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Boland L, Bennett KE, Cuffe S, Grant C, Kennedy MJ, Connolly D. Feasibility Randomised Control Trial of OptiMal: A Self-Management Intervention for Cancer Survivors. Curr Oncol 2023; 30:10195-10210. [PMID: 38132376 PMCID: PMC10742444 DOI: 10.3390/curroncol30120742] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/22/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Cancer survivors can experience symptoms such as fatigue, pain and distress that persist for many months following treatment. These enduring symptoms often impact on participation in self-care activities, returning to school and/or work, and leisure and social activities. Self-management support is increasingly recognised as a core aspect of cancer survivorship care to reduce the impact of persistent symptoms. The purpose of this study was to examine the feasibility and potential effectiveness of a group-based self-management intervention, OptiMal, to improve the physical and psychological health of cancer survivors. OptiMal is a six-week intervention comprising weekly sessions on fatigue, stress and physical activity, diet and effective communication strategies. METHODS A feasibility randomised control trial was undertaken. Individuals up to two years after cancer treatment were randomised to OptiMal or usual care. Feasibility was examined through recruitment and retention metrics. Potential effectiveness was tested through patient-reported outcomes collected at baseline and three months post-intervention. Descriptive and inferential statistics were used to analyse study data. RESULTS Recruitment for this study was 32.5% (80/246 eligible individuals) with 77.5% retention at three-month follow-up (82.5% for intervention group and 72.5% for control group). Of those who attended the intervention, 19 (73%) attended all OptiMal sessions, indicating high adherence to the intervention. The majority of participants had breast cancer and were between 12 and 24 months post-treatment. The intervention group (n = 29) had statistically significant greater improvements in anxiety (p = 0.04) and health-related quality of life (health index score: p = 0.023, visual analogue score: p = 0.035) at three months post-intervention than the control group. CONCLUSIONS Recruitment and retention in this study was similar to other cancer trials and the high adherence rate indicates that OptiMal is an acceptable self-management intervention for cancer survivors and warrants further investigation. OptiMal is intended to address symptoms reported across different cancer types. However, a limitation of this study was that the majority of participants had breast cancer, and therefore, generalisability of findings cannot be assumed for other cancer types. Future studies of OptiMal therefore need to use different strategies to recruit survivors of other cancer types.
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Affiliation(s)
- Lauren Boland
- Discipline of Occupational Therapy, Trinity College Dublin, D08 W9RT Dublin, Ireland;
| | - Kathleen E. Bennett
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland;
| | - Sinead Cuffe
- Medical Oncologist, St James’s Hospital, James’ St, D08 W9RT Dublin, Ireland; (S.C.); (C.G.); (M.J.K.)
| | - Cliona Grant
- Medical Oncologist, St James’s Hospital, James’ St, D08 W9RT Dublin, Ireland; (S.C.); (C.G.); (M.J.K.)
| | - M. John Kennedy
- Medical Oncologist, St James’s Hospital, James’ St, D08 W9RT Dublin, Ireland; (S.C.); (C.G.); (M.J.K.)
- Trinity St James’s Cancer Institute, D08 W9RT Dublin, Ireland
| | - Deirdre Connolly
- Discipline of Occupational Therapy, Trinity College Dublin, D08 W9RT Dublin, Ireland;
- Trinity St James’s Cancer Institute, D08 W9RT Dublin, Ireland
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Reynolds JV, Preston SR, O'Neill B, Lowery MA, Baeksgaard L, Crosby T, Cunningham M, Cuffe S, Griffiths GO, Parker I, Risumlund SL, Roy R, Falk S, Hanna GB, Bartlett FR, Alvarez-Iglesias A, Achiam MP, Nilsson M, Piessen G, Ravi N, O'Toole D, Johnston C, McDermott RS, Turkington RC, Wahed S, Sothi S, Ford H, Wadley MS, Power D. Trimodality therapy versus perioperative chemotherapy in the management of locally advanced adenocarcinoma of the oesophagus and oesophagogastric junction (Neo-AEGIS): an open-label, randomised, phase 3 trial. Lancet Gastroenterol Hepatol 2023; 8:1015-1027. [PMID: 37734399 PMCID: PMC10567579 DOI: 10.1016/s2468-1253(23)00243-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND The optimum curative approach to adenocarcinoma of the oesophagus and oesophagogastric junction is unknown. We aimed to compare trimodality therapy (preoperative radiotherapy with carboplatin plus paclitaxel [CROSS regimen]) with optimum contemporaneous perioperative chemotherapy regimens (epirubicin plus cisplatin or oxaliplatin plus fluorouracil or capecitabine [a modified MAGIC regimen] before 2018 and fluorouracil, leucovorin, oxaliplatin, and docetaxel [FLOT] subsequently). METHODS Neo-AEGIS (CTRIAL-IE 10-14) was an open-label, randomised, phase 3 trial done at 24 centres in Europe. Patients aged 18 years or older with clinical tumour stage T2-3, nodal stage N0-3, and M0 adenocarcinoma of the oesophagus and oesophagogastric junction were randomly assigned to perioperative chemotherapy (three preoperative and three postoperative 3-week cycles of intravenous 50 mg/m2 epirubicin on day 1 plus intravenous 60 mg/m2 cisplatin or intravenous 130 mg/m2 oxaliplatin on day 1 plus continuous infusion of 200 mg/m2 fluorouracil daily or oral 625 mg/m2 capecitabine twice daily up to 2018, with four preoperative and four postoperative 2-week cycles of 2600 mg/m2 fluorouracil, 85 mg/m2 oxaliplatin, 200 mg/m2 leucovorin, and 50 mg/m2 docetaxel intravenously on day 1 as an option from 2018) or trimodality therapy (41·4 Gy in 23 fractions on days 1-5, 8-12, 15-19, 22-26, and 29-31 with intravenous area under the curve 2 mg/mL per min carboplatin plus intravenous 50 mg/m2 paclitaxel on days 1, 8, 15, 22, and 29). The primary endpoint was overall survival, assessed in all randomly assigned patients who received at least one dose of study drug, regardless of which study drug they received, by intention to treat. Secondary endpoints were disease-free survival, site of treatment failure, operative complications, toxicity, pathological response (complete [ypT0N0] and major [tumour regression grade 1 and 2]), margin-free resection (R0), and health-related quality of life. Toxicity and safety data were analysed in the safety population, defined as patients who took at least one dose of study drug, according to treatment actually received. The initial power calculation was based on superiority of trimodality therapy (n=366 patients); it was adjusted after FLOT became an option to a non-inferiority design with a margin of 5% for perioperative chemotherapy (n=540). This study is registered with ClinicalTrials.gov, NCT01726452. FINDINGS Between Jan 24, 2013, and Dec 23, 2020, 377 patients were randomly assigned, of whom 362 were included in the intention-to treat population (327 [90%] male and 360 [99%] White): 184 in the perioperative chemotherapy group and 178 in the trimodality therapy group. The trial closed prematurely in December, 2020, after the second interim futility analysis (143 deaths), on the basis of similar survival metrics and the impact of the COVID-19 pandemic. At a median follow-up of 38·8 months (IQR 16·3-55·1), median overall survival was 48·0 months (95% CI 33·6-64·8) in the perioperative chemotherapy group and 49·2 months (34·8-74·4) in the trimodality therapy group (3-year overall survival 55% [95% CI 47-62] vs 57% [49-64]; hazard ratio 1·03 [95% CI 0·77-1·38]; log-rank p=0·82). Median disease-free survival was 32·4 months (95% CI 22·8-64·8) in the perioperative chemotherapy group and 24·0 months (18·0-40·8) in the trimodality therapy group [hazard ratio 0·89 [95% CI 0·68-1·17]; log-rank p=0·41). The pattern of recurrence, locoregional or systemic, was not significantly different (odds ratio 1·35 [95% CI 0·63-2·91], p=0·44). Pathological complete response (odds ratio 0·33 [95% CI 0·14-0·81], p=0·012), major pathological response (0·21 [0·12-0·38], p<0·0001), and R0 rates (0·21 [0·08-0·53], p=0·0003) favoured trimodality therapy. The most common grade 3-4 adverse event was neutropenia (49 [27%] of 183 patients in the perioperative chemotherapy group vs 11 [6%] of 178 patients in the trimodality therapy group), followed by diarrhoea (20 [11%] vs none), and pulmonary embolism (ten [5%] vs nine [5%]). One (1%) patient in the perioperative chemotherapy group and three (2%) patients in the trimodality therapy group died from serious adverse events, two (one in each group) of which were possibly related to treatment. No differences were seen in operative mortality (five [3%] deaths in the perioperative chemotherapy group vs four [2%] in the trimodality therapy group), major morbidity, or in global health status at 1 and 3 years. INTERPRETATION Although underpowered and incomplete, Neo-AEGIS provides the largest comprehensive randomised dataset for patients with adenocarcinoma of the oesophagus and oesophagogastric junction treated with perioperative chemotherapy (predominantly the modified MAGIC regimen), and CROSS trimodality therapy, and reports similar 3-year survival and no major differences in operative and health-related quality of life outcomes. We suggest that these data support continued clinical equipoise. FUNDING Health Research Board, Cancer Research UK, Irish Cancer Society, Oesophageal Cancer Fund, and French National Cancer Institute.
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Affiliation(s)
- John V Reynolds
- Cancer Trials Ireland, Dublin, Ireland; St James's Hospital, Dublin, Ireland.
| | - Shaun R Preston
- Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Brian O'Neill
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | | | | | | | | | | | - Gareth O Griffiths
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | | | | | - Rajarshi Roy
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Stephen Falk
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | | | | | | | - Magnus Nilsson
- Division of Surgery, CLINTEC, Karolinska Institutet and Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | | | | | | | | | - Richard C Turkington
- Belfast Health and Social Care Trust, Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, UK
| | - Shajahan Wahed
- Northern Oesophago-Gastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Sharmila Sothi
- University Hospitals Coventry and Warwickshire, Walsgrave, Coventry, UK
| | - Hugo Ford
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Martin S Wadley
- Worcestershire Acute Hospitals NHS Trust, Worcestershire Oncology Centre, Worcestershire Royal Hospital, Worcester, UK
| | - Derek Power
- Cork University Hospital, Wilton, Cork, Ireland
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Murphy C, Gornés Pons G, Keogh A, Ryan L, McCarra L, Jose CM, Kesar S, Nicholson S, Fitzmaurice GJ, Ryan R, Young V, Cuffe S, Finn SP, Gray SG. An Analysis of JADE2 in Non-Small Cell Lung Cancer (NSCLC). Biomedicines 2023; 11:2576. [PMID: 37761019 PMCID: PMC10526426 DOI: 10.3390/biomedicines11092576] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 09/29/2023] Open
Abstract
The JADE family comprises three members encoded by individual genes and roles for these proteins have been identified in chromatin remodeling, cell cycle progression, cell regeneration and the DNA damage response. JADE family members, and in particular JADE2 have not been studied in any great detail in cancer. Using a series of standard biological and bioinformatics approaches we investigated JADE2 expression in surgically resected non-small cell lung cancer (NSCLC) for both mRNA and protein to examine for correlations between JADE2 expression and overall survival. Additional correlations were identified using bioinformatic analyses on multiple online datasets. Our analysis demonstrates that JADE2 expression is significantly altered in NSCLC. High expression of JADE2 is associated with a better 5-year overall survival. Links between JADE2 mRNA expression and a number of mutated genes were identified, and associations between JADE2 expression and tumor mutational burden and immune cell infiltration were explored. Potential new drugs that can target JADE2 were identified. The results of this biomarker-driven study suggest that JADE2 may have potential clinical utility in the diagnosis, prognosis and stratification of patients into various therapeutically targetable options.
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Affiliation(s)
- Ciara Murphy
- Department of Histopathology, Labmed Directorate, St. James’s Hospital, D08 NHY1 Dublin, Ireland (S.P.F.)
- Thoracic Oncology Research Group, Central Pathology Laboratory, Trinity St. James’s Cancer Institute (TSJCI), St. James’s Hospital, D08 RX0X Dublin, Ireland (A.K.)
| | - Glòria Gornés Pons
- Thoracic Oncology Research Group, Central Pathology Laboratory, Trinity St. James’s Cancer Institute (TSJCI), St. James’s Hospital, D08 RX0X Dublin, Ireland (A.K.)
- Faculty of Biology, University of Barcelona, 08025 Barcelona, Spain
| | - Anna Keogh
- Thoracic Oncology Research Group, Central Pathology Laboratory, Trinity St. James’s Cancer Institute (TSJCI), St. James’s Hospital, D08 RX0X Dublin, Ireland (A.K.)
- Department of Histopathology and Morbid Anatomy, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Lisa Ryan
- Department of Histopathology, Labmed Directorate, St. James’s Hospital, D08 NHY1 Dublin, Ireland (S.P.F.)
| | - Lorraine McCarra
- Department of Histopathology, Labmed Directorate, St. James’s Hospital, D08 NHY1 Dublin, Ireland (S.P.F.)
| | - Chris Maria Jose
- School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Shagun Kesar
- School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Siobhan Nicholson
- Department of Histopathology, Labmed Directorate, St. James’s Hospital, D08 NHY1 Dublin, Ireland (S.P.F.)
| | - Gerard J. Fitzmaurice
- Surgery, Anaesthesia and Critical Care Directorate, St. James’s Hospital, D08 NHY1 Dublin, Ireland (V.Y.)
| | - Ronan Ryan
- Surgery, Anaesthesia and Critical Care Directorate, St. James’s Hospital, D08 NHY1 Dublin, Ireland (V.Y.)
| | - Vincent Young
- Surgery, Anaesthesia and Critical Care Directorate, St. James’s Hospital, D08 NHY1 Dublin, Ireland (V.Y.)
| | - Sinead Cuffe
- HOPE Directorate, St. James’s Hospital, D08 NHY1 Dublin, Ireland
| | - Stephen P. Finn
- Department of Histopathology, Labmed Directorate, St. James’s Hospital, D08 NHY1 Dublin, Ireland (S.P.F.)
- Thoracic Oncology Research Group, Central Pathology Laboratory, Trinity St. James’s Cancer Institute (TSJCI), St. James’s Hospital, D08 RX0X Dublin, Ireland (A.K.)
- Department of Histopathology and Morbid Anatomy, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Steven G. Gray
- Thoracic Oncology Research Group, Central Pathology Laboratory, Trinity St. James’s Cancer Institute (TSJCI), St. James’s Hospital, D08 RX0X Dublin, Ireland (A.K.)
