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Kisaka JK, Rauch D, Griffith M, Kyei GB. A macrophage-cell model of HIV latency reveals the unusual importance of the bromodomain axis. Virol J 2024; 21:80. [PMID: 38581045 PMCID: PMC10996205 DOI: 10.1186/s12985-024-02343-9] [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: 01/10/2024] [Accepted: 03/14/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Although macrophages are now recognized as an essential part of the HIV latent reservoir, whether and how viral latency is established and reactivated in these cell types is poorly understood. To understand the fundamental mechanisms of viral latency in macrophages, there is an urgent need to develop latency models amenable to genetic manipulations and screening for appropriate latency-reversing agents (LRAs). Given that differentiated THP-1 cells resemble monocyte-derived macrophages in HIV replication mechanisms, we set out to establish a macrophage cell model for HIV latency using THP-1 cells. METHODS We created single-cell clones of THP-1 cells infected with a single copy of the dual-labeled HIVGKO in which a codon switched eGFP (csGFP) is under the control of the HIV-1 5' LTR promoter, and a monomeric Kusabira orange 2 (mKO2) under the control of cellular elongation factor one alpha promoter (EF1α). Latently infected cells are csGFP-, mKO2+, while cells with actively replicating HIV (or reactivated virus) are csGFP+,mKO2+. After sorting for latently infected cells, each of the THP-1 clones with unique integration sites for HIV was differentiated into macrophage-like cells with phorbol 12-myristate 13-acetate (PMA) and treated with established LRAs to stimulate HIV reactivation. Monocyte-derived macrophages (MDMs) harboring single copies of HIVGKO were used to confirm our findings. RESULTS We obtained clones of THP-1 cells with latently infected HIV with unique integration sites. When the differentiated THP-1 or primary MDMs cells were treated with various LRAs, the bromodomain inhibitors JQ1 and I-BET151 were the most potent compounds. Knockdown of BRD4, the target of JQ1, resulted in increased reactivation, thus confirming the pharmacological effect. The DYRK1A inhibitor Harmine and lipopolysaccharide (LPS) also showed significant reactivation across all three MDM donors. Remarkably, LRAs like PMA/ionomycin, bryostatin-1, and histone deacetylase inhibitors known to potently reactivate latent HIV in CD4 + T cells showed little activity in macrophages. CONCLUSIONS Our results indicate that this model could be used to screen for appropriate LRAs for macrophages and show that HIV latency and reactivation mechanisms in macrophages may be distinct from those of CD4 + T cells.
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Affiliation(s)
- Javan K Kisaka
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Daniel Rauch
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Malachi Griffith
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
- McDonnell Genome Institute, Washington University School of Medicine in St. Louis, St. Louis, MO, 63108, USA
| | - George B Kyei
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA.
- Department of Molecular Microbiology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA.
- Department of Virology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
- Medical and Scientific Research Center, University of Ghana Medical Center, Accra, Ghana.
