%) (P = 0.85). CONCLUSIONS A 5-year OS rate of 73.1 ± 8.3% was obtained in children with first ITR of B-ALL occurring after 18 months of CR1 (length of first clinical remission) using intensive chemotherapy and limiting testicular radiation.
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Affiliation(s)
- Julio C. Barredo
- Division of Hematology and Oncology, Department of Pediatrics, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Caroline Hastings
- Department of Hematology/Oncology, Children's Hospital & Research Center Oakland, Oakland, California
| | - Xiamin Lu
- University of Florida, Gainesville, Florida
| | - Meenakshi Devidas
- Biostatistics & Children's Oncology Group, University of Florida, Gainesville, Florida
| | | | - Daniel Armstrong
- Division of Hematology and Oncology, Department of Pediatrics, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Naomi Winick
- Department of Pediatrics, UT Southwestern, Dallas, Texas
| | | | | | - Mignon Loh
- Helen Diller Family Comprehensive Cancer Center, UCSSF Medical Center-Parnassus, San Francisco, California
| | | | | | | | - Kim Ritchey
- Department of Pediatric Hematology/Oncology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
| | - William L. Carrol
- Department of Pediatrics, New York University School of Medicine, New York, New York
| | - Stephen P. Hunger
- Department of Pediatric Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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27
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Marcus R. Comments on Galli et al.: The effect of magnesium on early osseointegration in osteoporotic bone: a histological and gene expression investigation. Osteoporos Int 2018; 29:1003. [PMID: 29460104 DOI: 10.1007/s00198-017-4177-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 07/24/2017] [Indexed: 10/18/2022]
Affiliation(s)
- R Marcus
- Stanford University, Stanford, CA, USA.
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28
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Affiliation(s)
| | - John F Seymour
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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29
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Hussain N, Hodson D, Marcus R, Baglin T, Luddington R. The biphasic transmittance waveform: An early marker of sepsis in patients with neutropenia. Thromb Haemost 2017; 100:146-8. [DOI: 10.1160/th07-10-0622] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryTransmittance waveform (TW) analysis has been proposed as a method of both prediction and monitoring of non-overt and overt disseminated intravascular coagulation. This study assessed the use of the rapid TW of the activated partial thromboplastin time in the detection of sepsis in 49 consecutive neutropenic haemato-oncology patients. A slope 1 cut-off value of –0.050 was found to be optimum giving 85% sensitivity with 92% specificity and positive and negative predictive values of 62% and 98%, respectively. Furthermore a worsening slope 1 value at 24 hours was indicative of a 60% increase in mortality risk. Haemato-oncology patients have a significantly increased risk of developing sepsis during intensive chemotherapy, exacerbated by the resultant neutopenia. This sepsis may progress extremely rapidly and is associated with a high mortality. Early diagnosis is therefore critical and is currently made on a predominantly clinical basis with supporting microbiological evidence 2–3 days later. This study showed that TW offers an early marker, predictive of sepsis in neutropenic patients. It correlates with subsequent microbiological results and may identify patients at greater risk of clinical deterioration who may require more intensive early therapy or observation. It may also provide a useful marker to monitor the effects of treatment.
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30
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Fararjeh FA, Mahmood S, Tachtatzis P, Yallop D, Devereux S, Patten P, Agrawal K, Suddle A, O'Grady J, Heaton N, Marcus R, Kassam S. A retrospective analysis of post-transplant lymphoproliferative disorder following liver transplantation. Eur J Haematol 2017; 100:98-103. [PMID: 29094407 DOI: 10.1111/ejh.12988] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate response rates and survival in adults developing post-transplant lymphoproliferative disorder (PTLD) following liver transplantation. METHODS Patients were identified retrospectively and data collected through local liver and haematology electronic databases and pharmacy records. RESULTS Forty-five patients were identified. The median age at first transplant and at development of PTLD was 48 and 54 years, respectively, with the median time from transplant to PTLD diagnosis of 56 months. The majority of cases (76%) were monomorphic B-cell lymphomas, and 36% of tumours were EBV positive. Treatment involved reduction in immune-suppression (RIS) in 30 (67%) with RIS the only treatment in 3. Ten (22%) patients were treated with rituximab alone, 13 (29%) with chemotherapy alone and 14 (31%) patients were treated with rituximab and chemotherapy. Twenty-six (58%) patients achieved a complete response (CR). At a median follow-up of 27 months, the median overall survival (OS) was 50 months. Response and OS were not associated with clinical factors or the use of rituximab. CONCLUSION Outcomes reported in this study are favourable and comparable to those reported previously. The addition of rituximab did not appear to have improved outcomes in this series, although a significant proportion of patients were able to avoid chemotherapy.