- Department of Clinical Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
- School of Biological Sciences, Technological University Dublin, D07 XT95 Dublin, Ireland
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4
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Reynolds JV, Preston SR, O'Neill B, Lowery MA, Baeksgaard L, Crosby T, Cunningham M, Cuffe S, Griffiths GO, Roy R, Falk S, Hanna G, Bartlett FR, Parker I, Alvarez-Iglesias A, Nilsson M, Piessen G, Risum S, Ravi N, McDermott RS. Neo-AEGIS (Neoadjuvant Trial in Adenocarcinoma of the Esophagus and Esophago-Gastric Junction International Study): Final primary outcome analysis. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.295] [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: 01/25/2023] Open
Abstract
295 Background: The optimum combination curative approach to locally advanced adenocarcinoma of the esophagus and esophago-gastric junction (AEG) remains controversial, specifically whether multimodal therapy or perioperative chemotherapy is superior. Neo-AEGIS was designed as the first randomized clinical trial (RCT) to directly compare the multimodal CROSS regimen (carboplatin/paclitaxel, 41.4Gy radiation therapy) with a modified MAGIC (epirubicin, cisplatin (oxaliplatin), 5-FU (capecitabine)) regimen (pre-2018) and more latterly the FLOT (docetaxel, 5-FU, leucovorin, oxaliplatin) regimen. Methods: 377 patients with cT2-3N0-3M0 AEG were randomly assigned to CROSS or peri-operative chemotherapy (ECF/ECX/EOF/EOX pre-2018, FLOT option 2019/20) at 24 sites (Ireland, UK, Denmark, France, Sweden). The primary outcome was overall survival. The initial power calculation was based on CROSS superiority of 10%. This was modified after the first futility analysis (70 events) to a non-inferiority margin of 5% for peri-operative chemotherapy. Secondary end points included toxicity, pathologic measures of response, and postoperative complications as per the Esophageal Complications Consensus Group (ECCG) definitions and Clavien-Dindo severity grade. Results: Of 362 evaluable patients, 178 CROSS, 184 MAGIC/FLOT (157/27), 90% were male, median (range) age 64 (35-83), 84% were cT3, and 58% cN1. At a median (range) follow up of 34.2 (0.43-111.8) months, there were 186 deaths, 91 CROSS and 95 MAGIC/FLOT arm, with 3-year estimated survival probability of 57% (95% CI 49,64) and 55% (95% CI 47,62), respectively [(HR 1.03 (95%CI. 0.77-1.38))]. Conclusions: This RCT reveals no evidence that peri-operative chemotherapy is unacceptably inferior to multimodal therapy in the primary outcome of overall survival, notwithstanding greater proxy markers of local tumor response in the CROSS arm. Oncologic and operative outcomes were consistent with optimum modern benchmarks. These data strongly suggest non-inferiority and support equipoise in clinical decision making in modern practice. Clinical trial information: NCT01726452 . [Table: see text]
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Affiliation(s)
| | - Shaun R. Preston
- Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom
| | - Brian O'Neill
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | | | | | - Thomas Crosby
- Velindre University NHS Trust, Cardiff, United Kingdom
| | | | | | - Gareth Owen Griffiths
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Rajarshi Roy
- Hull University Teaching Hospital NHS Trust, Hull, United Kingdom
| | - Stephen Falk
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - George Hanna
- St. Mary's Hospital, Imperial College, London, United Kingdom
| | | | | | | | - Magnus Nilsson
- Division of Surgery, CLINTEC, Karolinska Institutet and Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
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Barr MP, Baird AM, Halliday S, Martin P, Allott EH, Phelan J, Korpanty G, Coate L, O’Brien C, Gray SG, Sui JSY, Hayes B, Cuffe S, Finn SP. Liquid Biopsy: A Multi-Parametric Analysis of Mutation Status, Circulating Tumor Cells and Inflammatory Markers in EGFR-Mutated NSCLC. Diagnostics (Basel) 2022; 12:diagnostics12102360. [PMID: 36292049 PMCID: PMC9600124 DOI: 10.3390/diagnostics12102360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/07/2022] [Accepted: 09/17/2022] [Indexed: 11/22/2022] Open
Abstract
The liquid biopsy has the potential to improve patient care in the diagnostic and therapeutic setting in non-small cell lung cancer (NSCLC). Consented patients with epidermal growth factor receptor (EGFR) positive disease (n = 21) were stratified into two cohorts: those currently receiving EGFR tyrosine kinase inhibitor (TKI) therapy (n = 9) and newly diagnosed EGFR TKI treatment-naïve patients (n = 12). Plasma genotyping of cell-free DNA was carried out using the FDA-approved cobas® EGFR mutation test v2 and compared to next generation sequencing (NGS) cfDNA panels. Circulating tumor cell (CTC) numbers were correlated with treatment response and EGFR exon 20 p.T790M. The prognostic significance of the neutrophil to lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) was also investigated. Patients in cohort 1 with an EGFR exon 20 p.T790M mutation progressed more rapidly than those with an EGFR sensitizing mutation, while patients in cohort 2 had a significantly longer progression-free survival (p = 0.04). EGFR exon 20 p.T790M was detected by liquid biopsy prior to disease progression indicated by computed tomography (CT) imaging. The cobas® EGFR mutation test detected a significantly greater number of exon 20 p.T790M mutations (p = 0.05). High NLR and derived neutrophil to lymphocyte ratio (dNLR) were associated with shorter time to progression and worse survival outcomes (p < 0.05). High LDH levels were significantly associated with shorter time to disease progression (p = 0.03). These data support the use of liquid biopsy for monitoring EGFR mutations and inflammatory markers as prognostic indicators in NSCLC.
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Affiliation(s)
- Martin P. Barr
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Correspondence: ; Tel.: +353-1-8963620
| | - Anne-Marie Baird
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Sophia Halliday
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - Petra Martin
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
- Department of Medical Oncology, Midlands Regional Hospital, R35 NY51 Tullamore, Ireland
| | - Emma H. Allott
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - James Phelan
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Greg Korpanty
- Department of Medical Oncology, University Hospital Limerick, V94 F858 Limerick, Ireland
| | - Linda Coate
- Department of Medical Oncology, University Hospital Limerick, V94 F858 Limerick, Ireland
| | - Cathal O’Brien
- Cancer Molecular Diagnostics Laboratory, St James’s Hospital, D08 W9RT Dublin, Ireland
| | - Steven G. Gray
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Jane S. Y. Sui
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
| | - Brian Hayes
- Department of Histopathology, Cork University Hospital, T12 XF62 Cork, Ireland
- Department of Pathology, University College Cork, T12 DC4A Cork, Ireland
| | - Sinead Cuffe
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
- Department of Medical Oncology, St James’s Hospital, D08 NHY1 Dublin, Ireland
| | - Stephen P. Finn
- Thoracic Oncology Research Group, Trinity St James’s Cancer Institute, St James’s Hospital, D08 W9RT Dublin, Ireland
- Department of Histopathology, St James’s Hospital, D08 RX0X Dublin, Ireland
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Sui JSY, Martin P, Keogh A, Murchan P, Ryan L, Nicholson S, Cuffe S, Broin PÓ, Finn SP, Fitzmaurice GJ, Ryan R, Young V, Gray SG. Altered expression of ACOX2 in non-small cell lung cancer. BMC Pulm Med 2022; 22:321. [PMID: 35999530 PMCID: PMC9396774 DOI: 10.1186/s12890-022-02115-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/16/2022] [Indexed: 12/24/2022] Open
Abstract
Peroxisomes are organelles that play essential roles in many metabolic processes, but also play roles in innate immunity, signal transduction, aging and cancer. One of the main functions of peroxisomes is the processing of very-long chain fatty acids into metabolites that can be directed to the mitochondria. One key family of enzymes in this process are the peroxisomal acyl-CoA oxidases (ACOX1, ACOX2 and ACOX3), the expression of which has been shown to be dysregulated in some cancers. Very little is however known about the expression of this family of oxidases in non-small cell lung cancer (NSCLC). ACOX2 has however been suggested to be elevated at the mRNA level in over 10% of NSCLC, and in the present study using both standard and bioinformatics approaches we show that expression of ACOX2 is significantly altered in NSCLC. ACOX2 mRNA expression is linked to a number of mutated genes, and associations between ACOX2 expression and tumour mutational burden and immune cell infiltration were explored. Links between ACOX2 expression and candidate therapies for oncogenic driver mutations such as KRAS were also identified. Furthermore, levels of acyl-CoA oxidases and other associated peroxisomal genes were explored to identify further links between the peroxisomal pathway and NSCLC. The results of this biomarker driven study suggest that ACOX2 may have potential clinical utility in the diagnosis, prognosis and stratification of patients into various therapeutically targetable options.
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Affiliation(s)
- Jane S Y Sui
- Thoracic Oncology Research Group, Laboratory Medicine and Molecular Pathology, Central Pathology Laboratory, St. James's Hospital, Dublin, D08RX0X, Ireland.,Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Petra Martin
- Thoracic Oncology Research Group, Laboratory Medicine and Molecular Pathology, Central Pathology Laboratory, St. James's Hospital, Dublin, D08RX0X, Ireland.,Midland Regional Hospital Tullamore, Tullamore, Ireland
| | - Anna Keogh
- Thoracic Oncology Research Group, Laboratory Medicine and Molecular Pathology, Central Pathology Laboratory, St. James's Hospital, Dublin, D08RX0X, Ireland
| | - Pierre Murchan
- Department of Histopathology and Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,School of Mathematics, Statistics, and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
| | - Lisa Ryan
- Department of Histopathology, Labmed Directorate, St. James's Hospital, Dublin, Ireland
| | - Siobhan Nicholson
- Department of Histopathology, Labmed Directorate, St. James's Hospital, Dublin, Ireland
| | - Sinead Cuffe
- HOPE Directorate, St James's Hospital, Dublin, Ireland
| | - Pilib Ó Broin
- School of Mathematics, Statistics, and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
| | - Stephen P Finn
- Thoracic Oncology Research Group, Laboratory Medicine and Molecular Pathology, Central Pathology Laboratory, St. James's Hospital, Dublin, D08RX0X, Ireland.,Department of Histopathology and Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,Department of Histopathology, Labmed Directorate, St. James's Hospital, Dublin, Ireland.,Cancer Molecular Diagnostics, Labmed Directorate, St. James's Hospital, Dublin, Ireland
| | - Gerard J Fitzmaurice
- Surgery, Anaesthesia and Critical Care Directorate, St James's Hospital, Dublin, Ireland
| | - Ronan Ryan
- Surgery, Anaesthesia and Critical Care Directorate, St James's Hospital, Dublin, Ireland
| | - Vincent Young
- Surgery, Anaesthesia and Critical Care Directorate, St James's Hospital, Dublin, Ireland
| | - Steven G Gray
- Thoracic Oncology Research Group, Laboratory Medicine and Molecular Pathology, Central Pathology Laboratory, St. James's Hospital, Dublin, D08RX0X, Ireland. .,Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland. .,School of Biological Sciences, Technological University Dublin, Dublin, Ireland.
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7
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Felip E, Smit EF, Molina-Vila MA, Dafni U, Massuti B, Berghmans T, de Marinis F, Passiglia F, Dingemans AMC, Cobo M, Viteri S, Britschgi C, Cuffe S, Provencio M, Merkelbach-Bruse S, Andriakopoulou C, Kammler R, Ruepp B, Roschitzki-Voser H, Peters S, Wolf J, Stahel R. Alectinib for the treatment of pretreated RET-rearranged advanced NSCLC: Results of the ETOP ALERT-lung trial. Lung Cancer 2022; 172:94-99. [PMID: 36030612 DOI: 10.1016/j.lungcan.2022.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 06/22/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Alectinib, a highly selective next generation ALK-inhibitor, has exhibited potent anti-tumour activity in RET-rearranged NSCLC in the preclinical stage. METHODS ALERT-lung is a single-arm, phase II trial evaluating the activity of alectinib for the treatment of pretreated RET-rearranged advanced NSCLC. Alectinib was administered orally, 600 mg, twice per day until progression, refusal or unacceptable toxicity (treatment could continue beyond progression, if patient was deriving clinical benefit). Patient recruitment closed prematurely due to discouraging results for alectinib in a phase I/II study in the same indication. RESULTS All 14 patients who enrolled until the premature accrual closure, received at lease one dose of alectinib. Among them, median age was 61 years, majority (71 %) was female, never smokers, of ECOG PS 1. No objective response (complete or partial response) was recorded. Of the 13 evaluable patients, three (23 %) achieved and maintained disease stabilisation for 24 weeks. Up to 31 March 2021 (median follow-up 15.9 months), 12 PFS-events (92 %) were observed, with median PFS of 3.7 months (95 % C.I.: 1.8 - 7.3 months). Overall, three deaths (23 %) were reported. Seven patients (50 %) experienced grade ≥ 3 adverse events, while three discontinued treatment due to erythema multiforme of grade 3, related to alectinib. No treatment-related serious adverse event was reported. CONCLUSIONS Accrual into our trial was terminated early in response to other reports of limited activity of alectinib in patients with RET-fusion NSCLC and the emergence of more potent selective RET-inhibitors. Also in our trial, alectinib did not show the expected potential for anti-tumour activity in NSCLC.
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Affiliation(s)
- Enriqueta Felip
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Egbert F Smit
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Miguel A Molina-Vila
- Laboratory of Oncology, Pangaea Oncology, Dexeus University Hospital, Barcelona, Spain
| | - Urania Dafni
- National and Kapodistrian University of Athens, Athens, Greece; Frontier Science Foundation Hellas, Athens, Greece
| | - Bartomeu Massuti
- Medical Oncology Department, Hospital General Universitario Alicante, Alicante, Spain
| | | | - Filippo de Marinis
- Thoracic Oncology Division, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesco Passiglia
- Department of Oncology, University of Turin, S. Luigi Hospital, Orbassano, Turin, Italy
| | - Anne-Marie C Dingemans
- Department of Pulmonology, Maastricht University Medical Center, Maastricht, the Netherlands & Department of Pulmonology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands
| | - Manuel Cobo
- Unidad Gestion Intercentros of Medical Oncology. Regional and Virgen de la Victoria University Hospitals (IBIMA), Málaga, Spain
| | - Santiago Viteri
- Instituto Oncológico Dr Rosell, Hospital Universitario Dexeus. Grupo QuironSalud, Barcelona, Spain
| | - Christian Britschgi
- Department of Medical Oncology and Hematology, University Hospital Zurich, Comprehensive Cancer Center Zurich, Zurich, Switzerland
| | - Sinead Cuffe
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland; Cancer Trials Ireland, Dublin, Ireland
| | - Mariano Provencio
- Hospital Puerta de Hierro, Majadahonda Medical Oncology Service, Madrid, Spain
| | - Sabine Merkelbach-Bruse
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Pathology, Cologne, Germany
| | | | - Roswitha Kammler
- ETOP IBCSG Partners Foundation, Coordinating Center, Bern, Switzerland
| | - Barbara Ruepp
- ETOP IBCSG Partners Foundation, Coordinating Center, Bern, Switzerland
| | | | - Solange Peters
- Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Jürgen Wolf
- Center for Integrated Oncology, University Hospital of Cologne, Cologne, Germany
| | - Rolf Stahel
- ETOP IBCSG Partners Foundation, Coordinating Center, Bern, Switzerland.
