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Rudin CM, Balli D, Lai WV, Richards AL, Nguyen E, Egger JV, Choudhury NJ, Sen T, Chow A, Poirier JT, Geese WJ, Hellmann MD, Forslund A. Clinical Benefit From Immunotherapy in Patients With SCLC Is Associated With Tumor Capacity for Antigen Presentation. J Thorac Oncol 2023; 18:1222-1232. [PMID: 37210008 PMCID: PMC10524620 DOI: 10.1016/j.jtho.2023.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [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: 02/02/2023] [Revised: 04/25/2023] [Accepted: 05/11/2023] [Indexed: 05/22/2023]
Abstract
INTRODUCTION A small percentage of patients with SCLC experience durable responses to immune checkpoint blockade (ICB). Defining determinants of immune response may nominate strategies to broaden the efficacy of immunotherapy in patients with SCLC. Prior studies have been limited by small numbers or concomitant chemotherapy administration. METHODS CheckMate 032, a multicenter, open-label, phase 1/2 trial evaluating nivolumab alone or with ipilimumab was the largest study of ICB alone in patients with SCLC. We performed comprehensive RNA sequencing of 286 pretreatment SCLC tumor samples, assessing outcome on the basis of defined SCLC subtypes (SCLC-A, -N, -P, and -Y), and expression signatures associated with durable benefit, defined as progression-free survival more than or equal to 6 months. Potential biomarkers were further explored by immunohistochemistry. RESULTS None of the subtypes were associated with survival. Antigen presentation machinery signature (p = 0.000032) and presence of more than or equal to 1% infiltrating CD8+ T cells by immunohistochemistry (hazard ratio = 0.51, 95% confidence interval: 0.27-0.95) both correlated with survival in patients treated with nivolumab. Pathway enrichment analysis revealed the association between durable benefit from immunotherapy and antigen processing and presentation. Analysis of epigenetic determinants of antigen presentation identified LSD1 gene expression as a correlate of worse survival outcomes for patients treated with either nivolumab or the combination of nivolumab and ipilimumab. CONCLUSIONS Tumor antigen processing and presentation is a key correlate of ICB efficacy in patients with SCLC. As antigen presentation machinery is frequently epigenetically suppressed in SCLC, this study defines a targetable mechanism by which we might improve clinical benefit of ICB for patients with SCLC.
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Affiliation(s)
- Charles M Rudin
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York; Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York.
| | | | - W Victoria Lai
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Allison L Richards
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Evelyn Nguyen
- Cancer Biology Program, Louis V. Gerstner Jr. Graduate School of Biomedical Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jacklynn V Egger
- Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Noura J Choudhury
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Triparna Sen
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Andrew Chow
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - John T Poirier
- Perlmutter Cancer Center, New York University Langone Health, New York, New York
| | | | - Matthew D Hellmann
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
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Paz-Ares L, Champiat S, Lai WV, Izumi H, Govindan R, Boyer M, Hummel HD, Borghaei H, Johnson ML, Steeghs N, Blackhall F, Dowlati A, Reguart N, Yoshida T, He K, Gadgeel SM, Felip E, Zhang Y, Pati A, Minocha M, Mukherjee S, Goldrick A, Nagorsen D, Hashemi Sadraei N, Owonikoko TK. Tarlatamab, a First-in-Class DLL3-Targeted Bispecific T-Cell Engager, in Recurrent Small-Cell Lung Cancer: An Open-Label, Phase I Study. J Clin Oncol 2023; 41:2893-2903. [PMID: 36689692 PMCID: PMC10414718 DOI: 10.1200/jco.22.02823] [Citation(s) in RCA: 50] [Impact Index Per Article: 50.0] [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: 12/14/2022] [Revised: 01/04/2023] [Accepted: 01/13/2023] [Indexed: 01/24/2023] Open
Abstract
PURPOSE Small-cell lung cancer (SCLC) is an aggressive malignancy with limited treatments. Delta-like ligand 3 (DLL3) is aberrantly expressed in most SCLC. Tarlatamab (AMG 757), a bispecific T-cell engager molecule, binds both DLL3 and CD3 leading to T-cellb-mediated tumor lysis. Herein, we report phase I results of tarlatamab in patients with SCLC. PATIENTS AND METHODS This study evaluated tarlatamab in patients with relapsed/refractory SCLC. The primary end point was safety. Secondary end points included antitumor activity by modified RECIST 1.1, overall survival, and pharmacokinetics. RESULTS By July 19, 2022, 107 patients received tarlatamab in dose exploration (0.003 to 100 mg; n = 73) and expansion (100 mg; n = 34) cohorts. Median prior lines of anticancer therapy were 2 (range, 1-6); 49.5% received antiprogrammed death-1/programmed death ligand-1 therapy. Any-grade treatment-related adverse events occurred in 97 patients (90.7%) and grade b % 3 in 33 patients (30.8%). One patient (1%) had grade 5 pneumonitis. Cytokine release syndrome was the most common treatment-related adverse event, occurring in 56 patients (52%) including grade 3 in one patient (1%). Maximum tolerated dose was not reached. Objective response rate was 23.4% (95% CI, 15.7 to 32.5) including two complete and 23 partial responses. The median duration of response was 12.3 months (95% CI, 6.6 to 14.9). The disease control rate was 51.4% (95% CI, 41.5 to 61.2). The median progression-free survival and overall survival were 3.7 months (95% CI, 2.1 to 5.4) and 13.2 months (95% CI, 10.5 to not reached), respectively. Exploratory analysis suggests that selecting for increased DLL3 expression can result in increased clinical benefit. CONCLUSION In patients with heavily pretreated SCLC, tarlatamab demonstrated manageable safety with encouraging response durability. Further evaluation of this promising molecule is ongoing.
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Affiliation(s)
- Luis Paz-Ares
- Hospital Universitario 12 de Octubre, CNIO-H120 Lung Cancer Unit, Ciberonc and Universidad Complutense, Madrid, Spain
| | - Stephane Champiat
- Gustave Roussy, DC(c)partement d'Innovation ThC(c)rapeutique et d'Essais PrC(c)coces (DITEP), Villejuif, France
| | - W. Victoria Lai
- Thoracic Oncology Service, Department of Medicine, Division of Solid Tumor Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Hiroki Izumi
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Ramaswamy Govindan
- Divisions of Hematology and Oncology, Washington University Medical School, St Louis, MO
| | - Michael Boyer
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Horst-Dieter Hummel
- Translational Oncology/Early Clinical Trial Unit (ECTU), Comprehensive Cancer Center Mainfranken, University Hospital Wuerzburg, Wuerzburg, Germany
| | | | | | - Neeltje Steeghs
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Fiona Blackhall
- Department of Medical Oncology, The Christie NHS Foundation Trust, Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Afshin Dowlati
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH
| | - Noemi Reguart
- Department of Medical Oncology, Thoracic Oncology Unit, IDIBAPS, Hospital Clinic, University of Barcelona School of Medicine, Barcelona, Spain
| | - Tatsuya Yoshida
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kai He
- Division of Medical Oncology, James Thoracic Oncology Center, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | | | - Enriqueta Felip
- Medical Oncology Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | | | | | | | | | | | | | | | - Taofeek K. Owonikoko
- UPMC Hillman Cancer Center, Division of Hematology/Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Febres-Aldana CA, Chang JC, Ptashkin R, Wang Y, Gedvilaite E, Baine MK, Travis WD, Ventura K, Bodd F, Yu HA, Quintanal-Villalonga A, Lai WV, Egger JV, Offin M, Ladanyi M, Rudin CM, Rekhtman N. Rb Tumor Suppressor in Small Cell Lung Cancer: Combined Genomic and IHC Analysis with a Description of a Distinct Rb-Proficient Subset. Clin Cancer Res 2022; 28:4702-4713. [PMID: 35792876 PMCID: PMC9623236 DOI: 10.1158/1078-0432.ccr-22-1115] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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: 04/08/2022] [Revised: 05/31/2022] [Accepted: 07/01/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE RB1 mutations and loss of retinoblastoma (Rb) expression represent consistent but not entirely invariable hallmarks of small cell lung cancer (SCLC). The prevalence and characteristics of SCLC retaining wild-type Rb are not well-established. Furthermore, the performance of targeted next-generation sequencing (NGS) versus immunohistochemistry for Rb assessment is not well-defined. EXPERIMENTAL DESIGN A total of 208 clinical SCLC samples were analyzed by comprehensive targeted NGS, covering all exons of RB1, and Rb IHC. On the basis of established coordination of Rb/p16/cyclinD1 expression, p16-high/cyclinD1-low profile was used as a marker of constitutive Rb deficiency. RESULTS Fourteen of 208 (6%) SCLC expressed wild-type Rb, accompanied by a unique p16-low/cyclinD1-high profile supporting Rb proficiency. Rb-proficient SCLC was associated with neuroendocrine-low phenotype, combined SCLC with non-SCLC (NSCLC) histology and aggressive behavior. These tumors exclusively harbored CCND1 amplification (29%), and were markedly enriched in CDKN2A mutations (50%) and NSCLC-type alterations (KEAP1, STK11, FGFR1). The remaining 194 of 208 SCLC were Rb-deficient (p16-high/cyclinD1-low), including 184 cases with Rb loss (of which 29% lacked detectable RB1 alterations by clinical NGS pipeline), and 10 cases with mutated but expressed Rb. CONCLUSIONS This is the largest study to date to concurrently analyze Rb by NGS and IHC in SCLC, identifying a 6% rate of Rb proficiency. Pathologic-genomic data implicate NSCLC-related progenitors as a putative source of Rb-proficient SCLC. Consistent upstream Rb inactivation via CDKN2A/p16↓ and CCND1/cyclinD1↑ suggests the potential utility of CDK4/6 inhibitors in this aggressive SCLC subset. The study also clarifies technical aspects of Rb status determination in clinical practice, highlighting the limitations of exon-only sequencing for RB1 interrogation. See related commentary by Mahadevan and Sholl, p. 4603.
