1
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Ujjani C, Gooley TA, Spurgeon SE, Stephens DM, Lai C, Broome CM, O’Brien S, Zhu H, Laing KJ, Winter AM, Pongas G, Greninger AL, Koelle DM, Siddiqi T, Davids MS, Rogers KA, Danilov AV, Sperling A, Tu B, Sorensen T, Launchbury K, Burrow CJ, Quezada G, Hill JA, Shadman M, Thompson PA. Diminished humoral and cellular responses to SARS-CoV-2 vaccines in patients with chronic lymphocytic leukemia. Blood Adv 2023; 7:4728-4737. [PMID: 36516082 PMCID: PMC9906469 DOI: 10.1182/bloodadvances.2022009164] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/07/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022] Open
Abstract
Previous studies have demonstrated low rates of seroconversion to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients with chronic lymphocytic leukemia (CLL). In this national collaboration of 11 cancer centers in the United States, we aimed to further characterize and understand vaccine-induced immune responses, including T-cell responses, and the impact of CLL therapeutics (#NCT04852822). Eligible patients were enrolled in 2 cohorts (1) at the time of initial vaccination and (2) at the time of booster vaccination. The serologic response rates (anti-S) from 210 patients in the initial vaccination cohort and 117 in the booster vaccination cohort were 56% (95% confidence interval [CI], 50-63) and 68% (95% CI, 60-77), respectively. Compared with patients not on therapy, those receiving B-cell-directed therapy were less likely to seroconvert (odds ratio [OR], 0.27; 95% CI, 0.15-0.49). Persistence of response was observed at 6 months; anti-S titers increased with the administration of booster vaccinations. In the initial vaccination cohort, positive correlations were observed between the quantitative serologic response and CD4 T-cell response for the Wuhan variant and, to a lesser degree, for the Omicron variant (Spearman P = 0.45 Wuhan; P = 0.25 Omicron). In the booster vaccination cohort, positive correlations were observed between serologic responses and CD4 T-cell responses for both variants (P = 0.58 Wuhan; P = 0.57 Omicron) and to a lesser degree for CD8 T-cell responses (P = 0.33 Wuhan; P = 0.22 Omicron). Although no deaths from coronavirus disease 2019 (COVID-19) have been reported after booster vaccinations, patients should use caution as newer variants emerge and escape vaccine-induced immunity. This trial was registered at www.clinicaltrials.gov as #NCT04852822.
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Affiliation(s)
- Chaitra Ujjani
- Fred Hutchinson Cancer Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
| | | | | | | | - Catherine Lai
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Catherine M. Broome
- Lombardi Comprehensive Cancer Center, Medstar Georgetown University Hospital, Washington, DC
| | - Susan O’Brien
- Chao Family Comprehensive Cancer Center, University of California-Irvine, Irvine, CA
| | - Haiying Zhu
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Kerry J. Laing
- Department of Medicine, University of Washington, Seattle, WA
| | | | - Georgios Pongas
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - Alexander L Greninger
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - David M. Koelle
- Fred Hutchinson Cancer Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
- Department of Global Health, University of Washington, Seattle, WA
- Benaroya Research Institute, Seattle, WA
| | | | | | - Kerry A. Rogers
- The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | | | | | - Brian Tu
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | | | | | | | | | - Joshua A. Hill
- Fred Hutchinson Cancer Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
| | - Mazyar Shadman
- Fred Hutchinson Cancer Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
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2
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Banerjee T, Newman M, Chen A, Maziarz RT, Schachter L, Spurgeon SE, Vallurupalli A. A retrospective single-center analysis of CD-19 directed CAR T-cell therapy in relapsed/refractory mantle cell lymphoma. Leuk Lymphoma 2023; 64:1472-1475. [PMID: 37287113 DOI: 10.1080/10428194.2023.2212098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 06/09/2023]
Affiliation(s)
- Titas Banerjee
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Matthew Newman
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Andy Chen
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Richard T Maziarz
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Levanto Schachter
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Stephen E Spurgeon
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Anusha Vallurupalli
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
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3
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Agrawal P, David KA, Chen Z, Sundaram S, Kim SH, Vaca R, Lin Y, Singer S, Malecek MK, Carter J, Zayac A, Kim MS, Reddy N, Ney D, Habib A, Strouse C, Graber J, Bachanova V, Salman S, Vendiola JA, Hossain N, Tsang M, Major A, Gandhi MK, Keane C, Bond DA, Folstad M, Chang J, Mier-Hicks A, Torka P, Rajakumar P, Venugopal P, Berg S, Glantz M, Goldlust SA, Matnani R, Kumar P, Ollila TA, Cai J, Spurgeon SE, Sieg AG, Cleveland J, Epperla N, Karmali R, Naik S, Smith SM, Rubenstein JL, Kahl BS, Chadburn A, Evens AM, Martin P. EBV-positive PCNSL in older patients: incidence, characteristics, tumor pathology, and outcomes across a large multicenter cohort. Leuk Lymphoma 2023:1-9. [PMID: 36960939 DOI: 10.1080/10428194.2023.2191152] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
The objective of this multicenter retrospective study was to examine the incidence, patient characteristics, pathology, and outcomes associated with Epstein-Barr virus (EBV)-related CNS lymphoma (CNSL) in older patients. Among 309 CNSL patients aged ≥60, 11.7% had EBV + tumors of which 72.2% were solid organ transplant (SOT)-related post-transplant lymphoproliferative disorders (PTLD). Younger age, SOT or autoimmune disease, and immunosuppressive treatment correlated highly with EBV-positivity. EBV + tumors were associated with absent C-MYC and BCL6 expression. EBV + PTLD was more likely to be associated with the absence of CD5 expression. EBV + non-PTLD had better median OS (not reached) compared to EBV + PTLD (10.8 months) and EBV-negative patients (43 months). Multivariable Cox regression analysis showed that age, performance status, and PTLD were negative predictors of OS. EBV status and immunosuppressive treatment were not correlated with OS. Our findings merit further investigation of EBV + PCNSL tumors and EBV-directed therapies.
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Affiliation(s)
- Prashasti Agrawal
- Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| | - Kevin A David
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Zhengming Chen
- Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| | | | - Seo-Hyun Kim
- Department of Internal Medicine, Division of Hematology, Oncology and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Ryan Vaca
- Department of Medicine, Penn State University College of Medicine, Hershey, PA, USA
| | - Yong Lin
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | - Mary-Kate Malecek
- Department of Medicine, Division of Hematology & Oncology, Washington University School of Medicine, University City, MO, USA
| | - Jordan Carter
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Adam Zayac
- Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA
| | - Myung Sun Kim
- Department of Internal Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Nishitha Reddy
- Department of Medicine, Division of Hematology & Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Douglas Ney
- Department of Neurology, University of Colorado, Aurora, CO, USA
| | - Alma Habib
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | | | - Jerome Graber
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Veronika Bachanova
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - Sidra Salman
- Department of Medicine and Cancer Biology, Loyola University, Chicago, IL, USA
| | - Jean A Vendiola
- Department of Medicine and Cancer Biology, Loyola University, Chicago, IL, USA
| | - Nasheed Hossain
- Department of Medicine and Cancer Biology, Loyola University, Chicago, IL, USA
| | - Mazie Tsang
- Department of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Ajay Major
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
| | | | - Colm Keane
- Princess Alexandria Hospital, Brisbane, Australia
| | - David A Bond
- Department of Medicine, Division of Hematology, The Ohio State University, Columbus, OH, USA
| | - Matthew Folstad
- Department of Medicine, Division of Hematology, Oncology and Palliative Care, University of Wisconsin, Madison, WI, USA
| | - Julie Chang
- Department of Medicine, Division of Hematology, Oncology and Palliative Care, University of Wisconsin, Madison, WI, USA
| | | | - Pallawi Torka
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Priya Rajakumar
- Department of Internal Medicine, Division of Hematology, Oncology and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Parameswaran Venugopal
- Department of Internal Medicine, Division of Hematology, Oncology and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Stephanie Berg
- Department of Medicine and Cancer Biology, Loyola University, Chicago, IL, USA
| | - Michael Glantz
- Department of Medicine, Penn State University College of Medicine, Hershey, PA, USA
| | | | - Rahul Matnani
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Pallavi Kumar
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Thomas A Ollila
- Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA
| | - Johnny Cai
- Department of Internal Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Stephen E Spurgeon
- Department of Internal Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Alex G Sieg
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Joseph Cleveland
- Department of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Narendranath Epperla
- Department of Medicine, Division of Hematology, The Ohio State University, Columbus, OH, USA
| | - Reem Karmali
- Division of Hematology Oncology, Northwestern University, Chicago, IL, USA
| | - Seema Naik
- Department of Medicine, Penn State University College of Medicine, Hershey, PA, USA
| | - Sonali M Smith
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
| | - James L Rubenstein
- Department of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Brad S Kahl
- Department of Medicine, Division of Hematology & Oncology, Washington University School of Medicine, University City, MO, USA
| | - Amy Chadburn
- Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| | - Andrew M Evens
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Peter Martin
- Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
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4
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Kim MS, Banerjee T, Chen A, Danilov A, MacKinnon R, Thurlow B, Thakurta S, Orand K, Degnin C, Park B, Spurgeon SE. A phase II study of obinutuzumab in combination with ibrutinib for treatment of relapsed mantle cell lymphoma. Leuk Lymphoma 2023; 64:722-724. [PMID: 35263204 DOI: 10.1080/10428194.2022.2045598] [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: 10/18/2022]
Affiliation(s)
- Myung Sun Kim
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Titas Banerjee
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Andy Chen
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | | | - Renee MacKinnon
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Bria Thurlow
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Sujata Thakurta
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Kirsten Orand
- City of Hope National Medical Center, Duarte, CA, USA
| | - Catherine Degnin
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Byung Park
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Stephen E Spurgeon
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
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5
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LeBlanc FR, Hasanali ZS, Stuart A, Shimko S, Sharma K, Leshchenko VV, Parekh S, Fu H, Zhang Y, Martin MM, Kester M, Fox T, Liao J, Loughran TP, Evans J, Pu JJ, Spurgeon SE, Aladjem MI, Epner EM. Combined epigenetic and immunotherapy for blastic and classical mantle cell lymphoma. Oncotarget 2022; 13:986-1002. [PMID: 36093297 PMCID: PMC9450988 DOI: 10.18632/oncotarget.28258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/01/2022] [Indexed: 11/30/2022] Open
Abstract
Classical MCL (cMCL) constitutes 6-8% of all B cell NHL. Despite recent advances, MCL is incurable except with allogeneic stem cell transplant. Blastic mantle cell lymphoma (bMCL) is a rarer subtype of cMCL associated with an aggressive clinical course and poor treatment response, frequent relapse and poor outcomes. We treated 13 bMCL patients with combined epigenetic and immunotherapy treatment consisting of vorinostat, cladribine and rituximab (SCR). We report an increased OS greater than 40 months with several patients maintaining durable remissions without relapse for longer than 5 years. This is remarkably better then current treatment regimens which in bMCL range from 14.5-24 months with conventional chemotherapy regimens. We demonstrate that the G/A870 CCND1 polymorphism is predictive of blastic disease, nuclear localization of cyclinD1 and response to SCR therapy. The major resistance mechanisms to SCR therapy are loss of CD20 expression and evasion of treatment by sanctuary in the CNS. These data indicate that administration of epigenetic agents improves efficacy of anti-CD20 immunotherapies. This approach is promising in the treatment of MCL and potentially other previously treatment refractory cancers.