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8
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Dafni U, Soo RA, Peters S, Tsourti Z, Zygoura P, Vervita K, Han JY, De Castro J, Coate L, Früh M, Hashemi SMS, Nadal E, Carcereny E, Sala MA, Bernabé R, Provencio M, Cuffe S, Roschitzki-Voser H, Ruepp B, Rosell R, Stahel RA. Impact of smoking status on the relative efficacy of the EGFR TKI/angiogenesis inhibitor combination therapy in advanced NSCLC-a systematic review and meta-analysis. ESMO Open 2022; 7:100507. [PMID: 35696746 PMCID: PMC9271510 DOI: 10.1016/j.esmoop.2022.100507] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 03/22/2022] [Revised: 04/27/2022] [Accepted: 05/04/2022] [Indexed: 11/12/2022] Open
Abstract
Background The ETOP 10-16 BOOSTER trial failed to demonstrate a progression-free survival (PFS) benefit for adding bevacizumab to osimertinib in second line. An exploratory subgroup analysis, however, suggested a PFS benefit of the combination in patients with a smoking history and prompted us to do this study. Methods A systematic review and meta-analysis to evaluate the differential effect of smoking status on the benefit of adding an angiogenesis inhibitor to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor therapy was carried out. All relevant randomized controlled trials appearing in main oncology congresses or in PubMed as of 1 November 2021 were used according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Primarily PFS according to smoking status, and secondarily overall survival (OS) were of interest. Pooled and interaction hazard ratios (HRs) were estimated by fixed or random effects models, depending on the detected degree of heterogeneity. Bias was assessed using the revised Cochrane tool for randomized controlled trials (RoB 2). Results Information by smoking was available for 1291 patients for PFS (seven studies) and 678 patients for OS (four studies). The risk of bias was low for all studies. Combination treatment significantly prolonged PFS for smokers [n = 502, HR = 0.55, 95% confidence interval (CI): 0.44-0.69] but not for nonsmokers (n = 789, HR = 0.92, 95% CI: 0.66-1.27; treatment-by-smoking interaction P = 0.02). Similarly, a significant OS benefit was found for smokers (n = 271, HR = 0.66, 95% CI: 0.47-0.93) but not for nonsmokers (n = 407, HR = 1.07, 95% CI: 0.82-1.42; treatment-by-smoking interaction P = 0.03). Conclusion In advanced EGFR-non-small-cell lung cancer patients, the addition of an angiogenesis inhibitor to EGFR-tyrosine kinase inhibitor therapy provides a statistically significant PFS and OS benefit in smokers, but not in non-smokers. The biological basis for this observation should be pursued and could determine whether this might be due to a specific co-mutational pattern produced by tobacco exposure. Target population consists of EGFR-non-small-cell lung cancer patients. The relative effect of adding an angiogenesis inhibitor to EGFR tyrosine kinase inhibitor by smoking status was explored. In patients with smoking history, the addition of an angiogenesis inhibitor provides significant PFS and OS benefit. This is not the case in patients with a negative smoking history. The biological basis for this observation should be pursued.
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Affiliation(s)
- U Dafni
- National and Kapodistrian University of Athens, Athens, Greece; Frontier Science Foundation Hellas, Athens, Greece
| | - R A Soo
- National University Cancer Institute, Department of Haematology-Oncology, Singapore
| | - S Peters
- Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Z Tsourti
- Frontier Science Foundation Hellas, Athens, Greece
| | - P Zygoura
- Frontier Science Foundation Hellas, Athens, Greece
| | - K Vervita
- Frontier Science Foundation Hellas, Athens, Greece
| | - J-Y Han
- National Cancer Center, Center for Lung Cancer, Goyang, Republic of Korea
| | - J De Castro
- Hospital Universitario La Paz, Medical Oncology Department, Madrid, Spain; Spanish Lung Cancer Group (SLCG), Barcelona, Spain
| | - L Coate
- Mid-Western Cancer Centre and University Hospital Limerick, Limerick, Ireland; Cancer Trials Ireland, Innovation House, Dublin, Ireland
| | - M Früh
- Cantonal Hospital St. Gallen, Oncology and Hematology, St. Gallen, Switzerland; Inselspital Bern, Department of Oncology, Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - S M S Hashemi
- Amsterdam UMC, VU University Medical Center, Department of Pulmonary Diseases, Amsterdam, the Netherlands
| | - E Nadal
- Spanish Lung Cancer Group (SLCG), Barcelona, Spain; ICO L'Hospitalet, Medical Oncology Department, Barcelona, Spain
| | - E Carcereny
- Spanish Lung Cancer Group (SLCG), Barcelona, Spain; Institut Català d'Oncologia Badalona-Hospital Germans Trias i Pujol, B-ARGO Group, Medical Oncology Department, Badalona, Spain
| | - M A Sala
- Spanish Lung Cancer Group (SLCG), Barcelona, Spain; Hospital Universitario Basurto, Medical Oncology Department, Bilbao, Spain
| | - R Bernabé
- Spanish Lung Cancer Group (SLCG), Barcelona, Spain; Hospital Virgen del Rocio, Medical Oncology Department, Seville, Spain
| | - M Provencio
- Spanish Lung Cancer Group (SLCG), Barcelona, Spain; Hospital Puerta de Hierro, Majadahonda Medical Oncology Service, Madrid, Spain
| | - S Cuffe
- Cancer Trials Ireland, Innovation House, Dublin, Ireland; St. James's Hospital, Department of Medical Oncology, Dublin, Ireland
| | | | - B Ruepp
- ETOP IBCSG Partners Foundation, Coordinating Office, Bern, Switzerland
| | - R Rosell
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; Catalan Institute of Oncology (ICO), Honorary Consultant, Barcelona, Spain
| | - R A Stahel
- ETOP IBCSG Partners Foundation, Coordinating Office, Bern, Switzerland.
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9
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Kieran R, Moloney C, Alken S, Corrigan L, Gallagher D, Grant C, Kelleher F, Kennedy MJ, Lowery MA, McCarthy M, O'Donnell DM, Sukor S, Cuffe S. Patient knowledge, personal experience, and impact of the first wave of the COVD-19 pandemic in an Irish oncology cohort. Ir J Med Sci 2022; 192:533-540. [PMID: 35411487 PMCID: PMC9001164 DOI: 10.1007/s11845-022-02999-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/30/2022] [Indexed: 11/27/2022]
Abstract
Background Oncology patients have had to make many changes to minimise their exposure to COVID-19, causing stress. Despite education, some patients still do not recognise potential COVID symptoms. Aims We assessed patient knowledge of COVID, and its impact on their behaviours, concerns, and healthcare experience. Methods A 16-page questionnaire was distributed to 120 oncology patients attending the day unit of a tertiary Irish cancer centre for systemic anti-cancer therapy (May/June 2020). The Irish 7-day COVID incidence during this period ranged from 2 to 11 cases/100,000 people. Results One hundred and one responses were received, 1% had tested positive for COVID, and 31% had undergone testing. Participant insight into their knowledge about COVID and their own behaviour was limited in some cases. Seventy-five percent reported total compliance with restrictions, but many were not fully compliant. Self-reported confidence in knowledge was high, but did not predict demonstrated knowledge. Sixty percent did not recognise two or more symptoms; 40% did not self-identify as high-risk. Patients reported more health-related worry (72%), loneliness (51%), and lower mood (42%) since the pandemic began. Financial toxicity worsened, with increased financial worry (78%), reductions in household income (40%), and increased costs due to lockdown (62%). Use of facemasks introduced new communications barriers for 67% of those with hearing loss. Conclusions Despite self-reported confidence in knowledge, some patient’s recognition of COVID symptoms and the preventative strategies they should use are not optimal, highlighting the need for further education in this regard. COVID has been a significant stressor for patients and more practical, financial, and psychological supports are needed.
Supplementary information The online version contains supplementary material available at 10.1007/s11845-022-02999-8.
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Affiliation(s)
- Ruth Kieran
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland.
| | - Carolyn Moloney
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Scheryll Alken
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Lynda Corrigan
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - David Gallagher
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Cliona Grant
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Fergal Kelleher
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - M John Kennedy
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland.,The Trinity St James's Cancer Institute, Dublin, Ireland
| | - Maeve A Lowery
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland.,The Trinity St James's Cancer Institute, Dublin, Ireland
| | - Michael McCarthy
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | | | - Sue Sukor
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Sinead Cuffe
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
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10
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Dafni U, Soo R, Peters S, Tsourti Z, Vervita K, Han JY, De Castro J, Coate L, Früh M, Hashemi S, Nadal E, Carcereny E, Angeles Sala González M, Bernabé Caro R, Provencio Pulla M, Cuffe S, Ruepp B, Roschitzki-Voser H, Rosell R, Stahel R. 32P Impact of smoking status on the relative efficacy of the EGFR TKI/angiogenesis inhibitor combination therapy in advanced NSCLC: A systematic review and meta-analysis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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11
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Soo RA, Han JY, Dafni U, Cho BC, Yeo CM, Nadal E, Carcereny E, de Castro J, Sala MA, Bernabé R, Coate L, Provencio Pulla M, Garcia Campelo R, Cuffe S, Hashemi SMS, Früh M, Massuti B, Garcia-Sanchez J, Dómine M, Majem M, Sanchez-Torres JM, Britschgi C, Pless M, Dimopoulou G, Roschitzki-Voser H, Ruepp B, Rosell R, Stahel RA, Peters S. A randomised phase II study of osimertinib and bevacizumab versus osimertinib alone as second-line targeted treatment in advanced NSCLC with confirmed EGFR and acquired T790M mutations: the European Thoracic Oncology Platform (ETOP 10-16) BOOSTER trial. Ann Oncol 2021; 33:181-192. [PMID: 34839016 DOI: 10.1016/j.annonc.2021.11.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [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: 08/23/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND While osimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) is the standard treatment in patients with advanced non-small-cell lung cancer (NSCLC) with sensitising EGFR and acquired T790M mutations, progression inevitably occurs. The angiogenic pathway is implicated in EGFR TKI resistance. PATIENTS AND METHODS BOOSTER is an open-label randomised phase II trial investigating the efficacy and safety of combined osimertinib 80 mg daily and bevacizumab 15 mg/kg every 3 weeks, versus osimertinib alone, in patients with EGFR-mutant advanced NSCLC and acquired T790M mutations after failure on previous EGFR TKI therapy. Primary endpoint was investigator-assessed progression-free survival (PFS). Secondary endpoints were overall survival (OS), objective response rate (ORR) and adverse events (AEs). RESULTS Between May 2017 and February 2019, 155 patients were randomised (combination: 78; osimertinib: 77). At data cut-off of 22 February 2021, median follow-up was 33.8 months [interquartile range (IQR): 26.5-37.6 months] and 129 (83.2%) PFS events were reported in the intention-to-treat population. There was no difference in median PFS between the combination [15.4 months; 95% confidence interval (CI) 9.2-18.0 months] and osimertinib arm (12.3 months; 95% CI 6.2-17.2 months; stratified log-rank P = 0.83), [hazard ratio (HR) = 0.96; 95% CI 0.68-1.37]. Median OS was 24.0 months (95% CI 17.8-32.1 months) in the combination arm and 24.3 months (95% CI 16.9-37.0 months) in the osimertinib arm (stratified log-rank P = 0.91), (HR = 1.03; 95% CI 0.67-1.56). Exploratory analysis revealed a significant interaction of smoking history with treatment for PFS (adjusted P = 0.0052) with a HR of 0.52 (95% CI 0.30-0.90) for smokers, and 1.47 (95% CI 0.92-2.33) for never smokers. ORR was 55% in both arms and the median time to treatment failure was significantly shorter in the combination than in the osimertinib arm, 8.2 months versus 10.8 months, respectively (P = 0.0074). Safety of osimertinib and bevacizumab was consistent with previous reports with grade ≥3 treatment-related AEs (TRAEs) reported in 47% and 18% of patients on combination and osimertinib alone, respectively. CONCLUSIONS No difference in PFS was observed between osimertinib plus bevacizumab and osimertinib alone. Grade ≥3 TRAEs were more common in patients on combination.
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Affiliation(s)
- R A Soo
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - J-Y Han
- National Cancer Center, Center for Lung Cancer, Goyang, Republic of Korea
| | - U Dafni
- National and Kapodistrian University of Athens, Athens, Greece; Frontier Science Foundation Hellas, Athens, Greece
| | - B C Cho
- Yonsei Cancer Center, Yonsei University College of Medicine, Division of Medical Oncology, Seoul, Republic of Korea
| | - C M Yeo
- Medical Oncology Department, Tan Tock Seng Hospital, Singapore, Singapore
| | - E Nadal
- Medical Oncology Department, ICO L'Hospitalet, Barcelona, Spain
| | - E Carcereny
- Medical Oncology Department, Institut Català d'Oncologia Badalona Hospital Germans Trias i Pujol, B-ARGO Group, Badalona, Spain
| | - J de Castro
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - M A Sala
- Medical Oncology Department, Hospital Universitario Basurto, Bilbao, Spain
| | - R Bernabé
- Medical Oncology Department, Hospital Virgen del Rocio, Sevilla, Spain
| | - L Coate
- Mid-Western Cancer Centre and University Hospital Limerick, Limerick, Ireland
| | - M Provencio Pulla
- Hospital Puerta de Hierro, Majadahonda Medical Oncology Service, Madrid, Spain
| | - R Garcia Campelo
- Medical Oncology Department, Hospital Teresa Herrera, La Coruña, Spain
| | - S Cuffe
- Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - S M S Hashemi
- Department of Pulmonary Diseases, Amsterdam UMC, VU University Medical Center, Amsterdam, Netherlands
| | - M Früh
- Cantonal Hospital St. Gallen, Oncology and Hematology, St. Gallen, Switzerland; Department of Oncology, Inselspital Bern, Bern, Switzerland
| | - B Massuti
- Medical Oncology Department, Hospital General Universitario Alicante, Alicante, Spain
| | - J Garcia-Sanchez
- Medical Oncology Service, Hospital Arnau Vilanova, Valencia, Spain
| | - M Dómine
- Department of Oncology, Hospital Universitario Fundacion Jimenez Díaz (IIS-FJD), Madrid, Spain
| | - M Majem
- Medical Oncology Department, Hospital De La Santa Creu I Sant Pau, Barcelona, Spain
| | - J-M Sanchez-Torres
- Medical Oncology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | - C Britschgi
- Department of Medical Oncology and Hematology, University Hospital Zurich, Comprehensive Cancer Center Zurich, Zurich, Switzerland
| | - M Pless
- Cantonal Hospital Winterthur, Oncology and Haematology, Winterthur, Switzerland
| | - G Dimopoulou
- Frontier Science Foundation Hellas, Athens, Greece
| | - H Roschitzki-Voser
- European Thoracic Oncology Platform (ETOP), Coordinating Office, Bern, Switzerland
| | - B Ruepp
- European Thoracic Oncology Platform (ETOP), Coordinating Office, Bern, Switzerland
| | - R Rosell
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain; Catalan Institute of Oncology (ICO), Honorary Consultant, Barcelona, Spain
| | - R A Stahel
- European Thoracic Oncology Platform (ETOP), Coordinating Office, Bern, Switzerland.
