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Rugo HS, Im SA, Joy AA, Shparyk Y, Walshe JM, Sleckman B, Loi S, Theall KP, Kim S, Huang X, Bananis E, Mahtani R, Finn RS, Diéras V. The effects of adding palbociclib to endocrine therapy to treat advanced breast cancer: a plain language summary of a study using the PALOMA-2 and PALOMA-3 trial results. Future Oncol 2024; 20:5-16. [PMID: 37916267 DOI: 10.2217/fon-2023-0407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Abstract
WHAT IS THIS SUMMARY ABOUT? This is a summary of an article that reported results of a study using data from two phase 3 clinical trials called "PALOMA-2" and "PALOMA-3." Both PALOMA-2 and PALOMA-3 trials included women with HR+/HER2- advanced breast cancer. HR+/HER2- breast cancer means the breast cancer cells of these women have receptors for female sex hormones and little or no HER2 receptors. Both PALOMA trials tested the effect of adding a medication called palbociclib (brand name, Ibrance®) to a hormone therapy. Hormone therapy, also known as endocrine therapy, is a treatment that blocks or removes hormones that cause cancer cells to grow and divide. In both trials, women took endocrine therapy with either palbociclib or a placebo. WHAT WAS THE AIM OF THIS STUDY? The researchers aimed to see if the results from the PALOMA trials were similar for subgroups of women in the 2 trials. The subgroups in the study included women who shared certain features about their cancer or treatment history, for example, women whose cancer had spread to the liver. For each subgroup, the study compared the results from the 2 treatment groups: (1) women who took palbociclib plus endocrine therapy, and (2) women who took placebo plus endocrine therapy. WHAT WERE THE RESULTS & WHAT DO THEY MEAN? The same effect was found in all subgroups. Compared with those who took placebo, women who took palbociclib lived longer without their cancer getting worse (growing or spreading). Also, among women who had chemotherapy after stopping the trial treatment, those who took palbociclib started chemotherapy later than those who took placebo. Because palbociclib slows cancer growth and leads to tumor shrinkage, this may have played a part in starting chemotherapy later. These results show that palbociclib plus endocrine therapy is better at slowing the progression of advanced HR+/HER2- breast cancer than endocrine therapy alone. This can be said for women with different advanced HR+/HER2- breast cancer features and treatment history. Overall, the results support women taking palbociclib with an endocrine therapy if they have advanced HR+/HER2- breast cancer.
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Affiliation(s)
- Hope S Rugo
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Seock-Ah Im
- Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Anil A Joy
- Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
| | - Yaroslav Shparyk
- Lviv State Oncologic Regional Treatment & Diagnostic Center, Lviv, Ukraine
| | - Janice M Walshe
- Cancer Trials Ireland, Cancer Trials Ireland, St Vincent's University Hospital, Elm Park, Dublin, Ireland
| | | | - Sherene Loi
- Peter MacCallum Cancer Centre, University of Melbourne, Australia
| | | | | | | | | | - Reshma Mahtani
- Miami Cancer Institute, Baptist Health South Florida, Plantation, FL, USA
| | - Richard S Finn
- David Geffen School of Medicine at University of California Los Angeles, Santa Monica, CA, USA
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André T, Falcone A, Shparyk Y, Moiseenko F, Polo-Marques E, Csöszi T, Campos-Bragagnoli A, Liposits G, Chmielowska E, Aubel P, Martín L, Fougeray R, Amellal N, Saunders MP. Trifluridine-tipiracil plus bevacizumab versus capecitabine plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer ineligible for intensive therapy (SOLSTICE): a randomised, open-label phase 3 study. Lancet Gastroenterol Hepatol 2023; 8:133-144. [PMID: 36470291 DOI: 10.1016/s2468-1253(22)00334-x] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Trifluridine-tipiracil plus bevacizumab has shown efficacy in previous phase 2 studies including patients with unresectable metastatic colorectal cancer. We aimed to investigate first-line trifluridine-tipiracil plus bevacizumab versus capecitabine plus bevacizumab in patients with unresectable metastatic colorectal cancer ineligible for intensive treatment. METHODS In this open-label, randomised, phase 3 study, we enrolled patients aged 18 years and older with histologically confirmed metastatic colorectal cancer, ineligible for full-dose doublet or triplet chemotherapy and curative resection across 25 countries and regions. Participants were randomly allocated (1:1) to trifluridine-tipiracil plus bevacizumab or capecitabine plus bevacizumab until disease progression or unacceptable toxicity using an interactive web response system, stratified by Eastern Cooperative Oncology Group (ECOG) performance status (0 vs 1 vs 2), primary tumour location (right vs left colon), and the main reason for not being a candidate for intensive therapy (clinical condition vs non-clinical condition). The primary endpoint was investigator-assessed progression-free survival, defined as the time from randomisation to radiological progression or death from any cause, in the intention-to-treat population. Safety was assessed in all patients having taken at least one dose of the study drug. The trial is ongoing, findings presented here are those of the primary analysis of progression-free survival, conducted after 629 events had occurred. This study is registered with ClinicalTrials.gov, NCT03869892. FINDINGS Between March 21, 2019, and Sept 14, 2020, 856 patients (54% male, 46% female) were randomly assigned to trifluridine-tipiracil plus bevacizumab (n=426) or capecitabine plus bevacizumab (n=430). After a median follow-up of 16·6 months (95% CI 16·5-17·1), the hazard ratio for progression-free survival for trifluridine-tipiracil plus bevacizumab versus capecitabine plus bevacizumab was 0·87 (0·75-1·02; p=0·0464; protocol-defined significance level of p=0·021 not met). Investigator-assessed median progression-free survival was 9·4 months (95% CI 9·1-10·9) with trifluridine-tipiracil plus bevacizumab versus 9·3 months (8·9-9·8) with capecitabine plus bevacizumab. The most common grade 3 and higher treatment-emergent adverse events were neutropenia (220 [52%] of 423 patients in the trifluridine-tipiracil plus bevacizumab group vs six [1%] of 427 in the capecitabine plus bevacizumab group), decreased neutrophil count (78 [18%] vs four [<1%]), anaemia (60 [14%] vs 16 [4%]), and hand-foot syndrome (none vs 61 [15%]). Nine deaths (five in the trifluridine-tipiracil plus bevacizumab group and four in the capecitabine plus bevacizumab group) were treatment related. INTERPRETATION First-line trifluridine-tipiracil plus bevacizumab was not superior to capecitabine plus bevacizumab in this population. As expected, the safety profile differed between the two treatments, but there were no new safety concerns. Trifluridine-tipiracil plus bevacizumab represents a feasible alternative to capecitabine plus bevacizumab in this population. FUNDING Servier International Research Institute, Suresnes, France.
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Affiliation(s)
- Thierry André
- Sorbonne University and Saint-Antoine Hospital, Department of Medical Oncology, Paris, France.
| | | | | | - Fedor Moiseenko
- Saint Petersburg Clinical Research and Practical Centre for Specialized Types of Medical Care (Oncological), St Petersburg, Russia
| | | | - Tibor Csöszi
- Géza Hetényi Hospital-Jász-Nagykun-Szolnok County Hospital Oncology Centre, Szolnok, Hungary
| | | | | | - Ewa Chmielowska
- Specialistic Oncologic Hospital Nu-Med, Tomaszów Mazowiecki, Poland
| | - Paul Aubel
- Servier International Research Institute, Suresnes, France
| | - Lourdes Martín
- Servier International Research Institute, Suresnes, France
| | - Ronan Fougeray
- Servier International Research Institute, Suresnes, France
| | - Nadia Amellal
- Servier International Research Institute, Suresnes, France
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Rugo HS, Im SA, Joy AA, Shparyk Y, Walshe JM, Sleckman B, Loi S, Theall KP, Kim S, Huang X, Bananis E, Mahtani R, Finn RS, Diéras V. Effect of palbociclib plus endocrine therapy on time to chemotherapy across subgroups of patients with hormone receptor‒positive/human epidermal growth factor receptor 2‒negative advanced breast cancer: Post hoc analyses from PALOMA-2 and PALOMA-3. Breast 2022; 66:324-331. [PMID: 36463643 PMCID: PMC9720565 DOI: 10.1016/j.breast.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Previous analyses from the PALOMA-2 and PALOMA-3 studies showed that palbociclib (PAL) plus endocrine therapy (ET) prolongs time to first subsequent chemotherapy (TTC) versus placebo (PBO) plus ET in the overall population of patients with hormone receptor‒positive/human epidermal growth factor receptor 2‒negative (HR+/HER2-) advanced breast cancer (ABC). Here, we evaluated TTC in relevant patient subgroups. METHODS These post hoc analyses evaluated TTC by subgroup using data from 2 randomized, phase 3 studies of women with HR+/HER2- ABC. In PALOMA-2, postmenopausal patients previously untreated for ABC were randomized 2:1 to receive PAL (125 mg/day, 3/1-week schedule) plus letrozole (LET; 2.5 mg/day; n = 444) or PBO plus LET (n = 222). In PALOMA-3, premenopausal or postmenopausal patients whose disease had progressed after prior ET were randomized 2:1 to receive PAL (125 mg/day, 3/1-week schedule) plus fulvestrant (FUL; 500 mg; n = 347) or PBO plus FUL (n = 174). RESULTS First subsequent chemotherapy was received by 35.5% and 56.2% in PALOMA-2 and PALOMA-3 after progression on palbociclib plus ET or placebo plus ET. Across all subgroups analyzed, the median progression-free survival (PFS) was longer in the PAL plus ET arm than the PBO plus ET arm. TTC was longer with PAL plus ET versus PBO plus ET across the same patient subgroups in both studies. CONCLUSIONS Across all subgroups, PAL plus ET versus PBO plus ET had longer median PFS and resulted in prolonged TTC in both the PALOMA-2 and PALOMA-3 studies. Pfizer Inc (NCT01740427, NCT01942135).
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Affiliation(s)
- Hope S. Rugo
- University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, Department of Medicine (Hematology/Oncology), 1825 4th Street, 3rd Floor, Box 1710, San Francisco, CA, 94158, USA,Corresponding author. University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, Department of Medicine (Hematology/Oncology), 1825 4th Street, 3rd Floor, Box 1710, San Francisco, CA, 94158-1710, USA.
| | - Seock-Ah Im
- Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University, 101 Daehak-ro, Jonro-gu, Seoul 03080, Republic of Korea
| | - Anil A. Joy
- Cross Cancer Institute, University of Alberta, 11560 University Ave NW, Edmonton, AB T6G1Z2, Canada
| | - Yaroslav Shparyk
- Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine
| | - Janice M. Walshe
- Cancer Trials Ireland, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Bethany Sleckman
- Mercy Hospital St. Louis, 607 S New Ballas Road, Suite 3300, St. Louis, MO, 63141, USA
| | - Sherene Loi
- Peter MacCallum Cancer Centre, University of Melbourne, Australia
| | | | - Sindy Kim
- Pfizer Inc, 10555 Science Center Dr, San Diego, CA 92121, USA
| | - Xin Huang
- Pfizer Inc, 10555 Science Center Dr, San Diego, CA 92121, USA
| | | | - Reshma Mahtani
- Miami Cancer Institute, Baptist Health South Florida, Member, Memorial Sloan Kettering Cancer Alliance, 1228 South Pine Island Road, Plantation, FL, 33324, USA
| | - Richard S. Finn
- David Geffen School of Medicine, 2825 Santa Monica Blvd, Suite 200, Santa Monica, CA, 90404, USA
| | - Véronique Diéras
- Unicancer Centre Eugène Marquis, Avenue de la Bataille Flandres-Dunkerque, CS 44229, 35042, Rennes Cedex, France
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Ayoub JP, Wildiers H, Friedlander M, Arun BK, Han HS, Puhalla S, Shparyk Y, Jakobsen EH, Wu M, Bach BA, Feng D, Ratajczak CK, Maag D, Diéras V. Safety and efficacy of veliparib plus carboplatin/paclitaxel in patients with HER2-negative metastatic or locally advanced breast cancer: subgroup analyses by germline BRCA1/ 2 mutations and hormone receptor status from the phase-3 BROCADE3 trial. Ther Adv Med Oncol 2021; 13:17588359211059601. [PMID: 34917174 PMCID: PMC8669119 DOI: 10.1177/17588359211059601] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 07/27/2021] [Accepted: 10/25/2021] [Indexed: 01/26/2023] Open
Abstract
Purpose To evaluate efficacy and safety of veliparib combined with carboplatin/paclitaxel in patients with advanced human epidermal growth factor receptor 2 (HER2)-negative, germline BRCA (gBRCA)-associated breast cancer defined by hormone receptor (HR) and gBRCA1/2 mutation status. Patients and Methods In this phase-3, double-blind, placebo-controlled trial, patients (N = 509) with advanced HER2-negative breast cancer and gBRCA1/2 mutations were randomized 2:1 to receive veliparib plus carboplatin/paclitaxel or placebo plus carboplatin/paclitaxel. Patients who discontinued chemotherapy prior to disease progression continued receiving blinded veliparib/placebo monotherapy. The primary endpoint was investigator-assessed progression-free survival (PFS). Subgroup analyses of PFS stratified by HR and gBRCA1/2 mutation status were prespecified. Results In the intention-to-treat population, there were similar proportions of patients with gBRCA1 versus gBRCA2 mutations (51% vs 49%) and HR+ disease versus triple-negative breast cancer (TNBC) (52% vs 48%). Median PFS was longer in the veliparib arm compared with the placebo arm for all subgroups (HR+: 13.0 vs 12.5 months, hazard ratio (95% confidence interval (CI)): 0.69 (0.52, 0.93), p = 0.013; TNBC: 16.6 vs 14.1 months, hazard ratio (95% CI): 0.72 (0.52, 1.00), p = 0.052; gBRCA1: 14.2 vs 12.6 months, hazard ratio (95% CI): 0.75 (0.55, 1.03), p = 0.073; gBRCA2: 14.6 vs 12.6 months, hazard ratio (95% CI): 0.69 (0.50, 0.95); p = 0.021). Benefit was durable, with improved PFS rates at 2 years (HR+, 27.5% vs 15.3%; TNBC, 40.4% vs 25.0%) and 3 years (HR+, 17.5% vs 8.6%; TNBC, 35.3% vs 13.0%) in all subgroups. gBRCA status (BRCA1 vs BRCA2) did not substantially affect the carboplatin/paclitaxel ± veliparib toxicity profile. Conclusion Veliparib plus carboplatin/paclitaxel resulted in durable benefit in subgroups defined by HR status or by gBRCA1 versus gBRCA2 mutation. Overall, addition of veliparib to carboplatin/paclitaxel was tolerable, and there were no clinically meaningful differences in adverse events between the gBRCA1 versus gBRCA2 and HR+ versus TNBC subgroups. Trial Registration NCT02163694, https://clinicaltrials.gov/ct2/show/NCT02163694.