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Affiliation(s)
- Francis R. LeBlanc
- 1Department of Medicine, Pennsylvania State University College of Medicine and Penn State Hershey Cancer Institute, Hershey, PA 17033, USA,*Co-first authors,Correspondence to:Francis R. LeBlanc, email:
| | - Zainul S. Hasanali
- 1Department of Medicine, Pennsylvania State University College of Medicine and Penn State Hershey Cancer Institute, Hershey, PA 17033, USA,*Co-first authors
| | - August Stuart
- 2Department of Hematology/Oncology, Penn State Hershey Cancer Institute, Hershey, PA 17033, USA
| | - Sara Shimko
- 2Department of Hematology/Oncology, Penn State Hershey Cancer Institute, Hershey, PA 17033, USA
| | - Kamal Sharma
- 3BayCare Medical Group, Cassidy Cancer Center, Winter Haven, FL 33881, USA
| | - Violetta V. Leshchenko
- 4Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Samir Parekh
- 4Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Haiqing Fu
- 5Developmental Therapeutics Branch, Center for Cancer Research, NCI, NIH, Bethesda, MD 20892, USA
| | - Ya Zhang
- 5Developmental Therapeutics Branch, Center for Cancer Research, NCI, NIH, Bethesda, MD 20892, USA
| | - Melvenia M. Martin
- 5Developmental Therapeutics Branch, Center for Cancer Research, NCI, NIH, Bethesda, MD 20892, USA
| | - Mark Kester
- 6Department of Pharmacology, University of Virginia, Charlottesville, VA 22908, USA
| | - Todd Fox
- 6Department of Pharmacology, University of Virginia, Charlottesville, VA 22908, USA
| | - Jiangang Liao
- 7Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA
| | - Thomas P. Loughran
- 8Department of Medicine/Hematology-Oncology, UVA Cancer Center, Charlottesville, VA 22908, USA
| | - Juanita Evans
- 9Department of Anatomic Pathology, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA
| | - Jeffrey J. Pu
- 10Department of Medicine and Cancer Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA
| | - Stephen E. Spurgeon
- 11Department of Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Mirit I. Aladjem
- 5Developmental Therapeutics Branch, Center for Cancer Research, NCI, NIH, Bethesda, MD 20892, USA
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6
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Bottomly D, Long N, Schultz AR, Kurtz SE, Tognon CE, Johnson K, Abel M, Agarwal A, Avaylon S, Benton E, Blucher A, Borate U, Braun TP, Brown J, Bryant J, Burke R, Carlos A, Chang BH, Cho HJ, Christy S, Coblentz C, Cohen AM, d'Almeida A, Cook R, Danilov A, Dao KHT, Degnin M, Dibb J, Eide CA, English I, Hagler S, Harrelson H, Henson R, Ho H, Joshi SK, Junio B, Kaempf A, Kosaka Y, Laderas T, Lawhead M, Lee H, Leonard JT, Lin C, Lind EF, Liu SQ, Lo P, Loriaux MM, Luty S, Maxson JE, Macey T, Martinez J, Minnier J, Monteblanco A, Mori M, Morrow Q, Nelson D, Ramsdill J, Rofelty A, Rogers A, Romine KA, Ryabinin P, Saultz JN, Sampson DA, Savage SL, Schuff R, Searles R, Smith RL, Spurgeon SE, Sweeney T, Swords RT, Thapa A, Thiel-Klare K, Traer E, Wagner J, Wilmot B, Wolf J, Wu G, Yates A, Zhang H, Cogle CR, Collins RH, Deininger MW, Hourigan CS, Jordan CT, Lin TL, Martinez ME, Pallapati RR, Pollyea DA, Pomicter AD, Watts JM, Weir SJ, Druker BJ, McWeeney SK, Tyner JW. Integrative analysis of drug response and clinical outcome in acute myeloid leukemia. Cancer Cell 2022; 40:850-864.e9. [PMID: 35868306 PMCID: PMC9378589 DOI: 10.1016/j.ccell.2022.07.002] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/30/2022] [Accepted: 06/30/2022] [Indexed: 12/17/2022]
Abstract
Acute myeloid leukemia (AML) is a cancer of myeloid-lineage cells with limited therapeutic options. We previously combined ex vivo drug sensitivity with genomic, transcriptomic, and clinical annotations for a large cohort of AML patients, which facilitated discovery of functional genomic correlates. Here, we present a dataset that has been harmonized with our initial report to yield a cumulative cohort of 805 patients (942 specimens). We show strong cross-cohort concordance and identify features of drug response. Further, deconvoluting transcriptomic data shows that drug sensitivity is governed broadly by AML cell differentiation state, sometimes conditionally affecting other correlates of response. Finally, modeling of clinical outcome reveals a single gene, PEAR1, to be among the strongest predictors of patient survival, especially for young patients. Collectively, this report expands a large functional genomic resource, offers avenues for mechanistic exploration and drug development, and reveals tools for predicting outcome in AML.
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Affiliation(s)
- Daniel Bottomly
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Nicola Long
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Anna Reister Schultz
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Stephen E Kurtz
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Cristina E Tognon
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Kara Johnson
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Melissa Abel
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Anupriya Agarwal
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA; Department of Molecular & Medical Genetics, Oregon Health & Science University, Portland, OR 97239, USA; Division of Oncologic Sciences, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Sammantha Avaylon
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Erik Benton
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Aurora Blucher
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Uma Borate
- Division of Hematology, Department of Internal Medicine, James Cancer Center, Ohio State University, Columbus, OH 43210, USA
| | - Theodore P Braun
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Jordana Brown
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Jade Bryant
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Russell Burke
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Amy Carlos
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Integrated Genomics Laboratory, Oregon Health & Science University, Portland, OR 97239, USA
| | - Bill H Chang
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology and Oncology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| | - Hyun Jun Cho
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Stephen Christy
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Cody Coblentz
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Aaron M Cohen
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Amanda d'Almeida
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rachel Cook
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Alexey Danilov
- Department of Hematology and Hematopoietic Stem Cell Transplant, City of Hope National Medical Center, Duarte, CA 91010, USA
| | | | - Michie Degnin
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - James Dibb
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Christopher A Eide
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Isabel English
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Stuart Hagler
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Heath Harrelson
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rachel Henson
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Integrated Genomics Laboratory, Oregon Health & Science University, Portland, OR 97239, USA
| | - Hibery Ho
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Sunil K Joshi
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Brian Junio
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Andy Kaempf
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Biostatistics Shared Resource, Oregon Health & Science University, Portland, OR 97239, USA
| | - Yoko Kosaka
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland, OR 97239, USA
| | | | - Matt Lawhead
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Hyunjung Lee
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Jessica T Leonard
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Chenwei Lin
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Integrated Genomics Laboratory, Oregon Health & Science University, Portland, OR 97239, USA
| | - Evan F Lind
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Selina Qiuying Liu
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Pierrette Lo
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Marc M Loriaux
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Pathology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Samuel Luty
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Julia E Maxson
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Oncologic Sciences, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Tara Macey
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Jacqueline Martinez
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Jessica Minnier
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Biostatistics Shared Resource, Oregon Health & Science University, Portland, OR 97239, USA; OHSU-PSU School of Public Health, VA Portland Health Care System, Oregon Health & Science University, Portland, OR 97239, USA
| | - Andrea Monteblanco
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Motomi Mori
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Quinlan Morrow
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Dylan Nelson
- High-Throughput Screening Services Laboratory, Oregon State University, Corvallis, OR 97331, USA
| | - Justin Ramsdill
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Angela Rofelty
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Alexandra Rogers
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Kyle A Romine
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Peter Ryabinin
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Jennifer N Saultz
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - David A Sampson
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Samantha L Savage
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | | | - Robert Searles
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Integrated Genomics Laboratory, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rebecca L Smith
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Stephen E Spurgeon
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Tyler Sweeney
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Ronan T Swords
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Aashis Thapa
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Karina Thiel-Klare
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Elie Traer
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Jake Wagner
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Beth Wilmot
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Joelle Wolf
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Guanming Wu
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Amy Yates
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Haijiao Zhang
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Oncologic Sciences, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Christopher R Cogle
- Department of Medicine, Division of Hematology and Oncology, University of Florida, Gainesville, FL 32610, USA
| | - Robert H Collins
- Department of Internal Medicine/ Hematology Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390-8565, USA
| | - Michael W Deininger
- Division of Hematology & Hematologic Malignancies, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Christopher S Hourigan
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20814-1476, USA
| | - Craig T Jordan
- Division of Hematology, University of Colorado, Denver, CO 80045, USA
| | - Tara L Lin
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas, Kansas City, KS 66205, USA
| | - Micaela E Martinez
- Clinical Research Services, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL 33136, USA
| | - Rachel R Pallapati
- Clinical Research Services, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL 33136, USA
| | - Daniel A Pollyea
- Division of Hematology, University of Colorado, Denver, CO 80045, USA
| | - Anthony D Pomicter
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Justin M Watts
- Division of Hematology, Department of Medicine, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL 33136, USA
| | - Scott J Weir
- Department of Cancer Biology, Division of Medical Oncology, Department of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Brian J Druker
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Shannon K McWeeney
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Jeffrey W Tyner
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA.
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Barr PM, Smith SD, Roschewski MJ, O'Brien SM, Sharman JP, Melear JM, Patel P, Calvo R, Yang H, Spurgeon SE. Phase 1/2 study of acalabrutinib and the PI3K delta inhibitor ACP-319 in relapsed/refractory B-cell Non-Hodgkin lymphoma. Leuk Lymphoma 2022; 63:1728-1732. [PMID: 35200084 DOI: 10.1080/10428194.2022.2043301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Paul M Barr
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Stephen D Smith
- University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Susan M O'Brien
- Chao Family Comprehensive Cancer Center, University of California-Irvine, Irvine, CA, USA
| | - Jeff P Sharman
- Willamette Valley Cancer Institute and Research Center, US Oncology Research, Eugene, OR, USA
| | | | | | | | - Helen Yang
- AstraZeneca, South San Francisco, CA, USA
| | - Stephen E Spurgeon
- Knight Cancer Institute, Oregon Health and Sciences University, Portland, OR, USA
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8
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Wang ML, Jurczak W, Jerkeman M, Trotman J, Zinzani PL, Belada D, Boccomini C, Flinn IW, Giri P, Goy A, Hamlin PA, Hermine O, Hernández-Rivas JÁ, Hong X, Kim SJ, Lewis D, Mishima Y, Özcan M, Perini GF, Pocock C, Song Y, Spurgeon SE, Storring JM, Walewski J, Zhu J, Qin R, Henninger T, Deshpande S, Howes A, Le Gouill S, Dreyling M. Ibrutinib plus Bendamustine and Rituximab in Untreated Mantle-Cell Lymphoma. N Engl J Med 2022; 386:2482-2494. [PMID: 35657079 DOI: 10.1056/nejmoa2201817] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Ibrutinib, a Bruton's tyrosine kinase inhibitor, may have clinical benefit when administered in combination with bendamustine and rituximab and followed by rituximab maintenance therapy in older patients with untreated mantle-cell lymphoma. METHODS We randomly assigned patients 65 years of age or older to receive ibrutinib (560 mg, administered orally once daily until disease progression or unacceptable toxic effects) or placebo, plus six cycles of bendamustine (90 mg per square meter of body-surface area) and rituximab (375 mg per square meter). Patients with an objective response (complete or partial response) received rituximab maintenance therapy, administered every 8 weeks for up to 12 additional doses. The primary end point was progression-free survival as assessed by the investigators. Overall survival and safety were also assessed. RESULTS Among 523 patients, 261 were randomly assigned to receive ibrutinib and 262 to receive placebo. At a median follow-up of 84.7 months, the median progression-free survival was 80.6 months in the ibrutinib group and 52.9 months in the placebo group (hazard ratio for disease progression or death, 0.75; 95% confidence interval, 0.59 to 0.96; P = 0.01). The percentage of patients with a complete response was 65.5% in the ibrutinib group and 57.6% in the placebo group (P = 0.06). Overall survival was similar in the two groups. The incidence of grade 3 or 4 adverse events during treatment was 81.5% in the ibrutinib group and 77.3% in the placebo group. CONCLUSIONS Ibrutinib treatment in combination with standard chemoimmunotherapy significantly prolonged progression-free survival. The safety profile of the combined therapy was consistent with the known profiles of the individual drugs. (Funded by Janssen Research and Development and Pharmacyclics; SHINE ClinicalTrials.gov number, NCT01776840.).