| | - S Peters
- Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland
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Reck M, Rodríguez-Abreu D, Robinson AG, Hui R, Csőszi T, Fülöp A, Gottfried M, Peled N, Tafreshi A, Cuffe S, O'Brien M, Rao S, Hotta K, Leal TA, Riess JW, Jensen E, Zhao B, Pietanza MC, Brahmer JR. Five-Year Outcomes With Pembrolizumab Versus Chemotherapy for Metastatic Non-Small-Cell Lung Cancer With PD-L1 Tumor Proportion Score ≥ 50. J Clin Oncol 2021; 39:2339-2349. [PMID: 33872070 PMCID: PMC8280089 DOI: 10.1200/jco.21.00174] [Citation(s) in RCA: 407] [Impact Index Per Article: 135.7] [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: 01/20/2021] [Revised: 02/04/2021] [Accepted: 03/18/2021] [Indexed: 12/21/2022] Open
Abstract
PURPOSE We report the first 5-year follow-up of any first-line phase III immunotherapy trial for non-small-cell lung cancer (NSCLC). KEYNOTE-024 (ClinicalTrials.gov identifier: NCT02142738) is an open-label, randomized controlled trial of pembrolizumab compared with platinum-based chemotherapy in patients with previously untreated NSCLC with a programmed death ligand-1 (PD-L1) tumor proportion score of at least 50% and no sensitizing EGFR or ALK alterations. Previous analyses showed pembrolizumab significantly improved progression-free survival and overall survival (OS). METHODS Eligible patients were randomly assigned (1:1) to pembrolizumab (200 mg once every 3 weeks for up to 35 cycles) or platinum-based chemotherapy. Patients in the chemotherapy group with progressive disease could cross over to pembrolizumab. The primary end point was progression-free survival; OS was a secondary end point. RESULTS Three hundred five patients were randomly assigned: 154 to pembrolizumab and 151 to chemotherapy. Median (range) time from randomization to data cutoff (June 1, 2020) was 59.9 (55.1-68.4) months. Among patients initially assigned to chemotherapy, 99 received subsequent anti-PD-1 or PD-L1 therapy, representing a 66.0% effective crossover rate. Median OS was 26.3 months (95% CI, 18.3 to 40.4) for pembrolizumab and 13.4 months (9.4-18.3) for chemotherapy (hazard ratio, 0.62; 95% CI, 0.48 to 0.81). Kaplan-Meier estimates of the 5-year OS rate were 31.9% for the pembrolizumab group and 16.3% for the chemotherapy group. Thirty-nine patients received 35 cycles (ie, approximately 2 years) of pembrolizumab, 82.1% of whom were still alive at data cutoff (approximately 5 years). Toxicity did not increase with longer treatment exposure. CONCLUSION Pembrolizumab provides a durable, clinically meaningful long-term OS benefit versus chemotherapy as first-line therapy for metastatic NSCLC with PD-L1 tumor proportion score of at least 50%.
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Affiliation(s)
- Martin Reck
- Lung Clinic Grosshansdorf, Airway Research Center North (ARCN), member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Delvys Rodríguez-Abreu
- Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Andrew G. Robinson
- Cancer Centre of Southeastern Ontario at Kingston General Hospital, Kingston, ON, Canada
| | - Rina Hui
- Westmead Hospital and the University of Sydney, Sydney, NSW, Australia
| | - Tibor Csőszi
- Jász-Nagykun-Szolnok County Hospital, Szolnok, Hungary
| | - Andrea Fülöp
- Országos Korányi Pulmonológiai Intézet, Budapest, Hungary
| | | | - Nir Peled
- Soroka Cancer Center, Ben Gurion University, Beer Sheva, Israel
| | - Ali Tafreshi
- Wollongong Private Hospital and University of Wollongong, Wollongong, NSW, Australia
| | - Sinead Cuffe
- St James's Hospital and Cancer Trials Ireland (formerly ICORG—All Ireland Cooperative Oncology Research Group), Dublin, Ireland
| | | | - Suman Rao
- MedStar Franklin Square Hospital, Baltimore, MD
| | | | | | | | | | | | | | - Julie R. Brahmer
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
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Soo R, Han JY, Dimopoulou G, Cho B, Yeo C, Nadal E, Carcereny E, de Castro J, Sala M, Bernabe R, Coate L, Provencio M, Campelo RG, Cuffe S, Hashemi S, Früh M, Ruepp B, Roschitzki-Voser H, Stahel R, Peters S. VP3-2021: A randomized phase II study of second-line osimertinib (Osi) and bevacizumab (Bev) versus Osi in advanced non-small-cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) and T790M mutations (mt): Results from the ETOP BOOSTER trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Sui J, Martin P, Nicholson S, Cuffe S, Finn S, Fitzmaurice G, Ryan R, Young V, Gray S. Altered expression of ACOX2 and other members of the peroxisome pathway in non-small cell lung cancer. Lung Cancer 2021. [DOI: 10.1016/s0169-5002(21)00203-8] [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]
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Reynolds JV, Preston SR, O'Neill B, Lowery MA, Baeksgaard L, Crosby T, Cunningham M, Cuffe S, Griffiths GO, Roy R, Falk S, Hanna G, Bartlett FR, Parker I, Alvarez-Iglesias A, Nilsson M, Piessen G, Risum S, Ravi N, McDermott RS. Neo-AEGIS (Neoadjuvant trial in Adenocarcinoma of the Esophagus and Esophago-Gastric Junction International Study): Preliminary results of phase III RCT of CROSS versus perioperative chemotherapy (Modified MAGIC or FLOT protocol). (NCT01726452). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.4004] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
4004 Background: The optimum combination curative approach to locally advanced adenocarcinoma of the esophagus and esophago-gastric junction (AEG) is unknown. A key question is whether neoadjuvant multimodal therapy, specifically CROSS (carboplatin/paclitaxel, 41.4Gy radiation therapy), is superior to optimum peri-operative chemotherapeutic regimens including modified MAGIC (epirubicin, cisplatin (oxaliplatin), 5-FU (capecitabine)) and more latterly FLOT (docetaxel, 5-FU, leucovorin, oxaliplatin). Neo-AEGIS was designed as the first randomised controlled trial to address this question. Methods: 377 patients with cT2-3N0-3M0 AEG were randomly assigned to CROSS or peri-operative chemotherapy (ECF/ECX/EOF/EOX pre-2018, FLOT option 2019/20) at 24 sites (Ireland, UK, Denmark, France, Sweden). The primary outcome was overall survival. The initial power calculation was based on CROSS superiority of 10%. This was modified after the first futility analysis (70 events) to a non-inferiority margin of 5%. Secondary end points included toxicity, pathologic measures of response, and postoperative complications as per the Esophageal Complications Consensus Group (ECCG) definitions and Clavien-Dindo severity grade. Results: Of 362 evaluable patients, 178 CROSS, 184 MAGIC/FLOT (157/27), 90% were male, median (range) age 64 (35-83), 84% were cT3, and 58% cN1. At a median (range) follow up of 24.5 (1-92) months, at the second futility analysis (60% of planned events), there were 143 deaths, 70 CROSS and 73 MAGIC/FLOT arm, with 3-year estimated survival probability of 56% (95% CI 47,64) and 57% (95% CI 48,65), respectively [(HR 1.02 (95%CI. 0.74-1.42))]. Based on the absence of futility evidenced in this data the DSMB recommended closure of recruitment in December 2020. Conclusions: This RCT reveals no evidence that peri-operative chemotherapy is unacceptably inferior to multimodal therapy, notwithstanding greater proxy markers of local tumour response in the CROSS arm. Oncologic and operative outcomes were consistent with optimum modern benchmarks. These data strongly suggest non-inferiority and support equipoise in decision making in modern practice. Clinical trial information: NCT01726452. [Table: see text]
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Affiliation(s)
| | - Shaun R. Preston
- Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom
| | - Brian O'Neill
- St. Luke’s Radiation Oncology Network, Dublin, Ireland
| | | | | | - Thomas Crosby
- Velindre University NHS Trust, Cardiff, United Kingdom
| | | | | | - Gareth Owen Griffiths
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Rajarshi Roy
- Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - Stephen Falk
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - George Hanna
- St. Mary's Hospital, Imperial College, London, United Kingdom
| | | | | | | | - Magnus Nilsson
- Division of Surgery, CLINTEC, Karolinska Institutet and Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
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16
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MacDonagh L, Gallagher MF, Ffrench B, Gasch C, Gray SG, Reidy M, Nicholson S, Leonard N, Ryan R, Young V, O'Leary JJ, Cuffe S, Finn SP, O'Byrne KJ, Barr MP. MicroRNA expression profiling and biomarker validation in treatment-naïve and drug resistant non-small cell lung cancer. Transl Lung Cancer Res 2021; 10:1773-1791. [PMID: 34012792 PMCID: PMC8107736 DOI: 10.21037/tlcr-20-959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background In the absence of targetable mutations or immune checkpoints, cisplatin-doublet chemotherapy remains the standard of care in non-small cell lung cancer (NSCLC). Drug resistance has however become a significant clinical challenge. Exploring a role for small non-coding microRNAs (miRNA) as biomarker candidates in cisplatin resistant (CisR) lung cancer is lacking and warrants further investigation. Methods miRNA expression profiling was assessed in a panel of cisplatin sensitive and resistant NSCLC cell lines and validated by qPCR. Modulation of altered miRNAs was studied using antagomiRs and pre-miRs while functional assays were used to assess cisplatin response. The translational relevance of these miRNAs as potential biomarkers was assessed in serum and matched normal and tumour lung tissues from chemo-naïve NSCLC patients, in addition to xenograft formalin-fixed paraffin-embedded (FFPE) tumours derived from cisplatin sensitive and resistant cell lines. Results Differential expression of a 5-miR signature (miR-30a-3p, miR-30b-5p, miR-30c-5p, miR-34a-5p, miR-4286) demonstrated their ability to distinguish between normal and tumour lung tissue and between NSCLC histologies. In squamous cell carcinoma (SqCC), tissue miRNA expression was associated with poor survival. miR-4286 showed promise as a blood-based diagnostic biomarker that could distinguish between adenocarcinoma and SqCC histologies. In a xenograft model of cisplatin resistance, using 7-9 week old female NOD/SCID mice (NOD.CB17-Prkdcscid/NCrCrl), a 5-miRNA panel showed altered expression between sensitive and resistant tumours. Conclusions This study identified a panel of miRNAs which may have diagnostic and prognostic potential as novel biomarkers in lung cancer and furthermore, may have a predictive role in monitoring the emergence of resistance to cisplatin.
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Affiliation(s)
- Lauren MacDonagh
- Thoracic Oncology Research Group, School of Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin, Ireland
| | - Michael F Gallagher
- Histopathology Department, Sir Patrick Dun Laboratories, Central Pathology Laboratory, St. James's Hospital & Pathology Research Laboratory, Coombe Women and Infant's University Hospital, Dublin, Ireland
| | - Brendan Ffrench
- Histopathology Department, Sir Patrick Dun Laboratories, Central Pathology Laboratory, St. James's Hospital & Pathology Research Laboratory, Coombe Women and Infant's University Hospital, Dublin, Ireland
| | - Claudia Gasch
- Histopathology Department, Sir Patrick Dun Laboratories, Central Pathology Laboratory, St. James's Hospital & Pathology Research Laboratory, Coombe Women and Infant's University Hospital, Dublin, Ireland
| | - Steven G Gray
- Thoracic Oncology Research Group, School of Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin, Ireland
| | - Marie Reidy
- Department of Histopathology, St. James's Hospital, Dublin, Ireland
| | | | - Niamh Leonard
- Department of Histopathology, St. James's Hospital, Dublin, Ireland
| | - Ronan Ryan
- Department of Cardiothoracic Surgery, St. James's Hospital, Dublin, Ireland
| | - Vincent Young
- Department of Cardiothoracic Surgery, St. James's Hospital, Dublin, Ireland
| | - John J O'Leary
- Histopathology Department, Sir Patrick Dun Laboratories, Central Pathology Laboratory, St. James's Hospital & Pathology Research Laboratory, Coombe Women and Infant's University Hospital, Dublin, Ireland
| | - Sinead Cuffe
- Thoracic Oncology Research Group, School of Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin, Ireland.,Department of Medical Oncology, St James's Hospital, Dublin, Ireland
| | - Stephen P Finn
- Thoracic Oncology Research Group, School of Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin, Ireland.,Department of Histopathology, St. James's Hospital, Dublin, Ireland
| | - Kenneth J O'Byrne
- Cancer & Ageing Research Program, Queensland University of Technology, Brisbane, Australia
| | - Martin P Barr
- Thoracic Oncology Research Group, School of Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College Dublin, Dublin, Ireland
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17
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MacDonagh L, Santiago RM, Gray SG, Breen E, Cuffe S, Finn SP, O'Byrne KJ, Barr MP. Exploitation of the vitamin A/retinoic acid axis depletes ALDH1-positive cancer stem cells and re-sensitises resistant non-small cell lung cancer cells to cisplatin. Transl Oncol 2021; 14:101025. [PMID: 33550205 PMCID: PMC7868629 DOI: 10.1016/j.tranon.2021.101025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 12/23/2022] Open
Abstract
Despite advances in personalised medicine and the emerging role of immune checkpoints in directing treatment decisions in subsets of lung cancer patients, non-small cell lung cancer (NSCLC) remains the most common cause of cancer-related deaths worldwide. The development of drug resistance plays a key role in the relapse of lung cancer patients in the clinical setting, mainly due to the unlimited renewal capacity of residual cancer stem cells (CSCs) within the tumour cell population during chemotherapy. In this study, we investigated the function of the CSC marker, aldehyde dehydrogenase (ALDH1) in retinoic acid cell signalling using an in vitro model of cisplatin resistant NSCLC. The addition of key components in retinoic acid cell signalling, all-trans retinoic acid (ATRA) and retinol to cisplatin chemotherapy, significantly reduced ALDH1-positive cell subsets in cisplatin resistant NSCLC cells relative to their sensitive counterparts resulting in the re-sensitisation of chemo-resistant cells to the cytotoxic effects of cisplatin. Furthermore, combination of ATRA or retinol with cisplatin significantly inhibited cell proliferation, colony formation and increased cisplatin-induced apoptosis. This increase in apoptosis may, at least in part, be due to differential gene expression of the retinoic acid (RARα/β) and retinoid X (RXRα) nuclear receptors in cisplatin-resistant lung cancer cells. These data support the concept of exploiting the retinoic acid signalling cascade as a novel strategy in targeting subsets of CSCs in cisplatin resistant lung tumours.
