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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Siddiqi T, Coutre S, McKinney M, Barr PM, Rogers K, Mokatrin A, Valentino R, Szoke A, Deshpande S, Zhu A, Arango-Hisijara I, Osei-Bonsu K, Wang M, O’Brien S. Characterization of low-grade arthralgia, myalgia, and musculoskeletal pain with ibrutinib therapy: pooled analysis of clinical trials in patients with chronic lymphocytic leukemia and mantle cell lymphoma. Leuk Lymphoma 2022; 63:1580-1588. [DOI: 10.1080/10428194.2022.2038372] [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: 10/19/2022]
Affiliation(s)
- Tanya Siddiqi
- City of Hope National Medical Center, Duarte, CA, USA
| | - Steven Coutre
- Stanford Cancer Center, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Paul M. Barr
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Ahmad Mokatrin
- Pharmacyclics LLC, an AbbVie Company, South San Francisco, CA, USA
| | - Rudy Valentino
- Pharmacyclics LLC, an AbbVie Company, South San Francisco, CA, USA
| | - Anita Szoke
- Pharmacyclics LLC, an AbbVie Company, South San Francisco, CA, USA
| | | | | | | | - Kojo Osei-Bonsu
- Pharmacyclics LLC, an AbbVie Company, South San Francisco, CA, USA
| | - Michael Wang
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Susan O’Brien
- UC Irvine, Chao Family Comprehensive Cancer Center, Irvine, CA, USA
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3
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Jain N, Thompson P, Burger J, Ferrajoli A, Takahashi K, Estrov Z, Borthakur G, Bose P, Kadia T, Pemmaraju N, Sasaki K, Konopleva M, Jabbour E, Garg N, Wang X, Kanagal-Shamanna R, Patel K, Wang W, Wang S, Jorgensen J, Lopez W, Ayala A, Plunkett W, Gandhi V, Kantarjian H, O’Brien S, Keating M, Wierda W. S149: LONG TERM OUTCOMES OF IFCG REGIMEN FOR FIRSTLINE TREATMENT OF PATIENTS WITH CLL WITH MUTATED IGHV AND WITHOUT DEL(17P)/TP53 MUTATION. Hemasphere 2022. [DOI: 10.1097/01.hs9.0000843488.43813.af] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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4
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Srinivasan M, Pasdar M, O’Brien S, Tchouaffe J, Datar A, Kuo M, Reynolds E, Terpilowski M, McCann C, Hanley P. Process Development and Manufacturing: FROZEN PEPMIX PULSED/IRRAIATED DENDRITIC CELLS AS ANTIGEN PRESENTING CELLS TO GENERATE MULTI-TUMOR-ANTIGEN REACTIVE T-CELLS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00452-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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5
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Mato AR, Davids MS, Sharman J, Roeker LE, Kay N, Kater A, Rogers K, Thompson MC, Rhodes J, Goy A, Skarbnik A, Schuster SJ, Tam CS, Eyre TA, O’Brien S, Nabhan C, Lamanna N, Sun C, Shadman M, Pagel JM, Ujjani C, Brander D, Coombs CC, Jain N, Cheah CY, Brown JR, Seymour JF, Woyach JA. Recognizing Unmet Need in the Era of Targeted Therapy for CLL/SLL: "What's Past Is Prologue" (Shakespeare). Clin Cancer Res 2022; 28:603-608. [PMID: 34789482 PMCID: PMC9253788 DOI: 10.1158/1078-0432.ccr-21-1237] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/18/2021] [Accepted: 11/16/2021] [Indexed: 11/16/2022]
Abstract
The management of chronic lymphocytic leukemia (CLL) has undergone unprecedented changes over the last decade. Modern targeted therapies are incorporated into clinical practice. Unfortunately, patients have begun to develop resistance or intolerance to multiple classes. Symptomatic patients previously treated with a BTK inhibitor (BTKi) and venetoclax represent a new and rapidly growing unmet need in CLL. Here, we define unmet needs in a modern treatment context. We also critically review the literature for PI3K inhibitors and chemoimmunotherapy and lack of data to support their utility following BTKis and venetoclax. Finally, we suggest opportunities to ensure the continued innovation for patients with CLL.
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Affiliation(s)
- Anthony R Mato
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Matthew S Davids
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Jeff Sharman
- Willamette Valley Cancer Institute/US Oncology, Eugene, OR, USA
| | | | - Neil Kay
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Arnon Kater
- Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, the Netherlands
| | - Kerry Rogers
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | | | - Joanna Rhodes
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Andre Goy
- MD Anderson Cancer Center, Houston, TX, USA
| | - Alan Skarbnik
- Lymphoproliferative Disorders Program, Novant Health, Charlotte, NC, USA
| | - Stephen J Schuster
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Constantine S Tam
- Peter MacCallum Cancer Center, Royal Melbourne Hospital, and University of Melbourne, Melbourne, Australia
| | - Toby A Eyre
- Churchill Cancer Center, Oxford University Hospitals NHS Foundation Trust, Old Road, UK
| | - Susan O’Brien
- Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA
| | - Chadi Nabhan
- Department of Clinical Pharmacy, University of South Carolina, Columbia, South Carolina, USA
| | - Nicole Lamanna
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
| | - Clare Sun
- Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mazyar Shadman
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - John M Pagel
- Center for Blood Disorders and Stem Cell Transplantation, Swedish Cancer Institute, Seattle, WA, USA
| | - Chaitra Ujjani
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Danielle Brander
- Division of Hematology and Oncology, Department of Internal Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Catherine C Coombs
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Nitin Jain
- MD Anderson Cancer Center, Houston, TX, USA
| | - Chan Y Cheah
- Linear Clinical Research and Sir Charles Gairdner Hospital and University of Western Australia, Perth, Australia
| | - Jennifer R Brown
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - John F Seymour
- Peter MacCallum Cancer Center, Royal Melbourne Hospital, and University of Melbourne, Melbourne, Australia
| | - Jennifer A Woyach
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
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Premachandra A, O’Brien S, Perna N, McGivern J, LaRue R, Latulippe DR. Treatment of complex multi-sourced industrial wastewater — New opportunities for nanofiltration membranes. Chem Eng Res Des 2021. [DOI: 10.1016/j.cherd.2021.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Affiliation(s)
- Deepa Jeyakumar
- Chao Comprehensive Cancer Center, University of California-Irvine, Orange
| | - Susan O’Brien
- Chao Comprehensive Cancer Center, University of California-Irvine, Orange
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8
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Cassaday RD, Marks DI, DeAngelo DJ, Jabbour EJ, Advani AS, O’Brien S, Wang T, Neuhof A, Vandendries E, Kantarjian HM, Stock W, Stelljes M. Impact of number of cycles on outcomes of patients with relapsed or refractory acute lymphoblastic leukaemia treated with inotuzumab ozogamicin. Br J Haematol 2020; 191:e77-e81. [DOI: 10.1111/bjh.17029] [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] [Received: 03/10/2020] [Accepted: 07/12/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Ryan D. Cassaday
- University of Washington School of Medicine and Fred Hutchinson Cancer Research Center Seattle WA USA
| | | | | | | | | | - Susan O’Brien
- Chao Family Comprehensive Cancer Center University of California Irvine Orange CAUSA
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9
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Lama TG, Kyung D, O’Brien S. Mechanisms of ibrutinib resistance in chronic lymphocytic leukemia and alternative treatment strategies. Expert Rev Hematol 2020; 13:871-883. [DOI: 10.1080/17474086.2020.1797482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Tsering Gyalpo Lama
- Division of Hematology/Oncology, Department of Medicine, UI Health, Orange, CA, USA
| | - Daniel Kyung
- Division of Hematology/Oncology, Department of Medicine, UI Health, Orange, CA, USA
| | - Susan O’Brien