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Affiliation(s)
- Feras Al Fararjeh
- Department of Haematology, King's College Hospital NHS Foundation Trust, London, UK
| | - Shameem Mahmood
- Department of Haematology, King's College Hospital NHS Foundation Trust, London, UK
| | - Phaedra Tachtatzis
- Department of Haematology, King's College Hospital NHS Foundation Trust, London, UK
| | - Deborah Yallop
- Department of Haematology, King's College Hospital NHS Foundation Trust, London, UK
| | - Stephen Devereux
- Department of Haematology, King's College Hospital NHS Foundation Trust, London, UK
| | - Piers Patten
- Department of Haematology, King's College Hospital NHS Foundation Trust, London, UK
| | - Kosh Agrawal
- Department of Hepatology, King's College Hospital NHS Foundation Trust, London, UK
| | - Abid Suddle
- Department of Hepatology, King's College Hospital NHS Foundation Trust, London, UK
| | - John O'Grady
- Department of Hepatology, King's College Hospital NHS Foundation Trust, London, UK
| | - Nigel Heaton
- Department of Hepatology, King's College Hospital NHS Foundation Trust, London, UK
| | - Robert Marcus
- Department of Haematology, King's College Hospital NHS Foundation Trust, London, UK
| | - Shireen Kassam
- Department of Haematology, King's College Hospital NHS Foundation Trust, London, UK
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Marcus R, Davies A, Ando K, Klapper W, Opat S, Owen C, Phillips E, Sangha R, Schlag R, Seymour JF, Townsend W, Trněný M, Wenger M, Fingerle-Rowson G, Rufibach K, Moore T, Herold M, Hiddemann W. Obinutuzumab for the First-Line Treatment of Follicular Lymphoma. N Engl J Med 2017; 377:1331-1344. [PMID: 28976863 DOI: 10.1056/nejmoa1614598] [Citation(s) in RCA: 459] [Impact Index Per Article: 65.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Rituximab-based immunochemotherapy has improved outcomes in patients with follicular lymphoma. Obinutuzumab is a glycoengineered type II anti-CD20 monoclonal antibody. We compared rituximab-based chemotherapy with obinutuzumab-based chemotherapy in patients with previously untreated advanced-stage follicular lymphoma. METHODS We randomly assigned patients to undergo induction treatment with obinutuzumab-based chemotherapy or rituximab-based chemotherapy. Patients with a response received maintenance treatment for up to 2 years with the same antibody that they had received in induction. The primary end point was investigator-assessed progression-free survival. RESULTS A total of 1202 patients with follicular lymphoma underwent randomization (601 patients in each group). After a median follow-up of 34.5 months (range, 0 to 54.5), a planned interim analysis showed that obinutuzumab-based chemotherapy resulted in a significantly lower risk of progression, relapse, or death than rituximab-based chemotherapy (estimated 3-year rate of progression-free survival, 80.0% vs. 73.3%; hazard ratio for progression, relapse, or death, 0.66; 95% confidence interval [CI], 0.51 to 0.85; P=0.001). Similar results were seen with regard to independently reviewed progression-free survival and other time-to-event end points. Response rates were similar in the two groups (88.5% in the obinutuzumab group and 86.9% in the rituximab group). Adverse events of grade 3 to 5 were more frequent in the obinutuzumab group than in the rituximab group (74.6% vs. 67.8%), as were serious adverse events (46.1% vs. 39.9%). The rates of adverse events resulting in death were similar in the two groups (4.0% in the obinutuzumab group and 3.4% in the rituximab group). The most common adverse events were infusion-related events that were considered by the investigators to be largely due to obinutuzumab in 353 of 595 patients (59.3%; 95% CI, 55.3 to 63.2) and to rituximab in 292 of 597 patients (48.9%; 95% CI, 44.9 to 52.9; P<0.001). Nausea and neutropenia were common. A total of 35 patients (5.8%) in the obinutuzumab group and 46 (7.7%) in the rituximab group died. CONCLUSIONS Obinutuzumab-based immunochemotherapy and maintenance therapy resulted in longer progression-free survival than rituximab-based therapy. High-grade adverse events were more common with obinutuzumab-based chemotherapy. (Funded by F. Hoffmann-La Roche; GALLIUM ClinicalTrials.gov number, NCT01332968 .).
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Affiliation(s)
- Robert Marcus
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Andrew Davies
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Kiyoshi Ando
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Wolfram Klapper
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Stephen Opat
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Carolyn Owen
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Elizabeth Phillips
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Randeep Sangha
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Rudolf Schlag
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - John F Seymour
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - William Townsend
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Marek Trněný
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Michael Wenger
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Günter Fingerle-Rowson
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Kaspar Rufibach
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Tom Moore
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Michael Herold
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
| | - Wolfgang Hiddemann
- From King's College Hospital (R.M.) and the Cancer Research UK and University College London Cancer Trials Centre (E.P., W.T.), London, and the Cancer Research UK Centre, University of Southampton, Southampton (A.D.) - all in the United Kingdom; the Tokai University School of Medicine, Isehara, Japan (K.A.); the University of Kiel, Kiel (W.K.), Gemeinschaftspraxis, Würzburg (R. Schlag), HELIOS Klinikum Erfurt, Erfurt (M.H.), and the Ludwig-Maximilians-University Hospital Grosshadern, Munich (W.H.) - all in Germany; Monash Health and Monash University (S.O.) and the Peter MacCallum Cancer Centre and University of Melbourne (J.F.S.), Melbourne, VIC, Australia; Foothills Medical Centre and Tom Baker Cancer Centre, Calgary, AB (C.O.), and the Cross Cancer Institute, Edmonton, AB (R. Sangha) - both in Canada; Charles University, Prague, Czech Republic (M.T.); and F. Hoffmann-La Roche, Basel, Switzerland (M.W., G.F.-R., K.R., T.M.)
