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Gourley C, Brown J, Lai Z, Lao-Sirieix P, Elks C, McGarvey H, French T, Milenkova T, Bloomfield R, Rowe P, Hodgson D, Barrett J, Moore K, DiSilvestro P, Harrington E. Analysis of tumour samples from SOLO1: Frequency of BRCA specific loss of heterozygosity (LOH) and progression-free survival (PFS) according to homologous recombination repair deficiency (HRD)-LOH score. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Douillard JY, Ostoros G, Cobo M, Ciuleanu T, McCormack R, Webster A, Milenkova T. First-line gefitinib in Caucasian EGFR mutation-positive NSCLC patients: a phase-IV, open-label, single-arm study. Br J Cancer 2013; 110:55-62. [PMID: 24263064 PMCID: PMC3887309 DOI: 10.1038/bjc.2013.721] [Citation(s) in RCA: 300] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 10/17/2013] [Accepted: 10/21/2013] [Indexed: 01/14/2023] Open
Abstract
Background: Phase-IV, open-label, single-arm study (NCT01203917) to assess efficacy and safety/tolerability of first-line gefitinib in Caucasian patients with stage IIIA/B/IV, epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC). Methods: Treatment: gefitinib 250 mg day−1 until progression. Primary endpoint: objective response rate (ORR). Secondary endpoints: disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and safety/tolerability. Pre-planned exploratory objective: EGFR mutation analysis in matched tumour and plasma samples. Results: Of 1060 screened patients with NSCLC (859 known mutation status; 118 positive, mutation frequency 14%), 106 with EGFR sensitising mutations were enrolled (female 70.8% adenocarcinoma 97.2% never-smoker 64.2%). At data cutoff: ORR 69.8% (95% confidence interval (CI) 60.5–77.7), DCR 90.6% (95% CI 83.5–94.8), median PFS 9.7 months (95% CI 8.5–11.0), median OS 19.2 months (95% CI 17.0–NC; 27% maturity). Most common adverse events (AEs; any grade): rash (44.9%), diarrhoea (30.8%); CTC (Common Toxicity Criteria) grade 3/4 AEs: 15% SAEs: 19%. Baseline plasma 1 samples were available in 803 patients (784 known mutation status; 82 positive; mutation frequency 10%). Plasma 1 EGFR mutation test sensitivity: 65.7% (95% CI 55.8–74.7). Conclusion: First-line gefitinib was effective and well tolerated in Caucasian patients with EGFR mutation-positive NSCLC. Plasma samples could be considered for mutation analysis if tumour tissue is unavailable.
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Affiliation(s)
- J-Y Douillard
- Institut de Cancérologie de l'Ouest, Centre René Gauducheau, Bd J. Monod, 44805 St-Herblain, Nantes, France
| | - G Ostoros
- National Koranyi Institute of Pulmonology, Piheno ut 1, Budapest H-1121, Hungary
| | - M Cobo
- Hospital Regional Universitario Carlos Haya, Málaga, Andalucia 29010, Spain
| | - T Ciuleanu
- Institutul Oncologic Ion Chiricuta and UMF Iuliu Hatieganu, Cluj-Napoca 400015, Romania
| | - R McCormack
- AstraZeneca, Alderley Park, Macclesfield, Cheshire SK10 4TG, UK
| | - A Webster
- AstraZeneca, Alderley Park, Macclesfield, Cheshire SK10 4TG, UK
| | - T Milenkova
- AstraZeneca, Alderley Park, Macclesfield, Cheshire SK10 4TG, UK
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Douillard J, Ostoros G, Cobo M, Ciuleanu T, McCormack R, Webster A, Milenkova T. 68O EFFICACY, SAFETY AND TOLERABILITY RESULTS FROM A PHASE IV, OPEN-LABEL, SINGLE ARM STUDY OF 1ST-LINE GEFITINIB IN CAUCASIAN PATIENTS (PTS) WITH EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) MUTATION-POSITIVE NON-SMALL-CELL LUNG CANCER (NSCLC). Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70288-5] [Citation(s) in RCA: 7] [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] [Indexed: 11/25/2022]
