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Jaradat E, Meziane A, Lamprou DA. Conventional vs PEGylated loaded liposomal formulations by microfluidics for delivering hydrophilic chemotherapy. Int J Pharm 2024; 655:124077. [PMID: 38569975 DOI: 10.1016/j.ijpharm.2024.124077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/05/2024]
Abstract
Developing drug delivery systems (DDSs) is one of the approaches used to improve cancer treatment, with the main goal of loading cancer drugs into a carrier targeting a specific organ and avoiding the distribution to healthy tissues. Nanoparticles (NPs) have been shown to be one of the optimum carriers that can be used as DDSs. Lipid-based NPs, such as liposomes, have been investigated in the current study due to their low toxicity and ability to carry hydrophilic and hydrophobic molecules. In the current studies, conventional liposomes composed of DPPC, and cholesterol and PEGylated liposomes composed of DPPC, cholesterol, and DSPE-PEG2000 are manufactured and loaded with Carboplatin. The study focused on investigating and comparing the impact of modifying the carboplatin-loaded liposomes with different concentrations of DSPE-PEG2000 on the NP diameter, polydispersity, ζ-potential, encapsulation efficiency (EE%), and drug release. The hydrodynamic microfluidic system was used to investigate any possible improvement in the EE% over other conventional methods. The results showed the microfluidic system's promising effect in enhancing the EE% of the Carboplatin. Moreover, the results showed a smaller diameter and higher stability of the PEGylated liposome. However, conventional liposomes represent better homogeneity and higher encapsulation efficiency for hydrophilic molecules.
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Affiliation(s)
- Eman Jaradat
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | | | - Dimitrios A Lamprou
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
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Habashy KJ, Dmello C, Chen L, Arrieta VA, Kim KS, Gould A, Youngblood MW, Bouchoux G, Burdett KB, Zhang H, Canney M, Stupp R, Sonabend AM. Paclitaxel and Carboplatin in Combination with Low-intensity Pulsed Ultrasound for Glioblastoma. Clin Cancer Res 2024; 30:1619-1629. [PMID: 38295144 DOI: 10.1158/1078-0432.ccr-23-2367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 11/22/2023] [Accepted: 01/29/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE We recently reported on clinical trials for patients with recurrent glioblastoma where low-intensity pulsed ultrasound and microbubbles (LIPU/MB) improved paclitaxel or carboplatin delivery into the brain. Here, we report variable local tumor control with paclitaxel at the maximal/target dose in our phase I trial (NCT04528680). To address this, we investigated the combination of paclitaxel with carboplatin in preclinical glioma models. EXPERIMENTAL DESIGN We performed MRI-based analysis to evaluate disease control in patients from our trial. We studied the cytotoxicity of paclitaxel and carboplatin against 11 human glioma lines as monotherapy and in combination at concentrations derived from human intraoperative studies. Synergy was assessed with the Loewe model and the survival benefit evaluated in two xenografts. We examined the effects on cell cycle progression, DNA damage, and apoptosis. RESULTS Patients treated with paclitaxel and LIPU/MB exhibited variable local tumor control, which correlated with overall survival. We observed limited cross-resistance to paclitaxel and carboplatin in glioma lines, with almost a third of them being exclusively susceptible to one drug. This combination led to susceptibility of 81% of lines and synergy in 55% of them. The combination proved more efficacious in two intracranial xenografts when administered with LIPU/MB, leading to complementary effects on cell cycle arrest. CONCLUSIONS Combining paclitaxel and carboplatin in gliomas may be more efficacious than monotherapy, as in other cancers, due to synergy and independent susceptibility to each drug. These results form the basis for an ongoing phase II trial (NCT04528680) where we investigate this combination with LIPU/MB.
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Affiliation(s)
- Karl J Habashy
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Northwestern Medicine Lou and Jean Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Crismita Dmello
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Northwestern Medicine Lou and Jean Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Li Chen
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Northwestern Medicine Lou and Jean Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Victor A Arrieta
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Northwestern Medicine Lou and Jean Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kwang-Soo Kim
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Northwestern Medicine Lou and Jean Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Andrew Gould
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Northwestern Medicine Lou and Jean Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Mark W Youngblood
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Northwestern Medicine Lou and Jean Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Kirsten B Burdett
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Hui Zhang
- Northwestern Medicine Lou and Jean Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Roger Stupp
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Northwestern Medicine Lou and Jean Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Division of Hematology/Oncology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Adam M Sonabend
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Northwestern Medicine Lou and Jean Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Park S, Kim TM, Han JY, Lee GW, Shim BY, Lee YG, Kim SW, Kim IH, Lee S, Kim YJ, Park JH, Park SG, Lee KH, Kang EJ, Kim JW, Shin SH, Ock CY, Nam BH, Lee J, Jung HA, Sun JM, Lee SH, Ahn JS, Ahn MJ. Phase III, Randomized Study of Atezolizumab Plus Bevacizumab and Chemotherapy in Patients With EGFR- or ALK-Mutated Non-Small-Cell Lung Cancer (ATTLAS, KCSG-LU19-04). J Clin Oncol 2024; 42:1241-1251. [PMID: 37861993 DOI: 10.1200/jco.23.01891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
PURPOSE In the treatment of non-small-cell lung cancer (NSCLC) with a driver mutation, the role of anti-PD-(L)1 antibody after tyrosine kinase inhibitor (TKI) remains unclear. This randomized, open-label, multicenter, phase III study evaluates the efficacy of atezolizumab plus bevacizumab, paclitaxel, and carboplatin (ABCP ) in EGFR- or ALK-mutated NSCLC that progressed before TKI therapy. MATERIALS AND METHODS We compared the clinical efficacy of ABCP followed by maintenance therapy with atezolizumab plus bevacizumab with pemetrexed plus carboplatin or cisplatin (PC) followed by pemetrexed maintenance. The primary end point was progression-free survival (PFS). RESULTS A total of 228 patients with activating EGFR mutation (n = 215) or ALK translocation (n = 13) were enrolled from 16 sites in the Republic of Korea and randomly assigned at 2:1 ratio to either ABCP (n = 154) or PC arm (n = 74). The median follow-up duration was 26.1 months (95% CI, 24.7 to 28.2). Objective response rates (69.5% v 41.9%, P < .001) and median PFS (8.48 v 5.62 months, hazard ratio [HR], 0.62 [95% CI, 0.45 to 0.86]; P = .004) were significantly better in the ABCP than PC arm. PFS benefit increased as PD-L1 expression increased, with an HR of 0.47, 0.41, and 0.24 for PD-L1 ≥1%, ≥10%, and ≥50%, respectively. Overall survival was similar between ABCP and PC arm (20.63 v 20.27 months, HR, 1.01 [95% CI, 0.69 to 1.46]; P = .975). The safety profile of the ABCP arm was comparable with that previously reported, with no additional safety signals, but higher rates of treatment-related adverse events were observed compared with the PC arm. CONCLUSION To our knowledge, this study is the first randomized phase III study to demonstrate the clinical benefit of anti-PD-L1 antibody in combination with bevacizumab and chemotherapy in patients with EGFR- or ALK-mutated NSCLC who have progressed on relevant targeted therapy.
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Affiliation(s)
- Sehhoon Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University Cancer Research Institute, Seoul, Korea
| | - Ji-Youn Han
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si Gyeonggi-do, Korea
| | - Gyeong-Won Lee
- Divisions of Hematology and Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Byoung Yong Shim
- Division of Medical Oncology, Department of Internal Medicine, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun-Gyoo Lee
- Division of Hematology & Medical Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang-We Kim
- Division of Oncology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il Hwan Kim
- Department of Internal Medicine, Division of Hemato-Oncology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Suee Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Yu Jung Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Hyun Park
- Department of Hemato-oncololgy, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Sang-Gon Park
- Department of Internal Medicine, Hemato-oncology, Chosun University Hospital, Gwangju, Korea
| | - Ki Hyeong Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Eun Joo Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ju Won Kim
- Divisions of Hematology-Oncology, Department of Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seong-Hoon Shin
- Division of Hemato-Oncology, Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | | | | | | | - Hyun-Ae Jung
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong-Mu Sun
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se-Hoon Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Seok Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung-Ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Mennecier B, Khalifa J, Descourt R, Greillier L, Naltet C, Falchero L. Real-life clinical management patterns in extensive-stage small cell lung cancer across France: a multi-method study. BMC Cancer 2024; 24:421. [PMID: 38580937 PMCID: PMC10996204 DOI: 10.1186/s12885-024-12117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 03/12/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND We designed this study based on both a physician practice survey and real-world patient data to: (1) evaluate clinical management practices in extensive-stage small cell lung cancer (ES-SCLC) among medical centers located across France; and (2) describe first-line treatment patterns among patients with ES-SCLC following the introduction of immunotherapy into clinical practice. METHODS A 50-item questionnaire was completed by physicians from 45 medical centers specialized in SCLC management. Responses were collected from June 2022 to January 2023. The survey questions addressed diagnostic workup of ES-SCLC, chemoimmunotherapy in first-line and second-line settings, and use of prophylactic cranial irradiation (PCI) and radiotherapy. In parallel, using a chart review approach, we retrospectively analyzed aggregated information from 548 adults with confirmed ES-SCLC receiving first-line treatment in the same centers. RESULTS In ES-SCLC, treatment planning is based on chest computed tomography (CT) (as declared by 100% of surveyed centers). Mean time between diagnosis and treatment initiation was 2-7 days, as declared by 82% of centers. For detection of brain metastases, the most common imaging test was brain CT (84%). The main exclusion criteria for first-line immunotherapy in the centers were autoimmune disease (87%), corticosteroid therapy (69%), interstitial lung disease (69%), and performance status ≥ 2 (69%). Overall, 53% and 36% of centers considered that patients are chemotherapy-sensitive if they relapse within ≥ 3 months or ≥ 6 months after first-line chemoimmunotherapy, respectively. Among the 548 analyzed patients, 409 (75%) received chemoimmunotherapy as a first-line treatment, 374 (91%) of whom received carboplatin plus etoposide and 35 (9%) cisplatin plus etoposide. Overall, 340/548 patients (62%) received maintenance immunotherapy. Most patients (68%) did not receive radiotherapy or PCI. CONCLUSIONS There is an overall alignment of practices reflecting recent clinical guidelines among medical centers managing ES-SCLC across France, and a high prescription rate of immunotherapy in the first-line setting.
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Affiliation(s)
- Bertrand Mennecier
- Department of Thoracic Oncology, Strasbourg University Hospital, Strasbourg, France.
| | - Jonathan Khalifa
- Department of Radiation Oncology, Claudius Regaud Institute, Cancer University Institute of Toulouse Oncopole, Toulouse, France
| | - Renaud Descourt
- Department of Medical Oncology, Augustin-Morvan Hospital, Brest University Hospital, Brest, France
| | - Laurent Greillier
- Aix Marseille University, APHM, INSERM, CNRS, CRCM, Hôpital Nord, Multidisciplinary Oncology and Therapeutic Innovations, Marseille, France
| | - Charles Naltet
- Department of Thoracic Oncology & CIC, Paris Saint Joseph Hospital, 1425/CLIP2 Paris-Nord, Paris, France
| | - Lionel Falchero
- Department of Pulmonology and Thoracic Oncology, North West Hospital of Villefranche, Villefranche, France
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Zhang GL, Zhu QK, Ma TY, Weng CG, Zhang DD, Zeng H, Wang T, Gao F, Mi LL, Wang R. Clinical study of camrelizumab combined with docetaxel and carboplatin as a neoadjuvant treatment for locally advanced oesophageal squamous cell carcinoma. Dis Esophagus 2024; 37:doad073. [PMID: 38189470 DOI: 10.1093/dote/doad073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Herein, we aimed to evaluate the efficacy and safety of camrelizumab combined with docetaxel and carboplatin as a neoadjuvant treatment for locally advanced oesophageal squamous cell carcinoma (OSCC). Fifty-one patients with OSCC, treated from July 2020 to October 2022, were analyzed. Of them, 41 patients underwent surgery 4-8 weeks after undergoing two cycles of camrelizumab (200 mg IV Q3W) combined with docetaxel (75 mg/m2 IV Q3W) and carboplatin (area under the curve = 5-6 IV Q3W). The primary endpoint was the pathological complete response rate. All 51 patients (100%) experienced treatment-related grades 1-2 adverse events, and 2 patients (3.9%) experienced grade 4 events (including elevated alanine transaminase/aspartate transferase levels and Guillain-Barre syndrome). Fifty patients were evaluated for the treatment efficacy. Of them, 13 achieved complete response, and the objective response rate was 74%. Only 41 patients underwent surgical treatment. The pathological complete response rate was 17.1%, the major pathological response rate was 63.4%, and the R0 resection rate was 100%. Approximately 22% of the patients had tumor regression grades 0. Eight patients (19.5%) developed surgery-related complications. The median follow-up time was 18 months (range: 3-29 months). Four patients experienced disease progression, while four died. The median disease-free survival and overall survival were not reached. Camrelizumab combined with docetaxel and carboplatin is an effective and safe neoadjuvant treatment for locally advanced OSCC. This regimen may afford a potential strategy to treat patients with locally advanced OSCC.
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Affiliation(s)
- Guo-Liang Zhang
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Qi-Kun Zhu
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Tian-You Ma
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Chen-Gang Weng
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Dan-Dan Zhang
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Hui Zeng
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Tao Wang
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Feng Gao
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Li-Li Mi
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Rui Wang
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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Kim DW, Chul Cho B, Pachipala K, Kim SW, Wang CL, Chang GC, Ahn MJ, Alvarez R, Chiu CH, Trigo J, Estival A, Karam SD, O'Brien C, Gowda H, Jiang H, Bauman JE. Durvalumab in combination with chemoradiotherapy for patients with unresectable stage III non-small-cell lung cancer: Results from the phase 1 CLOVER study. Lung Cancer 2024; 190:107530. [PMID: 38471416 DOI: 10.1016/j.lungcan.2024.107530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION For patients with unresectable, stage III non-small-cell lung cancer (NSCLC), current standard of care is concurrent chemoradiotherapy (cCRT) followed by consolidation durvalumab. However, earlier initiation of durvalumab simultaneously with cCRT may increase antitumor activity relative to initiation after cCRT. The phase 1 CLOVER study (NCT03509012) evaluated durvalumab combined with cCRT in patients with advanced solid tumors; we report findings from the NSCLC cohort. METHODS CLOVER comprised a dose-limiting toxicity (DLT) assessment part, followed by an expansion part. In the NSCLC cohort, patients with previously untreated, unresectable, stage III NSCLC were enrolled in three treatment arms: durvalumab every 4 weeks (Q4W) + cisplatin + etoposide + radiotherapy (Arm 1); durvalumab Q4W + carboplatin + paclitaxel + radiotherapy (Arm 2); or durvalumab Q4W + carboplatin or cisplatin + pemetrexed + radiotherapy (non-squamous histology only; Arm 3). Patients received durvalumab until disease progression or unacceptable toxicity. The primary endpoint was safety and tolerability. RESULTS Sixty-four patients were enrolled: 21, 22, and 21 in Arms 1, 2, and 3, respectively. One patient in Arm 1 had DLT (grade 3 aspartate aminotransferase increase and grade 4 alanine aminotransferase increase); no DLTs were observed in Arms 2 or 3. Grade 3/4 adverse events occurred in 76.6 % of patients overall; the most common were neutropenia (51.6 %), leukopenia (20.3 %), and anemia (17.2 %). In a post-hoc analysis, 7.8 % of patients had grade 3 pneumonitis/radiation pneumonitis (grouped term) events. Overall, the objective response rate was 60.9 % (95 % confidence interval [CI], 47.9-72.9); median duration of response was 15.8 months (95 % CI, 9.0-not estimable [NE]). Median progression-free survival was 13.4 months (95 % CI, 8.8-20.1) and median overall survival was not reached (95 % CI, 21.9-NE). CONCLUSION Durvalumab in combination with cCRT was well tolerated, with a manageable safety profile and showed encouraging antitumor activity in patients with unresectable, stage III NSCLC.
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Affiliation(s)
- Dong-Wan Kim
- Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Republic of Korea.
| | - Byoung Chul Cho
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | - Sang-We Kim
- Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Gee-Chen Chang
- School of Medicine and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan; Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Myung-Ju Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Rosa Alvarez
- Hospital General Universitario Gregorio Marañón, Instituto de Investigacion Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - José Trigo
- UGC Intercentros Oncología Hospital Regional y Virgen de la Victoria, Málaga, Spain
| | - Anna Estival
- Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Sana D Karam
- University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
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Matsumoto K, Sunaga Y, Ecstein-Fraisse E, Fujiwara K. Phase I study of ombrabulin in combination with paclitaxel and carboplatin in Japanese patients with advanced solid tumors. Int J Gynecol Cancer 2024; 34:586-593. [PMID: 37989482 DOI: 10.1136/ijgc-2022-003880] [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: 11/23/2023] Open
Abstract
OBJECTIVES To evaluate the maximum tolerated dose/maximum administered dose, safety, pharmacokinetic, and efficacy profiles of ombrabulin combined with paclitaxel and carboplatin in Japanese patients with solid tumors. METHODS Ombrabulin (25, 30, or 35 mg/m2) combined with paclitaxel (175 or 200 mg/m2) and carboplatin (AUC5 or AUC6) was administered by intravenous infusion once every 3 weeks to patients with advanced solid tumors, including cervical, ovarian, and uterine cancers. The maximum tolerated dose/maximum administered dose was defined based on the dose-limiting toxicity at cycle 1. Efficacy was assessed based on Response Evaluation Criteria In Solid Tumors (RECIST). RESULTS In total, 18 patients were recruited for this dose escalation study. One out of six patients treated with the highest doses of combination of ombrabulin (35 mg/m2), paclitaxel (200 mg/m2), and carboplatin (AUC6) presented a dose-limiting toxicity consisting of grade 3 Escherichia urinary tract infection. This dose was defined as the maximum tolerated dose of ombrabulin. The most frequent treatment-emergent adverse events were alopecia (83.3%), neutropenia and fatigue (72.2% each), decreased appetite, nausea, diarrhea, arthralgia, and myalgia (66.7% each). The grade 3-4 treatment-emergent adverse events included neutropenia (61.1%), Escherichia urinary tract infection, drug hypersensitivity, syncope, pulmonary embolism, and hydronephrosis (one patient each). In efficacy evaluation, seven patients achieved partial response or better (38.9%), including one complete response, and seven of 18 patients had stable disease (38.9%). Pharmacokinetic profiles in this Japanese study were comparable with those observed in the previous study without Japanese patients. CONCLUSIONS Although the maximum tolerated dose/maximum administered dose of ombrabulin (35 mg/m2) with taxane-platinum combination may be tolerable in Japanese patients in the first cycle, the dosages in the repeated treatment should be carefully selected for further study. TRIAL REGISTRATION NUMBER NCT01293630.
