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Catto JWF, Tran B, Rouprêt M, Gschwend JE, Loriot Y, Nishiyama H, Redorta JP, Daneshmand S, Hussain SA, Cutuli HJ, Procopio G, Guadalupi V, Vasdev N, Naini V, Crow L, Triantos S, Baig M, Steinberg G. Erdafitinib in BCG-treated high-risk non-muscle-invasive bladder cancer. Ann Oncol 2024; 35:98-106. [PMID: 37871701 DOI: 10.1016/j.annonc.2023.09.3116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/29/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Treatment options are limited for patients with high-risk non-muscle-invasive bladder cancer (NMIBC) with disease recurrence after bacillus Calmette-Guérin (BCG) treatment and who are ineligible for/refuse radical cystectomy. FGFR alterations are commonly detected in NMIBC. We evaluated the activity of oral erdafitinib, a selective pan-fibroblast growth factor receptor (FGFR) tyrosine kinase inhibitor, versus intravesical chemotherapy in patients with high-risk NMIBC and select FGFR3/2 alterations following recurrence after BCG treatment. PATIENTS AND METHODS Patients aged ≥18 years with recurrent, BCG-treated, papillary-only high-risk NMIBC (high-grade Ta/T1) and select FGFR alterations refusing or ineligible for radical cystectomy were randomized to 6 mg daily oral erdafitinib or investigator's choice of intravesical chemotherapy (mitomycin C or gemcitabine). The primary endpoint was recurrence-free survival (RFS). The key secondary endpoint was safety. RESULTS Study enrollment was discontinued due to slow accrual. Seventy-three patients were randomized 2 : 1 to erdafitinib (n = 49) and chemotherapy (n = 24). Median follow-up for RFS was 13.4 months for both groups. Median RFS was not reached for erdafitinib [95% confidence interval (CI) 16.9 months-not estimable] and was 11.6 months (95% CI 6.4-20.1 months) for chemotherapy, with an estimated hazard ratio of 0.28 (95% CI 0.1-0.6; nominal P value = 0.0008). In this population, safety results were generally consistent with known profiles for erdafitinib and chemotherapy. CONCLUSIONS Erdafitinib prolonged RFS compared with intravesical chemotherapy in patients with papillary-only, high-risk NMIBC harboring FGFR alterations who had disease recurrence after BCG therapy and refused or were ineligible for radical cystectomy.
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Affiliation(s)
- J W F Catto
- Department of Oncology and Metabolism, University of Sheffield, Sheffield; Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
| | - B Tran
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M Rouprêt
- Department of Urology, GRC 5 Predictive Onco-Uro, Hôpital Pitié-Salpêtrière, Sorbonne University, Paris, France
| | - J E Gschwend
- Department of Urology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Y Loriot
- Department of Cancer Medicine, INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - H Nishiyama
- Department of Urology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - J P Redorta
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Daneshmand
- Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - S A Hussain
- Department of Oncology and Metabolism, University of Sheffield, Sheffield; Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - H J Cutuli
- Uro-oncology and Research Unit, Sirio Libanes Hospital, Buenos Aires, Argentina
| | - G Procopio
- Oncologia Medica Genitourinaria, Fondazione IRCCS Istituto Nazionale Tumori Milano, Milan, Italy
| | - V Guadalupi
- Oncologia Medica Genitourinaria, Fondazione IRCCS Istituto Nazionale Tumori Milano, Milan, Italy
| | - N Vasdev
- Hertfordshire and Bedfordshire Urological Cancer Centre, Lister Hospital, East and North Herts NHS Trust, Stevenage; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - V Naini
- Janssen Research & Development, San Diego
| | - L Crow
- Janssen Research & Development, Spring House
| | - S Triantos
- Janssen Research & Development, Spring House
| | - M Baig
- Janssen Research & Development, Spring House
| | - G Steinberg
- Department of Urology, Rush University Medical Center, Chicago, USA