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Affiliation(s)
| | - Jason C. Chang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
| | - Ryan Ptashkin
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
| | - Yuhan Wang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
| | - Erika Gedvilaite
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
| | - Marina K. Baine
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
| | - William D. Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
| | - Katia Ventura
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
| | - Francis Bodd
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
| | - Helena A. Yu
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
| | | | - W. Victoria Lai
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
| | - Jacklynn V. Egger
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
| | - Michael Offin
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
| | - Marc Ladanyi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York
| | - Charles M. Rudin
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
| | - Natasha Rekhtman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
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Jee J, Lebow ES, Yeh R, Das JP, Namakydoust A, Paik PK, Chaft JE, Jayakumaran G, Rose Brannon A, Benayed R, Zehir A, Donoghue M, Schultz N, Chakravarty D, Kundra R, Madupuri R, Murciano-Goroff YR, Tu HY, Xu CR, Martinez A, Wilhelm C, Galle J, Daly B, Yu HA, Offin M, Hellmann MD, Lito P, Arbour KC, Zauderer MG, Kris MG, Ng KK, Eng J, Preeshagul I, Victoria Lai W, Fiore JJ, Iqbal A, Molena D, Rocco G, Park BJ, Lim LP, Li M, Tong-Li C, De Silva M, Chan DL, Diakos CI, Itchins M, Clarke S, Pavlakis N, Lee A, Rekhtman N, Chang J, Travis WD, Riely GJ, Solit DB, Gonen M, Rusch VW, Rimner A, Gomez D, Drilon A, Scher HI, Shah SP, Berger MF, Arcila ME, Ladanyi M, Levine RL, Shen R, Razavi P, Reis-Filho JS, Jones DR, Rudin CM, Isbell JM, Li BT. Overall survival with circulating tumor DNA-guided therapy in advanced non-small-cell lung cancer. Nat Med 2022; 28:2353-2363. [PMID: 36357680 PMCID: PMC10338177 DOI: 10.1038/s41591-022-02047-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [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: 02/15/2022] [Accepted: 09/16/2022] [Indexed: 11/12/2022]
Abstract
Circulating tumor DNA (ctDNA) sequencing guides therapy decisions but has been studied mostly in small cohorts without sufficient follow-up to determine its influence on overall survival. We prospectively followed an international cohort of 1,127 patients with non-small-cell lung cancer and ctDNA-guided therapy. ctDNA detection was associated with shorter survival (hazard ratio (HR), 2.05; 95% confidence interval (CI), 1.74-2.42; P < 0.001) independently of clinicopathologic features and metabolic tumor volume. Among the 722 (64%) patients with detectable ctDNA, 255 (23%) matched to targeted therapy by ctDNA sequencing had longer survival than those not treated with targeted therapy (HR, 0.63; 95% CI, 0.52-0.76; P < 0.001). Genomic alterations in ctDNA not detected by time-matched tissue sequencing were found in 25% of the patients. These ctDNA-only alterations disproportionately featured subclonal drivers of resistance, including RICTOR and PIK3CA alterations, and were associated with short survival. Minimally invasive ctDNA profiling can identify heterogeneous drivers not captured in tissue sequencing and expand community access to life-prolonging therapy.
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Affiliation(s)
- Justin Jee
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Emily S Lebow
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Randy Yeh
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeeban P Das
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Paul K Paik
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Jamie E Chaft
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | | | - A Rose Brannon
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ryma Benayed
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ahmet Zehir
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mark Donoghue
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Ritika Kundra
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Hai-Yan Tu
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chong-Rui Xu
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | | | - Clare Wilhelm
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jesse Galle
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bobby Daly
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Helena A Yu
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Michael Offin
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Matthew D Hellmann
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Piro Lito
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Kathryn C Arbour
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Marjorie G Zauderer
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Mark G Kris
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Kenneth K Ng
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Juliana Eng
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Isabel Preeshagul
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - W Victoria Lai
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - John J Fiore
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Afsheen Iqbal
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Daniela Molena
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Gaetano Rocco
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Bernard J Park
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Lee P Lim
- Resolution Bioscience, Agilent Technologies, Kirkland, WA, USA
| | - Mark Li
- Resolution Bioscience, Agilent Technologies, Kirkland, WA, USA
| | - Candace Tong-Li
- GenesisCare, University of Sydney, Sydney, Australia
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - David L Chan
- GenesisCare, University of Sydney, Sydney, Australia
| | | | | | | | - Nick Pavlakis
- GenesisCare, University of Sydney, Sydney, Australia
| | - Adrian Lee
- GenesisCare, University of Sydney, Sydney, Australia
| | - Natasha Rekhtman
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Jason Chang
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - William D Travis
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Gregory J Riely
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - David B Solit
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Mithat Gonen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Valerie W Rusch
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Andreas Rimner
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Daniel Gomez
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Alexander Drilon
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Howard I Scher
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Sohrab P Shah
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Maria E Arcila
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Marc Ladanyi
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Ross L Levine
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Ronglai Shen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Pedram Razavi
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Jorge S Reis-Filho
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - David R Jones
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Charles M Rudin
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - James M Isbell
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Bob T Li
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Weill Cornell Medicine, Cornell University, New York, NY, USA.
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5
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Paik PK, Luo J, Ai N, Kim R, Ahn L, Biswas A, Coker C, Ma W, Wong P, Buonocore DJ, Lai WV, Chaft JE, Acharyya S, Massagué J, Kris MG. Phase I trial of the TNF-α inhibitor certolizumab plus chemotherapy in stage IV lung adenocarcinomas. Nat Commun 2022; 13:6095. [PMID: 36241629 PMCID: PMC9568581 DOI: 10.1038/s41467-022-33719-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/29/2022] [Indexed: 12/24/2022] Open
Abstract
We previously identified a chemotherapy-induced paracrine inflammatory loop that paradoxically mitigates the anti-tumor effect of chemotherapy and triggers metastatic propagation in breast and lung cancer models. Therefore, we sought to further validate and translate these findings into patient care by coupling the anti-TNF-α drug certolizumab pegol with standard cisplatin doublet chemotherapy. Here we first validate the anti-metastatic effect of certolizumab in a liver-metastatic Lewis Lung Carcinoma model. We then evaluate the safety, efficacy, and pharmacodynamic effects of certolizumab with cisplatin and pemetrexed in an open label Phase 1 clinical trial (NCT02120807) of eighteen adult patients with stage IV lung adenocarcinomas. The primary outcome is maximum tolerated dose. Secondary outcomes are response rate and progression-free survival (PFS); pharmacodynamic changes in blood and tumor are evaluated as a correlative outcome. There were nine partial responses among 16 patients evaluable (56%, 95% CI 30 to 80%). The median duration of response was 9.0 months (range 5.9 to 42.6 months) and median PFS was 7.1 months (95% CI 6.3 to NR). The standard 400 mg dose of certolizumab, added to cisplatin and pemetrexed, is well-tolerated and, as a correlative endpoint, demonstrates potent pharmacodynamic inhibition of peripheral cytokines associated with the paracrine inflammatory loop.
