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Hindi N, Razak A, Rosenbaum E, Jonczak E, Hamacher R, Rutkowski P, Bhadri VA, Skryd A, Brahmi M, Alshibany A, Jagodzinska-Mucha P, Bauer S, Connolly E, Gelderblom H, Boye K, Henon C, Bae S, Bogefors K, Vincenzi B, Martinez-Trufero J, Lopez-Martin JA, Redondo A, Valverde C, Blay JY, Moura DS, Gutierrez A, Tap W, Martin-Broto J. Efficacy of immune checkpoint inhibitors in alveolar soft-part sarcoma: results from a retrospective worldwide registry. ESMO Open 2023; 8:102045. [PMID: 38016251 PMCID: PMC10698259 DOI: 10.1016/j.esmoop.2023.102045] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Conventional cytotoxic drugs are not effective in alveolar soft-part sarcoma (ASPS). Immune checkpoint (programmed cell death protein 1/programmed death-ligand 1) inhibitors (ICIs) are promising drugs in ASPS. A worldwide registry explored the efficacy of ICI in ASPS. MATERIALS AND METHODS Data from adult patients diagnosed with ASPS and treated with ICI for advanced disease in expert sarcoma centers from Europe, Australia and North America were retrospectively collected, including demographics and data related to treatments and outcome. RESULTS Seventy-six ASPS patients, with a median age at diagnosis of 25 years (range 3-61 years), were registered. All patients received ICI for metastatic disease. Immunotherapy regimens consisted of monotherapy in 38 patients (50%) and combination in 38 (50%) (23 with a tyrosine kinase inhibitor). Among the 68 assessable patients, there were 3 complete responses and 34 partial responses, translating into an overall response rate of 54.4%. After a median follow-up of 36 months [95% confidence interval (CI) 32-40 months] since the start of immunotherapy, 45 (59%) patients have progressed on ICI, with a median progression-free survival (PFS) of 16.3 months (95% CI 8-25 months). Receiving ICI in first line (P = 0.042) and achieving an objective response (P = 0.043) correlated with a better PFS. Median estimated overall survival (OS) from ICI initiation has not been reached. The 12-month and 24-month OS rates were 94% and 81%, respectively. CONCLUSIONS This registry constitutes the largest available series of ASPS treated with ICI. Our results suggest that the ICI treatment provides long-lasting disease control and prolonged OS in patients with advanced ASPS, an ultra-rare entity with limited active therapeutic options.
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Affiliation(s)
- N Hindi
- Medical Oncology Department, Fundacion Jimenez Diaz University Hospital and Hospital General de Villalba, Madrid; Instituto de Investigación Sanitaria-Fundación Jimenez Díaz-UAM (IIS-FJD-UAM), Madrid, Spain.
| | - A Razak
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada
| | - E Rosenbaum
- Memorial Sloan Kettering Cancer Center, New York
| | - E Jonczak
- Department of Hematology Oncology, Miami University, Miami, USA
| | - R Hamacher
- Medical Oncology Department, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - P Rutkowski
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - V A Bhadri
- Medical Oncology Department, Chris O Brien Lifehouse, Sydney, Australia
| | - A Skryd
- Miller School of Medicine, University of Miami, Miami, USA
| | - M Brahmi
- Centre Leon Berard & University Claude Bernard Lyon 1, Lyon, France
| | - A Alshibany
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada
| | - P Jagodzinska-Mucha
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - S Bauer
- Medical Oncology Department, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - E Connolly
- Medical Oncology Department, Chris O Brien Lifehouse, Sydney, Australia
| | - H Gelderblom
- Medical Oncology Department, Leiden University Medical Center, Leiden, The Netherlands
| | - K Boye
- Institute for Cancer Research, Oslo University Hospital, Oslo; Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - C Henon
- Medical Oncology Department, Institut de Cancérologie Gustave Roussy, Villejuif, France
| | - S Bae
- Medical Oncology Department, Peter Mac Callum Center, Melbourne, Australia
| | - K Bogefors
- Department of Oncology, Skåne University Hospital and Lund University, Lund, Sweden
| | - B Vincenzi
- Medical Oncology Department, University Campus Bio-Medico, Rome, Italy
| | - J Martinez-Trufero
- Medical Oncology Department, Hospital Universitario Miguel Servet, Zaragoza
| | - J A Lopez-Martin
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Translational Oncology Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid
| | - A Redondo
- Medical Oncology Department, Hospital Universitario La Paz-IdiPAZ, Madrid
| | - C Valverde
- Medical Oncology Department, Hospital Universitario Vall d'Hebron, Barcelona
| | - J-Y Blay
- Centre Leon Berard & University Claude Bernard Lyon 1, Lyon, France
| | - D S Moura
- Instituto de Investigación Sanitaria-Fundación Jimenez Díaz-UAM (IIS-FJD-UAM), Madrid, Spain
| | - A Gutierrez
- Hematology Department, Hospital Universitario Son Espases, Palma, Spain
| | - W Tap
- Memorial Sloan Kettering Cancer Center, New York
| | - J Martin-Broto
- Medical Oncology Department, Fundacion Jimenez Diaz University Hospital and Hospital General de Villalba, Madrid; Instituto de Investigación Sanitaria-Fundación Jimenez Díaz-UAM (IIS-FJD-UAM), Madrid, Spain
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Klemen N, Hwang S, Bradic M, Rosenbaum E, Dickson M, Gounder M, Kelly C, Keohan M, Movva S, Thornton K, Chi P, Nacev B, Chan J, Bartlett E, Richards A, Singer S, Donoghue M, Tap W, D'Angelo S. 1527MO Biomarkers of response and hyperprogression in patients with sarcoma treated with checkpoint blockade. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.857] [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: 11/26/2022] Open