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Affiliation(s)
- Michael L Wang
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Wojciech Jurczak
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Mats Jerkeman
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Judith Trotman
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Pier L Zinzani
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - David Belada
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Carola Boccomini
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Ian W Flinn
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Pratyush Giri
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Andre Goy
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Paul A Hamlin
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Olivier Hermine
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - José-Ángel Hernández-Rivas
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Xiaonan Hong
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Seok Jin Kim
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - David Lewis
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Yuko Mishima
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Muhit Özcan
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Guilherme F Perini
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Christopher Pocock
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Yuqin Song
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Stephen E Spurgeon
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - John M Storring
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Jan Walewski
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Jun Zhu
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Rui Qin
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Todd Henninger
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Sanjay Deshpande
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Angela Howes
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Steven Le Gouill
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
| | - Martin Dreyling
- From the University of Texas M.D. Anderson Cancer Center, Houston (M.L.W.); Maria Sklodowska-Curie National Research Institute of Oncology, Kraków (W.J.), and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw (J.W.) - both in Poland; Skane University Hospital and Lund University, Lund, Sweden (M.J.); Concord Repatriation General Hospital, University of Sydney, Sydney (J.T.), and Royal Adelaide Hospital, Adelaide, SA (P.G.) - both in Australia; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), and SC Ematologia, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin (C.B.) - both in Italy; the Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic (D.B.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (I.W.F.); John Theurer Cancer Center, Hackensack (A.G.), and Janssen Research and Development, Raritan (R.Q., T.H., S.D., A.H.) - both in New Jersey; Memorial Sloan Kettering Cancer Center, New York (P.A.H.); the Department of Hematology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris and Institut Imagine, Université de Paris, INSERM Unité Mixte de Recherche 1183 (O.H.), and Institut Curie Comprehensive Cancer Center (S.L.G.), Paris, and Hospitalier Universitaire de Nantes, Centre de Recherche en Cancérologie et Immunologie Nantes Angers, INSERM, Université de Nantes, Nantes (S.L.G.) - all in France; the Department of Hematology, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid (J.-Á.H.-R.); Fudan University Shanghai Cancer Center, Shanghai (X.H.), and Key Laboratory of Carcinogenesis and Translational Research, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing (Y.S., J.Z.) - both in China; the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); University Hospitals Plymouth NHS Trust, Plymouth (D.L.), and Kent and Canterbury Hospital, Canterbury (C.P.) - both in the United Kingdom; the Department of Hematology-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo (Y.M.); Ankara University School of Medicine, Ankara, Turkey (M.Ö.); Hospital Israelita Albert Einstein, São Paulo (G.F.P.); the Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland (S.E.S.); the Research Institute of the McGill University Health Centre, McGill University, Montreal (J.M.S.); and Klinikum der Universität München, Ludwig Maximilian University of Munich, Munich, Germany (M.D.)
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Orellana-Noia VM, Reed DR, McCook AA, Sen JM, Barlow CM, Malecek MK, Watkins M, Kahl BS, Spinner MA, Advani R, Voorhees TJ, Snow A, Grover NS, Ayers A, Romancik J, Liu Y, Huntington SF, Chavez JC, Saeed H, Lazaryan A, Raghunathan V, Spurgeon SE, Ollila TA, Del Prete C, Olszewski A, Ayers EC, Landsburg DJ, Echalier B, Lee J, Kamdar M, Caimi PF, Fu T, Liu J, David KA, Alharthy H, Law J, Karmali R, Shah H, Stephens DM, Major A, Rojek AE, Smith SM, Yellala A, Kallam A, Nakhoda S, Khan N, Sohail MA, Hill BT, Barrett-Campbell O, Lansigan F, Switchenko J, Cohen J, Portell CA. Single-route CNS prophylaxis for aggressive non-Hodgkin lymphomas: real-world outcomes from 21 US academic institutions. Blood 2022; 139:413-423. [PMID: 34570876 PMCID: PMC8777199 DOI: 10.1182/blood.2021012888] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/05/2021] [Indexed: 01/22/2023] Open
Abstract
Prophylaxis is commonly used to prevent central nervous sy stem (CNS) relapse in diffuse large B-cell lymphoma (DLBCL), with no clear standard of care. We retrospectively evaluated 1162 adult patients across 21 US academic centers with DLBCL or similar histologies who received single-route CNS prophylaxis as part of frontline therapy between 2013 and 2019. Prophylaxis was administered intrathecally(IT) in 894 (77%) and using systemic high-dose methotrexate (HD-MTX) in 236 (20%); 32 patients (3%) switched route due to toxicity and were assessed separately. By CNS-International Prognostic Index (IPI), 18% were considered low-risk, 51% moderate, and 30% high. Double-hit lymphoma (DHL) was confirmed in 243 of 866 evaluable patients (21%). Sixty-four patients (5.7%) had CNS relapse after median 7.1 months from diagnosis, including 15 of 64 (23%) within the first 6 months. There was no significant difference in CNS relapse between IT and HD-MTX recipients (5.4% vs 6.8%, P = .4), including after propensity score matching to account for differences between respective recipient groups. Weighting by CNS-IPI, expected vs observed CNS relapse rates were nearly identical (5.8% vs 5.7%). Testicular involvement was associated with high risk of CNS relapse (11.3%) despite most having lower CNS-IPI scores. DHL did not significantly predict for CNS relapse after single-route prophylaxis, including with adjustment for treatment regimen and other factors. This large study of CNS prophylaxis recipients with DLBCL found no significant difference in CNS relapse rates between routes of administration. Relapse rates among high-risk subgroups remain elevated, and reconsideration of prophylaxis strategies in DLBCL is of critical need.
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Affiliation(s)
- Victor Manuel Orellana-Noia
- Winship Cancer Institute, Department of Hematology and Medical Oncology, Emory University, Atlanta, GA
- Division of Hematology/Oncology, University of Virginia, Charlottesville, VA
| | - Daniel R Reed
- Division of Hematology/Oncology, University of Virginia, Charlottesville, VA
- Comprehensive Cancer Center of Wake Forest University, Section on Hematology and Oncology, Winston-Salem, NC
| | - Ashley Alesia McCook
- Winship Cancer Institute, Department of Biostatistics, Emory University, Atlanta, GA
| | | | - Christian M Barlow
- Division of Hematology/Oncology, University of Virginia, Charlottesville, VA
| | - Mary-Kate Malecek
- Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Marcus Watkins
- Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Brad S Kahl
- Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Michael A Spinner
- Division of Oncology, Stanford University Medical Center, Stanford, CA
| | - Ranjana Advani
- Division of Oncology, Stanford University Medical Center, Stanford, CA
| | - Timothy J Voorhees
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
- Division of Hematology, Ohio State University, Columbus, OH
| | - Anson Snow
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Natalie Sophia Grover
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Amy Ayers
- Winship Cancer Institute, Department of Hematology and Medical Oncology, Emory University, Atlanta, GA
| | - Jason Romancik
- Winship Cancer Institute, Department of Hematology and Medical Oncology, Emory University, Atlanta, GA
| | - Yuxin Liu
- Division of Hematology, Yale University, New Haven, CT
| | | | - Julio C Chavez
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL
| | - Hayder Saeed
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL
| | | | - Vikram Raghunathan
- Division of Hematology and Oncology, Oregon Health Sciences University, Portland, OR
- Division of Medical Oncology, University of Washington, Seattle, WA
| | - Stephen E Spurgeon
- Division of Hematology and Oncology, Oregon Health Sciences University, Portland, OR
| | - Thomas A Ollila
- Division of Hematology/Oncology, Brown University, Providence, RI
| | | | - Adam Olszewski
- Division of Hematology/Oncology, Brown University, Providence, RI
| | - Emily C Ayers
- Division of Hematology/Oncology, University of Virginia, Charlottesville, VA
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Daniel J Landsburg
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | | | - Jun Lee
- Division of Hematology, University of Colorado, Denver, CO
| | - Manali Kamdar
- Division of Hematology, University of Colorado, Denver, CO
| | - Paolo F Caimi
- Adult Hematologic Malignancies and Stem Cell Transplant Section, University Hospitals Seidman Cancer Center, Cleveland, OH
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Timothy Fu
- Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ
| | - Jieqi Liu
- Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ
| | - Kevin A David
- Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ
| | - Hanan Alharthy
- Department of Medicine, University of Maryland Medical Center, Baltimore, MD
| | - Jennie Law
- Division of Hematology and Oncology, University of Maryland Greenbaum Comprehensive Cancer Center, Baltimore, MD
| | - Reem Karmali
- Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL
| | - Harsh Shah
- University of Utah/Huntsman Cancer Institute, Salt Lake City, UT
| | | | - Ajay Major
- Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | | | - Sonali M Smith
- Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | - Amulya Yellala
- Department of Hematology and Oncology, University of Nebraska Medical Center, Omaha, NE
| | - Avyakta Kallam
- Department of Hematology and Oncology, University of Nebraska Medical Center, Omaha, NE
| | | | - Nadia Khan
- Fox Chase Cancer Center, Philadelphia, PA; and
| | - Mohammad Ahsan Sohail
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Brian T Hill
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH
| | | | - Frederick Lansigan
- Division of Hematology and Oncology, Dartmouth Geisel School of Medicine, Hanover, NH
| | - Jeffrey Switchenko
- Winship Cancer Institute, Department of Biostatistics, Emory University, Atlanta, GA
| | - Jonathon Cohen
- Winship Cancer Institute, Department of Hematology and Medical Oncology, Emory University, Atlanta, GA
| | - Craig A Portell
- Division of Hematology/Oncology, University of Virginia, Charlottesville, VA
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Wang ML, Barrientos JC, Furman RR, Mei M, Barr PM, Choi MY, de Vos S, Kallam A, Patel K, Kipps TJ, Rule S, Flanders K, Jessen KA, Ren H, Riebling PC, Graham P, King L, Thurston AW, Sun M, Schmidt EM, Lannutti BJ, Johnson DM, Miller LL, Spurgeon SE. Zilovertamab Vedotin Targeting of ROR1 as Therapy for Lymphoid Cancers. NEJM Evid 2022; 1:EVIDoa2100001. [PMID: 38319241 DOI: 10.1056/evidoa2100001] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Zilovertamab Vedotin Targeting of ROR1 as Therapy for Lymphoid Cancers In a Phase 1 trial, patients with refractory lymphoid cancers, an antibody-drug complex directed against ROR1 had no unexpected toxicities. About half of the patients with mantle cell lymphoma and diffuse large B-cell lymphoma had clinically meaningful responses.
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Affiliation(s)
| | | | | | | | | | | | - Sven de Vos
- University of California, Los Angeles, Los Angeles
| | | | | | | | | | | | | | | | | | | | - Lydia King
- Catalyst Clinical Research, Wilmington, NC
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11
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Lyski ZL, Kim S, Lee DX, Sampson D, Raué HP, Raghunathan V, Ryan D, Brunton AE, Slifka MK, Messer WB, Spurgeon SE. Immunogenicity of Pfizer mRNA COVID-19 vaccination followed by J&J adenovirus COVID-19 vaccination in two CLL patients. medRxiv 2021:2021.09.02.21262146. [PMID: 34518841 PMCID: PMC8437317 DOI: 10.1101/2021.09.02.21262146] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
IMPORTANCE Individuals with Chronic Lymphocytic Leukemia have significant immune disfunction, often further disrupted by treatment. While currently available COVID-19 vaccinations are highly effective in immunocompetent individuals, they are often poorly immunogenic in CLL patients. It is important to understand the role heterologous boost would have in patients who did not respond to the recommended two-dose mRNA vaccine series with a SARS-CoV-2 specific immune response. OBJECTIVE To characterize the immune response of two CLL patients who failed to seroconvert after initial mRNA vaccine series following a third, heterologous, COVID-19 vaccination with Ad26.COV2.S. DESIGN Two subjects with CLL were enrolled in an IRB-approved observational longitudinal cohort study of the immune response to COVID-19 vaccination. After enrollment, they received a third vaccination with Ad26.COV2.S. Blood was drawn prior to original vaccination series, four weeks after mRNA vaccination, and again four weeks after third vaccination. SETTING Eligible subjects were approached by oncologist overseeing CLL treatment and informed about study, at time of enrollment subjects consented to join the cohort study. PARTICIPANTS Sixteen subjects enrolled in the larger CLL cohort study, of whom two subjects received a third COVID-19 vaccination and were included in this analysis. Subject 1 is CLL treatment naive, while Subject 2 is currently on active treatment. MAIN OUTCOMES AND MEASURES SARS-CoV-2 specific immune response, including plasma antibodies, memory B-cells, CD4 and CD8 T-cells were assessed prior to vaccination (baseline) as well as post vaccination series and post third dose. RESULTS Of the two subjects who received Ad26.COV2.S doses, Subject 1 seroconverted, had RBD-specific memory B-cells as well as spike-specific CD4 T-cells while Subject 2 did not. Both subjects had a spike-specific CD8 T-cell response after original mRNA vaccination series that was further boosted after third dose (Subject 1), or remained stable (Subject 2). CONCLUSIONS AND RELEVANCE The results of this study, however small, is especially promising to CLL individuals who did not seroconvert following initial mRNA vaccination series. Especially those that are treatment naive, not currently in active treatment, or who may consider vaccination before beginning active treatment.
