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Zhou J, Yang J, Zhang Z, Li Y, Yi B, Tang Y, Li D, Li X, Peng D, Li XI, Wang Y, Li H, Li B, Wang C, Zhu P, Chen L, Wu S, Fang S, Li C, Qiu F, Chuai S, Zhang Z. Abstract 5917: Patient-specific tumor-informed circulating tumor DNA (ctDNA) analysis for postoperative monitoring of patients with stages I-III colorectal cancer (CRC). Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-5917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Identifying molecular residual disease (MRD) with tailored tumor-informed ctDNA based next-generation sequencing (NGS) assays after curative surgery could facilitate the individualized management of resected CRC patients. Here, we investigated the clinical utility of tumor-informed ctDNA mutation analysis using a novel Patient-specific pROgnostic and Potential tHErapeutic marker Tracking (PROPHET) approach for accessing MRD in resected CRC patients. Using the same set of baseline and post-operative blood samples, we compared the performance of PROPHET assay with tumor-naïve fixed panel for detecting MRD and predicting recurrence in resected CRC patients.
Methods: The prospective study recruited 42 patients diagnosed with stage I-III CRC from May 2019 to Jun 2020 at the First Affiliated Hospital of Soochow University. Tumor tissue samples were collected at surgery. Blood samples collected before surgery (baseline), 8-day post-operative time point before any adjuvant therapy were analyzed. The detection and quantification of ctDNA for MRD assessment was investigated using PROPHET, a personalized, tumor-informed ctDNA assay designed to track up to 50 top-ranked patient-specific somatic variants based on whole-exome sequencing (WES) of the tumor tissue and matched white blood cells (WBCs). Tumor- naïve fixed assay was performed using targeted NGS panel, containing 41 gastrointestinal cancer-related genes.
Results: Baseline ctDNA status was detected in 95.23% (40/42) of the patients with PROPHET assay, and 69.05% (29/42) of the patients with fixed panel. Of 42 patients included in the analysis, 1, 25, and 16 patients had pathological stages I, II, and III CRC with baseline ctDNA detected in 100% (1/1), 92% (23/25), 100% (16/16) patients with PROPHET assay, and 100% (1/1), 64% (16/25), 75% (12/16) patients with fixed panel. Post-operative ctDNA-positive status with PROPHET assay was associated with 3-year DFS, compared with ctDNA-negative group (hazard ratio [HR], 16.57, 95% confidence interval [CI]:3.01-91.36, p=0.014). 15% (6/40) patients were identified to be MRD- positive and 83.33% (5/6) patients eventually relapsed at 3-years follow-up. Although fixed panel also showed high performance in predicting relapse HR, 4.48, 95% CI:1.9-10.9; p< 0.001, 27.5% (11/40) patients were identified to be MRD-positive and only 45.45% (5/11) patients eventually relapsed. 3-year prognostication with PROPHET assay at 8-day post-operation yielded higher positive predictive value (83.33% vs 45.45%), negative predictive value (91.18% vs 89.66%), and specificity (96.88% vs 81.25%) as compared with tumor-naïve fixed panel.
Conclusion: Patient-specific PROPHET assay based on unique somatic mutation profiles detects patients with high-risk of recurrence, which achieved higher specificity than tumor-naïve fixed panel.
Citation Format: Jian Zhou, Jian Yang, Zixiang Zhang, Ye Li, Bin Yi, Yuchen Tang, Dechun Li, Xiaozhe Li, Di Peng, XI Li, Yang Wang, Haiyan Li, Bing Li, Chenyang Wang, Pengfei Zhu, Longfei Chen, Shuailai Wu, Shuai Fang, Chenxi Li, Fujun Qiu, Shannon Chuai, Zhihong Zhang. Patient-specific tumor-informed circulating tumor DNA (ctDNA) analysis for postoperative monitoring of patients with stages I-III colorectal cancer (CRC) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5917.