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Verzoni E, Todoerti K, Rivoltini L, Huber V, Rodolfo M, Agnelli L, Devecchi A, Busico A, Perrone F, Centonze G, De Cecco L, Claps M, Guadalupi V, Stellato M, Giannatempo P, De Braud F, Procopio G, Sepe P. 1470P Transcriptomic signature and immune infiltrate in metastatic collecting duct renal cell carcinoma patients treated with first-line cabozantinib: Results of exploratory endpoints from BONSAI trial (Meeturo 2). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1573] [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: 11/01/2022] Open
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Procopio G, Claps M, Sepe P, Buti S, de Cecco L, Devecchi A, Dugo M, Gargiuli C, Guadalupi V, Ottini A, Sensi M, De Braud F, Verzoni E. 654MO A phase II prospective trial of frontline cabozantinib in metastatic collecting ducts renal cell carcinoma: The BONSAI trial (Meeturo 2). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Bongiovanni A, Foca F, Menis J, Stucci L, Artioli F, Guadalupi V, Forcignanò M, Fantini M, Recine F, Mercatali L, Spadazzi C, De Vita A, Casadei R, Falasconi M, Fausti V, Pallotti M, Bertoni M, Vanni S, Ibrahim T. 1296P Immune checkpoint inhibitors with or without bone targeted therapy in NSCLC patients with bone metastases and prognostic significance of neutrophil-to-lymphocyte ratio. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Claps M, Jachetti E, Ferri R, Badenchini F, Verzoni E, Montone R, Sepe P, Guadalupi V, Ottini A, Baciarello G, Valdagni R, Colombo M, de Braud F, Procopio G. 1647TiP Antiandrogen therapy and TMPRSS2 status: How prostate cancer patients are protected from COVID-19 pandemic. Ann Oncol 2021. [PMCID: PMC8454317 DOI: 10.1016/j.annonc.2021.08.1640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Ratti M, Procopio G, Guadalupi V, Grizzi G, Bonomi M, Saleri J, Gobbi A, Marchi R, Pogliacomi G, Donati G, Nazzari M, Bacciocchini N, Brighenti M, Perrucci B, Giganti M, Panni S, Donini M, Curti A, Gregorc V, Passalacqua R. 1610P Delivery of ONCOlogic care at HOME: Ready for “ONCOHOME”. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1603] [Citation(s) in RCA: 1] [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: 11/16/2022] Open
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Mennitto A, Verzoni E, Cognetti F, Miceli R, Milella M, Mosca A, Chiuri VE, Bearz A, Morelli F, Ortega C, Atzori F, Donini M, Claps M, Guadalupi V, Sepe P, Cappelletti V, de Braud FG, Procopio G. Radical metastasectomy followed by sorafenib versus observation in patients withclear cell renal cell carcinoma: extended follow -up of efficacy results from the randomized phase II RESORT trial. Expert Rev Clin Pharmacol 2021; 14:261-268. [PMID: 33472450 DOI: 10.1080/17512433.2021.1879639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: The RESORT trial showed no longer relapse free survival (RFS) with sorafenib following radical metastasectomy in metastatic renal cell carcinoma. We present the updated 42-month follow-up data.Methods: The phase II RESORT trial randomized patients to sorafenib or observation within 12 weeks from surgery. RFS was the primary endpoint.Results: We analyzed 68 patients (32 in sorafenib and 36 in the observation arm), randomized between November 2012 and November 2017. Eighty-one percent in the sorafenib arm and 80% in the observation arm had one metastasis . At a median follow-up of 42 months (interquartile range 31-58), in the observation arm the median RFS was 35 months, RFS probability was 57% (95% CI 42-76%) at 24 and 44% (95% CI 30-65%) at 48 months. In the sorafenib arm, median RFS was 21 months, RFS probability was 50% (95% CI 34-71%) at 24 and 32% (95% CI 18-57%) at 48 months (p = 0.342;HR 1.35;95% CI 0.72-2.54). Forty-seven percent and 37.5% of the patients in the two arms, respectively, are disease free. The site of relapses was independent of the previous metastasectomy site.Expert commentary: Sorafenib after metastasectomy did not improve RFS, but surgery in selected patients should be considered in order to potentially improve survival.Clinical trial registration: www.clinicaltrials.gov identifier is NCT0144480.