- Division of Hematology/Oncology, Department of Medicine, UI Health, Orange, CA, USA
- Associate Director for Clinical Sciences, Chao Family Comprehensive Cancer Center, UCI Health, Orange Country, CA, USA
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10
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Wright L, Cazares A, Figueroa W, Walshaw M, O’Brien S, Winstanley C, Fothergill J. WS08.6 Pseudomonas aeruginosa phage gene expression changes in co-culture with Streptococcus and Rothia spp. in an artificial sputum model. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30211-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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11
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Jabbour E, Gökbuget N, Advani A, Stelljes M, Stock W, Liedtke M, Martinelli G, O’Brien S, Wang T, Laird AD, Vandendries E, Neuhof A, Nguyen K, Dakappagari N, DeAngelo DJ, Kantarjian H. Impact of minimal residual disease status in patients with relapsed/refractory acute lymphoblastic leukemia treated with inotuzumab ozogamicin in the phase III INO-VATE trial. Leuk Res 2020; 88:106283. [DOI: 10.1016/j.leukres.2019.106283] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 11/23/2019] [Indexed: 01/05/2023]
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12
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Affiliation(s)
- Yasir Khan
- Division of Hematology and Oncology, University of California Irvine, Irvine, CA, USA
| | - Yung Lyou
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Monica El-Masry
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Susan O’Brien
- Division of Hematology and Oncology, University of California Irvine, Irvine, CA, USA
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13
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Jabbour E, Sasaki K, Ravandi F, Short NJ, Garcia-Manero G, Daver N, Kadia T, Konopleva M, Jain N, Cortes J, Issa GC, Jacob J, Kwari M, Thompson P, Garris R, Pemmaraju N, Yilmaz M, O’Brien S, Kantarjian H. Inotuzumab ozogamicin in combination with low-intensity chemotherapy (mini-HCVD) with or without blinatumomab versus standard intensive chemotherapy (HCVAD) as frontline therapy for older patients with Philadelphia chromosome-negative acute lymphoblastic leukemia: A propensity score analysis. Cancer 2019; 125:2579-2586. [PMID: 30985931 PMCID: PMC6625850 DOI: 10.1002/cncr.32139] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/08/2019] [Accepted: 03/08/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND The outcome of older patients with newly diagnosed, Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) is poor. The combination of targeted therapy with low-intensity chemotherapy is safe and effective. The objective of the current analysis was to compare the outcome of patients who received a combination of inotuzumab ozogamicin plus low-intensity chemotherapy (mini-hyperfractionated cyclophosphamide, vincristine, and dexamethasone [mini-HCVD]) with or without blinatumomab versus the outcome of those who received the standard, intensive, hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (HCVAD) regimen. METHODS The authors analyzed 135 older patients with newly diagnosed, Ph-negative ALL who were treated prospectively with standard HCVAD (n = 77) or with the combination of inotuzumab ozogamicin plus mini-HCVD with or without blinatumomab (n = 58). A propensity score analysis was conducted using 1:1 matching using the nearest neighbor matching method. RESULTS Propensity score matching identified 38 patients in each cohort. The antibody plus low-intensity chemotherapy combination induced higher response rates (98% vs 88%), with lower rates of early death (0% vs 8%) and lower rates of death in complete remission (5% vs 17%). With propensity score matching, the 3-year event-free survival rates for patients who received HCVAD and those who received the combination of inotuzumab ozogamicin plus mini-HCVD with or without blinatumomab were 34% and 64%, respectively (P = .003), and the 3-year overall survival rates were 34% and 63%, respectively (P = .004). By multivariate analysis, age (P = .019; hazard ratio, 1.045) and the combination of inotuzumab plus mini-HCVD with or without blinatumomab (P = .020; hazard ratio, 0.550) were identified as independent prognostic factors for survival. CONCLUSIONS The combination of inotuzumab ozogamicin plus mini-HCVD with or without blinatumomab is safe and effective in older patients with newly diagnosed, Ph-negative ALL and confers a better outcome compared with standard HCVAD chemotherapy.
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Affiliation(s)
- Elias Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Koji Sasaki
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Farhad Ravandi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nicholas J. Short
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Naval Daver
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tapan Kadia
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Marina Konopleva
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nitin Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jorge Cortes
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ghayas C. Issa
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jovitta Jacob
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Monica Kwari
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Philip Thompson
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rebecca Garris
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Naveen Pemmaraju
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Musa Yilmaz
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Susan O’Brien
- Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA
| | - Hagop Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
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Kantarjian H, O’Brien S. Poor Penetration of Existing Effective Chemoimmunotherapy for the Treatment of Older Patients With Newly Diagnosed Acute Lymphocytic Leukemia (ALL) or Refractory/Relapsed ALL. J Oncol Pract 2019; 15:77-79. [DOI: 10.1200/jop.18.00799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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15
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Mault N, Nelson G, O’Brien S, Peck E, Claire F, Gilbert A, Jennifer F. Evaluation of an undergraduate student mentorship programme (SMP) within a national specialist centre. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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O’Brien S, Patel M, Kahl BS, Horwitz SM, Foss FM, Porcu P, Jones J, Burger J, Jain N, Allen K, Faia K, Douglas M, Stern HM, Sweeney J, Kelly P, Kelly V, Flinn I. Duvelisib, an oral dual PI3K-δ,γ inhibitor, shows clinical and pharmacodynamic activity in chronic lymphocytic leukemia and small lymphocytic lymphoma in a phase 1 study. Am J Hematol 2018; 93:1318-1326. [PMID: 30094870 PMCID: PMC8260004 DOI: 10.1002/ajh.25243] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/06/2018] [Accepted: 08/03/2018] [Indexed: 02/03/2023]
Abstract
Duvelisib (IPI-145), an oral, dual inhibitor of phosphoinositide-3-kinase (PI3K)-δ and -γ, was evaluated in a Phase 1 study in advanced hematologic malignancies, which included expansion cohorts in relapsed/refractory (RR) chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) and treatment-naïve (TN) CLL. Per protocol, TN patients were at least 65 years old or had a del(17p)/TP53 mutation. Duvelisib was administered twice daily (BID) in 28-day cycles at doses of 8-75 mg in RR patients (n = 55) and 25 mg in TN patients (n = 18.) Diarrhea was the most common nonhematologic AE (TN 78%, RR 47%); transaminase elevations the most frequent lab-abnormality AE (TN 33.3%, RR 30.9%); and neutropenia the most common ≥grade 3 AE (RR 44%, TN 33%). The overall response rates were 56.4% for RR patients (1.8% CR, 54.5% PR) and 83.3% for TN patients (all PRs); median response duration was 21.0 months in RR patients but was not reached for TN patients. Based upon phase 1 efficacy, pharmacodynamics, and safety, duvelisib 25 mg BID was selected for further investigation in a phase 3 study in RR CLL/SLL.