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Affiliation(s)
- Jean-Pierre Ayoub
- Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | | | - Michael Friedlander
- Prince of Wales Clinical School UNSW and Prince of Wales Hospital, Sydney, NSW, Australia
| | - Banu K Arun
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hyo S Han
- Moffitt Cancer Center, Tampa, FL, USA
| | - Shannon Puhalla
- Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Yaroslav Shparyk
- Lviv State Oncological Regional Treatment and Diagnostic Center, Lviv, Ukraine
| | | | | | | | - Dai Feng
- AbbVie Inc., North Chicago, IL, USA
| | | | | | - Véronique Diéras
- Centre Eugène Marquis, Avenue de la Bataille Flandres-Dunkerque, 35042 Rennes Cedex, FranceInstitut Curie, Paris, France
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Kristeleit R, Lisyanskaya A, Fedenko A, Dvorkin M, de Melo AC, Shparyk Y, Rakhmatullina I, Bondarenko I, Colombo N, Svintsitskiy V, Biela L, Nechaeva M, Raspagliesi F, Scambia G, Cibula D, Póka R, Oaknin A, Safra T, Mackowiak-Matejczyk B, Ma L, Thomas D, Lin K, McLachlan K, Goble S, Oza A. 1Rucaparib versus chemotherapy in patients with advanced, relapsed ovarian cancer and a deleterious BRCA mutation: efficacy and safety from ARIEL4, a randomized phase III study. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)00656-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rini BI, Atkins MB, Plimack ER, Soulières D, McDermott RS, Bedke J, Tartas S, Alekseev B, Melichar B, Shparyk Y, Kondoh C, Langiewicz P, Wood LA, Hammers H, Silber CG, Haber B, Jensen E, Chen M, Powles T. Characterization and Management of Treatment-emergent Hepatic Toxicity in Patients with Advanced Renal Cell Carcinoma Receiving First-line Pembrolizumab plus Axitinib. Results from the KEYNOTE-426 Trial. Eur Urol Oncol 2021; 5:225-234. [PMID: 34244116 DOI: 10.1016/j.euo.2021.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/12/2021] [Accepted: 05/24/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Pembrolizumab plus axitinib improved efficacy over sunitinib in treatment-naive advanced renal cell carcinoma in the KEYNOTE-426 (NCT02853331) study. However, a relatively high incidence of grade 3/4 aminotransferase elevations was observed. OBJECTIVE To further characterize treatment-emergent aminotransferase elevations in patients treated with pembrolizumab-axitinib. DESIGN, SETTING, AND PARTICIPANTS Patients enrolled in KEYNOTE-426 were included in this study. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Three Standardized MedDRA Queries for potential hepatic disorders were used to identify patients for the hepatic event analysis subpopulation (HEAS). Alanine aminotransferase events were characterized for time to onset, time to recovery, corticosteroid use, and rechallenge with study treatment(s). RESULTS AND LIMITATIONS The HEAS comprised 189/429 (44%) pembrolizumab-axitinib patients and 128/425 (30%) sunitinib patients. Grade 3/4 hepatic adverse events were more common in the combination arm: 22% (94/429) versus 7% (29/425); 3% (13/429) discontinued the combination due to hepatic adverse events. In the pembrolizumab-axitinib arm, 125/426 patients (29%) had alanine aminotransferase (ALT) ≥3× upper limit of normal (ULN), with median time to onset of 84 d (range, 7-840 d). Among patients with ALT ≥3× ULN, 120/125 (96%) recovered to <3× ULN following study treatment interruption/discontinuation, with a median time to recovery of 15 d (3-176 d): 68/120 (57%) received corticosteroids. One hundred patients were rechallenged with one or both study treatment(s): 45/100 (45%) had ALT ≥3× ULN recurrence, and all 45 recovered to ALT <3× ULN following study treatment interruption/discontinuation. No fatal hepatic events occurred. CONCLUSIONS A higher incidence of grade 3/4 aminotransferase elevations occurs with pembrolizumab-axitinib. These events should be carefully evaluated and managed with prompt study treatment interruption or discontinuation, with or without corticosteroid treatment. The decision to rechallenge with one or both drugs should be based on severity of event and thorough causality assessment. PATIENT SUMMARY Renal cell carcinoma patients receiving pembrolizumab-axitinib are at a higher risk of liver enzyme elevations, which could be reversed with appropriate management.
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Affiliation(s)
- Brian I Rini
- Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Michael B Atkins
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | | | - Denis Soulières
- Centre Hospitalier de l'Universite de Montréal, Montréal, QC, Canada
| | | | - Jens Bedke
- Eberhard Karls University of Tübingen, Tübingen, Germany
| | | | - Boris Alekseev
- Federal Medical Research Center n.a. P.A. Hertsen, Moscow, Russia
| | - Bohuslav Melichar
- Lekarska fakulta Univerzity Palackeho a Fakultni nemocnice Olomouc, Czech Republic
| | - Yaroslav Shparyk
- Lviv State Oncology Regional Treatment and Diagnostic Center, Lviv, Ukraine
| | | | | | - Lori A Wood
- Queen Elizabeth II Health Sciences Center, Halifax, NS, Canada
| | - Hans Hammers
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | | | - Mei Chen
- Merck & Co., Inc., Kenilworth, NJ, USA
| | - Thomas Powles
- Barts Health and the Royal Free NHS Trusts, Barts Cancer Institute, and Queen Mary University of London, London, UK
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Ayoub JP, Friedlander M, Dieras V, Wildiers H, Arun B, Han H, Puhalla S, Shparyk Y, Jakobsen E, Kundu M, Wu M, Ratajczak C, Maag D, Kaufman B. 140O Veliparib plus carboplatin-paclitaxel in patients with HER2-negative advanced/metastatic gBRCA-associated breast cancer: Results in hormone receptor-positive and triple-negative breast cancer subgroups from the phase III BROCADE3 trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Rugo HS, Diéras V, Gelmon KA, Finn RS, Slamon DJ, Martin M, Neven P, Shparyk Y, Mori A, Lu DR, Bhattacharyya H, Bartlett CHUANG, Iyer S, Johnston S, Ettl J, Harbeck N. Impact of palbociclib plus letrozole on patient-reported health-related quality of life: results from the PALOMA-2 trial. Ann Oncol 2019; 29:888-894. [PMID: 29360932 PMCID: PMC5913649 DOI: 10.1093/annonc/mdy012] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Patient-reported outcomes are integral in benefit-risk assessments of new treatment regimens. The PALOMA-2 study provides the largest body of evidence for patient-reported health-related quality of life (QOL) for patients with metastatic breast cancer (MBC) receiving first-line endocrine-based therapy (palbociclib plus letrozole and letrozole alone). Patients and methods Treatment-naïve postmenopausal women with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-) MBC were randomized 2 : 1 to palbociclib plus letrozole (n = 444) or placebo plus letrozole (n = 222). Patient-reported outcomes were assessed at baseline, day 1 of cycles 2 and 3, and day 1 of every other cycle from cycle 5 using the Functional Assessment of Cancer Therapy (FACT)-Breast and EuroQOL 5 dimensions (EQ-5D) questionnaires. Results As of 26 February 2016, the median duration of follow-up was 23 months. Baseline scores were comparable between the two treatment arms. No significant between-arm differences were observed in change from baseline in FACT-Breast Total, FACT-General Total, or EQ-5D scores. Significantly greater improvement in pain scores was observed in the palbociclib plus letrozole arm (-0.256 versus -0.098; P = 0.0183). In both arms, deterioration of FACT-Breast Total score was significantly delayed in patients without progression versus those with progression and patients with partial or complete response versus those without. No significant difference was observed in FACT-Breast and EQ-5D index scores in patients with and without neutropenia. Conclusions Overall, women with MBC receiving first-line endocrine therapy have a good QOL. The addition of palbociclib to letrozole maintains health-related QOL and improves pain scores in treatment-naïve postmenopausal patients with ER+/HER2- MBC compared with letrozole alone. Significantly greater delay in deterioration of health-related QOL was observed in patients without progression versus those who progressed and in patients with an objective response versus non-responders. ClinicalTrials.gov: NCT01740427 (https://clinicaltrials.gov/ct2/show/NCT01740427).
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Affiliation(s)
- H S Rugo
- Department of Medicine (Hematology/Oncology), University of California San Francisco Comprehensive Cancer Center, San Francisco, USA.
| | - V Diéras
- Department of Medical Oncology, Institut Curie, Paris, France
| | - K A Gelmon
- Department of Medical Oncology, British Columbia Cancer Agency-Vancouver Centre, Vancouver, Canada
| | - R S Finn
- Division of Hematology/Oncology, University of California, Los Angeles, USA
| | - D J Slamon
- Division of Hematology/Oncology, University of California, Los Angeles, USA
| | - M Martin
- Medical Oncology Service, Instituto de Investigación Sanitaria Gregorio Marañón, GEICAM, Universidad Complutense, Madrid, Spain
| | - P Neven
- Department of Oncology, Universitair Ziekenhuis Leuven-Campus Gasthuisberg, Leuven, Belgium
| | - Y Shparyk
- Department of Chemotherapy, Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine
| | - A Mori
- Global Product Developmen, Clinical, Pfizer s.r.l., Milan, Italy
| | - D R Lu
- Global Product Developmen, Statistics, Pfizer Inc., La Jolla, USA
| | | | | | - S Iyer
- Global Outcomes and Evidence, Pfizer Inc., New York, USA
| | - S Johnston
- Department of Medical Oncology, The Royal Marsden NHS Foundation, London, UK
| | - J Ettl
- Department of Obstetrics and Gynecology, Frauenklinik und Poliklinik Klinikum Rechts der Isar, Technische Universität München, München, Germany
| | - N Harbeck
- Department of Obstetrics and Gynecology, Brustzentrum der Universität München (LMU), München, Germany
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Diéras V, Han H, Kaufman B, Wildiers H, Friedlander M, Ayoub JP, Puhalla S, Bondarenko I, Campone M, Jakobsen E, Jalving M, Oprean C, Palácová M, Park Y, Shparyk Y, Yañez E, Dudley M, Ratajczak C, Maag D, Arun B. Phase III study of veliparib with carboplatin and paclitaxel in HER2-negative advanced/metastatic gBRCA-associated breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Waller CF, Ranganna GM, Pennella EJ, Blakeley C, Bronchud MH, Mattano LA, Berzoy O, Voitko N, Shparyk Y, Lytvyn I, Rusyn A, Popov V, Láng I, Beckmann K, Sharma R, Baczkowski M, Kothekar M, Barve A. Randomized phase 3 efficacy and safety trial of proposed pegfilgrastim biosimilar MYL-1401H in the prophylactic treatment of chemotherapy-induced neutropenia. Ann Hematol 2019; 98:1217-1224. [PMID: 30824956 PMCID: PMC6469669 DOI: 10.1007/s00277-019-03639-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 10/26/2018] [Accepted: 02/10/2019] [Indexed: 12/17/2022]
Abstract
Pegfilgrastim is indicated for reducing the duration of neutropenia and incidence of febrile neutropenia in patients receiving cytotoxic chemotherapy. Here, safety and efficacy of MYL-1401H, a proposed pegfilgrastim biosimilar, were investigated as prophylaxis for chemotherapy-induced neutropenia. This was a phase 3, multicenter, randomized, double-blind, parallel-group equivalence trial of MYL-1401H vs European Union–sourced reference pegfilgrastim. Patients with newly diagnosed stage II/III breast cancer eligible to receive (neo) adjuvant chemotherapy with docetaxel/doxorubicin/cyclophosphamide every 3 weeks for 6 cycles were enrolled and randomized 2:1 to 6 mg of MYL-1401H or reference pegfilgrastim 24 h (+ 2-h window after the first 24 h) after the end of chemotherapy. The primary efficacy endpoint was the duration of severe neutropenia in cycle 1 (i.e., days with absolute neutrophil count (ANC) < 0.5 × 109/L). Mean (standard deviation (SD)) duration of severe neutropenia in MYL-1401H and reference pegfilgrastim groups was 1.2 days (0.93) and 1.2 days (1.10), respectively. The 95% CI for least squares mean difference (− 0.285, 0.298) was within the predefined equivalence range of ± 1 day. Secondary endpoints, including grade ≥ 3 neutropenia (frequency, 91% and 82% for MYL-1401H and reference pegfilgrastim, respectively), time to ANC nadir (mean (SD), 6.2 (0.98) and 6.3 (1.57) days), and duration of post-nadir recovery (mean (SD), 1.9 (0.85) and 1.7 (0.91) days) were comparable. Overall safety profiles of the study drugs were comparable. MYL-1401H demonstrated equivalent efficacy and similar safety to reference pegfilgrastim and may be an equivalent option for reducing incidence of neutropenia. (ClinicalTrials.gov, NCT02467868; EudraCT, 2014-002324-27).
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Affiliation(s)
- Cornelius F Waller
- Department of Haematology, Oncology and Stem Cell Transplantation, University Medical Centre Freiburg and Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106, Freiburg, Germany.