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Affiliation(s)
- Zoe L. Lyski
- Department of Molecular Microbiology & Immunology, Oregon Health & Science University (OHSU), Portland, OR 97239, USA
| | - Sunny Kim
- Knight Cancer Institute, Oregon Health & Science University (OHSU), Portland, OR 97239, USA
| | - David Xthona Lee
- Department of Molecular Microbiology & Immunology, Oregon Health & Science University (OHSU), Portland, OR 97239, USA
| | - David Sampson
- Knight Cancer Institute, Oregon Health & Science University (OHSU), Portland, OR 97239, USA
| | - Hans P. Raué
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon, USA
| | - Vikram Raghunathan
- Knight Cancer Institute, Oregon Health & Science University (OHSU), Portland, OR 97239, USA
| | - Debbie Ryan
- Knight Cancer Institute, Oregon Health & Science University (OHSU), Portland, OR 97239, USA
| | | | - Mark K. Slifka
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon, USA
| | - William B. Messer
- Department of Molecular Microbiology & Immunology, Oregon Health & Science University (OHSU), Portland, OR 97239, USA
- OHSU-PSU School of Public Health, Portland, OR 97239, USA
- Department of Medicine, Division of Infectious Diseases, Oregon Health & Science University (OHSU), Portland, OR 97239, USA
| | - Stephen E. Spurgeon
- Knight Cancer Institute, Oregon Health & Science University (OHSU), Portland, OR 97239, USA
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12
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Kittai AS, Best S, Thurlow B, Lam V, Hashiguchi T, Goodyear S, Persky DO, Okada C, Park B, Spurgeon SE, Danilov AV. Entospletinib and obinutuzumab in patients with relapsed/refractory chronic lymphocytic leukemia and B-cell malignancies. Haematologica 2021; 106:2022-2025. [PMID: 33504141 PMCID: PMC8252925 DOI: 10.3324/haematol.2020.270298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Adam S Kittai
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | - Scott Best
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | - Bria Thurlow
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | - Vi Lam
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | - Taylor Hashiguchi
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | - Shaun Goodyear
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | | | - Craig Okada
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | - Byung Park
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | - Stephen E Spurgeon
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | - Alexey V Danilov
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR; City of Hope Comprehensive Cancer Center, Duarte, CA.
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13
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Lam V, Best S, Kittai A, Orand K, Spurgeon SE, Liu T, Danilov AV. Proapoptotic and immunomodulatory effects of SYK inhibitor entospletinib in combination with obinutuzumab in patients with chronic lymphocytic leukaemia. Br J Clin Pharmacol 2021; 88:836-841. [PMID: 34196037 DOI: 10.1111/bcp.14962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 11/28/2022] Open
Abstract
Spleen tyrosine kinase (SYK) is indispensable in B-cell receptor signalling. SYK inhibitor entospletinib demonstrated clinical efficacy in patients with chronic lymphocytic leukaemia (CLL). However, pharmacodynamic effects of SYK inhibition in CLL cells and immunomodulatory effects of B-cell receptor-signalling inhibitors in patients with CLL are poorly understood. We conducted a phase 2 trial of entospletinib in combination with obinutuzumab, an anti-CD20 antibody, in 17 patients with relapsed/refractory CLL. Pharmacodynamic analysis demonstrated that treatment with entospletinib led to rapid downmodulation of pSTAT3 and the anti-apoptotic protein MCL1 in CLL cells. Meanwhile, 6 months of combination therapy was accompanied by a reduction in interferon-γ secretion in CD4+ T-cells and a reversal of exhausted phenotype, as evidenced by downregulation of PD-1. Thus, SYK inhibition downmodulates MCL-1 and partially restores T-cell immunity in CLL. Trial registration number NCT03010358.
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Affiliation(s)
- Vi Lam
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Scott Best
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | | | - Kirsten Orand
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Stephen E Spurgeon
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Tingting Liu
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Alexey V Danilov
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA.,Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
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14
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Chopra P, Andeen NK, Spurgeon SE. Worsening Kidney Function, Proteinuria, and Hematuria in a Patient with CLL. Kidney360 2021; 2:916-917. [PMID: 35373070 PMCID: PMC8791335 DOI: 10.34067/kid.0003452020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/30/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Pavan Chopra
- Oregon Health and Science University, Portland, Oregon
| | | | - Stephen E. Spurgeon
- Oregon Health and Science University, Portland, Oregon,Knight Cancer Institute, Portland, Oregon
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15
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Khountham S, Shindiapina P, Mo X, Lachowiez C, Wiczer T, Mousa L, Rogers KA, Andritsos LA, Woyach JA, Byrd JC, Spurgeon SE, Awan FT. Natural history of noninfectious, ibrutinib-attributable adverse events in patients with chronic lymphocytic leukemia. Leuk Lymphoma 2020; 62:716-721. [PMID: 33210562 DOI: 10.1080/10428194.2020.1838508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Soun Khountham
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Polina Shindiapina
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Xiaokui Mo
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Curtis Lachowiez
- Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR, USA
| | - Tracy Wiczer
- Department of Pharmacy, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Luay Mousa
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Kerry A Rogers
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Leslie A Andritsos
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Jennifer A Woyach
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - John C Byrd
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Stephen E Spurgeon
- Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR, USA
| | - Farrukh T Awan
- Division of Hematology and Medical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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16
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Raghunathan V, Fan G, Kittai AS, Okada C, Danilov AV, Spurgeon SE. A novel somatic PLCG2 variant associated with resistance to BTK and SYK inhibition in chronic lymphocytic leukemia. Eur J Haematol 2020; 106:294-297. [PMID: 33089525 DOI: 10.1111/ejh.13538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/14/2020] [Accepted: 10/17/2020] [Indexed: 11/27/2022]
Abstract
The treatment of chronic lymphocytic leukemia (CLL) has been transformed by the use of targeted small molecules inhibiting components of the B cell receptor (BCR) signaling pathway (Haematologica, 103, 2018 and e204; Curr Hematol Malig Rep, 14, 2019, 302). Chief among these is ibrutinib, an irreversible inhibitor of Bruton tyrosine kinase (BTK), which produces deep, durable responses in CLL with good tolerability (Haematologica, 103, 2018 and e204). Though prolonged exposure to the drug can exert selective pressure on CLL cells and allow for the emergence of drug-resistant clones, primary ibrutinib treatment failure is rare (Expert Rev Hematol, 11 and 2018, 185; N Engl J Med, 370, 2014 and 2352; N Engl J Med, 373, 2015 and 25, 2425; Blood, 128, 2016 and 2199). Activating mutations in the gene PLCG2, which encodes a downstream target of BTK, appear to enable constitutive BCR signaling and have been associated with ibrutinib resistance (Int J Cancer, 146 and 2020, 85; J Clin Oncol, 35, 2017 and 1437; Blood, 126, 2015 and 61). In recent years, novel investigational agents have targeted other components of the BCR pathway. Among these is entospletinib, an orally bioavailable, selective inhibitor of splenic tyrosine kinase (SYK) (Blood, 126, 2015 and 1744), which lies upstream of the enzyme phospholipase C-gamma-2 (PLCG2). Here, we describe a patient who was found to harbor a novel somatic variant of PLCG2 and experienced a lack of treatment response to both ibrutinib and entospletinib.
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Affiliation(s)
- Vikram Raghunathan
- Division of Hematology and Oncology, Oregon Health & Science University, Portland, OR, USA
| | - Guang Fan
- Department of Pathology, Oregon Health & Science University, Portland, OR, USA
| | - Adam S Kittai
- The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH, USA
| | - Craig Okada
- Division of Hematology and Oncology, Oregon Health & Science University, Portland, OR, USA
| | - Alexey V Danilov
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Stephen E Spurgeon
- Division of Hematology and Oncology, Oregon Health & Science University, Portland, OR, USA
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17
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Fay E, Herzig D, Sharzehi K, Spurgeon SE. The First Report of Endoscopic Ultrasound-guided Intralesional Rituximab in a Patient With Mantle Cell Lymphoma Presenting With Isolated Colorectal Involvement. Clin Lymphoma Myeloma Leuk 2020; 20:e485-e487. [PMID: 32278675 DOI: 10.1016/j.clml.2020.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Emily Fay
- Department of Hematology and Oncology, Oregon Health and Science University, Portland, OR.
| | - Daniel Herzig
- Department of Gastrointestinal and General Surgery, Oregon Health and Science University, Portland, OR
| | - Kaveh Sharzehi
- Department of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, OR
| | - Stephen E Spurgeon
- Department of Hematology and Oncology, Oregon Health and Science University, Portland, OR
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18
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Spurgeon SE, Sharma K, Claxton DF, Ehmann C, Pu J, Shimko S, Stewart A, Subbiah N, Palmbach G, LeBlanc F, Latour E, Chen Y, Mori M, Hasanali Z, Epner EM. Phase 1-2 study of vorinostat (SAHA), cladribine and rituximab (SCR) in relapsed B-cell non-Hodgkin lymphoma and previously untreated mantle cell lymphoma. Br J Haematol 2019; 186:845-854. [PMID: 31177537 DOI: 10.1111/bjh.16008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 02/08/2019] [Accepted: 04/09/2019] [Indexed: 12/11/2022]
Abstract
Altered DNA methylation and histone acetylation in lymphoma provided the rationale for using vorinostat (SAHA), cladribine and rituximab (SCR) in non-Hodgkin lymphomas (NHL) in this phase 1-2 study (NCT00764517). Treatment included cladribine 5 mg/m2 intravenously (IV) (days 1-5), rituximab 375 mg/m2 IV (weekly 4× for cycle 1 and 1×/month) and vorinostat orally once daily (days 1-14) every 28 days for up to six cycles. Phase 1 included relapsed patients (n = 10) in a standard 3 + 3 dose escalation design (vorinostat: 200, 300 and 400 mg). No dose-limiting toxicities were seen. The phase 2 dose for vorinostat was 400 mg po (days 1-14). The majority of phase 2 patients had mantle cell lymphoma (MCL) (n = 57; 39 previously untreated, 10 relapsed). The primary objective was objective response rate [complete response (CR) + partial response] which was 39% (7/18) in relapsed patients and 97% (38/39) with 80% (31/39) attaining a CR in previously untreated MCL. At a median follow-up of 42 months, median progression-free survival (PFS) and overall survival (OS) for relapsed NHL were 19·5 [95% confidence interval (CI): 2·0-33·0] and 25·0 (95% CI: 12·0-45·0) months respectively. Median PFS for previously untreated MCL was 84·0 months; OS could not be estimated. Toxicities were primarily haematological.
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Affiliation(s)
- Stephen E Spurgeon
- Center for Hematologic Malignancies, Knight Cancer Institute at Oregon Health & Science University, Portland, OR, USA
| | - Kamal Sharma
- Penn State Hershey Cancer Institute, Hershey, PA, USA.,Cassidy Cancer Center, Winter Haven, FL, USA
| | | | | | - Jeffrey Pu
- Upstate Cancer Center, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Sara Shimko
- Penn State Hershey Cancer Institute, Hershey, PA, USA
| | | | - Nan Subbiah
- Center for Hematologic Malignancies, Knight Cancer Institute at Oregon Health & Science University, Portland, OR, USA
| | - Gundula Palmbach
- Center for Hematologic Malignancies, Knight Cancer Institute at Oregon Health & Science University, Portland, OR, USA
| | - Francis LeBlanc
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Emile Latour
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - YiYi Chen
- Biostatistics Shared Resource, Oregon Health and Science University, Portland, OR, USA
| | - Motomi Mori
- Biostatistics Shared Resource, Oregon Health and Science University, Portland, OR, USA
| | | | - Elliot M Epner
- Penn State Hershey Cancer Institute, Hershey, PA, USA.,Enloe Medical Center, Chico, CA, USA
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19
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Tyner JW, Tognon CE, Bottomly D, Wilmot B, Kurtz SE, Savage SL, Long N, Schultz AR, Traer E, Abel M, Agarwal A, Blucher A, Borate U, Bryant J, Burke R, Carlos A, Carpenter R, Carroll J, Chang BH, Coblentz C, d'Almeida A, Cook R, Danilov A, Dao KHT, Degnin M, Devine D, Dibb J, Edwards DK, Eide CA, English I, Glover J, Henson R, Ho H, Jemal A, Johnson K, Johnson R, Junio B, Kaempf A, Leonard J, Lin C, Liu SQ, Lo P, Loriaux MM, Luty S, Macey T, MacManiman J, Martinez J, Mori M, Nelson D, Nichols C, Peters J, Ramsdill J, Rofelty A, Schuff R, Searles R, Segerdell E, Smith RL, Spurgeon SE, Sweeney T, Thapa A, Visser C, Wagner J, Watanabe-Smith K, Werth K, Wolf J, White L, Yates A, Zhang H, Cogle CR, Collins RH, Connolly DC, Deininger MW, Drusbosky L, Hourigan CS, Jordan CT, Kropf P, Lin TL, Martinez ME, Medeiros BC, Pallapati RR, Pollyea DA, Swords RT, Watts JM, Weir SJ, Wiest DL, Winters RM, McWeeney SK, Druker BJ. Functional genomic landscape of acute myeloid leukaemia. Nature 2018; 562:526-531. [PMID: 30333627 PMCID: PMC6280667 DOI: 10.1038/s41586-018-0623-z] [Citation(s) in RCA: 731] [Impact Index Per Article: 121.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/14/2018] [Indexed: 01/08/2023]
Abstract
The implementation of targeted therapies for acute myeloid leukaemia (AML) has been challenging because of the complex mutational patterns within and across patients as well as a dearth of pharmacologic agents for most mutational events. Here we report initial findings from the Beat AML programme on a cohort of 672 tumour specimens collected from 562 patients. We assessed these specimens using whole-exome sequencing, RNA sequencing and analyses of ex vivo drug sensitivity. Our data reveal mutational events that have not previously been detected in AML. We show that the response to drugs is associated with mutational status, including instances of drug sensitivity that are specific to combinatorial mutational events. Integration with RNA sequencing also revealed gene expression signatures, which predict a role for specific gene networks in the drug response. Collectively, we have generated a dataset-accessible through the Beat AML data viewer (Vizome)-that can be leveraged to address clinical, genomic, transcriptomic and functional analyses of the biology of AML.