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Affiliation(s)
| | | | | | | | | | - Pierluigi Porcu
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jeffrey Jones
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jan Burger
- MD Anderson Cancer Center, Houston, Texas
| | - Nitin Jain
- MD Anderson Cancer Center, Houston, Texas
| | - Kerstin Allen
- Infinity Pharmaceuticals, Inc., Cambridge, Massachusetts
| | - Kerrie Faia
- Infinity Pharmaceuticals, Inc., Cambridge, Massachusetts
| | - Mark Douglas
- Infinity Pharmaceuticals, Inc., Cambridge, Massachusetts
| | | | | | - Patrick Kelly
- Infinity Pharmaceuticals, Inc., Cambridge, Massachusetts
| | - Virginia Kelly
- Infinity Pharmaceuticals, Inc., Cambridge, Massachusetts
| | - Ian Flinn
- Sarah Cannon Research Institute, Nashville, Tennessee
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17
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Archer A, Benbow W, Bird R, Brose R, Buchovecky M, Buckley J, Bugaev V, Connolly M, Cui W, Daniel M, Feng Q, Finley J, Fortson L, Furniss A, Gillanders G, Hütten M, Hanna D, Hervet O, Holder J, Hughes G, Humensky T, Johnson C, Kaaret P, Kar P, Kelley-Hoskins N, Kertzman M, Kieda D, Krause M, Krennrich F, Kumar S, Lang M, Lin T, Maier G, McArthur S, Moriarty P, Mukherjee R, O’Brien S, Ong R, Otte A, Petrashyk A, Pohl M, Pueschel E, Quinn J, Ragan K, Reynolds P, Richards G, Roache E, Rulten C, Sadeh I, Santander M, Sembroski G, Staszak D, Sushch I, Wakely S, Wells R, Wilcox P, Wilhelm A, Williams D, Williamson T, Zitzer B. Measurement of cosmic-ray electrons at TeV energies by VERITAS. Int J Clin Exp Med 2018. [DOI: 10.1103/physrevd.98.062004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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18
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Klampatsa A, O’Brien S, Eruslanov E, Rao A, Thompson J, Kim S, Cengel K, Moon E, Singhal S, Albelda S. PO-387 Phenotypic and functional analysis of malignant mesothelioma tumor-infiltrating lymphocytes (TILs). ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Pagoti R, O’Brien S, Blaney J, Doran E, Beverland D. Knee manipulation for reduced flexion after Total Knee Arthroplasty. Is timing critical? J Clin Orthop Trauma 2018; 9:295-299. [PMID: 30449974 PMCID: PMC6224686 DOI: 10.1016/j.jcot.2017.11.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 11/26/2017] [Accepted: 11/30/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Reduced flexion following knee arthroplasty (TKA) may compromise patient's function and outcome. The timing of manipulation under anaesthesia (MUA) has been controversial. We present our experience in a high volume practice and analyse the impact of timing. METHODS All TKA patients requiring MUA from February 1996 to June 2015 under the care of a single surgeon were analysed. MUA was offered to patients who had ≤ 75° of flexion post-op, providing that they had 30° more flexion preoperatively. To address the impact of timing from primary surgery to MUA on flexion gain we looked at 3 groups: Group I ≤ 90 days, Group II 91-180 days and Group III > 180 days. RESULTS Sixty two out of 7,423 (0.84%) underwent MUA. The MUA patients were significantly younger than the overall TKA cohort 61.2 vs 70.5 years (p = < 0.01). The median duration between arthroplasty and MUA was 3.9 months (IQR 3.4, Range 1.6-72.5 months). Overall flexion gained at 6-12 Weeks and 1 year post MUA showed significant improvements of 20.9° (p = <0.01) and 25° respectively (p = < 0.01). The flexion gain in group I (≤ 90 days) was significantly better than group III ( > 180 days) both at 6 weeks and 1 year following MUA but not better than group II (90-180 days). CONCLUSIONS MUA is an effective treatment for reduced flexion following TKA and should be the first line of management after failed physiotherapy. It can still have benefit beyond 6 months but the gains become less effective with time.
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Affiliation(s)
- R. Pagoti
- Corresponding author. Permanent address: 63 Glenburn Road, Dunmurry, Belfast, BT17 9AN, UK.
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Dupont E, Otuka N, Cabellos O, Aberle O, Aerts G, Altstadt S, Alvarez H, Alvarez-Velarde F, Andriamonje S, Andrzejewski J, Audouin L, Bacak M, Badurek G, Balibrea J, Barbagallo M, Barros S, Baumann P, Bécares V, Bečvář F, Beinrucker C, Belloni F, Berthier B, Berthoumieux E, Billowes J, Boccone V, Bosnar D, Brown A, Brugger M, Caamaño M, Calviani M, Calviño F, Cano-Ott D, Capote R, Cardella R, Carrapiço C, Casanovas A, Castelluccio D, Cennini P, Cerutti F, Chen Y, Chiaveri E, Chin M, Colonna N, Cortés G, Cortés-Giraldo M, Cosentino L, Couture A, Cox J, Damone L, David S, Deo K, Diakaki M, Dillmann I, Domingo-Pardo C, Dressler R, Dridi W, Duran I, Eleftheriadis C, Embid-Segura M, Fernández-Domínguez B, Ferrant L, Ferrari A, Ferreira P, Finocchiaro P, Fraval K, Frost R, Fujii K, Furman W, Ganesan S, Garcia A, Gawlik A, Gheorghe I, Gilardoni S, Giubrone G, Glodariu T, Göbel K, Gomez-Hornillos M, Goncalves I, Gonzalez-Romero E, Goverdovski A, Gramegna F, Griesmayer E, Guerrero C, Gunsing F, Gurusamy P, Haight R, Harada H, Heftrich T, Heil M, Heinitz S, Hernández-Prieto A, Heyse J, Igashira M, Isaev S, Jenkins D, Jericha E, Kadi Y, Kaeppeler F, Kalamara A, Karadimos D, Karamanis D, Katabuchi T, Kavrigin P, Kerveno M, Ketlerov V, Khryachkov V, Kimura A, Kivel N, Kokkoris M, Konovalov V, Krtička M, Kroll J, Kurtulgil D, Lampoudis C, Langer C, Leal-Cidoncha E, Lederer C, Leeb H, Naour CL, Lerendegui-Marco J, Leong L, Licata M, Meo SL, Lonsdale S, Losito R, Lozano M, Macina D, Manousos A, Marganiec J, Martinez T, Marrone S, Masi A, Massimi C, Mastinu P, Mastromarco M, Matteucci F, Maugeri E, Mazzone A, Mendoza E, Mengoni A, Milazzo P, Mingrone F, Mirea M, Mondelaers W, Montesano S, Moreau C, Mosconi M, Musumarra A, Negret A, Nolte R, O’Brien S, Oprea A, Palomo-Pinto F, Pancin J, Paradela C, Patronis N, Pavlik A, Pavlopoulos P, Perkowski J, Perrot L, Pigni M, Plag R, Plompen A, Plukis L, Poch A, Porras I, Praena J, Pretel C, Quesada J, Radeck D, Rajeev K, Rauscher T, Reifarth R, Riego A, Robles M, Roman F, Rout P, Rudolf G, Rubbia C, Rullhusen P, Ryan J, Sabaté-Gilarte M, Salgado J, Santos C, Sarchiapone L, Sarmento R, Saxena A, Schillebeeckx P, Schmidt S, Schumann D, Sedyshev P, Smith A, Sosnin N, Stamatopoulos A, Stephan C, Suryanarayana S, Tagliente G, Tain J, Tarifeño-Saldivia A, Tarrío D, Tassan-Got L, Tavora L, Terlizzi R, Tsinganis A, Valenta S, Vannini G, Variale V, Vaz P, Ventura A, Versaci R, Vermeulen M, Villamarin D, Vicente M, Vlachoudis V, Vlastou R, Voss F, Wallner A, Walter S, Ware T, Warren S, Weigand M, Weiß C, Wolf C, Wiesher M, Wisshak K, Woods P, Wright T, Žugec P. Dissemination of data measured at the CERN n_TOF facility. EPJ Web Conf 2017. [DOI: 10.1051/epjconf/201714607002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Patel VM, Balakrishnan K, Douglas M, Tibbitts T, Xu EY, Kutok JL, Ayers M, Sarkar A, Guerrieri R, Wierda WG, O’Brien S, Jain N, Stern HM, Gandhi V. Duvelisib treatment is associated with altered expression of apoptotic regulators that helps in sensitization of chronic lymphocytic leukemia cells to venetoclax (ABT-199). Leukemia 2017; 31:1872-1881. [PMID: 28017967 PMCID: PMC5540815 DOI: 10.1038/leu.2016.382] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 11/21/2016] [Accepted: 11/24/2016] [Indexed: 12/18/2022]
Abstract
Duvelisib, an oral dual inhibitor of PI3K-δ and PI3K-γ, is in phase III trials for the treatment of chronic lymphocytic leukemia (CLL) and indolent non-Hodgkin's lymphoma. In CLL, duvelisib monotherapy is associated with high iwCLL (International Workshop on Chronic Lymphocytic Leukemia) and nodal response rates, but complete remissions are rare. To characterize the molecular effect of duvelisib, we obtained samples from CLL patients on the duvelisib phase I trial. Gene expression studies (RNAseq, Nanostring, Affymetrix array and real-time RT-PCR) demonstrated increased expression of BCL2 along with several BH3-only pro-apoptotic genes. In concert with induction of transcript levels, reverse phase protein arrays and immunoblots confirmed increase at the protein level. The BCL2 inhibitor venetoclax induced greater apoptosis in ex vivo-cultured CLL cells obtained from patients on duvelisib compared with pre-treatment CLL cells from the same patients. In vitro combination of duvelisib and venetoclax resulted in enhanced apoptosis even in CLL cells cultured under conditions that simulate the tumor microenvironment. These data provide a mechanistic rationale for testing the combination of duvelisib and venetoclax in the clinic. Such combination regimen (NCT02640833) is being evaluated for patients with B-cell malignancies including CLL.