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Affiliation(s)
- Paul K Paik
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - Jia Luo
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ni Ai
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Rachel Kim
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Linda Ahn
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anup Biswas
- Institute for Cancer Genetics, Columbia University, New York, NY, USA
| | - Courtney Coker
- Institute for Cancer Genetics, Columbia University, New York, NY, USA
| | - Wanchao Ma
- Institute for Cancer Genetics, Columbia University, New York, NY, USA
| | - Phillip Wong
- Ludwig Center for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Darren J Buonocore
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - W Victoria Lai
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Jamie E Chaft
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Swarnali Acharyya
- Institute for Cancer Genetics, Columbia University, New York, NY, USA
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
| | - Joan Massagué
- Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mark G Kris
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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6
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Baine MK, Febres-Aldana CA, Chang JC, Jungbluth AA, Sethi S, Antonescu CR, Travis WD, Hsieh MS, Roh MS, Homer RJ, Ladanyi M, Egger JV, Lai WV, Rudin CM, Rekhtman N. POU2F3 in SCLC: Clinicopathologic and Genomic Analysis With a Focus on Its Diagnostic Utility in Neuroendocrine-Low SCLC. J Thorac Oncol 2022; 17:1109-1121. [PMID: 35760287 PMCID: PMC9427708 DOI: 10.1016/j.jtho.2022.06.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [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: 04/13/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION POU2F3 is a recent marker of a small cell lung carcinoma (SCLC) subtype related to chemosensory tuft cells (SCLC-P). The characteristics of SCLC-P have not been fully defined, and the data on POU2F3 expression in other lung tumors are scarce. METHODS We screened 254 SCLC for POU2F3 expression and comprehensively analyzed histopathologic, genomic, and clinical characteristics of POU2F3-positive tumors. We also explored POU2F3 expression in other major lung cancer types (n = 433) and a targeted set of potential diagnostic mimics of SCLC (n = 123). RESULTS POU2F3 was expressed in 30 of 254 (12%) SCLC and was strongly associated with low expression of standard neuroendocrine markers (synaptophysin, chromogranin A, CD56, INSM1). Notably, POU2F3 was expressed in 75% of SCLC with entirely negative or minimal neuroendocrine marker expression (15/20) and was helpful in supporting the diagnosis of SCLC in such cases. Broad targeted next-generation sequencing revealed that SCLC-P (n = 12) exhibited enrichment in several alterations, including PTEN inactivation, MYC amplifications, and 20q13 amplifications, but similar rates of RB1 and TP53 alterations as other SCLC (n = 155). Beyond SCLC, POU2F3 expression was exclusively limited to large cell neuroendocrine carcinoma (12%) and basaloid squamous cell carcinoma (22%). CONCLUSIONS This is the largest cohort of SCLC-P clinical samples to date, where we describe the diagnostic utility of POU2F3 in a challenging subset of SCLC with low or absent expression of standard neuroendocrine markers. The distinct genomic alterations in SCLC-P may offer a novel avenue for therapeutic targeting. The role of POU2F3 in a narrow subset of other lung cancer types warrants further study.
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Affiliation(s)
- Marina K Baine
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Jason C Chang
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Achim A Jungbluth
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Shenon Sethi
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Cristina R Antonescu
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - William D Travis
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Min-Shu Hsieh
- Department of Pathology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Mee Sook Roh
- Department of Pathology, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Robert J Homer
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Marc Ladanyi
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jacklynn V Egger
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - W Victoria Lai
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Charles M Rudin
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Natasha Rekhtman
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
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7
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Caeser R, Egger JV, Chavan S, Socci ND, Jones CB, Kombak FE, Asher M, Roehrl MH, Shah NS, Allaj V, Manoj P, Tischfield SE, Kulick A, Meneses M, Iacobuzio-Donahue CA, Lai WV, Bhanot U, Baine MK, Rekhtman N, Hollmann TJ, de Stanchina E, Poirier JT, Rudin CM, Sen T. Genomic and transcriptomic analysis of a library of small cell lung cancer patient-derived xenografts. Nat Commun 2022; 13:2144. [PMID: 35440124 PMCID: PMC9018685 DOI: 10.1038/s41467-022-29794-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 03/28/2022] [Indexed: 12/12/2022] Open
Abstract
Access to clinically relevant small cell lung cancer (SCLC) tissue is limited because surgical resection is rare in metastatic SCLC. Patient-derived xenografts (PDX) and circulating tumor cell-derived xenografts (CDX) have emerged as valuable tools to characterize SCLC. Here, we present a resource of 46 extensively annotated PDX/CDX models derived from 33 patients with SCLC. We perform multi-omic analyses, using targeted tumor next-generation sequencing, RNA-sequencing, and immunohistochemistry to deconvolute the mutational landscapes, global expression profiles, and molecular subtypes of these SCLC models. SCLC subtypes characterized by transcriptional regulators, ASCL1, NEUROD1 and POU2F3 are confirmed in this cohort. A subset of SCLC clinical specimens, including matched PDX/CDX and clinical specimen pairs, confirm that the primary features and genomic and proteomic landscapes of the tumors of origin are preserved in the derivative PDX models. This resource provides a powerful system to study SCLC biology.
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Affiliation(s)
- Rebecca Caeser
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Jacklynn V Egger
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Shweta Chavan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Nicholas D Socci
- Bioinformatics Core, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Caitlin Byrne Jones
- Bioinformatics Core, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Faruk Erdem Kombak
- Precision Pathology Center, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Marina Asher
- Precision Pathology Center, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Michael H Roehrl
- Precision Pathology Center, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Nisargbhai S Shah
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Viola Allaj
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Parvathy Manoj
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Sam E Tischfield
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Amanda Kulick
- Antitumor Assessment Core Facility, Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY10065, USA
| | - Maximiliano Meneses
- Antitumor Assessment Core Facility, Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY10065, USA
| | - Christine A Iacobuzio-Donahue
- Precision Pathology Center, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - W Victoria Lai
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Umeshkumar Bhanot
- Precision Pathology Center, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Marina K Baine
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Natasha Rekhtman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Travis J Hollmann
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elisa de Stanchina
- Antitumor Assessment Core Facility, Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY10065, USA
| | - John T Poirier
- Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - Charles M Rudin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
| | - Triparna Sen
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
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8
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Chan JM, Quintanal-Villalonga Á, Gao VR, Xie Y, Allaj V, Chaudhary O, Masilionis I, Egger J, Chow A, Walle T, Mattar M, Yarlagadda DVK, Wang JL, Uddin F, Offin M, Ciampricotti M, Qeriqi B, Bahr A, de Stanchina E, Bhanot UK, Lai WV, Bott MJ, Jones DR, Ruiz A, Baine MK, Li Y, Rekhtman N, Poirier JT, Nawy T, Sen T, Mazutis L, Hollmann TJ, Pe'er D, Rudin CM. Signatures of plasticity, metastasis, and immunosuppression in an atlas of human small cell lung cancer. Cancer Cell 2021; 39:1479-1496.e18. [PMID: 34653364 PMCID: PMC8628860 DOI: 10.1016/j.ccell.2021.09.008] [Citation(s) in RCA: 128] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 07/26/2021] [Accepted: 09/15/2021] [Indexed: 12/11/2022]
Abstract
Small cell lung cancer (SCLC) is an aggressive malignancy that includes subtypes defined by differential expression of ASCL1, NEUROD1, and POU2F3 (SCLC-A, -N, and -P, respectively). To define the heterogeneity of tumors and their associated microenvironments across subtypes, we sequenced 155,098 transcriptomes from 21 human biospecimens, including 54,523 SCLC transcriptomes. We observe greater tumor diversity in SCLC than lung adenocarcinoma, driven by canonical, intermediate, and admixed subtypes. We discover a PLCG2-high SCLC phenotype with stem-like, pro-metastatic features that recurs across subtypes and predicts worse overall survival. SCLC exhibits greater immune sequestration and less immune infiltration than lung adenocarcinoma, and SCLC-N shows less immune infiltrate and greater T cell dysfunction than SCLC-A. We identify a profibrotic, immunosuppressive monocyte/macrophage population in SCLC tumors that is particularly associated with the recurrent, PLCG2-high subpopulation.
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Affiliation(s)
- Joseph M Chan
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Program for Computational and Systems Biology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10016, USA
| | - Álvaro Quintanal-Villalonga
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Vianne Ran Gao
- Program for Computational and Systems Biology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10016, USA; Weill Cornell Medical College, New York, NY 10065, USA
| | - Yubin Xie
- Program for Computational and Systems Biology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10016, USA; Weill Cornell Medical College, New York, NY 10065, USA
| | - Viola Allaj
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Ojasvi Chaudhary
- Program for Computational and Systems Biology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10016, USA
| | - Ignas Masilionis
- Program for Computational and Systems Biology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10016, USA
| | - Jacklynn Egger
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Andrew Chow
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Thomas Walle
- Department of Medical Oncology; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Clinical Cooperation Unit Virotherapy; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Marissa Mattar
- Antitumor Assessment Core Facility, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Dig V K Yarlagadda
- Program for Computational and Systems Biology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10016, USA
| | - James L Wang
- Department of Computer Science, Columbia University, New York, NY 10027, USA
| | - Fathema Uddin
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Michael Offin
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Metamia Ciampricotti
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Besnik Qeriqi
- Antitumor Assessment Core Facility, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Amber Bahr
- Antitumor Assessment Core Facility, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Elisa de Stanchina
- Antitumor Assessment Core Facility, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Umesh K Bhanot
- Precision Pathology Center, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - W Victoria Lai
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Matthew J Bott
- Thoracic Service, Department of Surgery, Fiona and Stanley Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - David R Jones
- Thoracic Service, Department of Surgery, Fiona and Stanley Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Arvin Ruiz
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Marina K Baine
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Yanyun Li
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Natasha Rekhtman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - John T Poirier
- Perlmutter Cancer Center, New York University Langone Health, New York, NY 10065, USA
| | - Tal Nawy
- Program for Computational and Systems Biology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10016, USA
| | - Triparna Sen
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Weill Cornell Medical College, New York, NY 10065, USA
| | - Linas Mazutis
- Institute of Biotechnology, Vilnius University, Vilnius, Lithuania
| | - Travis J Hollmann
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Dana Pe'er
- Program for Computational and Systems Biology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10016, USA; Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Charles M Rudin
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Weill Cornell Medical College, New York, NY 10065, USA.