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Affiliation(s)
- Jian Zhou
- 1the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jian Yang
- 1the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zixiang Zhang
- 1the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ye Li
- 1the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bin Yi
- 1the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuchen Tang
- 1the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Dechun Li
- 1the First Affiliated Hospital of Soochow University, Suzhou, China
| | | | - Di Peng
- 2Burning Rock Biotech, Guangzhou, China
| | - XI Li
- 2Burning Rock Biotech, Guangzhou, China
| | - Yang Wang
- 2Burning Rock Biotech, Guangzhou, China
| | - Haiyan Li
- 2Burning Rock Biotech, Guangzhou, China
| | - Bing Li
- 2Burning Rock Biotech, Guangzhou, China
| | | | | | | | | | | | - Chenxi Li
- 2Burning Rock Biotech, Guangzhou, China
| | - Fujun Qiu
- 2Burning Rock Biotech, Guangzhou, China
| | | | - Zhihong Zhang
- 3The First Affiliated Hospital of Soochow University, Suzhou, China
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Rugo HS, Dieras V, Cortes J, Patt D, Wildiers H, O'Shaughnessy J, Zamora E, Yardley DA, Carter GC, Sheffield KM, Li L, Andre VAM, Li XI, Frenzel M, Huang YJ, Dickler MN, Tolaney SM. Real-world survival outcomes of heavily pretreated patients with refractory HR+, HER2-metastatic breast cancer receiving single-agent chemotherapy-a comparison with MONARCH 1. Breast Cancer Res Treat 2020; 184:161-172. [PMID: 32789591 PMCID: PMC7568708 DOI: 10.1007/s10549-020-05838-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/25/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE In MONARCH 1 (NCT02102490), single-agent abemaciclib demonstrated promising efficacy activity and tolerability in a population of heavily pretreated women with refractory HR+, HER2- metastatic breast cancer (MBC). To help interpret these results and put in clinical context, we compared overall survival (OS) and duration of therapy (DoT) between MONARCH 1 and a real-world single-agent chemotherapy cohort. METHODS The real-world chemotherapy cohort was created from a Flatiron Health electronic health records-derived database based on key eligibility criteria from MONARCH 1. The chemotherapies included in the cohort were single-agent capecitabine, gemcitabine, eribulin, or vinorelbine. Results were adjusted for baseline demographics and clinical differences using Mahalanobis distance matching (primary analysis) and entropy balancing (sensitivity analysis). OS and DoT were analyzed using the Kaplan-Meier method and Cox proportional hazards regression. RESULTS A real-world single-agent chemotherapy cohort (n = 281) with eligibility criteria similar to the MONARCH 1 population (n = 132) was identified. The MONARCH 1 (n = 108) cohort was matched to the real-world chemotherapy cohort (n = 108). Median OS was 22.3 months in the abemaciclib arm versus 13.6 months in the matched real-world chemotherapy cohort with an estimated hazard ratio (HR) of 0.54. The median DoT was 4.1 months in MONARCH 1 compared to 2.9 months in the real-world chemotherapy cohort with HR of 0.76. CONCLUSIONS This study demonstrates an approach to create a real-world chemotherapy cohort suitable to serve as a comparator for trial data. These exploratory results suggest a survival advantage and place the benefit of abemaciclib monotherapy in clinical context.
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Affiliation(s)
- Hope S Rugo
- Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
| | | | - Javier Cortes
- IOB Institute of Oncology, Quironsalud Group, Madrid, Spain.,IOB Institute of Oncology, Quironsalud Group, Barcelona, Spain.,Vall D'Hebron University Hospital, Vall D'Hebron Institute of Oncology, Barcelona, Spain
| | - Debra Patt
- Texas Oncology, Austin, TX, USA.,US Oncology, Dallas, TX, USA
| | - Hans Wildiers
- Department of General Medical Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Joyce O'Shaughnessy
- Texas Oncology, US Oncology, Baylor University Medical Center, Dallas, TX, USA
| | - Esther Zamora
- Vall D'Hebron University Hospital, Vall D'Hebron Institute of Oncology, Barcelona, Spain
| | - Denise A Yardley
- Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN, USA
| | | | | | - Li Li
- Eli Lilly and Company, Indianapolis, IN, USA
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Rugo H, Dieras V, Cortes J, Patt D, Wildiers H, O'Shaughnessy J, Zamora E, Yardley DY, Carter GC, Sheffield KM, Li L, Andre VA, Derbyshire RE, Li XI, Frenzel M, Huang YJ, Dickler MN, Tolaney SM. Abstract P6-18-19: Real-world survival of heavily pretreated patients with refractory HR+, HER2- metastatic breast cancer receiving single-agent chemotherapy - A comparison with MONARCH 1. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
In MONARCH 1 (NCT02102490), abemaciclib demonstrated promising single-agent activity and tolerability in a population of heavily pretreated women with refractory HR+, HER2- metastatic breast cancer (MBC).1 Confirmed objective response rate (ORR) was 19.7% (95% CI: 13.3, 27.5) and at 18 months minimum follow-up median overall survival (OS) was 22.3 months. Due to the single-arm trial design of MONARCH 1, there is a need to view these results in clinical context relative to available treatment options. This study compared the OS results of abemaciclib in MONARCH 1 vs that in a real-world single-agent chemotherapy cohort with similar patient and disease characteristics.