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Affiliation(s)
- Viralkumar M. Patel
- Department of Experimental Therapeutics, UT MD Anderson Cancer Center, Houston, TX
| | - Kumudha Balakrishnan
- Department of Experimental Therapeutics, UT MD Anderson Cancer Center, Houston, TX
| | | | | | - Ethan Y. Xu
- Infinity Pharmaceuticals Inc., Cambridge, MA
| | | | - Mary Ayers
- Department of Experimental Therapeutics, UT MD Anderson Cancer Center, Houston, TX
| | - Aloke Sarkar
- Department of Experimental Therapeutics, UT MD Anderson Cancer Center, Houston, TX
| | - Renato Guerrieri
- Department of Experimental Therapeutics, UT MD Anderson Cancer Center, Houston, TX
| | | | - Susan O’Brien
- Department of Leukemia, UT MD Anderson Cancer Center, Houston, TX
| | - Nitin Jain
- Department of Leukemia, UT MD Anderson Cancer Center, Houston, TX
| | | | - Varsha Gandhi
- Department of Experimental Therapeutics, UT MD Anderson Cancer Center, Houston, TX
- Department of Leukemia, UT MD Anderson Cancer Center, Houston, TX
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Blaney J, Harty H, Doran E, O’Brien S, Hill J, Dobie I, Beverland D. Five-year clinical and radiological outcomes in 257 consecutive cementless Oxford medial unicompartmental knee arthroplasties. Bone Joint J 2017; 99-B:623-631. [DOI: 10.1302/0301-620x.99b5.bjj-2016-0760.r1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 01/13/2017] [Indexed: 12/24/2022]
Abstract
Aims Our aim was to examine the clinical and radiographic outcomes in 257 consecutive Oxford unicompartmental knee arthroplasties (OUKAs) (238 patients), five years post-operatively. Patients and Methods A retrospective evaluation was undertaken of patients treated between April 2008 and October 2010 in a regional centre by two non-designing surgeons with no previous experience of UKAs. The Oxford Knee Scores (OKSs) were recorded and fluoroscopically aligned radiographs were assessed post-operatively at one and five years. Results The median age of the 238 patients was 65.0 years (interquartile range (IQR) 59.0 to 73.0), the median body mas index was 30.0 (IQR 27.5 to 33.0) and 51.7% were male. There were no intra-operative complications. There was a significant improvement in the median OKS at six weeks (34, IQR 31.0 to 37.0), one year (38, IQR 29.0 to 43.0) and five years (37, IQR 27.0 to 42.0) when compared with the pre-operative scores (16, IQR 13.0 to 19.0) (all p = < 0.01). No patient had progressive radiolucent lines or loosening. A total of 16 patients had died by five years. The cumulative survival at five years was 98.8% and the mean survival time was 5.8 years (95% confidence interval 5.6 to 5.9). A total of seven OUKAs (2.7%) were revised; three within five years and four thereafter, between 5.1 and 5.7 years post-operatively. Five (1.9%) had re-operations within five years. Conclusion The proportion of patients requiring revision at five years is lower than that generally reported for UKA. These findings add support for the use of the cementless OUKA outside the design centre. Longer follow-up is required. Cite this article: Bone Joint J 2017;99-B:623–31.
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Affiliation(s)
- J. Blaney
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - H. Harty
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - E. Doran
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - S. O’Brien
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - J. Hill
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - I. Dobie
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
| | - D. Beverland
- Primary Joint Unit, Musgrave Park Hospital, Stockmans
Lane, Belfast, Co. Antrim, BT9 7JB, UK
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Archambault S, Archer A, Benbow W, Bird R, Bourbeau E, Brantseg T, Buchovecky M, Buckley J, Bugaev V, Byrum K, Cerruti M, Christiansen J, Connolly M, Cui W, Daniel M, Feng Q, Finley J, Fleischhack H, Fortson L, Furniss A, Geringer-Sameth A, Griffin S, Grube J, Hütten M, Håkansson N, Hanna D, Hervet O, Holder J, Hughes G, Hummensky B, Johnson C, Kaaret P, Kar P, Kelley-Hoskins N, Kertzman M, Kieda D, Koushiappas S, Krause M, Krennrich F, Lang M, Lin T, McArthur S, Moriarty P, Mukherjee R, Nieto D, O’Brien S, Ong R, Otte A, Park N, Pohl M, Popkow A, Pueschel E, Quinn J, Ragan K, Reynolds P, Richards G, Roache E, Rulten C, Sadeh I, Santander M, Sembroski G, Shahinyan K, Smith A, Staszak D, Telezhinsky I, Trepanier S, Tucci J, Tyler J, Wakely S, Weinstein A, Wilcox P, Williams D, Zitzer B. Dark matter constraints from a joint analysis of dwarf Spheroidal galaxy observations with VERITAS. Int J Clin Exp Med 2017. [DOI: 10.1103/physrevd.95.082001] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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24
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Hao YN, Bi K, O’Brien S, Wang XH, Lombardi J, Pearsall F, Li WL, Lei M, Wu Y, Li LT. Correction: Interface structure, precursor rheology and dielectric properties of BaTiO 3/PVDF–hfp nanocomposite films prepared from colloidal perovskite nanoparticles. RSC Adv 2017. [DOI: 10.1039/c7ra90094e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Correction for ‘Interface structure, precursor rheology and dielectric properties of BaTiO3/PVDF–hfp nanocomposite films prepared from colloidal perovskite nanoparticles’ by Y. N. Hao et al., RSC Adv., 2017, 7, 32886–32892.
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Abstract
The advent of novel small-molecule inhibitors has transformed the treatment approaches for patients with chronic lymphocytic leukemia (CLL). These therapies are becoming increasingly used in patients with relapsed disease, patients with 17p deletion, and, as of recently, also in the frontline setting for previously untreated patients with CLL. Moreover, many of these are oral therapies that are significantly less myelosuppressive than chemoimmunotherapy. However, these agents have their own set of unique toxicities with which providers must gain familiarity. There is also ongoing development of second-generation agents which have the promise of less toxicity than the US Food and Drug Administration (FDA)-approved compounds. In addition, immunotherapy and the role of the microenvironment are becoming increasingly important and have therapeutic implications in the treatment of patients with CLL. Ultimately, investigators need to evaluate how to position these and other new exciting therapies and decide on the ultimate role for chemoimmunotherapy in modern times.