| | - Gopinath M Ranganna
- Global Clinical Research & Development, Mylan, Prestige Tech Park Platina-3, 7th to 12th Floor, Kadubesanahalli, Bangalore, 560103, India
| | - Eduardo J Pennella
- Global Clinical Research, Mylan, 1000 Mylan Boulevard, Canonsburg, PA, 15317, USA
| | - Christopher Blakeley
- Medical and Scientific Affairs, Worldwide Clinical Trials, 172 Tottenham Court Road, Fitzrovia, London, W1T 7DL, UK
| | - Miguel H Bronchud
- GenesisCare Corachan Institute of Oncology, Buïgas 19, 08017, Barcelona, Spain
| | - Leonard A Mattano
- HARP Pharma Consulting, LLC, 184 Masons Island Road, Mystic, CT, 06355, USA
| | - Oleksandr Berzoy
- Mammalogy Center, Odessa Regional Hospital, Akademika Zabolotnogo Str. 26, Odessa, 65025, Ukraine
| | - Nataliia Voitko
- Chemotherapy II, Kyiv City Clinical Oncological Centre, Kyiv, Street, Verkhovyna, 69, Kiev, 03115, Ukraine
| | - Yaroslav Shparyk
- Department of Chemotherapy, Lviv State Regional Treatment and Diagnostics Oncology Center, Lviv Street, Pekarskaya, 69, Lviv, 79010, Ukraine
| | - Iryna Lytvyn
- Department of Chemotherapy, Dnipropetrovsk Regional Clinical Oncology Center, Kosmicheskaja Street, 21, Dnepropetrovsk, 49100, Ukraine
| | - Andriy Rusyn
- Department of Chemotherapy, Transkarpathian Regional University Oncology Clinic, Narodna Square, 3, Uzhgorod, 88000, Ukraine
| | - Vasil Popov
- Department of Medical Oncology and Palliative Care, SHATOD Dr. Marko Аntonov Markov, Varna EOOD, SHOP "Tsar Osvoboditel" Boulevard 100000, 9000, Varna, Bulgaria
| | - István Láng
- Department of Medical Oncology and Clinical Pharmacology B, National Institute of Oncology Országos Onkológiai Intézet, Budapest Ráth György u. 7-9, Budapest, 1122, Hungary
| | - Katrin Beckmann
- Global Clinical Operations, Mylan Healthcare GmbH, Freundallee 9A, 30173, Hannover, Germany
| | - Rajiv Sharma
- Global Product Safety and Risk Management, Mylan, Building 4 Trident Place, Mosquito Way, Hatfield, AL10 9UL, UK
| | - Mark Baczkowski
- Product Safety and Risk Management, Mylan, 781 Chestnut Ridge Road, Morgantown, WV, 26505, USA
| | - Mudgal Kothekar
- Clinical Development, Biocon Research Ltd, 131, Jigani Road, RK Twp, Bommasandra Industrial Area, Bangalore, Karnataka, 560099, India
| | - Abhijit Barve
- Global Clinical Research, Mylan, 1000 Mylan Boulevard, Canonsburg, PA, 15317, USA
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Pivot X, Bondarenko I, Dvorkin M, Sarosiek T, Wojtukiewicz M, Shparyk Y, Kim Y, Lim J. 3-year follow-up of a phase III study comparing SB3 (trastuzumab biosimilar) and reference trastuzumab in HER2 positive early or locally advanced breast cancer in neoadjuvant setting. Breast 2019. [DOI: 10.1016/s0960-9776(19)30257-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Romera A, Peredpaya S, Shparyk Y, Bondarenko I, Mendonça Bariani G, Abdalla KC, Roca E, Franke F, Melo Cruz F, Ramesh A, Ostwal V, Shah P, Rahuman SA, Paravisini A, Huerga C, Del Campo García A, Millán S. Bevacizumab biosimilar BEVZ92 versus reference bevacizumab in combination with FOLFOX or FOLFIRI as first-line treatment for metastatic colorectal cancer: a multicentre, open-label, randomised controlled trial. Lancet Gastroenterol Hepatol 2018; 3:845-855. [DOI: 10.1016/s2468-1253(18)30269-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/13/2018] [Accepted: 08/15/2018] [Indexed: 11/24/2022]
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Pivot X, Bondarenko I, Nowecki Z, Dvorkin M, Trishkina E, Ahn JH, Vinnyk Y, Im SA, Sarosiek T, Chatterjee S, Wojtukiewicz MZ, Moiseyenko V, Shparyk Y, Bello M, Semiglazov V, Song S, Lim J. Phase III, Randomized, Double-Blind Study Comparing the Efficacy, Safety, and Immunogenicity of SB3 (Trastuzumab Biosimilar) and Reference Trastuzumab in Patients Treated With Neoadjuvant Therapy for Human Epidermal Growth Factor Receptor 2–Positive Early Breast Cancer. J Clin Oncol 2018; 36:968-974. [DOI: 10.1200/jco.2017.74.0126] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose This phase III study compared SB3, a trastuzumab (TRZ) biosimilar, with reference TRZ in patients with human epidermal growth factor receptor 2–positive early breast cancer in the neoadjuvant setting ( ClinicalTrials.gov identifier: NCT02149524). Patients and Methods Patients were randomly assigned to receive neoadjuvant SB3 or TRZ for eight cycles concurrently with chemotherapy (four cycles of docetaxel followed by four cycles of fluorouracil, epirubicin, and cyclophosphamide) followed by surgery, and then 10 cycles of adjuvant SB3 or TRZ. The primary objective was comparison of breast pathologic complete response (bpCR) rate in the per-protocol set; equivalence was declared if the 95% CI of the ratio was within 0.785 to 1.546 or the 95% CI of the difference was within ± 13%. Secondary end points included comparisons of total pathologic complete response rate, overall response rate, event-free survival, overall survival, safety, pharmacokinetics, and immunogenicity. Results Eight hundred patients were included in the per-protocol set (SB3, n = 402; TRZ, n = 398). The bpCR rates were 51.7% and 42.0% with SB3 and TRZ, respectively. The adjusted ratio of bpCR was 1.259 (95% CI, 1.085 to 1.460), which was within the predefined equivalence margins. The adjusted difference was 10.70% (95% CI, 4.13% to 17.26%), with the lower limit contained within and the upper limit outside the equivalence margin. The total pathologic complete response rates were 45.8% and 35.8% and the overall response rates were 96.3% and 91.2% with SB3 and TRZ, respectively. Overall, 96.6% and 95.2% of patients experienced one or more adverse event, 10.5% and 10.7% had a serious adverse event, and 0.7% and 0.0% had antidrug antibodies (up to cycle 9) with SB3 and TRZ, respectively. Conclusion Equivalence for efficacy was demonstrated between SB3 and TRZ on the basis of the ratio of bpCR rates. Safety and immunogenicity were comparable.
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Affiliation(s)
- Xavier Pivot
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Igor Bondarenko
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Zbigniew Nowecki
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Mikhail Dvorkin
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Ekaterina Trishkina
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Jin-Hee Ahn
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Yuriy Vinnyk
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Seock-Ah Im
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Tomasz Sarosiek
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Sanjoy Chatterjee
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Marek Z. Wojtukiewicz
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Vladimir Moiseyenko
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Yaroslav Shparyk
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Maximino Bello
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Vladimir Semiglazov
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Sujeong Song
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
| | - Jaeyun Lim
- Xavier Pivot, University Hospital Jean Minjoz, Institut National de la Santé et de la Recherche Médicale 1098, Besançon, France; Igor Bondarenko, State Institution Dnipropetrovsk Medical, Academy of the Ministry of Health of Ukraine, Communal Institution Dnipropetrovsk City Multifield Clinical Hospital No. 4 of Dnipropetrovsk Regional Council, Dnipropetrovsk; Yuriy Vinnyk, Communal Healthcare Institution Kharkiv, Regional Clinical Oncological Center, Kharkiv; Yaroslav Shparyk, Lviv State Oncological
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Harbeck N, Dieras V, Finn R, Gelmon KA, Walshe JM, Shparyk Y, Mori A, Lui DR, Bhattacharyya H, Iyer S, Johnston S, Rugo HS. Abstract P5-19-01: Impact of palbociclib plus letrozole on patient-reported general health status compared with letrozole alone in ER+/HER2- advanced/metastatic breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-19-01] [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: Palbociclib plus letrozole significantly improved progression-free survival (PFS) compared with letrozole plus placebo in treatment-naive postmenopausal patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC) in the phase 3 PALOMA-2 trial. Here, we compare patient-reported general health status with extended (max 53 cycles) follow-up (data cut off May31st, 2017) (Pfizer: NCT01740427).
METHODS: PALOMA-2 randomized patients 2:1 to palbociclib + letrozole (n=444) or placebo + letrozole (n=222). Patient-reported outcomes were assessed at baseline, day 1 of cycles 1, 2, and 3, and day 1 of every other cycle from cycle 5 until the end of treatment using the EuroQol 5-Dimension Questionnaire (EQ-5D). The EQ-5D is a standardized measure of health status that consists of a descriptive system comprising the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression rated at 3 levels (no, some, or extreme problems) and a single index score for health status (ranges generally from 0 [dead] to 1 [full health]) calculated using a standard algorithm. In addition, a visual analog scale (VAS) measured self-rated health status from 0 (worst imaginable) to 100 (best imaginable). Repeated measures mixed-effects analyses were performed to compare overall index and VAS scores between treatments, controlling for baseline.
RESULTS: Completion rates at baseline were >95% in each group. The mean (SD) scores at baseline were comparable between palbociclib plus letrozole and letrozole alone for the VAS (71.3 [21.2] vs 72.3 [19.8]) and the EQ-5D index scores (0.70 [0.25]) vs (0.73 [0.21]). Median follow up was 38 months for palbociclib plus letrozole and 37 months for letrozole only. No statistically significant difference in overall change from baseline in general health status was observed between the treatment arms. The proportion of patients reporting the presence of a problem at baseline was similar for palbociclib plus letrozole and letrozole, respectively: mobility (39% vs 39%), self-care (12% vs 12%), usual activities (44% vs 39%), pain (69% vs 65%), and anxiety/depression (54% vs 54%). No statistically significant difference in overall mean EQ-5D index scores (0.73 vs. 0.71) was observed between the treatment arms.
CONCLUSION: Addition of palbociclib to letrozole maintained general health status and EQ-5D index scores in ER+ HER2- advanced/metastatic breast cancer with no statistically significant differences observed compared to letrozole alone.
Citation Format: Harbeck N, Dieras V, Finn R, Gelmon KA, Walshe JM, Shparyk Y, Mori A, Lui DR, Bhattacharyya H, Iyer S, Johnston S, Rugo HS. Impact of palbociclib plus letrozole on patient-reported general health status compared with letrozole alone in ER+/HER2- advanced/metastatic breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-19-01.
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Affiliation(s)
- N Harbeck
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
| | - V Dieras
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
| | - R Finn
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
| | - KA Gelmon
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
| | - JM Walshe
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
| | - Y Shparyk
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
| | - A Mori
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
| | - DR Lui
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
| | - H Bhattacharyya
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
| | - S Iyer
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
| | - S Johnston
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
| | - HS Rugo
- Brustzentrum der Universität München (LMU), Marchioninistrasse 15, Munchen, Germany; Institut Curie, Paris, France; University of California, Los Angeles, CA; 5British Columbia Cancer Agency-Vancouver Centre, Vancouver, BC, Canada; Cancer Trials Ireland, Dublin, Ireland; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Pfizer s.r.l., Milan, Italy; Pfizer, Inc, La Jolla, CA; Pfizer, Inc, New York, NY; The Royal Marsden NHS Foundation, London, United Kingdom; University of California, San Francisco, CA
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Leyland-Jones B, Bondarenko I, Nemsadze G, Smirnov V, Litvin I, Kokhreidze I, Abshilava L, Janjalia M, Li R, Lakshmaiah KC, Samkharadze B, Tarasova O, Shparyk Y, Polenkov S, Vladimirov V, Han J, Safonov I, Appiani C, Leitz G. Abstract P1-14-01: Final analysis of overall survival (OS) for the epoetin alfa (EPO) phase 3 study, EPO-ANE-3010, of EPO plus standard supportive care (SOC) versus SOC in anemic patients with metastatic breast cancer (MBC) receiving standard chemotherapy. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-14-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In the interim analysis of study EPO-ANE-3010, for the primary endpoint of progression-free survival (PFS), the non-inferiority objective in ruling out a 15% increased risk in progressive death (PD) or death per investigator-determined PD was not achieved (JCO 34:1197-1207, 2016). PFS, based on independent review committee (IRC)-determined PD, however, met the non-inferiority criteria. At the interim analysis, OS with 1,337 deaths was reported; we now report the final analysis at 1,653 deaths and the updated PFS.
Methods: This multinational (19 countries and 132 participating sites), phase 3, randomized, open-label noninferiority study included anemic (≤11.0 g/dL hemoglobin) women receiving first- or second-line standard chemotherapy for MBC (Eastern Cooperative Oncology Group performance status of 0 or 1). Subjects were randomized (1:1) to receive either standard SOC for treatment of anemia plus EPO (40,000 IU subcutaneous) weekly up to 4 weeks after the last dose of cytotoxic chemotherapy, or SOC alone. The primary endpoint was PFS (using Cox's regression model). Secondary endpoints included OS, time to tumor progression (TPP), overall response rate (ORR) and safety assessments.
Results: A total of 2,098 subjects were enrolled (EPO plus SOC: n=1,050; SOC alone: n=1048). Demographic and baseline characteristics were well-balanced across the groups; median age was 52 years, most were white (67.5%) or Asian (30.5%) and median BMI was 26.0 kg/m2. Primary efficacy analysis (based on investigator-determined PD) showed a median PFS of 7.4 months for both groups (hazard ratio [HR], 1.094; 95% CI: 0.996, 1.201);upper bound exceeded prespecified noninferiority margin of 1.15. A 9% increased risk for PD/death in the EPO plus SOC group was observed and did not statistically rule out a 15% increased risk. Median PFS per IRC-determined PD was 7.6 months in both groups (HR, 1.028; 95% CI: 0.922, 1.146), this met pre-defined non-inferiority margin of 1.15 with a 3% risk increase in PD/death in EPO plus SOC group. At the final analysis for OS, median OS was 17.8 months in the EPO plus SOC group and 18.0 months in the SOC group; HR: 1.073 (95% CI: 0.974, 1.182); median TPP was 7.5 months in both groups (HR, 1.099; 95% CI, 0.998 to 1.210), and ORR was 50% in the EPO plus SOC group and 51% in the SOC group (odds ratio, 0.939; 95% CI, 0.789, 1.117). Red blood cell (RBC) transfusions were 5.8% versus 11.5% (P<0.001), and thrombotic vascular events were 2.8% versus 1.4% (P=0.038), respectively, in EPO plus SOC group and SOC group. The incidence of death due to PD were similar in both groups (EPO plus SOC: 93%; SOC: 91%).
Conclusion:The primary endpoint, PFS based on investigator-determined PD, did not meet noninferiority criteria but for PFS based on IRC-determined PD, noninferiority criteria was met. Overall, this study did not statistically rule-out a 15% increased risk in PD/death. The final analysis did not show statistically different OS in the EPO plus SOC group versus the SOC group. No new safety signals were noted with EPO treatment and the results are consistent with the known safety profile of EPO.
Citation Format: Leyland-Jones B, Bondarenko I, Nemsadze G, Smirnov V, Litvin I, Kokhreidze I, Abshilava L, Janjalia M, Li R, Lakshmaiah KC, Samkharadze B, Tarasova O, Shparyk Y, Polenkov S, Vladimirov V, Han J, Safonov I, Appiani C, Leitz G. Final analysis of overall survival (OS) for the epoetin alfa (EPO) phase 3 study, EPO-ANE-3010, of EPO plus standard supportive care (SOC) versus SOC in anemic patients with metastatic breast cancer (MBC) receiving standard chemotherapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-14-01.
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Affiliation(s)
- B Leyland-Jones
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - I Bondarenko
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - G Nemsadze
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - V Smirnov
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - I Litvin
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - I Kokhreidze
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - L Abshilava
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - M Janjalia
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - R Li
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - KC Lakshmaiah
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - B Samkharadze
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - O Tarasova
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - Y Shparyk
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - S Polenkov
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - V Vladimirov
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - J Han
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - I Safonov
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - C Appiani
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
| | - G Leitz
- Avera Cancer Institute, Sioux Falls, SD; Dnepropetrovsk Medical Academy, Dnepropetrovsk, Ukraine; Institute of Clinical Oncology (LTD. K. Madichi Mammological Center), Tbilisi, Georgia; Donetsk Regional Anticancer Center, Donetsk, Ukraine; Dnepropetrovsk Regional Oncological Dispensary, Dnepropetrovsk, Ukraine; Martin D. Abeloff Laboratory Cancer Research Center, Tbilisi, Ukraine; Chemotherapy and Immunotherapy Clinic MEDULLA, Tbilisi, Georgia; Tbilisi Cancer Center, Tbilisi, Georgia; St. Luke's Medical Center, Quezon City, Philippines; Kidwai Memorial Institute of Oncology, Bangalore, India; Research Institute of Clinical Medicine, Tbilisi, Georgia; Institute of Medical Radiology, Kharkiv, Ukraine; Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine; Chernigov Regional Oncology Center, Chernigov, Ukraine; Pyatigorsk Oncology Dispensary, Pyatigorsk, Russian Federation; Janssen R&D, Titusville; Janssen R&D, Neuss, Germany
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Han HS, Diéras V, Robson M, Palácová M, Marcom PK, Jager A, Bondarenko I, Citrin D, Campone M, Telli ML, Domchek SM, Friedlander M, Kaufman B, Garber JE, Shparyk Y, Chmielowska E, Jakobsen EH, Kaklamani V, Gradishar W, Ratajczak CK, Nickner C, Qin Q, Qian J, Shepherd SP, Isakoff SJ, Puhalla S. Veliparib with temozolomide or carboplatin/paclitaxel versus placebo with carboplatin/paclitaxel in patients with BRCA1/2 locally recurrent/metastatic breast cancer: randomized phase II study. Ann Oncol 2018; 29:154-161. [PMID: 29045554 PMCID: PMC5834075 DOI: 10.1093/annonc/mdx505] [Citation(s) in RCA: 149] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Homologous recombination defects in BRCA1/2-mutated tumors result in sensitivity to poly(ADP-ribose) polymerase inhibitors, which interfere with DNA damage repair. Veliparib, a potent poly(ADP-ribose) polymerase inhibitor, enhanced the antitumor activity of platinum agents and temozolomide in early phase clinical trials. This phase II study examined the safety and efficacy of intermittent veliparib with carboplatin/paclitaxel (VCP) or temozolomide (VT) in patients with BRCA1/2-mutated breast cancer. Patients and methods Eligible patients ≥18 years with locally recurrent or metastatic breast cancer and a deleterious BRCA1/2 germline mutation were randomized 1 : 1 : 1 to VCP, VT, or placebo plus carboplatin/paclitaxel (PCP). Primary end point was progression-free survival (PFS); secondary end points included overall survival (OS) and overall response rate (ORR). Results Of 290 randomized patients, 284 were BRCA+, confirmed by central laboratory. For VCP versus PCP, median PFS was 14.1 and 12.3 months, respectively [hazard ratio (HR) 0.789; 95% CI 0.536-1.162; P = 0.227], interim median OS 28.3 and 25.9 months (HR 0.750; 95% CI 0.503-1.117; P = 0.156), and ORR 77.8% and 61.3% (P = 0.027). For VT (versus PCP), median PFS was 7.4 months (HR 1.858; 95% CI 1.278-2.702; P = 0.001), interim median OS 19.1 months (HR 1.483; 95% CI 1.032-2.131; P = 0.032), and ORR 28.6% (P < 0.001). Safety profile was comparable between carboplatin/paclitaxel arms. Adverse events (all grades) of neutropenia, anemia, alopecia, and neuropathy were less frequent with VT versus PCP. Conclusion Numerical but not statistically significant increases in both PFS and OS were observed in patients with BRCA1/2-mutated recurrent/metastatic breast cancer receiving VCP compared with PCP. The addition of veliparib to carboplatin/paclitaxel significantly improved ORR. There was no clinically meaningful increase in toxicity with VCP versus PCP. VT was inferior to PCP. An ongoing phase III trial is evaluating VCP versus PCP, with optional continuation single-agent therapy with veliparib/placebo if chemotherapy is discontinued without progression, in this patient population. Clinical trial information NCT01506609.