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De Boer R, Arrieta Ó, Gottfried M, Blackhall FH, Raats J, Yang CH, Langmuir P, Milenkova T, Read J, Vansteenkiste J. Vandetanib plus pemetrexed versus pemetrexed as second-line therapy in patients with advanced non-small cell lung cancer (NSCLC): A randomized, double-blind phase III trial (ZEAL). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8010] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8010 Background: Vandetanib is a once-daily oral inhibitor of VEGFR, EGFR and RET signaling. A phase I trial of vandetanib + pemetrexed (pem) supported further investigation of this combination (de Boer et al, Ann Oncol 2008). Methods: The primary objective was to determine whether vandetanib 100 mg/day + pem 500 mg/m2 every 21 days (max 6 cycles) prolonged progression-free survival (PFS) vs placebo + pem. Overall survival (OS), objective response rate (ORR), time to deterioration of symptoms (TDS, by Lung Cancer Symptom Scale) and safety were secondary endpoints. Efficacy and safety were assessed in females as a co-primary analysis population. Eligibility criteria included stage IIIB/IV NSCLC, PS 0–2, and previous 1st-line therapy. Results: Between Jan 07-Mar 08, 534 patients (mean age 59 yrs; 38% female; 21% squamous histology; 8% brain metastases; stage IV 84%; PS 0/1/2: 41%/53%/6%) were randomized 1:1 to receive vandetanib + pem (n=256) or placebo + pem (n=278). Baseline characteristics were similar in both arms. Median duration of follow-up was 9.0 months, with 83% patients progressed and 50% deceased. There were positive trends seen for vandetanib + pem for both PFS (hazard ratio [HR] 0.86, 97.58% CI 0.69–1.06; P=0.108) and OS (HR 0.86, 97.54% CI 0.65–1.13; P=0.219); similar advantages were observed for females. There were statistically significant advantages for ORR (19.1% vs 7.9%, P<0.001) and TDS (HR 0.61, P=0.004). The adverse event profile was consistent with previous studies of vandetanib: rash (38% vs 26%), diarrhea (26% vs 18%) and hypertension (12% vs 3%) being more frequent in the vandetanib arm. There was evidence of reduced pem toxicity with the addition of vandetanib: anemia 8% vs 22%, nausea 29% vs 37%, vomiting 15% vs 22%, fatigue 37% vs 45%, and asthenia 11% vs 17%. The incidence of protocol-defined QTc prolongation was <1%. There was no increase in bleeding or thrombotic events in the vandetanib arm. Conclusions: The combination of vandetanib + pem demonstrated evidence of clinical benefit in patients with pretreated advanced NSCLC, although the study did not meet the primary endpoint of statistically significant PFS prolongation vs pem alone. Vandetanib + pem was generally well tolerated. [Table: see text]
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Affiliation(s)
- R. De Boer
- Western Hospital, Melbourne, Australia; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico; Meir Medical Center, Kfar Saba, Israel; Christie Hospital NHS Trust, Manchester, United Kingdom; Panorama Medical Center, Capetown, South Africa; National Taiwan University Hospital, Taipei, Taiwan; AstraZeneca, Wilmington, DE; AstraZeneca, Macclesfield, United Kingdom; University Hospital Leuven, Leuven, Belgium
| | - Ó. Arrieta
- Western Hospital, Melbourne, Australia; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico; Meir Medical Center, Kfar Saba, Israel; Christie Hospital NHS Trust, Manchester, United Kingdom; Panorama Medical Center, Capetown, South Africa; National Taiwan University Hospital, Taipei, Taiwan; AstraZeneca, Wilmington, DE; AstraZeneca, Macclesfield, United Kingdom; University Hospital Leuven, Leuven, Belgium
| | - M. Gottfried