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Affiliation(s)
- Lauren MacDonagh
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St James's Hospital & Trinity College Dublin, Ireland.
| | - Rhyla Mae Santiago
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St James's Hospital & Trinity College Dublin, Ireland.
| | - Steven G Gray
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St James's Hospital & Trinity College Dublin, Ireland.
| | - Eamon Breen
- Flow Cytometry Facility, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, Trinity College Dublin, Ireland.
| | - Sinead Cuffe
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St James's Hospital & Trinity College Dublin, Ireland; Medical Oncology Department, St James's Hospital, Dublin, Ireland.
| | - Stephen P Finn
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St James's Hospital & Trinity College Dublin, Ireland; Histopathology Department, St James's Hospital & Trinity College Dublin, Ireland.
| | - Kenneth J O'Byrne
- Cancer & Ageing Research Program, Queensland University of Technology, Brisbane, Australia.
| | - Martin P Barr
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St James's Hospital & Trinity College Dublin, Ireland.
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18
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Clement M, Tranberg Madsen A, Finn S, Cuffe S, Sorensen B, Gately K. P69.03 Targeting the STAT3/PIM Kinase Pathway to Overcome EMT-Mediated Acquired Resistance to EGFR TKIs in NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Bracken-Clarke D, Kapoor D, Baird AM, Buchanan PJ, Gately K, Cuffe S, Finn SP. Vaping and lung cancer - A review of current data and recommendations. Lung Cancer 2021; 153:11-20. [PMID: 33429159 DOI: 10.1016/j.lungcan.2020.12.030] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [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: 09/08/2020] [Revised: 12/15/2020] [Accepted: 12/19/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Lung cancer is the most common cause of cancer mortality worldwide and, while tobacco smoke remains the primary cause, there is increasing concern that vaping and E-cigarette use may also increase lung cancer risk. This review concentrates on the current data, scholarship and active foci of research regarding potential cancer risk and oncogenic mechanisms of vaping and lung cancer. MATERIALS AND METHODS We performed a literature review of current and historical publications on lung cancer oncogenesis, vaping device/e-liquid contents and daughter products, molecular oncogenic mechanisms and the fundamental, potentially oncogenic, effects of electronic cigarette smoke/e-liquid products. RESULTS E-cigarette devices and vaping fluids demonstrably contain a series of both definite and probable oncogens including nicotine derivatives (e.g. nitrosnornicotine, nitrosamine ketone), polycyclic aromatic hydrocarbons, heavy metals (including organometal compounds) and aldehydes/other complex organic compounds. These arise both as constituents of the e-liquid (with many aldehydes and other complex organics used as flavourings) and as a result of pyrolysis/complex organic reactions in the electronic cigarette device (including unequivocal carcinogens such as formaldehyde - formed from pyrolysis of glycerol). Various studies demonstrate in vitro transforming and cytotoxic activity of these derivatives. E-cigarette device use has been significantly increasing - particularly amongst the younger cohort and non-smokers; thus, this is an area of significant concern for the future. CONCLUSION Although research remains somewhat equivocal, there is clear reason for concern regarding the potential oncogenicity of E-Cigarettes/E-Liquids with a strong basic and molecular science basis. Given lag times (extrapolating from tobacco smoke data) of perhaps 20 years, this may have significant future public health implications. Thus, the authors feel further study in this field is strongly warranted and consideration should be made for tighter control and regulation of these products.
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Affiliation(s)
| | - Dhruv Kapoor
- Department of Medical Oncology, St James' Hospital, Dublin, Ireland
| | - Anne Marie Baird
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | - Paul James Buchanan
- DCU Cancer Research, Faculty of Science and Health, Dublin City University, Dublin, Ireland; National Institute of Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - Kathy Gately
- Department of Clinical Medicine, Trinity College School of Medicine and St James's Hospital, Dublin, Ireland
| | - Sinead Cuffe
- Department of Medical Oncology, St James' Hospital, Dublin, Ireland
| | - Stephen P Finn
- Department of Pathology, St James' Hospital and Trinity College School of Medicine, Dublin, Ireland
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20
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Mansoor W, Arkenau HT, Alsina M, Shitara K, Thuss-Patience P, Cuffe S, Dvorkin M, Park D, Ando T, Van Den Eynde M, Beretta GD, Zaniboni A, Doi T, Tabernero J, Ilson DH, Makris L, Benhadji KA, Van Cutsem E. Trifluridine/tipiracil in patients with metastatic gastroesophageal junction cancer: a subgroup analysis from the phase 3 TAGS study. Gastric Cancer 2021; 24:970-977. [PMID: 33713215 PMCID: PMC8205879 DOI: 10.1007/s10120-021-01156-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/06/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with advanced gastroesophageal junction cancer (GEJC) have poor survival outcomes, and GEJC-specific data from trials evaluating agents in gastric cancers (GCs) as a whole are lacking. Trifluridine/tipiracil (FTD/TPI) was approved for previously treated metastatic GC or GEJC (mGC/mGEJC) based on results of the phase 3 TAGS trial. Subgroup analyses by primary tumor type (GC or GEJC) in TAGS are reported here. METHODS Pa tients with mGC/mGEJC treated with ≥ 2 prior chemotherapy regimens were randomized (2:1) to receive FTD/TPI or placebo, plus best supportive care. A pre-planned sub-analysis was performed to evaluate efficacy and safety outcomes by primary tumor type (GEJC or GC). RESULTS Of 507 randomized patients, 145 (29%) had GEJC and 360 (71%) had GC as the primary disease site. Baseline characteristics were generally similar between the GEJC and GC subgroups, except that more patients in the GEJC subgroup had received ≥ 3 prior regimens (72 vs. 59% in the GC subgroup). Survival benefit with FTD/TPI was observed in both subgroups. The overall survival hazard ratio for FTD/TPI vs placebo was 0.75 (95% CI 0.50-1.11) and 0.67 (95% CI 0.52-0.87) in the GEJC and GC subgroups, respectively. Grade ≥ 3 adverse events of any cause were reported in 75 (77%) and 192 (81%) FTD/TPI-treated patients in the GEJC and GC subgroups, respectively. No new safety concerns were noted with FTD/TPI. CONCLUSION As in patients with GC, FTD/TPI showed an efficacy benefit in patients with GEJC in the TAGS trial, along with demonstrating a manageable safety profile.
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Affiliation(s)
- Wasat Mansoor
- grid.412917.80000 0004 0430 9259The Christie NHS Foundation Trust, Manchester, UK
| | - Hendrik-Tobias Arkenau
- grid.83440.3b0000000121901201Sarah Cannon Research Institute, Cancer Institute, University College London, London, UK
| | - Maria Alsina
- grid.7080.fVall D, Institute of Oncology (VHIO), Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Kohei Shitara
- grid.497282.2National Cancer Center Hospital East, Chiba, Japan
| | - Peter Thuss-Patience
- grid.6363.00000 0001 2218 4662Charité-Universitätsmedizin Berlin, Medizinische Klinik M.S. Hämatologie, Onkologie Und Tumorimmunologie, Berlin, Germany
| | - Sinead Cuffe
- grid.416409.e0000 0004 0617 8280St. James’s Hospital, Dublin, Republic of Ireland
| | - Mikhail Dvorkin
- Omsk Regional Clinical Centre of Oncology, Omsk, Russian Federation
| | - David Park
- St. Jude Crosson Cancer Institute/St, Joseph Heritage Healthcare, Fullerton, CA USA
| | - Takayuki Ando
- grid.267346.20000 0001 2171 836XUniversity of Toyama, Toyama, Japan
| | - Marc Van Den Eynde
- grid.48769.340000 0004 0461 6320UCL Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | - Alberto Zaniboni
- grid.415090.90000 0004 1763 5424Fondazione Poliambulanza–Istituto Ospedaliero, Brescia, Italy
| | - Toshihiko Doi
- grid.497282.2National Cancer Center Hospital East, Chiba, Japan
| | - Josep Tabernero
- grid.411083.f0000 0001 0675 8654Institute of Oncology (VHIO), Vall D’Hebron University Hospital, UVic-UCC, IOB-Quiron, Barcelona, Spain
| | - David H. Ilson
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center, New York, NY USA
| | | | | | - Eric Van Cutsem
- grid.410569.f0000 0004 0626 3338University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium
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21
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Harrold EC, Idris AF, Keegan NM, Corrigan L, Teo MY, O'Donnell M, Lim ST, Duff E, O'Donnell DM, Kennedy MJ, Sukor S, Grant C, Gallagher DG, Collier S, Kingston T, O'Dwyer AM, Cuffe S. Prevalence of Insomnia in an Oncology Patient Population: An Irish Tertiary Referral Center Experience. J Natl Compr Canc Netw 2020; 18:1623-1630. [PMID: 33285516 DOI: 10.6004/jnccn.2020.7611] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 06/26/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The NCCN Guidelines for Survivorship recommend dedicated sleep assessment. Reported insomnia prevalence in the general Irish population is 6% to 15%. Reported insomnia prevalence internationally among new/recently diagnosed patients with cancer varies from 30.9% to 54.3%. Insomnia prevalence has not been previously quantified in an Irish oncology cohort. METHODS A 40-item questionnaire was prospectively administered to ambulatory patients with cancer aged ≥18 years. Prespecified criteria to define insomnia syndrome combined those of the International Classification of Sleep Disorders, version 1, and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The Hospital Anxiety and Depression Scale-Depression/Anxiety (HADS-D/A) was used to screen for potential confounding variables. RESULTS The response rate to the questionnaire was 87% (294/337). The predominant respondent age group was 55 to 64 years (26%; 77/294), 70.7% were female (208/294), and the most common cancer subtypes were breast (37.4%), colorectal (12.9%), and lung (12.2%). A total of 62% (183/294) of patients reported sleep disturbance after diagnosis, 63% (115/183) reported moderate/severe distress related to this disturbance, and 37% (61/183) reported a significant impact on physical function. Although 33% (98/294) met insomnia syndrome criteria, only 34% (33/98) of these patients had a preexisting history of sleep disturbance. Female sex, age <65 years, cancer subtype, alcohol consumption, and HADS-D/A ≥11 were associated with statistically significant higher odds ratios (OR) of insomnia syndrome. Multivariate analysis identified breast cancer (OR, 3.17; P=.01), age <65 years (OR, 1.8; P=.03), and alcohol consumption (OR, 2.3; P=.005) as independent predictors of insomnia syndrome. CONCLUSIONS Insomnia syndrome prevalence in this cohort is comparable to that reported previously and supports dedicated sleep assessment. This study identifies potentially modifiable risk factors for insomnia and demonstrates additional utility of the HADS score in identifying patients at risk.
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Affiliation(s)
- Emily C Harrold
- 1Department of Medical Oncology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Ahmad F Idris
- 2Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Niamh M Keegan
- 3Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lynda Corrigan
- 2Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Min Yuen Teo
- 3Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Sean Tee Lim
- 4Trinity College Medical School, Dublin, Ireland; and
| | - Eimear Duff
- 4Trinity College Medical School, Dublin, Ireland; and
| | | | - M John Kennedy
- 2Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Sue Sukor
- 2Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Cliona Grant
- 2Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - David G Gallagher
- 2Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Sonya Collier
- 5Department of Psychological Oncology Medicine, St. James's University Hospital, Dublin, Ireland
| | - Tara Kingston
- 5Department of Psychological Oncology Medicine, St. James's University Hospital, Dublin, Ireland
| | - Ann Marie O'Dwyer
- 5Department of Psychological Oncology Medicine, St. James's University Hospital, Dublin, Ireland
| | - Sinead Cuffe
- 2Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
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22
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Kieran R, moloney C, Kennedy J, Lowery MA, Grant C, Gallagher DJ, O'Donnell DM, Kelleher F, Sukor S, McCarthy MT, Cuffe S. Patient self-reported awareness of COVID: Overconfidence in knowledge, underestimation of risk. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.29_suppl.174] [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
174 Background: Oncology patients have had to adapt to minimize the risks of contracting COVID-19. We assessed patient knowledge of COVID, and the impact of the pandemic on their behaviours, concerns and healthcare experience, to identify any further education/quality improvement needs. Methods: Following ethical approval, a 16 page survey was distributed to 120 oncology patients attending the day unit of a tertiary Irish cancer center for systemic anti-cancer therapy (May/June 2020). The Irish COVID rate during this period was 33.8 new cases/day (pop. 4.9 million). Results: 101 responses were received. Cancer types included breast (19%), gastrointestinal (29%), head and neck (11%), and lung (13%). 31% had been tested for COVID; just 1 patient was positive. 100% were aware of advice to “cocoon” and reported good understanding of this. 75% reported complete compliance, but of those, 73% were not social-distancing within their homes, 22% received visitors, and 36% continued to shop in-store; of these, 42% shopped as/more often than pre-COVID. Of the 51 patients regularly shopping, many were not using risk-reduction strategies e.g. social distancing (22%), mask-wearing (20%), using “priority shopping’ hours (31%), avoiding public transport (26%). 94% felt confident/very confident in recognizing COVID symptoms, but 66% did not recognize two or more key symptoms from a list of 10, most frequently aches/pains (58%), fatigue (55%), altered smell/taste (33%) and dyspnea (14%). The number recognized did not correlate with confidence (p = 0.9) or desire for more information about COVID (p = 0.9). 40% did not feel they were at higher risk of contracting COVID, while 15% thought they were no more likely to be very sick than an average person if infected. Many did not know that chemotherapy, steroids, radiation, and immunotherapy can impact morbidity/mortality in COVID (31%, 70%, 44% and 49% respectively). 46% were somewhat/very fearful of COVID, but this did not strongly predict for either protective (e.g. mask-wearing: OR 1.1, 95% CI 0.3-4.8 p = 0.9), or risk behaviors (e.g. continuing to shop frequently: OR 0.5, 95% CI 0.1-1.4 p = 0.2). 66% would like more cancer specific information, particularly about prevention (45%) and symptoms (33%), with a preference for written information (74%). Conclusions: Despite self-reported confidence in knowledge, patient’s self-assessments of their risk category and the preventative strategies they should use may be inaccurate. Increased education about risk, cocooning and symptom recognition is necessary.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sue Sukor
- St James's Hospital, Dublin, Ireland
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23
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Donlon NE, Ravi N, King S, Cunninhgam M, Cuffe S, Lowery M, Wall C, Hughes N, Muldoon C, Ryan C, Moore J, O'Farrell C, Gorry C, Duff AM, Enright C, Nugent TS, Elliot JA, Donohoe CL, Reynolds JV. Modern oncological and operative outcomes in oesophageal cancer: the St. James's hospital experience. Ir J Med Sci 2020; 190:297-305. [PMID: 32696244 DOI: 10.1007/s11845-020-02321-4] [Citation(s) in RCA: 7] [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: 06/06/2020] [Accepted: 07/17/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Oesophageal cancer has a reputation for poor survival, and a relatively high risk of major postoperative morbidity and mortality. Encouragingly, a recent international cancer registry study reports a doubling of survival outcomes in Ireland over the last 20 years. This study focused on both oncologic and operative outcomes in patients treated with curative intent requiring surgery at a high-volume center. METHODS All patients undergoing surgery or multimodal therapy with curative intent from 2009 to 2018 were studied. All data was recorded prospectively and maintained internally. The period 2009-2013 was compared with 2014-2018 to monitor any change in trends. RESULTS Four hundred and seventy-five patients (adenocarcinoma 77%, mean age 65; 76% male; 64% neoadjuvant therapy) underwent open surgical resection, 54% via en bloc 2-stage, 19.8% en bloc 3-stage, and 26.5% by a transhiatal approach. New onset atrial fibrillation was the commonest index complication, in 108 (22.7%), 80 (18%) developed suspected pneumonia/respiratory tract infection, 20 (4.2%) an anastomotic leak, and 25 (5.2%) a chyle leak. The 90-day mortality rate was 1.2% and 0.8% at 30 days. The median survival was 77.17 months, with a 5-year survival of 56%. CONCLUSION Consistent with registry data on population survival for oesophageal cancer, this study highlights markedly improved survival outcomes in patients treated curatively, reflecting international trends, as well as low mortality rates; however, cardiorespiratory complications remain significant.