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Affiliation(s)
- H S Han
- Moffitt Cancer Center, Tampa, USA
| | - V Diéras
- Institut Curie, Paris, France, USA
| | - M Robson
- Weill Cornell Medical College, New York, USA
| | - M Palácová
- Masarykův Onkologický Ústav, Brno, Czech Republic, Durham, USA
| | | | - A Jager
- Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - I Bondarenko
- Dnepropetrovsk Medical Academy, City Hospital #4, Dnipro, Ukraine
| | - D Citrin
- Midwestern Regional Medical Center, Zion, USA
| | - M Campone
- Institut de Cancérologie de l’Ouest, Saint Herblain, France
| | - M L Telli
- Stanford University School of Medicine, Stanford, USA
| | - S M Domchek
- University of Pennsylvania, Philadelphia, USA
| | | | - B Kaufman
- Sheba Medical Center, Tel Hashomer, Israel
| | - J E Garber
- Dana-Farber Cancer Institute, Boston, USA
| | - Y Shparyk
- Chemotherapy Department, Lviv State Regional Treatment and Diagnostics Oncology Center, Lviv, Ukraine
| | - E Chmielowska
- Department of Clinical Oncology, Oncology Centre, Bydgoszcz, UMK, Torun, Poland
| | - E H Jakobsen
- Department of Oncology, Vejle Hospital/Lillebaelt Hospital, Vejle, Denmark
| | - V Kaklamani
- Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - W Gradishar
- Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, USA
| | | | | | - Q Qin
- AbbVie Inc., North Chicago, USA
| | - J Qian
- AbbVie Inc., North Chicago, USA
| | | | | | - S Puhalla
- University of Pittsburgh Cancer Institute, Pittsburgh, USA
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Pivot X, Bondarenko I, Nowecki Z, Dvorkin M, Trishkina E, Ahn J, Vinnyk Y, Im SA, Sarosiek T, Chatterjee S, Wojtukiewicz M, Moiseyenko V, Shparyk Y, Bello III M, Semiglazov V, Younju L, Lim J. One-year safety, immunogenicity, and survival results from a phase III study comparing SB3 (a proposed trastuzumab biosimilar) and originator trastuzumab in HER2-positive early breast cancer treated with neoadjuvant-adjuvant treatment. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Gligorov J, Ataseven B, Verrill M, De Laurentiis M, Jung K, Azim H, Al-Sakaff N, Lauer S, Shing M, Pivot X, Koroveshi D, Bouzid K, Casalnuovo M, Cascallar D, Korbenfeld EP, Bastick P, Beith J, Colosimo M, Friedlander M, Ganju V, Green M, Patterson K, Redfern A, Richardson G, Ceric T, Gordana K, Beato CA, Ferrari M, Hegg R, Helena V, Ismael GF, Lessa AE, Mano M, Morelle A, Nogueira JA, Timcheva K, Tomova A, Tsakova M, Zlatareva-Petrova A, Asselah J, Assi H, Brezden-Masley C, Chia S, Freedman O, Harb M, Joy AA, Kulkarni S, Prady C, Gaete AAA, Matamala L, Torres R, Yanez E, Franco S, Urrego M, Gugić D, Vrbanec D, Melichar B, Prausová J, Vyzula R, Pilarte RG, León MI, Muñoz R, Ramos G, Azeem HA, Aziz AA, El Zawahry H, Osegueda FR, Alexandre J, Artignan X, Barletta H, Beguier E, Berdah JF, Marty CB, Bollet M, Bourgeois H, Bressac C, Burki F, Campone M, Coeffic D, Cojocarasu OZ, Dagada C, Dalenc F, Del Piano F, Desauw C, Desmoulins I, Dohollou N, Egreteau J, Ferrero JM, Foa C, Garidi R, Gasnault L, Gligorov J, Guardiola E, Hamizi S, Jarcau R, Jacquin JP, Jaubert D, Jolimoy G, Mineur HL, Largillier R, Leduc B, Martin P, Melis A, Monge J, Moullet I, Mousseau M, Nguyen S, Orfeuvre H, Petit T, Pivot X, Priou F, Bach IS, Simon H, Stefani L, Uwer L, Youssef A, Aktas B, von der Assen A, Augustin D, Balser C, Bauer LE, Bechtner C, Beyer G, Brucker C, Bückner U, Busch S, Christensen B, Deryal M, Farrokh A, Faust E, Friedrichs K, Graf H, Griesshammer M, Grischke EM, Hänle C, Heider A, Henschen S, Hesse T, Jackisch C, Kisro J, Köhler A, Kuemmel S, Lampe D, Lantzsch T, Latos K, Lex B, Liedtke C, Luedders D, Maintz C, Müller V, Overkamp F, Park-Simon TW, Paul M, Prechtl A, Ringsdorf U, Runnebaum I, Ruth S, Salat C, Scheffen I, Schilling J, Schmatloch S, Schmidt M, Schneeweiss A, Schrader I, Seipelt G, Simon E, Stefek A, Stickeler E, Thill M, Tio J, Tuczek A, Warm M, Weigel M, Wischnik A, Wojcinski S, Ziegler-Löhr K, Aravantinos G, Ardavanis A, Fountzilas G, Gogas H, Kakolyris S, Mavroudis D, Papadimitriou C, Papandreou C, Papazisis K, Castro H, Hernandez-Monroy CE, Ngan R, Yeo W, Bittner N, Boer K, Csejtei A, Horvath Z, Kocsis J, Mangel LC, Mezei K, Nagy Z, Szanto J, Atmakusuma D, Fadjari H, Kurnianda D, Prayogo N, Tanggo EH, Coate L, Hennessy B, Kelly C, Martin M, Nasim S, O'Connor M, Aieta M, Allegrini G, Amadori D, Bidoli P, Biti G, Bordonaro R, Bottini A, Carterni G, Cavanna L, Cazzaniga M, Cognetti F, Contu A, Cruciani G, Donadio M, Falcone A, Farci D, Forcignanò RC, Frassoldati A, Gaion F, Gamucci T, Giotta F, de Laurentiis M, Livi L, Lorusso V, Maiello E, Marchetti P, Mariani G, Mion M, Moscetti L, Musolino A, Pazzola A, Pedrazzoli P, Pigi A, de Placido S, Caremoli ER, Santoro A, Tienghi A, Ahn JS, Jung KH, Lee KS, Lee SH, Seo JH, Sohn JH, Cesas A, Juozaityte E, Cheah NLC, Chong FLT, Devi BC, Phua V, Teoh D, Ching LW, Yusof M, Corona J, Dominguez A, Mendoza RLG, Hernandez CA, Ramiro AJ, Santos JM, Espinosa PM, Villarreal Garza CM, Errihani H, Bakker S, van den Berkmortel F, Blaisse R, Huinink DTB, van den Bosch J, Braun J, Dercksen M, Droogendijk H, Erdkamp F, Haringhuizen A, de Jongh F, Kok T, Los M, Madretsma S, Terwogt JMM, van der Padt A, van Rossum-Schornagel QC, Smilde T, de Valk B, van der Velden A, van Warmerdam L, van de Wouw A, North R, Kersten C, Mjaaland I, Wist E, Aziz Z, Masood N, Rashid K, Shah M, Alcedo JC, Aleman D, Neciosup S, Reategui R, Valdiviezo N, Vera L, Fernando G, Roque F, Strebel HM, Krzemieniecki K, Litwiniuk M, Mruk A, Pienkowski T, Sawrycki P, Slomian G, Tomczak P, Afonso N, Cardoso F, Damasceno M, Nave M, Badulescu F, Ciule L, Curescu S, Eniu A, Filip D, Grecea D, Jinga DC, Lungulescu D, Oprean CM, Stanculeanu DL, Turdean M, Dvornichenko V, Emelyanov S, Lichinitser M, Manikhas A, Sakaeva D, Shirinkin V, Stroyakovskiy D, Abulkhair O, Zekri J, Filipovic S, Kovcin V, Nedovic J, Pesic J, Vasovic S, Ng R, Bystricky B, Leskova J, Mardiak J, Mišurová E, Wagnerova M, Takač I, Demetriou GS, Dreosti L, Govender P, Jordaan JP, Veersamy P, Romero JLA, Lopez NB, Arias CC, Chacon J, Aramburo AF, Morales LAF, Garcia M, Estevez LG, Garcia-Palomo Perez A, Garcia Saenz JA, Garcia Sanchis L, Cubells LG, Cortijo LG, Santiago SG, De Aranguiz BHF, Mañas JJI, Gallego PJ, Cussac AL, Ferrandiz CL, Garrido ML, Alvarez PL, Vega JML, Del Prado PM, Jañez NM, Murillo SM, Rosales AM, Jaso LM, Fernandez IP, Martorell AP, Carrion RP, Simon SP, Alcibar AP, Lorenzo JP, Garcia VQ, Asensio TRYC, Maicas MDT, Villanueva Silva MJ, Killander F, Svensson JH, Fehr M, Hauser N, Müller A, Pagani O, Passmann-Kegel H, Popescu R, Rabaglio M, Rauch D, Schlatter C, Zaman K, Chang TW, Huang CS, Wang HC, Yu JC, Bandidwattanawong C, Maneechavakajorn J, Seetalarom K, Dejthevaporn T(S, Somwangprasert A, Vongsaisuwon M, Akbulut H, Altundag K, Arican A, Bozcuk H, Eralp Y, Idris M, Isikdogan A, Senol CH, Sevinc A, Uygun K, Yucel E, Yucel I, Yumuk F, Shparyk Y, Voitko N, Jaloudi M, Adams J, Agrawal R, Ahmed S, Alhasso A, Allerton R, Anwar S, Archer C, Ashford R, Barraclough L, Bertelli G, Bishop J, Branson T, Butt M, Chakrabarti A, Chakraborti P, Churn M, Crowley C, Davis R, Dhadda A, Eldeeb H, Fraser J, Hall J, Hickish T, Hogg M, Howe T, Joffe J, Kelleher M, Kelly S, Kendall A, Kristeleit H, Lumsden G, Macmillan C, MacPherson I, Malik Z, Mithal N, Neal A, Panwar U, Proctor A, Proctor SJ, Raj S, Rehman S, Sandri I, Scatchard K, Sherwin E, Sims E, Singer J, Smith S, Tahir S, Taylor W, Tsalic M, Verrill M, Wardley A, Waters S, Wheatley D, Wright K, Yuille F, Alonso I, Artagaveytia N, Rodriguez R, Arbona E, Garcia Y, Lion L, Marcano D, Van Thuan T. Safety and tolerability of subcutaneous trastuzumab for the adjuvant treatment of human epidermal growth factor receptor 2-positive early breast cancer: SafeHer phase III study's primary analysis of 2573 patients. Eur J Cancer 2017. [DOI: 10.1016/j.ejca.2017.05.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ajani J, Abramov M, Bondarenko I, Shparyk Y, Gorbunova V, Hontsa A, Otchenash N, Alsina M, Lazarev S, Feliu J, Elme A, Esko V, Abdalla K, Verma U, Benedetti F, Aoyama T, Mizuguchi H, Makris L, Rosati G. A phase III trial comparing oral S-1/cisplatin and intravenous 5-fluorouracil/cisplatin in patients with untreated diffuse gastric cancer. Ann Oncol 2017; 28:2142-2148. [DOI: 10.1093/annonc/mdx275] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Waller C, Blakeley C, Pennella E, Bronchud M, Mattano L, Berzoy O, Voitko N, Adamchuk H, Zautashvili Z, Vinnyk Y, Nemsadze G, Dzagnidze G, Shparyk Y, Lytvyn I, Rusyn A, Popov V, Láng I, Sharma R, Baczkowski M, Kothekar M. Phase 3 efficacy and safety trial of proposed pegfilgrastim biosimilar MYL-1401H vs EU-Neulasta ® in the prophylactic treatment of chemotherapy-induced neutropenia. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30217-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Robertson JFR, Bondarenko IM, Trishkina E, Dvorkin M, Panasci L, Manikhas A, Shparyk Y, Cardona-Huerta S, Cheung KL, Philco-Salas MJ, Ruiz-Borrego M, Shao Z, Noguchi S, Rowbottom J, Stuart M, Grinsted LM, Fazal M, Ellis MJ. Fulvestrant 500 mg versus anastrozole 1 mg for hormone receptor-positive advanced breast cancer (FALCON): an international, randomised, double-blind, phase 3 trial. Lancet 2016; 388:2997-3005. [PMID: 27908454 DOI: 10.1016/s0140-6736(16)32389-3] [Citation(s) in RCA: 342] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 11/08/2016] [Accepted: 11/11/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Aromatase inhibitors are a standard of care for hormone receptor-positive locally advanced or metastatic breast cancer. We investigated whether the selective oestrogen receptor degrader fulvestrant could improve progression-free survival compared with anastrozole in postmenopausal patients who had not received previous endocrine therapy. METHODS In this phase 3, randomised, double-blind trial, we recruited eligible patients with histologically confirmed oestrogen receptor-positive or progesterone receptor-positive, or both, locally advanced or metastatic breast cancer from 113 academic hospitals and community centres in 20 countries. Eligible patients were endocrine therapy-naive, with WHO performance status 0-2, and at least one measurable or non-measurable lesion. Patients were randomly assigned (1:1) to fulvestrant (500 mg intramuscular injection; on days 0, 14, 28, then every 28 days thereafter) or anastrozole (1 mg orally daily) using a computer-generated randomisation scheme. The primary endpoint was progression-free survival, determined by Response Evaluation Criteria in Solid Tumors version 1·1, intervention by surgery or radiotherapy because of disease deterioration, or death from any cause, assessed in the intention-to-treat population. Safety outcomes were assessed in all patients who received at least one dose of randomised treatment (including placebo). This trial is registered with ClinicalTrials.gov, number NCT01602380. FINDINGS Between Oct 17, 2012, and July 11, 2014, 524 patients were enrolled to this study. Of these, 462 patients were randomised (230 to receive fulvestrant and 232 to receive anastrozole). Progression-free survival was significantly longer in the fulvestrant group than in the anastrozole group (hazard ratio [HR] 0·797, 95% CI 0·637-0·999, p=0·0486). Median progression-free survival was 16·6 months (95% CI 13·83-20·99) in the fulvestrant group versus 13·8 months (11·99-16·59) in the anastrozole group. The most common adverse events were arthralgia (38 [17%] in the fulvestrant group vs 24 [10%] in the anastrozole group) and hot flushes (26 [11%] in the fulvestrant group vs 24 [10%] in the anastrozole group). 16 (7%) of 228 patients in in the fulvestrant group and 11 (5%) of 232 patients in the anastrozole group discontinued because of adverse events. INTERPRETATION Fulvestrant has superior efficacy and is a preferred treatment option for patients with hormone receptor-positive locally advanced or metastatic breast cancer who have not received previous endocrine therapy compared with a third-generation aromatase inhibitor, a standard of care for first-line treatment of these patients. FUNDING AstraZeneca.