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Affiliation(s)
- A Mennitto
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Verzoni
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Cognetti
- Medical Oncology Department, Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | - R Miceli
- Department of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Milella
- Department of Medicine, Medical Oncology, University and Hospital Trust of Verona, Verona, Italy
| | - A Mosca
- Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - V E Chiuri
- Medical Oncology Department, Ospedale Vito Fazzi, Lecce, Italy
| | - A Bearz
- Medical Oncology Department, National Cancer Institute, Aviano, Italy
| | - F Morelli
- Medical Oncology Department, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - C Ortega
- Department of Medical Oncology, Ospedale S. Lazzaro ASL CN2 Alba-Bra, Cuneo, Italy
| | - F Atzori
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - M Donini
- Medical Oncology Department, Ospedale di Cremona, Cremona, Italy
| | - M Claps
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Guadalupi
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Sepe
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Cappelletti
- Biomarker Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori di Milano, Milan, Italy
| | - F G de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - G Procopio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Procopio G, Cognetti F, Miceli R, Milella M, Mosca A, Chiuri V, Bearz A, Morelli F, Ortega C, Atzori F, Donini M, Passalacqua R, Mennitto A, Sepe P, Martinetti A, Montone R, Apollonio G, Guadalupi V, Verzoni E, Claps M. 736P Updated data on patients (pts) with metastatic renal cell carcinoma (mRCC) treated with sorafenib (SOR) vs observation (obs) after radical metastasectomy in the RESORT trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Procopio G, Verzoni E, Iacovelli R, Mattana F, Guadalupi V, Mariani L, Stagni S, Salvioni R, Buzzoni R. Prognostic factors for survival in patients with metastatic renal cell carcinoma (mRCC) treated with antiangiogenic therapies: Overall results of a large experience. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15026] [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: 11/20/2022] Open
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Procopio G, Verzoni E, Iacovelli R, Guadalupi V, Nicolai N, Torelli T, Biasoni D, Colecchia M, Salvioni R. Is there a role for targeted therapies in the collecting ducts of Bellini carcinoma? J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
396 Background: Carcinoma of Bellini collecting ducts (CDC) is very uncommon but it is one of the most aggressive urological entities. For this tumor, originating from the epithelium of Bellini ducts in the distal tubule and preferentially occurring in young populations, no standard effective therapy has been so far established. Results of previous clinical experiences with chemo- or immunotherapy have been disappointing. We report our experience in 7 cases of CDC treated with targeted therapies. Methods: From December 2004 to May 2010, 333 patients with advanced renal cell carcinoma have been treated with targeted therapies at Istituto Nazionale Tumori of Milan. From the global database analysis, seven cases with histological subtype of CDC have been identified. All patients had advanced disease and received a targeted therapy as first-line treatment. Six of them underwent previous nephrectomy, all had nodal involvement, and three had two or more sites of disease including lung, liver, and adrenal glands. Four patients received sorafenib as first-line treatment, two sunitinib, and one temsirolimus. After sorafenib failure, two patients received a second-line treatment consisting of both sunitinib and temsirolimus. Results: Five patients developed early progression of disease with a very short 4-month survival. One patient had a long term partial response of 33 months with sorafenib, he underwent second-line sunitinib and had no progression for further 10 months. The last patient reached a progression-free survival of 6 months with temsirolimus; when progressed, he achieved a disease control for further 9 months during sunitinib therapy. Both patients are alive after 50 and 15 months of treatment, respectively. The most common adverse events, low or moderate in severity, consisted of fatigue, hand-foot skin reaction, diarrhea, hypertension, and anemia. Conclusions: Prognosis of advanced CDC remains unfavorable. New target agents may be active in this disease and need further prospective phase II studies. [Table: see text]
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Affiliation(s)
- G. Procopio
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - E. Verzoni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - R. Iacovelli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - V. Guadalupi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - N. Nicolai
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - T. Torelli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - D. Biasoni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - M. Colecchia
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - R. Salvioni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
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Porta C, Procopio G, Sabbatini R, Bearz A, Chiappino I, Imarisio I, Guadalupi V, Paglino C, Verzoni E, Ferraris E, Bajetta E. 252 RETROSPECTIVE ANALYSIS OF THE SEQUENTIAL USE OF SORAFENIB AND SUNITINIB IN PATIENTS WITH ADVANCED RENAL CELL CARCINOMA (RCC). ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1569-9056(09)60257-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Procopio G, Pietrantonio F, Verzoni E, Guadalupi V, Ducceschi M, Ferrario E. Rediscovering immunotherapy in combination with molecularly targeted agents in renal cell cancer. EJC Suppl 2008. [DOI: 10.1016/j.ejcsup.2008.06.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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