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9
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Chan DL, Ulaner GA, Pattison D, Wyld D, Ladwa R, Kirchner J, Li BT, Lai WV, Pavlakis N, Roach PJ, Bailey DL. Dual PET Imaging in Bronchial Neuroendocrine Neoplasms: The NETPET Score as a Prognostic Biomarker. J Nucl Med 2021; 62:1278-1284. [PMID: 33579809 DOI: 10.2967/jnumed.120.257659] [Citation(s) in RCA: 9] [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: 10/18/2020] [Revised: 01/03/2021] [Indexed: 12/31/2022] Open
Abstract
PET scans using 18F-FDG and somatostatin receptor imaging agents are both used in imaging of neuroendocrine neoplasms (NENs). We have suggested the "NETPET score," using uptake of both PET tracers, as a prognostic biomarker in NENs. The name NETPET score was suggested previously to capture the score's intent to summarize information from dual PET imaging in neuroendocrine tumors. We previously demonstrated the effectiveness of the NETPET score in gastroenteropancreatic NENs (GEPNENs). Its prognostic relevance in bronchial NENs remains undetermined. Methods: This is a retrospective multicenter study (2011-2018) assessing patients who had advanced bronchial NEN and who underwent both 18F-FDG and 68Ga-DOTATATE PET within 60 d of each other. The NETPET score was assigned by experienced nuclear medicine physicians and compared with other clinical data such as World Health Organization grade. The primary outcome was overall survival; NETPET score and other prognostic variables were analyzed using univariate and multivariate analyses by the Cox proportional-hazards model. Results: Thirty-eight patients were included for review. The NETPET score and histology were significantly correlated with overall survival in univariate analyses (P = 0.003, P = 0.01). On multivariate analysis, only the NETPET score remained significant (P = 0.03). The NETPET score was significantly associated with histologic grade (P = 0.006, χ2 test). Conclusion: The NETPET score is a prognostic biomarker in bronchial NENs as well as GEPNENs. Although it needs to be validated in prospective studies, it holds significant promise as a biomarker for a wide range of NENs.
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Affiliation(s)
- David L Chan
- Department of Medical Oncology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia; .,Bill Walsh Translational Cancer Research Laboratory, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Gary A Ulaner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David Pattison
- Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - David Wyld
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Department of Medical Oncology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Rahul Ladwa
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Department of Medical Oncology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Julian Kirchner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Bob T Li
- Department of Thoracic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - W Victoria Lai
- Department of Thoracic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nick Pavlakis
- Department of Medical Oncology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia.,Bill Walsh Translational Cancer Research Laboratory, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Paul J Roach
- Department of Nuclear Medicine, Royal North Shore Hospital, St. Leonards, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; and
| | - Dale L Bailey
- Department of Nuclear Medicine, Royal North Shore Hospital, St. Leonards, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; and.,Sydney Vital Translational Cancer Research Centre, Sydney, New South Wales, Australia
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10
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Baine MK, Hsieh MS, Lai WV, Egger JV, Jungbluth AA, Daneshbod Y, Beras A, Spencer R, Lopardo J, Bodd F, Montecalvo J, Sauter JL, Chang JC, Buonocore DJ, Travis WD, Sen T, Poirier JT, Rudin CM, Rekhtman N. SCLC Subtypes Defined by ASCL1, NEUROD1, POU2F3, and YAP1: A Comprehensive Immunohistochemical and Histopathologic Characterization. J Thorac Oncol 2020; 15:1823-1835. [PMID: 33011388 PMCID: PMC8362797 DOI: 10.1016/j.jtho.2020.09.009] [Citation(s) in RCA: 196] [Impact Index Per Article: 49.0] [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: 06/26/2020] [Revised: 08/21/2020] [Accepted: 09/09/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Recent studies have identified subtypes of small cell lung carcinoma (SCLC) defined by the RNA expression of ASCL1, NEUROD1, POU2F3, and YAP1 transcriptional regulators. There are only limited data on the distribution of these markers at the protein level and associated pathologic characteristics in clinical SCLC samples. METHODS The expression of ASCL1, NEUROD1, POU2F3, and YAP1 was analyzed by immunohistochemistry in 174 patient samples with SCLC. Subtypes defined by these markers were correlated with histologic characteristics, expression of classic neuroendocrine markers (synaptophysin, chromogranin A, CD56, INSM1), and other SCLC markers, including the neuroendocrine phenotype-associated markers TTF-1 and DLL3. RESULTS ASCL1 and NEUROD1 expression had the following distribution: (1) 41% ASCL1+/NEUROD1-; (2) 37% ASCL1+/NEUROD1+; (3) 8% ASCL1-/NEUROD1+; and (4) 14% ASCL1-/NEUROD1-. On the basis of their relative expression, 69% of cases were ASCL1-dominant and 17% were NEUROD1-dominant. POU2F3 was expressed in 7% of SCLC and was mutually exclusive of ASCL1 and NEUROD1. YAP1 was expressed at low levels, primarily in combined SCLC, and was not exclusive of other subtypes. Both ASCL1-dominant and NEUROD1-dominant subtypes were associated with neuroendocrine markerhigh/TTF-1high/DLL3high profile, whereas POU2F3 and other ASCL1/NEUROD1 double-negative tumors were neuroendocrine markerlow/TTF-1low/DLL3low. CONCLUSIONS This is the first comprehensive immunohistochemical and histopathologic analysis of novel SCLC subtypes in patient samples. We confirm that ASCL1/NEUROD1 double-negative tumors represent a distinct neuroendocrine-low subtype of SCLC, which is either uniquely associated with POU2F3 or lacks a known dominant regulator. The expression profiles of these markers appear more heterogeneous in native samples than in experimental models, particularly with regard to the high prevalence of ASCL1/NEUROD1 coexpression. These findings may have prognostic and therapeutic implications and warrant further clinical investigation.
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Affiliation(s)
- Marina K Baine
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Min-Shu Hsieh
- Department of Pathology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - W Victoria Lai
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jacklynn V Egger
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Achim A Jungbluth
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yahya Daneshbod
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pathology, Loma Linda University School of Medicine, Loma Linda, California
| | - Amanda Beras
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rowanne Spencer
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jessica Lopardo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Francis Bodd
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joseph Montecalvo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pathology, Henry Ford Hospital, Detroit, Michigan
| | - Jennifer L Sauter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jason C Chang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Darren J Buonocore
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - William D Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Triparna Sen
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - John T Poirier
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Perlmutter Cancer Center, New York University Langone Health, New York, New York
| | - Charles M Rudin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Natasha Rekhtman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
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11
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Borghaei H, Boyer M, Johnson M, Govindan R, Rodrigues LPA, Blackhall F, Boosman R, Champiat S, Hummel HD, Victoria Lai W, Udagawa H, Chiang A, Dowlati A, Hann C, Salgia R, Vokes E, Minocha M, Hashemi-Sadraei N, Shetty A, Smit MAD, Yang H, Owonikoko T. 359 AMG 757, a half-life extended bispecific T-cell engager (BiTE®) immune therapy against DLL3 in SCLC: phase 1 interim results. J Immunother Cancer 2020. [DOI: 10.1136/jitc-2020-sitc2020.0359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BackgroundDelta-like ligand 3 (DLL3) is an inhibitory Notch ligand that is highly expressed in small cell lung cancer (SCLC) and minimally expressed in normal tissues.1 AMG 757, a half-life extended BiTE® immune therapy, binds to DLL3 on tumor cells and CD3 on T cells, resulting in T cell-dependent killing of tumor cells. We report initial safety and efficacy from the ongoing phase 1 study of AMG 757 in patients with SCLC.MethodsAMG 757 was administered intravenously every two weeks (with/without step dose) at doses of 0.003–3.0 mg. Eligible patients had SCLC that progressed or recurred following ≥1 platinum-based regimen. Antitumor activity was assessed using modified RECIST 1.1. The study was approved by the Ethics Board at participating institutions.ResultsAs of 1 June 2020, safety and efficacy data are available for 31 patients enrolled at the first seven dose levels (DL) with median age, 63 (44–74) years; ECOG PS: 0–1, n=30 (96.8%); median prior lines, 2.0 (1–6); and previous PD-1/PD-L1 treatment: n=12 (38.7%). Median treatment duration was 6.1 (0.1–59.4) weeks. Treatment-emergent adverse events (AEs) were reported for 30 (96.8%) patients. AMG 757-related AEs occurred in 25 (80.6%) patients, including 5 (16.1%) that were grade ≥3 and one (3.2%) grade 5 (pneumonitis in DL5 [0.3 mg]). Three AEs (dyspnea, pneumonitis, fatigue) led to treatment discontinuation. The most common AE was cytokine release syndrome (CRS), which was reported in 11 (35.5%) patients. CRS AEs were grade 1–2, consisted mainly of fever with/without hypotension, and occurred mostly within 24 hours of the first or second dose of AMG 757. CRS events were reversible, did not lead to treatment interruption or discontinuation, and were managed with supportive care, corticosteroids, and/or anti-IL 6 therapy. The MTD for AMG 757 has not yet been reached. AMG 757 exhibited dose proportional increase in exposures. Response to AMG 757 is shown (figure 1). Confirmed partial response was reported in 5 (16.1%) patients (1/12 [8.3%] in DL5, 1/8 [12.5%] in DL6, 3/7 [42.9%] in DL7), and stable disease in 8 (25.8%) of all treated patients. Most responses occurred after 8 weeks on treatment. All responders remain on treatment with duration of response ranging from 2.0+ to 7.4 months+.Abstract 359 Figure 1Tumor shrinkage over time in response to AMG 757ConclusionsAMG 757 administered at a dose of up to 3 mg every two weeks has an acceptable safety profile and shows anti-tumor activity in patients with relapsed/refractory SCLC. Further dose escalation is ongoing.Trial RegistrationNCT03319940Ethics ApprovalThe study was approved by the Ethics Board at participating institutions.ConsentN/AReferenceLeonetti A, Facchinetti F, Minari R, Cortellini A, Rolfo CD, Giovannetti E, Tiseo M. Cell Oncol (Dordr). 2019;42:261–273.