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Saag KG, Agnusdei D, Hans D, Kohlmeier LA, Krohn KD, Leib ES, MacLaughlin EJ, Alam J, Simonelli C, Taylor KA, Marcus R. Trabecular Bone Score in Patients With Chronic Glucocorticoid Therapy-Induced Osteoporosis Treated With Alendronate or Teriparatide. Arthritis Rheumatol 2017; 68:2122-8. [PMID: 27111239 DOI: 10.1002/art.39726] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 04/14/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To determine the effect of alendronate (ALN) and teriparatide on trabecular bone score (TBS) in patients with glucocorticoid-induced osteoporosis. METHODS Patients with chronic glucocorticoid therapy-induced osteoporosis (median 7.5 mg/day prednisone equivalent for ≥90 days) were randomized to receive oral ALN 10 mg/day (n = 214) or subcutaneous teriparatide 20 μg/day (n = 214) for 36 months; 118 patients in the ALN group and 123 patients in the teriparatide group completed treatment. Dual x-ray absorptiometry (DXA) results for 53 patients receiving ALN and 56 patients receiving teriparatide who had DXA scans with adequate resolution to perform TBS analysis and completed 36 months of therapy were blindly analyzed for TBS at baseline and 3, 6, 12, 18, 24, and 36 months. RESULTS In teriparatide-treated patients, TBS was significantly increased at 18 months compared to baseline, and by 36 months had increased 3.7% (P < 0.05). In ALN-treated patients, there was not a significant change in TBS compared to baseline at any time point. Changes in lumbar spine bone mineral density (BMD) measured by DXA in the subgroup with TBS data were similar to BMD results in the overall study population. At 36 months, increases in lumbar spine BMD were 5.5% and 10.3% in patients treated with ALN and teriparatide, respectively. CONCLUSION In patients with glucocorticoid-induced osteoporosis, both ALN and teriparatide increased lumbar spine BMD. However, trabecular bone score significantly increased with teriparatide but did not significantly change with ALN. The pathogenesis of glucocorticoid-induced osteoporosis is predominantly reduced bone formation. TBS may represent a sensitive measure to discriminate treatment effects of an anabolic versus an antiresorptive drug in glucocorticoid-induced osteoporosis.
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Affiliation(s)
| | | | - Didier Hans
- Lausanne University Hospital, Lausanne, Switzerland
| | | | | | - Edward S Leib
- University of Vermont College of Medicine, Burlington
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Trotman J, Barrington S, Belada D, Meignan M, MacEwan R, Owen C, Ptáčník V, Rosta A, Fingerle-Rowson G, Mattiello F, Nielsen T, Sahin D, Hiddemann W, Marcus R, Davies A. PROGNOSTIC VALUE OF PET-CT AFTER FIRST-LINE IMMUNOCHEMOTHERAPY FOR FOLLICULAR LYMPHOMA IN THE PHASE III GALLIUM STUDY. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- J. Trotman
- Haematology Department; Concord Repatriation General Hospital; Sydney Australia
| | - S. Barrington
- KCL and Guys' & St Thomas PET Imaging Centre, Division of Imaging and Biomedical Engineering; Kings College London; London UK
| | - D. Belada
- 4th Department of Internal Medicine - Hematology, University Hospital Hradec Kralove, and Charles University in Prague; Faculty of Medicine in Hradec Kralove; Hradec Kralove Czech Republic
| | - M. Meignan
- Service de Médecine Nucléaire; Hôpital Henri Mondor and Université Paris Est Créteil; Créteil France
| | - R. MacEwan
- Cross Cancer Institute; University of Alberta; Edmonton Canada
| | - C. Owen
- Division of Hematology and Hematological Malignancies; Foothills Medical Centre and Tom Baker Cancer Centre; Calgary Canada
| | - V. Ptáčník
- Department of Nuclear Medicine, First Faculty of Medicine; Charles University; Prague Czech Republic
| | - A. Rosta
- Department of Medicine; National Institute of Oncology; Budapest Hungary
| | - G. Fingerle-Rowson
- Pharma Development Clinical Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - F. Mattiello
- Pharma Development Biometrics Biostatistics; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - T. Nielsen
- Pharma Development Clinical Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - D. Sahin
- Pharma Development Clinical Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - W. Hiddemann
- Medical Department III; Ludwig-Maximilians-University Hospital Munich; Munich Germany
| | - R. Marcus
- Department of Haematology; Kings College Hospital; London UK
| | - A. Davies
- Cancer Research UK Centre; University of Southampton; Southampton UK
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Herold M, Hoster E, Janssens A, McCarthy H, Tedeschi A, Pocock C, Rosta A, Schmidt P, Trněný M, Burciu A, Fingerle-Rowson G, Rufibach K, Zeuner H, Hiddemann W, Marcus R. IMMUNOCHEMOTHERAPY WITH OBINUTUZUMAB OR RITUXIMAB IN a SUBSET OF PATIENTS IN THE RANDOMISED GALLIUM TRIAL WITH PREVIOUSLY UNTREATED MARGINAL ZONE LYMPHOMA (MZL). Hematol Oncol 2017. [DOI: 10.1002/hon.2437_136] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M. Herold
- Oncology Center, HELIOS-Klinikum Erfurt; Erfurt Germany
| | - E. Hoster