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Affiliation(s)
- Koji Matsumoto
- Division of Medical Oncology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | | | | | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Japan
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Rühle A, Weymann M, Behrens M, Marschner S, Haderlein M, Fabian A, Senger C, Dickstein DR, Kraft J, von der Grün J, Chen E, Aquino-Michaels T, Domschikowski J, Bickel A, Altay-Langguth A, Kalinauskaite G, Lewitzki V, Bonomi M, Blakaj DM, Jhawar SR, Baliga S, Barve R, Ferentinos K, Zamboglou C, Schnellhardt S, Haehl E, Spohn SKB, Kuhnt T, Zöller D, Guckenberger M, Budach V, Belka C, Bakst R, Mayer A, Schmidberger H, Grosu AL, Balermpas P, Stromberger C, Nicolay NH. A Multicenter Evaluation of Different Chemotherapy Regimens in Older Adults With Head and Neck Squamous Cell Carcinoma Undergoing Definitive Chemoradiation. Int J Radiat Oncol Biol Phys 2024; 118:1282-1293. [PMID: 37914144 DOI: 10.1016/j.ijrobp.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/26/2023] [Accepted: 10/14/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE The number of older adults with head and neck squamous cell carcinoma (HNSCC) is increasing, and treatment of these patients is challenging. Although cisplatin-based chemotherapy concomitantly with radiation therapy is considered the standard regimen for patients with locoregionally advanced HNSCC, there is substantial real-world heterogeneity regarding concomitant chemotherapy in older patients with HNSCC. METHODS AND MATERIALS The SENIOR study is an international multicenter cohort study including older patients (≥65 years) with HNSCC treated with definitive radiation therapy at 13 academic centers in the United States and Europe. Patients with concomitant chemoradiation were analyzed regarding overall survival (OS) and progression-free survival (PFS) via Kaplan-Meier analyses. Fine-Gray competing risk regressions were performed regarding the incidence of locoregional failures and distant metastases. RESULTS Six hundred ninety-seven patients with a median age of 71 years were included in this analysis. Single-agent cisplatin was the most common chemotherapy regimen (n = 310; 44%), followed by cisplatin plus 5-fluorouracil (n = 137; 20%), carboplatin (n = 73; 10%), and mitomycin C plus 5-fluorouracil (n = 64; 9%). Carboplatin-based regimens were associated with diminished PFS (hazard ratio [HR], 1.39 [1.03-1.89]; P < .05) and a higher incidence of locoregional failures (subdistribution HR, 1.54 [1.00-2.38]; P = .05) compared with single-agent cisplatin, whereas OS (HR, 1.15 [0.80-1.65]; P = .46) was comparable. There were no oncological differences between single-agent and multiagent cisplatin regimens (all P > .05). The median cumulative dose of cisplatin was 180 mg/m2 (IQR, 120-200 mg/m2). Cumulative cisplatin doses ≥200 mg/m2 were associated with increased OS (HR, 0.71 [0.53-0.95]; P = .02), increased PFS (HR, 0.66 [0.51-0.87]; P = .003), and lower incidence of locoregional failures (subdistribution HR, 0.50 [0.31-0.80]; P = .004). Higher cumulative cisplatin doses remained an independent prognostic variable in the multivariate regression analysis for OS (HR, 0.996 [0.993-0.999]; P = .009). CONCLUSIONS Single-agent cisplatin can be considered in the standard chemotherapy regimen for older patients with HNSCC who can tolerate cisplatin. Cumulative cisplatin doses are prognostically relevant in older patients with HNSCC.
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Affiliation(s)
- Alexander Rühle
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany; German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiation Oncology, University of Leipzig, Leipzig, Germany; Cancer Center Central Germany (CCCG), Partner Site Leipzig, Leipzig, Germany.
| | - Maria Weymann
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Max Behrens
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Sebastian Marschner
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany; German Cancer Consortium (DKTK) Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marlen Haderlein
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Alexander Fabian
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Carolin Senger
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin; Freie Universität Berlin, Humboldt-Universität zu Berlin; and Berlin Institute of Health, Berlin, Germany; German Cancer Consortium (DKTK) Partner Site Berlin, German Cancer Research Center (DKFZ), Neuenheimer Feld 280, Heidelberg, Germany
| | - Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Johannes Kraft
- Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
| | - Jens von der Grün
- Department of Radiotherapy and Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany; German Cancer Consortium (DKTK) Partner Site Frankfurt, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Eric Chen
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio
| | - Todd Aquino-Michaels
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio
| | - Justus Domschikowski
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Amanda Bickel
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Alev Altay-Langguth
- Department of Radiotherapy and Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany; German Cancer Consortium (DKTK) Partner Site Frankfurt, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Goda Kalinauskaite
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin; Freie Universität Berlin, Humboldt-Universität zu Berlin; and Berlin Institute of Health, Berlin, Germany; German Cancer Consortium (DKTK) Partner Site Berlin, German Cancer Research Center (DKFZ), Neuenheimer Feld 280, Heidelberg, Germany
| | - Victor Lewitzki
- Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
| | - Marcelo Bonomi
- Department of Medical Oncology, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Dukagjin M Blakaj
- Department of Radiation Oncology, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Sachin R Jhawar
- Department of Radiation Oncology, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Sujith Baliga
- Department of Radiation Oncology, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Rahul Barve
- Department of Radiation Oncology, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Konstantinos Ferentinos
- Department of Radiation Oncology, German Oncology Center, European University of Cyprus, Limassol, Cyprus
| | - Constantinos Zamboglou
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany; German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiation Oncology, German Oncology Center, European University of Cyprus, Limassol, Cyprus
| | - Sören Schnellhardt
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Department of Radiotherapy and Radiation Oncology, Saarland University Medical Center, Homburg, Germany
| | - Erik Haehl
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany; German Cancer Consortium (DKTK) Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Simon K B Spohn
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany; German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Thomas Kuhnt
- Department of Radiation Oncology, University of Leipzig, Leipzig, Germany; Cancer Center Central Germany (CCCG), Partner Site Leipzig, Leipzig, Germany
| | - Daniela Zöller
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Matthias Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Volker Budach
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin; Freie Universität Berlin, Humboldt-Universität zu Berlin; and Berlin Institute of Health, Berlin, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany; German Cancer Consortium (DKTK) Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Richard Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Arnulf Mayer
- Department of Radiation Oncology and Radiation Therapy, University Medical Center Mainz, Mainz, Germany; German Cancer Consortium (DKTK) Partner Site Mainz, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Heinz Schmidberger
- Department of Radiation Oncology and Radiation Therapy, University Medical Center Mainz, Mainz, Germany; German Cancer Consortium (DKTK) Partner Site Mainz, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anca-Ligia Grosu
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany; German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Panagiotis Balermpas
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Carmen Stromberger
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin; Freie Universität Berlin, Humboldt-Universität zu Berlin; and Berlin Institute of Health, Berlin, Germany; German Cancer Consortium (DKTK) Partner Site Berlin, German Cancer Research Center (DKFZ), Neuenheimer Feld 280, Heidelberg, Germany
| | - Nils H Nicolay
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany; German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiation Oncology, University of Leipzig, Leipzig, Germany; Cancer Center Central Germany (CCCG), Partner Site Leipzig, Leipzig, Germany
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Yang Y, Zhao M, Jia Q, Tang H, Xing T, Li Y, Tang B, Xu L, Wei W, Zheng H, Shi R, Xia B, Chen J. Mesonephric-like adenocarcinoma of the ovary. J Ovarian Res 2024; 17:57. [PMID: 38444000 PMCID: PMC10916164 DOI: 10.1186/s13048-024-01383-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/26/2024] [Indexed: 03/07/2024] Open
Abstract
Mesonephric-like adenocarcinoma is a new class of rare subtypes of the female reproductive system. Its clinical symptoms are similar to other types of ovarian tumors. The diagnosis is based on pathological and immunohistochemical methods. The main treatment option is surgery combined with chemotherapy. Few cases have been reported at home and abroad. We reported a case of a 45-year-old woman with a cystic solid mass in the left adnexa. The postoperative pathological diagnosis was mesonephric-like adenocarcinoma of the left ovary and mature cystic teratoma (partial infiltration of the small intestine). This case had no specific clinical symptoms. Immunohistochemical findings showed positive results of GATA3, TTF1, CD10, ER, and PR. Paclitaxel and carboplatin chemotherapy were given after the operation. Currently, no specific criteria are available for diagnosis and treatment of the disease. This article aims to improve the understanding of clinicians in this disease and create a basis for clinical diagnosis and treatment.
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Affiliation(s)
- Yun Yang
- Dalian Medical University, Dalian, 116000, PR China
| | - Mengru Zhao
- Dalian Medical University, Dalian, 116000, PR China
| | - Qiuchen Jia
- Department of Gynecology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213003, PR China
| | - Huimin Tang
- Department of Gynecology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213003, PR China
| | - Tingwei Xing
- Department of Gynecology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213003, PR China
| | - Yang Li
- Department of Gynecology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213003, PR China
| | - Bin Tang
- Department of Gynecology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213003, PR China
| | - Lin Xu
- Department of Gynecology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213003, PR China
| | - Weiwei Wei
- Department of Gynecology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213003, PR China
| | - Hong Zheng
- Department of Gynecology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213003, PR China
| | - Ruxia Shi
- Department of Gynecology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213003, PR China
| | - Bairong Xia
- Department of Gynecological Oncology, Division of Life Sciences and Medicine, the First Affiliated Hospital of University of Science and Technology of China, University of Science and Technology of China, Hefei, 230031, PR China.
| | - Jiming Chen
- Department of Gynecology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213003, PR China.
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10
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Diéras V, Han HS, Wildiers H, Friedlander M, Ayoub JP, Puhalla SL, Loirat D, Ratajczak C, Adamu H, Girardi V, Arun BK. Veliparib with carboplatin and paclitaxel in BRCA-mutated advanced breast cancer (BROCADE3): Final overall survival results from a randomized phase 3 trial. Eur J Cancer 2024; 200:113580. [PMID: 38309017 DOI: 10.1016/j.ejca.2024.113580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND In the BROCADE3 study, the addition of veliparib to carboplatin plus paclitaxel resulted in a significant improvement in progression-free survival (PFS) compared with placebo plus carboplatin and paclitaxel, in patients with germline BRCA1 or BRCA2 (BRCA1/2)-mutated, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. We now report final overall survival (OS) data. METHODS BROCADE3 is a randomized phase 3 study that enrolled patients with BRCA1/2-mutated, HER2-negative advanced breast cancer who received ≤ 2 prior lines of chemotherapy for metastatic disease. Patients were randomized 2:1 to carboplatin and paclitaxel, dosed with either veliparib or matching placebo. OS was a secondary endpoint. RESULTS In the intention-to-treat population (N = 509), 337 patients were randomized to receive veliparib and 172 to placebo. Median OS was 32.4 months vs 28.2 months (hazard ratio, 0.916; 95% CI, 0.736-1.140; P = .434). The updated safety data for veliparib are consistent with those reported in the primary analysis; the addition of veliparib was generally well tolerated. CONCLUSIONS Final OS data indicate that the PFS improvement shown in the primary analysis did not translate into an OS benefit. The long survival times observed in both arms suggest that combination therapy with paclitaxel and carboplatin provides clinical benefit in the population of patients with BRCA1/2-mutated metastatic breast cancer.
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Affiliation(s)
- Véronique Diéras
- Medical Oncology Department, Institut Curie, 26 rue d'Ulm, 75005, Paris, France; Medical Oncology Department, Centre Eugène Marquis, Av. de la Bataille Flandres-Dunkerque CS 44229, 35000 Rennes, France.
| | - Hyo S Han
- Moffitt Cancer Center, 12920 McKinley Drive, Tampa, FL 33612, USA
| | - Hans Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, O&N4 box 818, 3000 Leuven, Belgium
| | - Michael Friedlander
- School of Clinical Medicine, UNSW Sydney, Cnr High St & Botany St., Sydney NSW 2052, Australia; Department of Medical Oncology, The Prince of Wales Hospital, Barker Street, Randwick, NSW 2031 Australia
| | - Jean-Pierre Ayoub
- Centre Hospitalier de l'Université de Montréal, 1000 rue Saint-Denis, Montréal, QC H2X 0C1, Canada
| | - Shannon L Puhalla
- UPMC Hillman Cancer Center, 9100 Babcock Blvd Ste G600, Pittsburgh, PA 15237, USA
| | - Delphine Loirat
- Medical Oncology Department, Institut Curie, 26 rue d'Ulm, 75005, Paris, France
| | | | | | | | - Banu K Arun
- The University of Texas MD Anderson Cancer Center, 1155 Pressler St, Houston, TX 77030, USA
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11
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Komatsu H, Matsumoto K, Morita M, Nagasawa T, Nishio H, Suzuki J, Nishio S, Kobara H, Yunokawa M, Ariyoshi K, Hirayama T, Tokunaga H, Ukita M, Yoriki K, Mori‐Uchino M, Furusawa A, Togami S, Nakamura H, Ishikawa M, Satoh T. A survey of carboplatin desensitization therapy in Japan: A multicenter retrospective study. Cancer Med 2024; 13:e6968. [PMID: 38491829 PMCID: PMC10943373 DOI: 10.1002/cam4.6968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION Hypersensitivity reactions (HSRs) to chemotherapy are serious adverse events associated with cancer drug therapy and can occur with any antitumor drug. This study investigated the safety and efficacy of carboplatin desensitization therapy in Japan and established a method for treating carboplatin HSRs. METHODS Patients diagnosed with gynecological (ovarian, endometrial, or cervical) cancers who underwent carboplatin desensitization therapy between 2016 and 2020 at the Gynecologic Cancer Study Group of Japan Clinical Oncology Group were included. The carboplatin desensitization therapy at each institution and the implementation cases were registered in an online case report form. RESULTS This retrospective study enrolled 136 patients (ovarian, 108; endometrial, 17; and cervical cancer, 11). Pre-existing allergies were present in 37 (27.2%) patients, and 32 (23.5%) patients exhibited prodromal symptoms during treatment before HSR onset. Erythema was the most common symptom at HSR onset, affecting 93 (68.4%) patients, followed by itching in 72 (52.9%) patients and decreased oxygen saturation in 43 (31.6%) patients. Loss of consciousness occurred in three (2.2%) patients. The most common timing of HSR onset was during the first recurrence treatment (47%). The mean total carboplatin dose until HSR onset was 7331 (2620-18,282) mg, and the mean number of doses was 14 (4-63). Desensitization treatment was completed in 75% of cases, and breakthrough HSRs occurred in 25% (34/136). No deaths occurred in the study cohort. The risk factors for HSRs were not identified. CONCLUSION Although carboplatin desensitization therapy has high success rates in Japan, erythema and pruritus are important HSRs to consider.
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Affiliation(s)
- Hiroaki Komatsu
- Department of Obstetrics and GynecologyTottori University School of MedicineYonagoTottoriJapan
| | - Koji Matsumoto
- Department of Medical OncologyHyogo Cancer CenterAkashiHyogoJapan
| | - Mitsunori Morita
- Department of Medical OncologyHyogo Cancer CenterAkashiHyogoJapan
| | - Takayuki Nagasawa
- Department of Obstetrics and GynecologyIwate Medical University School of MedicineMoriokaIwateJapan
| | - Hiroshi Nishio
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
| | - Jiro Suzuki
- Department of Obstetrics and GynecologyThe Jikei University School of MedicineTokyoJapan
| | - Shin Nishio
- Department of Obstetrics and GynecologyKurume University School of MedicineKurumeJapan
| | - Hisanori Kobara
- Department of Obstetrics and GynecologyShinshu UniversityNaganoJapan
| | - Mayu Yunokawa
- Department of GynecologyThe Cancer Institute Hospital of JFCRTokyoJapan
| | - Kazuya Ariyoshi
- Department of Gynecology ServiceNational Kyushu Cancer CenterFukuokaJapan
| | - Takashi Hirayama
- Department of Obstetrics and GynecologyJuntendo University HospitalTokyoJapan
| | - Hideki Tokunaga
- Department of GynecologyTohoku University Graduate School of MedicineSendaiJapan
| | - Masayo Ukita
- Department of Gynecology and Obstetrics, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Kaori Yoriki
- Department of Obstetrics and Gynecology, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Mayuyo Mori‐Uchino
- Department of Obstetrics and Gynecology, Faculty of MedicineThe University of TokyoTokyoJapan
| | - Akiko Furusawa
- Department of GynecologyTokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalTokyoJapan
| | - Shinichi Togami
- Department of Obstetrics and Gynecology, Faculty of MedicineKagoshima UniversityKagoshimaJapan
| | - Hiroko Nakamura
- Department of Obstetrics and GynecologyNational Hospital Organization Kure Medical Center and Chugoku Cancer CenterKureJapan
| | - Mitsuya Ishikawa
- Department of Gynecology, National Cancer Center HospitalTokyoJapan
| | - Toyomi Satoh
- Department of Obstetrics and Gynecology, Institute of MedicineUniversity of TsukubaTsukubaJapan
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Ouali K, Michels J, Blanc-Durand F, Leary A, Kfoury M, Genestie C, Morice P, Zaccarini F, Scherrier S, Gouy S, Maulard A, Pautier P. [Current post-surgical treatment strategies in first-line ovarian cancer]. Bull Cancer 2024; 111:267-276. [PMID: 36863923 DOI: 10.1016/j.bulcan.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/18/2022] [Accepted: 01/29/2023] [Indexed: 03/04/2023]
Abstract
Although the management of epithelial ovarian cancer has evolved significantly over the past few years, it remains a public health issue, as most patients are diagnosed at an advanced stage and relapse after first line treatment. Chemotherapy remains the standard adjuvant treatment for International Federation of Gynecology and Obstetrics (FIGO) stage I and II tumors, with some exceptions. For FIGO stage III/IV tumors, carboplatin- and paclitaxel-based chemotherapy are the standard of care, in combination with targeted therapies, especially bevacizumab and/or poly-(ADP-ribose) polymerase inhibitors, that have become a key milestone of first-line treatment. Our decision making for the maintenance therapy is based on the FIGO stage, tumor histology, timing of surgery (i.e. primary or interval debulking surgery), residual tumor, response to chemotherapy, BRCA mutation and homologous recombination (HR) status.