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Luo J, Rizvi H, Preeshagul IR, Egger JV, Hoyos D, Bandlamudi C, McCarthy CG, Falcon CJ, Schoenfeld AJ, Arbour KC, Chaft JE, Daly RM, Drilon A, Eng J, Iqbal A, Lai WV, Li BT, Lito P, Namakydoust A, Ng K, Offin M, Paik PK, Riely GJ, Rudin CM, Yu HA, Zauderer MG, Donoghue MTA, Łuksza M, Greenbaum BD, Kris MG, Hellmann MD. COVID-19 in patients with lung cancer. Ann Oncol 2020; 31:1386-1396. [PMID: 32561401 PMCID: PMC7297689 DOI: 10.1016/j.annonc.2020.06.007] [Citation(s) in RCA: 160] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Patients with lung cancers may have disproportionately severe coronavirus disease 2019 (COVID-19) outcomes. Understanding the patient-specific and cancer-specific features that impact the severity of COVID-19 may inform optimal cancer care during this pandemic. PATIENTS AND METHODS We examined consecutive patients with lung cancer and confirmed diagnosis of COVID-19 (n = 102) at a single center from 12 March 2020 to 6 May 2020. Thresholds of severity were defined a priori as hospitalization, intensive care unit/intubation/do not intubate ([ICU/intubation/DNI] a composite metric of severe disease), or death. Recovery was defined as >14 days from COVID-19 test and >3 days since symptom resolution. Human leukocyte antigen (HLA) alleles were inferred from MSK-IMPACT (n = 46) and compared with controls with lung cancer and no known non-COVID-19 (n = 5166). RESULTS COVID-19 was severe in patients with lung cancer (62% hospitalized, 25% died). Although severe, COVID-19 accounted for a minority of overall lung cancer deaths during the pandemic (11% overall). Determinants of COVID-19 severity were largely patient-specific features, including smoking status and chronic obstructive pulmonary disease [odds ratio for severe COVID-19 2.9, 95% confidence interval 1.07-9.44 comparing the median (23.5 pack-years) to never-smoker and 3.87, 95% confidence interval 1.35-9.68, respectively]. Cancer-specific features, including prior thoracic surgery/radiation and recent systemic therapies did not impact severity. Human leukocyte antigen supertypes were generally similar in mild or severe cases of COVID-19 compared with non-COVID-19 controls. Most patients recovered from COVID-19, including 25% patients initially requiring intubation. Among hospitalized patients, hydroxychloroquine did not improve COVID-19 outcomes. CONCLUSION COVID-19 is associated with high burden of severity in patients with lung cancer. Patient-specific features, rather than cancer-specific features or treatments, are the greatest determinants of severity.
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Affiliation(s)
- J Luo
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - H Rizvi
- Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, USA
| | - I R Preeshagul
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J V Egger
- Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, USA
| | - D Hoyos
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Bandlamudi
- Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C G McCarthy
- Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C J Falcon
- Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, USA
| | - A J Schoenfeld
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - K C Arbour
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - J E Chaft
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - R M Daly
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - A Drilon
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - J Eng
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - A Iqbal
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - W V Lai
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - B T Li
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - P Lito
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - A Namakydoust
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - K Ng
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M Offin
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - P K Paik
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - G J Riely
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - C M Rudin
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - H A Yu
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - M G Zauderer
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - M T A Donoghue
- Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - M Łuksza
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, USA
| | - B D Greenbaum
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M G Kris
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA
| | - M D Hellmann
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical Center, New York, USA; Parker Institute for Cancer Immunotherapy at Memorial Sloan Kettering Cancer Center, New York, USA.
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Muller S, Victoria Lai W, Adusumilli PS, Desmeules P, Frosina D, Jungbluth A, Ni A, Eguchi T, Travis WD, Ladanyi M, Zauderer MG, Sauter JL. V-domain Ig-containing suppressor of T-cell activation (VISTA), a potentially targetable immune checkpoint molecule, is highly expressed in epithelioid malignant pleural mesothelioma. Mod Pathol 2020; 33:303-311. [PMID: 31537897 PMCID: PMC8366498 DOI: 10.1038/s41379-019-0364-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [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: 07/18/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 12/13/2022]
Abstract
V-domain Ig-containing suppressor of T-cell activation (VISTA) is an immune checkpoint gene that inhibits anti-tumor immune responses. Since most malignant pleural mesotheliomas do not respond to anti-programmed cell death(-ligand)1 (PD-(L)1)/cytotoxic T-lymphocyte-associated protein 4 (CTLA4) therapy and given the recent finding of The Cancer Genome Atlas Study that pleural mesothelioma displays the highest expression of VISTA among all cancers studied, we examined VISTA expression in a large pleural mesothelioma cohort. VISTA and PD-L1 immunohistochemistry were performed on tissue microarray of immunotherapy-naive pleural mesotheliomas (254 epithelioid, 24 biphasic and 41 sarcomatoid) and ten whole-tissue sections of benign pleura (VISTA only). Percentages of tumor and inflammatory cells with positive staining were assessed. Optimal prognostic cutoff percentages were determined using maximally selected rank statistics. Overall survival was evaluated using Kaplan-Meier methods and Cox proportional hazard analysis. All benign mesothelium expressed VISTA. Eighty-five percent of 319 and 38% of 304 mesotheliomas expressed VISTA and PD-L1 (88% and 33% of epithelioid, 90% and 43% of biphasic, and 42% and 75% of sarcomatoid), respectively. Median VISTA score was significantly higher in epithelioid (50%) (vs. biphasic [20%] and sarcomatoid [0]) (p < 0.001), while median PD-L1 score was significantly higher in sarcomatoid tumors (20%) (vs. biphasic and epithelioid [both 0%]) (p < 0.001). VISTA and PD-L1 were expressed in inflammatory cells in 94% (n = 317) and 24% (n = 303) of mesothelioma, respectively. Optimal prognostic cutoffs for VISTA and PD-L1 were 40% and 30%, respectively. On multivariable analysis, VISTA and PD-L1 expression in mesothelioma were associated with better and worse overall survival (p = 0.001 and p = 0.002), respectively, independent of histology. In a large cohort of mesothelioma, we report frequent expression of VISTA and infrequent expression of PD-L1 with favorable and unfavorable survival correlations, respectively. These findings may explain poor responses to anti-PD-(L)1 immunotherapy and suggest VISTA as a potential novel target in pleural mesothelioma.