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Bauer S, George S, Kang Y, Jones R, Mir O, Tap W, Doyle A, Picazio N, Zhou T, Roche M, Heinrich M. VOYAGER: an open-label, randomised, phase 3 study of avapritinib vs regorafenib in patients with locally advanced metastatic or unresectable gastrointestinal stromal tumour. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Schram AM, Reales D, Galle J, Cambria R, Durany R, Feldman D, Sherman E, Rosenberg J, D’Andrea G, Baxi S, Janjigian Y, Tap W, Dickler M, Baselga J, Taylor BS, Chakravarty D, Gao J, Schultz N, Solit DB, Berger MF, Hyman DM. Oncologist use and perception of large panel next-generation tumor sequencing. Ann Oncol 2017; 28:2298-2304. [PMID: 28911072 PMCID: PMC5834089 DOI: 10.1093/annonc/mdx294] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Genomic profiling is increasingly incorporated into oncology research and the clinical care of cancer patients. We sought to determine physician perception and use of enterprise-scale clinical sequencing at our center, including whether testing changed management and the reasoning behind this decision-making. PATIENTS AND METHODS All physicians who consented patients to MSK-IMPACT, a next-generation hybridization capture assay, in tumor types where molecular profiling is not routinely performed were asked to complete a questionnaire for each patient. Physician determination of genomic 'actionability' was compared to an expertly curated knowledgebase of somatic variants. Reported management decisions were compared to chart review. RESULTS Responses were received from 146 physicians pertaining to 1932 patients diagnosed with 1 of 49 cancer types. Physicians indicated that sequencing altered management in 21% (331/1593) of patients in need of a treatment change. Among those in whom treatment was not altered, physicians indicated the presence of an actionable alteration in 55% (805/1474), however, only 45% (362/805) of these cases had a genomic variant annotated as actionable by expert curators. Further evaluation of these patients revealed that 66% (291/443) had a variant in a gene associated with biologic but not clinical evidence of actionability or a variant of unknown significance in a gene with at least one known actionable alteration. Of the cases annotated as actionable by experts, physicians identified an actionable alteration in 81% (362/445). In total, 13% (245/1932) of patients were enrolled to a genomically matched trial. CONCLUSION Although physician and expert assessment differed, clinicians demonstrate substantial awareness of the genes associated with potential actionability and report using this knowledge to inform management in one in five patients. CLINICAL TRIAL NUMBER NCT01775072.
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Affiliation(s)
- A. M. Schram
- Department of Medicine, Division of Solid Tumor Oncology
| | | | - J. Galle
- Clinical Research Administration
| | | | - R. Durany
- Josie Robertson Surgical Center, MSKCC, New York
| | - D. Feldman
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - E. Sherman
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - J. Rosenberg
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - G. D’Andrea
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - S. Baxi
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - Y. Janjigian
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - W. Tap
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - M. Dickler
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
| | - J. Baselga
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
- Human Oncology and Pathogenesis Program
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
| | - B. S. Taylor
- Human Oncology and Pathogenesis Program
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
- Department of Epidemiology and Biostatistics
| | - D. Chakravarty
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
| | - J. Gao
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
| | - N. Schultz
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
- Department of Epidemiology and Biostatistics
| | - D. B. Solit
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
- Human Oncology and Pathogenesis Program
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
| | - M. F. Berger
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
- Department of Pathology, MSKCC, New York, USA
| | - D. M. Hyman
- Department of Medicine, Division of Solid Tumor Oncology
- Weill Cornell Medical College, New York
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Lowery M, You D, Samoila A, Peerschke E, Viale A, Patel R, Selcuklu D, Rusek M, Cercek A, Kemeny N, Harding J, Mellinghoff I, Tap W, Abou-Alfa G, Moynahan M. Detection of IDH1 mutations in circulating free DNA in patients with cholangiocarcinoma. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33021-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tap W, Papai Z, van Tine B, Attia S, Ganjoo K, Jones R, Schuetze S, Reed D, Chawla S, Riedel R, Krarup-Hansen A, Italiano A, Hohenberger P, Grignani G, Cranmer L, Alcindor T, Lopez-Pousa A, Pearce T, Kroll S, Schoffski P. Randomized phase 3, multicenter, open-label study comparing evofosfamide (Evo) in combination with doxorubicin (D) vs. D alone in patients (pts) with advanced soft tissue sarcoma (STS): Study TH-CR-406/SARC021. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw388.01] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tap W, Jones R, Chmielowski B, Elias A, Adkins D, Van Tine B, Agulnik M, Cooney M, Livingston M, Pennock G, Qin A, Shahir A, Ilaria R, Conti I, Schwartz G. A randomized phase 1b/2 study evaluating the safety and efficacy of doxorubicin (dox) with or without olaratumab (IMC-3G3), a human anti–platelet-derived growth factor &agr; (pdgfr&agr;) monoclonal antibody, in advanced soft tissue sarcoma (sts). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw343.01] [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: 11/13/2022] Open
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