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Affiliation(s)
- Kaïssa Ouali
- Institut Gustave-Roussy, Département d'innovations thérapeutiques et essais précoces (DITEP), 114, avenue Édouard-Vaillant, 94805 Villejuif, France; Institut Gustave-Roussy, Département de médecine, 114, avenue Édouard-Vaillant, 94805 Villejuif, France.
| | - Judith Michels
- Institut Gustave-Roussy, Département de médecine, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
| | - Felix Blanc-Durand
- Institut Gustave-Roussy, Département de médecine, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
| | - Alexandra Leary
- Institut Gustave-Roussy, Département de médecine, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
| | - Maria Kfoury
- Institut Gustave-Roussy, Département de médecine, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
| | - Catherine Genestie
- Institut Gustave-Roussy, Département de biologie et pathologie médicale, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
| | - Philippe Morice
- Institut Gustave-Roussy, Département d'anesthésie, chirurgie et imagerie interventionnelle, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
| | - François Zaccarini
- Institut Gustave-Roussy, Département d'anesthésie, chirurgie et imagerie interventionnelle, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
| | - Stéphanie Scherrier
- Institut Gustave-Roussy, Département d'anesthésie, chirurgie et imagerie interventionnelle, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
| | - Sebastien Gouy
- Institut Gustave-Roussy, Département d'anesthésie, chirurgie et imagerie interventionnelle, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
| | - Amandine Maulard
- Institut Gustave-Roussy, Département d'anesthésie, chirurgie et imagerie interventionnelle, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
| | - Patricia Pautier
- Institut Gustave-Roussy, Département de médecine, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
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13
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Chinnadurai A, Breadner D, Baloush Z, Lohmann AE, Black M, D'Souza D, Welch S. Adjuvant carboplatin and paclitaxel with "sandwich" method radiotherapy for stage III or IV endometrial cancer: long-term follow-up at a single-institution. J Gynecol Oncol 2024; 35:e16. [PMID: 37921600 PMCID: PMC10948991 DOI: 10.3802/jgo.2024.35.e16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/15/2023] [Accepted: 10/03/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE To evaluate disease-free survival (DFS) and overall survival (OS) associated with adjuvant carboplatin and paclitaxel chemotherapy interposed with radiation for advanced endometrial cancer. METHODS This is a cohort study of adult women with stage III or IV endometrial cancer treated at a single institution, between April 2002 and October 2017. Tumor and treatment characteristics were recorded. Treatment consisted of 4 cycles of intravenous paclitaxel and carboplatin every 3 weeks, followed by external beam radiotherapy to the pelvis (45-50 Gy), and another 2 cycles of chemotherapy. One cohort of patients were prospectively enrolled from 2002 through 2006 and an additional cohort from 2007 to 2017, which was retrospectively analyzed. Primary endpoints for this study were DFS and OS rates which were calculated using Cox regression models. RESULTS Eighty-two patients with a median age of 66.5 years (range, 35-83 years) were included. Median follow-up was 46 months (range, 9-196 months). Most patients had stage IIIC disease (62.2%) and serous carcinoma histology (46.3%). Median OS was 146 months and median DFS was 71 months. A 5-year OS and DFS were 64.9% and 55.7%, respectively. Age >60 years subgroup was at a significantly higher risk of DFS event or death. Histological subtype, location of positive nodes, and cancer stage (IIIa vs. higher stage) did not correlate to a higher risk of recurrence or death. CONCLUSION Long term follow-up and a larger population confirm that the chemoradiotherapy sandwich method yields favorable outcomes in patients with high-risk endometrial cancer.
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Affiliation(s)
- Anu Chinnadurai
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Daniel Breadner
- London Regional Cancer Program, London Health Sciences Centre, Victoria Hospital, London, ON, Canada
- Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
| | - Ziad Baloush
- London Regional Cancer Program, London Health Sciences Centre, Victoria Hospital, London, ON, Canada
| | - Ana Elisa Lohmann
- London Regional Cancer Program, London Health Sciences Centre, Victoria Hospital, London, ON, Canada
| | - Morgan Black
- London Regional Cancer Program, London Health Sciences Centre, Victoria Hospital, London, ON, Canada
| | - David D'Souza
- London Regional Cancer Program, London Health Sciences Centre, Victoria Hospital, London, ON, Canada
- Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Stephen Welch
- London Regional Cancer Program, London Health Sciences Centre, Victoria Hospital, London, ON, Canada
- Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
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14
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Rosell R, Codony-Servat J, González J, Santarpia M, Jain A, Shivamallu C, Wang Y, Giménez-Capitán A, Molina-Vila MA, Nilsson J, González-Cao M. KRAS G12C-mutant driven non-small cell lung cancer (NSCLC). Crit Rev Oncol Hematol 2024; 195:104228. [PMID: 38072173 DOI: 10.1016/j.critrevonc.2023.104228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/02/2023] [Indexed: 02/20/2024] Open
Abstract
KRAS G12C mutations in non-small cell lung cancer (NSCLC) partially respond to KRAS G12C covalent inhibitors. However, early adaptive resistance occurs due to rewiring of signaling pathways, activating receptor tyrosine kinases, primarily EGFR, but also MET and ligands. Evidence indicates that treatment with KRAS G12C inhibitors (sotorasib) triggers the MRAS:SHOC2:PP1C trimeric complex. Activation of MRAS occurs from alterations in the Scribble and Hippo-dependent pathways, leading to YAP activation. Other mechanisms that involve STAT3 signaling are intertwined with the activation of MRAS. The high-resolution MRAS:SHOC2:PP1C crystallization structure allows in silico analysis for drug development. Activation of MRAS:SHOC2:PP1C is primarily Scribble-driven and downregulated by HUWE1. The reactivation of the MRAS complex is carried out by valosin containing protein (VCP). Exploring these pathways as therapeutic targets and their impact on different chemotherapeutic agents (carboplatin, paclitaxel) is crucial. Comutations in STK11/LKB1 often co-occur with KRAS G12C, jeopardizing the effect of immune checkpoint (anti-PD1/PDL1) inhibitors.
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Affiliation(s)
- Rafael Rosell
- Germans Trias i Pujol Research Institute, Badalona (IGTP), Spain; IOR, Hospital Quiron-Dexeus, Barcelona, Spain.
| | | | - Jessica González
- Germans Trias i Pujol Research Institute, Badalona (IGTP), Spain
| | - Mariacarmela Santarpia
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Italy
| | - Anisha Jain
- Department of Microbiology, JSS Academy of Higher Education & Research, Mysuru, India
| | - Chandan Shivamallu
- Department of Biotechnology & Bioinformatics, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Yu Wang
- Genfleet Therapeutics, Shanghai, China
| | | | | | - Jonas Nilsson
- Department Radiation Sciences, Oncology, Umeå University, Sweden
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15
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Ilhan-Ayisigi E, Saglam-Metiner P, Sanci E, Bakan B, Yildirim Y, Buhur A, Yavasoglu A, Yavasoglu NUK, Yesil-Celiktas O. Receptor mediated targeting of EGF-conjugated alginate-PAMAM nanoparticles to lung adenocarcinoma: 2D/3D in vitro and in vivo evaluation. Int J Biol Macromol 2024; 261:129758. [PMID: 38286366 DOI: 10.1016/j.ijbiomac.2024.129758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/06/2024] [Accepted: 01/24/2024] [Indexed: 01/31/2024]
Abstract
Carboplatin (cis-diamine (1,1-cyclobutandicarboxylaso)‑platinum (II)) is a second-generation antineoplastic drug, which is widely used for chemotherapy of lung, colon, breast, cervix, testicular and digestive system cancers. Although preferred over cisplatin due to the lower incidence of nephrotoxicity and ototoxicity, efficient carboplatin delivery remains as a major challenge. In this study, carboplatin loaded alginate- poly(amidoamine) (PAMAM) hybrid nanoparticles (CAPs) with mean sizes of 192.13 ± 4.15 nm were synthesized using a microfluidic platform, then EGF was conjugated to the surface of CAPs (EGF-CAPs) for the receptor-targeted delivery. Hence, increased FITC+ cell counts were observed in A549 spheroids after EGF-CAP treatment compared to CAP in the 3D cellular uptake study. As such, the cytotoxicity of EGF-CAP was approximately 2-fold higher with an IC50 value of 35.89 ± 10.37 μg/mL compared to the CAPs in A549 spheroids. Based on in vivo experimental animal model, anti-tumor activities of the group treated with CAP decreased by 61 %, whereas the group treated with EGF-CAP completely recovered. Additionally, EGF-CAP application was shown to induce apoptotic cell death. Our study provided a new strategy for designing a hybrid nanoparticle for EGFR targeted carboplatin delivery with improved efficacy both in vitro and in vivo applications.
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Affiliation(s)
- Esra Ilhan-Ayisigi
- Department of Genetic and Bioengineering, Faculty of Engineering and Architecture, Kirsehir Ahi Evran University, Kirsehir, Turkey; Department of Bioengineering, Faculty of Engineering, Ege University, Izmir, Turkey
| | - Pelin Saglam-Metiner
- Department of Bioengineering, Faculty of Engineering, Ege University, Izmir, Turkey; Translational Pulmonary Research Center (EgeSAM), Ege University, Izmir, Turkey
| | - Ebru Sanci
- Center for Drug Research and Pharmacokinetic Applications (ARGEFAR), Ege University, Izmir, Turkey
| | - Buket Bakan
- Department of Molecular Biology and Genetics, Faculty of Science, Ataturk University, Erzurum, Turkey
| | - Yeliz Yildirim
- Department of Chemistry, Faculty of Science, Ege University, Izmir, Turkey
| | - Aylin Buhur
- Department of Histology and Embryology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Altug Yavasoglu
- Department of Histology and Embryology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - N Ulku Karabay Yavasoglu
- Translational Pulmonary Research Center (EgeSAM), Ege University, Izmir, Turkey; Center for Drug Research and Pharmacokinetic Applications (ARGEFAR), Ege University, Izmir, Turkey; Department of Biology, Faculty of Science, Ege University, Izmir, Turkey.
| | - Ozlem Yesil-Celiktas
- Department of Bioengineering, Faculty of Engineering, Ege University, Izmir, Turkey; Translational Pulmonary Research Center (EgeSAM), Ege University, Izmir, Turkey.
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16
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Song Y, Xu T. Neoadjuvant combination therapy (immunotherapy and chemotherapy) and treatment-related biomarkers in upper tract urothelial carcinoma. World J Urol 2024; 42:110. [PMID: 38421514 DOI: 10.1007/s00345-024-04838-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024] Open
Affiliation(s)
- Yuxuan Song
- Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - Tao Xu
- Department of Urology, Peking University People's Hospital, Beijing, 100044, China.
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17
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Dai J, Zheng S, Falco MM, Bao J, Eriksson J, Pikkusaari S, Forstén S, Jiang J, Wang W, Gao L, Perez-Villatoro F, Dufva O, Saeed K, Wang Y, Amiryousefi A, Färkkilä A, Mustjoki S, Kauppi L, Tang J, Vähärautio A. Tracing back primed resistance in cancer via sister cells. Nat Commun 2024; 15:1158. [PMID: 38326354 PMCID: PMC10850087 DOI: 10.1038/s41467-024-45478-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024] Open
Abstract
Exploring non-genetic evolution of cell states during cancer treatments has become attainable by recent advances in lineage-tracing methods. However, transcriptional changes that drive cells into resistant fates may be subtle, necessitating high resolution analysis. Here, we present ReSisTrace that uses shared transcriptomic features of sister cells to predict the states priming treatment resistance. Applying ReSisTrace in ovarian cancer cells perturbed with olaparib, carboplatin or natural killer (NK) cells reveals pre-resistant phenotypes defined by proteostatic and mRNA surveillance features, reflecting traits enriched in the upcoming subclonal selection. Furthermore, we show that DNA repair deficiency renders cells susceptible to both DNA damaging agents and NK killing in a context-dependent manner. Finally, we leverage the obtained pre-resistance profiles to predict and validate small molecules driving cells to sensitive states prior to treatment. In summary, ReSisTrace resolves pre-existing transcriptional features of treatment vulnerability, facilitating both molecular patient stratification and discovery of synergistic pre-sensitizing therapies.
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Affiliation(s)
- Jun Dai
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Shuyu Zheng
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Matías M Falco
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jie Bao
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Johanna Eriksson
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sanna Pikkusaari
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sofia Forstén
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jing Jiang
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Wenyu Wang
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Luping Gao
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Fernando Perez-Villatoro
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- iCAN Digital Precision Cancer Medicine, Helsinki, Finland
| | - Olli Dufva
- Research Program in Translational Immunology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Khalid Saeed
- Research Program in Translational Immunology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Yinyin Wang
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ali Amiryousefi
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anniina Färkkilä
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- iCAN Digital Precision Cancer Medicine, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, and Clinical Trial Unit, Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland
| | - Satu Mustjoki
- Research Program in Translational Immunology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Liisa Kauppi
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jing Tang
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Anna Vähärautio
- Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
- Foundation for the Finnish Cancer Institute, Helsinki, Finland.
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18
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Cheng Y, Wu L, Huang D, Wang Q, Fan Y, Zhang X, Fan H, Yao W, Liu B, Yu G, Pan Y, Xu F, He Z, Dong X, Ma R, Min X, Ge X, Chen H, Liu Q, Hu Y, Liu Y, Yang C, Yang Y, Li X, Zhou L. Myeloprotection with trilaciclib in Chinese patients with extensive-stage small cell lung cancer receiving chemotherapy: Results from a randomized, double-blind, placebo-controlled phase III study (TRACES). Lung Cancer 2024; 188:107455. [PMID: 38224653 DOI: 10.1016/j.lungcan.2023.107455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/26/2023] [Accepted: 12/26/2023] [Indexed: 01/17/2024]
Abstract
INTRODUCTION Trilaciclib is a transient cyclin-dependent kinase 4/6 inhibitor that decreases the incidence of chemotherapy-induced myelosuppression in extensive-stage small cell lung cancer (ES-SCLC). TRACES study was designed to assess the safety, efficacy and pharmacokinetics (PK) of trilaciclib before chemotherapy in Chinese patients with ES-SCLC. METHODS The study included an open-label safety run-in part (Part 1) and double-blinded, placebo-controlled part (Part 2) where patients received trilaciclib or placebo before chemotherapy. Treatment-naïve or previously treated ES-SCLC patients received intravenous trilaciclib (240 mg/m2) or placebo before etoposide/carboplatin or topotecan, respectively. Primary endpoints were PK, safety and duration of severe neutropenia (DSN) in Cycle 1 in Part 1 and Part 2. Exploratory endpoints included the effect of trilaciclib on other myeloprotection endpoints, safety and antitumor efficacy. RESULTS Overall, 95 Chinese patients were enrolled, of which 12 and 83 patients were in Part 1 and Part 2, respectively. In Part 1, trilaciclib was well tolerated. Non-compartmental analysis results revealed no substantial differences in the main exposure parameters. In Part 2, 41 patients received trilaciclib, and 42 received placebo. Patients in trilaciclib arm vs placebo arm had a clinically and statistically significant decrease in DSN (mean [SD]) in Cycle 1 (0 [1.7] vs 2 [3.0] days; P = 0.0003), with improvements in additional neutrophil, red blood cell, and platelet measures. After a median follow-up of 14.1 months, the median overall survival was 12.0 months in trilaciclib arm and 8.8 months in placebo arm (HR, 0.69; 95 % CI: 0.40-1.22). Median progression-free survival was 4.8 months and 4.3 months, respectively (HR, 0.86; 95 % CI: 0.53-1.39). Trilaciclib had a well-tolerated safety profile. CONCLUSIONS Trilaciclib in the Chinese population demonstrated a similar PK and safety profile as seen in other global trials. There was significant reduction of DSN in Cycle 1, thereby substantiating the myeloprotective effects of trilaciclib in Chinese ES-SCLC patients.
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Affiliation(s)
- Ying Cheng
- Jilin Cancer Hospital, Changchun, China.
| | - Lin Wu
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Dingzhi Huang
- Tianjin Medical University Cancer Hospital and Institute, Tianjin, China
| | - QiMing Wang
- Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Yun Fan
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - XiQin Zhang
- Shandong Cancer Hospital & Institute, Jinan, China
| | - HuiJie Fan
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - BaoGang Liu
- Harbin Medical University Cancer Hospital, Harbin, China
| | - GuoHua Yu
- Weifang People's Hospital, Weifang, China
| | - YueYin Pan
- The First Affiliated Hospital of USTC, Hefei, China
| | - Fei Xu
- The First Affiliated Hospital of Nanchang University, Nanchang, China
| | | | - XiaoRong Dong
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Ma
- Liaoning Cancer Hospital, Shenyang, China
| | | | - XiaoSong Ge
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Hualin Chen
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Qun Liu
- The First Affiliated Hospital of Xiamen University, Xiamen, China
| | | | - Ying Liu
- Jilin Cancer Hospital, Changchun, China
| | - Chen Yang
- State Key Laboratory of Neurology and Oncology Drug Development, Nanjing, China and Simcere Zaiming Medical Technology Co., Ltd, Beijing, China
| | - Yang Yang
- State Key Laboratory of Neurology and Oncology Drug Development, Nanjing, China and Simcere Zaiming Medical Technology Co., Ltd, Beijing, China
| | - Xiucui Li
- State Key Laboratory of Neurology and Oncology Drug Development, Nanjing, China and Simcere Zaiming Medical Technology Co., Ltd, Beijing, China
| | - Li Zhou
- State Key Laboratory of Neurology and Oncology Drug Development, Nanjing, China and Simcere Zaiming Medical Technology Co., Ltd, Beijing, China
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19
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Humphries A, Zhou CJ, Welsh M, Lem M, Kang H, Algazi AP. Carboplatin and paclitaxel after anti-PD-1 or anti-PD-L1 antibody therapy in recurrent and/or metastatic squamous cell carcinoma of head and neck. Head Neck 2024; 46:321-327. [PMID: 37997549 DOI: 10.1002/hed.27580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/01/2023] [Accepted: 11/12/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The impact of concurrent chemotherapy and immunotherapy has been well characterized in patients with recurrent and metastatic head and neck squamous cell carcinoma (RM-SCCHN). Here, we report outcomes in patients treated sequentially with immune checkpoint inhibition (ICI) followed by carboplatin and paclitaxel. METHODS Patients with RM-SCCHN treated with ICI followed by carboplatin/paclitaxel at a single institution were identified retrospectively. ICI therapy history, p16, and PD-L1 status were collected. The best overall response was assessed by RECIST v1.1. RESULTS Twelve patients met inclusion criteria. Eight patients received pembrolizumab, three durvalumab, and one nivolumab. The median duration of ICI was 3.44 months, median PFS was 5.8 months, and median OS was 15.2 months. 66.7% of patients had an objective response on carboplatin/paclitaxel. CONCLUSIONS Carboplatin/paclitaxel can induce objective responses in patients with prior treatment with ICI and clinical outcomes in this small series compare favorably to those seen in ICI naïve patients.