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Affiliation(s)
- Stephanie Muller
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - W Victoria Lai
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Prasad S Adusumilli
- Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Patrice Desmeules
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- Department of Pathology, Quebec Heart and Lung Institute, 1050 Rue de la Médecine, Québec, QC, G1V 0A6, Canada
| | - Denise Frosina
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Achim Jungbluth
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Ai Ni
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Takashi Eguchi
- Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - William D Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Marc Ladanyi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Marjorie G Zauderer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Jennifer L Sauter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
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Lei JT, Shao J, Zhang J, Iglesia M, Chan DW, Cao J, Anurag M, Singh P, He X, Kosaka Y, Matsunuma R, Crowder R, Hoog J, Phommaly C, Goncalves R, Ramalho S, Peres RMR, Punturi N, Schmidt C, Bartram A, Jou E, Devarakonda V, Holloway KR, Lai WV, Hampton O, Rogers A, Tobias E, Parikh PA, Davies SR, Li S, Ma CX, Suman VJ, Hunt KK, Watson MA, Hoadley KA, Thompson EA, Chen X, Kavuri SM, Creighton CJ, Maher CA, Perou CM, Haricharan S, Ellis MJ. Functional Annotation of ESR1 Gene Fusions in Estrogen Receptor-Positive Breast Cancer. Cell Rep 2020; 24:1434-1444.e7. [PMID: 30089255 PMCID: PMC6171747 DOI: 10.1016/j.celrep.2018.07.009] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/08/2018] [Accepted: 07/01/2018] [Indexed: 01/29/2023] Open
Abstract
RNA sequencing (RNA-seq) detects estrogen receptor alpha gene (ESR1) fusion transcripts in estrogen receptor-positive (ER+) breast cancer, but their role in disease pathogenesis remains unclear. We examined multiple ESR1 fusions and found that two, both identified in advanced endocrine treatment-resistant disease, encoded stable and functional fusion proteins. In both examples, ESR1-e6>YAP1 and ESR1-e6>PCDH11X, ESR1 exons 1-6 were fused in frame to C-terminal sequences from the partner gene. Functional properties include estrogen-independent growth, constitutive expression of ER target genes, and anti-estrogen resistance. Both fusions activate a metastasis-associated transcriptional program, induce cellular motility, and promote the development of lung metastasis. ESR1-e6>YAP1- and ESR1-e6>PCDH11X-induced growth remained sensitive to a CDK4/6 inhibitor, and a patient-derived xenograft (PDX) naturally expressing the ESR1-e6>YAP1 fusion was also responsive. Transcriptionally active ESR1 fusions therefore trigger both endocrine therapy resistance and metastatic progression, explaining the association with fatal disease progression, although CDK4/6 inhibitor treatment is predicted to be effective.
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Affiliation(s)
- Jonathan T Lei
- Department of Medicine, Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX 77030, USA; Interdepartmental Graduate Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jieya Shao
- Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA; Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Jin Zhang
- Cancer Biology Division, Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO 63110, USA; Institute for Informatics (I(2)), Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Michael Iglesia
- Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Doug W Chan
- Department of Medicine, Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jin Cao
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Meenakshi Anurag
- Department of Medicine, Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Purba Singh
- Department of Medicine, Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Xiaping He
- Department of Genetics, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Yoshimasa Kosaka
- Department of Breast and Endocrine Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0375, Japan
| | - Ryoichi Matsunuma
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka 431-3192, Japan
| | - Robert Crowder
- Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Jeremy Hoog
- Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Chanpheng Phommaly
- Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Rodrigo Goncalves
- Department of Obstetrics and Gynecology, University of São Paulo School of Medicine (FMUSP), Cerqueira César, São Paulo 01246-903, Brazil
| | - Susana Ramalho
- Department of Obstetrics and Gynecology, Faculty of Medical Science, State University of Campinas - UNICAMP, Campinas, São Paulo 13083-970, Brazil
| | - Raquel Mary Rodrigues Peres
- Department of Obstetrics and Gynecology, Faculty of Medical Science, State University of Campinas - UNICAMP, Campinas, São Paulo 13083-970, Brazil
| | - Nindo Punturi
- Department of Medicine, Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Cheryl Schmidt
- Department of Medicine, Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Alex Bartram
- Queens' College, University of Cambridge, Cambridge CB3 9ET, UK
| | - Eric Jou
- Queens' College, University of Cambridge, Cambridge CB3 9ET, UK
| | - Vaishnavi Devarakonda
- Department of Medicine, Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Kimberly R Holloway
- Department of Medicine, Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - W Victoria Lai
- Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Oliver Hampton
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Anna Rogers
- Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Ethan Tobias
- University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Poojan A Parikh
- School of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Sherri R Davies
- Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Shunqiang Li
- Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Cynthia X Ma
- Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Vera J Suman
- Alliance Statistical Center, Mayo Clinic, Rochester, MN 55905, USA
| | - Kelly K Hunt
- Department of Breast Surgical Oncology, MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mark A Watson
- Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Katherine A Hoadley
- Department of Genetics, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, USA
| | - E Aubrey Thompson
- Department of Cancer Biology, Mayo Clinic Comprehensive Cancer Center, Jacksonville, FL 32224, USA
| | - Xi Chen
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Shyam M Kavuri
- Department of Medicine, Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Chad J Creighton
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Christopher A Maher
- Department of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA; The McDonnell Genome Institute, Washington University in St. Louis, St. Louis, MO 63108, USA
| | - Charles M Perou
- Department of Genetics, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Svasti Haricharan
- Department of Medicine, Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Matthew J Ellis
- Department of Medicine, Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX 77030, USA; Interdepartmental Graduate Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX 77030, USA; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA.
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Sabari JK, Leonardi GC, Shu CA, Umeton R, Montecalvo J, Ni A, Chen R, Dienstag J, Mrad C, Bergagnini I, Lai WV, Offin M, Arbour KC, Plodkowski AJ, Halpenny DF, Paik PK, Li BT, Riely GJ, Kris MG, Rudin CM, Sholl LM, Nishino M, Hellmann MD, Rekhtman N, Awad MM, Drilon A. PD-L1 expression, tumor mutational burden, and response to immunotherapy in patients with MET exon 14 altered lung cancers. Ann Oncol 2019; 29:2085-2091. [PMID: 30165371 DOI: 10.1093/annonc/mdy334] [Citation(s) in RCA: 204] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background MET exon 14 alterations are actionable oncogenic drivers. Durable responses to MET inhibitors are observed in patients with advanced MET exon 14-altered lung cancers in prospective trials. In contrast, the activity of immunotherapy, PD-L1 expression and tumor mutational burden (TMB) of these tumors and are not well characterized. Patients and methods Patients with MET exon 14-altered lung cancers of any stage treated at two academic institutions were identified. A review of clinicopathologic and molecular features, and an analysis of response to single-agent or combination immune checkpoint inhibition were conducted. PD-L1 immunohistochemistry was carried out and TMB was calculated by estimation from targeted next-generation sequencing panels. Results We identified 147 patients with MET exon 14-altered lung cancers. PD-L1 expression of 0%, 1%-49%, and ≥50% were 37%, 22%, and 41%, respectively, in 111 evaluable tumor samples. The median TMB of MET exon 14-altered lung cancers was lower than that of unselected non-small-cell lung cancers (NSCLCs) in both independently evaluated cohorts: 3.8 versus 5.7 mutations/megabase (P < 0.001, n = 78 versus 1769, cohort A), and 7.3 versus 11.8 mutations/megabase (P < 0.001, n = 62 versus 1100, cohort B). There was no association between PD-L1 expression and TMB (Spearman's rho=0.18, P = 0.069). In response-evaluable patients (n = 24), the objective response rate was 17% (95% CI 6% to 36%) and the median progression-free survival was 1.9 months (95% CI 1.7-2.7). Responses were not enriched in tumors with PD-L1 expression ≥50% nor high TMB. Conclusion A substantial proportion of MET exon 14-altered lung cancers express PD-L1, but the median TMB is lower compared with unselected NSCLCs. Occasional responses to PD-1 blockade can be achieved, but overall clinical efficacy is modest.
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Affiliation(s)
- J K Sabari
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - G C Leonardi
- Lowe Center for Thoracic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - C A Shu
- Division of Hematology Oncology, Department of Medicine, Columbia University, New York, USA
| | - R Umeton
- Department of Informatics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - J Montecalvo
- Department of Pathology, Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, USA
| | - A Ni
- Department of Epidemiology and Biostatistics, Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, USA
| | - R Chen
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - J Dienstag
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - C Mrad
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - I Bergagnini
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - W V Lai
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - M Offin
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - K C Arbour
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - A J Plodkowski
- Department of Radiology, Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, USA
| | - D F Halpenny
- Department of Radiology, Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, USA
| | - P K Paik
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - B T Li
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA; Department of Early Drug Development Service, Division of Solid Tumor Oncology, Department of Medicine, Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, USA
| | - G J Riely
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - M G Kris
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - C M Rudin
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - L M Sholl
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - M Nishino
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Radiology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - M D Hellmann
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA
| | - N Rekhtman
- Department of Informatics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - M M Awad
- Lowe Center for Thoracic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - A Drilon
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, USA; Department of Early Drug Development Service, Division of Solid Tumor Oncology, Department of Medicine, Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, USA.