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MESH Headings
- Antineoplastic Agents/therapeutic use
- Chromosome Deletion
- Chromosomes, Human, Pair 17/genetics
- Chromosomes, Human, Pair 17/immunology
- Drug Approval
- Humans
- Immunotherapy/methods
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Smith-Magenis Syndrome/genetics
- Smith-Magenis Syndrome/immunology
- Smith-Magenis Syndrome/therapy
- Tumor Microenvironment/immunology
- United States
- United States Food and Drug Administration
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Affiliation(s)
- Nicole Lamanna
- Leukemia Service, Chronic Lymphocytic Leukemia Program, Hematologic Malignancies Section, Herbert Irving Comprehensive Cancer Center, New York–Presbyterian/Columbia University Medical Center, New York, NY; and
| | - Susan O’Brien
- Chao Family Comprehensive Cancer Center, Sue and Ralph Stern Center for Clinical Trials & Research, Division of Hematology/Oncology, Department of Medicine, University of California, Irvine, Orange, CA
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Abstract
A 61-year-old man with a history of chronic lymphocytic leukemia (CLL) presents with complaints of worsening fatigue and night sweats. He was diagnosed with CLL 3 years ago on routine blood count testing. He has no major medical comorbidities. On examination, he has several 2- to 3-cm lymph nodes in the cervical and axillary area. Spleen is palpable 5 cm below the costal margin. Blood counts show lymphocytosis with thrombocytopenia and anemia. Prognostic markers include deletion 13q by fluorescence in situ hybridization analysis and mutated IGHV You are asked by the hematology fellow you are supervising about the best treatment of this patient.
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MESH Headings
- Chromosome Deletion
- Chromosomes, Human, Pair 13/genetics
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Male
- Middle Aged
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Affiliation(s)
- Nitin Jain
- Department of Leukemia, MD Anderson Cancer Center, Houston, TX; and
| | - Susan O’Brien
- Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange, CA
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Rose T, Adams N, Taylor-Robinson D, Barr B, Hawker J, O’Brien S, Violato M, Whitehead M. Relationship between socioeconomic status and measures of infectious intestinal disease severity. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw166.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kantarjian HM, DeAngelo DJ, Stelljes M, Martinelli G, Liedtke M, Stock W, Gökbuget N, O’Brien S, Wang K, Wang T, Paccagnella ML, Sleight B, Vandendries E, Advani AS. Inotuzumab Ozogamicin versus Standard Therapy for Acute Lymphoblastic Leukemia. N Engl J Med 2016; 375:740-53. [PMID: 27292104 PMCID: PMC5594743 DOI: 10.1056/nejmoa1509277] [Citation(s) in RCA: 852] [Impact Index Per Article: 106.5] [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] [Indexed: 12/13/2022]
Abstract
BACKGROUND The prognosis for adults with relapsed acute lymphoblastic leukemia is poor. We sought to determine whether inotuzumab ozogamicin, an anti-CD22 antibody conjugated to calicheamicin, results in better outcomes in patients with relapsed or refractory acute lymphoblastic leukemia than does standard therapy. METHODS In this phase 3 trial, we randomly assigned adults with relapsed or refractory acute lymphoblastic leukemia to receive either inotuzumab ozogamicin (inotuzumab ozogamicin group) or standard intensive chemotherapy (standard-therapy group). The primary end points were complete remission (including complete remission with incomplete hematologic recovery) and overall survival. RESULTS Of the 326 patients who underwent randomization, the first 218 (109 in each group) were included in the primary intention-to-treat analysis of complete remission. The rate of complete remission was significantly higher in the inotuzumab ozogamicin group than in the standard-therapy group (80.7% [95% confidence interval {CI}, 72.1 to 87.7] vs. 29.4% [95% CI, 21.0 to 38.8], P<0.001). Among the patients who had complete remission, a higher percentage in the inotuzumab ozogamicin group had results below the threshold for minimal residual disease (0.01% marrow blasts) (78.4% vs. 28.1%, P<0.001); the duration of remission was longer in the inotuzumab ozogamicin group (median, 4.6 months [95% CI, 3.9 to 5.4] vs. 3.1 months [95% CI, 1.4 to 4.9]; hazard ratio, 0.55 [95% CI, 0.31 to 0.96]; P=0.03). In the survival analysis, which included all 326 patients, progression-free survival was significantly longer in the inotuzumab ozogamicin group (median, 5.0 months [95% CI, 3.7 to 5.6] vs. 1.8 months [95% CI, 1.5 to 2.2]; hazard ratio, 0.45 [97.5% CI, 0.34 to 0.61]; P<0.001); the median overall survival was 7.7 months (95% CI, 6.0 to 9.2) versus 6.7 months (95% CI, 4.9 to 8.3), and the hazard ratio was 0.77 (97.5% CI, 0.58 to 1.03) (P=0.04). In the safety population, the most frequent grade 3 or higher nonhematologic adverse events with inotuzumab ozogamicin were liver-related. Veno-occlusive liver disease of any grade occurred in 15 patients (11%) who received inotuzumab ozogamicin and in 1 patient (1%) who received standard therapy. CONCLUSIONS The rate of complete remission was higher with inotuzumab ozogamicin than with standard therapy, and a higher percentage of patients in the inotuzumab ozogamicin group had results below the threshold for minimal residual disease. Both progression-free and overall survival were longer with inotuzumab ozogamicin. Veno-occlusive liver disease was a major adverse event associated with inotuzumab ozogamicin. (Funded by Pfizer; INO-VATE ALL ClinicalTrials.gov number, NCT01564784.).
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Affiliation(s)
- Hagop M. Kantarjian
- MD Anderson Cancer Center, Houston, TX, USA
- Address correspondence to: Hagop M. Kantarjian, MD, Department of Leukemia, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, Tel: (713) 792-7026, Fax: (713) 794-4297,
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Köhrer S, Havranek O, Seyfried F, Hurtz C, Coffey GP, Kim E, Hacken ET, Jäger U, Vanura K, O’Brien S, Thomas DA, Kantarjian H, Ghosh D, Wang Z, Zhang M, Ma W, Jumaa H, Debatin KM, Müschen M, Meyer LH, Davis RE, Burger JA. Pre-BCR signaling in precursor B-cell acute lymphoblastic leukemia regulates PI3K/AKT, FOXO1 and MYC, and can be targeted by SYK inhibition. Leukemia 2016; 30:1246-54. [PMID: 26847027 PMCID: PMC5459356 DOI: 10.1038/leu.2016.9] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/20/2015] [Accepted: 12/23/2015] [Indexed: 12/11/2022]
Abstract
Precursor-B-cell receptor (pre-BCR) signaling and spleen tyrosine kinase (SYK) recently were introduced as therapeutic targets for patients with B-cell acute lymphoblastic leukemia (B-ALL), but the importance of this pathway in B-ALL subsets and mechanism of downstream signaling have not fully been elucidated. Here, we provide new detailed insight into the mechanism of pre-BCR signaling in B-ALL. We compared the effects of pharmacological and genetic disruption of pre-BCR signaling in vitro and in mouse models for B-ALL, demonstrating exquisite dependency of pre-BCR(+) B-ALL, but not other B-ALL subsets, on this signaling pathway. We demonstrate that SYK, PI3K/AKT, FOXO1 and MYC are important downstream mediators of pre-BCR signaling in B-ALL. Furthermore, we define a characteristic immune phenotype and gene expression signature of pre-BCR(+) ALL to distinguish them from other B-ALL subsets. These data provide comprehensive new insight into pre-BCR signaling in B-ALL and corroborate pre-BCR signaling and SYK as promising new therapeutic targets in pre-BCR(+) B-ALL.