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Affiliation(s)
- Audrey Humphries
- Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Connie J Zhou
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Melinda Lem
- Department of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California, USA
| | - Hyunseok Kang
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Alain P Algazi
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
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20
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Simone CB, Serebrenik AA, Gore EM, Mohindra P, Brown SL, Wang D, Chetty IJ, Vujaskovic Z, Menon S, Thompson J, Fine G, Kaytor MD, Movsas B. Multicenter Phase 1b/2a Clinical Trial of Radioprotectant BIO 300 Oral Suspension for Patients With Non-Small Cell Lung Cancer Receiving Concurrent Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2024; 118:404-414. [PMID: 37652301 DOI: 10.1016/j.ijrobp.2023.08.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/03/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE Radiation therapy is part of the standard treatment regimen for non-small cell lung cancer (NSCLC). Although radiation therapy is an effective tool to manage NSCLC, it can be associated with significant dose-limiting toxicities. These toxicities can lead to treatment interruption or early termination and worsening clinical outcomes in addition to reductions in patient quality of life. Based on preclinical efficacy for radioprotection of normal tissues, we evaluated the clinical utility of BIO 300 Oral Suspension (BIO 300; synthetic genistein nanosuspension) in patients with NSCLC. METHODS AND MATERIALS In this multicenter, open-label, single-arm, ascending dose phase 1b/2a study, patients were enrolled with newly diagnosed stage II-IV NSCLC planned for 60 to 70/1.8-2.0 Gy radiation therapy and concurrent weekly paclitaxel/carboplatin. Oral BIO 300 (cohort 1, 500 mg/d; cohort 2, 1000 mg/d; cohort 3, 1500 mg/d) was self-administered once daily starting 2 to 7 days before initiating concurrent chemoradiotherapy and continued until the end of radiation therapy. The primary endpoint was acute dose-limiting toxicities attributable to BIO 300. Secondary outcomes included pharmacokinetics, pharmacodynamics, overall toxicity profile, quality of life, local response rate, and survival. RESULTS Twenty-one participants were enrolled. No dose-limiting toxicities were reported. BIO 300 dosing did not alter chemotherapy pharmacokinetics. Adverse events were not dose-dependent, and those attributable to BIO 300 (n = 11) were all mild to moderate in severity (grade 1, n = 9; grade 2, n = 2) and predominantly gastrointestinal (n = 7). A dose-dependent decrease in serum transforming growth factor β1 levels was observed across cohorts. Based on safety analysis, the maximum tolerated dose of BIO 300 was not met. Patient-reported quality of life and weight were largely stable throughout the study period. No patient had progression as their best overall response, and a 65% tumor response rate was achieved (20% complete response rate). CONCLUSIONS The low toxicity rates, along with the pharmacodynamic results and tumor response rates, support further investigation of BIO 300 as an effective radioprotector.
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Affiliation(s)
- Charles B Simone
- Baltimore and Maryland Proton Treatment Center, University of Maryland School of Medicine, Baltimore, Maryland; New York Proton Center, New York, New York; Memorial Sloan Kettering Cancer Center, New York, New York.
| | | | - Elizabeth M Gore
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Pranshu Mohindra
- Baltimore and Maryland Proton Treatment Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Stephen L Brown
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, Michigan
| | - Ding Wang
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, Michigan
| | - Indrin J Chetty
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, Michigan
| | - Zeljko Vujaskovic
- Baltimore and Maryland Proton Treatment Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Smitha Menon
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jonathan Thompson
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Gil Fine
- Humanetics Corporation, Minneapolis, Minnesota
| | | | - Benjamin Movsas
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, Michigan
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21
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Carneiro BA, Cavalcante L, Mahalingam D, Saeed A, Safran H, Ma WW, Coveler AL, Powell S, Bastos B, Davis E, Sahai V, Mikrut W, Longstreth J, Smith S, Weisskittel T, Li H, Borden BA, Harvey RD, Sahebjam S, Cervantes A, Koukol A, Mazar AP, Steeghs N, Kurzrock R, Giles FJ, Munster P. Phase I Study of Elraglusib (9-ING-41), a Glycogen Synthase Kinase-3β Inhibitor, as Monotherapy or Combined with Chemotherapy in Patients with Advanced Malignancies. Clin Cancer Res 2024; 30:522-531. [PMID: 37982822 DOI: 10.1158/1078-0432.ccr-23-1916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/21/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE The safety, pharmacokinetics, and efficacy of elraglusib, a glycogen synthase kinase-3β (GSK-3β) small-molecule inhibitor, as monotherapy or combined with chemotherapy, in patients with relapsed or refractory solid tumors or hematologic malignancies was studied. PATIENTS AND METHODS Elraglusib (intravenously twice weekly in 3-week cycles) monotherapy dose escalation was followed by dose escalation with eight chemotherapy regimens (gemcitabine, doxorubicin, lomustine, carboplatin, irinotecan, gemcitabine/nab-paclitaxel, paclitaxel/carboplatin, and pemetrexed/carboplatin) in patients previously exposed to the same chemotherapy. RESULTS Patients received monotherapy (n = 67) or combination therapy (n = 171) elraglusib doses 1 to 15 mg/kg twice weekly. The initial recommended phase II dose (RP2D) of elraglusib was 15 mg/kg twice weekly and was defined, without dose-limiting toxicity observation, due to fluid volumes necessary for drug administration. The RP2D was subsequently reduced to 9.3 mg/kg once weekly to reduce elraglusib-associated central/peripheral vascular access catheter blockages. Other common elraglusib-related adverse events (AE) included transient visual changes and fatigue. Grade ≥3 treatment-emergent AEs occurred in 55.2% and 71.3% of patients on monotherapy and combination therapy, respectively. Part 1 monotherapy (n = 62) and part 2 combination (n = 138) patients were evaluable for response. In part 1, a patient with melanoma had a complete response, and a patient with acute T-cell leukemia/lymphoma had a partial response (PR). In part 2, seven PRs were observed, and the median progression-free survival and overall survival were 2.1 [95% confidence interval (CI), 2-2.6] and 6.9 (95% CI, 5.7-8.4) months, respectively. CONCLUSIONS Elraglusib had a favorable toxicity profile as monotherapy and combined with chemotherapy and was associated with clinical benefit supporting further clinical evaluation in combination with chemotherapy.
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Affiliation(s)
- Benedito A Carneiro
- Legorreta Cancer Center, Brown University and Lifespan Cancer Institute, Providence, Rhode Island
| | | | | | - Anwaar Saeed
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Howard Safran
- Legorreta Cancer Center, Brown University and Lifespan Cancer Institute, Providence, Rhode Island
| | | | | | - Steven Powell
- Sanford Health, University of South Dakota Medical Center, Sioux Falls, South Dakota
| | - Bruno Bastos
- Miami Cancer Institute at Baptist Health, Miami, Florida
| | | | | | | | | | | | | | - Hu Li
- Mayo Clinic Cancer Center, Rochester, Minnesota
| | - Brittany A Borden
- Legorreta Cancer Center, Brown University and Lifespan Cancer Institute, Providence, Rhode Island
| | | | | | - Andrés Cervantes
- Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | | | | | | | | | | | - Pamela Munster
- University of California San Francisco, San Francisco, California
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22
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Jenkins SV, Shruti Shah, Jamshidi-Parsian A, Mortazavi A, Kristian H, Boysen G, Vang KB, Griffin RJ, Rajaram N, Dings RP. Acquired Radiation Resistance Induces Thiol-dependent Cisplatin Cross-resistance. Radiat Res 2024; 201:174-187. [PMID: 38329819 PMCID: PMC10993299 DOI: 10.1667/rade-23-00005.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 11/22/2023] [Indexed: 02/10/2024]
Abstract
Resistance to radiation remains a significant clinical challenge in non-small cell lung carcinoma (NSCLC). It is therefore important to identify the underlying molecular and cellular features that drive acquired resistance. We generated genetically matched NSCLC cell lines to investigate characteristics of acquired resistance. Murine Lewis lung carcinoma (LLC) and human A549 cells acquired an approximate 1.5-2.5-fold increase in radiation resistance as compared to their parental match, which each had unique intrinsic radio-sensitivities. The radiation resistance (RR) was reflected in higher levels of DNA damage and repair marker γH2AX and reduced apoptosis induction after radiation. Morphologically, we found that radiation resistance A549 (A549-RR) cells exhibited a greater nucleus-to-cytosol (N/C) ratio as compared to its parental counterpart. Since the N/C ratio is linked to the differentiation state, we next investigated the epithelial-to-mesenchymal transition (EMT) phenotype and cellular plasticity. We found that A549 cells had a greater radiation-induced plasticity, as measured by E-cadherin, vimentin and double-positive (DP) modulation, as compared to LLC. Additionally, migration was suppressed in A549-RR cells, as compared to A549 cells. Subsequently, we confirmed in vivo that the LLC-RR and A549-RR cells are also more resistance to radiation than their isogenic-matched counterpart. Moreover, we found that the acquired radiation resistance also induced resistance to cisplatin, but not carboplatin or oxaliplatin. This cross-resistance was attributed to induced elevation of thiol levels. Gamma-glutamylcysteine synthetase inhibitor buthionine sulfoximine (BSO) sensitized the resistant cells to cisplatin by decreasing the amount of thiols to levels prior to obtaining acquired radiation resistance. By generating radiation-resistance genetically matched NSCLC we were able to identify and overcome cisplatin cross-resistance. This is an important finding arguing for combinatorial treatment regimens including glutathione pathway disruptors in patients with the potential of improving clinical outcomes in the future.
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Affiliation(s)
- Samir V. Jenkins
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Shruti Shah
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Azemat Jamshidi-Parsian
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Amir Mortazavi
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Hailey Kristian
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Gunnar Boysen
- Environment Health Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Kieng B. Vang
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Robert J. Griffin
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Narasimhan Rajaram
- Department for Biomedical Engineering, University of Arkansas, University of Arkansas at Fayetteville, Fayetteville, Arkansas 72701
| | - Ruud P.M. Dings
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
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23
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Westin SN, Moore K, Chon HS, Lee JY, Thomes Pepin J, Sundborg M, Shai A, de la Garza J, Nishio S, Gold MA, Wang K, McIntyre K, Tillmanns TD, Blank SV, Liu JH, McCollum M, Contreras Mejia F, Nishikawa T, Pennington K, Novak Z, De Melo AC, Sehouli J, Klasa-Mazurkiewicz D, Papadimitriou C, Gil-Martin M, Brasiuniene B, Donnelly C, del Rosario PM, Liu X, Van Nieuwenhuysen E. Durvalumab Plus Carboplatin/Paclitaxel Followed by Maintenance Durvalumab With or Without Olaparib as First-Line Treatment for Advanced Endometrial Cancer: The Phase III DUO-E Trial. J Clin Oncol 2024; 42:283-299. [PMID: 37864337 PMCID: PMC10824389 DOI: 10.1200/jco.23.02132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/13/2023] [Accepted: 10/14/2023] [Indexed: 10/22/2023] Open
Abstract
PURPOSE Immunotherapy and chemotherapy combinations have shown activity in endometrial cancer, with greater benefit in mismatch repair (MMR)-deficient (dMMR) than MMR-proficient (pMMR) disease. Adding a poly(ADP-ribose) polymerase inhibitor may improve outcomes, especially in pMMR disease. METHODS This phase III, global, double-blind, placebo-controlled trial randomly assigned eligible patients with newly diagnosed advanced or recurrent endometrial cancer 1:1:1 to: carboplatin/paclitaxel plus durvalumab placebo followed by placebo maintenance (control arm); carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab plus olaparib placebo (durvalumab arm); or carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab plus olaparib (durvalumab + olaparib arm). The primary end points were progression-free survival (PFS) in the durvalumab arm versus control and the durvalumab + olaparib arm versus control. RESULTS Seven hundred eighteen patients were randomly assigned. In the intention-to-treat population, statistically significant PFS benefit was observed in the durvalumab (hazard ratio [HR], 0.71 [95% CI, 0.57 to 0.89]; P = .003) and durvalumab + olaparib arms (HR, 0.55 [95% CI, 0.43 to 0.69]; P < .0001) versus control. Prespecified, exploratory subgroup analyses showed PFS benefit in dMMR (HR [durvalumab v control], 0.42 [95% CI, 0.22 to 0.80]; HR [durvalumab + olaparib v control], 0.41 [95% CI, 0.21 to 0.75]) and pMMR subgroups (HR [durvalumab v control], 0.77 [95% CI, 0.60 to 0.97]; HR [durvalumab + olaparib v control] 0.57; [95% CI, 0.44 to 0.73]); and in PD-L1-positive subgroups (HR [durvalumab v control], 0.63 [95% CI, 0.48 to 0.83]; HR [durvalumab + olaparib v control], 0.42 [95% CI, 0.31 to 0.57]). Interim overall survival results (maturity approximately 28%) were supportive of the primary outcomes (durvalumab v control: HR, 0.77 [95% CI, 0.56 to 1.07]; P = .120; durvalumab + olaparib v control: HR, 0.59 [95% CI, 0.42 to 0.83]; P = .003). The safety profiles of the experimental arms were generally consistent with individual agents. CONCLUSION Carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab with or without olaparib demonstrated a statistically significant and clinically meaningful PFS benefit in patients with advanced or recurrent endometrial cancer.
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Affiliation(s)
| | - Kathleen Moore
- Stephenson Cancer Center at the University of Oklahoma Medical Center, Oklahoma, OK
| | | | - Jung-Yun Lee
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | | | - Ayelet Shai
- RAMBAM Health Care Campus, Haifa, and Israeli Society of Gynecologic Oncology (ISGO), Israel
| | | | - Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Michael A. Gold
- Oklahoma Cancer Specialists and Research Institute, Tulsa, OK
| | - Ke Wang
- Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | | | - Todd D. Tillmanns
- West Cancer Center Research Institute & University of Tennessee Health Science Center, Memphis, TN
| | - Stephanie V. Blank
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, and GOG Foundation (GOG-F), USA
| | - Ji-Hong Liu
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Michael McCollum
- Virginia Oncology Associates, Brock Cancer Center, Norfolk, VA, and GOG Foundation (GOG-F), USA
| | | | - Tadaaki Nishikawa
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kathryn Pennington
- Fred Hutchinson Cancer Center, University of Washington Medical Center, Seattle, WA
| | - Zoltan Novak
- National Institute of Oncology, Budapest, and Central and Eastern European Gynecologic Oncology Group (CEEGOG), Hungary
| | - Andreia Cristina De Melo
- Clinical Research and Technological Development Division, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
| | - Jalid Sehouli
- Charité—Department of Gynecology with Center of Oncological Surgery, Universitätsmedizin Berlin, Berlin, and North Eastern German Society of Gynecological Oncology (NOGGO), Germany
| | - Dagmara Klasa-Mazurkiewicz
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, Gdańsk, and Polish Gynecologic Oncology Group (PGOG), Poland
| | - Christos Papadimitriou
- Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, and Hellenic Cooperative Oncology Group (HeCOG), Greece
| | - Marta Gil-Martin
- Medical Oncology Department, Catalan Institute of Oncology-Institut d'Investigació Biomédica de Bellvitge (IDIBELL), Hospital Duran i Reynals, L'Hospitalet-Barcelona, Barcelona, and Grupo Español de Investigación en Cáncer de Ovario (GEICO), Spain
| | - Birute Brasiuniene
- Department of Medical Oncology, National Cancer Institute of Lithuania, Faculty of Medicine of Vilnius University, Vilnius, and Nordic Society of Gynaecological Oncology (NSGO), Lithuania
| | - Conor Donnelly
- Oncology Biometrics, AstraZeneca, Cambridge, United Kingdom
| | | | - Xiaochun Liu
- Oncology R&D, Late-stage Development, AstraZeneca, Gaithersburg, MD
| | - Els Van Nieuwenhuysen
- University Hospital Leuven, Leuven, and Luxembourg Gynaecological Oncology Group (BGOG), Belgium
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24
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Khokhar FM, Jahangir TM, Khuhawar MY, Khaskheli MI, Khokhar LA, Abro MI, Khaskheli MA, Muqaddisa P. Analysis of platinum-based anticancer injections cisplatin and carboplatin in blood serum and urine of cancer patients by photometry, fluorometry, liquid chromatography using a Schiff-base as derivatizing reagent. J Pharm Biomed Anal 2024; 238:115808. [PMID: 37939547 DOI: 10.1016/j.jpba.2023.115808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/15/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023]
Abstract
Photometric, fluorometric and liquid chromatographic methods were proposed to analyze Pt(II) from cis-platin and carbo-platin injections after derivatization with reagent 2-oxo-propanoic acid N-phenylhydrazonecarbothioamide. The reagent reacted with metals Au(III), Ag(I), Mn(II), Pt(II), Mo(VI), V(V/IV) to develop their characteristic colors in the pH range 3-12 and were extracted in organic solvent trichloromethane. The photoluminescent behavior of ligand and its metal complexes was investigated to correlate the emission pattern. Liquid chromatographic method was also proposed to analyze cis-platin and carbo-platin anti-cancer drugs based on the pre-column derivatizing platinum(II) with ligand. The complex of platinum was separated and eluted from HPLC column Microsorb C-18, (150 cm x 4.6 mm i.d, 5 µm) comprising eluents - tetrabutyl ammonium bromide (1 mM)-sodium acetate (1 mM)-acetonitrile-water-methanol (02:02:06:22:68 v/v/v/v/v). Metals Au(III), Ag(I), Mn(II), V(IV/V), Mo(VI) were also separated completely. The linear calibration range 0.5-2.5 µg/mL was observed following Beer's law with detection limit of 150.00 ng/mL Pt(II). The determination of cis-platin and carbo-platin injections by photometric, fluorometric and chromatographic methods showed RSD (n = 3) 1.14-3.12, 0.98-2.84, 0.92-2.72% respectively. The developed methods were employed to analyze cis-platin in samples of serum and urine of cancer patients undergoing chemotherapy and platinum amounts were observed within 45.0-86.0, 49.0-91.0, 42.0-84.0 ng/mL and 82.0-398, 81.0-389, 74.0-391 ng/mL with relative standard deviation (RSD) (n = 4) of 2.28-3.88, 2.40-3.82, 2.52-3.82% and 2.52-3.91, 2.44-3.94, 1.98-3.24% by liquid chromatographic, fluorometric and photometric techniques respectively.