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16
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Offin M, Feldman D, Ni A, Myers ML, Lai WV, Pentsova E, Boire A, Daras M, Jordan EJ, Solit DB, Arcila ME, Jones DR, Isbell JM, Beal K, Young RJ, Rudin CM, Riely GJ, Drilon A, Tabar V, DeAngelis LM, Yu HA, Kris MG, Li BT. Frequency and outcomes of brain metastases in patients with HER2-mutant lung cancers. Cancer 2019; 125:4380-4387. [PMID: 31469421 DOI: 10.1002/cncr.32461] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/13/2019] [Accepted: 06/20/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Mutations in human epidermal growth factor receptor 2 (HER2; also known as ERBB2) are found in approximately 2% of lung adenocarcinomas. The frequency and clinical course of brain metastases in this oncogenic subset are ill defined. METHODS Baseline and subsequent development of brain metastases was evaluated in consecutive patients with HER2-mutant (n = 98), epidermal growth factor receptor (EGFR)-mutant (n = 200), and KRAS-mutant lung cancers (n = 200). RESULTS At metastatic diagnosis, the odds ratio (ORs) for brain metastases was similar for patients whose tumors harbored HER2 mutations (19%) in comparison with patients with KRAS mutations (24%; OR for HER2 vs KRAS, 0.7; P = .33) but lower compared to patients with EGFR mutations (31%; OR for HER2 vs EGFR, 0.5; P = .03). Patients with lung cancer and HER2 mutations developed more brain metastases on treatment than patients with KRAS mutations (28% vs 8%; hazard ratio [HR], 5.2; P < .001) and trended more than patients with EGFR mutations (28% vs 16%; HR, 1.7; P = .06). Patients with HER2 YVMA mutations also developed more brain metastases on treatment than patients with KRAS mutations (HR, 5.9; P < .001). The median overall survival (OS) was shorter for patients with HER2-mutant (1.6 years; P < .001) or KRAS-mutant lung cancers (1.1 years; P < .001) than patients with EGFR-mutant lung cancers (3.0 years). Brain metastases occurred in 47% of patients with HER2-mutant lung cancers, which imparted shorter OS (HR, 2.7; P < .001). CONCLUSIONS These data provide a framework for brain imaging surveillance in patients with HER2-mutant lung cancers and underpin the need to develop HER2-targeted agents with central nervous system activity.
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Affiliation(s)
- Michael Offin
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Daniel Feldman
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ai Ni
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mackenzie L Myers
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - W Victoria Lai
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Elena Pentsova
- Weill Cornell Medical College, New York, New York.,Neurology Service, Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Adrienne Boire
- Weill Cornell Medical College, New York, New York.,Neurology Service, Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York.,Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mariza Daras
- Weill Cornell Medical College, New York, New York.,Neurology Service, Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Emmet J Jordan
- Medical Oncology, University Hospital Waterford, Waterford, Ireland
| | - David B Solit
- Weill Cornell Medical College, New York, New York.,Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York.,Marie-Josée & Henry R. Kravis Center for Molecular Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Maria E Arcila
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David R Jones
- Weill Cornell Medical College, New York, New York.,Thoracic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - James M Isbell
- Weill Cornell Medical College, New York, New York.,Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kathryn Beal
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Robert J Young
- Weill Cornell Medical College, New York, New York.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Charles M Rudin
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Gregory J Riely
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Alexander Drilon
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Viviane Tabar
- Weill Cornell Medical College, New York, New York.,Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lisa M DeAngelis
- Weill Cornell Medical College, New York, New York.,Neurology Service, Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Helena A Yu
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Mark G Kris
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Bob T Li
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
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17
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Lai WV, Rudin CM. Analyzing the Thin Tail: Searching for Biomarkers of Exceptional Survival in SCLC. J Thorac Oncol 2019; 14:1122-1124. [PMID: 31235032 DOI: 10.1016/j.jtho.2019.05.011] [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] [Received: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 11/29/2022]
Affiliation(s)
- W Victoria Lai
- Memorial Sloan Kettering Cancer Center, New York, New York
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18
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Lai WV, Lebas L, Barnes TA, Milia J, Ni A, Gautschi O, Peters S, Ferrara R, Plodkowski AJ, Kavanagh J, Sabari JK, Clarke SJ, Pavlakis N, Drilon A, Rudin CM, Arcila ME, Leighl NB, Shepherd FA, Kris MG, Mazières J, Li BT. Afatinib in patients with metastatic or recurrent HER2-mutant lung cancers: a retrospective international multicentre study. Eur J Cancer 2019; 109:28-35. [PMID: 30685684 DOI: 10.1016/j.ejca.2018.11.030] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/19/2018] [Accepted: 11/23/2018] [Indexed: 01/26/2023]
Abstract
INTRODUCTION HER2 mutations occur in 1-3% of lung adenocarcinomas. With increasing use of next-generation sequencing at diagnosis, more patients with HER2-mutant tumours present for treatment. Few data are available to describe the clinical course and outcomes of these patients when treated with afatinib, a pan-HER inhibitor. METHODS We identified patients with metastatic or recurrent HER2-mutant lung adenocarcinomas treated with afatinib among seven institutions across Europe, Australia, and North America between 2009 and 2017. We determined the partial response rate to afatinib, types of HER2 mutations, duration of response, time on treatment, and survival. RESULTS We collected information on 27 patients with stage IV or recurrent HER2-mutant lung adenocarcinomas treated with afatinib. Of 23 patients evaluable for response, three partial responses were noted (13%, 95% confidence interval [CI] 4-33%). In addition, 57% of patients (13/23) had stable disease, and 30% (7/23) had progressive disease. We documented partial responses in patients with HER2 exon 20 insertions, including two with YVMA insertion and one with VAG insertion. Two patients with partial responses were previously treated with trastuzumab and pertuzumab. Median duration of response to afatinib was 6 months (range 5-10); median time on treatment was 3 months (range 1-30) and median overall survival from the date of diagnosis of metastatic or recurrent disease was 23 months (95% CI 18-53 months). CONCLUSIONS Afatinib is modestly active in patients with HER2-mutant lung adenocarcinomas, including responses after progression on prior HER2-targeted therapies. However, investigations into the biology of HER2-mutant lung adenocarcinomas and development of better HER2-directed therapies are warranted.
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Affiliation(s)
- W Victoria Lai
- Department of Medicine, Division of Solid Tumor Oncology, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Tristan A Barnes
- Princess Margaret Cancer Centre, Toronto, Canada(2); Northern Beaches Cancer Service, Manly NSW Australia(3)
| | - Julie Milia
- Toulouse University Hospital, Toulouse, France
| | - Ai Ni
- Department of Medicine, Division of Solid Tumor Oncology, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | | | - Andrew J Plodkowski
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John Kavanagh
- Toronto General Hospital, University Health Network and University of Toronto, Toronto, Canada
| | - Joshua K Sabari
- Department of Medicine, Division of Solid Tumor Oncology, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA; New York University Langone Health, Laura and Isaac Perlmutter Cancer Center, New York, NY, USA(3)
| | - Stephen J Clarke
- Royal North Shore Hospital, University of Sydney, Sydney, Australia
| | - Nick Pavlakis
- Royal North Shore Hospital, University of Sydney, Sydney, Australia
| | - Alexander Drilon
- Department of Medicine, Division of Solid Tumor Oncology, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Charles M Rudin
- Department of Medicine, Division of Solid Tumor Oncology, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maria E Arcila
- Department of Medicine, Division of Solid Tumor Oncology, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Mark G Kris
- Department of Medicine, Division of Solid Tumor Oncology, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Bob T Li
- Department of Medicine, Division of Solid Tumor Oncology, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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19
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Arbour KC, Mezquita L, Long N, Rizvi H, Auclin E, Ni A, Martínez-Bernal G, Ferrara R, Lai WV, Hendriks LEL, Sabari JK, Caramella C, Plodkowski AJ, Halpenny D, Chaft JE, Planchard D, Riely GJ, Besse B, Hellmann MD. Impact of Baseline Steroids on Efficacy of Programmed Cell Death-1 and Programmed Death-Ligand 1 Blockade in Patients With Non-Small-Cell Lung Cancer. J Clin Oncol 2018; 36:2872-2878. [PMID: 30125216 DOI: 10.1200/jco.2018.79.0006] [Citation(s) in RCA: 641] [Impact Index Per Article: 106.8] [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
PURPOSE Treatment with programmed cell death-1 or programmed death ligand 1 (PD-(L)1) inhibitors is now standard therapy for patients with lung cancer. The immunosuppressive effect of corticosteroids may reduce efficacy of PD-(L)1 blockade. On-treatment corticosteroids for treatment of immune-related adverse events do not seem to affect efficacy, but the potential impact of baseline corticosteroids at the time of treatment initiation is unknown. Clinical trials typically excluded patients who received baseline corticosteroids, which led us to use real-world data to examine the effect of corticosteroids at treatment initiation. METHODS We identified patients who were PD-(L)1-naïve with advanced non-small-cell lung cancer from two institutions-Memorial Sloan Kettering Cancer Center and Gustave Roussy Cancer Center-who were treated with single-agent PD-(L)1 blockade. Clinical and pharmacy records were reviewed to identify corticosteroid use at the time of beginning anti-PD-(L)1 therapy. We performed multivariable analyses using Cox proportional hazards regression model and logistic regression. RESULTS Ninety (14%) of 640 patients treated with single-agent PD-(L)1 blockade received corticosteroids of ≥ 10 mg of prednisone equivalent daily at the start of the PD-(L)1 blockade. Common indications for corticosteroids were dyspnea (33%), fatigue (21%), and brain metastases (19%). In both independent cohorts, Memorial Sloan Kettering Cancer Center (n = 455) and Gustave Roussy Cancer Center (n = 185), baseline corticosteroids were associated with decreased overall response rate, progression-free survival, and overall survival with PD-(L)1 blockade. In a multivariable analysis of the pooled population, adjusting for smoking history, performance status, and history of brain metastases, baseline corticosteroids remained significantly associated with decreased progression-free survival (hazard ratio, 1.3; P = .03), and overall survival (hazard ratio, 1.7; P < .001). CONCLUSION Baseline corticosteroid use of ≥ 10 mg of prednisone equivalent was associated with poorer outcome in patients with non-small-cell lung cancer who were treated with PD-(L)1 blockade. Prudent use of corticosteroids at the time of initiating PD-(L)1 blockade is recommended.