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Affiliation(s)
- Noel E Donlon
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland.
| | - Narayanasamy Ravi
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Sinead King
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Moya Cunninhgam
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Sinead Cuffe
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Maeve Lowery
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Carmel Wall
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Niall Hughes
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Cian Muldoon
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Ciara Ryan
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Jenny Moore
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Catherine O'Farrell
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Claire Gorry
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Ann-Marie Duff
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Cathy Enright
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Tim S Nugent
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Jessie A Elliot
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - Claire L Donohoe
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
| | - John V Reynolds
- National Oesophageal and Gastric Centre, St James's Hospital and Trinity College Dublin, Dublin 8, Ireland
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Peters S, Danson S, Hasan B, Dafni U, Reinmuth N, Majem M, Tournoy KG, Mark MT, Pless M, Cobo M, Rodriguez-Abreu D, Falchero L, Moran T, Ortega Granados AL, Monnet I, Mohorcic K, Sureda BM, Betticher D, Demedts I, Macias JA, Cuffe S, Luciani A, Sanchez JG, Curioni-Fontecedro A, Gautschi O, Price G, Coate L, von Moos R, Zielinski C, Provencio M, Menis J, Ruepp B, Pochesci A, Roschitzki-Voser H, Besse B, Rabaglio M, O'Brien MER, Stahel RA. A Randomized Open-Label Phase III Trial Evaluating the Addition of Denosumab to Standard First-Line Treatment in Advanced NSCLC: The European Thoracic Oncology Platform (ETOP) and European Organisation for Research and Treatment of Cancer (EORTC) SPLENDOUR Trial. J Thorac Oncol 2020; 15:1647-1656. [PMID: 32565388 DOI: 10.1016/j.jtho.2020.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 04/07/2020] [Revised: 05/26/2020] [Accepted: 06/07/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Receptor activator of NF-kB ligand stimulates NF-kB-dependent cell signaling and acts as the primary signal for bone resorption. Retrospective analysis of a large trial comparing denosumab versus zoledronic acid in bone metastatic solid tumors suggested significant overall survival (OS) advantage for patients with lung cancer with denosumab (p = 0.01). The randomized open-label phase III SPLENDOUR trial was designed to evaluate whether the addition of denosumab to standard first-line platinum-based doublet chemotherapy improved OS in advanced NSCLC. METHODS Patients with stage IV NSCLC were randomized in a 1:1 ratio to either chemotherapy with or without denosumab (120 mg every 3-4 wks), stratified by the presence of bone metastases (at diagnosis), Eastern Cooperative Oncology Group performance status, histology, and region. To detect an OS increase from 9 to 11.25 months (hazard ratio [HR] = 0.80), 847 OS events were required. The trial closed prematurely owing to decreasing accrual rate. RESULTS A total of 514 patients were randomized, with 509 receiving one or more doses of the assigned treatment (chemotherapy: 252, chemotherapy-denosumab: 257). The median age was 66.1 years, 71% were men, and 59% were former smokers. Bone metastases were identified in 275 patients (53%). Median OS (95% confidence interval [CI]) was 8.7 (7.6-11.0) months in the control arm versus 8.2 (7.5-10.4) months in the chemotherapy-denosumab arm (HR = 0.96; 95% CI: 0.78-1.19; one-sided p = 0.36). For patients with bone metastasis, HR was 1.02 (95% CI: 0.77-1.35), whereas for those without, HR was 0.90 (95% CI: 0.66-1.23). Adverse events grade 3 or greater were observed in 40.9%, 5.2%, 8.7% versus 45.5%, 10.9%, 10.5% of patients. Conditional power for OS benefit was less than or equal to 10%. CONCLUSIONS Denosumab was well-tolerated without unexpected safety concerns. There was no OS improvement for denosumab when added to chemotherapy in the intention-to-treat population and the subgroups with and without bone metastases. Our data do not provide evidence of a clinical benefit for denosumab in patients with NSCLC without bone metastases.
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Affiliation(s)
- Solange Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
| | - Sarah Danson
- Department of Oncology and Metabolism & Sheffield Experimental Cancer Medicine Centre, University of Sheffield, Weston Park Hospital, Sheffield, United Kingdom
| | - Baktiar Hasan
- European Organization for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Urania Dafni
- School of Health Sciences, National and Kapodistrian University of Athens & Frontier Science Foundation-Hellas, Athens, Greece
| | - Niels Reinmuth
- Asklepios Kliniken GmbH, Asklepios Fachkliniken Muenchen, Gauting, Germany
| | - Margarita Majem
- Department of Medical Oncology, Hospital De La Santa Creu I Sant Pau, Barcelona, Spain; Spanish lung cancer group (Grupo Español de Cancer de Pulmón (GECP)), Barcelona, Spain
| | - Kurt G Tournoy
- Faculty of Medicine and Life Sciences, Ghent University and Onze-Lieve-Vrouwziekenhuis (OLV), Aalst, Belgium
| | - Michael T Mark
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Department of Medical Oncology, Cantonal Hospital Graubuenden, Chur, Switzerland
| | - Miklos Pless
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Department of Medical Oncology and Hematology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Manuel Cobo
- Spanish lung cancer group (Grupo Español de Cancer de Pulmón (GECP)), Barcelona, Spain; Unidad Gestion Intercentros of Medical Oncology. Regional and Virgen de la Victoria University Hospitals (IBIMA), Málaga, Spain
| | - Delvys Rodriguez-Abreu
- Spanish lung cancer group (Grupo Español de Cancer de Pulmón (GECP)), Barcelona, Spain; Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Lionel Falchero
- Department of Pneumology and Thoracic Oncology, Hopital Nord-Ouest, Villefranche-sur-Saône Cedex, France
| | - Teresa Moran
- Spanish lung cancer group (Grupo Español de Cancer de Pulmón (GECP)), Barcelona, Spain; Department of Medical Oncology, Institut Català d'Oncologia (ICO) Badalona, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona Applied Research Group in Oncology (B-ARGO), Barcelona, Spain
| | - Ana Laura Ortega Granados
- Spanish lung cancer group (Grupo Español de Cancer de Pulmón (GECP)), Barcelona, Spain; Department of Medical Oncology, Hospital Universitario de Jaén, Jaén, Spain
| | - Isabelle Monnet
- Department of Pneumology, Centre Hopitalier Intercommunal De Créteil, Créteil, France
| | - Katja Mohorcic
- Department of Medical Oncology, University Clinic Golnik, Golnik, Slovenia
| | - Bartomeu Massutí Sureda
- Spanish lung cancer group (Grupo Español de Cancer de Pulmón (GECP)), Barcelona, Spain; El Instituto de Investigación Sanitaria y Biomédica de Alicante (SABIAL), Hospital Universitario Alicante, Alicante, Spain
| | - Daniel Betticher
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Department of Medical Oncology, Fribourg Cantonal Hospital (HFR), Fribourg, Switzerland
| | - Ingel Demedts
- Department of Pulmonary Diseases, AZ Delta, Roeselare, Belgium
| | - Jose Antionio Macias
- Spanish lung cancer group (Grupo Español de Cancer de Pulmón (GECP)), Barcelona, Spain; Department of Hematology and Oncology, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Sinead Cuffe
- Cancer Trials Ireland, Dublin, Ireland; Department of Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Andrea Luciani
- Department of Medical Oncology, Ospedale San Paolo, Milano, Italy
| | - Jose Garcia Sanchez
- Spanish lung cancer group (Grupo Español de Cancer de Pulmón (GECP)), Barcelona, Spain; Department of Medical Oncology, University Hospital Arnau de Vilanova, Valencia, Spain
| | - Alessandra Curioni-Fontecedro
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Department for Medical Oncology and Hematology, University Hospital Zürich, Zürich, Switzerland
| | - Oliver Gautschi
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cantonal Hospital Lucerne, Lucern, Switzerland
| | - Gillian Price
- Department of Medical Oncology, Aberdeen Royal Infirmary NHS Grampian, Aberdeen, United Kingdom
| | - Linda Coate
- Cancer Trials Ireland, Dublin, Ireland; Mid-Western Cancer Centre, University Hospital Limerick, Limerick, Ireland
| | - Roger von Moos
- Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Department of Medical Oncology, Cantonal Hospital Graubuenden, Chur, Switzerland
| | - Christoph Zielinski
- Clinical Division of Oncology, Medical University Vienna, Vienna, Austria; Central European Cooperative Oncology Group, Vienna, Austria
| | - Mariano Provencio
- Spanish lung cancer group (Grupo Español de Cancer de Pulmón (GECP)), Barcelona, Spain; Department of Medical Oncology, Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Jessica Menis
- European Organization for Research and Treatment of Cancer (EORTC), Brussels, Belgium; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Medical Oncology Department, Istituto Oncologico Veneto, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy
| | - Barbara Ruepp
- European Thoracic Oncology Platform (ETOP), Bern, Switzerland
| | - Alessia Pochesci
- European Organization for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | - Benjamin Besse
- European Organization for Research and Treatment of Cancer (EORTC), Brussels, Belgium; Gustave Roussy Cancer Center Villejuif, Paris Saclay University, Orsay, France
| | | | - Mary E R O'Brien
- Department of Medical Oncology, Royal Marsden Hospital, Sutton, United Kingdom
| | - Rolf A Stahel
- Department for Medical Oncology and Hematology, University Hospital Zürich, Zürich, Switzerland
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25
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Molina-Vila MA, Stahel RA, Dafni U, Jordana-Ariza N, Balada-Bel A, Garzón-Ibáñez M, García-Peláez B, Mayo-de-las-Casas C, Felip E, Curioni Fontecedro A, Gautschi O, Peters S, Massutí B, Palmero R, Ponce Aix S, Carcereny E, Früh M, Pless M, Popat S, Cuffe S, Bidoli P, Kammler R, Roschitzki-Voser H, Tsourti Z, Karachaliou N, Rosell R. Evolution and Clinical Impact of EGFR Mutations in Circulating Free DNA in the BELIEF Trial. J Thorac Oncol 2020; 15:416-425. [DOI: 10.1016/j.jtho.2019.11.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/12/2019] [Accepted: 11/19/2019] [Indexed: 01/05/2023]
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Malone T, Schäfer L, Simon N, Heavey S, Cuffe S, Finn S, Moore G, Gately K. Current perspectives on targeting PIM kinases to overcome mechanisms of drug resistance and immune evasion in cancer. Pharmacol Ther 2019; 207:107454. [PMID: 31836451 DOI: 10.1016/j.pharmthera.2019.107454] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 12/03/2019] [Indexed: 12/22/2022]
Abstract
PIM kinases are a class of serine/threonine kinases that play a role in several of the hallmarks of cancer including cell cycle progression, metabolism, inflammation and immune evasion. Their constitutively active nature and unique catalytic structure has led them to be an attractive anticancer target through the use of small molecule inhibitors. This review highlights the enhanced activity of PIM kinases in cancer that can be driven by hypoxia in the tumour microenvironment and the important role that aberrant PIM kinase activity plays in resistance mechanisms to chemotherapy, radiotherapy, anti-angiogenic therapies and targeted therapies. We highlight an interaction of PIM kinases with numerous major oncogenic players, including but not limited to, stabilisation of p53, synergism with c-Myc, and notable parallel signalling with PI3K/Akt. We provide a comprehensive overview of PIM kinase's role as an escape mechanism to targeted therapies including PI3K/mTOR inhibitors, MET inhibitors, anti-HER2/EGFR treatments and the immunosuppressant rapamycin, providing a rationale for co-targeting treatment strategies for a more durable patient response. The current status of PIM kinase inhibitors and their use as a combination therapy with other targeted agents, in addition to the development of novel multi-molecularly targeted single therapeutic agents containing a PIM kinase targeting moiety are discussed.
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Affiliation(s)
- Tom Malone
- Dept. of Clinical Medicine, Trinity Translational Medicine Institute, St. James's Hospital, Dublin, Ireland
| | - Lea Schäfer
- Dept. of Clinical Medicine, Trinity Translational Medicine Institute, St. James's Hospital, Dublin, Ireland
| | - Nathalie Simon
- Dept. of Clinical Medicine, Trinity Translational Medicine Institute, St. James's Hospital, Dublin, Ireland
| | - Susan Heavey
- Molecular Diagnostics and Therapeutics Group, University College London, London, UK
| | - Sinead Cuffe
- Dept. of Clinical Medicine, Trinity Translational Medicine Institute, St. James's Hospital, Dublin, Ireland
| | - Stephen Finn
- Dept. of Clinical Medicine, Trinity Translational Medicine Institute, St. James's Hospital, Dublin, Ireland
| | - Gillian Moore
- School of Pharmacy and Biomolecular Sciences, RCSI, Dublin, Ireland
| | - Kathy Gately
- Dept. of Clinical Medicine, Trinity Translational Medicine Institute, St. James's Hospital, Dublin, Ireland.