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Affiliation(s)
- John F R Robertson
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.
| | - Igor M Bondarenko
- Oncology Department, Dnipropetrovsk State Medical Academy, Dnipropetrovsk, Ukraine
| | | | | | - Lawrence Panasci
- Department of Oncology, Jewish General Hospital, Montreal, Canada
| | | | - Yaroslav Shparyk
- Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine
| | | | - Kwok-Leung Cheung
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | | | | | - Zhimin Shao
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Shinzaburo Noguchi
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Mary Stuart
- AstraZeneca, Alderley Park, Macclesfield, UK
| | | | | | - Matthew J Ellis
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, Texas, USA
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Ellis M, Bondarenko I, Trishkina E, Dvorkin M, Panasci L, Manikhas A, Shparyk Y, Cardona-Huerta S, Cheung KL, Philco-Salas M, Ruiz-Borrego M, Shao Z, Noguchi S, Grinsted L, Fazal M, Stuart M, Robertson J. FALCON: A phase III randomised trial of fulvestrant 500 mg vs. anastrozole for hormone receptor-positive advanced breast cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw435.04] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rugo H, Dieras V, Gelmon K, Finn R, Slamon D, Miguel M, Neven P, Ettl J, Shparyk Y, Mori A, Lu D, Bhattacharyya H, Bartlett C, Iyer S, Johnston S, Harbeck N. Impact of palbociclib plus letrozole on health related quality of life (HRQOL) compared with letrozole alone in treatment naïve postmenopausal patients with ER+ HER2- metastatic breast cancer (MBC): results from PALOMA-2. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Waller C, Blakeley C, Pennella E, Bronchud M, Berzoy O, Voitko N, Adamchuk H, Zautashvili Z, Vinnyk Y, Nemsadze G, Dzagnidze G, Shparyk Y, Lytvyn I, Rusyn A, Popov V, Lang I, Sharma R, Baczkowski M, Kothekar M, Barve A. Phase 3 efficacy and safety trial of proposed pegfilgrastim biosimilar MYL-1401H vs EU-neulasta® in the prophylaxis of chemotherapy-induced neutropenia. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hutson TE, Al-Shukri S, Stus VP, Lipatov ON, Shparyk Y, Bair AH, Rosbrook B, Andrews GI, Vogelzang NJ. Axitinib Versus Sorafenib in First-Line Metastatic Renal Cell Carcinoma: Overall Survival From a Randomized Phase III Trial. Clin Genitourin Cancer 2016; 15:72-76. [PMID: 27498023 DOI: 10.1016/j.clgc.2016.05.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [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: 02/17/2016] [Revised: 04/27/2016] [Accepted: 05/18/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND In a randomized phase III trial in treatment-naive patients with metastatic renal cell carcinoma (RCC), axitinib versus sorafenib yielded numerically longer progression-free survival (median, 10.1 vs. 6.5 months; hazard ratio [HR], 0.77; 1-sided P = .038) and significantly higher objective response rate (32% vs. 15%; 1-sided P = .0006). In this article, we report overall survival (OS) and updated safety results. PATIENTS AND METHODS Previously untreated patients with metastatic RCC (n = 288), stratified according to Eastern Cooperative Oncology Group performance status (ECOG PS; 0 vs. 1), were randomized 2:1 to receive axitinib 5 mg twice per day (b.i.d.; n = 192) or sorafenib 400 mg b.i.d. (n = 96). RESULTS Median OS (95% confidence interval [CI]) was 21.7 months (18.0-31.7) with axitinib versus 23.3 months (18.1-33.2) with sorafenib (stratified HR, 0.995; 95% CI, 0.731-1.356; 1-sided P = .4883). Among patients with ECOG PS of 0, median OS was numerically longer with axitinib than with sorafenib (41.2 vs. 31.9 months; HR, 0.811, 1-sided P = .1748), whereas among patients with ECOG PS 1, median OS was shorter with axitinib than with sorafenib (14.2 vs. 19.8 months; HR, 1.203; 1-sided; P = .7973). Incidence and severity of common adverse events were consistent with previous reports. CONCLUSION OS was similar between axitinib and sorafenib in treatment-naive patients with metastatic RCC, and no new safety signals emerged.
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Affiliation(s)
- Thomas E Hutson
- Charles A. Sammons Cancer Center, Dallas, and US Oncology Research, Houston, TX.
| | - Salman Al-Shukri
- Urological Department, First Saint-Petersburg State Pavlov Medical University, Saint Petersburg, Russian Federation
| | - Viktor P Stus
- Urology Department #2, Municipal Institution "Dnipropetrovsk Regional Clinical Hospital n.a. I.I. Mechnikov", Dnipropetrovsk, Ukraine
| | - Oleg N Lipatov
- Department of Oncology, Republican Clinical Oncology Dispensary, Ufa, Russian Federation
| | - Yaroslav Shparyk
- Lviv State Oncologic Regional Treatment and Diagnostic Center, Chemotherapy Department, Lviv, Ukraine
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Finn RS, Crown JP, Ettl J, Pinter T, Thummala A, Shparyk Y, Patel R, Randolph S, Kim S, Huang X, Nadanaciva S, Huang Bartlett C, Slamon DJ. Abstract P4-13-02: Treatment patterns of post-disease progression in the PALOMA-1/TRIO-18 trial. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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
Palbociclib (P) is an oral CDK4/6 inhibitor. In PALOMA-1/TRIO-18, a randomized phase 2 trial, addition of P to letrozole (L) significantly prolonged progression-free survival (PFS) (20 mo with P+L vs 10 mo with L alone; HR = 0.488, P=0.0004; Finn et al, Lancet Oncol, 2015) in postmenopausal women with estrogen-receptor-positive (ER+), HER2-negative advanced breast cancer (ABC) in the first-line setting. At the time of final PFS analysis, overall survival (OS) was immature.
Objectives
It is clinically important to understand whether patients (pts) benefit from standard of care endocrine therapy (ET) after they progressed on P+L as first-line treatment for ABC. We report patterns of post-progression treatment in the next line of therapy immediately following participation in the PALOMA-1 trial.
Methods
Postmenopausal women with ER+ and HER2- ABC who had not received any treatment for their advanced disease were randomized to receive P+L (N = 84) or L alone (N = 81) in the first-line setting. The primary endpoint was investigator-assessed PFS. Tumor assessment was performed every 8 weeks. Post-progression treatment data was captured and analyzed.
Results
As of the data cut-off (Nov 29, 2013), 40 progression events had occurred in the P+L arm and 59 in the L alone arm. 50% of pts in the P+L arm vs. 64% in the L alone arm received ET after progression on study treatment. 60% of pts in the P+L arm vs. 66% in the L alone arm received chemotherapy (CT) after progression on study treatment. The time to 1st subsequent ET/ CT after progression on study treatment, duration of 1st subsequent ET/CT, and choice of 1st subsequent ET/ CT are shown in Table 1.
Table 1 P + LL N=84N=81Patients (pts) with Disease Progression, NN (%)a40 (47.6)59 (72.8)Pts who received subsequent Endocrine Therapy (ET) after progression on study treatment, n(%)b20 (50.0)*38 (64.4)*Time from randomization to 1st subsequent ET (days), median (range)465.5 (239-1100)368.5 (65-1102)Duration of 1st subsequent ET (days), median (range)**153 (24-592)151 (16-1135)Choice of 1st subsequent ET, n(%)bFulvestrant9 (22.5)15 (25.4)Exemestane6 (15.0)9 (15.3)Medroxyprogesterone4 (10.0)1 (1.7)Letrozole1 (2.5)5 (8.5)Tamoxifen08 (13.6)Pts who received subsequent Chemotherapy (CT) after progression on study treatment, n(%)b24 (60.0)*39 (66.1)*Time from randomization to 1st subsequent CT (days), median (range)388.5 (69-918)281 (46-1013)Duration of 1st subsequent CT (days), median (range)**92 (1-457)120 (1-1143)Choice of 1st subsequent CT, n(%)bCapecitabine1 (2.5)10 (17.0)Mitoxantrone13 (32.5)1 (1.7)Paclitaxel013 (22.0)Other10 (25)15 (25.4)apercentages are based on N as denominator; bpercentages based on NN as denominator; *some patients had both ET and CT after progression; **calculated as treatment stop date minus treatment start date +1; if treatment was ongoing at time of data cut-off, stop date was imputed as Nov 29, 2013.
Conclusions
P+L delayed the time to ET/CT as compared to L alone. Pts benefited from standard of care ET/CT after they progressed on P+L as first-line treatment for ABC as demonstrated by the length of time on subsequent therapies; no difference was observed from the L alone arm.
Clinical Trial Information: NCT00721409
Funding Source: Pfizer.
Citation Format: Finn RS, Crown JP, Ettl J, Pinter T, Thummala A, Shparyk Y, Patel R, Randolph S, Kim S, Huang X, Nadanaciva S, Huang Bartlett C, Slamon DJ. Treatment patterns of post-disease progression in the PALOMA-1/TRIO-18 trial. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-02.
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Affiliation(s)
- RS Finn
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - JP Crown
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - J Ettl
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - T Pinter
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - A Thummala
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - Y Shparyk
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - R Patel
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - S Randolph
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - S Kim
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - X Huang
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - S Nadanaciva
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - C Huang Bartlett
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
| | - DJ Slamon
- University of California Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Technical University of Munich, Munich, Germany; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Lviv State Oncologic Regional Treatment and Diagnostic Center, Lviv, Ukraine; Comprehensive Blood and Cancer Center, Bakersfield, CA; Pfizer Oncology, La Jolla, CA; Pfizer Oncology, Groton, CT; Pfizer Oncology, NY, NY
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Hecht JR, Bang YJ, Qin SK, Chung HC, Xu JM, Park JO, Jeziorski K, Shparyk Y, Hoff PM, Sobrero A, Salman P, Li J, Protsenko SA, Wainberg ZA, Buyse M, Afenjar K, Houé V, Garcia A, Kaneko T, Huang Y, Khan-Wasti S, Santillana S, Press MF, Slamon D. Lapatinib in Combination With Capecitabine Plus Oxaliplatin in Human Epidermal Growth Factor Receptor 2–Positive Advanced or Metastatic Gastric, Esophageal, or Gastroesophageal Adenocarcinoma: TRIO-013/LOGiC—A Randomized Phase III Trial. J Clin Oncol 2016; 34:443-51. [DOI: 10.1200/jco.2015.62.6598] [Citation(s) in RCA: 397] [Impact Index Per Article: 49.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To evaluate the efficacy of adding lapatinib to capecitabine and oxaliplatin (CapeOx) in patients with previously untreated human epidermal growth factor receptor 2 (HER2) –amplified advanced gastroesophageal adenocarcinoma. Patients and Methods Patients with HER2-positive advanced gastroesophageal adenocarcinoma were randomly assigned at a one-to-one ratio to CapeOx plus lapatinib 1,250 mg or placebo daily. Primary end point was overall survival (OS) in patients with centrally confirmed HER2 amplification in the primary efficacy population. Results A total of 545 patients were randomly assigned, and 487 patients comprised the primary efficacy population. Median OS in the lapatinib and placebo arms was 12.2 (95% CI, 10.6 to 14.2) and 10.5 months (95% CI, 9.0 to 11.3), respectively, which was not significantly different (hazard ratio, 0.91; 95% CI, 0.73 to 1.12). Median progression-free survival in the lapatinib and placebo arms was 6.0 (95% CI, 5.6 to 7.0) and 5.4 months (95% CI, 4.4 to 5.7), respectively (hazard ratio, 0.82; 95% CI, 0.68 to 1.00; P = .0381). Response rate was significantly higher in the lapatinib arm: 53% (95% CI, 46.4 to 58.8) compared with 39% (95% CI, 32.9 to 45.3) in the placebo arm (P = .0031). Preplanned exploratory subgroup analyses showed OS in the lapatinib arm was prolonged in Asian and younger patients. No correlation was observed between HER2 immunohistochemistry status and survival. There were increased toxicities in the lapatinib arm, particularly diarrhea. Conclusion Addition of lapatinib to CapeOx did not increase OS in patients with HER2-amplified gastroesophageal adenocarcinoma. There were clear differences in the effect of lapatinib depending on region and age. Future studies could examine this correlation.
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Affiliation(s)
- J. Randolph Hecht
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Yung-Jue Bang
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Shukui K. Qin
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Hyun C. Chung
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Jianming M. Xu
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Joon O. Park
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Krzysztof Jeziorski
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Yaroslav Shparyk
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Paulo M. Hoff
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Alberto Sobrero
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Pamela Salman
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Jin Li
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Svetlana A. Protsenko
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Zev A. Wainberg
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Marc Buyse
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Karen Afenjar
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Vincent Houé
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Agathe Garcia
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Tomomi Kaneko
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Yingjie Huang
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Saba Khan-Wasti
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Sergio Santillana
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Michael F. Press
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
| | - Dennis Slamon
- J. Randolph Hecht, Zev A. Wainberg, and Dennis Slamon, David Geffen School of Medicine, University of California Los Angeles, Santa Monica; Michael F. Press, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA; Yung-Jue Bang, Seoul National University College of Medicine; Hyun C. Chung, Yonsei Cancer Center, Yonsei Cancer Research Institute, Yonsei University College of Medicine; Joon O. Park, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
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Hawkins RE, Gore M, Shparyk Y, Bondar V, Gladkov O, Ganev T, Harza M, Polenkov S, Bondarenko I, Karlov P, Karyakin O, Khasanov R, Hedlund G, Forsberg G, Nordle Ö, Eisen T. A Randomized Phase II/III Study of Naptumomab Estafenatox + IFNα versus IFNα in Renal Cell Carcinoma: Final Analysis with Baseline Biomarker Subgroup and Trend Analysis. Clin Cancer Res 2016; 22:3172-81. [PMID: 26851187 DOI: 10.1158/1078-0432.ccr-15-0580] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 11/03/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE To prospectively determine the efficacy of naptumomab estafenatox (Nap) + IFNα versus IFN in metastatic renal cell carcinoma (RCC). EXPERIMENTAL DESIGN In a randomized, open-label, multicenter, phase II/III study, 513 patients with RCC received Nap (15 μg/kg i. v. in three cycles of four once-daily injections) + IFN (9 MU s.c. three times weekly), or the same regimen of IFN monotherapy. The primary endpoint was overall survival (OS). RESULTS This phase II/III study did not meet its primary endpoint. Median OS/PFS for Nap + IFN patients was 17.1/5.8 months versus 17.5/5.8 months for the patients receiving IFN alone (P = 0.56; HR, 1.08/P = 0.41; HR, 0.92). Post hoc exploratory subgroup and trend analysis revealed that the baseline plasma concentrations of anti-SEA/E-120 (anti-Nap antibodies) for drug exposure and IL6 for immune status could be used as predictive biomarkers. A subgroup of patients (SG; n = 130) having concentrations below median of anti-SEA/E-120 and IL6 benefitted greatly from the addition of Nap. In SG, median OS/PFS for the patients treated with Nap + IFN was 63.3/13.7 months versus 31.1/5.8 months for the patients receiving IFN alone (P = 0.02; HR, 0.59/P = 0.02; HR, 0.62). Addition of Nap to IFN showed predicted and transient immune related AEs and the treatment had an acceptable safety profile. CONCLUSIONS The study did not meet its primary endpoint. Nap + IFN has an acceptable safety profile, and results from post hoc subgroup analyses showed that the treatment might improve OS/PFS in a baseline biomarker-defined RCC patient subgroup. The results warrant further studies with Nap in this subgroup. Clin Cancer Res; 22(13); 3172-81. ©2016 AACR.