- Department of Medicine III; Ludwig-Maximilians-University Hospital Munich; Munich Germany
| | - A. Janssens
- Department of Haematology; UZ Leuven; Leuven Belgium
| | - H. McCarthy
- Department of Haematology; Royal Bournemouth General Hospital; Bournemouth UK
| | - A. Tedeschi
- Division of Hematology; A. O. Ospedale Niguarda Ca’ Granda; Milan Italy
| | - C. Pocock
- Department of Haematology; Kent & Canterbury Hospital; Canterbury UK
| | - A. Rosta
- Department of Haematology, Országos Onkológiai Intézet; Budapest Hungary
| | - P. Schmidt
- Dr. med. Peter Schmidt; Praxis Neunkirchen/Saar Germany
| | - M. Trněný
- 1st Department of Medicine; Charles University General Hospital; Prague Czech Republic
| | - A. Burciu
- Pharma Development Safety and Risk Management; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - G. Fingerle-Rowson
- Pharma Development Clinical Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - K. Rufibach
- Pharma Development Biometrics Biostatistics; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - H. Zeuner
- Pharma Development Clinical Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - W. Hiddemann
- Department of Medicine III; Ludwig-Maximilians-University Hospital Munich; Munich Germany
| | - R. Marcus
- Department of Haematology; Kings College Hospital; London UK
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Fornecker L, Ou F, Dixon J, Casulo C, Hoster E, Hiddemann W, Sebban C, Morschhauser F, Marcus R, Hochster H, Rummel M, Hagenbeeck A, Kimby E, Herold M, Peterson B, Gyan E, Ladetto M, Zucca E, Nielsen T, Foon K, Vitolo U, Flowers C, Shi Q, Salles G. CLINICAL CHARACTERISTICS AND TREATMENT OUTCOMES FOR YOUNG PATIENTS WITH FIRST-LINE FOLLICULAR LYMPHOMA: A POOLED ANALYSIS OF 4249 PATIENTS FROM THE FLASH DATABASE. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- L. Fornecker
- Department of Hematology; University Hospital of Strasbourg; Strasbourg France
| | - F. Ou
- Division of Biomedical Statistics and Informatics, Mayo Clinic; Rochester USA
| | - J.G. Dixon
- Division of Biomedical Statistics and Informatics, Mayo Clinic; Rochester USA
| | - C. Casulo
- School of Medicine and Dentistry; University of Rochester Medical Center; Rochester USA
| | - E. Hoster
- Department of Internal Medicine III; Ludwig-Maximilians University Hospital, Campus Großhadern; Munich Germany
| | - W. Hiddemann
- Department of Internal Medicine III; Ludwig-Maximilians University Hospital, Campus Großhadern; Munich Germany
| | - C. Sebban
- Onco-Hematology, Centre Leon Berard; University Claude Bernard Lyon 1; Lyon France
| | - F. Morschhauser
- Department of Clinical Hematology; Centre Hospitalier Universitaire, Université de Lille; Lille France
| | - R. Marcus
- Department of Haematology; Addenbrookes Hospital; Cambridge UK
| | - H. Hochster
- Yale Cancer Center; Department of Medicine; New Haven USA
| | - M. Rummel
- Medizinische Klinik IV; University Hospital; Gießen Germany
| | - A. Hagenbeeck
- Department of Hematology; Academic Medical Center; Amsterdam The Netherlands
| | - E. Kimby
- Hematology Centre at Karolinska University Hospital; Karolinska Institutet; Stockholm Sweden
| | - M. Herold
- Department of Hematology and Oncology, HELIOS Klinikum; Erfurt Germany
| | - B.A. Peterson
- Division of Hematology, Oncology and Transplantation; University of Minnesota; Minneapolis USA
| | - E. Gyan
- Department of Hematology and Cell Therapy; University Hospital; Tours France
| | - M. Ladetto
- Department of Hematology, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo; Alessandria Italy
| | - E. Zucca
- Department of Hematology, Oncology Institute of Southern Switzerland (IOSI); Bellinzona Switzerland
| | - T. Nielsen
- Department of Medical Affairs; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - K. Foon
- Department of Medical Affairs, Celgene Corporation; Summit USA
| | - U. Vitolo
- Department of Hematology; Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino; Torino Italy
| | - C.R. Flowers
- Department of Bone Marrow and Stem Cell Transplantation; Winship Cancer Institute of Emory University; Atlanta USA
| | - Q. Shi
- Division of Biomedical Statistics and Informatics, Mayo Clinic; Rochester USA
| | - G. Salles
- Department of Hematology; Centre Hospitalier Lyon-Sud; Pierre-Benite France
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Hiddemann W, Barbui A, Canales Albendea M, Cannell P, Collins G, Dürig J, Forstpointner R, Herold M, Hertzberg M, Klanova M, Radford J, Tobinai K, Burciu A, Fingerle-Rowson G, Nielsen T, Wolbers M, Marcus R. IMMUNOCHEMOTHERAPY WITH OBINUTUZUMAB OR RITUXIMAB IN PREVIOUSLY UNTREATED FOLLICULAR LYMPHOMA IN THE RANDOMISED PHASE III GALLIUM STUDY: ANALYSIS BY CHEMOTHERAPY REGIMEN. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_106] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- W. Hiddemann
- Department of Medicine III; Ludwig-Maximilians-University Hospital Munich; Munich Germany
| | - A.M. Barbui
- Department of Hematology; Azienda Ospedaliera Papa Giovanni XXIII; Bergamo Italy
| | | | - P.K. Cannell
- Haematology Department; Fiona Stanley Hospital; Murdoch Australia
| | - G.P. Collins
- Department of Clinical Haematology; Oxford Cancer and Haematology Centre, Churchill Hospital; Oxford UK