- Western Hospital, Melbourne, Australia; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico; Meir Medical Center, Kfar Saba, Israel; Christie Hospital NHS Trust, Manchester, United Kingdom; Panorama Medical Center, Capetown, South Africa; National Taiwan University Hospital, Taipei, Taiwan; AstraZeneca, Wilmington, DE; AstraZeneca, Macclesfield, United Kingdom; University Hospital Leuven, Leuven, Belgium
| | - F. H. Blackhall
- Western Hospital, Melbourne, Australia; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico; Meir Medical Center, Kfar Saba, Israel; Christie Hospital NHS Trust, Manchester, United Kingdom; Panorama Medical Center, Capetown, South Africa; National Taiwan University Hospital, Taipei, Taiwan; AstraZeneca, Wilmington, DE; AstraZeneca, Macclesfield, United Kingdom; University Hospital Leuven, Leuven, Belgium
| | - J. Raats
- Western Hospital, Melbourne, Australia; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico; Meir Medical Center, Kfar Saba, Israel; Christie Hospital NHS Trust, Manchester, United Kingdom; Panorama Medical Center, Capetown, South Africa; National Taiwan University Hospital, Taipei, Taiwan; AstraZeneca, Wilmington, DE; AstraZeneca, Macclesfield, United Kingdom; University Hospital Leuven, Leuven, Belgium
| | - C. H. Yang
- Western Hospital, Melbourne, Australia; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico; Meir Medical Center, Kfar Saba, Israel; Christie Hospital NHS Trust, Manchester, United Kingdom; Panorama Medical Center, Capetown, South Africa; National Taiwan University Hospital, Taipei, Taiwan; AstraZeneca, Wilmington, DE; AstraZeneca, Macclesfield, United Kingdom; University Hospital Leuven, Leuven, Belgium
| | - P. Langmuir
- Western Hospital, Melbourne, Australia; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico; Meir Medical Center, Kfar Saba, Israel; Christie Hospital NHS Trust, Manchester, United Kingdom; Panorama Medical Center, Capetown, South Africa; National Taiwan University Hospital, Taipei, Taiwan; AstraZeneca, Wilmington, DE; AstraZeneca, Macclesfield, United Kingdom; University Hospital Leuven, Leuven, Belgium
| | - T. Milenkova
- Western Hospital, Melbourne, Australia; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico; Meir Medical Center, Kfar Saba, Israel; Christie Hospital NHS Trust, Manchester, United Kingdom; Panorama Medical Center, Capetown, South Africa; National Taiwan University Hospital, Taipei, Taiwan; AstraZeneca, Wilmington, DE; AstraZeneca, Macclesfield, United Kingdom; University Hospital Leuven, Leuven, Belgium
| | - J. Read
- Western Hospital, Melbourne, Australia; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico; Meir Medical Center, Kfar Saba, Israel; Christie Hospital NHS Trust, Manchester, United Kingdom; Panorama Medical Center, Capetown, South Africa; National Taiwan University Hospital, Taipei, Taiwan; AstraZeneca, Wilmington, DE; AstraZeneca, Macclesfield, United Kingdom; University Hospital Leuven, Leuven, Belgium
| | - J. Vansteenkiste
- Western Hospital, Melbourne, Australia; Instituto Nacional de Cancerología (INCan), Mexico City, Mexico; Meir Medical Center, Kfar Saba, Israel; Christie Hospital NHS Trust, Manchester, United Kingdom; Panorama Medical Center, Capetown, South Africa; National Taiwan University Hospital, Taipei, Taiwan; AstraZeneca, Wilmington, DE; AstraZeneca, Macclesfield, United Kingdom; University Hospital Leuven, Leuven, Belgium
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de Boer R, Humblet Y, Wolf J, Nogová L, Ruffert K, Milenkova T, Smith R, Godwood A, Vansteenkiste J. An open-label study of vandetanib with pemetrexed in patients with previously treated non-small-cell lung cancer. Ann Oncol 2009; 20:486-91. [PMID: 19088171 DOI: 10.1093/annonc/mdn674] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- R de Boer
- Department of Medical Oncology, Western Hospital, Melbourne, Australia.