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Affiliation(s)
| | - Martin Gore
- Royal Marsden Hospital NHS Trust, London, United Kingdom
| | - Yaroslav Shparyk
- State Regional Treatment and Diagnostics Oncology Center, Lviv, Ukraine
| | - Vladimir Bondar
- Public Clinical Treatment and Prophylaxis Institution, Donetsk, Ukraine
| | - Oleg Gladkov
- Chelyabinsk Regional Clinical Oncology Dispensary, Chelyabinsk, Russia
| | - Tosho Ganev
- Urology Clinic General Hospital for Active Treatment "St. Anna", Varna, Bulgaria
| | - Mihai Harza
- Fundeni Clinical Institute, Bucharest, Romania
| | - Serhii Polenkov
- Public Treatment and Prophylaxis Institution, Chernihiv Regional Oncology Center, Chernihiv, Ukraine
| | | | - Petr Karlov
- City Clinical Oncology Dispensary, St. Petersburg, Russia
| | - Oleg Karyakin
- Medical Radiological Research Center, Obninsk, Russia
| | | | | | | | | | - Timothy Eisen
- Cambridge University Health Partners, Addenbrooke's Hospital, Cambridge, United Kingdom
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Gladkov O, Moiseyenko V, Bondarenko IN, Shparyk Y, Barash S, Adar L, Avisar N. A Phase III Study of Balugrastim Versus Pegfilgrastim in Breast Cancer Patients Receiving Chemotherapy With Doxorubicin and Docetaxel. Oncologist 2015; 21:7-15. [PMID: 26668251 DOI: 10.1634/theoncologist.2015-0152] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 09/23/2015] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the efficacy and safety of once-per-cycle balugrastim versus pegfilgrastim for neutrophil support in breast cancer patients receiving myelosuppressive chemotherapy. METHODS Breast cancer patients (n = 256) were randomized to 40 or 50 mg of subcutaneous balugrastim or 6 mg of pegfilgrastim ≈24 hours after chemotherapy (60 mg/m(2) doxorubicin and 75 mg/m(2) docetaxel, every 21 days for up to 4 cycles). The primary efficacy parameter was the duration of severe neutropenia (DSN) in cycle 1. Secondary parameters included DSN (cycles 2-4), absolute neutrophil count (ANC) nadir, febrile neutropenia rates, and time to ANC recovery (cycles 1-4). Safety, pharmacokinetics, and immunogenicity were assessed. RESULTS Mean cycle 1 DSN was 1.0 day with 40 mg of balugrastim, 1.3 with 50 mg of balugrastim, and 1.2 with pegfilgrastim (upper limit of 95% confidence intervals for between-group DSN differences was <1.0 day for both balugrastim doses versus pegfilgrastim). Between-group efficacy parameters were comparable except for time to ANC recovery in cycle 1 (40 mg of balugrastim, 2.0 days; 50 mg of balugrastim, 2.1; pegfilgrastim, 2.6). Median terminal elimination half-life was ≈37 hours for 40 mg of balugrastim, ≈36 for 50 mg of balugrastim, and ≈45 for pegfilgrastim. Antibody response to balugrastim was low and transient, with no neutralizing effect. CONCLUSION Once-per-cycle balugrastim is not inferior to pegfilgrastim in reducing cycle 1 DSN in breast cancer patients receiving chemotherapy; both drugs have comparable safety profiles. IMPLICATIONS FOR PRACTICE This paper provides efficacy and safety data for a new, once-per-cycle granulocyte colony-stimulating factor, balugrastim, for the prevention of chemotherapy-induced neutropenia in patients with breast cancer receiving myelosuppressive chemotherapy. In this phase III trial, balugrastim was shown to be not inferior to pegfilgrastim in the duration of severe neutropenia in cycle 1 of doxorubicin/docetaxel chemotherapy, and the safety profiles of the two agents were similar. Once-per-cycle balugrastim is a safe and effective alternative to pegfilgrastim for hematopoietic support in patients with breast cancer receiving myelosuppressive chemotherapy associated with a greater than 20% risk of developing febrile neutropenia.
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Affiliation(s)
- Oleg Gladkov
- Chelyabinsk Regional Clinical Oncology Dispensary, Chelyabinsk, Russia
| | | | - Igor N Bondarenko
- Dnipropetrovsk Medical Academy, City Clinical Hospital, Dnipropetrovsk, Ukraine
| | | | - Steve Barash
- Teva Biopharmaceuticals, Rockville, Maryland, USA
| | - Liat Adar
- Teva Pharmaceuticals, Inc., Netanya, Israel
| | - Noa Avisar
- Teva Pharmaceuticals, Inc., Netanya, Israel
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Eisen T, Loembé AB, Shparyk Y, MacLeod N, Jones RJ, Mazurkiewicz M, Temple G, Dressler H, Bondarenko I. A randomised, phase II study of nintedanib or sunitinib in previously untreated patients with advanced renal cell cancer: 3-year results. Br J Cancer 2015; 113:1140-7. [PMID: 26448178 PMCID: PMC4647871 DOI: 10.1038/bjc.2015.313] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 07/29/2015] [Accepted: 07/31/2015] [Indexed: 01/07/2023] Open
Abstract
Background: This exploratory study evaluated the safety/efficacy of nintedanib or sunitinib as first-line therapy in patients with advanced renal cell carcinoma (RCC). Methods: Ninety-six patients were randomised (2:1) to either nintedanib (200 mg twice daily) or sunitinib (50 mg kg−1 once daily (4 weeks on treatment; 2 weeks off)). Primary endpoint was progression-free survival (PFS) at 9 months. P-values reported are descriptive only; the study was not powered for such comparisons. Results: Progression-free survival at 9 months was comparable between nintedanib and sunitinib (43.1% vs 45.2%, respectively; P=0.85). Median PFS was 8.4 months in each group (hazard ratio (HR), 1.12; 95% confidence interval (CI): 0.70–1.80; P=0.64). Median overall survival was 20.4 and 21.2 months for nintedanib and sunitinib, respectively (HR, 0.92; 95% CI: 0.54–1.56; P=0.76). Overall incidence of any grade adverse events (AEs) was comparable (90.6% vs 93.8%); AEs grade ⩾3 were lower with nintedanib than sunitinib (48.4% vs 59.4%). Nintedanib was associated with lower incidences of some AEs typical of antiangiogenic tyrosine kinase inhibitors (TKIs): hypertension, hypothyroidism, hand–foot syndrome, cardiac disorders and haematological abnormalities. Conclusions: In patients with advanced RCC, nintedanib has promising efficacy and similar tolerability to sunitinib, and a manageable safety profile with fewer TKI-associated AEs.
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Affiliation(s)
- T Eisen
- Department of Oncology, Cambridge University Health Partners, Addenbrooke's Hospital, Cambridge, UK
| | - A-B Loembé
- Medical Department, Boehringer Ingelheim B.V., Alkmaar, The Netherlands
| | - Y Shparyk
- Department of Chemotherapy, Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine
| | - N MacLeod
- Cancer Research UK Clinical Research Unit, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - R J Jones
- Cancer Research UK Clinical Research Unit, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | | | - G Temple
- Medical Department, Boehringer Ingelheim Ltd., Bracknell, UK
| | - H Dressler
- Global Pharmacovigilance, Boehringer Ingelheim Pharma GmbH, Ingelheim, Germany
| | - I Bondarenko
- Oncology Department, Dnipropetrovsk State Medical Academy, Clinical Hospital #4, Dnipropetrovsk, Ukraine
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Miles D, Cameron D, Bondarenko I, Lyudmila M, Alcedo J, Lopez R, Im S, Canon J, Shparyk Y, Yardley D, Masuda N, Ro J, Hubeaux S, Quah C, Bais C, O'Shaughnessy J. 1866 First results from the double-blind placebo (PL)-controlled randomised phase III MERiDiAN trial prospectively evaluating plasma (p)VEGF-A in patients (pts) receiving first-line paclitaxel (PAC) +/- bevacizumab (BV) for HER2-negative metastatic breast cancer (mBC). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30816-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Waller CF, Vynnychenko I, Bondarenko I, Shparyk Y, Hodge JP, Freeman A, Huber B, Lieberman R, Shelton MJ, Dave H. An Open-Label, Multicenter, Randomized Phase Ib/II Study of Eribulin Mesylate Administered in Combination With Pemetrexed Versus Pemetrexed Alone as Second-Line Therapy in Patients With Advanced Nonsquamous Non–Small-Cell Lung Cancer. Clin Lung Cancer 2015; 16:92-9. [DOI: 10.1016/j.cllc.2014.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 09/30/2014] [Accepted: 10/07/2014] [Indexed: 11/30/2022]
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Bang YJ, Qin S, Chung HC, Xu JM, Park JO, Jeziorski K, Shparyk Y, Hoff PM, Sobrero AF, Salman P, Li J, Protsenko S, Buyse ME, Afenjar K, Houe V, Garcia A, Huang Y, Armour A, Slamon DJ, Hecht JR. Post-hoc analyses of overall survival (OS) and progression-free survival (PFS) in the TRIO-013/LOGiC trial of lapatinib (L) in combination with capecitabine plus oxaliplatin (CapeOx). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.3_suppl.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
133 Background: Results of the primary and secondary endpoints (OS and PFS, respectively) in the primary efficacy population for the randomized, phase III trial (TRIO-013/LOGiC; NCT00680901), conducted in patients with advanced, HER2-positive upper gastrointestinal adenocarcinoma were previously presented (Hecht JR et al, ASCO 2013). Differences in OS were non-significant between the lapatinib (CapeOx + L) and placebo (CapeOx + P) arms. In prespecified analyses, a treatment effect of L was observed in Asian (majority Chinese or South Korean) patients and patients <60 years (y) when comparing OS in the two arms. Methods: Here, we present the results of post-hoc analyses in TRiO-013/LOGiC which assessed OS, PFS and safety by age and by region. Results: In the Asian subgroups, median OS was longer with L compared with P (see Table). In the rest of the world (ROW) subgroups, median OS was longer in patients <60 y but shorter in patients ≥60 y with L compared with P (see Table). Similar findings were observed for PFS in the 4 subgroups (see Table).More adverse events (AEs) were observed in the Asian subgroups; overall, the incidence of AEs (by region) was similar between age subgroups. Conclusions: OS and PFS were improved in Asian patients (both age subgroups) and younger patients in ROW given CapeOx + L, compared with CapeOx + P. The lower OS and PFS observed in older patients in the ROW subgroups may have affected the overall data. Further trials with CapeOx + L in Asian populations are being considered. Clinical trial information: NCT00680901. [Table: see text]
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Affiliation(s)
- Yung-Jue Bang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Shukui Qin
- PLA Cancer Center of Nanjing Bayi Hospital, Nanjing, China
| | - Hyun-Choel Chung
- Yonsei Cancer Center, Yonsei Cancer Research Institute, Seoul, South Korea
| | - Jian-Ming Xu
- Hospital Affiliated to Military Medical Science Academy, Beijing, China
| | - Joon Oh Park
- Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - Krzysztof Jeziorski
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Yaroslav Shparyk
- Lviv State Regional Oncology Med and Diagnostics Center, Lviv, Ukraine
| | - Paulo M. Hoff
- Sociedade Beneficente de Senhoras-Hospital Sirio Libanes, Sao Paolo, Brazil
| | - Alberto F. Sobrero
- Ospedale San Martino di Genova e Cliniche Universitarie Convenzionate Oncologia Medica, Genova, Italy
| | | | - Jin Li
- Cancer Hospital of Shanghai Fudan University, Shanghai, China
| | | | - Marc E. Buyse
- International Drug Development Institute, Leuven, Belgium
| | | | - Vincent Houe
- Translational Research In Oncology, Paris, France
| | | | | | | | - Dennis J. Slamon
- David Geffen School of Medicine at UCLA, Santa Monica, Los Angeles, CA
| | - J. Randolph Hecht
- David Geffen School of Medicine at UCLA, Santa Monica, Los Angeles, CA
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Finn RS, Crown JP, Lang I, Boer K, Bondarenko IM, Kulyk SO, Ettl J, Patel R, Pinter T, Schmidt M, Shparyk Y, Thummala AR, Voytko NL, Fowst C, Huang X, Kim ST, Randolph S, Slamon DJ. The cyclin-dependent kinase 4/6 inhibitor palbociclib in combination with letrozole versus letrozole alone as first-line treatment of oestrogen receptor-positive, HER2-negative, advanced breast cancer (PALOMA-1/TRIO-18): a randomised phase 2 study. Lancet Oncol 2014; 16:25-35. [PMID: 25524798 DOI: 10.1016/s1470-2045(14)71159-3] [Citation(s) in RCA: 1322] [Impact Index Per Article: 132.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Palbociclib (PD-0332991) is an oral, small-molecule inhibitor of cyclin-dependent kinases (CDKs) 4 and 6 with preclinical evidence of growth-inhibitory activity in oestrogen receptor-positive breast cancer cells and synergy with anti-oestrogens. We aimed to assess the safety and efficacy of palbociclib in combination with letrozole as first-line treatment of patients with advanced, oestrogen receptor-positive, HER2-negative breast cancer. METHODS In this open-label, randomised phase 2 study, postmenopausal women with advanced oestrogen receptor-positive and HER2-negative breast cancer who had not received any systemic treatment for their advanced disease were eligible to participate. Patients were enrolled in two separate cohorts that accrued sequentially: in cohort 1, patients were enrolled on the basis of their oestrogen receptor-positive and HER2-negative biomarker status alone, whereas in cohort 2 they were also required to have cancers with amplification of cyclin D1 (CCND1), loss of p16 (INK4A or CDKN2A), or both. In both cohorts, patients were randomly assigned 1:1 via an interactive web-based randomisation system, stratified by disease site and disease-free interval, to receive continuous oral letrozole 2.5 mg daily or continuous oral letrozole 2.5 mg daily plus oral palbociclib 125 mg, given once daily for 3 weeks followed by 1 week off over 28-day cycles. The primary endpoint was investigator-assessed progression-free survival in the intention-to-treat population. Accrual to cohort 2 was stopped after an unplanned interim analysis of cohort 1 and the statistical analysis plan for the primary endpoint was amended to a combined analysis of cohorts 1 and 2 (instead of cohort 2 alone). The study is ongoing but closed to accrual; these are the results of the final analysis of progression-free survival. The study is registered with the ClinicalTrials.gov, number NCT00721409. FINDINGS Between Dec 22, 2009, and May 12, 2012, we randomly assigned 165 patients, 84 to palbociclib plus letrozole and 81 to letrozole alone. At the time of the final analysis for progression-free survival (median follow-up 29.6 months [95% CI 27.9-36.0] for the palbociclib plus letrozole group and 27.9 months [25.5-31.1] for the letrozole group), 41 progression-free survival events had occurred in the palbociclib plus letrozole group and 59 in the letrozole group. Median progression-free survival was 10.2 months (95% CI 5.7-12.6) for the letrozole group and 20.2 months (13.8-27.5) for the palbociclib plus letrozole group (HR 0.488, 95% CI 0.319-0.748; one-sided p=0.0004). In cohort 1 (n=66), median progression-free survival was 5.7 months (2.6-10.5) for the letrozole group and 26.1 months (11.2-not estimable) for the palbociclib plus letrozole group (HR 0.299, 0.156-0.572; one-sided p<0.0001); in cohort 2 (n=99), median progression-free survival was 11.1 months (7.1-16.4) for the letrozole group and 18.1 months (13.1-27.5) for the palbociclib plus letrozole group (HR 0.508, 0.303-0.853; one-sided p=0.0046). Grade 3-4 neutropenia was reported in 45 (54%) of 83 patients in the palbociclib plus letrozole group versus one (1%) of 77 patients in the letrozole group, leucopenia in 16 (19%) versus none, and fatigue in four (4%) versus one (1%). Serious adverse events that occurred in more than one patient in the palbociclib plus letrozole group were pulmonary embolism (three [4%] patients), back pain (two [2%]), and diarrhoea (two [2%]). No cases of febrile neutropenia or neutropenia-related infections were reported during the study. 11 (13%) patients in the palbociclib plus letrozole group and two (2%) in the letrozole group discontinued the study because of adverse events. INTERPRETATION The addition of palbociclib to letrozole in this phase 2 study significantly improved progression-free survival in women with advanced oestrogen receptor-positive and HER2-negative breast cancer. A phase 3 trial is currently underway. FUNDING Pfizer.