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Affiliation(s)
- Stefan Köhrer
- Department of Leukemia, Unit 428, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Ondrej Havranek
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Felix Seyfried
- Ulm University Medical Center, Department of Pediatrics and Adolescent Medicine, Ulm, Germany
| | - Christian Hurtz
- Department of Laboratory Medicine, University of California, San Francisco, CA 94143
| | | | - Ekaterina Kim
- Department of Leukemia, Unit 428, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Elisa ten Hacken
- Department of Leukemia, Unit 428, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Ulrich Jäger
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Katrina Vanura
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Susan O’Brien
- Department of Leukemia, Unit 428, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Deborah A. Thomas
- Department of Leukemia, Unit 428, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Hagop Kantarjian
- Department of Leukemia, Unit 428, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Dipanjan Ghosh
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Zhiqiang Wang
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Min Zhang
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Wencai Ma
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Hassan Jumaa
- Ulm University, Department of Immunology, Ulm, Germany
| | - Klaus-Michael Debatin
- Ulm University Medical Center, Department of Pediatrics and Adolescent Medicine, Ulm, Germany
| | - Markus Müschen
- Department of Laboratory Medicine, University of California, San Francisco, CA 94143
| | - Lüder H. Meyer
- Ulm University Medical Center, Department of Pediatrics and Adolescent Medicine, Ulm, Germany
| | - R. Eric Davis
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
| | - Jan A. Burger
- Department of Leukemia, Unit 428, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States, 77030
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Vernardou D, Marathianou I, Katsarakis N, Koudoumas E, Kazadojev I, O’Brien S, Pemble M, Povey I. Capacitive behavior of Ag doped V2O5 grown by aerosol assisted chemical vapour deposition. Electrochim Acta 2016. [DOI: 10.1016/j.electacta.2016.02.186] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Diakaki M, Audouin L, Berthoumieux E, Calviani M, Colonna N, Dupont E, Duran I, Gunsing F, Leal-Cidoncha E, Le Naour C, Leong L, Mastromarco M, Paradela C, Tarrio D, Tassan-Got L, Aerts G, Altstadt S, Alvarez H, Alvarez-Velarde F, Andriamonje S, Andrzejewski J, Badurek G, Barbagallo M, Baumann P, Becares V, Becvar F, Belloni F, Berthier B, Billowes J, Boccone V, Bosnar D, Brugger M, Calvino F, Cano-Ott D, Capote R, Carrapiço C, Cennini P, Cerutti F, Chiaveri E, Chin M, Cortes G, Cortes-Giraldo M, Cosentino L, Couture A, Cox J, David S, Dillmann I, Domingo-Pardo C, Dressler R, Dridi W, Eleftheriadis C, Embid-Segura M, Ferrant L, Ferrari A, Finocchiaro P, Fraval K, Fujii K, Furman W, Ganesan S, Garcia A, Giubrone G, Gomez-Hornillos M, Goncalves I, Gonzalez-Romero E, Goverdovski A, Gramegna F, Griesmayer E, Guerrero C, Gurusamy P, Haight R, Heil M, Heinitz S, Igashira M, Isaev S, Jenkins D, Jericha E, Kadi Y, Kaeppeler F, Karadimos D, Karamanis D, Kerveno M, Ketlerov V, Kivel N, Kokkoris M, Konovalov V, Krticka M, Kroll J, Lampoudis C, Langer C, Lederer C, Leeb H, Lo Meo S, Losito R, Lozano M, Manousos A, Marganiec J, Martinez T, Marrone S, Massimi C, Mastinu P, Mendoza E, Mengoni A, Milazzo P, Mingrone F, Mirea M, Mondelaers W, Moreau C, Mosconi M, Musumarra A, O’Brien S, Pancin J, Patronis N, Pavlik A, Pavlopoulos P, Perkowski J, Perrot L, Pigni M, Plag R, Plompen A, Plukis L, Poch A, Pretel C, Praena J, Quesada J, Rauscher T, Reifarth R, Riego A, Roman F, Rudolf G, Rubbia C, Rullhusen P, Salgado J, Santos C, Sarchiapone L, Sarmento R, Saxena A, Schillebeeckx P, Schmidt S, Schumann D, Stephan C, Tagliente G, Tain J, Tavora L, Terlizzi R, Tsinganis A, Valenta S, Vannini G, Variale V, Vaz P, Ventura A, Versaci R, Vermeulen M, Villamarin D, Vincente M, Vlachoudis V, Vlastou R, Voss F, Wallner A, Walter S, Ware T, Weigand M, Weiß C, Wiesher M, Wisshak K, Wright T, Zugec P. Towards the high-accuracy determination of the238U fission cross section at the threshold region at CERN – n_TOF. EPJ Web of Conferences 2016. [DOI: 10.1051/epjconf/201611102002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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32
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Mahon N, O'Neill J, O’Brien S, McCarthy J, O’Loughlin C, Carton E. 17 Outcome of extra-corporeal life support for fulminant heart failure/cardiogenic shock. Heart 2015. [DOI: 10.1136/heartjnl-2015-308621.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jabbour E, O’Brien S, Thomas D, Sasaki K, Garcia-Manero G, Ravandi F, Borthakur G, York S, Garris R, Cortes J, Kantarjian H. Inotuzumab Ozogamicin (IO) in Combination with Low-Intensity Chemotherapy (mini-hyper-CVD) as Frontline Therapy for Older Patients (pts) and as Salvage Therapy for Adult with Relapsed/Refractory (R/R) Acute Lymphoblastic Leukemia (ALL). Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Poon ML, Fox PS, Samuels BI, O’Brien S, Jabbour E, Hsu Y, Gulbis A, Korbling M, Champlin R, Abruzzo LV, Bassett RL, Khouri IF. Allogeneic stem cell transplant in patients with chronic lymphocytic leukemia with 17p deletion: consult-transplant versus consult- no-transplant analysis. Leuk Lymphoma 2015; 56:711-5. [PMID: 24913509 PMCID: PMC4454336 DOI: 10.3109/10428194.2014.930848] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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] [Indexed: 11/13/2022]
Abstract
Allogeneic stem cell transplant (alloSCT) can overcome the adverse prognosis of chronic lymphocytic leukemia with 17p deletion (17p- CLL). However, its applicability remains unclear. Since 2007, our leukemia service has referred patients with 17p- CLL for alloSCT at presentation. In this study, the outcomes of these patients were reviewed retrospectively to determine whether they underwent alloSCT and why patients did not undergo alloSCT. Fifty-two patients with 17p- CLL who were referred to the transplant service from 2007 to 2010 were identified. Of these patients, 32 (62%) did not undergo alloSCT, mainly because of treatment- or disease-related complications (n = 15). The 2-year post-referral overall survival rates of the alloSCT and non-SCT groups were 64% and 25%, respectively (p = 0.001). These findings suggest that while alloSCT is an effective therapy in patients with 17p- CLL, pre-SCT complications may preclude a significant proportion of patients from undergoing the procedure.
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Affiliation(s)
- Michelle L. Poon
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Patricia S. Fox
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Barry I. Samuels
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan O’Brien
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elias Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yvonne Hsu
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Alison Gulbis
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Martin Korbling
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lynne V. Abruzzo
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Roland L. Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Issa F. Khouri
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Abstract
Ceramic-on-metal (CoM) is a relatively new bearing combination for total hip arthroplasty (THA) with few reported outcomes. A total of 287 CoM THAs were carried out in 271 patients (mean age 55.6 years (20 to 77), 150 THAs in female patients, 137 in male) under the care of a single surgeon between October 2007 and October 2009. With the issues surrounding metal-on-metal bearings the decision was taken to review these patients between March and November 2011, at a mean follow-up of 34 months (23 to 45) and to record pain, outcome scores, radiological analysis and blood ion levels. The mean Oxford Hip Score was 19.2 (12 to 53), 254 patients with 268 hips (95%) had mild/very mild/no pain, the mean angle of inclination of the acetabular component was 44.8o (28o to 63o), 82 stems (29%) had evidence of radiolucent lines of > 1 mm in at least one Gruen zone and the median levels of cobalt and chromium ions in the blood were 0.83 μg/L (0.24 μg/L to 27.56 μg/L) and 0.78 μg/L (0.21 μg/L to 8.84 μg/L), respectively. The five-year survival rate is 96.9% (95% confidence interval 94.7% to 99%). Due to the presence of radiolucent lines and the higher than expected levels of metal ions in the blood, we would not recommend the use of CoM THA without further long-term follow-up. We plan to monitor all these patients regularly. Cite this article: Bone Joint J 2015;97-B:300–5.