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De Boer R, Vansteenkiste J, Humblet Y, Wolf J, Nogova L, Ruffert K, Smith R, Godwood A, Milenkova T. Vandetanib with pemetrexed in patients with previously treated non-small cell lung cancer (NSCLC): An open-label, multicenter phase I study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7654 Background: Vandetanib (ZD6474) is a once-daily oral anticancer drug that selectively inhibits VEGF-dependent tumor angiogenesis and EGFR- and RET-dependent tumor cell proliferation and survival. Methods: Eligible patients had locally advanced or metastatic NSCLC (stage IIIB/IV) after failure of 1st-line chemotherapy. An initial cohort of 10 patients received once- daily oral vandetanib (100 mg) with pemetrexed (500 mg/m2 i.v. infusion every 21 days). If <2 patients experienced a vandetanib- related dose-limiting toxicity (DLT), an additional cohort received vandetanib 300 mg + pemetrexed. The planned duration of treatment was =6 weeks. The primary objective of the study was to establish the safety and tolerability of vandetanib + pemetrexed. Secondary objectives included an assessment of pharmacokinetic (PK) interaction and preliminary assessment of efficacy (RECIST). Results: Twenty- one patients (14 male, 7 female; mean age 60 years, range 44–77) received vandetanib 100 mg + pemetrexed (n=10) or vandetanib 300 mg + pemetrexed (n=11). One DLT was reported in each cohort: QTc prolongation (>100 ms from baseline, but absolute QTc <500 ms) in a male patient who had electrolyte imbalance and short baseline QTc interval of 318 ms (100 mg cohort); and interstitial lung disease, which resolved after steroid therapy, in a Caucasian female patient with bronchoalveolar carcinoma and a long smoking history (300 mg cohort). The most common adverse events (AEs) were rash, anorexia, fatigue and diarrhea (all n=10; 48%). The most frequent CTC grade 3/4 AEs were increased gamma-glutamyltransferase (n=4), anorexia (n=3) and dyspnea (n=3), which are generally consistent with previous experience with vandetanib and pemetrexed as monotherapies. There was no apparent PK interaction between vandetanib and pemetrexed. In 18 patients evaluable for efficacy, there was one confirmed partial response (female; 100 mg cohort) and 13 stable disease =6 weeks. Conclusions: In patients with advanced NSCLC, vandetanib + pemetrexed was generally well tolerated, with no apparent PK interaction. A Phase III trial of vandetanib 100 mg + pemetrexed in 2nd-line NSCLC has begun. No significant financial relationships to disclose.
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Affiliation(s)
- R. De Boer
- Western Hospital, Melbourne, Australia; University Hospital Leuven, Leuven, Belgium; Université Catholique de Louvain Hospital, Brussels, Belgium; University Hospital Cologne, Cologne, Germany; Clinic and General Practice of Internal Medicine, Jena, Germany; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Loughborough, United Kingdom
| | - J. Vansteenkiste
- Western Hospital, Melbourne, Australia; University Hospital Leuven, Leuven, Belgium; Université Catholique de Louvain Hospital, Brussels, Belgium; University Hospital Cologne, Cologne, Germany; Clinic and General Practice of Internal Medicine, Jena, Germany; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Loughborough, United Kingdom
| | - Y. Humblet
- Western Hospital, Melbourne, Australia; University Hospital Leuven, Leuven, Belgium; Université Catholique de Louvain Hospital, Brussels, Belgium; University Hospital Cologne, Cologne, Germany; Clinic and General Practice of Internal Medicine, Jena, Germany; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Loughborough, United Kingdom
| | - J. Wolf
- Western Hospital, Melbourne, Australia; University Hospital Leuven, Leuven, Belgium; Université Catholique de Louvain Hospital, Brussels, Belgium; University Hospital Cologne, Cologne, Germany; Clinic and General Practice of Internal Medicine, Jena, Germany; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Loughborough, United Kingdom
| | - L. Nogova
- Western Hospital, Melbourne, Australia; University Hospital Leuven, Leuven, Belgium; Université Catholique de Louvain Hospital, Brussels, Belgium; University Hospital Cologne, Cologne, Germany; Clinic and General Practice of Internal Medicine, Jena, Germany; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Loughborough, United Kingdom
| | - K. Ruffert
- Western Hospital, Melbourne, Australia; University Hospital Leuven, Leuven, Belgium; Université Catholique de Louvain Hospital, Brussels, Belgium; University Hospital Cologne, Cologne, Germany; Clinic and General Practice of Internal Medicine, Jena, Germany; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Loughborough, United Kingdom
| | - R. Smith
- Western Hospital, Melbourne, Australia; University Hospital Leuven, Leuven, Belgium; Université Catholique de Louvain Hospital, Brussels, Belgium; University Hospital Cologne, Cologne, Germany; Clinic and General Practice of Internal Medicine, Jena, Germany; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Loughborough, United Kingdom