| | - J. Dürig
- Medical Faculty (Haematology), Universitaetsklinikum Essen; Essen Germany
| | - R. Forstpointner
- Department of Medicine III; Ludwig-Maximilians-University Hospital Munich; Munich Germany
| | - M. Herold
- Oncology Center; HELIOS-Klinikum Erfurt; Erfurt Germany
| | - M. Hertzberg
- Department of Haematology; Prince of Wales Hospital; Sydney Australia
| | - M. Klanova
- 1st Department of Medicine; Charles University General Hospital, Prague, Czech Republic and Pharma Development Clinical Oncology, F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - J.A. Radford
- Manchester Academic Health Science Centre; The University of Manchester and The Christie NHS Foundation Trust; Manchester UK
| | - K. Tobinai
- Department of Hematology; National Cancer Center Hospital; Tokyo Japan
| | - A. Burciu
- Pharma Development Safety and Risk Management; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - G.R. Fingerle-Rowson
- Pharma Development Clinical Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - T. Nielsen
- Pharma Development Clinical Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - M. Wolbers
- Pharma Development Biometrics Biostatistics; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - R. Marcus
- Department of Haematology; Kings College Hospital; London UK
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Dhanapal V, Gunasekara M, Lianwea C, Marcus R, De Lord C, Bowcock S, Devereux S, Patten P, Yallop D, Wrench D, Fields P, Kassam S. Outcome for patients with relapsed/refractory aggressive lymphoma treated with gemcitabine and oxaliplatin with or without rituximab; a retrospective, multicentre study. Leuk Lymphoma 2017; 58:1-9. [DOI: 10.1080/10428194.2016.1276288] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Vijay Dhanapal
- Department of Haematology, Medway Maritime Hospital, London, UK
| | | | - Chia Lianwea
- Department of Haematology, Medway Maritime Hospital, London, UK
| | - Robert Marcus
- Department of Haematology, King’s College Hospital, London, UK
| | - Corinne De Lord
- Department of Haematology, King’s College Hospital, London, UK
| | - Stella Bowcock
- Department of Haematology, King’s College Hospital, London, UK
| | | | - Piers Patten
- Department of Haematology, King’s College Hospital, London, UK
| | - Deborah Yallop
- Department of Haematology, King’s College Hospital, London, UK
| | - David Wrench
- Department of Haematology, Guy’s & St Thomas’ Hospital, London, UK
| | - Paul Fields
- Department of Haematology, Guy’s & St Thomas’ Hospital, London, UK
| | - Shireen Kassam
- Department of Haematology, King’s College Hospital, London, UK
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Shi Q, Flowers CR, Hiddemann W, Marcus R, Herold M, Hagenbeek A, Kimby E, Hochster H, Vitolo U, Peterson BA, Gyan E, Ghielmini M, Nielsen T, De Bedout S, Fu T, Valente N, Fowler NH, Hoster E, Ladetto M, Morschhauser F, Zucca E, Salles G, Sargent DJ. Thirty-Month Complete Response as a Surrogate End Point in First-Line Follicular Lymphoma Therapy: An Individual Patient-Level Analysis of Multiple Randomized Trials. J Clin Oncol 2016; 35:552-560. [PMID: 28029309 DOI: 10.1200/jco.2016.70.8651] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Follicular lymphoma (FL) is an indolent cancer, with effective but rarely curative treatment options. As a standard study end point for first-line FL therapy, progression-free survival (PFS) requires extended follow-up (median PFS, > 7 years). To provide patients with earlier access to newer therapies, an earlier end point to expedite clinical trials is needed. Our objective was to formally assess the complete response rate at 30 months (CR30) after initiation of induction therapy as a potential surrogate end point for PFS in first-line FL therapy. Patients and Methods We analyzed individual patient data from 13 randomized multicenter trials of induction and maintenance regimens in first-line FL therapy published after 1990 and with sufficient data to evaluate whether CR30 could predict treatment effects on PFS. Correlation of the CR30 odds ratio with the PFS hazard ratio was evaluated by both linear regression (R2WLS) and bivariate copula (R2Copula) models. Prespecified criteria for surrogacy required either R2WLS or R2Copula ≥ 0.80, with a lower-bound 95% CI > 0.60. Results Data from eight induction and five maintenance randomized trials in 3,837 evaluable patients were analyzed. The prespecified surrogacy threshold was met, with an R2WLS of 0.88 (95% CI, 0.77 to 0.96) and an R2Copula of 0.86 (95% CI, 0.72 to 1.00). Multiple sensitivity and supplemental analyses supported the robustness of the findings. A minimum 11% absolute improvement in CR30 from a 50% control rate predicted a significant treatment effect on PFS (hazard ratio, 0.69). Conclusion This large, prospective, pooled analysis of randomized chemotherapy, immunotherapy, and chemoimmunotherapy trials demonstrates that CR30 is a surrogate end point for PFS in first-line FL treatment trials. Use of this end point may expedite therapeutic development with the intent of bringing novel therapies to this patient population years before PFS results are mature.