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Affiliation(s)
- Faiz Muhammad Khokhar
- Institute of Advanced Research Studies in Chemical Sciences, University of Sindh, Zip Code: 71500, Jamshoro, Pakistan.
| | - Taj Muhammad Jahangir
- Institute of Advanced Research Studies in Chemical Sciences, University of Sindh, Zip Code: 71500, Jamshoro, Pakistan
| | - Muhammad Yar Khuhawar
- Institute of Advanced Research Studies in Chemical Sciences, University of Sindh, Zip Code: 71500, Jamshoro, Pakistan
| | - Mazhar Iqbal Khaskheli
- Institute of Advanced Research Studies in Chemical Sciences, University of Sindh, Zip Code: 71500, Jamshoro, Pakistan
| | - Laeeq Ahmed Khokhar
- Institute of Advanced Research Studies in Chemical Sciences, University of Sindh, Zip Code: 71500, Jamshoro, Pakistan
| | - Muhammad Ilyas Abro
- Department of Basic Sciences and Humanities, Dawood University of Engineering and Technology, Karachi, Pakistan
| | | | - Pirh Muqaddisa
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro 76080, Pakistan
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25
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Oaknin A, Gladieff L, Martínez-García J, Villacampa G, Takekuma M, De Giorgi U, Lindemann K, Woelber L, Colombo N, Duska L, Leary A, Godoy-Ortiz A, Nishio S, Angelergues A, Rubio MJ, Fariñas-Madrid L, Yamaguchi S, Lorusso D, Ray-Coquard I, Manso L, Joly F, Alarcón J, Follana P, Romero I, Lebreton C, Pérez-Fidalgo JA, Yunokawa M, Dahlstrand H, D'Hondt V, Randall LM. Atezolizumab plus bevacizumab and chemotherapy for metastatic, persistent, or recurrent cervical cancer (BEATcc): a randomised, open-label, phase 3 trial. Lancet 2024; 403:31-43. [PMID: 38048793 DOI: 10.1016/s0140-6736(23)02405-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/26/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND The GOG240 trial established bevacizumab with chemotherapy as standard first-line therapy for metastatic or recurrent cervical cancer. In the BEATcc trial (ENGOT-Cx10-GEICO 68-C-JGOG1084-GOG-3030), we aimed to evaluate the addition of an immune checkpoint inhibitor to this standard backbone. METHODS In this investigator-initiated, randomised, open-label, phase 3 trial, patients from 92 sites in Europe, Japan, and the USA with metastatic (stage IVB), persistent, or recurrent cervical cancer that was measurable, previously untreated, and not amenable to curative surgery or radiation were randomly assigned 1:1 to receive standard therapy (cisplatin 50 mg/m2 or carboplatin area under the curve of 5, paclitaxel 175 mg/m2, and bevacizumab 15 mg/kg, all on day 1 of every 3-week cycle) with or without atezolizumab 1200 mg. Treatment was continued until disease progression, unacceptable toxicity, patient withdrawal, or death. Stratification factors were previous concomitant chemoradiation (yes vs no), histology (squamous cell carcinoma vs adenocarcinoma including adenosquamous carcinoma), and platinum backbone (cisplatin vs carboplatin). Dual primary endpoints were investigator-assessed progression-free survival according to Response Evaluation Criteria in Solid Tumours version 1.1 and overall survival analysed in the intention-to-treat population. This study is registered with ClinicalTrials.gov, NCT03556839, and is ongoing. FINDINGS Between Oct 8, 2018, and Aug 20, 2021, 410 of 519 patients assessed for eligibility were enrolled. Median progression-free survival was 13·7 months (95% CI 12·3-16·6) with atezolizumab and 10·4 months (9·7-11·7) with standard therapy (hazard ratio [HR]=0·62 [95% CI 0·49-0·78]; p<0·0001); at the interim overall survival analysis, median overall survival was 32·1 months (95% CI 25·3-36·8) versus 22·8 months (20·3-28·0), respectively (HR 0·68 [95% CI 0·52-0·88]; p=0·0046). Grade 3 or worse adverse events occurred in 79% of patients in the experimental group and in 75% of patients in the standard group. Grade 1-2 diarrhoea, arthralgia, pyrexia, and rash were increased with atezolizumab. INTERPRETATION Adding atezolizumab to a standard bevacizumab plus platinum regimen for metastatic, persistent, or recurrent cervical cancer significantly improves progression-free and overall survival and should be considered as a new first-line therapy option. FUNDING F Hoffmann-La Roche.
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Affiliation(s)
- Ana Oaknin
- Medical Oncology Service, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
| | | | | | - Guillermo Villacampa
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology, Barcelona, Spain; The Institute of Cancer Research, London, UK
| | | | - Ugo De Giorgi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Kristina Lindemann
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Oslo University Hospital, Oslo, Norway
| | - Linn Woelber
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicoletta Colombo
- Gynecologic Oncology Department, European Institute of Oncology IRCCS Milan, Milan, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Linda Duska
- University of Virginia Cancer Center, Charlottesville, VA, USA
| | | | | | | | | | | | - Lorena Fariñas-Madrid
- Medical Oncology Service, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | | - Domenica Lorusso
- Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Catholic University of Sacred Heart, Rome, Italy
| | | | - Luis Manso
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | - Ignacio Romero
- Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
| | | | - J Alejandro Pérez-Fidalgo
- University Hospital of Valencia, Valencia, Spain; INCLIVA Biomedical Research Institute, Valencia, Spain; CIBERONC, Valencia, Spain
| | | | - Hanna Dahlstrand
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden
| | | | - Leslie M Randall
- Massey Comprehensive Cancer Center, VCUHealth, Richmond, VA, USA
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26
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Khanmammadov N, Doğan İ, Okay NS, Azizy A, Saip P, Aydiner A. Comparative analysis of doublet chemotherapy regimens plus bevacizumab in patients with recurrent ovarian cancer. Medicine (Baltimore) 2024; 103:e36750. [PMID: 38181291 PMCID: PMC10766248 DOI: 10.1097/md.0000000000036750] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/01/2023] [Indexed: 01/07/2024] Open
Abstract
Among all gynecological malignancies, ovarian cancer is the predominant cause of mortality. Hence, various chemotherapy protocols have been established for managing metastatic ovarian cancer cases. The present study aimed to assess and compare the efficacy of dual chemotherapy regimens plus bevacizumab in patients diagnosed with recurrent platinum-sensitive epithelial ovarian cancer. This was a retrospective observational study. Data on the clinical, pathological, radiological, and treatment characteristics of the patients were recorded. Survival analyses were performed using the Kaplan-Meier method. Moreover, multivariate Cox regression analysis was conducted. Data of a total of 198 patients with a median follow-up duration of 18.7 months after bevacizumab treatment were analyzed. Serous carcinoma was found to be the most common pathological subtype in the analyzed patients, accounting for 85.8% of all cases. In total, 46.5% (n = 92), 38.4% (n = 76) and 15.2% (n = 30) patients had received gemcitabine plus carboplatin, paclitaxel plus carboplatin (PC), and gemcitabine plus cisplatin combined with bevacizumab, respectively. The complete response rate was 18.7%, partial response rate was 56.1%, stable disease rate was 6.6%, and progressive disease rate was 18.7%. The patients received bevacizumab treatment at a median of 9 cycles and doublet chemotherapy at a median of 7 cycles. The median progression-free survival was 11.9 (95% CI: 9.2-14.5) months, and the median overall survival (OS) was 24.7 (95% CI: 19.9-29.4) months. The results showed that a history of surgery prior to bevacizumab treatment was a significant factor affecting OS (P = .006). Patients who had received gemcitabine plus carboplatin with bevacizumab (28 months) had significantly better OS than patients who had received paclitaxel plus carboplatin (20.1 months) and gemcitabine plus cisplatin (17 months) (P = .009). Doublet chemotherapy regimens plus bevacizumab are safe and effective against recurrent platinum-sensitive epithelial ovarian cancer. Gemcitabine plus carboplatin with bevacizumab was superior to other treatment regimens in terms of OS outcomes.
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Affiliation(s)
- Ni̇jat Khanmammadov
- Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - İzzet Doğan
- Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Necla Simay Okay
- Department of Internal Medicine, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Abdulmunir Azizy
- Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Pinar Saip
- Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Adnan Aydiner
- Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
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27
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Johnson D, Weisleder H, Yuan H, Carrozzi G. Paclitaxel-induced myocarditis presenting as new-onset heart failure. BMJ Case Rep 2024; 17:e255646. [PMID: 38176758 PMCID: PMC10773322 DOI: 10.1136/bcr-2023-255646] [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: 01/06/2024] Open
Abstract
Myocarditis with systolic dysfunction is not typically associated with paclitaxel use. Here, we present a case of paclitaxel-induced myocarditis with systolic dysfunction developing after two cycles of carboplatin/paclitaxel in a woman with uterine papillary serous carcinoma and no cardiac risk factors. Myocarditis was diagnosed by cardiac MRI. The management of paclitaxel-induced myocarditis includes intravenous diuresis and initiation of heart failure with reduced ejection fraction guideline-directed medical therapy. Cessation of paclitaxel is also recommended in these patients.
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Affiliation(s)
- Devin Johnson
- Internal Medicine, Montefiore Medical Center, Bronx, New York, USA
| | | | - Haoxuan Yuan
- Internal Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Gianni Carrozzi
- Internal Medicine, Montefiore Medical Center, Bronx, New York, USA
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28
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Barlin JN, Mahar B, Ata A, Cormier B, Michelin D, Salani R, Backes F, Levinson K, Cantrell LA, Weinberg L, Wagreich A, Savage D, Gasson C, Denniston K, Martin J, McElrath T, Timmins PF. Lunchbox trial: A randomized phase III trial of cisplatin and irradiation followed by carboplatin and paclitaxel versus sandwich therapy of carboplatin and paclitaxel followed by irradiation then carboplatin and paclitaxel for advanced endometrial carcinoma. Gynecol Oncol 2024; 180:63-69. [PMID: 38052110 DOI: 10.1016/j.ygyno.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 11/01/2023] [Accepted: 11/12/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND The objective was to compare sequencing strategies for treatment of advanced endometrial carcinoma. METHODS Patients were eligible if they had FIGO 2009 Stage III or IVA endometrial carcinoma or Stage I or II serous or clear cell endometrial carcinoma and positive cytology. Patients were randomized to: Cisplatin 50 mg/m2 IV Days 1 and 29 plus radiation followed by Carboplatin AUC 5 or 6 plus Paclitaxel 175 mg/m2 q 21 days for 4 cycles (chemoRT then chemo) vs. Carboplatin AUC 6 plus Paclitaxel 175 mg/m2 q 21 days for 3 cycles followed by radiation followed by Carboplatin AUC 5 or 6 plus Paclitaxel 175 mg/m2 q 21 days for 3 cycles (sandwich therapy). Futility analysis was planned. The primary objective was to determine if chemoRT then chemo improves recurrence-free survival (RFS) compared to sandwich therapy. RESULTS Of the 48 patients enrolled at 8 sites, 42 patients were eligible for futility analysis, and the trial was closed early. The median follow-up was 30.9 months. The 3-year RFS was 85.7% (95% confidence interval [CI], 62 to 95) in the chemoRT then chemo arm and 73.4% (95% CI, 43 to 89) in the sandwich therapy group (p = 0.58). The 3-year overall survival (OS) was 88.4% (95% CI, 61 to 97) in the chemoRT then chemo arm and 80.9% (95% CI, 51 to 93) in the sandwich therapy group (p = 0.55). CONCLUSION There was no observed significant difference between chemoRT then chemo compared to sandwich therapy in terms of RFS, OS, or adverse events, although the trial was underpowered and closed early due to low accrual.
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Affiliation(s)
| | - Barb Mahar
- Women's Cancer Care Associates, Albany, NY, USA
| | - Ashar Ata
- Albany Medical Center, Albany, NY, USA
| | - Beatrice Cormier
- Centre Hospitalier de l'Université de Montréal, Montreal, Canada
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29
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Feroz Z, Kumar R, Tiwari S, Kumar M. Survival analysis in association with GST gene polymorphism and Treatment outcomes of Gemcitabine and Cisplatin/ Carboplatin-based chemotherapy among patients with Gallbladder Carcinoma. J Cancer Res Ther 2024; 20:289-296. [PMID: 38554336 DOI: 10.4103/jcrt.jcrt_1897_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/01/2022] [Indexed: 04/01/2024]
Abstract
PURPOSE Majority of the gallbladder cancer (GBC) cases are diagnosed at an advanced stage where chemotherapy alone (or in combination with other treatment methods) is mainly opted as therapeutic approach. However, success or failure of this approach largely depends on the interindividual genetic differences. Careful consideration on the genetic association could assist in the evaluation of patient's treatment response and survival rate. Hence, the present study aims to investigate the survival of patients with GBC and their treatment response to gemcitabine and cisplatin/carboplatin-based chemotherapy in association with Glutathione S-transferase (GSTs) gene polymorphism. MATERIAL AND METHODS A total of 216 histologically confirmed cases of gallbladder cancer were recruited. A total of 180 patients were treated with gemcitabine and cisplatin/carboplatin-based chemotherapy. GSTM1, GSTT1, and GSTP1 genotypes were determined by multiplex PCR and by PCR restriction fragment length polymorphism (PCR-RFLP), respectively. The influence of genetic polymorphism on overall survival was analyzed by Kaplan-Meier method, survival rate difference was analyzed by log-rank test, and hazard ratio for mortality outcomes was estimated using Cox regression method. RESULTS GBC patients having genotype GSTP1 (AG + GG) showed poor 3-year survival rate of 0.8% compared to 10.9% of GSTP1 (AA) genotype (χ2 = 6.456, P = 0.011). The multivariate Cox regression results showed that the death risk was significantly higher in GSTP1 (AG + GG) genotype (HR = 3.858, P = 0.050). We found no association of GSTM1 and GSTT1 gene polymorphism with the survival; however, the combined genotypes of GSM1/GSTP1, GSTT1/GSTP1, and GSTM1/GSTT1/GSTP1 were associated with survival (P = 0.053, 0.006, and 0.058, respectively). Increased death hazard was noted by the genotype combinations of GSTM1+/GSTP1AG + GG (HR = 3.484, P = 0.024), GSTM1-/GSTP1AG + GG (HR = 2.721, P = 0.014), GSTT1+/GSTP1AG + GG (HR = 20.690, P = 0.001), and GSTT1-/GSTP1AA (HR = 26.111, P < 0.0001). Our findings indicate that chemotherapy treatment response of GSTP1 (AG + GG) has 1.62-fold increased risk for progression compared to GSTP1 (AA) genotype (p = 0.018); however, none of the genotypes showed association with overall survival and death risk after chemotherapeutic treatment. CONCLUSION We found that the presence of GSTP1 (AG + GG) genotype showed survival disadvantage and poor treatment outcomes in response to gemcitabine and cisplatin/carboplatin-based chemotherapy. This could serve as biomarker, and future research in pharmacogenomics will definitely pave the way for the development of better treatment approach for GBC.
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Affiliation(s)
- Zainab Feroz
- Department of Biochemistry, University of Allahabad, Prayagraj, Uttar Pradesh, India
| | - Rishabh Kumar
- Department of Biochemistry, University of Allahabad, Prayagraj, Uttar Pradesh, India
| | - Sonia Tiwari
- Department of Radiation Oncology, Kamala Nehru Memorial Hospital, Uttar Pradesh, India
| | - Munish Kumar
- Department of Biochemistry, University of Allahabad, Prayagraj, Uttar Pradesh, India
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30
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Nieder C, Aanes SG, Dalhaug A, Haukland EC. Sex Differences in Presentation, Treatment, and Survival in Patients Receiving Palliative (Chemo)Radiotherapy for Non-Small Cell Lung Cancer. Anticancer Res 2024; 44:301-305. [PMID: 38159983 DOI: 10.21873/anticanres.16812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND/AIM The aim of this study was to analyze sex differences in a real-world cohort of patients who received palliative thoracic radiotherapy or chemoradiotherapy for non-small cell lung cancer. PATIENTS AND METHODS Retrospectively, baseline, treatment, toxicity, and survival data from a single institution were analyzed. The study included 181 patients (82 females, 99 males). RESULTS Despite borderline significant differences in disease presentation (T and N stage), final assignment to stage II, III or IV was similar. The same was true for target volume size. Neither radiotherapy parameters nor systemic treatment approaches were significantly different. Toxicity profiles and survival were similar too. Less than 1 out of 3 patients experienced high-grade toxicity, largely esophagitis. Median survival was 8.1 (males) versus 7.8 months (females) and the corresponding 2-year survival rates were 16 and 15%, respectively (p=0.78). CONCLUSION Relevant sex differences were not observed in this study of common radiotherapy regimes such as 10 fractions of 3 Gy or 15 fractions of 2.8 Gy, the latter often combined with carboplatin/vinorelbine chemotherapy.