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Affiliation(s)
- Jeffrey W Tyner
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Cristina E Tognon
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
- Howard Hughes Medical Institute, Portland, OR, USA
| | - Daniel Bottomly
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Beth Wilmot
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
- Oregon Clinical & Translational Research Institute, Oregon Health & Science University, Portland, OR, USA
| | - Stephen E Kurtz
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Samantha L Savage
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Nicola Long
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Anna Reister Schultz
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Elie Traer
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Melissa Abel
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Anupriya Agarwal
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Department of Molecular & Medical Genetics, Oregon Health & Science University, Portland, OR, USA
| | - Aurora Blucher
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Uma Borate
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Jade Bryant
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Russell Burke
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Amy Carlos
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Integrated Genomics Laboratories, Oregon Health & Science University, Portland, OR, USA
| | - Richie Carpenter
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Joseph Carroll
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Technology Transfer & Business Development, Oregon Health & Science University, Portland, OR, USA
| | - Bill H Chang
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology and Oncology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Cody Coblentz
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Amanda d'Almeida
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Rachel Cook
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Alexey Danilov
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Kim-Hien T Dao
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Michie Degnin
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Deirdre Devine
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - James Dibb
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - David K Edwards
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Christopher A Eide
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
- Howard Hughes Medical Institute, Portland, OR, USA
| | - Isabel English
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Jason Glover
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology and Oncology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Rachel Henson
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Integrated Genomics Laboratories, Oregon Health & Science University, Portland, OR, USA
| | - Hibery Ho
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Abdusebur Jemal
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology and Oncology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Kara Johnson
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Ryan Johnson
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Brian Junio
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Andy Kaempf
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Biostatistics Shared Resource, Oregon Health & Science University, Portland, OR, USA
| | - Jessica Leonard
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Chenwei Lin
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Integrated Genomics Laboratories, Oregon Health & Science University, Portland, OR, USA
| | - Selina Qiuying Liu
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Pierrette Lo
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Marc M Loriaux
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Dapartment of Pathology, Oregon Health & Science University, Portland, OR, USA
| | - Samuel Luty
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Tara Macey
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Jason MacManiman
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Jacqueline Martinez
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Motomi Mori
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Biostatistics Shared Resource, Oregon Health & Science University, Portland, OR, USA
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Dylan Nelson
- High-Throughput Screening Services Laboratory, Oregon State University, Corvalis, OR, USA
| | - Ceilidh Nichols
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Jill Peters
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Justin Ramsdill
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
- Oregon Clinical & Translational Research Institute, Oregon Health & Science University, Portland, OR, USA
| | - Angela Rofelty
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Robert Schuff
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
- Oregon Clinical & Translational Research Institute, Oregon Health & Science University, Portland, OR, USA
| | - Robert Searles
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Integrated Genomics Laboratories, Oregon Health & Science University, Portland, OR, USA
| | - Erik Segerdell
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Rebecca L Smith
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Stephen E Spurgeon
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Tyler Sweeney
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Aashis Thapa
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Corinne Visser
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Jake Wagner
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Kevin Watanabe-Smith
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Kristen Werth
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Joelle Wolf
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology and Oncology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Libbey White
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Amy Yates
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
- Oregon Clinical & Translational Research Institute, Oregon Health & Science University, Portland, OR, USA
| | - Haijiao Zhang
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Christopher R Cogle
- Department of Medicine, Division of Hematology and Oncology, University of Florida, Gainesville, FL, USA
| | - Robert H Collins
- Department of Internal Medicine/Hematology Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Denise C Connolly
- Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA, USA
- Fox Chase Cancer Center Biosample Repository Facility, Philadelphia, PA, USA
| | - Michael W Deininger
- Division of Hematology & Hematologic Malignancies, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Leylah Drusbosky
- Department of Medicine, Division of Hematology and Oncology, University of Florida, Gainesville, FL, USA
| | - Christopher S Hourigan
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Craig T Jordan
- Division of Hematology, University of Colorado, Denver, CO, USA
| | - Patricia Kropf
- Bone Marrow Transplant Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Tara L Lin
- Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas, Kansas City, KS, USA
| | - Micaela E Martinez
- Clinical Research Services, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Bruno C Medeiros
- Department of Medicine-Hematology, Stanford University, Stanford, CA, USA
| | - Rachel R Pallapati
- Clinical Research Services, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | | | - Ronan T Swords
- Department of Hematology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Justin M Watts
- Department of Hematology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Scott J Weir
- Department of Toxicology, Pharmacology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Medicine, Division of Medical Oncology, University of Kansas Medical Center, Kansas City, KS, USA
| | - David L Wiest
- Blood Cell Development and Function Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Ryan M Winters
- Fox Chase Cancer Center Biosample Repository Facility, Philadelphia, PA, USA
| | - Shannon K McWeeney
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA.
- Oregon Clinical & Translational Research Institute, Oregon Health & Science University, Portland, OR, USA.
| | - Brian J Druker
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
- Howard Hughes Medical Institute, Portland, OR, USA.
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Gordon MJ, Churnetski M, Alqahtani H, Rivera X, Kittai A, Amrock SM, James S, Hoff S, Manda S, Spurgeon SE, Choi M, Cohen JB, Persky D, Danilov AV. Comorbidities predict inferior outcomes in chronic lymphocytic leukemia treated with ibrutinib. Cancer 2018; 124:3192-3200. [DOI: 10.1002/cncr.31554] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/13/2018] [Accepted: 04/26/2018] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Hamood Alqahtani
- Moores Cancer CenterUniversity of California San DiegoSan Diego California
| | | | - Adam Kittai
- Oregon Health and Science UniversityPortland Oregon
| | | | - Spencer James
- Dartmouth‐Hitchcock Medical CenterLebanon New Hampshire
| | - Sheila Hoff
- Moores Cancer CenterUniversity of California San DiegoSan Diego California
| | - Sudhir Manda
- Dartmouth‐Hitchcock Medical CenterLebanon New Hampshire
| | | | - Michael Choi
- Moores Cancer CenterUniversity of California San DiegoSan Diego California
| | | | | | - Alexey V. Danilov
- Oregon Health and Science UniversityPortland Oregon
- Dartmouth‐Hitchcock Medical CenterLebanon New Hampshire
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21
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Edwards V DK, Sweeney DT, Ho H, Eide CA, Rofelty A, Agarwal A, Liu SQ, Danilov AV, Lee P, Chantry D, McWeeney SK, Druker BJ, Tyner JW, Spurgeon SE, Loriaux MM. Targeting of colony-stimulating factor 1 receptor (CSF1R) in the CLL microenvironment yields antineoplastic activity in primary patient samples. Oncotarget 2018; 9:24576-24589. [PMID: 29872489 PMCID: PMC5973855 DOI: 10.18632/oncotarget.25191] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 09/26/2017] [Accepted: 03/01/2018] [Indexed: 12/29/2022] Open
Abstract
In many malignancies, the tumor microenvironment includes CSF1R-expressing supportive monocyte/macrophages that promote tumor cell survival. For chronic lymphocytic leukemia (CLL), these supportive monocyte/macrophages are known as nurse-like cells (NLCs), although the potential effectiveness of selective small-molecule inhibitors of CSF1R against CLL is understudied. Here, we demonstrate the preclinical activity of two inhibitors of CSF1R, GW-2580 and ARRY-382, in primary CLL patient samples. We observed at least 25% of CLL samples showed sub-micromolar sensitivity to CSF1R inhibitors. This sensitivity was observed in samples with varying genetic and clinical backgrounds, although higher white cell count and monocyte cell percentage was associated with increased sensitivity. Depleting CD14-expressing monocytes preferentially decreased viability in samples sensitive to CSF1R inhibitors, and treating samples with CSF1R inhibitors eliminated the presence of NLCs in long-term culture conditions. These results indicate that CSF1R small-molecule inhibitors target CD14-expressing monocytes in the CLL microenvironment, thereby depriving leukemia cells of extrinsic support signals. In addition, significant synergy was observed combining CSF1R inhibitors with idelalisib or ibrutinib, two current CLL therapies that disrupt tumor cell intrinsic B-cell receptor signaling. These findings support the concept of simultaneously targeting supportive NLCs and CLL cells and demonstrate the potential clinical utility of this combination.
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Affiliation(s)
- David K Edwards V
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR, USA
| | - David Tyler Sweeney
- Division of Hematology & Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
| | - Hibery Ho
- Division of Hematology & Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
| | - Christopher A Eide
- Division of Hematology & Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
| | - Angela Rofelty
- Division of Hematology & Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
| | - Anupriya Agarwal
- Division of Hematology & Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
| | - Selina Qiuying Liu
- Division of Hematology & Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
| | - Alexey V Danilov
- Division of Hematology & Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
| | | | | | - Shannon K McWeeney
- Department of Bioinformatics and Computational Biology, Oregon Health & Science University, Portland, OR, USA
| | - Brian J Druker
- Division of Hematology & Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA.,Howard Hughes Medical Institute, Oregon Health & Science University, Knight Cancer Institute, Portland, OR, USA
| | - Jeffrey W Tyner
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR, USA
| | - Stephen E Spurgeon
- Division of Hematology & Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
| | - Marc M Loriaux
- Division of Hematology & Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
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22
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Leonard JT, Rowley JSJ, Eide CA, Traer E, Hayes-Lattin B, Loriaux M, Spurgeon SE, Druker BJ, Tyner JW, Chang BH. Targeting BCL-2 and ABL/LYN in Philadelphia chromosome-positive acute lymphoblastic leukemia. Sci Transl Med 2017; 8:354ra114. [PMID: 27582059 DOI: 10.1126/scitranslmed.aaf5309] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/29/2016] [Indexed: 12/17/2022]
Abstract
Treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+)ALL) remains a challenge. Although the addition of targeted tyrosine kinase inhibitors (TKIs) to standard cytotoxic therapy has greatly improved upfront treatment, treatment-related morbidity and mortality remain high. TKI monotherapy provides only temporary responses and renders patients susceptible to the development of TKI resistance. Thus, identifying agents that could enhance the activity of TKIs is urgently needed. Recently, a selective inhibitor of B cell lymphoma 2 (BCL-2), ABT-199 (venetoclax), has shown impressive activity against hematologic malignancies. We demonstrate that the combination of TKIs with venetoclax is highly synergistic in vitro, decreasing cell viability and inducing apoptosis in Ph(+)ALL. Furthermore, the multikinase inhibitors dasatinib and ponatinib appear to have the added advantage of inducing Lck/Yes novel tyrosine kinase (LYN)-mediated proapoptotic BCL-2-like protein 11 (BIM) expression and inhibiting up-regulation of antiapoptotic myeloid cell leukemia 1 (MCL-1), thereby potentially overcoming the development of venetoclax resistance. Evaluation of the dasatinib-venetoclax combination for the treatment of primary Ph(+)ALL patient samples in xenografted immunodeficient mice confirmed the tolerability of this drug combination and demonstrated its superior antileukemic efficacy compared to either agent alone. These data suggest that the combination of dasatinib and venetoclax has the potential to improve the treatment of Ph(+)ALL and should be further evaluated for patient care.