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Affiliation(s)
- Kathryn C Arbour
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Laura Mezquita
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Niamh Long
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Hira Rizvi
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Edouard Auclin
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Andy Ni
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Gala Martínez-Bernal
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Roberto Ferrara
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - W Victoria Lai
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Lizza E L Hendriks
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Joshua K Sabari
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Caroline Caramella
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Andrew J Plodkowski
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Darragh Halpenny
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jamie E Chaft
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - David Planchard
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Gregory J Riely
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Benjamin Besse
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Matthew D Hellmann
- Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks, Caroline Caramella, Benjamin Besse, and David Planchard, Gustave Roussy Cancer Center, Villejuif; Edouard Auclin, Hôpital Européen Georges Pompidou; Benjamin Besse, Paris-Sud University, Le Kremlin Bicêtre, Paris, France; Gala Martínez-Bernal, Virgen del Rocío Hospital, Seville, Spain; Lizza E.L. Hendriks, Maastricht University Medical Center, Maastricht, the Netherlands
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20
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Zauderer MG, Tsao AS, Dao T, Panageas K, Lai WV, Rimner A, Rusch VW, Adusumilli PS, Ginsberg MS, Gomez D, Rice D, Mehran R, Scheinberg DA, Krug LM. A Randomized Phase II Trial of Adjuvant Galinpepimut-S, WT-1 Analogue Peptide Vaccine, After Multimodality Therapy for Patients with Malignant Pleural Mesothelioma. Clin Cancer Res 2017; 23:7483-7489. [PMID: 28972039 DOI: 10.1158/1078-0432.ccr-17-2169] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/09/2017] [Accepted: 09/22/2017] [Indexed: 12/29/2022]
Abstract
Purpose: Determine the 1-year progression-free survival (PFS) rate among patients with malignant pleural mesothelioma (MPM) receiving the WT1 peptide vaccine galinpepimut-S after multimodality therapy versus those receiving control adjuvants.Experimental Design: This double-blind, controlled, two center phase II trial randomized MPM patients after surgery and another treatment modality to galinpepimut-S with GM-CSF and Montanide or GM-CSF and Montanide alone. An improvement in 1-year PFS from 50% to 70% was the predefined efficacy threshold, and 78 patients total were planned. The study was not powered for comparison between the two arms.Results: Forty-one patients were randomized. Treatment-related adverse events were mild, self-limited, and not clinically significant. On the basis of a stringent prespecified futility analysis (futility = ≥10 of 20 patients on one arm experiencing progression < 1 year), the control arm closed early. The treatment arm was subsequently closed because of the resultant unblinding. The PFS rate at 1 year from beginning study treatment was 33% and 45% in the control and vaccine arms, respectively. Median PFS was 7.4 months versus 10.1 months and median OS was 18.3 months versus 22.8 months in the control and vaccine arms, respectively.Conclusions: The favorable safety profile was confirmed. PFS and OS were greater in those who received vaccine, but the trial was neither designed nor powered for comparison between the arms. On the basis of these promising results, the investigators are planning a larger randomized trial with greater statistical power to define the optimal use and benefit of galinpepimut-S in the treatment of MPM. Clin Cancer Res; 23(24); 7483-9. ©2017 AACR.
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Affiliation(s)
- Marjorie G Zauderer
- Division of Solid Tumor Oncology, Department of Medicine, Thoracic Oncology Service Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York.
| | - Anne S Tsao
- Division of Cancer Medicine, Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tao Dao
- Molecular Pharmacology Program, Sloan Kettering Institute, New York, New York
| | - Katherine Panageas
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - W Victoria Lai
- Division of Solid Tumor Oncology, Department of Medicine, Thoracic Oncology Service Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - Andreas Rimner
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Valerie W Rusch
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Prasad S Adusumilli
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michelle S Ginsberg
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Daniel Gomez
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David Rice
- Department of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Reza Mehran
- Department of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David A Scheinberg
- Molecular Pharmacology Program, Sloan Kettering Institute, New York, New York.,Deparment of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lee M Krug
- Division of Solid Tumor Oncology, Department of Medicine, Thoracic Oncology Service Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
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21
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Sabari JK, Santini FC, Schram AM, Bergagnini I, Chen R, Mrad C, Lai WV, Arbour KC, Drilon A. The activity, safety, and evolving role of brigatinib in patients with ALK-rearranged non-small cell lung cancers. Onco Targets Ther 2017; 10:1983-1992. [PMID: 28435288 PMCID: PMC5388194 DOI: 10.2147/ott.s109295] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Brigatinib (AP26113) is a dimethylphosphine oxide group-containing tyrosine kinase inhibitor (TKI) constructed around a bisanilinopyrimidine scaffold with potent activity against the anaplastic lymphoma kinase (ALK) and several other targets. Despite the activity of first- and second-generation ALK inhibitors in advanced ALK-rearranged lung cancers, the development of acquired resistance represents an ongoing challenge. Later generation ALK inhibitors such as brigatinib are important potential tools in the management of patients with acquired resistance characterized by continued dependency on ALK. Brigatinib is active in vitro against many ALK kinase domain mutations that may mediate acquired resistance to other ALK TKIs, with reported activity (IC50 <50 nM) against ALK C1156Y, I1171S/T, V1180L, L1196M, L1152R/P, E1210K, and G1269A. In patients with ALK-rearranged lung cancers who receive brigatinib after crizotinib, substantial and durable responses and intracranial disease control can be achieved based on early-phase clinical trial data. The drug is also being explored in TKI-naïve patients. From a safety perspective, early pulmonary toxicity has been observed, prompting the decision to pursue lead-in dosing for the drug. Early data point to ALK G1202R and ALK E1210K as potential mechanisms of clinical resistance to brigatinib.
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Affiliation(s)
- Joshua K Sabari
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Fernando C Santini
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center
- Developmetal Therapeutics, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Alison M Schram
- Developmetal Therapeutics, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Isabella Bergagnini
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Ruqin Chen
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Chebli Mrad
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - W Victoria Lai
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Kathryn C Arbour
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Alexander Drilon
- Developmetal Therapeutics, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
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22
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Sabari JK, Santini F, Bergagnini I, Lai WV, Arbour KC, Drilon A. Changing the Therapeutic Landscape in Non-small Cell Lung Cancers: the Evolution of Comprehensive Molecular Profiling Improves Access to Therapy. Curr Oncol Rep 2017; 19:24. [PMID: 28303491 PMCID: PMC6428198 DOI: 10.1007/s11912-017-0587-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 12/12/2022]
Abstract
Targeting genomic alterations has led to a paradigm shift in the treatment of patients with lung cancer. In an effort to better identify potentially actionable alterations that may predict response to FDA-approved and or investigational therapies, many centers have migrated towards performing targeted exome sequencing in patients with stage IV disease. The implementation of next-generation sequencing (NGS) in the evaluation of tumor tissue from patients with NSCLC has led to the discovery of targetable alterations in tumors that previously had no known actionable targets by less comprehensive profiling. An improved understanding of the molecular pathways that drive oncogenesis in NSCLC and a revolution in the technological advances in NGS have led to the development of new therapies through biomarker-driven clinical trials. This review will focus on the advances in molecular profiling that continue to fuel the revolution of precision medicine, identifying targets such as MET exon 14 skipping alterations and select recurrent gene alterations with increasing frequency.
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Affiliation(s)
- Joshua K Sabari
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY, 10065, USA
| | - Fernando Santini
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY, 10065, USA
| | - Isabella Bergagnini
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY, 10065, USA
| | - W Victoria Lai
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY, 10065, USA
| | - Kathryn C Arbour
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY, 10065, USA
| | - Alexander Drilon
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, 300 East 66th Street, New York, NY, 10065, USA.
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