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Affiliation(s)
- Carsten Nieder
- Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway;
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Siv Gyda Aanes
- Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway
| | - Astrid Dalhaug
- Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway
| | - Ellinor Christin Haukland
- Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway
- SHARE - Center for Resilience in Healthcare, Faculty of Health Sciences, Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway
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31
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Yadav R, Bhawale R, Kapoor DN, Singh SB, Mehra NK. Experimental design approach for development of carboplatin loaded chitosan modified liposomal formulation with improved topical vaginal therapeutic potential. Pharm Dev Technol 2024; 29:1-12. [PMID: 38015058 DOI: 10.1080/10837450.2023.2289133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/20/2023] [Indexed: 11/29/2023]
Abstract
One of the most prevalent cancers affecting women globally is cervical cancer. Cervical cancer is thought to cause 570 000 new cases annually, and standard treatments can have serious side effects. In this work, the main aim is to design, fabrication, and evaluation of carboplatin loaded chitosan coated liposomal formulation (CCLF-I) for vaginal delivery in the treatment of cervical cancer. The particle size and polydispersity index of the CCLF-1 were observed at 269.33 ± 1.15 and 0.40 ± 0.002 nm, respectively. The in vitro mucin binding studies showed good adhesiveness of CCLF-I as compared to plain liposomes (CPLF-I), which was found at 23.49 and 10.80%, respectively. The ex-vivo percent drug permeation from plain liposomal formulation (CPLF-I) was found to be higher in comparison to chitosan coated liposomal formulation which was 56.33% while in CCLF-I it was observed 47.32% this is due to, higher retainability of delivery system (CCLF-I) on targeted site attained by coating of mucoadhesive polymer on liposomes. Ex vivo tissue retention studies exhibited 24.2% of CCLF-I in comparison to 10.34% from plain drug formulation (CPLF-I). The in vivo vaginal retention studies exhibited 14% of drug retention after 24 h from the novel formulation in comparison to 6% from the plain formulation. The developed CCLF-I formulation would open a new avenue in the cervical treatment.
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Affiliation(s)
- Rati Yadav
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Hyderabad, India
- School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, India
| | - Rohit Bhawale
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Hyderabad, India
| | - Deepak N Kapoor
- School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, India
| | - Shashi Bala Singh
- Department of Biological Sciences, National Institute of Pharmaceutical Education and Research, Hyderabad, India
| | - Neelesh Kumar Mehra
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Hyderabad, India
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Chang TY, Yeh CY, Yang CY, Lin WC, Huang CC, Hung YC. Ovarian clear cell carcinoma with uterine intramural recurrence: Case report of ovarian clear cell carcinoma with fertility sparing treatment. Taiwan J Obstet Gynecol 2024; 63:90-94. [PMID: 38216278 DOI: 10.1016/j.tjog.2023.05.017] [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] [Accepted: 05/04/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE Ovarian clear cell carcinoma has a poor prognosis in comparison with other pathological types of epithelial ovarian carcinoma. It also has relative resistance to first-line platinum-based chemotherapy with a great risk of recurrence. CASE REPORT We report a case of recurrent ovarian clear cell carcinoma status after left salpingo-oophorectomy (fertility-sparing debulking operation) and six courses of adjuvant chemotherapy (paclitaxel (175 mg/m2)/carboplatin (AUC 6)). However, two years after diagnosis, elevated CA-125 accompanied by an intrapelvic mass was noted. Uterine intramural recurrence was found during the second laparotomy. She was treated with right salpingo-oophorectomy and abdominal hysterectomy combined with systemic chemotherapy administration (paclitaxel (175 mg/m2)/carboplatin (AUC 6)) and maintenance therapy (bevacizumab (7.5 mg/kg)). There was no other recurrence until one and a half years postoperatively, and the patient was tumor free with regular follow-up. CONCLUSION In young patients with stage I ovarian clear cell carcinoma, fertility-sparing surgery was considered. Most patients will suffer from tumor recurrence, and also intrauterine recurrence rarely happen.
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Affiliation(s)
- Ting Yu Chang
- Department of Obstetrics and Gynecology, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taichung, Taiwan.
| | - Chiung-Yi Yeh
- Department of Obstetrics and Gynecology, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taichung, Taiwan; Graduate Institution of Biomedical Sciences, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taichung, Taiwan.
| | - Chih-Yi Yang
- Department of Obstetrics and Gynecology, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taichung, Taiwan; Department of Public Health, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taichung, Taiwan.
| | - Wu-Chou Lin
- Department of Obstetrics and Gynecology, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taichung, Taiwan; Department of Medicine, China Medical University, Taichung, Taiwan.
| | - Chien-Chu Huang
- Department of Obstetrics and Gynecology, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taichung, Taiwan.
| | - Yao-Ching Hung
- Department of Obstetrics and Gynecology, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taichung, Taiwan; Graduate Institution of Biomedical Sciences, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taichung, Taiwan; Department of Obstetrics and Gynecology, Asia University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taichung, Taiwan.
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Ligorio F, Lobefaro R, Fucà G, Provenzano L, Zanenga L, Nasca V, Sposetti C, Salvadori G, Ficchì A, Franza A, Martinetti A, Sottotetti E, Formisano B, Depretto C, Scaperrotta G, Belfiore A, Vingiani A, Ferraris C, Pruneri G, de Braud F, Vernieri C. Adding fasting-mimicking diet to first-line carboplatin-based chemotherapy is associated with better overall survival in advanced triple-negative breast cancer patients: A subanalysis of the NCT03340935 trial. Int J Cancer 2024; 154:114-123. [PMID: 37615485 DOI: 10.1002/ijc.34701] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/25/2023]
Abstract
Severe calorie restriction, in the form of cyclic fasting or fasting-mimicking diets (FMDs), boosts the antitumor activity of cytotoxic chemotherapy in mouse models of triple-negative breast cancer (TNBC). This effect is mostly mediated by fasting/FMD-induced reduction of plasma glucose concentration and by a boost in antitumor immunity. However, clinical evidence that cyclic FMD may impact on the outcomes of advanced TNBC (aTNBC) patients is lacking. We compared the overall survival (OS) of 14 aTNBC patients receiving first-line carboplatin-gemcitabine plus cyclic FMD in the context of the NCT03340935 trial with the OS of 76 consecutive aTNBC patients treated with carboplatin-based chemotherapy alone at Fondazione IRCCS Istituto Nazionale dei Tumori. Multivariable Cox regression models were used to adjust the prognostic impact of FMD for other prognostic variables. Patients undergoing cyclic FMD in combination with carboplatin-gemcitabine had better OS when compared to patients receiving chemotherapy alone (median OS 30.3 months, 95% CI 18-NR, vs 17.2 months, 95% CI 15.3-25.1, log-rank P value .041). Multivariable analysis confirmed an association between FMD use and better OS (HR: 0.40; 95% CI: 0.19-0.86; P = .019) also after propensity score-based matching according to patient ECOG PS and the presence of de novo metastatic disease (HR: 0.41; 95% CI: 0.21-0.83; P = .013). Cyclic FMD in combination with first-line chemotherapy may improve clinical outcomes in aTNBC patients. Our study paves the way for conducting phase II trials to investigate if cyclic FMD can increase the antitumor activity/efficacy of chemotherapy or chemoimmunotherapy in patients with early-stage TNBC or aTNBC.
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Affiliation(s)
- Francesca Ligorio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- IFOM ETS, The AIRC Institute of Molecular Oncology, Milan, Italy
- Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - Riccardo Lobefaro
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanni Fucà
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Leonardo Provenzano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - Lucrezia Zanenga
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Vincenzo Nasca
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - Caterina Sposetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - Giulia Salvadori
- IFOM ETS, The AIRC Institute of Molecular Oncology, Milan, Italy
| | - Angela Ficchì
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Franza
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - Antonia Martinetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elisa Sottotetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Barbara Formisano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Catherine Depretto
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Antonino Belfiore
- Pathology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Vingiani
- Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
- Pathology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cristina Ferraris
- Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giancarlo Pruneri
- Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
- Pathology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Filippo de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - Claudio Vernieri
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- IFOM ETS, The AIRC Institute of Molecular Oncology, Milan, Italy
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Li L, Chen J, Wang A, Yi K. ALKBH5 regulates ovarian cancer growth via demethylating long noncoding RNA PVT1 in ovarian cancer. J Cell Mol Med 2024; 28:e18066. [PMID: 38098223 PMCID: PMC10826426 DOI: 10.1111/jcmm.18066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 02/01/2024] Open
Abstract
The long noncoding RNA PVT1 is reported to act as an oncogene in several kinds of cancers, especially ovarian cancer (OV). Abnormal levels of N6 -methyladenosine, a dynamic and reversible modification, are associated with tumorigenesis and malignancies. Our previous study reported that PVT1 plays critical roles in regulating OV. However, it is still largely unknown how m6 A modification affects OV via PVT1. In this study, we aimed to investigate the regulation of ALKBH5 by affecting PVT1 in OV. We first found that the PVT1 RNA level was higher in OV cells than in IOSE80 cells, and conversely, the m6 A modification level of PVT1 was lower in OV cells. By searching the HPA, ALKBH5, which is responsible for PVT1 demethylation, was found to be upregulated in OV tissues versus normal ovarian tissues. ALKBH5 binds to PVT1 RNA, and knockdown of ALKBH5 decreased PVT1 RNA levels. ALKBH5 also increased FOXM1 levels by upregulating PVT1, at least partially. Knockdown of ALKBH5 suppressed OV growth, colony formation, tumour formation and invasion, which were partially reversed by overexpression of PVT1. Moreover, ALKBH5 knockdown decreased FOXM1 levels by regulating PVT1 RNA expression, subsequently increasing the sensitivity to carboplatin, 5-FU and docetaxel chemotherapy. Taken together, these results indicate that ALKBH5 directly regulates the m6 A modification and stability of PVT1. Then, modified PVT1 further regulates FOXM1 and thus affects malignant behaviours and chemosensitivity in OV cells. All these results indicate that ALKBH5 regulates the malignant behaviour of OV by regulating PVT1/FOXM1.
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Affiliation(s)
- Lin Li
- Department of Obstetrics and Gynecology, West China Second University HospitalSichuan UniversityChengduSichuanChina
- The Key Laboratory of Birth Defects and Related Diseases of Women and Children (West China Second University Hospital Sichuan University), Ministry of EducationChengduSichuanChina
| | - Jie Chen
- Department of Obstetrics and Gynecology, West China Second University HospitalSichuan UniversityChengduSichuanChina
- The Key Laboratory of Birth Defects and Related Diseases of Women and Children (West China Second University Hospital Sichuan University), Ministry of EducationChengduSichuanChina
| | - Ao Wang
- Department of Obstetrics and Gynecology, West China Second University HospitalSichuan UniversityChengduSichuanChina
- The Key Laboratory of Birth Defects and Related Diseases of Women and Children (West China Second University Hospital Sichuan University), Ministry of EducationChengduSichuanChina
| | - Ke Yi
- Department of Obstetrics and Gynecology, West China Second University HospitalSichuan UniversityChengduSichuanChina
- The Key Laboratory of Birth Defects and Related Diseases of Women and Children (West China Second University Hospital Sichuan University), Ministry of EducationChengduSichuanChina
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Kubota T, Sakai M, Anabuki K, Takamatsu K, Mukaida K, Kobayashi K, Yamagami T, Yokoyama A. A Phase I Trial of Weekly Nab-paclitaxel Plus Carboplatin With Thoracic Radiotherapy for Non-small Cell Lung Cancer. In Vivo 2024; 38:259-263. [PMID: 38148041 PMCID: PMC10756434 DOI: 10.21873/invivo.13433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND/AIM This study aimed to evaluate the safety and recommended dose of nab-paclitaxel in combination with carboplatin and thoracic radiotherapy for locally advanced non-small cell lung cancer (NSCLC). PATIENTS AND METHODS Nab-paclitaxel was administered weekly with escalating doses, combined with carboplatin area under the curve (AUC) 2 and concurrent standard thoracic radiotherapy. Escalating doses of nab-paclitaxel were as follows: level 0, 30 mg/m2; level 1, 35 mg/m2; level 2, 40 mg/m2; level 3, 45 mg/m2 Results: Twelve patients were enrolled and received the treatment according to the protocol; seven patients (58%) had squamous cell carcinoma and all cases had stage III disease. At level 1, none of the three patients experienced dose limiting toxicity (DLT). At level 2, one of the first three patients experienced a fatal DLT of bronchopulmonary hemorrhage. None of the three more additional patients experienced DLT. At level 3, two of the three patients experienced a DLT of grade 3 febrile neutropenia and grade 4 neutropenia, respectively. Consolidation chemotherapy was provided to 10 of 12 patients. Radiation pneumonitis developed in five of 12 patients (42%). Eight patients (66.7%) showed partial response, and four (33.3%) showed stable disease. For the above reasons, level 2 (40 mg/m2) was considered the recommended dose in this study. CONCLUSION Concurrent chemoradiotherapy with weekly nab-paclitaxel (40 mg/m2) and carboplatin (AUC 2) is a feasible and well-tolerated regimen in patients with previously untreated locally advanced NSCLC. A phase II trial with this regimen is warranted.
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Affiliation(s)
- Tetsuya Kubota
- Department of Respiratory Medicine and Allergology, Kochi University, Kochi Medical School, Kochi, Japan
| | - Mizu Sakai
- Department of Respiratory Medicine and Allergology, Kochi University, Kochi Medical School, Kochi, Japan
| | - Kazuki Anabuki
- Department of Respiratory Medicine and Allergology, Kochi University, Kochi Medical School, Kochi, Japan
| | - Kazufumi Takamatsu
- Department of Respiratory Medicine and Allergology, Kochi University, Kochi Medical School, Kochi, Japan
| | - Kenichi Mukaida
- Department of Respiratory Medicine and Allergology, Kochi University, Kochi Medical School, Kochi, Japan
| | - Kana Kobayashi
- Department of Radiology, Kochi University, Kochi Medical School, Kochi, Japan
| | - Takuji Yamagami
- Department of Radiology, Kochi University, Kochi Medical School, Kochi, Japan
| | - Akihito Yokoyama
- Department of Respiratory Medicine and Allergology, Kochi University, Kochi Medical School, Kochi, Japan
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Nakamichi S, Kubota K, Matsuyama K, Misumi T, Kozuki T, Sugawara S, Naoki K, Kobayashi N, Shukuya T, Shimokawa T, Ishihara M, Wakui H, Hosomi Y, Tanaka H, Saito H, Hosokawa S, Takiguchi Y, Kasai T, Nokihara H, Morita R, Aono H, Furuya N, Okamoto H. A Phase Ⅱ Study of Ubenimex Combined With Pembrolizumab, Nab-Paclitaxel, and Carboplatin for Previously Untreated Advanced Squamous Non-Small-Cell Lung Cancer: TORG2241 (UBE-Q). Clin Lung Cancer 2024; 25:85-90. [PMID: 37981477 DOI: 10.1016/j.cllc.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/30/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND According to the results of the KEYNOTE-407 trial, pembrolizumab plus platinum-based chemotherapy is the standard of care for patients with previously untreated advanced squamous non-small-cell lung cancer (NSCLC). Ubenimex, a potent aminopeptidase inhibitor, is an oral drug with immunostimulatory and antitumor activities. We aim to assess the safety and efficacy of ubenimex in combination with pembrolizumab, nab-paclitaxel, and carboplatin in patients with previously untreated advanced squamous NSCLC. PATIENTS AND METHODS This prospective, single-arm, multicenter, phase II clinical trial is conducted to confirm the tolerability and efficacy of the tested drugs. Patients with previously untreated advanced squamous NSCLC will receive a predetermined daily dose of ubenimex orally plus 4 cycles of pembrolizumab, nab-paclitaxel, and carboplatin, followed by continuous administration of ubenimex and pembrolizumab for a maximum of 2 years. To confirm tolerability, the daily dose of ubenimex will begin at level 1 (30 mg), which will be increased to levels 2 (60 mg) and 3 (120 mg) according to the escalation criteria, with a standard 3 + 3 design for achieving the target dose-limiting toxicity rate of 33%. The efficacy, safety, and tolerability of ubenimex at the determined dose level will be analyzed. The primary endpoint of the efficacy evaluation will be the objective response rate assessed by an independent review committee. CONCLUSIONS This is the first study to evaluate the efficacy and safety of ubenimex combined with pembrolizumab, nab-paclitaxel, and carboplatin in patients with previously untreated advanced squamous NSCLC. The results will help devise future treatment strategies.
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Affiliation(s)
- Shinji Nakamichi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
| | - Kotone Matsuyama
- Department of Health Policy and Management, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Toshihiro Misumi
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama-shi, Kanagawa, Japan
| | - Toshiyuki Kozuki
- Department of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai-shi, Miyagi, Japan
| | - Katsuhiko Naoki
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara-shi, Kanagawa, Japan
| | - Nobuaki Kobayashi
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Takehito Shukuya
- Department of Respiratory Medicine, Juntendo University, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Tsuneo Shimokawa
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Masashi Ishihara
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Hiroshi Wakui
- Division of Respiratory Diseases, Department of Internal Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Tanaka
- Department of Internal Medicine, Niigata Cancer Center Hospital, Chuo-ku, Niigata, Japan
| | - Haruhiro Saito
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Shinobu Hosokawa
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama-shi, Okayama, Japan
| | - Yuichi Takiguchi
- Department of Medical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takashi Kasai
- Division of Thoracic Oncology, Department of Medical Oncology, Tochigi Cancer Center, Utsunomiya-shi, Tochigi, Japan
| | - Hiroshi Nokihara
- Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Hiroshima, Japan
| | - Ryo Morita
- Department of Respiratory Medicine, Akita Kousei Medical Center, Akita, Japan
| | - Hiromi Aono
- Department of Respiratory Medicine, Tokyo Metropolitan Police Hospital, Nakano-ku, Tokyo, Japan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
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Yang ST, Chang WH, Chou FW, Liu HH, Lee WL, Wang PH. Front-line chemoimmunotherapy for treating epithelial ovarian cancer: Part II promising results of phase 2 study of paclitaxel- carboplatin-oregovomab regimen. Taiwan J Obstet Gynecol 2024; 63:10-16. [PMID: 38216242 DOI: 10.1016/j.tjog.2023.11.005] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 01/14/2024] Open
Abstract
In the Part I, we have discussed the background of CA125 and the development of anti-CA125 monoclonal antibody (MAb) to highlight the potential role of CA125 and anti-CA125 MAb in the management of women with advanced stage epithelial ovarian cancer (EOC). Glycosylation change either by N-link or by O-link of CA125 is supposed to play a role in the modification of immunity. Anti-CA125 MAb, which can be classified as OC 125-like Abs, M11-like Abs, and OV197-like Abs, is often used for diagnosing, screening, monitoring and detecting the mesothelin-related diseases of the abdominal cavity, particular for those women with EOC. Additionally, anti-CA125 MAb also plays a therapeutic role, named as OvaRex MAb-B43.13 (oregovomab), which has also been extensively reviewed in the Part I review article. The main mechanisms include (a) forming CA125 immune complexes to activate the antigen-presenting cells; (b) triggering induction of CA125-specific immune responses, including anti-CA125 Abs against various epitopes and CA125-specific B and T cell responses; and (c) triggering CD4 and CD8 T-cell responses specific for B43.13 to produce specific and non-specific immune response. With success in vitro, in vivo and in primitive studies, phase II study was conducted to test the effectiveness of chemoimmunotherapy (CIT) for the management of EOC patients. In the 97 EOC patients after optimal debulking surgery (residual tumor <1 cm or no gross residual tumor), patients treated with CIT had a dramatical and statistically significant improvement of both progression-free survival (PFS) and overall survival (OS) compared to those treated with chemotherapy alone with a median PFS of 41.8 months versus 12.2 months (hazard ratio [HR] 0.46, 95 % confidence interval [CI] 0.28-0.7) and OS not yet been reached (NE) versus 42.3 months (HR 0.35, 95 % CI 0.16-0.74), respectively. The current review as Part II will explore the possibility of using CIT as front-line therapy in the management of advanced-stage EOC patients after maximal cytoreductive surgery based on the evidence by many phase 2 studies.