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Affiliation(s)
- Jessica T Leonard
- Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Joelle S J Rowley
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Christopher A Eide
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA. Howard Hughes Medical Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Elie Traer
- Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR 97239, USA. Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Brandon Hayes-Lattin
- Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR 97239, USA. Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Marc Loriaux
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA. Department of Pathology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Stephen E Spurgeon
- Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR 97239, USA. Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Brian J Druker
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA. Howard Hughes Medical Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Jeffrey W Tyner
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA. Department of Cell, Developmental, and Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Bill H Chang
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA. Division of Pediatric Hematology and Oncology, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR 97239, USA.
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23
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Scott EC, Maziarz RT, Spurgeon SE, Medvedova E, Gajewski J, Reasor-Heard S, Park B, Kratz A, Thomas GV, Loriaux M, Cascio M, Podolak J, Gordon M, Botelho J, Stadtmauer E, Amaravadi R, Vogl DT. Double autophagy stimulation using chemotherapy and mTOR inhibition combined with hydroxychloroquine for autophagy modulation in patients with relapsed or refractory multiple myeloma. Haematologica 2017; 102:e261-e265. [PMID: 28385778 DOI: 10.3324/haematol.2016.162321] [Citation(s) in RCA: 14] [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: 01/28/2023] Open
Affiliation(s)
- Emma C Scott
- The Department of Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Richard T Maziarz
- The Department of Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Stephen E Spurgeon
- The Department of Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Eva Medvedova
- The Department of Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - James Gajewski
- The Department of Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Shara Reasor-Heard
- The Department of Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Byung Park
- Public Health and Preventative Medicine, Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Anne Kratz
- The Department of Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - George V Thomas
- The Department of Pathology and Laboratory Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Marc Loriaux
- The Department of Pathology and Laboratory Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Michael Cascio
- The Department of Pathology and Laboratory Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Jennifer Podolak
- The Department of Pathology and Laboratory Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Miranda Gordon
- The Department of Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Jennifer Botelho
- The Department of Medicine and the Knight Cancer Institute at Oregon Health & Science University, the University of Pennsylvania, PN, USA
| | - Edward Stadtmauer
- Department of Medicine and the Abramson Cancer Center, the University of Pennsylvania, PN, USA
| | - Ravi Amaravadi
- Department of Medicine and the Abramson Cancer Center, the University of Pennsylvania, PN, USA
| | - Dan T Vogl
- Department of Medicine and the Abramson Cancer Center, the University of Pennsylvania, PN, USA
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Raess PW, Cascio MJ, Fan G, Press R, Druker BJ, Brewer D, Spurgeon SE. Concurrent STAT3, DNMT3A, and TET2 mutations in T-LGL leukemia with molecularly distinct clonal hematopoiesis of indeterminate potential. Am J Hematol 2017; 92:E6-E8. [PMID: 27761930 DOI: 10.1002/ajh.24586] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/10/2016] [Accepted: 10/17/2016] [Indexed: 01/19/2023]
Affiliation(s)
- Philipp W. Raess
- Department of Pathology; Oregon Health and Science University; Portland Oregon
| | - Michael J. Cascio
- Department of Pathology; Oregon Health and Science University; Portland Oregon
| | - Guang Fan
- Department of Pathology; Oregon Health and Science University; Portland Oregon
| | - Richard Press
- Department of Pathology; Oregon Health and Science University; Portland Oregon
- Knight Cancer Institute, Oregon Health and Science University; Portland Oregon
| | - Brian J. Druker
- Knight Cancer Institute, Oregon Health and Science University; Portland Oregon
| | - Diana Brewer
- Knight Cancer Institute, Oregon Health and Science University; Portland Oregon
| | - Stephen E. Spurgeon
- Knight Cancer Institute, Oregon Health and Science University; Portland Oregon
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Spurgeon SE, Till BG, Martin P, Goy AH, Dreyling MP, Gopal AK, LeBlanc M, Leonard JP, Friedberg JW, Baizer L, Little RF, Kahl BS, Smith MR. Recommendations for Clinical Trial Development in Mantle Cell Lymphoma. J Natl Cancer Inst 2016; 109:2758475. [PMID: 28040733 DOI: 10.1093/jnci/djw263] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/24/2016] [Accepted: 10/04/2016] [Indexed: 12/16/2022] Open
Abstract
Mantle cell lymphoma (MCL) comprises around 6% of all non-Hodgkin's lymphoma (NHL) diagnoses. In younger patients, age less than 60 to 65 years, aggressive induction often followed by consolidation with autologous stem cell transplant has suggested improved outcomes in this population. Less intensive therapies in older patients often followed by maintenance have been studied or are under active investigation. However, despite recent advances, MCL remains incurable, with a median overall survival of around five years. Patients with high-risk disease have particularly poor outcomes. Treatment varies widely across institutions, and to date no randomized trials comparing intensive vs less intensive approaches have been reported. Although recent data have highlighted the heterogeneity of MCL outcomes, patient assessment for treatment selection has largely been driven by patient age with little regard to fitness, disease biology, or disease risk. One critical advance is the finding that minimal residual disease status (MRD) after induction correlates with long-term outcomes. As such, its use as a potential end point could inform clinical trial design. In order to more rapidly improve the outcomes of MCL patients, clinical trials are needed that prospectively stratify patients on the basis of MCL biology and disease risk, incorporate novel agents, and use MRD to guide the need for additional therapy.
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Affiliation(s)
- Stephen E Spurgeon
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - Brian G Till
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - Peter Martin
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - Andre H Goy
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - Martin P Dreyling
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - Ajay K Gopal
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - Michael LeBlanc
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - John P Leonard
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - Jonathan W Friedberg
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - Lawrence Baizer
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - Richard F Little
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - Brad S Kahl
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
| | - Mitchell R Smith
- Affiliations of authors: Division of Hematology and Medical Oncology, Oregon Health and Science (OHSU) University Knight Cancer Institute, Portland, OR (SES); Clinical Research Division, Fred Hutchinson Cancer Research Center/ Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA (BGT, AKG); Department of Medicine, Weill Cornell Medicine, New York, NY (PM, JPL); John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ (AHG); Department of Medicine III, Klinikum der Universität München, Campus Grosshadern, Munich, Germany (MPD); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (ML); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester, Rochester, NY (JWF); Coordinating Center for Clinical Trials, National Cancer Institute, National Institutes of Health, Bethesda, MD (LB); HIV and AIDS Malignancy Branch, Center for Cancer Research, and Clinical Investigations Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD (RFL); Department of Medicine, Oncology Division, Washington University, St. Louis, MO (BSK); Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH (MRS)
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Gordon MJ, Tardi P, Loriaux MM, Spurgeon SE, Traer E, Kovacsovics T, Mayer LD, Tyner JW. CPX-351 exhibits potent and direct ex vivo cytotoxicity against AML blasts with enhanced efficacy for cells harboring the FLT3-ITD mutation. Leuk Res 2016; 53:39-49. [PMID: 28013106 DOI: 10.1016/j.leukres.2016.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 12/08/2016] [Accepted: 12/10/2016] [Indexed: 12/23/2022]
Abstract
PURPOSE Identify AML patients most likely to respond to CPX-351, a nano-scale liposome formulation containing cytarabine and daunorubicin co-encapsulated at a 5:1 molar ratio. METHODS We examined the ex vivo cytotoxic activity of CPX-351 against leukemic cells isolated from 53 AML patients and an additional 127 samples including acute lymphoblastic leukemia, myelodysplastic syndrome/myeloproliferative neoplasms, or chronic lymphocytic leukemia/lymphoma. We assessed activity with respect to common molecular lesions and used flow cytometry to assess CPX-351 cellular uptake. RESULTS AML specimen sensitivity to CPX-351 was similar across conventional risk groups. FLT3-ITD cases were five-fold more sensitive to CPX-351. CPX-351 was active across other indications with nearly all cases exhibiting IC50 values markedly lower than reported 72-h plasma drug concentration in patients receiving CPX-351. The range and distribution of CPX-351 IC50 values were comparable for AML, CLL, and ALL, whereas MDS/MPN cases were less sensitive. CPX-351 uptake analysis revealed a correlation between uptake of CPX-351 and cytotoxic potency. CONCLUSIONS Our findings are consistent with clinical data, in which CPX-351 activity is retained in high-risk AML patients. Ex vivo analysis of cytotoxic potency may provide a means to identify specific AML subsets, such as FLT3-ITD, that benefit most from CPX-351 and warrant additional clinical evaluation.
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Affiliation(s)
- Max J Gordon
- Department of Internal Medicine, Oregon Health & Sciences University, Portland, OR, USA
| | - Paul Tardi
- Jazz Pharmaceuticals, Suite 250 - 887 Great Northern Way, Vancouver, BC V5T 4T5, Canada
| | - Marc M Loriaux
- Department of Pathology, Oregon Health & Science University, Portland, OR, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Stephen E Spurgeon
- Division of Hematology & Medical Oncology, Oregon Health & Science University, Portland, OR, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Elie Traer
- Division of Hematology & Medical Oncology, Oregon Health & Science University, Portland, OR, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Tibor Kovacsovics
- Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute, Huntsman Cancer Hospital, The University of Utah, Salt Lake City, USA
| | - Lawrence D Mayer
- Jazz Pharmaceuticals, Suite 250 - 887 Great Northern Way, Vancouver, BC V5T 4T5, Canada
| | - Jeffrey W Tyner
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland, OR, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.
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Siegel MB, Liu SQ, Davare MA, Spurgeon SE, Loriaux MM, Druker BJ, Scott EC, Tyner JW. Small molecule inhibitor screen identifies synergistic activity of the bromodomain inhibitor CPI203 and bortezomib in drug resistant myeloma. Oncotarget 2016; 6:18921-32. [PMID: 26254279 PMCID: PMC4662464 DOI: 10.18632/oncotarget.4214] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 05/12/2015] [Indexed: 11/25/2022] Open
Abstract
Purpose Despite significant therapeutic progress in multiple myeloma, drug resistance is uniformly inevitable and new treatments are needed. Our aim was to identify novel, efficacious small-molecule combinations for use in drug resistant multiple myeloma. Experimental Design A panel of 116 small molecule inhibitors was used to screen resistant myeloma cell lines for potential therapeutic targets. Agents found to have enhanced activity in the bortezomib or melphalan resistant myeloma cell lines were investigated further in combination. Synergistic combinations of interest were evaluated in primary patient cells. Results The overall single-agent drug sensitivity profiles were dramatically different between melphalan and bortezomib resistant cells, however, the bromodomain inhibitor, CPI203, was observed to have enhanced activity in both the bortezomib and melphalan resistant lines compared to their wild-type counterparts. The combination of bortezomib and CPI203 was found to be synergistic in both the bortezomib and melphalan resistant cell lines as well as in a primary multiple myeloma sample from a patient refractory to recent proteasome inhibitor treatment. The CPI203-bortezomib combination led to enhanced apoptosis and anti-proliferative effects. Finally, in contrast to prior reports of synergy between bortezomib and other epigenetic modifying agents, which implicated MYC downregulation or NOXA induction, our analyses suggest that CPI203-bortezomib synergy is independent of these events. Conclusion Our preclinical data supports a role for the clinical investigation of the bromodomain inhibitor CPI203 combined with bortezomib or alkylating agents in resistant multiple myeloma.