Methods
MONARCH 1 study design and key eligibility criteria were previously described.1 The real-world cohort was based on Flatiron Health electronic health records-derived, nationally representative (USA-based) database comprising patient-level structured and unstructured data, curated via technology-enabled abstraction, for patients with MBC between January 1, 2011 through February 28, 2018. A real-world single-agent chemotherapy cohort was created based on the key eligibility criteria of MONARCH 1 and included patients diagnosed with HR+, HER2- MBC who received single-agent chemotherapy (eribulin, capecitabine, gemcitabine, or vinorelbine) following 1-2 prior chemotherapy regimens in the metastatic setting, had an ECOG PS of 0-1, and no prior CDK4 & 6 therapy. The index date was the start of the eligible single-agent chemotherapy, and patients were followed from the index date until date of death, loss to follow-up, or end of the database, whichever occurred earlier. OS results were adjusted using 2 methods (Mahalanobis distance matching and entropy balancing with bootstrapping) to account for baseline demographic and clinical differences between the real-world and trial cohorts.
Results
A real-world cohort (n=281) with eligibility criteria similar to the MONARCH 1 population (n=132) was identified. A subsequent matching based on Mahalanobis distance was performed to match MONARCH 1 population (n=108) with the real-world cohort (n=108). The matched cohorts demonstrated similar patient and disease characteristics. Median OS was 22.3 months in the abemaciclib arm vs 13.6 months in the matched cohort with an estimated hazard ratio (HR) of 0.54 (95% CI: 0.37, 0.77). Results of a sensitivity analysis performed using entropy balancing were consistent with an adjusted median OS of 12.7 months in the real-world cohort (n=281)with HR of 0.57 (95% CI from bootstrapping: 0.44, 0.78).
Conclusion
Methodological advances to adjust for potential biases, and improvements in data quality, have evolved enabling the ability to leverage a real-world cohort as an external comparator arm. This study demonstrates the ability to create a real-world chemotherapy cohort suitable to serve as a comparator for MONARCH 1. These exploratory results suggest a survival advantage and adequately place the clinical benefit of abemaciclib monotherapy in clinical context.
References
Dickler et al, CCR 2017
Citation Format: Rugo H, Dieras V, Cortes J, Patt D, Wildiers H, O'Shaughnessy J, Zamora E, Yardley DY, Carter GC, Sheffield KM, Li L, Andre VA, Derbyshire RE, Li XI, Frenzel M, Huang Y-J, Dickler MN, Tolaney SM. Real-world survival of heavily pretreated patients with refractory HR+, HER2- metastatic breast cancer receiving single-agent chemotherapy - A comparison with MONARCH 1 [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-19.
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Affiliation(s)
- H Rugo
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - V Dieras
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - J Cortes
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - D Patt
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - H Wildiers
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - J O'Shaughnessy
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - E Zamora
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - DY Yardley
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - GC Carter
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - KM Sheffield
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - L Li
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - VA Andre
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - RE Derbyshire
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - XI Li
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - M Frenzel
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - Y-J Huang
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - MN Dickler
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
| | - SM Tolaney
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Centre Eugene Marquis UNICANCER, Rennes Cedex, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Texas Oncology, Austin, TX; US Oncology, Dallas, TX; University Hospital Gasthuisberg, Leuven, Belgium; Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX; Eli Lilly and Company, Indianapolis; Sarah Cannon Research Institute, Tennessee Oncology PLLC, Nashville, TN; Dana-Farber Cancer Institute, Boston
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