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Affiliation(s)
- Szu-Ting Yang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Hsun Chang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fang-Wei Chou
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hung-Hsien Liu
- Department of Medical Imaging and Intervention, Tucheng Hospital, New Taipei City, Taiwan
| | - Wen-Ling Lee
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan.
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Female Cancer Foundation, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
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Filippini DM, Pagani R, Tober N, Lorini L, Riefolo M, Molinari G, Burato A, Alfieri S, Bossi P, Presutti L. HER2-targeted therapies for salivary gland cancers. Oral Oncol 2024; 148:106612. [PMID: 38016228 DOI: 10.1016/j.oraloncology.2023.106612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/20/2023] [Accepted: 10/29/2023] [Indexed: 11/30/2023]
Abstract
Salivary gland cancers (SGCs) are a heterogeneous group of rare tumors including various histological subtypes with different molecular profiling. Human epidermal growth factor receptor 2 (HER2) is one of the most intriguing and studied molecular alterations with prognostic and predictive roles. Indeed, HER2 overexpression is commonly correlated with aggressive histological subtypes and poorer prognosis. However, HER2 may represent the target of personalized treatment. We performed a literature review of use of anti-HER2 targeted agents for treatment of recurrent or metastatic SGCs. The efficacy and safety of anti-HER2 were firstly evaluated in patients affected with other solid tumors, mostly breast and gastric cancers. For SGCs the literature is mainly comprised of case reports or case series and small clinical trials. The most common used drug is trastuzumab in combination with chemotherapy (i.e. taxanes, capecitabine, carboplatin, eribulin) or with another anti-HER2 targeted agent (i.e. pertuzumab). The use of anti-HER2 therapies induces improvement in clinical responses, which are mostly durable. Besides, new anti-HER2 drugs such as antibody-drug conjugates (ADC) (i.e. trastuzumab emtansine, trastuzumab deruxtecan) have been introduced in this setting inducing further therapeutic advances. Anti-HER2 treatment strategy is emerging as potentially effective in selected HER2 overexpressing SGCs. However, prospective and multicentric clinical trials are needed to evaluate the efficacy of these therapeutic regimens within larger cohorts and to assess the most appropriate treatment sequence strategy.
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Affiliation(s)
- Daria Maria Filippini
- Division of Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, Università di Bologna, 40138 Bologna, Italy.
| | - Rachele Pagani
- Division of Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
| | - Nastassja Tober
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Azienda Ospedaliera Maggiore Della Caritá, Novara, Italy
| | - Luigi Lorini
- IRCCS Humanitas Research Hospital, Medical Oncology and Hematology Unit, 20089 Rozzano (Milan), Italy
| | - Mattia Riefolo
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giulia Molinari
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, Università di Bologna, 40138 Bologna, Italy; Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Arianna Burato
- Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Salvatore Alfieri
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Paolo Bossi
- IRCCS Humanitas Research Hospital, Medical Oncology and Hematology Unit, 20089 Rozzano (Milan), Italy; Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
| | - Livio Presutti
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, Università di Bologna, 40138 Bologna, Italy; Department of Otolaryngology - Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Li X, Liu L. Comment on "Concurrent carboplatin and paclitaxel definitive radiation therapy for locally advanced head and neck cancer". Head Neck 2024; 46:228-229. [PMID: 37880929 DOI: 10.1002/hed.27559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023] Open
Abstract
see pages 230‐231
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Affiliation(s)
- Xueting Li
- Division of Head & Neck Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- Department of Oncology, 363 Hospital, Chengdu, China
| | - Lei Liu
- Division of Head & Neck Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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Guo Y, Nakashima T, Cho BC, Lim DWT, Yang MH, Lou PJ, Corry J, Lin JC, Zhu GP, Kim KH, Zhang B, Li Z, Hong RL, Ng JYS, Tan EM, Liu YP, Stylianou C, Spiteri C, Porceddu S. Clinical decision pathway and management of locally advanced head and neck squamous cell carcinoma: A multidisciplinary consensus in Asia-Pacific. Oral Oncol 2024; 148:106657. [PMID: 38101313 DOI: 10.1016/j.oraloncology.2023.106657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/26/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES To develop consensus on patient characteristics and disease-related factors considered in deciding treatment approaches for locally advanced head and neck squamous cell carcinoma (LA-HNSCC) based on real-world treatment patterns in 4 territories in Asia-Pacific. METHODS A three-round modified Delphi involving a multidisciplinary panel of HN surgeons, medical oncologists, and radiation oncologists was used. Of 41 panelists recruited, responses of 26 from Australia, Japan, Singapore, and Taiwan were analyzed. All panelists had ≥five years' experience managing LA-HNSCC patients and treated ≥15 patients with LA-HNSCC annually. RESULTS All statements on definitions of LA-HNSCC, treatment intolerance and cisplatin dosing reached consensus. 4 of 7 statements on unresectability, 2 of 4 on adjuvant chemoradiotherapy, 7 of 13 on induction chemotherapy, 1 of 8 on absolute contraindications and 7 of 11 on relative contraindications to high-dose cisplatin did not reach consensus. In all territories except Taiwan, high-dose cisplatin was preferred in definitive and adjuvant settings for patients with no contraindications to cisplatin; weekly cisplatin (40 mg/m2) preferred for patients with relative contraindications to high-dose cisplatin. For Taiwan, the main treatment option was weekly cisplatin. For patients with absolute contraindications to cisplatin, carboplatin ± 5-fluorouracil or radiotherapy alone were preferred alternatives in both definitive and adjuvant settings. CONCLUSION This multidisciplinary consensus provides insights into management of LA-HNSCC in Asia-Pacific based on patient- and disease-related factors that guide selection of treatment modality and systemic treatment. Despite strong consensus on use of cisplatin-based regimens, areas of non-consensus showed that variability in practice exists where there is limited evidence.
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Affiliation(s)
- Ye Guo
- Department of Oncology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
| | - Torahiko Nakashima
- Department of Otorhinolaryngology, Head & Neck Cancer Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Byoung Chul Cho
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Darren W-T Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Muh-Hwa Yang
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Jen Lou
- Department of Otolaryngology, National Taiwan University Hospital, Taipei City, Taiwan
| | - June Corry
- Department Radiation Oncology, Genesis Care St Vincent's Hospital, Melbourne, Australia
| | - Jin Ching Lin
- Department of Radiation Oncology, Changhua Christian Hospital, Changhua, Taiwan
| | - Guo Pei Zhu
- Department of Oral and Maxillofacial Head Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, People's Republic of China
| | - Kyung Hwan Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Bin Zhang
- Department of Head and Neck Surgery, Peking University Cancer Hospital and Institute, Beijing, China
| | - Zhiming Li
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangdong, China
| | - Ruey-Long Hong
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Ee Min Tan
- IQVIA Real-World Solutions Asia-Pacific, Singapore
| | | | | | | | - Sandro Porceddu
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria, Australia
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Ueki Y, Ohshima S, Yokoyama Y, Takahashi T, Shodo R, Yamazaki K, Ohtaki K, Saijo K, Tanaka R, Togashi T, Sato Y, Takano S, Omata J, Takahashi N, Okabe R, Horii A. Multicenter prospective phase II trial of concurrent chemoradiotherapy with weekly low-dose carboplatin for cisplatin-ineligible patients with advanced head and neck squamous cell carcinoma. Int J Clin Oncol 2024; 29:20-26. [PMID: 37843751 DOI: 10.1007/s10147-023-02423-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND The optimal chemotherapy regimen in concurrent chemoradiotherapy (CCRT) for cisplatin-ineligible head and neck squamous cell carcinoma (HNSCC) has not been established. We aimed to evaluate the feasibility, efficacy, and safety of CCRT with weekly low-dose carboplatin for the treatment of advanced HNSCC in patients who are cisplatin-ineligible. METHODS This prospective phase II study enrolled adult patients (age ≥ 20 years) with HNSCC receiving whole-neck irradiation including bilateral levels II-IV and who were aged (≥ 75-year-old patients with 40 mL/min estimated glomerular filtration rate [eGFR] or better) or had renal dysfunction (< 75-year-old patients with 30-60 mL/min eGFR). Carboplatin was administered weekly (area under the plasma concentration-time curve = 2.0) for up to seven cycles during concurrent radiotherapy (70 Gy/35 Fr). The primary endpoint was the completion rate of CCRT. Secondary endpoints included overall response rate and incidence of adverse events. RESULTS Among the 30 patients enrolled, 28 were men. The median age was 73.5 years. Seventeen patients were < 75 years whereas 13 were ≥ 75 years old. The completion rate of CCRT was 90%. The overall response rate was 90%. Grade 3 adverse events that occurred in 10% or more patients were oral/pharyngeal mucositis (47%), leukocytopenia (20%), and neutropenia (10%). Grade 4 adverse events occurred in one patient (elevation of alanine aminotransferase level). No treatment-related deaths occurred. CONCLUSION CCRT with weekly low-dose carboplatin is a promising treatment option, with favorable feasibility, efficacy, and acceptable toxicity, for patients who are cisplatin-ineligible with advanced HNSCC. CLINICAL TRIAL REGISTRATION NUMBER jRCTs031190028.
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Affiliation(s)
- Yushi Ueki
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-Dori, Chuo-Ku, Niigata City, Niigata, 950-8510, Japan.
| | - Shusuke Ohshima
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-Dori, Chuo-Ku, Niigata City, Niigata, 950-8510, Japan
| | - Yusuke Yokoyama
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-Dori, Chuo-Ku, Niigata City, Niigata, 950-8510, Japan
| | - Takeshi Takahashi
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-Dori, Chuo-Ku, Niigata City, Niigata, 950-8510, Japan
| | - Ryusuke Shodo
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-Dori, Chuo-Ku, Niigata City, Niigata, 950-8510, Japan
| | - Keisuke Yamazaki
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-Dori, Chuo-Ku, Niigata City, Niigata, 950-8510, Japan
| | - Kohei Ohtaki
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata City, Niigata, Japan
| | - Kohei Saijo
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata City, Niigata, Japan
| | - Ryoko Tanaka
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata City, Niigata, Japan
| | - Takafumi Togashi
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata City, Niigata, Japan
| | - Yuichiro Sato
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata City, Niigata, Japan
| | - Satoshi Takano
- Department of Otorhinolaryngology, Nagaoka Red Cross Hospital, Nagaoka City, Niigata, Japan
| | - Jo Omata
- Department of Otorhinolaryngology, Nagaoka Red Cross Hospital, Nagaoka City, Niigata, Japan
| | - Nao Takahashi
- Department of Otorhinolaryngology, Nagaoka Red Cross Hospital, Nagaoka City, Niigata, Japan
| | - Ryuichi Okabe
- Department of Otorhinolaryngology, Nagaoka Red Cross Hospital, Nagaoka City, Niigata, Japan
| | - Arata Horii
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-Dori, Chuo-Ku, Niigata City, Niigata, 950-8510, Japan
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Watanabe S, Furuya N, Nakamura A, Shiihara J, Nakachi I, Tanaka H, Nakao M, Minato K, Seike M, Sasaki S, Kisohara A, Takeuchi S, Honda R, Takamura K, Kagamu H, Yoshimura K, Kobayashi K, Kikuchi T. A phase II study of atezolizumab with bevacizumab, carboplatin, and paclitaxel for patients with EGFR-mutated NSCLC after TKI treatment failure (NEJ043 study). Eur J Cancer 2024; 197:113469. [PMID: 38061214 DOI: 10.1016/j.ejca.2023.113469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 11/26/2023] [Indexed: 01/02/2024]
Abstract
INTRODUCTION Treatment options for patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) after EGFR-tyrosine kinase inhibitor (TKI) treatment failure are limited. An exploratory analysis of 26 patients in the IMpower150 study indicated that treatment with atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP) was effective in patients with EGFR-mutated NSCLC. This phase II study was conducted to assess the efficacy of ABCP in EGFR-mutated NSCLC patients after TKI treatment. METHODS Patients with non-squamous NSCLC harboring sensitizing EGFR mutations were enrolled. ABCP therapy was administered every 3 weeks for four cycles, followed by maintenance therapy with atezolizumab and bevacizumab. The primary endpoint was progression-free survival (PFS) according to extramural review (ER). Key secondary endpoints and preplanned analysis included overall survival (OS), overall response rate (ORR), and differences in the efficacy of ABCP according to prior EGFR-TKI administration, liver metastases, and brain metastases. RESULTS Sixty patients from 26 centers were enrolled. Median PFS was 7.4 months (95% confidence interval [CI]: 5.7-8.2). The median OS was 23.1 months (95% CI: 13.1-not reached), and the ORR was 55.9%. PFS was significantly shorter in patients who had received osimertinib as a first-line treatment (7.2 months vs. 7.4 months, hazard ratio [HR] 1.932, p = 0.023), those with brain metastases (5.7 months vs. 8 months, HR 1.86, p = 0.032), or those with liver metastases (5.4 months vs. 7.9 months, HR 2.779, p = 0.003). CONCLUSIONS Although this study did not meet the primary endpoint, ABCP showed clinically meaningful efficacy in EGFR-mutated NSCLC patients.
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Affiliation(s)
- Satoshi Watanabe
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Japan.
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | | | - Jun Shiihara
- Department of Respiratory Medicine, Jichi Medical University Saitama Medical Center, Japan
| | - Ichiro Nakachi
- Pulmonary Division, Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Japan
| | - Hisashi Tanaka
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Japan
| | - Mika Nakao
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
| | - Koichi Minato
- Department of Respiratory Medicine, Gunma Prefectural Cancer Center, Japan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Shinichi Sasaki
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Akira Kisohara
- Department of Respiratory Medicine, Kasukabe Medical Center, Japan
| | - Susumu Takeuchi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan; Department of Thoracic Surgery, Tokyo Medical University, Japan
| | - Ryoichi Honda
- Department of Respiratory Medicine, Asahi General Hospital, Japan
| | - Kei Takamura
- First Department of Internal Medicine, Obihiro Kosei General Hospital, Japan
| | - Hiroshi Kagamu
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Japan
| | - Kenichi Yoshimura
- Medical Center for Clinical and Translational Research, Hiroshima University Hospital, Japan
| | - Kunihiko Kobayashi
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Japan
| | - Toshiaki Kikuchi
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Japan
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Naito M, Terasaki M, Ouchi N, Toyoshima M. Uterine carcinosarcoma showing immature teratoid-like differentiation. BMJ Case Rep 2023; 16:e257228. [PMID: 38154864 PMCID: PMC10759010 DOI: 10.1136/bcr-2023-257228] [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: 12/30/2023] Open
Abstract
A carcinosarcoma is a rare form of cancer characterised by the presence of both carcinomatous and sarcomatous components. Here, we present our experience with an extremely rare case of an uterine carcinosarcoma with immature teratoid-like differentiation. The patient was a woman in her 60s. She was referred for the evaluation of a uterine tumour. She underwent total abdominal hysterectomy with bilateral adnexectomy and received postoperative treatment with paclitaxel and carboplatin. On microscopic examination, the tumour had a heterogeneous appearance with a combination of carcinomatous and sarcomatous elements, and teratoid features. The tumour included immature squamous epithelial cells and immature epithelial glands, and focal atypical fused glands, which are consistent with endometrioid carcinoma, were identified in the endometrium. Pathological differentiation from extrarenal Wilms' tumour and teratocarcinosarcoma was challenging. The final pathological diagnosis was uterine carcinosarcoma with immature teratoid-like differentiation. At 14 months after the surgery, the patient has not experienced recurrence.
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Affiliation(s)
- Mio Naito
- Obstetrics and Gynecology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Mika Terasaki
- Analytic Human Pathology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Nozomi Ouchi
- Obstetrics and Gynecology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Masafumi Toyoshima
- Obstetrics and Gynecology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
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Heitz F, Marth C, Henry S, Reuss A, Cibula D, Gaba Garcia L, Colombo N, Schmalfeld B, de Gregorio N, Wimberger P, Hasenburg A, Sehouli J, Gropp-Meier M, Schouten PC, Hahnen E, Hauke J, Polleis S, Harter P. AGO-OVAR 28/ENGOT-ov57. Niraparib alone versus niraparib in combination with bevacizumab in patients with carboplatin-taxane-based chemotherapy in advanced ovarian cancer: a multicenter randomized phase III trial. Int J Gynecol Cancer 2023; 33:1966-1969. [PMID: 37935524 DOI: 10.1136/ijgc-2023-004944] [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: 11/09/2023] Open
Abstract
BACKGROUND Phase III trial data have shown a significant benefit by the addition of a maintenance treatment with niraparib, irrespective of BRCA or HRD status, in patients with advanced high-grade ovarian cancers; and, a significant benefit of the combination of olaparib and bevacizumab compared with bevacizumab monotherapy in HRD positive patients. However, it is unclear whether a PARP inhibitor monotherapy is sufficient, or if the addition of bevacizumab is needed. PRIMARY OBJECTIVES This trial will investigate if the treatment strategy of carboplatin/paclitaxel/bevacizumab/niraparib is superior to the treatment of carboplatin/paclitaxel/niraparib in an all-comer population. STUDY HYPOTHESIS Adding bevacizumab to chemotherapy followed by niraparib maintenance improves progression-free survival in patients with newly diagnosed advanced ovarian cancer. TRIAL DESIGN AGO-OVAR 28/ENGOT-ov57 is an international, multicenter, randomized, prospective phase III trial within the the European Network for Gynecological Oncological Trial (ENGOT), led by the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) study group. All patients should have completed the first cycle of chemotherapy (carboplatin and paclitaxel) as part of the Study Run-In-Period. Prior to day 1 of cycle 2, patients with a valid central tumor BRCA (tBRCA) test result were randomized in a 1:1 ratio into either: Arm 1, to receive five additional cycles of carboplatin and paclitaxel q21d, followed by niraparib for up to 3 years; or Arm 2, to receive five additional cycles of carboplatin and paclitaxel plus bevacizumab q21d, followed by bevacizumab q21d (for up to 1 year), and niraparib for up to 3 years. MAJOR INCLUSION/EXCLUSION CRITERIA The trial population is composed of adult patients with newly diagnosed, advanced high-grade epithelial ovarian cancer, primary peritoneal cancer, or fallopian tube cancer FIGO III/IV (except FIGO IIIA2 without nodal involvement). Patients who are scheduled for neoadjuvant chemotherapy and interval debulking surgery are also eligible for the trial. PRIMARY ENDPOINT The primary endpoint is progression-free survival. SAMPLE SIZE The study plans to recruit 970 patients (485 patients in each arm). ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS The Last-Patient-In is expected to be enrolled in September 2024, with presentation of the primary endpoint in 2028. TRIAL REGISTRATION NCT05009082; EudraCT Number: 2021-001271-16.