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Affiliation(s)
| | | | - Monika A Davare
- Knight Cancer Institute, Portland, Oregon, USA.,Department of Pediatrics at Oregon Health and Science University, Portland, Oregon, USA
| | | | | | - Brian J Druker
- Knight Cancer Institute, Portland, Oregon, USA.,Howard Hughes Medical Institute, Portland, Oregon, USA
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Paiva C, Godbersen JC, Soderquist RS, Rowland T, Kilmarx S, Spurgeon SE, Brown JR, Srinivasa SP, Danilov AV. Cyclin-Dependent Kinase Inhibitor P1446A Induces Apoptosis in a JNK/p38 MAPK-Dependent Manner in Chronic Lymphocytic Leukemia B-Cells. PLoS One 2015; 10:e0143685. [PMID: 26606677 PMCID: PMC4659573 DOI: 10.1371/journal.pone.0143685] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 11/09/2015] [Indexed: 01/17/2023] Open
Abstract
CDK (cyclin-dependent kinase) inhibitors have shown remarkable activity in CLL, where its efficacy has been linked to inhibition of the transcriptional CDKs (7 and 9) and deregulation of RNA polymerase and short-lived pro-survival proteins such as MCL1. Furthermore, ER (endoplasmic reticulum) stress has been implicated in CDK inhibition in CLL. Here we conducted a pre-clinical study of a novel orally active kinase inhibitor P1446A in CLL B-cells. P1446A inhibited CDKs at nanomolar concentrations and induced rapid apoptosis of CLL cells in vitro, irrespective of chromosomal abnormalities or IGHV mutational status. Apoptosis preceded inactivation of RNA polymerase, and was accompanied by phosphorylation of stress kinases JNK (c-Jun N-terminal kinase) and p38 MAPK (mitogen-activated protein kinase). Pharmacologic inhibitors of JNK/p38 MAPK conferred protection from P1446A-mediated apoptosis. Treatment with P1446A led to a dramatic induction of NOXA in a JNK-dependent manner, and sensitized CLL cells to ABT-737, a BH3-mimetic. We observed concurrent activation of apoptosis stress-inducing kinase 1 (ASK1) and its interaction with inositol-requiring enzyme 1 (IRE1) and tumor necrosis factor receptor-associated factor 2 (TRAF2) in CLL cells treated with P1446A, providing insights into upstream regulation of JNK in this setting. Consistent with previous reports on limited functionality of ER stress mechanism in CLL cells, treatment with P1446A failed to induce an extensive unfolded protein response. This study provides rationale for additional investigations of P1446A in CLL.
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Affiliation(s)
- Cody Paiva
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, United States of America
| | | | | | - Taylor Rowland
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, United States of America
| | - Sumner Kilmarx
- Dartmouth College, Hanover, NH, United States of America
| | - Stephen E. Spurgeon
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, United States of America
| | - Jennifer R. Brown
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States of America
| | | | - Alexey V. Danilov
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, United States of America
- * E-mail:
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Abstract
Mantle cell lymphoma (MCL) is a rare subtype of non-Hodgkin's lymphoma typically marked by an aggressive clinical course and a predilection for relapse. The B-cell receptor (BCR) signaling survival pathway is chronically activated in MCL, contributing to its pathogenesis. Ibrutinib is an inhibitor of Bruton's tyrosine kinase, a vital component of this pathway. This article details the current clinical experience with ibrutinib in the treatment of patients with MCL, including completed and published clinical trials and reviews potential adverse events (AEs) and pitfalls associated with ibrutinib therapy. Although most AEs experienced by patients treated with ibrutinib are mild, some can be severe and treatment limiting and may be attributed to off-target effects. Ibrutinib is a very promising agent for patients with MCL with notable response rates. However, when used as a single agent, around one third of patients relapse in the first 2 years of treatment. Recently reported combination therapies have shown significant activity. Emerging data evaluating potential mechanisms of drug resistance and the poor clinical outcomes after treatment failure are also discussed. Further understanding of resistance and its implications not only in relapsed disease but in the frontline setting are needed. Investigation of strategies to overcome resistance remains an area of high unmet clinical need. Evaluation of the impact of shorter treatment duration, effects on minimal residual disease, and incorporation of novel combinations are also warranted.
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Affiliation(s)
- Deborah M Stephens
- Division of Hematology, Department of Internal Medicine, Huntsman Cancer Institute, The University of Utah, 2000 Circle of Hope, Room 4246, Salt Lake City, UT 84112, USA
| | - Stephen E Spurgeon
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Knight Cancer Institute at Oregon Health Sciences University, Portland, OR, USA
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Braun TP, Maxson JE, Agarwal A, Dunlap J, Spurgeon SE, Traer E. Acute promyelocytic leukemia with JAK2 V617F and severe differentiation syndrome. Leuk Res Rep 2015; 4:8-11. [PMID: 25628989 PMCID: PMC4306096 DOI: 10.1016/j.lrr.2014.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 12/20/2014] [Indexed: 12/02/2022] Open
Abstract
Myeloproliferative neoplasms transformed into AML usually have a poor prognosis. We report a case of essential thrombocythemia with myelofibrosis that transformed into acute promyelocytic leukemia (APL) with both the t(15;17) translocation as well as the JAK2 V617F mutation. Clinically, this case was notable for severe differentiation syndrome despite treatment with high-dose dexamethasone. Cytokine production by differentiating APL cells was not directly abrogated by JAK2 inhibitors in vitro, suggesting that JAK2 V617F enhances the hyperinflammatory response downstream of cytokines. JAK1/2 inhibitors may therefore dampen the inflammatory cascade downstream of cytokine production, similar to glucocorticoids, and have a role in treating severe differentiation syndrome. Case of essential thrombocythemia transformed to acute promyelocytic leukemia. Leukemia cells contained both t(15;17) and JAK2 V617F mutation. Severe differentiation syndrome in response to ATRA, possibly related to JAK2 V617F. JAK1/2 inhibitors may have clinical utility in differentiation syndrome.
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Affiliation(s)
- Theodore P Braun
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA ; MD/PhD Program
| | - Julia E Maxson
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Anupriya Agarwal
- Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR 97239, USA ; Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Jennifer Dunlap
- Department of Pathology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Stephen E Spurgeon
- Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR 97239, USA ; Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Elie Traer
- Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR 97239, USA ; Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
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Flatley E, Chen AI, Zhao X, Jaffe ES, Dunlap JB, Pittaluga S, Abdullah S, Olson SB, Spurgeon SE, Fan G. Aberrations of MYC are a common event in B-cell prolymphocytic leukemia. Am J Clin Pathol 2014; 142:347-54. [PMID: 25125625 DOI: 10.1309/ajcpubhm8u7zflob] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES B-cell prolymphocytic leukemia (B-PLL) remains a controversial entity, and its molecular pathogenesis is largely unknown. Patients are older, typically having marked lymphocytosis and splenomegaly in the absence of lymphadenopathy. It is defined as a mature B-cell leukemia with more than 55% circulating prolymphocytes. Leukemic mantle cell lymphoma and chronic lymphocytic leukemia in prolymphocytic transformation must be excluded. METHODS Case archives were retrospectively reviewed for B-PLL in patients without a previous diagnosis of chronic lymphocytic leukemia or other B-cell neoplasm. RESULTS We identified six cases of B-PLL with available cytogenetic data, five of which showed evidence of aberrations in MYC. Three cases showed additional signals for the MYC gene by fluorescence in situ hybridization (FISH), and two cases demonstrated t(8;14)MYC/IGH by karyotyping or FISH. High levels of MYC protein expression were detected in all cases tested with MYC aberrations. CONCLUSIONS These results suggest that deregulation of MYC plays an important role in the pathogenesis of B-PLL and expands the spectrum of B-cell neoplasms associated with aberrations of MYC.
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Affiliation(s)
- Ellen Flatley
- Department of Pathology, Oregon Health & Science University, Portland
| | - Andy I. Chen
- Department of Hematology-Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Xiangrong Zhao
- Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Elaine S. Jaffe
- Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | | | - Stefania Pittaluga
- Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Shahed Abdullah
- Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Susan B. Olson
- Knight Diagnostic Laboratory, Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Stephen E. Spurgeon
- Department of Hematology-Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Guang Fan
- Department of Pathology, Oregon Health & Science University, Portland
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Pagel JM, Spurgeon SE, Byrd JC, Awan FT, Flinn IW, Lanasa MC, Eisenfeld AJ, Stromatt SC, Gopal AK. Otlertuzumab (TRU-016), an anti-CD37 monospecific ADAPTIR(™) therapeutic protein, for relapsed or refractory NHL patients. Br J Haematol 2014; 168:38-45. [PMID: 25146490 DOI: 10.1111/bjh.13099] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [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: 04/02/2014] [Accepted: 07/15/2014] [Indexed: 12/22/2022]
Abstract
CD37 is cell surface tetraspanin present on normal and malignant B cells. Otlertuzumab (TRU-016) is a novel humanized anti-CD37 protein therapeutic. Patients with relapsed or refractory follicular non-Hodgkin lymphoma (FL), mantle cell lymphoma (MCL), or Waldenström's macroglobulinaemia (WM) received otlertuzumab at 20 mg/kg administered intravenously once a week for up to 8 weeks followed by 4 monthly doses. Sixteen patients were treated; median age was 62·5 years (range, 41-81), and median number of prior regimens was 4 (range, 1-7). Twelve patients were refractory to prior treatment, 5 were refractory to rituximab. The mean terminal half-life was 9·5 days. Lymph node reduction of ≥50% by computerized tomography scan measurements was seen in 3 of 12 patients, including one FL patient who had a partial response. One WM patient had a minor response. The most frequent adverse events were neutropenia, fatigue, nausea, thrombocytopenia, diarrhoea, and peripheral oedema; most were grade 1/2. Otlertuzumab treatment appears to have been well tolerated by the patients in this study. Clinical activity was observed in this small heterogeneous cohort of highly refractory, heavily pretreated B-cell non-Hodgkin lymphoma patients. These data suggest that further clinical investigation in non-Hodgkin lymphoma is warranted.
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Affiliation(s)
- John M Pagel
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
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Geller MD, Pei Y, Spurgeon SE, Durum C, Leeborg NJ. Chronic lymphocytic leukemia with a FGFR3 translocation: case report and literature review of an uncommon cytogenetic event. Cancer Genet 2014; 207:340-3. [DOI: 10.1016/j.cancergen.2014.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 09/05/2014] [Accepted: 09/06/2014] [Indexed: 10/24/2022]
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Flinn IW, Kahl BS, Leonard JP, Furman RR, Brown JR, Byrd JC, Wagner-Johnston ND, Coutre SE, Benson DM, Peterman S, Cho Y, Webb HK, Johnson DM, Yu AS, Ulrich RG, Godfrey WR, Miller LL, Spurgeon SE. Idelalisib, a selective inhibitor of phosphatidylinositol 3-kinase-δ, as therapy for previously treated indolent non-Hodgkin lymphoma. Blood 2014; 123:3406-13. [PMID: 24615776 PMCID: PMC4260978 DOI: 10.1182/blood-2013-11-538546] [Citation(s) in RCA: 169] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 01/19/2014] [Indexed: 01/26/2023] Open
Abstract
Idelalisib (GS-1101, CAL-101), an oral inhibitor of phosphatidylinositol 3-kinase-δ, was evaluated in a phase I study in 64 patients with relapsed indolent non-Hodgkin lymphoma (iNHL). Patients had a median (range) age of 64 (32-91) years, 34 (53%) had bulky disease (≥1 lymph nodes ≥5 cm), and 37 (58%) had refractory disease. Patients had received a median (range) of 4 (1-10) prior therapies. Eight dose regimens of idelalisib were evaluated; idelalisib was taken once or twice daily continuously at doses ranging from 50 to 350 mg. After 48 weeks, patients still benefitting (n = 19; 30%) enrolled into an extension study. Adverse events (AEs) occurring in 20% or more patients (total%/grade ≥3%) included diarrhea (36/8), fatigue (36/3), nausea (25/3), rash (25/3), pyrexia (20/3), and chills (20/0). Laboratory abnormalities included neutropenia (44/23), anemia (31/5), thrombocytopenia (25/11), and serum transaminase elevations (48/25). Twelve (19%) patients discontinued therapy due to AEs. Idelalisib induced disease regression in 46/54 (85%) of evaluable patients achieving an overall response rate of 30/64 (47%), with 1 patient having a complete response (1.6%). Median duration of response was 18.4 months, median progression-free survival was 7.6 months. Idelalisib is well tolerated and active in heavily pretreated, relapsed/refractory patients with iNHL. These trials were registered at clinicaltrials.gov as NCT00710528 and NCT01090414.