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27
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Baird A, Wright M, Mccarra L, Thirstrup H, Schønau A, Cuffe S, Finn S, Gray S. P2.09-16 Assessment of PD-L1 and CD8 Expression in Lung Cancer Using RNA in Situ Hybridisation. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1665] [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: 10/25/2022]
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28
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Reck M, Rodríguez-Abreu D, Robinson A, Hui R, Csőszi T, Fülöp A, Gottfried M, Peled N, Tafreshi A, Cuffe S, O'Brien M, Rao S, Hotta K, Garay T, Jensen E, Ebiana V, Brahmer J. OA14.01 KEYNOTE-024 3-Year Survival Update: Pembrolizumab vs Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.483] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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29
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Mansoor W, Arkenau HT, ALSINA MARIA, Shitara K, Tejani MA, Thuss-Patience PC, Cuffe S, Dvorkin M, Park D, Ando T, Van Den Eynde M, Beretta GD, Zaniboni A, Doi T, Tabernero J, Ilson DH, Makris L, McGuigan S, Van Cutsem E. Trifluridine/tipiracil (FTD/TPI) in patients (pts) with metastatic gastroesophageal junction cancer (mGEJC): Subgroup analysis from TAGS. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.4038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4038 Background: The incidence of GEJC is increasing in North America and Europe, especially among white men. Many pts present with metastatic disease or relapse locally or systemically after resection of early-stage disease. The global phase 3 study TAGS (NCT02500043) demonstrated the efficacy and safety of FTD/TPI in previously treated pts with metastatic gastric cancer (mGC)/mGEJC. Here we report results in the mGEJC subgroup from TAGS. Methods: Pts with mGC/mGEJC treated with ≥2 prior chemotherapy regimens were randomized (2:1) to receive FTD/TPI (35 mg/m2 BID on days 1–5 and 8–12 of each 28-day cycle) or placebo, plus best supportive care. A preplanned efficacy and safety analysis was performed in pts with mGEJC. Results: Of 507 randomized pts, 145 (29%) had GEJC as the sole primary disease site (FTD/TPI, 98/337; placebo, 47/170). Of pts with mGEJC, 85% were male and 83% were white (overall population, 73% and 70%). Baseline characteristics were generally balanced for pts with mGEJC across treatment groups, except for fewer pts having prior gastrectomy (40% vs 55%) and more pts having received ≥3 prior regimens (74% vs 66%) in the FTD/TPI group than in the placebo group. FTD/TPI had an efficacy benefit in pts with mGEJC, and the FTD/TPI safety profile was similar in this subgroup and the overall population (table). Conclusions: FTD/TPI showed a manageable safety profile and efficacy benefit in pts with mGEJC in the TAGS trial, despite heavier pretreatment of the FTD/TPI than the placebo group. Clinical trial information: NCT02500043. [Table: see text]
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Affiliation(s)
| | - Hendrik-Tobias Arkenau
- Sarah Cannon Research Institute, Cancer Institute, University College London, London, United Kingdom
| | - MARIA ALSINA
- Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | | | | | - Peter C. Thuss-Patience
- Charité–University Medicine Berlin, Department of Haematology, Oncology and Tumorimmunology, Berlin, Germany
| | | | | | - David Park
- St Jude Crosson Cancer Institute/St Joseph Heritage Healthcare, Fullerton, CA
| | - Takayuki Ando
- Third Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Marc Van Den Eynde
- Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | | | | | | | - Josep Tabernero
- Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | | | | | | | - Eric Van Cutsem
- University Hospitals Gasthuisberg, Leuven and KU Leuven, Leuven, Belgium
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30
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Reck M, Rodríguez-Abreu D, Robinson AG, Hui R, Csőszi T, Fülöp A, Gottfried M, Peled N, Tafreshi A, Cuffe S, O'Brien M, Rao S, Hotta K, Vandormael K, Riccio A, Yang J, Pietanza MC, Brahmer JR. Updated Analysis of KEYNOTE-024: Pembrolizumab Versus Platinum-Based Chemotherapy for Advanced Non-Small-Cell Lung Cancer With PD-L1 Tumor Proportion Score of 50% or Greater. J Clin Oncol 2019; 37:537-546. [PMID: 30620668 DOI: 10.1200/jco.18.00149] [Citation(s) in RCA: 971] [Impact Index Per Article: 194.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE In the randomized, open-label, phase III KEYNOTE-024 study, pembrolizumab significantly improved progression-free survival and overall survival (OS) compared with platinum-based chemotherapy in patients with previously untreated advanced non-small-cell lung cancer (NSCLC) with a programmed death ligand 1 tumor proportion score of 50% or greater and without EGFR/ALK aberrations. We report an updated OS and tolerability analysis, including analyses adjusting for potential bias introduced by crossover from chemotherapy to pembrolizumab. PATIENTS AND METHODS Patients were randomly assigned to pembrolizumab 200 mg every 3 weeks (for up to 2 years) or investigator's choice of platinum-based chemotherapy (four to six cycles). Patients assigned to chemotherapy could cross over to pembrolizumab upon meeting eligibility criteria. The primary end point was progression-free survival; OS was an important key secondary end point. Crossover adjustment analysis was done using the following three methods: simplified two-stage method, rank-preserving structural failure time, and inverse probability of censoring weighting. RESULTS Three hundred five patients were randomly assigned (pembrolizumab, n = 154; chemotherapy, n = 151). At data cutoff (July 10, 2017; median follow-up, 25.2 months), 73 patients in the pembrolizumab arm and 96 in the chemotherapy arm had died. Median OS was 30.0 months (95% CI, 18.3 months to not reached) with pembrolizumab and 14.2 months (95% CI, 9.8 to 19.0 months) with chemotherapy (hazard ratio, 0.63; 95% CI, 0.47 to 0.86). Eighty-two patients assigned to chemotherapy crossed over on study to receive pembrolizumab. When adjusted for crossover using the two-stage method, the hazard ratio for OS for pembrolizumab versus chemotherapy was 0.49 (95% CI, 0.34 to 0.69); results using rank-preserving structural failure time and inverse probability of censoring weighting were similar. Treatment-related grade 3 to 5 adverse events were less frequent with pembrolizumab compared with chemotherapy (31.2% v 53.3%, respectively). CONCLUSION With prolonged follow-up, first-line pembrolizumab monotherapy continues to demonstrate an OS benefit over chemotherapy in patients with previously untreated, advanced NSCLC without EGFR/ALK aberrations, despite crossover from the control arm to pembrolizumab as subsequent therapy.
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Affiliation(s)
- Martin Reck
- Lung Clinic Grosshansdorf, Airway Research Center North, Grosshansdorf, Germany
| | - Delvys Rodríguez-Abreu
- Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Andrew G Robinson
- Cancer Centre of Southeastern Ontario at Kingston General Hospital, Kingston, Ontario, Canada
| | - Rina Hui
- Westmead Hospital and the University of Sydney, Sydney, NSW, Australia
| | - Tibor Csőszi
- Jász-Nagykun-Szolnok County Hospital, Szolnok, Hungary
| | - Andrea Fülöp
- Országos Korányi Pulmonológiai Intézet, Budapest, Hungary
| | | | - Nir Peled
- The Cancer Institute, Soroka Medical Center and Ben-Gurion University, Beer-Sheva, Israel
| | - Ali Tafreshi
- Wollongong Oncology and University of Wollongong, Wollongong, NSW, Australia
| | - Sinead Cuffe
- St James's Hospital and Cancer Trials Ireland, Dublin, Ireland
| | - Mary O'Brien
- The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Suman Rao
- MedStar Franklin Square Hospital, Baltimore, MD
| | | | | | | | | | | | - Julie R Brahmer
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
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31
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Baird AM, Easty D, Jarzabek M, Shiels L, Soltermann A, Klebe S, Raeppel S, MacDonagh L, Wu C, Griggs K, Kirschner MB, Stanfill B, Nonaka D, Goparaju CM, Murer B, Fennell DA, O'Donnell DM, Barr MP, Mutti L, Reid G, Finn S, Cuffe S, Pass HI, Opitz I, Byrne AT, O'Byrne KJ, Gray SG. When RON MET TAM in Mesothelioma: All Druggable for One, and One Drug for All? Front Endocrinol (Lausanne) 2019; 10:89. [PMID: 30863365 PMCID: PMC6399142 DOI: 10.3389/fendo.2019.00089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/31/2019] [Indexed: 12/12/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive inflammatory cancer with a poor survival rate. Treatment options are limited at best and drug resistance is common. Thus, there is an urgent need to identify novel therapeutic targets in this disease in order to improve patient outcomes and survival times. MST1R (RON) is a trans-membrane receptor tyrosine kinase (RTK), which is part of the c-MET proto-oncogene family. The only ligand recognized to bind MST1R (RON) is Macrophage Stimulating 1 (MST1), also known as Macrophage Stimulating Protein (MSP) or Hepatocyte Growth Factor-Like Protein (HGFL). In this study, we demonstrate that the MST1-MST1R (RON) signaling axis is active in MPM. Targeting this pathway with a small molecule inhibitor, LCRF-0004, resulted in decreased proliferation with a concomitant increase in apoptosis. Cell cycle progression was also affected. Recombinant MST1 treatment was unable to overcome the effect of LCRF-0004 in terms of either proliferation or apoptosis. Subsequently, the effect of an additional small molecular inhibitor, BMS-777607 (which targets MST1R (RON), MET, Tyro3, and Axl) also resulted in a decreased proliferative capacity of MPM cells. In a cohort of MPM patient samples, high positivity for total MST1R by IHC was an independent predictor of favorable prognosis. Additionally, elevated expression levels of MST1 also correlated with better survival. This study also determined the efficacy of LCRF-0004 and BMS-777607 in xenograft MPM models. Both LCRF-0004 and BMS-777607 demonstrated significant anti-tumor efficacy in vitro, however BMS-777607 was far superior to LCRF-0004. The in vivo and in vitro data generated by this study indicates that a multi-TKI, targeting the MST1R/MET/TAM signaling pathways, may provide a more effective therapeutic strategy for the treatment of MPM as opposed to targeting MST1R alone.
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Affiliation(s)
- Anne-Marie Baird
- Thoracic Oncology Research Group, Labmed Directorate, St. James's Hospital, Dublin, Ireland
- Cancer and Ageing Research Program, Queensland University of Technology, Brisbane, QLD, Australia
| | - David Easty
- Thoracic Oncology Research Group, Labmed Directorate, St. James's Hospital, Dublin, Ireland
| | - Monika Jarzabek
- Department of Physiology and Medical Physics and Centre for Systems Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Liam Shiels
- Department of Physiology and Medical Physics and Centre for Systems Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Alex Soltermann
- Department of Clinical Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Sonja Klebe
- Department of Anatomical Pathology, Flinders University of South Australia, Bedford Park, SA, Australia
| | | | - Lauren MacDonagh
- Thoracic Oncology Research Group, Labmed Directorate, St. James's Hospital, Dublin, Ireland
| | - Chengguang Wu
- Department of Clinical Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Kim Griggs
- Department of Anatomical Pathology, Flinders University of South Australia, Bedford Park, SA, Australia
| | - Michaela B. Kirschner
- Asbestos Diseases Research Institute, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, NSW, Australia
| | - Bryan Stanfill
- The Commonwealth Scientific and Industrial Research Organization, Brisbane, QLD, Australia
| | - Daisuke Nonaka
- Department of Histopathology, The Christie NHS Foundation Trust, Manchester, United Kingdom
- Department of Cardiothoracic Surgery, New York University (NYU) Langone Medical Center, New York, NY, United States
| | - Chandra M. Goparaju
- Department of Cardiothoracic Surgery, New York University (NYU) Langone Medical Center, New York, NY, United States
| | - Bruno Murer
- Department of Clinical Pathology, Ospedale dell'Angelo, Venice, Italy
| | - Dean A. Fennell
- MRC Toxicology Unit, University of Leicester and Leicester University Hospitals, Leicester, United Kingdom
| | | | - Martin P. Barr
- Thoracic Oncology Research Group, Labmed Directorate, St. James's Hospital, Dublin, Ireland
| | - Luciano Mutti
- Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, PA, United States
| | - Glen Reid
- Asbestos Diseases Research Institute, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, NSW, Australia
| | - Stephen Finn
- Department of Histopathology and Morbid Anatomy, Trinity College Dublin, Dublin, Ireland
| | - Sinead Cuffe
- HOPE Directorate, St James's Hospital, Dublin, Ireland
| | - Harvey I. Pass
- Department of Cardiothoracic Surgery, New York University (NYU) Langone Medical Center, New York, NY, United States
| | - Isabelle Opitz
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Annette T. Byrne
- Department of Physiology and Medical Physics and Centre for Systems Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Kenneth J. O'Byrne
- Thoracic Oncology Research Group, Labmed Directorate, St. James's Hospital, Dublin, Ireland
- Cancer and Ageing Research Program, Queensland University of Technology, Brisbane, QLD, Australia
- HOPE Directorate, St James's Hospital, Dublin, Ireland
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Steven G. Gray
- Thoracic Oncology Research Group, Labmed Directorate, St. James's Hospital, Dublin, Ireland
- Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
- *Correspondence: Steven G. Gray
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Boland L, Bennett K, Cuffe S, Gleeson N, Grant C, Kennedy J, Connolly D. Cancer survivors' experience of OptiMal, a 6-week, occupation-based, self-management intervention. Br J Occup Ther 2018. [DOI: 10.1177/0308022618804704] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Lauren Boland
- PhD Candidate, Discipline of Occupational Therapy, Trinity College Dublin, Ireland
| | - Kathleen Bennett
- Associate Professor, Division of Population Health Sciences, Royal College of Surgeons in Ireland
| | - Sinead Cuffe
- Consultant Medical Oncologist, St James Hospital, Dublin, Ireland
| | - Noreen Gleeson
- Consultant Gynaecological Oncologist and Pelvic Surgeon, St James' Hospital, Dublin, Ireland
| | - Cliona Grant
- Consultant Medical Oncologist, St James Hospital, Dublin, Ireland
| | - John Kennedy
- Consultant Medical Oncologist, St James Hospital, Dublin, Ireland
| | - Deirdre Connolly
- Associate Professor, Discipline of Occupational Therapy, Trinity College Dublin, Ireland
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Curioni A, Felip E, Dafni U, Molina MA, Gautschi O, Peters S, Massutí B, Palmero R, Ponce S, Carcereny E, Früh M, Pless M, Popat S, Cuffe S, Karachaliou N, Kammler R, Kassapian M, Roschitzki-Voser H, Stahel R, Rosell R. Evolution and clinical impact of EGFR mutations in circulating free DNA in the BELIEF trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Barr M, Farrell R, Singh S, Foley E, He Y, Brady L, Young V, Ryan R, Nicholson S, Leonard N, Cuffe S, Finn S. MA06.09 XRCC6BP1: A DNA Repair Gene in Cisplatin Resistant Lung Cancer Stem Cells That May Predict Survival Outcomes in Patients. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Barr M, Singh S, Farrell R, Foley E, He Y, Nicholson S, Leonard N, Brady L, Cuffe S, Finn S. PO-510 XRCC6BP1: a novel role in the DNA repair of platinum resistant NSCLC cells. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.1011] [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: 11/04/2022] Open
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36
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Gately K, Heavey S, Cuffe S, Finn S, O’Byrne K, O’Neill M, Moore G. PO-505 Targeting PIM kinase to overcome resistance to PI3K-mTOR inhibition in NSCLC. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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37
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Aleem U, Grant C, Gallagher DJ, Sukor S, Kennedy J, Kelleher CF, Lowery MA, O' Donnell DM, Gleeson J, Glennon L, Cuffe S. Immunotherapy awareness in the oncology patient population: An Irish hospital experience. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e15160] [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: 11/20/2022] Open
Affiliation(s)
- Umair Aleem
- St James's Hospital Dublin-8, Republic of Ireland, Dublin, IE
| | | | | | | | | | | | | | | | - June Gleeson
- St James's Hospital, Dublin 8, Ireland, Dublin, Ireland
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MacDonagh L, Gray SG, Breen E, Cuffe S, Finn SP, O'Byrne KJ, Barr MP. BBI608 inhibits cancer stemness and reverses cisplatin resistance in NSCLC. Cancer Lett 2018; 428:117-126. [PMID: 29653268 DOI: 10.1016/j.canlet.2018.04.008] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [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: 02/05/2018] [Revised: 03/30/2018] [Accepted: 04/05/2018] [Indexed: 12/15/2022]
Abstract
Non-small cell lung cancer (NSCLC) is the most common cause of cancer-related deaths worldwide. While partial or complete tumor regression can be achieved in patients, particularly with cisplatin-based strategies, these initial responses are frequently short-lived and are followed by tumor relapse and chemoresistance. Identifying the root of cisplatin resistance in NSCLC and elucidating the mechanism(s) of tumor relapse, is of critical importance in order to determine the point of therapeutic failure, which in turn, will aid the discovery of novel therapeutics, new combination strategies and a strategy to enhance the efficacy of current chemotherapeutics. It has been hypothesized that cancer stem cells (CSCs) may be the initiating factor of resistance. We have previously identified and characterized an aldehyde dehydrogenase 1 CSC subpopulation in cisplatin resistant NSCLC. BBI608 is a small molecule STAT3 inhibitor known to suppress cancer relapse, progression and metastasis. Here, we show that BBI608 can inhibit stemness gene expression, deplete CSCs and overcome cisplatin resistance in NSCLC.