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Affiliation(s)
- J. C. Hill
- Musgrave Park Hospital, Stockman’s
Lane, Belfast, BT9 7JB, UK
| | - O. J. Diamond
- Musgrave Park Hospital, Stockman’s
Lane, Belfast, BT9 7JB, UK
| | - S. O’Brien
- Musgrave Park Hospital, Stockman’s
Lane, Belfast, BT9 7JB, UK
| | - J. G. Boldt
- Private Hospital Worbstrasse, 324
CH 3073 Guemligen, Switzerland
| | - M. Stevenson
- Institute of Clinical Science 'B' , Grosvenor
Road, Belfast BT12 6BJ, UK
| | - D. E. Beverland
- Musgrave Park Hospital, Stockman’s
Lane, Belfast, BT9 7JB, UK
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Wei Y, Kadia T, Tong W, Zhang M, Jia Y, Yang H, Hu Y, Viallet J, O’Brien S, Garcia-Manero G. The combination of a histone deacetylase inhibitor with the BH3-mimetic GX15-070 has synergistic antileukemia activity by activating both apoptosis and autophagy. Autophagy 2014; 6:976-8. [DOI: 10.4161/auto.6.7.13117] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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37
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Pearson R, Devlin J, Hannan K, Hein N, Bywater M, Drygin D, O’Brien S, Cullinane C, McArthur G, Hannan R. 707: Multi-point targeting of the synthetic lethal interactions between Myc, ribosome biogenesis and ribosome function cooperates to treat B-cell lymphoma. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50625-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rytting M, Triche L, Thomas D, O’Brien S, Kantarjian H. Initial experience with CMC-544 (inotuzumab ozogamicin) in pediatric patients with relapsed B-cell acute lymphoblastic leukemia. Pediatr Blood Cancer 2014; 61:369-72. [PMID: 24000241 PMCID: PMC5042143 DOI: 10.1002/pbc.24721] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 07/15/2013] [Indexed: 01/25/2023]
Abstract
Survival is poor in pediatric patients with relapsed or refractory acute B-cell lymphoblastic leukemia (ALL) and therapeutic options are limited. CMC-544 (inotuzumab ozogamicin) has shown significant activity in adult patients with relapsed and refractory ALL. We evaluated CMC-544 in pediatric patients with multiply relapsed ALL. Five children 4-15 years old with relapsed, CD 22 positive B-cell ALL were enrolled on a phase II non-randomized trial of CMC-544. CMC-544 was initially administered at 1.3 mg/m(2) every 3 weeks. The dose then increased to 1.8 mg/m(2) every 3 weeks. Subsequently, a weekly schedule of CMC-544 given as 0.8 mg/m(2) on day 1 followed by 0.5 mg/m(2) on days 8 and 15 was administered. All five patients had refractory relapsed B-cell ALL. Lymphoblasts for all patients highly expressed CD22. Four patients had two or more relapses before starting the study drug. One patient achieved a complete remission in the bone marrow and normal peripheral counts, and two patients achieved bone marrow morphologic remission with absolute neutrophils >1,000/µl but platelets <100,000/µl. Two patients had no response to the drug. Toxicities consisted of fever, sepsis, and liver enzyme elevation. Single agent CMC-544 given at the single dose of 1.8 mg/m(2) every 3 weeks or given as a split, weekly dose was generally well tolerated considering the inherent risks in this population of patients and showed promising activity in pediatric patients with relapsed and refractory ALL.
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Affiliation(s)
- Michael Rytting
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Texas,Department of Leukemia, The University of Texas MD Anderson Cancer Center, Texas
| | - Lisa Triche
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Texas
| | - Deborah Thomas
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Texas
| | - Susan O’Brien
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Texas
| | - Hagop Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Texas
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Gulino M, Spitaleri C, Tang X, Guardo G, Lamia L, Cherubini S, Bucher B, Burjan V, Couder M, Davies P, deBoer R, Fang X, Goldberg V, Hons Z, Kroha V, Lamm L, La Cognata M, Li C, Ma C, Mrazek J, Mukhamedzhanov A, Notani M, O’Brien S, Pizzone R, Rapisarda G, Roberson D, Sergi M, Tan W, Thompson I, Wiescher M. Application of the Trojan Horse Method to study neutron induced reactions: the 17O( n, α) 14Creaction. EPJ Web of Conferences 2014. [DOI: 10.1051/epjconf/20146607008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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40
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Fiorcari S, Brown WS, McIntyre BW, Estrov Z, Maffei R, O’Brien S, Sivina M, Hoellenriegel J, Wierda WG, Keating MJ, Ding W, Kay NE, Lannutti BJ, Marasca R, Burger JA. The PI3-kinase delta inhibitor idelalisib (GS-1101) targets integrin-mediated adhesion of chronic lymphocytic leukemia (CLL) cell to endothelial and marrow stromal cells. PLoS One 2013; 8:e83830. [PMID: 24376763 PMCID: PMC3871531 DOI: 10.1371/journal.pone.0083830] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [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: 07/03/2013] [Accepted: 11/10/2013] [Indexed: 11/19/2022] Open
Abstract
CLL cell trafficking between blood and tissue compartments is an integral part of the disease process. Idelalisib, a phosphoinositide 3-kinase delta (PI3Kδ) inhibitor causes rapid lymph node shrinkage, along with an increase in lymphocytosis, prior to inducing objective responses in CLL patients. This characteristic activity presumably is due to CLL cell redistribution from tissues into the blood, but the underlying mechanisms are not fully understood. We therefore analyzed idelalisib effects on CLL cell adhesion to endothelial and bone marrow stromal cells (EC, BMSC). We found that idelalisib inhibited CLL cell adhesion to EC and BMSC under static and shear flow conditions. TNFα-induced VCAM-1 (CD106) expression in supporting layers increased CLL cell adhesion and accentuated the inhibitory effect of idelalisib. Co-culture with EC and BMSC also protected CLL from undergoing apoptosis, and this EC- and BMSC-mediated protection was antagonized by idelalisib. Furthermore, we demonstrate that CLL cell adhesion to EC and VLA-4 (CD49d) resulted in the phosphorylation of Akt, which was sensitive to inhibition by idelalisib. These findings demonstrate that idelalisib interferes with integrin-mediated CLL cell adhesion to EC and BMSC, providing a novel mechanism to explain idelalisib-induced redistribution of CLL cells from tissues into the blood.