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Affiliation(s)
- Ian W Flinn
- Sarah Cannon Research Institute, Nashville, TN
| | - Brad S Kahl
- University of Wisconsin Carbone Cancer Center, Madison, WI
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Kahl BS, Spurgeon SE, Furman RR, Flinn IW, Coutre SE, Brown JR, Benson DM, Byrd JC, Peterman S, Cho Y, Yu A, Godfrey WR, Wagner-Johnston ND. A phase 1 study of the PI3Kδ inhibitor idelalisib in patients with relapsed/refractory mantle cell lymphoma (MCL). Blood 2014; 123:3398-405. [PMID: 24615778 PMCID: PMC4260977 DOI: 10.1182/blood-2013-11-537555] [Citation(s) in RCA: 204] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 01/21/2014] [Indexed: 11/20/2022] Open
Abstract
Idelalisib, an oral inhibitor of phosphatidylinositol-3-kinase δ (PI3Kδ), was evaluated in a 48-week phase 1 study (50-350 mg daily or twice daily) enrolling 40 patients with relapsed or refractory mantle cell lymphoma (MCL). Primary outcome was safety and dose-limiting toxicity (DLT). Secondary outcomes were pharmacokinetic parameters, pharmacodynamic effects, overall response rate (ORR), progression-free survival (PFS), and duration of response (DOR). Patients without DLT and no evidence of disease progression after 48 weeks enrolled in the extension study. Patients had median age of 69 years (range, 52-83) and received median of 4 prior therapies (1-14); 17 of 40 patients (43%) were refractory to their most recent treatment. Median duration of idelalisib treatment was 3.5 months (range, 0.7-30.7), with 6 (15%) continuing extension treatment. Common grade ≥3 adverse events (AEs) included (total%/grade ≥3%) diarrhea (40/18), nausea (33/5), pyrexia (28/0), fatigue (25/3), rash (23/3), decreased appetite (20/15), upper respiratory infection (20/0), pneumonia (13/10), and alanine transaminase or aspartate transaminase elevations (60/20). ORR was 16 of 40 patients (40%), with CR in 2 of 40 patients (5%). Median DOR was 2.7 months, median PFS was 3.7 months, and 1-year PFS was 22%. These data provide proof of concept that targeting PI3Kδ is a viable strategy and worthy of additional study in MCL. This trial was registered at www.clinicaltrials.gov as #NCT00710528.
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Affiliation(s)
- Brad S Kahl
- Department of Medicine, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Stephen E Spurgeon
- Department of Medicine, Oregon Health and Sciences University, Portland, OR
| | - Richard R Furman
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Ian W Flinn
- Sarah Cannon Research Institute, Nashville, TN
| | | | | | - Don M Benson
- Department of Medicine, Ohio State University, Columbus, OH
| | - John C Byrd
- Department of Medicine, Ohio State University, Columbus, OH
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Burke RT, Meadows S, Loriaux MM, Currie KS, Mitchell SA, Maciejewski P, Clarke AS, Dipaolo JA, Druker BJ, Lannutti BJ, Spurgeon SE. A potential therapeutic strategy for chronic lymphocytic leukemia by combining Idelalisib and GS-9973, a novel spleen tyrosine kinase (Syk) inhibitor. Oncotarget 2014; 5:908-15. [PMID: 24659719 PMCID: PMC4011593 DOI: 10.18632/oncotarget.1484] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 10/28/2013] [Indexed: 12/30/2022] Open
Abstract
Agents that target B-cell receptor (BCR) signaling in lymphoid malignancies including idelalisib (GS-1101) and fostamatinib which inhibit the delta isoform of PI3 kinase (PI3Kd) and spleen tyrosine kinase (Syk) respectively have shown significant clinical activity. By disrupting B-cell signaling pathways, idelalisib treatment has been associated with a dramatic lymph node response, but eradication of disease and relapse in high risk disease remain challenges. Targeting the BCR signaling pathway with simultaneous inhibition of PI3Kd and Syk has not yet been reported. We evaluated the pre-clinical activity of idelalisib combined with the novel and selective Syk inhibitor GS-9973 in primary peripheral blood and bone marrow Chronic Lymphocytic Leukemia (CLL) samples. Both PI3Kd and Syk inhibition reduced CLL survival and in combination induced synergistic growth inhibition and further disrupted chemokine signaling at nanomolar concentrations including in bone marrow derived and poor risk samples. Simultaneous targeting of these kinases may significantly increase clinical activity.
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Affiliation(s)
- Russell T Burke
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | | | - Marc M Loriaux
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR
- Division of Pathology, Oregon Health & Science University, Portland, OR
| | | | | | | | | | | | - Brian J. Druker
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR
- Howard Hughes Medical Institute, Bethesda, MD
| | | | - Stephen E. Spurgeon
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR
- Division of Hematology and Medical Oncology, Oregon Health & Science University
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Wang ML, Rule S, Martin P, Goy A, Auer R, Kahl BS, Jurczak W, Advani RH, Romaguera JE, Williams ME, Barrientos JC, Chmielowska E, Radford J, Stilgenbauer S, Dreyling M, Jedrzejczak WW, Johnson P, Spurgeon SE, Li L, Zhang L, Newberry K, Ou Z, Cheng N, Fang B, McGreivy J, Clow F, Buggy JJ, Chang BY, Beaupre DM, Kunkel LA, Blum KA. Targeting BTK with ibrutinib in relapsed or refractory mantle-cell lymphoma. N Engl J Med 2013; 369:507-16. [PMID: 23782157 PMCID: PMC4513941 DOI: 10.1056/nejmoa1306220] [Citation(s) in RCA: 1223] [Impact Index Per Article: 111.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Bruton's tyrosine kinase (BTK) is a mediator of the B-cell-receptor signaling pathway implicated in the pathogenesis of B-cell cancers. In a phase 1 study, ibrutinib, a BTK inhibitor, showed antitumor activity in several types of non-Hodgkin's lymphoma, including mantle-cell lymphoma. METHODS In this phase 2 study, we investigated oral ibrutinib, at a daily dose of 560 mg, in 111 patients with relapsed or refractory mantle-cell lymphoma. Patients were enrolled into two groups: those who had previously received at least 2 cycles of bortezomib therapy and those who had received less than 2 complete cycles of bortezomib or had received no prior bortezomib therapy. The primary end point was the overall response rate. Secondary end points were duration of response, progression-free survival, overall survival, and safety. RESULTS The median age was 68 years, and 86% of patients had intermediate-risk or high-risk mantle-cell lymphoma according to clinical prognostic factors. Patients had received a median of three prior therapies. The most common treatment-related adverse events were mild or moderate diarrhea, fatigue, and nausea. Grade 3 or higher hematologic events were infrequent and included neutropenia (in 16% of patients), thrombocytopenia (in 11%), and anemia (in 10%). A response rate of 68% (75 patients) was observed, with a complete response rate of 21% and a partial response rate of 47%; prior treatment with bortezomib had no effect on the response rate. With an estimated median follow-up of 15.3 months, the estimated median response duration was 17.5 months (95% confidence interval [CI], 15.8 to not reached), the estimated median progression-free survival was 13.9 months (95% CI, 7.0 to not reached), and the median overall survival was not reached. The estimated rate of overall survival was 58% at 18 months. CONCLUSIONS Ibrutinib shows durable single-agent efficacy in relapsed or refractory mantle-cell lymphoma. (Funded by Pharmacyclics and others; ClinicalTrials.gov number, NCT01236391.)
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Affiliation(s)
- Michael L Wang
- Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
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Prins RC, Burke RT, Tyner JW, Druker BJ, Loriaux MM, Spurgeon SE. CX-4945, a selective inhibitor of casein kinase-2 (CK2), exhibits anti-tumor activity in hematologic malignancies including enhanced activity in chronic lymphocytic leukemia when combined with fludarabine and inhibitors of the B-cell receptor pathway. Leukemia 2013; 27:2094-6. [DOI: 10.1038/leu.2013.228] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Chandran R, Gardiner SK, Smith SD, Spurgeon SE. Improved survival in hairy cell leukaemia over three decades: a SEER database analysis of prognostic factors. Br J Haematol 2013; 163:407-9. [PMID: 23889044 DOI: 10.1111/bjh.12490] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Spurgeon SE, Coffey G, Fletcher LB, Burke R, Tyner JW, Druker BJ, Betz A, DeGuzman F, Pak Y, Baker D, Pandey A, Hollenbach SJ, Sinha U, Loriaux MM. The selective SYK inhibitor P505-15 (PRT062607) inhibits B cell signaling and function in vitro and in vivo and augments the activity of fludarabine in chronic lymphocytic leukemia. J Pharmacol Exp Ther 2012; 344:378-87. [PMID: 23220742 DOI: 10.1124/jpet.112.200832] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
B-cell receptor (BCR) associated kinases including spleen tyrosine kinase (SYK) contribute to the pathogenesis of B-cell malignancies. SYK is persistently phosphorylated in a subset of non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL), and SYK inhibition results in abrogation of downstream kinase activity and apoptosis. P505-15 (also known as PRT062607) is a novel, highly selective, and orally bioavailable small molecule SYK inhibitor (SYK IC(50) = 1 nM) with anti-SYK activity that is at least 80-fold greater than its affinity for other kinases. We evaluated the preclinical characteristics of P505-15 in models of NHL and CLL. P505-15 successfully inhibited SYK-mediated B-cell receptor signaling and decreased cell viability in NHL and CLL. Oral dosing in mice prevented BCR-mediated splenomegaly and significantly inhibited NHL tumor growth in a xenograft model. In addition, combination treatment of primary CLL cells with P505-15 plus fludarabine produced synergistic enhancement of activity at nanomolar concentrations. Our findings support the ongoing development of P505-15 as a therapeutic agent for B-cell malignancies. A dose finding study in healthy volunteers has been completed.
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Affiliation(s)
- Stephen E Spurgeon
- Knight Cancer Institute, Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR 97239, USA.
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Tyner JW, Yang WF, Bankhead A, Fan G, Fletcher LB, Bryant J, Glover JM, Chang BH, Spurgeon SE, Fleming WH, Kovacsovics T, Gotlib JR, Oh ST, Deininger MW, Zwaan CM, Den Boer ML, van den Heuvel-Eibrink MM, O'Hare T, Druker BJ, Loriaux MM. Kinase pathway dependence in primary human leukemias determined by rapid inhibitor screening. Cancer Res 2012; 73:285-96. [PMID: 23087056 DOI: 10.1158/0008-5472.can-12-1906] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Kinases are dysregulated in most cancers, but the frequency of specific kinase mutations is low, indicating a complex etiology in kinase dysregulation. Here, we report a strategy to rapidly identify functionally important kinase targets, irrespective of the etiology of kinase pathway dysregulation, ultimately enabling a correlation of patient genetic profiles to clinically effective kinase inhibitors. Our methodology assessed the sensitivity of primary leukemia patient samples to a panel of 66 small-molecule kinase inhibitors over 3 days. Screening of 151 leukemia patient samples revealed a wide diversity of drug sensitivities, with 70% of the clinical specimens exhibiting hypersensitivity to one or more drugs. From this data set, we developed an algorithm to predict kinase pathway dependence based on analysis of inhibitor sensitivity patterns. Applying this algorithm correctly identified pathway dependence in proof-of-principle specimens with known oncogenes, including a rare FLT3 mutation outside regions covered by standard molecular diagnostic tests. Interrogation of all 151 patient specimens with this algorithm identified a diversity of kinase targets and signaling pathways that could aid prioritization of deep sequencing data sets, permitting a cumulative analysis to understand kinase pathway dependence within leukemia subsets. In a proof-of-principle case, we showed that in vitro drug sensitivity could predict both a clinical response and the development of drug resistance. Taken together, our results suggested that drug target scores derived from a comprehensive kinase inhibitor panel could predict pathway dependence in cancer cells while simultaneously identifying potential therapeutic options.
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Affiliation(s)
- Jeffrey W Tyner
- Department of Cell and Developmental Biology, Oregon Health & Science University, Portland, OR 97239, USA
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Abstract
A retrospective analysis was done using the Surveillance, Epidemiology, and End-Results (SEER) database to determine the trends in overall survival and identify prognostic factors in patients with mantle cell lymphoma (MCL). In total 5367 cases of MCL identified from 1992 to 2007 were split into three cohorts, group 1(1992-1999), group 2 (2000-2003) and group 3 (2004-2007). Survival was analyzed using the Cox proportional hazards model to correct for age, gender and stage of disease. The proportion of patients with advanced disease at diagnosis, male gender and advanced age increased over time and these were all associated with increased mortality. The overall survival remained unchanged. However, when adjusted for the increased proportion of patients with poor prognostic features noted above, we found a significant improvement in survival. The adjusted model also showed an improvement in predicted survival over time in patients with advanced stage. No change in survival was seen in patients with localized disease. Although this analysis is not designed to evaluate specific treatment modalities, these data suggest that the development of new treatment strategies over the past decade may be impacting the survival of patients with advanced MCL despite the finding that the overall survival remains unchanged in the general US population.
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Spurgeon SE, Pindyck T, Okada C, Chen Y, Chen Z, Mater E, Abbi K, Epner EM. Cladribine plus rituximab is an effective therapy for newly diagnosed mantle cell lymphoma. Leuk Lymphoma 2011; 52:1488-94. [DOI: 10.3109/10428194.2011.575489] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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