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Affiliation(s)
- Qian Shi
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Christopher R Flowers
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Wolfgang Hiddemann
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Robert Marcus
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Herold
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Anton Hagenbeek
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Eva Kimby
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Howard Hochster
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Umberto Vitolo
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Bruce A Peterson
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Emmanuel Gyan
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michele Ghielmini
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tina Nielsen
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sabine De Bedout
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tommy Fu
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nancy Valente
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nathan H Fowler
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Eva Hoster
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Marco Ladetto
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Franck Morschhauser
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Emanuele Zucca
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gilles Salles
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Daniel J Sargent
- Qian Shi and Daniel J. Sargent, Mayo Clinic, Rochester; Bruce A. Peterson, University of Minnesota, Minneapolis, MN; Christopher R. Flowers, Winship Cancer Institute of Emory University, Atlanta, GA; Wolfgang Hiddemann and Eva Hoster, Ludwig-Maximilians University Hospital, Munich; Michael Herold, HELIOS Kliniken, Erfurt, Germany; Robert Marcus, Addenbrooke's Hospital, Cambridge, United Kingdom; Anton Hagenbeek, Academic Medical Center, Amsterdam, the Netherlands; Eva Kimby, Karolinska Institutet, Stockholm, Sweden; Howard Hochster, Yale Cancer Center, New Haven, CT; Umberto Vitolo, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin; Marco Ladetto, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Emmanuel Gyan, University Hospital, Tours; Franck Morschhauser, Service Université de Lille 2, Lille; Gilles Salles, Université Claude Bernard, Pierre Bénite, France; Michele Ghielmini and Emanuele Zucca, Oncology Institute of Southern Switzerland, Bellinzona; Michele Ghielmini and Emanuele Zucca, Swiss Group for Clinical Cancer Research, Bern; Tina Nielsen, F. Hoffmann-La Roche, Basel; Sabine De Bedout, Celgene, Boudry, Switzerland; Tommy Fu, Celgene, Summit, NJ; Nancy Valente, Genentech, South San Francisco, CA; and Nathan H. Fowler, University of Texas MD Anderson Cancer Center, Houston, TX
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Affiliation(s)
- Ruben Geevarghese
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, King’s Health Partners, London, UK
- Department of Neurosurgery, Charing Cross Hospital, London, UK
| | - Robert Marcus
- Deparment of Haematology, King’s College Hospital NHS Foundation Trust, King’s Health Partners, London, UK
| | - Miren Aizpurua
- Department of Neuropathology, King's College Hospital NHS Foundation Trust, King's Health Partners, London, UK
| | - Safa Al-Sarraj
- Department of Neuropathology, King's College Hospital NHS Foundation Trust, King's Health Partners, London, UK
| | - Keyoumars Ashkan
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, King’s Health Partners, London, UK
- Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Mehra V, Pomplum S, Ireland R, Yallop D, Devereux S, Marcus R, Shah C, Patten P, Kassam S. ALK-positive large B-cell lymphoma with strong CD30 expression; a diagnostic pitfall and resistance to brentuximab and crizotinib. Histopathology 2016; 69:880-882. [DOI: 10.1111/his.13002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Varun Mehra
- Department of Haematology; King's College Hospital; London UK
| | - Sabine Pomplum
- Department of Histopathology; University College Hospital; London UK
| | - Robin Ireland
- Department of Haematology; King's College Hospital; London UK
| | - Deborah Yallop
- Department of Haematology; King's College Hospital; London UK
| | | | - Robert Marcus
- Department of Haematology; King's College Hospital; London UK
| | - Chirag Shah
- Department of Histopathology; King's College Hospital; London UK
| | - Piers Patten
- Department of Haematology; King's College Hospital; London UK
| | - Shireen Kassam
- Department of Haematology; King's College Hospital; London UK
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Miles TP, Schwartz AV, Villa ML, Prill M, Kelsey JA, Galinus JA, Delay RR, Nevitt MC, Bloch DA, Marcus R, Kelsey JL. SPECIAL POPULATIONS IN GERIATRICS. J Am Geriatr Soc 2015. [DOI: 10.1111/j.1532-5415.1999.tb07443.x] [Citation(s) in RCA: 23] [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: 10/23/2022]
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Marcus R. Parathyroid venous sampling: indications, techniques, and outcomes. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.473] [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: 11/16/2022] Open
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Casey DE, Laubmeier KK, Eudicone JM, Marcus R, Berman RM, Rahman Z, Sheehan J. Response and remission rates with adjunctive aripiprazole in patients with major depressive disorder who exhibit minimal or no improvement on antidepressant monotherapy. Int J Clin Pract 2014; 68:1301-8. [PMID: 25196314 DOI: 10.1111/ijcp.12480] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The efficacy of adjunctive aripiprazole in patients with major depressive disorder (MDD) with no improvement after 8 weeks of prior antidepressant monotherapy has not been evaluated. METHODS A post hoc analysis of three similarly designed, randomised, double-blind, placebo-controlled, phase III studies was conducted investigating the efficacy and safety of aripiprazole adjunctive to standard antidepressant treatment (ADT) in MDD patients with a prior inadequate response to one to three ADTs. Minimal improvement to antidepressant monotherapy was defined as a Clinical Global Impressions - Improvement (CGI-I) score of 3 and non-improvement as a CGI-I of 4 at weeks 6 and 8 of antidepressant monotherapy. RESULTS The end-point response rate for ADT minimal improvers receiving adjunctive aripiprazole was 38.8% vs. 26.6% for adjunctive placebo (p < 0.05; number needed to treat [NNT] = 9 [95% confidence interval: 4.8-27.7]), and for ADT non-improvers receiving adjunctive aripiprazole was 24.0% vs. 10.3% for adjunctive placebo (p < 0.05; NNT = 8 [95% confidence interval: 4.4-21.5]). ADT minimal improvers and non-improvers demonstrated significant improvements in response vs. ADT alone as early as after 1 and 2 weeks of adjunctive treatment, respectively. The end-point remission rate for ADT minimal improvers receiving adjunctive aripiprazole was 34.2% vs. 21.0% for adjunctive placebo (p < 0.05; NNT = 8), and for ADT non-improvers receiving adjunctive aripiprazole was 16.0% vs. 5.9% for adjunctive placebo (p < 0.05; NNT = 10). The most common adverse events for ADT minimal improvers and non-improvers receiving adjunctive aripiprazole were akathisia, restlessness and insomnia. CONCLUSION Patients with minimal or no improvement after 8 weeks of antidepressant monotherapy significantly benefited from adjunctive aripiprazole treatment, supporting the efficacy of this treatment for MDD patients with all levels of response to ADT.