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Affiliation(s)
- Stefania Fiorcari
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
- Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Wells S. Brown
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Bradley W. McIntyre
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Zeev Estrov
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Rossana Maffei
- Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Susan O’Brien
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Mariela Sivina
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Julia Hoellenriegel
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - William G. Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Michael J. Keating
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Wei Ding
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Neil E. Kay
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | | | - Roberto Marasca
- Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Jan A. Burger
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
- * E-mail:
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O’Brien S, Radich JP, Abboud CN, Akhtari M, Altman JK, Berman E, DeAngelo DJ, Deininger M, Devine S, Fathi AT, Gotlib J, Jagasia M, Kropf P, Moore JO, Pallera A, Pinilla-Ibarz J, Reddy VVB, Shah NP, Smith BD, Snyder DS, Wetzler M, Gregory K, Sundar H. Chronic Myelogenous Leukemia, Version 1.2014. J Natl Compr Canc Netw 2013; 11:1327-40. [DOI: 10.6004/jnccn.2013.0157] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ghanem H, Cornelison AM, Garcia-Manero G, Kantarjian H, Ravandi F, Kadia T, Cortes J, O’Brien S, Brandt M, Borthakur G, Jabbour E. Decitabine can be safely reduced after achievement of best objective response in patients with myelodysplastic syndrome. Clin Lymphoma Myeloma Leuk 2013; 13 Suppl 2:S289-94. [PMID: 23969308 PMCID: PMC4120258 DOI: 10.1016/j.clml.2013.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 05/08/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Decitabine is standard therapy in patients with myelodysplastic syndrome (MDS). Current recommendations suggest a dose of 20 mg/m(2) intravenously (IV) daily for 5 days every 4 weeks. However, this therapy is associated with frequent grade 3/4 hematologic toxicity, requiring dose delays and/or dose reductions (DD/DR). RESULTS We investigated the outcomes of 122 patients with MDS who had DD/DR of frontline decitabine therapy. Sixty-five patients (53%) had DR by at least 25% or DD (defined as a delay beyond 5 weeks between cycles). Thirty-five patients (29%) underwent DD/DR after achieving best objective response, 30 patients (25%) underwent DD/DR before best objective response, and 57 (54%) patients had no DD/DR. There was a trend for more durable responses in favor of patients requiring DD/DR after the achievement of best objective response (median not reached) (P = .161). Overall survival rates were significantly higher for patients who had DD/DR after best objective response compared with those who had DD/DR before best objective response or those with no DD/DR (30 vs. 22 vs. 11 months, respectively; P < .001). Progression-free survival (PFS) rates also trended higher for those with DD/DR after best objective response (median not reached) compared with those who required DD/DR before best objective response (median of 15 months) (P = .285). CONCLUSION DD/DR may be safely accomplished once the patient has achieved best objective response (preferably complete remission [CR]) without impacting outcome. Prospective evaluation of an approach conceived of a loading dose for induction of a best objective response followed by a maintenance schedule is to be considered.
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Affiliation(s)
- Hady Ghanem
- Department of Leukemia, Box 428, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030
| | - A. Megan Cornelison
- Department of Leukemia, Box 428, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030
| | - Guillermo Garcia-Manero
- Department of Leukemia, Box 428, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030
| | - Hagop Kantarjian
- Department of Leukemia, Box 428, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030
| | - Farhad Ravandi
- Department of Leukemia, Box 428, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030
| | - Tapan Kadia
- Department of Leukemia, Box 428, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030
| | - Jorge Cortes
- Department of Leukemia, Box 428, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030
| | - Susan O’Brien
- Department of Leukemia, Box 428, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030
| | - Mark Brandt
- Department of Leukemia, Box 428, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030
| | - Gautam Borthakur
- Department of Leukemia, Box 428, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030
| | - Elias Jabbour
- Department of Leukemia, Box 428, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, Texas 77030
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Nagle C, Marquart L, Bain C, O’Brien S, Lahmann P, Quinn M, Oehler M, Obermair A, Spurdle A, Webb P. Impact of weight change and weight cycling on risk of different subtypes of endometrial cancer. Eur J Cancer 2013; 49:2717-26. [DOI: 10.1016/j.ejca.2013.03.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 03/05/2013] [Accepted: 03/07/2013] [Indexed: 10/26/2022]
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Abstract
The outcomes in adult B-cell acute lymphoblastic leukemia (ALL) remain inferior to those achieved in pediatric populations. Targeted therapy with monoclonal antibodies may improve outcomes in adult B-cell ALL without significant additive toxicity. Rituximab is the best known monoclonal antibody and is routinely used in combination chemo-immunotherapy for treatment of adult B-cell ALL and Burkitts leukemia. A number of other monoclonal antibodies are currently under investigation for treatment of adult B-cell ALL including unconjugated antibodies (eg., ofatumumab, alemtuzumab and epratuzumab), antibodies conjugated to cytotoxic agents (eg., inotuzumab ozogamycin and SAR3419), antibodies conjugated to toxins such Pseudomonas or Diptheria toxins (eg., BL22 and moxetumomab pasudotox), and T-cell engaging bi-specific antibodies that redirect cytotoxic T lymphocytes to lyse target ALL cells (eg., blinatumomab). In this article we review the therapeutic implications, current status and results of monoclonal antibody-based therapy in adult B-cell ALL.
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Affiliation(s)
- Naval Daver
- Department of Leukemia, University of Texas M D Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 0428, Houston, TX 77030, USA
| | - Susan O’Brien
- Department of Leukemia, University of Texas M D Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 0428, Houston, TX 77030, USA
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Lenehan D, Scanlon N, Conrick-Martin I, O’Gorman J, Oshodi D, O’Brien S, Hannan M, Lynch M, Carton E, Meegan C. CPC-093 Nosocomial Infections in a Cohort of Extra-Corporeal Life Support Patients. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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46
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Verma S, Greaves WO, Ravandi F, Reddy N, Bueso-Ramos CE, O’Brien S, Thomas DA, Kantarjian H, Medeiros LJ, Luthra R, Patel KP. Rapid detection and quantitation of BRAF mutations in hairy cell leukemia using a sensitive pyrosequencing assay. Am J Clin Pathol 2012; 138:153-6. [PMID: 22706871 DOI: 10.1309/ajcpl0opxi9lzitv] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BRAF protooncogene is an important mediator of cell proliferation and survival signals. BRAF p.V600E mutation was recently described as a molecular marker of hairy cell leukemia (HCL). We developed and validated a pyrosequencing-based approach that covers BRAF mutational hotspots in exons 11 (codon 468) and 15 (codons 595 to 600). The assay detects BRAF mutations at an analytical sensitivity of 5%. We screened 16 unenriched archived bone marrow aspirate samples from patients with a diagnosis of HCL (n = 12) and hairy cell leukemia-variant (HCL-v) (n = 4) using pyrosequencing. BRAF p.V600E mutation was present in all HCL cases and absent in all HCL-v. Our data support the recent finding that BRAF p.V600E mutation is universally present in HCL. Moreover, our pyrosequencing-based assay provides a convenient, rapid, sensitive, and quantitative tool for the detection of BRAF p.V600E mutations in HCL for clinical diagnostic testing.
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47
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Meagher D, McFarland J, Saunders J, Kealy B, O’Brien S. P-878 - A randomized-controlled trial of intensive case management emphasizing the recovery model among patients with severe and enduring mental illness. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)75045-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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48
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Quintás-Cardama A, Kantarjian H, O’Brien S, Jabbour E, Borthakur G, Ravandi F, Verstovsek S, Shan J, Cortes J. Outcome of patients with chronic myeloid leukemia with multiple ABL1 kinase domain mutations receiving tyrosine kinase inhibitor therapy. Haematologica 2011; 96:918-21. [PMID: 21357704 PMCID: PMC3105655 DOI: 10.3324/haematol.2010.039321] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [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: 02/03/2023] Open
Abstract
We investigated the impact of carrying more than one BCR-ABL1 mutation in 207 patients with chronic myeloid leukemia (102 chronic, 61 accelerated, and 44 blast phase) post-imatinib failure. Seven (8%) of 92 patients carrying mutations had more than one mutation: 4 (4%) in chronic phase, 2 (2%) in accelerated phase, and one (1 %) in blast phase. The cytogenetic response rate to second generation TKIs for patients with no, one, or more than one mutation was 88%, 69%, 50% (P=0.03) in chronic phase, 54%, 42%, 50% in accelerated phase (P=0.67), and 35%, 25%, 0% (P=0.63) in blast phase, respectively. No differences were observed in event free survival or overall survival in accelerated or blast phase according to their mutational status. However, the 4-year event free survival rates among patients in chronic phase with no, one, or more than one BCR-ABL1 mutation were 56%, 49%, and 0%, respectively (P=0.02), with overall survival rates of 91%, 69%, and 75%, respectively (P=0.13). In conclusion, patients with more than one BCR-ABL1 mutation fare worse than those with no or one mutation.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jorge Cortes
- Correspondence: Jorge Cortes, M.D., UT MD Anderson Cancer Center, Department of Leukemia, Unit 428 1515 Holcombe Blvd. Houston, TX 77030 USA. Phone: international +713.7945783. Fax: international +713.7944297. E-mail:
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