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Affiliation(s)
- Richard S Finn
- University of California Los Angeles, Los Angeles, CA, USA
| | - John P Crown
- Irish Cooperative Oncology Research Group, Dublin, Ireland
| | - Istvan Lang
- Orszagos Onkologiai Intezet, Budapest, Hungary
| | - Katalin Boer
- Szent Margit Korhaz, Onkologia, Budapest, Hungary
| | - Igor M Bondarenko
- Dnipropetrovsk Medical Academy, City Multiple-Discipline Clinical Hospital 4, Dnipropetrovsk, Ukraine
| | - Sergey O Kulyk
- Municipal Treatment and Prophylactic Institution, Donetsk, Ukraine
| | | | | | | | | | - Yaroslav Shparyk
- Lviv State Oncologic Regional Treatment and Diagnostic Centre, Lviv, Ukraine
| | - Anu R Thummala
- Comprehensive Cancer Centers of Nevada, Las Vegas, NV, USA
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Hecht JR, Bang YJ, Qin S, Chung HC, Xu JM, Park JO, Jeziorski K, Shparyk Y, Hoff PM, Sobrero AF, Salman P, Li J, Protsenko S, Buyse ME, Afenjar K, Kaneko T, Kemner A, Santillana S, Press MF, Slamon DJ. Lapatinib in combination with capecitabine plus oxaliplatin (CapeOx) in HER2-positive advanced or metastatic gastric, esophageal, or gastroesophageal adenocarcinoma (AC): The TRIO-013/LOGiC Trial. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.18_suppl.lba4001] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
LBA4001 Background: HER2 amplification is common in upper GI tract (UGIT) adenocarcinomas and inhibition improves clinical outcomes. Lapatinib ditosylate (L), a dual anti EGFR and anti HER2 tyrosine kinase inhibitor with preclinical activity against these cancers, was investigated in a phase III, randomized, double blind trial evaluating efficacy and safety in combination with CapeOx as first-line treatment of advanced or metastatic HER2+ UGIT ACs. Methods: Subjects had measurable and/or non-measurable disease with overexpression or amplification of HER2 (IHC2+ and FISH amplified, or IHC 3+, or FISH, CISH, or SISH amplified). HER2 status was reviewed by the central lab. Subjects were randomized 1:1 to CapeOx q3w (oxaliplatin 130mg/m2 day 1; capecitabine 850mg/m2/BID days 1 – 14), and daily L (1250mg) (CapeOx+L) or placebo (CapeOx+P). The primary efficacy population (PEP) comprised all subjects whose tumors were centrally confirmed to be FISH amplified. The primary endpoint was overall survival (OS) of the PEP. Secondary endpoints included progression free survival (PFS), overall response rate (ORR) and safety. Results: 545 pts were randomized and 487 had HER2+ centrally confirmed. The primary endpoint was not reached with a hazard ratio (HR) for OS of CapeOx+L compared to CapeOx+P of 0.91 (95% CI 0.73, 1.12, p=0.35); median 12.2 vs. 10.5 months, respectively. HR for uncensored PFS was 0.86 (95% CI 0.71 - 1.04, p=0.10); median 6.0 vs. 5.4 months. The analysis of PFS censored by the time of subsequent anticancer therapy as per protocol showed a HR of 0.82 (95% CI 0.68, 1.00, p=0.04). ORR was 53% in the CapeOx+L arm and 40% in the CapeOx+P arm. Pre-specified subgroup analyses showed significant improvements in OS in Asian pts (HR= 0.68) and those under 60 years (HR=0.69). There was no association between IHC and OS. Toxicity profiles were similar except for increased overall diarrhea, and skin toxicity and grade 3+ diarrhea (12 vs 3%) with CapeOx+L. Conclusions: The addition of L to CapeOx did not reach its primary endpoint, though certain subgroups showed improvement. Further clinical and molecular analyses will be presented. Clinical trial information: NCT00680901.
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Affiliation(s)
- J. Randolph Hecht
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA
| | - Yung-Jue Bang
- Seoul National University Hospital, Seoul, South Korea
| | - Shukui Qin
- Nanjing Yanggongjing Hospital, Nanjing, China
| | - Hyun-Chul Chung
- Yonsei University College of Medicine Severance Hospital, Yonsei, South Korea
| | - Jian-Ming Xu
- Cancer Center, 307 Hospital, Academy of Military Medical Science, Beijing, China
| | - Joon Oh Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - Yaroslav Shparyk
- Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine
| | - Paulo M. Hoff
- Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil
| | | | | | - Jin Li
- Fudan University Shanghai Cancer Center, Shanghai, China
| | | | - Marc E. Buyse
- International Drug Development Institute, Louvain la Neuve, Belgium
| | | | | | | | | | | | - Dennis J. Slamon
- University of California, Los Angeles, School of Medicine/Translational Oncology Research Laboratory, Los Angeles, CA
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Eisen T, Shparyk Y, Jones R, MacLeod NJ, Temple G, Finnigan H, Kaiser R, Studeny M, Loembe AB, Bondarenko I. Phase II efficacy and safety study of nintedanib versus sunitinib in previously untreated renal cell carcinoma (RCC) patients. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.4506] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4506 Background: Sunitinib (S) is established as a standard first-line therapy for patients (pts) with advanced RCC. However, treatment can be limited by the occurrence of drug-related adverse events (AEs). This Phase II study assessed the efficacy and safety of nintedanib (N) – a potent, triple angiokinase inhibitor of VEGFR-1–3, PDGFR-α/β, and FGFR-1–3, as well as RET and Flt3 – vs S in previously untreated pts with RCC. Methods: Ninety-nine eligible pts (96 of whom were treated) with advanced, unresectable/recurrent clear cell RCC, an ECOG performance status of 0–1, and no prior systemic therapy were randomized 2:1 to receive N 200 mg twice daily (n=64; given in 4-week cycles) or S 50 mg once daily (n=32; 4 weeks on, 2 weeks off schedule). Treatment continued until disease progression or unacceptable drug-related AEs. Primary endpoints were progression-free survival at 9 months (PFS-9) and, in N-treated pts only, QTc interval change (baseline to day 15). Secondary endpoints included PFS, objective response rate (ORR; RECIST 1.1), overall survival (OS), time to progression (TTP), time to treatment failure (TTF), and AEs. Results: Baseline characteristics were balanced between the arms. PFS-9 was not statistically significantly different between N- and S-treated pts (43 vs 45%; p=0.85). There were also no statistically significant differences between N and S with regard to PFS (median: 8.44 vs 8.38 mo; hazard ratio: 1.16; 95% CI: 0.71–1.89; p=0.56), confirmed ORR (18.8 vs 31.3%; p=0.19), OS (median: 20.37 vs 21.22 mo; p=0.63), TTP (median: 8.48 vs 8.54 mo; p=0.52), and TTF (median: 8.41 vs 8.36 mo; p=0.46). Grade ≥3 AEs occurred in 47% of N-treated pts and 56% of S-treated pts. Common AEs (all grades; N vs S) included diarrhea (61 vs 50%), nausea (38 vs 34%), fatigue (both 25%), and vomiting (16 vs 22%). Dermatologic AEs (8 vs 47%) were less frequent with N than S. There was no increase from baseline in QTc >60 ms on days 1 or 15 in N-treated pts, and there was no relationship between N exposure and QT interval change. Conclusions: N demonstrated similar efficacy to S and had a manageable safety profile, including a lower incidence of dermatologic AEs vs S. In addition, N was not associated with QT prolongation. Clinical trial information: NCT01024920.
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Affiliation(s)
- Tim Eisen
- Cambridge University Health Partners, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Yaroslav Shparyk
- Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine
| | - Robert Jones
- Cancer Research UK Clinical Research Unit (CRU), Glasgow, United Kingdom
| | | | - Graham Temple
- Boehringer Ingelheim GmbH, Bracknell, United Kingdom
| | | | - Rolf Kaiser
- Boehringer Ingelheim GmbH, Biberach, Germany
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Hecht JR, Bang YJ, Qin S, Chung HC, Xu JM, Park JO, Jeziorski K, Shparyk Y, Hoff PM, Sobrero AF, Salman P, Li J, Protsenko S, Buyse ME, Afenjar K, Kaneko T, Kemner A, Santillana S, Press MF, Slamon DJ. Lapatinib in combination with capecitabine plus oxaliplatin (CapeOx) in HER2 positive advanced or metastatic gastric (A/MGC), esophageal (EAC), or gastroesophageal (GEJ) adenocarcinoma: The LOGiC trial. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.lba4001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA4001 The full, final text of this abstract will be available at abstract.asco.org at 7:30 AM (EDT) on Monday, June, 3, 2013, and in the Annual Meeting Proceedings online supplement to the June 20, 2013, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Monday edition of ASCO Daily News.
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Affiliation(s)
- J. Randolph Hecht
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA
| | - Yung-Jue Bang
- Seoul National University Hospital, Seoul, South Korea
| | - Shukui Qin
- Nanjing Yanggongjing Hospital, Nanjing, China
| | - Hyun-Chul Chung
- Yonsei University College of Medicine Severance Hospital, Yonsei, South Korea
| | - Jian-Ming Xu
- Cancer Center, 307 Hospital, Academy of Military Medical Science, Beijing, China
| | - Joon Oh Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - Yaroslav Shparyk
- Lviv State Oncology Regional Treatment and Diagnostic Centre, Lviv, Ukraine
| | - Paulo M. Hoff
- Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil
| | | | | | - Jin Li
- Fudan University Shanghai Cancer Center, Shanghai, China
| | | | - Marc E. Buyse
- International Drug Development Institute, Louvain la Neuve, Belgium
| | | | | | | | | | | | - Dennis J. Slamon
- University of California, Los Angeles, School of Medicine/Translational Oncology Research Laboratory, Los Angeles, CA
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Hawkins RE, Gore ME, Shparyk Y, Bondar V, Gladkov O, Ganev T, Harza M, Polenkov S, Bondarenko I, Karlov PA, Karyakin O, Khasanov R, Hedlund GE, Forsberg G, Nordle O, Eisen T. A randomized phase II/III study of naptumomab estafenatox plus IFN-α versus IFN-α in advanced renal cell carcinoma. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.3073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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
3073 Background: Naptumomab estafenatox/ANYARA (Nap) is a fusion protein of an antibody (5T4) and a superantigen (SEA/E-120). After phase I studies (Borghaei. J Clin Oncol. 2009, 27:4116) a prospective, randomized phase II/III trial of Nap + IFN-α (A) vs IFN-α (I) was conducted. Methods: Patients (pts) with RCC were randomized in an open label study to receive A or I. The primary endpoint was OS. Secondary endpoints were PFS, response rate and safety. Baseline (bl) plasma IL-6 was predictive of pazopanib (Tran. Lancet Oncol. 2012, 13:827) and MVA-5T4 vaccine (Harrop. Cancer Immunol Immunother. 2012, 61:2283) benefit in RCC pts. IL-6 and anti-SEA/E-120 antibodies (a-S) were analyzed. A subgroup SG1 had bl levels below median for IL-6 (<7 pg/ml) and a-S. Another subgroup SG2 had IL-6 below 13 pg/ml (Tran. Lancet Oncol. 2012, 13:827) and excluding upper quartile of a-S according to phase 1 levels (Borghaei. J Clin Oncol. 2009, 27:4116). Results: From 5/2007 to 10/2010 513 pts were treated (ITT) with a median follow-up time for censored pts of 43 months. Unexpectedly, pts in certain territories had increased bl a-S (median of 61 pmol/ml in Russia vs 34 in UK). The table summarizes efficacy results. The primary endpoint was not met. Multivariate analysis adjusted for risk scores and subsequent TKI usage verified Nap benefit in pts with low IL-6 and normal a-S. Nap was well tolerated. Pyrexia (A:46%/I:18%), nausea (21%/11%), back pain (18%/6%), vomiting (16%/7%) and chills (12%/4%) were more common after Nap. Conclusions: The study did not meet primary endpoint. In pts with low IL-6 and normal levels of a-S, addition of Nap to IFN-α improves OS and PFS. The results warrant further studies with Nap in sequence or combo with e.g. TKIs in this subgroup. More generally, as bl IL-6 appears to be prognostic and predictive of outcome on treatment with TKIs and immunotherapies this may be a stratification factor for RCC studies. Clinical trial information: NCT00420888. [Table: see text]
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Affiliation(s)
- Robert E. Hawkins
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | | | - Yaroslav Shparyk
- State Regional Treatment and Diagnostics Oncology Center, Lviv, Ukraine
| | - Vladimir Bondar
- Public Clinical Treatment and Prophylaxis Institution, Donetsk, Ukraine
| | - Oleg Gladkov
- Chelyabinsk Regional Clinical Oncology Center, Chelyabinsk, Russia
| | - Tosho Ganev
- Urology Clinic General Hospital for Active Treatment “St. Anna”, Varna, Bulgaria
| | - Mihai Harza
- Fundeni Clinical Institute, Bucharest, Romania
| | - Serhii Polenkov
- Public Treatment and Prophylaxis Institution: Chernihiv Regional Oncology Center, Chernihiv, Ukraine
| | | | - Petr A Karlov
- City Clinical Oncology Dispensary, St. Petersburg, Russia
| | - Oleg Karyakin
- Medical Radiological Research Center, Obninsk, Russia
| | | | | | | | | | - Tim Eisen
- Cambridge University Health Partners, Addenbrooke’s Hospital, Cambridge, United Kingdom
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Carrato A, Swieboda-Sadlej A, Staszewska-Skurczynska M, Lim R, Roman L, Shparyk Y, Bondarenko I, Jonker DJ, Sun Y, De la Cruz JA, Williams JA, Korytowsky B, Christensen JG, Lin X, Tursi JM, Lechuga MJ, Van Cutsem E. Fluorouracil, leucovorin, and irinotecan plus either sunitinib or placebo in metastatic colorectal cancer: a randomized, phase III trial. J Clin Oncol 2013; 31:1341-7. [PMID: 23358972 DOI: 10.1200/jco.2012.45.1930] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This double-blind, phase III study aimed to demonstrate that sunitinib plus FOLFIRI (fluorouracil, leucovorin, and irinotecan) was superior to placebo plus FOLFIRI in previously untreated metastatic colorectal cancer (mCRC). PATIENTS AND METHODS Patients were randomly assigned to receive FOLFIRI and either sunitinib (37.5 mg per day) or placebo (4 weeks on treatment, followed by 2 weeks off [schedule 4/2]) until disease progression. The primary end point was progression-free survival (PFS). Secondary end points included overall survival, safety, and patient-reported outcomes. The correlation between genotype and clinical outcomes was also analyzed. RESULTS In all, 768 patients were randomly assigned to sunitinib plus FOLFIRI (n = 386) or placebo plus FOLFIRI (n = 382). Following a second prespecified interim analysis, the study was stopped because of potential futility of sunitinib plus FOLFIRI. Final results are reported. The PFS hazard ratio was 1.095 (95% CI, 0.892 to 1.344; one-sided stratified log-rank P = .807), indicating a lack of superiority for sunitinib plus FOLFIRI. Median PFS for the sunitinib arm was 7.8 months (95% CI, 7.1 to 8.4 months) versus 8.4 months (95% CI, 7.6 to 9.2 months) for the placebo arm. Sunitinib plus FOLFIRI was associated with more grade ≥ 3 adverse events and laboratory abnormalities than placebo (especially diarrhea, stomatitis/oral syndromes, fatigue, hand-foot syndrome, neutropenia, thrombocytopenia, anemia, and febrile neutropenia). More deaths as a result of toxicity (12 v four) and significantly more dose delays, dose reductions, and treatment discontinuations occurred in the sunitinib arm. CONCLUSION Sunitinib 37.5 mg per day (schedule 4/2) plus FOLFIRI is not superior to FOLFIRI alone and has a poorer safety profile. This combination regimen is not recommended for previously untreated mCRC.