| | - A. Godwood
- Western Hospital, Melbourne, Australia; University Hospital Leuven, Leuven, Belgium; Université Catholique de Louvain Hospital, Brussels, Belgium; University Hospital Cologne, Cologne, Germany; Clinic and General Practice of Internal Medicine, Jena, Germany; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Loughborough, United Kingdom
| | - T. Milenkova
- Western Hospital, Melbourne, Australia; University Hospital Leuven, Leuven, Belgium; Université Catholique de Louvain Hospital, Brussels, Belgium; University Hospital Cologne, Cologne, Germany; Clinic and General Practice of Internal Medicine, Jena, Germany; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Loughborough, United Kingdom
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Van Cruijsen H, Voest EE, Van Herpen CM, Hoekman K, Witteveen PO, Tjin-A-ton ML, Punt CJ, Puchalski T, Milenkova T, Giaccone G. Phase I evaluation of AZD2171, a highly potent, selective VEGFR signaling inhibitor, in combination with gefitinib, in patients with advanced tumors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3017 Background: AZD2171 is an oral, highly potent, vascular endothelial growth factor (VEGF) signaling inhibitor. This Phase I trial is evaluating the safety, tolerability, pharmacokinetics (PK) and efficacy of AZD2171, in combination with gefitinib (IRESSA), an inhibitor of EGF receptor tyrosine kinase. Methods: Patients with advanced solid tumors refractory to standard therapies received once-daily, oral AZD2171 (20, 25, 30 or 45 mg) and gefitinib 250 (Part A1) or 500 mg (Part B1) until dose-limiting toxicity was observed. The potential PK interaction of AZD2171 30 mg with gefitinib 250 mg was studied in an expanded cohort (Part A2). Part B2 follows the design of Part A2, with a gefitinib dose of 500 mg. Results: As of September 1, 2005, 70 patients (22–78 years) have received treatment ( Table ). Overall, the most frequently reported adverse events (AEs) were diarrhea, anorexia, fatigue and hypertension (91%, 64%, 51% and 51% of patients; respectively), with evidence of an AZD2171-related dose response for hypertension (reported in 36%, 75%, 47% and 75% of patients at AZD2171 20, 25, 30 and 45 mg; respectively). These were also the most commonly reported CTC grade ≥3 AEs, occurring in <13% of patients, in addition to increases in alanine aminotransferase (7%) and aspartate aminotransferase (4%). The steady-state PK parameters for AZD2171 (30 mg) and gefitinib (250 mg) are comparable with those seen previously with either agent alone. In total, 28 patients had a best RECIST response of stable disease (22 patients were non-evaluable). A patient with mesothelioma (45 mg AZD2171, Part A1) and a patient with renal cancer (20 mg AZD2171, Part B1) had confirmed partial responses. The second patient underwent surgery and is currently disease-free. Conclusions: No unexpected toxicities are associated with AZD2171 (20–45 mg) in combination with gefitinib (250 or 500 mg) and the preliminary response data are encouraging. [Table: see text] [Table: see text]
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Affiliation(s)
- H. Van Cruijsen
- VU Medical Center, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; Radboud University Medical Center, Nijmegen, The Netherlands; AstraZeneca, Wilmington, DE
| | - E. E. Voest
- VU Medical Center, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; Radboud University Medical Center, Nijmegen, The Netherlands; AstraZeneca, Wilmington, DE
| | - C. M. Van Herpen
- VU Medical Center, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; Radboud University Medical Center, Nijmegen, The Netherlands; AstraZeneca, Wilmington, DE
| | - K. Hoekman
- VU Medical Center, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; Radboud University Medical Center, Nijmegen, The Netherlands; AstraZeneca, Wilmington, DE
| | - P. O. Witteveen
- VU Medical Center, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; Radboud University Medical Center, Nijmegen, The Netherlands; AstraZeneca, Wilmington, DE
| | - M. L. Tjin-A-ton
- VU Medical Center, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; Radboud University Medical Center, Nijmegen, The Netherlands; AstraZeneca, Wilmington, DE
| | - C. J. Punt
- VU Medical Center, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; Radboud University Medical Center, Nijmegen, The Netherlands; AstraZeneca, Wilmington, DE
| | - T. Puchalski
- VU Medical Center, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; Radboud University Medical Center, Nijmegen, The Netherlands; AstraZeneca, Wilmington, DE
| | - T. Milenkova
- VU Medical Center, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; Radboud University Medical Center, Nijmegen, The Netherlands; AstraZeneca, Wilmington, DE
| | - G. Giaccone
- VU Medical Center, Amsterdam, The Netherlands; University Medical Center, Utrecht, The Netherlands; Radboud University Medical Center, Nijmegen, The Netherlands; AstraZeneca, Wilmington, DE
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