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Affiliation(s)
- D E Casey
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
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Bower M, Palfreeman A, Alfa-Wali M, Bunker C, Burns F, Churchill D, Collins S, Cwynarski K, Edwards S, Fields P, Fife K, Gallop-Evans E, Kassam S, Kulasegaram R, Lacey C, Marcus R, Montoto S, Nelson M, Newsom-Davis T, Orkin C, Shaw K, Tenant-Flowers M, Webb A, Westwell S, Williams M. British HIV Association guidelines for HIV-associated malignancies 2014. HIV Med 2014; 15 Suppl 2:1-92. [PMID: 24528810 DOI: 10.1111/hiv.12136] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Dreyling M, Ghielmini M, Marcus R, Salles G, Vitolo U, Ladetto M. Newly diagnosed and relapsed follicular lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2014; 25 Suppl 3:iii76-82. [PMID: 25122695 DOI: 10.1093/annonc/mdu200] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- M Dreyling
- Department of Medicine III, University of Munich, Munich, Germany
| | - M Ghielmini
- Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
| | - R Marcus
- Haematology, Kings College Hospital, London, UK
| | - G Salles
- Service D'Hématologie, Centre Hospitalier Lyon-Sud, Pierre-Benite, France
| | - U Vitolo
- Haematology II, Centro Universitario Ricerca Oncologica Ospedale Molinette, Turin
| | - M Ladetto
- Divisione di Ematologia, Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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Noriega V, Kaur H, Devereux S, Byrne J, Marcus R, Haynes A, Yallop D, McMillan A, Ingram W, Khan A, Kenyon M, Potter V, Russell N, Mufti GJ, Pagliuca A. Long term follow-up of BEAM-autologous and BEAM-alemtuzumab allogeneic stem cell transplantation in relapsed advanced stage follicular lymphoma. Leuk Res 2014; 38:737-43. [PMID: 24787231 DOI: 10.1016/j.leukres.2014.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 10/30/2013] [Revised: 02/17/2014] [Accepted: 03/09/2014] [Indexed: 10/25/2022]
Abstract
This is an analysis in 171 patients comparing BEAM-Auto and BEAM-Allo (alemtuzumab)-hematopoietic stem cell transplantation in relapsed follicular lymphoma. BEAM-Allo group had a lower 10 years cumulative incidence of relapse(31.4% vs 55.1%, p=0.042), a trend to a plateau in survival but no statistical differences in OS or DFS, and a TRM of 24%. When transplanted in CR BEAM-Allo patients had better OS and DFS. Incidence of acute and chronic GVHD was 16.6% and 22%. 29% of BEAM-Allo patients received DLI (all but two remain in CR and alive). Our data supports Allo-HSCT as a potential curative treatment for selected patients with FL.
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Affiliation(s)
- Victor Noriega
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK.