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Affiliation(s)
- Alfredo Carrato
- Medical Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain.
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Finn RS, Crown JP, Lang I, Boer K, Bondarenko IM, Kulyk SO, Ettl J, Patel R, Pinter T, Schmidt M, Shparyk Y, Thummala AR, Voytko NL, Breazna A, Kim ST, Randolph S, Slamon DJ. Abstract S1-6: Results of a randomized phase 2 study of PD 0332991, a cyclin-dependent kinase (CDK) 4/6 inhibitor, in combination with letrozole vs letrozole alone for first-line treatment of ER+/HER2− advanced breast cancer (BC). Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-s1-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: PD 0332991, a selective inhibitor of CDK 4/6, prevents cellular DNA synthesis by blocking cell cycle progression. Preclinical studies in a BC cell line panel identified the luminal ER subtype, elevated expression of cyclin D1 and Rb protein, and reduced p16 expression as being associated with sensitivity to PD 0332991 (Finn et al. 2009). Synergistic activity was also observed in vitro when combined with tamoxifen. After determination of the recommended phase 2 dose in combination with letrozole (letrozole 2.5 mg QD plus PD 0332991 125 mg QD on Schedule 3/1), a randomized phase 2 study comparing letrozole alone (L) to letrozole plus PD 0332991 (L+P) was initiated.
Methods: The phase 2 portion of the study was designed as a two-part study; Part 1 enrolled post- menopausal women with ER+/HER2− advanced BC; Part 2 in addition to ER+/HER2− as eligibility criteria, screened for CCND1 amplification and/or loss of p16 by FISH. The primary endpoint is progression-free survival (PFS); secondary endpoints include response rate, overall survival, safety, and correlative biomarker studies. In both parts, post-menopausal women with ER+/HER2− advanced BC were randomized 1:1 to receive letrozole either with or without PD 0332991. Pts continue on assigned study treatment until disease progression, unacceptable toxicity, or consent withdrawal, and are followed for tumor assessments every 2 months.
Results: 66 pts were randomized in Part 1 and 99 pts in Part 2. Preliminary results from Part 1 of this study have been previously reported (IMPAKT Breast Cancer Conference, Abstract #292, Finn et al. May 2012) demonstrating a significant improvement in median PFS in the L+P vs. L arm (HR = 0.35; 95% CI, 0.17 to 0.72; p = 0.006). With the additional 99 pts randomized in Part 2 (N = 165), the statistically significant improvement in median PFS (26.2 vs. 7.5 months, respectively) continues to be observed with a HR=0.32 (95% CI, 0.19 to 0.56) with p <0.001. The response rate for the L+P arm (n = 84) was 31% vs. 26% for the L arm (n = 81) and the clinical benefit rate was 68% vs. 44%, respectively. The most commonly reported treatment-related AEs in the combination arm were neutropenia, leukopenia, anemia, and fatigue. The updated results from the combined Part 1 and Part 2 group will be presented in December 2012.
Conclusions: The combination of PD 0332991 and letrozole is well tolerated and shows encouraging clinical benefit, confirming the sensitivity of ER+ BC to PD 0332991 observed in preclinical models. A phase 3 trial in this setting will commence in 2013.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr S1-6.
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Affiliation(s)
- RS Finn
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - JP Crown
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - I Lang
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - K Boer
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - IM Bondarenko
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - SO Kulyk
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - J Ettl
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - R Patel
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - T Pinter
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - M Schmidt
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - Y Shparyk
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - AR Thummala
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - NL Voytko
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - A Breazna
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - ST Kim
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - S Randolph
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
| | - DJ Slamon
- University of California, Los Angeles, Los Angeles, CA; Irish Cooperative Oncology Research Group, Dublin, Ireland; Orszagos Onkologiai Intezet, Budapest, Hungary; Szent Margit Korhaz, Budapest, Hungary; Dnipropetrovsk City Multiple-Discipline Clinical Hospital, Ukraine; Municipal Treatment-and-Prophylactic Institution “Donetsk City Oncological Dispensary”, Ukraine; Technical University of Munich, Germany; Comprehensive Blood and Cancer Center, Bakersfield, CA; Petz Aladar Megyei Oktato Korhaz, Gyor, Hungary; University Hospital Mainz, Mainz, Germany; Lviv State Oncologic Regional Treatment and Diagnostic Center, Ukraine; Comprehensive Cancer Centers of Nevada, Henderson, NV; Kyiv City Clinical Oncology Center, Ukraine; Pfizer Oncology, New York, NY; Pfizer Oncology, San Diego, CA
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Eisen T, Shparyk Y, MacLeod NJ, Wallenstein G, Temple G, Khder Y, Dallinger C, Studeny M, Loembe AB, Bondarenko IN. Effects of nintedanib (BIBF 1120) on QTc interval in previously untreated patients with renal cell cancer (RCC): Results from an open-label, phase II study. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e15037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15037 Background: Nintedanib (BIBF 1120), an angiokinase inhibitor of VEGFR 1–3, PDGFR-α/-β, and FGFR 1–3, has shown clinical activity with a good safety profile in patients (pts) with solid tumors in previous Phase II clinical trials. Several classes of targeted agents are associated with QT prolongation, including the multi-targeted tyrosine kinase inhibitors. Here, we prospectively evaluated the cardiac safety of nintedanib, specifically assessing the QT liability in an open-label, randomized, phase II efficacy and safety study of nintedanib vs sunitinib in pts with previously untreated RCC. Methods: Eligible pts (advanced, measurable, unresectable, recurrent RCC, ECOG PS 0–1, chemo-naïve, life expectancy >3 months) were randomized to receive either nintedanib 200 mg bid or sunitinib 50 mg od in a 2:1 ratio. Time-matched electrocardiograms of patients treated with nintedanib were collected over 12 hrs. Primary endpoint was the time-matched change from baseline (Day –1 prior nintedanib dosing) to Day 15 (steady-state) in the QTcF interval (QT interval corrected for heart rate dependency by the Fridericia formula) observed at each timepoint. PK parameters were determined and AEs were reported until Day 15. Results: 64 pts were treated with nintedanib. Estimated mean time-matched changes in the QTcF interval (ms) from baseline to Day 15 ranged from –1.7 (90% CI: –4.9, 1.6) at 2 hrs to 3.1 (90% CI: –0.2, 6.4) at 7 hrs. Upper CIs at all timepoints were <10 ms, the ICH E14 guideline threshold level of regulatory concern. Changes from baseline to Day 1 and changes in QT interval were also within the threshold of 10 ms. No pts showed a QTcF or a QT value >500 ms at baseline, Day 1 or Day 15, and no patient experienced an increase from baseline in QTcF >60 ms on Days 1 and 15. PK/QTc analyses did not indicate any relationship between exposure to nintedanib and a change from baseline in QTcF or the QT interval. The most frequently reported drug-related AEs were nausea (14.1%), diarrhea (12.5%) and vomiting (6.3%). Conclusions: Single and multiple doses of 200 mg nintedanib administered until steady-state did not prolong the QTcF interval compared with baseline in pts with RCC.
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Affiliation(s)
- Tim Eisen
- Cambridge University Hospitals NHS Foundation Trust, Department of Oncology, Cambridge, United Kingdom
| | - Yaroslav Shparyk
- Lviv State Regional Oncological Centre of Therapy and Diagnosis, Lviv, Ukraine
| | | | | | | | | | | | - Matus Studeny
- Boehringer Ingelheim RCV GmbH & Co. KG, Vienna, Austria
| | | | - Igor N. Bondarenko
- Dnipropetrovsk Medical Academy under the Ministry of Health of Ukraine, Dnipropetrovsk, Ukraine
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Vrdoljak E, Ciuleanu T, Kharkevich G, Mardiak J, Mego M, Padrik P, Petruželka L, Purkalne G, Shparyk Y, Škrbinc B, Szczylik C, Torday L. Optimizing treatment for patients with metastatic renal cell carcinoma in the central and Eastern European region. Expert Opin Pharmacother 2011; 13:159-74. [DOI: 10.1517/14656566.2012.647406] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ibrahim NK, Yariz KO, Bondarenko I, Manikhas A, Semiglazov V, Alyasova A, Komisarenko V, Shparyk Y, Murray JL, Jones D, Senderovich S, Chau A, Erlandsson F, Acton G, Pegram M. Randomized phase II trial of letrozole plus anti-MUC1 antibody AS1402 in hormone receptor-positive locally advanced or metastatic breast cancer. Clin Cancer Res 2011; 17:6822-30. [PMID: 21878535 DOI: 10.1158/1078-0432.ccr-11-1151] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE AS1402 is a humanized immunoglobulin G1 antibody that targets the aberrantly glycosylated antigen MUC1, which is overexpressed in 90% of breast tumors and contributes to estrogen-mediated growth and survival of breast cancer cells in vitro by modulating estrogen receptor (ER) activity. Aromatase inhibitors have been reported to enhance antibody-dependent cell-mediated cytotoxicity elicited by antibodies in vitro. We compared the outcomes of patients with breast cancer treated with letrozole with or without AS1402. EXPERIMENTAL DESIGN The study population included 110 patients with locally advanced or metastatic hormone receptor-positive breast cancer randomized to receive 2.5 mg letrozole only once daily or with a weekly 9 mg/kg AS1402 infusion. The primary endpoint was overall response rate. Secondary endpoints included progression-free survival, time to progression, and safety. AS1402 exposure and influence of allotypes of FcγRIIIa, FcγRIIa, and MUC1 were evaluated. RESULTS The study was stopped early because of a trend toward worse response rates and a higher rate of early disease progression in the AS1402 + letrozole arm. Final analysis revealed no significant difference in efficacy between the study arms. Evaluated gene polymorphisms did not define patient subgroups with improved outcomes. Addition of AS1402 to letrozole was associated with manageable toxicity. CONCLUSIONS Because adding AS1402 to letrozole did not improve outcomes compared with letrozole only, blocking ER may be a better strategy for harnessing MUC1 modulation of the ER to a clinical advantage. FcγRIIIa, FcγRIIa, and MUC1 allotype did not predict outcome for patients treated with letrozole with or without AS1402.
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Affiliation(s)
- Nuhad K Ibrahim
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
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Kitsera N, Shparyk Y, Polishchuk R. P158 Breast cancer frequency in families with a child having acute lymphoblastic leukemia. Breast 2007. [DOI: 10.1016/s0960-9776(07)70218-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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O'Brien MER, Ciuleanu TE, Tsekov H, Shparyk Y, Cuceviá B, Juhasz G, Thatcher N, Ross GA, Dane GC, Crofts T. Phase III trial comparing supportive care alone with supportive care with oral topotecan in patients with relapsed small-cell lung cancer. J Clin Oncol 2006; 24:5441-7. [PMID: 17135646 DOI: 10.1200/jco.2006.06.5821] [Citation(s) in RCA: 410] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE For patients with small-cell lung cancer (SCLC), further chemotherapy is routinely considered at relapse after first-line therapy. However, proof of clinical benefit has not been documented. PATIENTS AND METHODS This study randomly assigned patients with relapsed SCLC not considered as candidates for standard intravenous therapy to best supportive care (BSC) alone (n = 70) or oral topotecan (2.3 mg/m2/d, days 1 through 5, every 21 days) plus BSC (topotecan; n = 71). RESULTS In the intent-to-treat population, survival (primary end point) was prolonged in the topotecan group (log-rank P = .0104). Median survival with BSC was 13.9 weeks (95% CI, 11.1 to 18.6) and with topotecan, 25.9 weeks (95% CI, 18.3 to 31.6). Statistical significance for survival was maintained in a subgroup of patients with a short treatment-free interval (< or = 60 days). Response to topotecan was 7% partial and 44% stable disease. Patients on topotecan had slower quality of life deterioration and greater symptom control. Principal toxicities with topotecan were hematological: grade 4 neutropenia, 33%; grade 4 thrombocytopenia, 7%; and grade 3/4 anemia, 25%. Comparing topotecan with BSC, infection grade 2 was 14% versus 12% and sepsis 4% versus 1%; other grade 3/4 events included vomiting 3% versus 0, diarrhea 6% versus 0, dyspnea 3% versus 9%, and pain 3% versus 6%. Toxic deaths occurred in four patients (6%) in the topotecan arm. All cause mortality within 30 days of random assignment was 13% on BSC and 7% on topotecan. CONCLUSION Chemotherapy with oral topotecan is associated with prolongation of survival and quality of life benefit in patients with relapsed SCLC.
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Affiliation(s)
- Mary E R O'Brien
- Royal Marsden Hospital, National Health System Trust, Sutton, Surrey, England. mary.o'
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Gatzemeier U, Freund M, Haas S, Kakkar A, Zatloukal P, Kelbel C, Tchibisov L, Shparyk Y, Ciuleanu T, Huisman M. O-163 Prevention of thromboembolic complications with the low-molecular-weight heparin certoparin in non-small-cell lung carcinoma (TOPIC-2). Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80297-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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O'Brien M, Ciuleanu T, Tsekov H, Shparyk Y, Cucevic B, Juhasz G, Ross G, Dane G, Crofts T. O-157 Survival benefit of oral topotecan plus supportive care versus supportive care alone in relapsed, resistant SCLC. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80291-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abramyuk A, Shparyk Y. Metastatic brain involvement in children with Ewing's sarcoma. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)80844-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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