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Affiliation(s)
- Florian Heitz
- AGO Studygroup and Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte Evangelische Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
- Department for Gynecology with the Center for Oncologic Surgery Charité Campus Virchow-Klinikum, Berlin Institute of Health, Berlin, Germany
| | - Christian Marth
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | | | - Alexander Reuss
- Coordinating Centre for Clinical Trials, Philipps-Universität Marburg, Marburg, Germany
| | - David Cibula
- CEEGOG & Department of Obstetrics and Gynecology, First Medical Faculty of the Charles University, Prague, Czech Republic
| | - Lydia Gaba Garcia
- Department of Medical Oncology, Hospital Clinic Barcelona, Barcelona, Spain
| | - Nicoletta Colombo
- Medical Gynecologic Oncology Unit, University of Milan Bicocca, Milan, Italy
- European Institute of Oncology, Milan, Italy
| | - Barbara Schmalfeld
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Pauline Wimberger
- Gyncology and Obstetrics, Technische Universitat Dresden Medizinische Fakultat Carl Gustav Carus, Dresden, Germany
| | | | - Jalid Sehouli
- Gynecology with Center of Oncological Surgery, Charite Universitatsmedizin Berlin, Berlin, Germany
| | | | | | - Eric Hahnen
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Jan Hauke
- University Hospital Cologne, Cologne, Germany
| | | | - Philipp Harter
- AGO Studygroup and Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte Evangelische Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
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Gurney H, Clay TD, Oliveira N, Wong S, Tran B, Harris C. Systemic treatment of advanced and metastatic urothelial cancer: The landscape in Australia. Asia Pac J Clin Oncol 2023; 19:585-595. [PMID: 37727139 DOI: 10.1111/ajco.14001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/10/2023] [Accepted: 08/24/2023] [Indexed: 09/21/2023]
Abstract
The 5-year survival rate of metastatic urothelial carcinoma (mUC) is estimated to be as low as 5%. Currently, systemic platinum-based chemotherapy followed by avelumab maintenance therapy is the only first-line treatment for mUC that has an overall survival benefit. Cisplatin-based chemotherapy (usually in combination with gemcitabine) is the preferred treatment but carboplatin is substituted where contraindications to cisplatin exist. Treatment with immune checkpoint inhibitors, antibody-drug conjugates, and kinase inhibitors has not yet demonstrated superiority to chemotherapy as first-line therapy and remains investigational in this setting. A recent media release indicates that chemotherapy plus nivolumab gives an OS advantage as first-line treatment but results of this study have not yet been made public. Pembrolizumab remains an option in those having primary progression on first-line chemotherapy or within 12 months of neoadjuvant chemotherapy. The antibody-drug conjugate, enfortumab vedotin has TGA approval for patients whose cancer has progressed following chemotherapy and immunotherapy and has just received a positive Pharmaceutical Benefits Scheme recommendation. The use of molecular screens for somatic genetic mutations, gene amplifications, and protein expression is expanding as drugs that target such abnormalities show promise. However, despite these advances, a substantial proportion of patients with mUC have significant barriers to receiving any treatment, including advancing age, frailty, and comorbidities, and less toxic, effective therapies are needed.
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Affiliation(s)
- Howard Gurney
- Faculty of Medicine, Health and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Timothy D Clay
- St John of God Subiaco Hospital, Subiaco, Washington, Australia
- Icon Cancer Care, Midland, Washington, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Washington, Australia
| | - Niara Oliveira
- Mater Hospital Brisbane, Mater Misericordiae Ltd., South Brisbane, Queensland, Australia
- School of Clinical Medicine, Mater Clinical Unit, The University of Queensland, Brisbane, Queensland, Australia
| | - Shirley Wong
- Department of Medical Oncology, Western Health, Melbourne, Victoria, Australia
| | - Ben Tran
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Carole Harris
- Department of Medical Oncology, St George Hospital, Kogarah, NSW, Australia
- Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
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Liu SV, Mok TSK, Nabet BY, Mansfield AS, De Boer R, Losonczy G, Sugawara S, Dziadziuszko R, Krzakowski M, Smolin A, Hochmair MJ, Garassino MC, Gay CM, Heymach JV, Byers LA, Lam S, Cardona A, Morris S, Adler L, Shames DS, Reck M. Clinical and molecular characterization of long-term survivors with extensive-stage small cell lung cancer treated with first-line atezolizumab plus carboplatin and etoposide. Lung Cancer 2023; 186:107418. [PMID: 37931445 DOI: 10.1016/j.lungcan.2023.107418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/06/2023] [Accepted: 10/29/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES In the Phase I/III IMpower133 study, first-line atezolizumab plus carboplatin and etoposide (CP/ET) treatment for extensive-stage small cell lung cancer (ES-SCLC) significantly improved overall survival (OS) and progression-free survival versus placebo plus CP/ET. We explored patient and disease characteristics associated with long-term survival in IMpower133, and associations of differential gene expression and SCLC-A (ASCL1-driven), SCLC-N (NEUROD1-driven), SCLC-P (POU2F3-driven), and SCLC-inflamed (SCLC-I) transcriptional subtypes with long-term survival. MATERIALS AND METHODS Patients with previously untreated ES-SCLC were randomized 1:1 to four 21-day cycles of CP/ET with atezolizumab or placebo. Long-term survivors (LTS) were defined as patients who lived ≥ 18 months post randomization. A generalized linear model was used to evaluate the odds of living ≥ 18 months. Differential gene expression was analyzed using RNA-sequencing data in LTS and non-LTS. OS was assessed by T-effector and B-cell gene signature expression. Distribution of SCLC transcriptional subtypes was assessed in LTS and non-LTS. RESULTS More LTS were in the atezolizumab arm (34%) than in the placebo arm (20%). The odds ratio for living ≥ 18 months in the atezolizumab arm versus the placebo arm was 2.1 (P < 0.03). Enhanced immune-related signaling was seen in LTS in both arms. Exploratory OS analyses showed atezolizumab treatment benefit versus placebo across T-effector and B-cell gene signature expression subgroups. A higher proportion of LTS than non-LTS in both arms had the SCLC-I subtype; this difference was particularly pronounced in the atezolizumab arm. CONCLUSION These exploratory analyses suggest that long-term survival is more likely with atezolizumab than placebo in ES-SCLC, confirming the treatment benefit of the IMpower133 regimen. CLINICALTRIAL gov Identifier: NCT02763579.
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Affiliation(s)
- Stephen V Liu
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.
| | - Tony S K Mok
- State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | | | | | | | - György Losonczy
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | | | - Rafal Dziadziuszko
- Department of Oncology and Radiotherapy and Early Phase Clinical Trials Center, Medical University of Gdańsk, Gdańsk, Poland
| | - Maciej Krzakowski
- Maria Sklodowska Curie National Research Institute of Oncology, Warsaw, Poland
| | - Alexey Smolin
- Burdenko Main Military Clinical Hospital, Moscow, Russia
| | - Maximilian J Hochmair
- Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Vienna North Hospital Klinik Floridsdorf, Vienna, Austria
| | - Marina C Garassino
- The University of Chicago Department of Hematology/Oncology, Chicago, IL, USA
| | - Carl M Gay
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John V Heymach
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lauren A Byers
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | | | - Leah Adler
- F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | | | - Martin Reck
- Lung Clinic Grosshansdorf, Airway Research Center North, German Center of Lung Research, Grosshansdorf, Germany
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Hikino H, Otani A, Makino Y, Murata Y. [A Case of Breast Cancer Brain Metastases Successfully Treated with Pembrolizumab Therapy after Disease Progression with Atezolizumab Therapy]. Gan To Kagaku Ryoho 2023; 50:1456-1458. [PMID: 38303306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
A 39-year-old woman was diagnosed with right breast cancer(cT3N1M0, cStage ⅢA, triple negative type). After preoperative chemotherapy using dose-dense doxorubicin and cyclophosphamide, followed by dose-dense paclitaxel every 2 weeks, the patient underwent right modified radical mastectomy. Postmastectomy radiotherapy to the right chest wall and right supraclavicular area and oral capecitabine therapy were administered. Computed tomography 1 year after surgery showed multiple lung metastases. The patient received atezolizumab and nab-paclitaxel therapy. Six months after the first chemotherapy, metastatic brain tumor in right frontal lobe, 12 mm in size, was observed along with enlargement of lung metastases. Because the brain tumor showed rapid growth after CyberKnife therapy, emergency tumorectomy was performed. One month after cranial surgery, new 3 brain metastases were appeared. Gamma knife therapy to brain metastases and pembrolizumab, carboplatin, gemcitabine therapy was started. Although insufficient doses of carboplatin and gemcitabine were administered due to bone marrow suppression, no progression was observed for about 1 year after initiation of pembrolizumab therapy. Pembrolizumab therapy may show anti-tumor effect to breast cancer brain metastases, even after a failure of atezolizumab therapy.
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Kim N, Kim JY, Park W, Cho WK, Kim TG, Im YH, Ahn JS, Lee JE, Nam SJ, Kim SW, Yu J, Chae BJ, Lee SK, Ryu JM, Park YH, Kim H. Benefit of postoperative regional nodal irradiation in patients receiving preoperative systemic therapy with docetaxel/ carboplatin/trastuzumab/pertuzumab for HER2-positive breast cancer. Breast 2023; 72:103594. [PMID: 37924622 PMCID: PMC10654605 DOI: 10.1016/j.breast.2023.103594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/10/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023] Open
Abstract
AIM The role of regional nodal irradiation (RNI) after preoperative systemic treatment (PST) with targeted therapy for HER2-positive breast cancer remains uncertain. This study aimed to investigate the impact of RNI on locoregional recurrence (LRR) and disease-free survival (DFS) outcomes after docetaxel/carboplatin/trastuzumab/pertuzumab (TCHP) for PST. METHODS We retrospectively analyzed 255 patients who were treated with six cycles of TCHP between 2016 and 2019. The patients were divided into four groups based on clinical nodal involvement: group A, with no nodal disease; group B, with axillary lymph node (AXL) level I; group C, with AXL level I with II/III; and group D, with supraclavicular or internal mammary nodes. RESULTS The RNI group had more advanced nodal disease (C/D) than the no RNI group (56.9 % vs. 6.8 %). With a median follow-up of 51.3 months, there were two (0.8 %), three (1.2 %), and 15 (5.9 %) local, regional, and distant metastases, respectively. LRR did not differ significantly according to the RNI (2.6 % vs. 1.0 %, p = 0.651). Group D had the most frequent distant metastases (17.5 %; p = 0.005). The 4-year DFS rate was 92.7 %, and DFS did not improve significantly after RNI (p = 0.074). When stratified by clinical nodal groups and pathological axillary response, RNI had no effect on LRR/DFS outcomes. CONCLUSION With a rare incidence of LRR, RNI did not significantly affect LRR or DFS in patients with HER2-positive breast cancer after with PST-TCHP. However, intensive systemic treatment is required for advanced diseases (C/D). Selective de-intensified RNI and intensified systemic treatment should be investigated in future studies.
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Affiliation(s)
- Nalee Kim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji-Yeon Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Kyung Cho
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Gyu Kim
- Department of Radiation Oncology, Samsung Changwon Hospital, Changwon, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Young-Hyuck Im
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin Seok Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeong Eon Lee
- Department of Radiation Oncology, Samsung Changwon Hospital, Changwon, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Seok Jin Nam
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jonghan Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byung Joo Chae
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sei Kyung Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jai-Min Ryu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yeon Hee Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Haeyoung Kim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Kotaka S, Kondo E, Kawai Y, Okamoto K, Kishigami Y, Yamawaki T, Nagao K, Toru H, Suzuki S. Paclitaxel- carboplatin plus bevacizumab therapy for advanced neuroendocrine carcinoma of the uterine cervix: A retrospective case series. J Obstet Gynaecol Res 2023; 49:2868-2874. [PMID: 37658751 DOI: 10.1111/jog.15783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023]
Abstract
AIM There is no conclusive data on the prognosis of patients who receive paclitaxel-carboplatin (TC) plus bevacizumab therapy for advanced neuroendocrine carcinoma (NEC) of the uterine cervix, a rare histological subtype of cervical cancer. Thus, the aim of this study was to determine the efficacy of TC chemotherapy plus bevacizumab and bevacizumab single maintenance therapy for advanced NEC of the cervix. METHODS This was a retrospective review of patients who received TC plus bevacizumab therapy for metastatic, recurrent, or persistent NEC of the cervix at seven institutions between 2015 and 2020. Relevant data were extracted from the patients' medical records and analyzed. RESULTS Seven patients, including six with small-cell NEC and one with large-cell NEC, were included for analysis. Three patients received bevacizumab single maintenance therapy following TC plus bevacizumab therapy, whereas four patients did not receive bevacizumab single maintenance therapy. The median overall survival and progression-free survival of the patients who received bevacizumab single maintenance therapy were longer than those of the patients who did not receive the therapy (34 months vs. 10.5 months and 19 months vs. 5 months, respectively). However, the patients who received bevacizumab single maintenance therapy had received cisplatin-based chemotherapy previously. CONCLUSIONS On the premise that cisplatin-based chemotherapy is administered as the first-line treatment for advanced NEC of the cervix, bevacizumab single maintenance therapy following TC plus bevacizumab may be considered the second- or third-line treatment. However, the risk of adverse events, such as intestinal perforation, should be discussed with patients.
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Affiliation(s)
- Saki Kotaka
- Department of Gynecologic Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie, Japan
- Department of Obstetrics and Gynecology, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie, Japan
| | - Yosuke Kawai
- Department of Obstetrics and Gynecology, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Kota Okamoto
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie, Japan
| | - Yasuyuki Kishigami
- Department of Obstetrics and Gynecology, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Takaharu Yamawaki
- Department of Obstetrics and Gynecology, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Kenji Nagao
- Department of Obstetrics and Gynecology, Yokkaichi Municipal Hospital, Yokkaichi, Mie, Japan
| | - Hirata Toru
- Department of Obstetrics and Gynecology, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Shiro Suzuki
- Department of Gynecologic Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
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de Moraes FCA, Pasqualotto E, Lopes LM, Cavalcanti Souza ME, de Oliveira Rodrigues ALS, de Almeida AM, Stecca C, Fernandes MR, Dos Santos NPC. PD-1/PD-L1 inhibitors plus carboplatin and paclitaxel compared with carboplatin and paclitaxel in primary advanced or recurrent endometrial cancer: a systematic review and meta-analysis of randomized clinical trials. BMC Cancer 2023; 23:1166. [PMID: 38031003 PMCID: PMC10688003 DOI: 10.1186/s12885-023-11654-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/18/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Paclitaxel and carboplatin is the standard chemotherapy for the treatment of advanced or recurrent endometrial cancer. However, the benefit of adding programmed cell death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors to chemotherapy is still unclear. METHOD We searched PubMed, Scopus, Cochrane, and Web of Science databases for randomized controlled trials that investigated PD-1/PD-L1 inhibitors plus carboplatin and paclitaxel compared with carboplatin and paclitaxel in primary advanced or recurrent endometrial cancer. We computed hazard ratios (HRs) or risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). We used DerSimonian and Laird random-effect models for all endpoints. Heterogeneity was assessed using I2 statistics. R, version 4.2.3, was used for statistical analyses. RESULTS A total of three studies and 1,431 patients were included. Compared with carboplatin plus paclitaxel-based chemotherapy, progression-free survival (PFS) rate (HR 0.32; 95% CI 0.23-0.44; p < 0.001) and overall survival (OS) at 30 months (RR 3.13; 95% CI 1.26-7.78; p = 0.01) were significant in favor of the PD-1/PD-L1 inhibitors plus carboplatin and paclitaxel group in the mismatch repair-deficient subgroup. However, there were no significant differences in the mismatch repair-proficient subgroup for PFS (HR 0.74; 95% CI 0.50-1.08; p = 0.117) or OS at 30 months (RR 2.24; 95% CI 0.79-6.39; p = 0.13). CONCLUSION Immunotherapy plus carboplatin-paclitaxel increased significantly PFS and OS among patients with advanced or recurrent endometrial cancer, with a significant benefit in the mismatch repair-deficient and high microsatellite instability population.
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Affiliation(s)
- Francisco Cezar Aquino de Moraes
- Oncology Research Center, Federal University of Pará, University Hospital João de Barros de Barreto, Rua dos Mundurucus, nº4487, Belém, 66073-000, PA, Brazil.
| | - Eric Pasqualotto
- Federal University of Santa Catarina, Florianópolis, 88040-900, Santa Catarina, Brazil
| | | | | | | | | | - Carlos Stecca
- Mackenzie Evangelical University Hospital, Curitiba, 80730-150, Paraná, Brazil
| | - Marianne Rodrigues Fernandes
- Oncology Research Center, Federal University of Pará, University Hospital João de Barros de Barreto, Rua dos Mundurucus, nº4487, Belém, 66073-000, PA, Brazil
| | - Ney Pereira Carneiro Dos Santos
- Oncology Research Center, Federal University of Pará, University Hospital João de Barros de Barreto, Rua dos Mundurucus, nº4487, Belém, 66073-000, PA, Brazil
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