| | - Harpreet Kaur
- Centre for Clinical Haematology, Nottingham University Hospital, Nottingham, UK
| | - Stephen Devereux
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK
| | - Jennifer Byrne
- Centre for Clinical Haematology, Nottingham University Hospital, Nottingham, UK
| | - Robert Marcus
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK
| | - Andrew Haynes
- Centre for Clinical Haematology, Nottingham University Hospital, Nottingham, UK
| | - Deborah Yallop
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK
| | - Andrew McMillan
- Centre for Clinical Haematology, Nottingham University Hospital, Nottingham, UK
| | - Wendy Ingram
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK
| | - Anjum Khan
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK
| | - Michelle Kenyon
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK
| | - Victoria Potter
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK
| | - Nigel Russell
- Centre for Clinical Haematology, Nottingham University Hospital, Nottingham, UK
| | - Ghulam J Mufti
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK
| | - Antonio Pagliuca
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK
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Jô LF, Marcus R, Marcelin O. Nitric acid recycling and copper nitrate recovery from effluent. Environ Sci Pollut Res Int 2014; 21:6975-6981. [PMID: 24627202 DOI: 10.1007/s11356-014-2724-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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 02/28/2014] [Indexed: 06/03/2023]
Abstract
The recycling of nitric acid and copper nitrate contained in an industrial effluent was studied. The experiments conducted on such a medium showed that the presence of copper nitrate significantly improves nitric acid-water separation during distillation in an azeotropic medium. At the temperature of the azeotrope, however, this metal salt starts to precipitate, making the medium pasty, thus inhibiting the nitric acid extraction process. The optimisation of parameters such as column efficiency and adding water to the boiler at the azeotrope temperature are recommended in this protocol in order to collect the various components while avoiding the formation of by-products: NOx compounds. Thus, the absence of column, along with the addition of a small volume of water at a temperature of 118 °C, significantly increases the yield, allowing 94 % nitric acid to be recovered at the end of the process, along with the residual copper nitrate. The resulting distillate, however, is sufficiently dilute to not be used as is. Rectification is required to obtain concentrated nitric acid at 15 mol·l(-1), along with a weakly acidic distillate from the distillation front. This latter is quenched using potassium hydroxide and is used as a fertiliser solution for horticulture or sheltered market gardening. This process thus allows complete recycling of all the medium's components, including that of the distillate resulting from the nitric acid rectification operation.
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Affiliation(s)
- L F Jô
- Université des Antilles et de la Guyane, Schoelcher, Martinique, France,
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Sivananthan G, Menashe L, MacArthur D, Marcus R, Halin N. Cephalic arch stenosis in hemodialysis patients: what is the cephalic arch and does the precise location of stenosis effect patency? J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.048] [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: 11/17/2022] Open
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Potter VT, Krishnamurthy P, Barber LD, Lim Z, Kenyon M, Ireland RM, de Lavallade H, Dhouri A, Marsh JCW, Marcus R, Devereux S, Ho A, Pagliuca A, Mufti GJ. Long-term outcomes of alemtuzumab-based reduced-intensity conditioned hematopoietic stem cell transplantation for myelodysplastic syndrome and acute myelogenous leukemia secondary to myelodysplastic syndrome. Biol Blood Marrow Transplant 2013; 20:111-7. [PMID: 24216184 DOI: 10.1016/j.bbmt.2013.10.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [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: 06/23/2013] [Accepted: 10/22/2013] [Indexed: 12/01/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) with reduced-intensity conditioning (RIC) offers a potential cure for patients with myelodysplastic syndrome (MDS) who are ineligible for standard-intensity regimens. Previously published data from our institution suggest excellent outcomes at 1 yr using a uniform fludarabine, busulfan, and alemtuzumab-based regimen. Here we report long-term follow-up of 192 patients with MDS and acute myelogenous leukemia (AML) secondary to MDS (MDS-AML) transplanted with this protocol, using sibling (n = 45) or matched unrelated (n = 147) donors. The median age of the cohort was 57 yr (range, 21 to 72 yr), and median follow-up was 4.5 yr (range, 0.1 to 10.6 yr). The 5-yr overall survival (OS), event-free survival, and nonrelapse mortality were 44%, 33%, and 26% respectively. The incidence of de novo chronic graft-versus-host disease (GVHD) was low at 19%, illustrating the efficacy of alemtuzumab for GVHD prophylaxis. Conversely, the 5-yr relapse rate was 51%. For younger patients (age <50 yr), the 5-yr OS and relapse rates were 58% and 39%, respectively. On multivariate analysis, advanced age predicted significantly worse outcomes, with patients age >60 yr having a 5-yr OS of 15% and relapse rate of 66%. Patients receiving preemptive donor lymphocyte infusions had an impressive 5-yr OS of 67%, suggesting that this protocol may lend itself to the incorporation of immunotherapeutic strategies. Overall, these data demonstrate good 5-yr OS for patients with MDS and MDS-AML undergoing alemtuzumab-based RIC-HSCT. The low rate of chronic GVHD is encouraging, and comparative studies with other RIC protocols are warranted.
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Affiliation(s)
- Victoria T Potter
- Department of Haematological Medicine, King's College Hospital, London, UK
| | | | - Linda D Barber
- Department of Haematological Medicine, King's College Hospital, London, UK
| | - Ziyi Lim
- Department of Haematological Medicine, King's College Hospital, London, UK
| | - Michelle Kenyon
- Department of Haematological Medicine, King's College Hospital, London, UK
| | - Robin M Ireland
- Department of Haematological Medicine, King's College Hospital, London, UK
| | | | - Abdel Dhouri
- Department of Statistics, King's College, London, UK
| | - Judith C W Marsh
- Department of Haematological Medicine, King's College Hospital, London, UK
| | - Robert Marcus
- Department of Haematological Medicine, King's College Hospital, London, UK
| | - Stephen Devereux
- Department of Haematological Medicine, King's College Hospital, London, UK
| | - Aloysius Ho
- Department of Haematological Medicine, King's College Hospital, London, UK
| | - Antonio Pagliuca
- Department of Haematological Medicine, King's College Hospital, London, UK
| | - Ghulam J Mufti
- Department of Haematological Medicine, King's College Hospital, London, UK.
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