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Affiliation(s)
- Lauren MacDonagh
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College, Dublin, Ireland
| | - Steven G Gray
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College, Dublin, Ireland
| | - Eamon Breen
- Flow Cytometry Facility, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College, Dublin, Ireland
| | - Sinead Cuffe
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College, Dublin, Ireland; Medical Oncology, St. James's Hospital, Dublin, Ireland
| | - Stephen P Finn
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College, Dublin, Ireland; Department of Histopathology, St. James's Hospital and Trinity College, Dublin, Ireland
| | - Kenneth J O'Byrne
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College, Dublin, Ireland; Cancer & Ageing Research Program, Queensland University of Technology, Brisbane, Australia
| | - Martin P Barr
- Thoracic Oncology Research Group, School of Clinical Medicine, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St. James's Hospital and Trinity College, Dublin, Ireland.
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Korpanty GJ, Eng L, Qiu X, Faluyi OO, Renouf DJ, Cheng D, Patel D, Chen Z, Tse BC, Knox JJ, Dodbiba L, Teichman J, Azad AK, Wong R, Darling G, Reisman D, Cuffe S, Liu G, Xu W. Association of BRM promoter polymorphisms and esophageal adenocarcinoma outcome. Oncotarget 2018; 8:28093-28100. [PMID: 28427211 PMCID: PMC5438633 DOI: 10.18632/oncotarget.15890] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 02/22/2017] [Indexed: 12/16/2022] Open
Abstract
Purpose Brahma (BRM) is a critical catalytic subunit of the SWI/SNF chromatin remodeling complex; expression of BRM is commonly lost in various cancer types. BRM promoter polymorphisms (BRM-741; BRM-1321) are associated with loss of BRM expression, and with cancer risk/survival. We evaluated these two polymorphisms in the overall survival (OS) of esophageal adenocarcinoma (EAC) patients. Results Of 270 patients, 37% were stage IV. Minor allele frequencies were 47−49%; 15% were double-homozygotes. When compared to the wild-type genotype, the homozygous variant of BRM-741 carried an adjusted OS hazard ratio (aHR) of 1.64 (95% CI:1.1−2.4); for BRM-1321, the aHR was 2.09 (95% CI:1.4−3.0). Compared to the double wild-type, carrying homozygous variants of both promoter polymorphisms (double-homozygote) yielded an aHR of 2.21 (95% CI:1.4−3.6). Directions/magnitudes of associations were similar in subsets by age, gender, smoking status, use of platinum agents, and disease stage, and for progression-free survival. Materials and Methods In a cohort of EAC patients of all stages (84% male; median age of 64 years), two BRM polymorphisms were genotyped. Cox proportional hazards models, adjusted for known prognostic variables, estimated the association of polymorphisms with OS. Conclusions BRM polymorphisms were associated with OS in EAC in this study. Validation studies are warranted.
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Affiliation(s)
- Grzegorz J Korpanty
- Princess Margaret Cancer Centre, Department of Medicine, University Health Network, Toronto, ON, Canada.,Canadian Cancer Trials Group, Department of Medicine, Queens University, Kingston, ON, Canada
| | - Lawson Eng
- Princess Margaret Cancer Centre, Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Xin Qiu
- Princess Margaret Cancer Centre, Department of Biostatistics, University Health Network, Toronto, ON, Canada
| | - Olusola Olusesan Faluyi
- Princess Margaret Cancer Centre, Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Daniel J Renouf
- Department of Medical Oncology, University of British Columbia and British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Dangxiao Cheng
- Princess Margaret Cancer Centre, Department of Medical Biophysics, University Health Network, Toronto, ON, Canada
| | - Devalben Patel
- Princess Margaret Cancer Centre, Department of Medical Biophysics, University Health Network, Toronto, ON, Canada
| | - Zhuo Chen
- Princess Margaret Cancer Centre, Department of Medical Biophysics, University Health Network, Toronto, ON, Canada
| | - Brandon C Tse
- Princess Margaret Cancer Centre, Department of Medical Biophysics, University Health Network, Toronto, ON, Canada
| | - Jennifer J Knox
- Princess Margaret Cancer Centre, Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Lorin Dodbiba
- Princess Margaret Cancer Centre, Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Jennifer Teichman
- Princess Margaret Cancer Centre, Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Abul Kalam Azad
- Princess Margaret Cancer Centre, Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Rebecca Wong
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON, Canada
| | - Gail Darling
- Department of Surgery, Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - David Reisman
- Department of Medicine in the College of Medicine, Division of Hematology and Oncology, University of Florida, Gainesville, FL, USA
| | - Sinead Cuffe
- Princess Margaret Cancer Centre, Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Geoffrey Liu
- Princess Margaret Cancer Centre, Department of Medicine, University Health Network, Toronto, ON, Canada.,Princess Margaret Cancer Centre, Department of Medical Biophysics, University Health Network, Toronto, ON, Canada.,Department of Epidemiology, Dalla Lana School of Pubic Health, Toronto, ON, Canada
| | - Wei Xu
- Princess Margaret Cancer Centre, Department of Biostatistics, University Health Network, Toronto, ON, Canada
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Heavey S, Cuffe S, Finn S, Young V, Ryan R, Nicholson S, Leonard N, McVeigh N, Barr M, O'Byrne K, Gately K. In pursuit of synergy: An investigation of the PI3K/mTOR/MEK co-targeted inhibition strategy in NSCLC. Oncotarget 2018; 7:79526-79543. [PMID: 27765909 PMCID: PMC5346733 DOI: 10.18632/oncotarget.12755] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 09/12/2016] [Indexed: 12/20/2022] Open
Abstract
Clinical PI3K inhibition has been somewhat disappointing, due to both inadequate patient stratification and compensatory cell signalling through bypass mechanisms. As such, investigation of PI3K-MEK co-targeted inhibition has been recommended. With high mortality rates and a clear need for new therapeutic intervention strategies, non-small cell lung cancer (NSCLC) is an important setting to investigate the effectiveness of this approach. Here, 174 NSCLC tumours were screened for 150 mutations by Fluidigm technology, with 15 patients being profiled for phosphoprotein expression. The effects of GDC-0941 (a pan PI3K inhibitor), GDC-0980 (a dual PI3K/mTOR inhibitor) and GDC-0973 (a MEK inhibitor) alone and in combination were assessed in 3 NSCLC cell lines. PIK3CA was mutated in 5.17% of NSCLC patients. GDC-0941 and GDC-0980 treatment induced anti-proliferative and pro-apoptotic responses across all NSCLC cell lines, while GDC-0973 treatment induced only anti-proliferative responses. GDC-0980 and GDC-0973 combined treatment led to significant increases in apoptosis and synergistic reductions in proliferation across the panel of cell lines. This study found that the PI3K/MEK co-targeted inhibition strategy is synergistic in all 3 molecular subtypes of NSCLC investigated. Consequently, we would advocate clinical trials for NSCLC patients combining GDC-0980 and GDC-0973, each of which are separately under clinical investigation currently.
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Affiliation(s)
- Susan Heavey
- Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sinead Cuffe
- Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Stephen Finn
- Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Vincent Young
- Department of Cardiothoracic Surgery, St. James's Hospital, Dublin, Ireland
| | - Ronan Ryan
- Department of Cardiothoracic Surgery, St. James's Hospital, Dublin, Ireland
| | | | - Niamh Leonard
- Department of Histopathology, St James Hospital, Dublin, Ireland
| | - Niall McVeigh
- Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Martin Barr
- Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Kenneth O'Byrne
- Cancer and Ageing Research Program, Institute of Health and Biomedical Innovation at the Translational Research Institute (TRI), Queensland University of Technology, Brisbane, Australia
| | - Kathy Gately
- Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
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41
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Heavey S, Dowling P, Moore G, Barr MP, Kelly N, Maher SG, Cuffe S, Finn SP, O'Byrne KJ, Gately K. Development and characterisation of a panel of phosphatidylinositide 3-kinase - mammalian target of rapamycin inhibitor resistant lung cancer cell lines. Sci Rep 2018; 8:1652. [PMID: 29374181 PMCID: PMC5786033 DOI: 10.1038/s41598-018-19688-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 07/13/2017] [Accepted: 01/05/2018] [Indexed: 12/19/2022] Open
Abstract
The PI3K-mTOR pathway is involved in regulating all hallmarks of cancer, and is often dysregulated in NSCLC, making it an attractive therapeutic target in this setting. Acquired resistance to PI3K-mTOR inhibition is a major hurdle to overcome in the success of PI3K-mTOR targeted agents. H460, A549, and H1975 resistant cells were generated by prolonged treatment in culture with Apitolisib (GDC-0980), a dual PI3K-mTOR inhibitor over a period of several months, from age-matched parent cells. Resistance was deemed to have developed when a log fold difference in IC50 had been achieved. Resistant cell lines also exhibited resistance to another widely investigated PI3K-mTOR dual inhibitor; Dactolisib (BEZ235). Cell lines were characterised at the level of mRNA (expression array profiling expression of >150 genes), miRNA (expression array profiling of 2100 miRNAs), protein (bottoms-up label-free mass spectrometry) and phosphoprotein (expression array profiling of 84 phospho/total proteins). Key alterations were validated by qPCR and Western blot. H1975 cells were initially most sensitive to Apitolisib (GDC-0980), but developed resistance more quickly than the other cell lines, perhaps due to increased selective pressure from the impressive initial effect. In-depth molecular profiling suggested epithelial-mesenchymal transition (EMT) may play a role in resistance to PI3K-mTOR dual inhibition in NSCLC.
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Affiliation(s)
- Susan Heavey
- Thoracic Oncology Research Group, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland.
| | | | - Gillian Moore
- Thoracic Oncology Research Group, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | - Martin P Barr
- Thoracic Oncology Research Group, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | - Niamh Kelly
- Thoracic Oncology Research Group, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | - Stephen G Maher
- Department of Surgery, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | - Sinead Cuffe
- Thoracic Oncology Research Group, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | - Stephen P Finn
- Thoracic Oncology Research Group, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | | | - Kathy Gately
- Thoracic Oncology Research Group, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
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MacDonagh L, Gray S, Cuffe S, Finn S, Nicholson S, Ryan R, Young V, Leonard N, O’Byrne K, Barr M. In with the old! Repurposing disulfiram to target cancer stem cells (CSCs) and the root of cisplatin resistance. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30031-x] [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]
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43
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Elbai S, Cuffe S, Finn S, Gately K. Tracking the molecular evolution of drug resistance to PI3K/mTOR inhibition in NSCLC. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30035-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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44
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MacDonagh L, Gray S, Gallagher M, French B, Gasch C, Young V, Ryan R, Nicholson S, Leonard N, Finn S, Cuffe S, O’Byrne K, Barr M. Big applications for a microRNA signature: the diagnostic, prognostic and predictive biomarker potential of a novel 5-miR signature associated with cisplatin resistant NSCLC. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30037-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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45
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Moore G, Heavey S, O’Byrne K, Cuffe S, Finn S, O’Neill M, Gately K. Activated cMyc/PIM kinase promotes resistance to PI3K/mTOR inhibition in NSCLC. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30030-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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46
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MacDonagh L, Gray S, Gallagher M, French B, Gasch C, Finn S, Cuffe S, O’Byrne K, Barr M. Is miR-34a the micromanager of cancer stemness and resistance in NSCLC? Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30027-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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47
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MacDonagh L, Gray S, Cuffe S, Finn S, O’Byrne K, Barr M. BBI608, a small molecule stemness inhibitor, packs a big punch against cisplatin resistant NSCLC. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30029-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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48
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Brahmer JR, Rodríguez-Abreu D, Robinson AG, Hui R, Csőszi T, Fülöp A, Gottfried M, Peled N, Tafreshi A, Cuffe S, O'Brien M, Rao S, Hotta K, Zhang J, Lubiniecki GM, Deitz AC, Rangwala R, Reck M. Health-related quality-of-life results for pembrolizumab versus chemotherapy in advanced, PD-L1-positive NSCLC (KEYNOTE-024): a multicentre, international, randomised, open-label phase 3 trial. Lancet Oncol 2017; 18:1600-1609. [DOI: 10.1016/s1470-2045(17)30690-3] [Citation(s) in RCA: 222] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/10/2017] [Accepted: 08/14/2017] [Indexed: 12/23/2022]
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49
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Donagh LM, Gray S, Finn S, Cuffe S, O’Byrne K, Barr M. P1.03-042 BBI608, a Small Molecule Stemness Inhibitor, Circumvents Cisplatin Resistance in NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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50
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Barr M, Pidgeon G, Gray S, Gately K, Hams E, Fallon P, Cuffe S, Finn S, O’Byrne K. P2.02-069 Targeting Neuropilin-1 in NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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