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Pokhrel NK, Panfil A, Habib H, Seeniraj S, Joseph A, Rauch D, Cox L, Sprung R, Gilmore PE, Zhang Q, Townsend RR, Yu L, Yilmaz AS, Aurora R, Park W, Ratner L, Weilbaecher KN, Veis DJ. HTLV-1 infected T cells cause bone loss via small extracellular vesicles. bioRxiv 2024:2024.02.29.582779. [PMID: 38496506 PMCID: PMC10942274 DOI: 10.1101/2024.02.29.582779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Adult T cell leukemia (ATL), caused by infection with human T cell leukemia virus type 1 (HTLV-1), is often complicated by hypercalcemia and osteolytic lesions. Therefore, we studied the communication between patient-derived ATL cells (ATL-PDX) and HTLV-1 immortalized CD4+ T cell lines (HTLV/T) with osteoclasts and their effects on bone mass in mice. Intratibial inoculation of some HTLV/T lead to a profound local decrease in bone mass similar to marrow-replacing ATL-PDX, despite the fact that few HTLV/T cells persisted in the bone. To study the direct effect of HTLV/T and ATL-PDX on osteoclasts, supernatants were added to murine and human osteoclast precursors. ATL-PDX supernatants from hypercalcemic patients promoted formation of mature osteoclasts, while those from HTLV/T were variably stimulatory, but had largely consistent effects between human and murine cultures. Interestingly, this osteoclastic activity did not correlate with expression of osteoclastogenic cytokine RANKL, suggesting an alternative mechanism. HTLV/T and ATL-PDX produce small extracellular vesicles (sEV), known to facilitate HTLV-1 infection. We hypothesized that these sEV also mediate bone loss by targeting osteoclasts. We isolated sEV from both HTLV/T and ATL-PDX, and found they carried most of the activity found in supernatants. In contrast, sEV from uninfected activated T cells had little effect. Analysis of sEV (both active and inactive) by mass spectrometry and electron microscopy confirmed absence of RANKL and intact virus. Viral proteins Tax and Env were only present in sEV from the active, osteoclast-stimulatory group, along with increased representation of proteins involved in osteoclastogenesis and bone resorption. sEV injected over mouse calvaria in the presence of low dose RANKL caused more osteolysis than RANKL alone. Thus, HTLV-1 infection of T cells can cause release of sEV with strong osteolytic potential, providing a mechanism beyond RANKL production that modifies the bone microenvironment, even in the absence of overt leukemia.
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Rauch D. Teaching Scholarship and Who Needs to Learn It. Hosp Pediatr 2024; 14:e13-e14. [PMID: 38073336 DOI: 10.1542/hpeds.2023-007534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2024]
Affiliation(s)
- Daniel Rauch
- Department of Pediatrics, Hackensack Meridian School of Medicine, and Divisions of Pediatric Hospital Medicine and General Academic Pediatrics, Hackensack Meridian Children's Health, Hackensack, New Jersey
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Ribi K, Pagan E, Sala I, Ruggeri M, Bianco N, Bucci EO, Graffeo R, Borner M, Giordano M, Gianni L, Rabaglio M, Freschi A, Cretella E, Seles E, Farolfi A, Simoncini E, Ciccarese M, Rauch D, Favaretto A, Glaus A, Berardi R, Franzetti-Pellanda A, Bagnardi V, Gelber S, Partridge AH, Goldhirsch A, Pagani O. Employment trajectories of young women with breast cancer: an ongoing prospective cohort study in Italy and Switzerland. J Cancer Surviv 2023; 17:1847-1858. [PMID: 35689003 DOI: 10.1007/s11764-022-01222-y] [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: 02/16/2022] [Accepted: 05/26/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Despite extensive research on cancer and work-related outcomes, evidence from longitudinal cohort studies is limited, especially in young women with breast cancer (BC). We aimed to investigate employment trajectories in young BC survivors and to identify potential factors associated with changes in work activity. METHODS The HOHO European prospective multicenter cohort study enrolled 300 young women (≤ 40 years) with newly diagnosed BC. Women completed surveys at baseline and every 6 months for 3 years, then yearly for up to 10 years to assess, among other variables, employment status, sociodemographic, medical, and treatment data. Symptoms were assessed by the Breast Cancer Prevention Trial symptom scales and single items from the Cancer Rehabilitation Evaluation System. Univariable and multivariable multinomial logistic regression analyses identified factors associated with changes in employment status. RESULTS Among the 245 women included in this analysis, 85% were employed at the last individual post-baseline assessment (1 to 10 years). At 5 years, women had a 29.4% probability (95% CI: 23.6-35.5) of experiencing any reduction and a 14.9% probability (95% CI: 10.6-19.9) of experiencing any increase in work activities. Being enrolled in Switzerland (vs. Italy) and reporting more trouble in performing daily activities were significantly associated with work reduction. CONCLUSION Our results suggest that most young BC survivors remain employed in the long-term. IMPLICATIONS FOR CANCER SURVIVORS Regular evaluation of symptoms which may interfere with daily life and identification of financial discomfort is critical in providing timely and individually tailored interventions and in limiting unwanted reductions in work activities.
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Affiliation(s)
- Karin Ribi
- Quality of Life Office, International Breast Cancer Study Group, Bern, Switzerland.
| | - Eleonora Pagan
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Isabella Sala
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Monica Ruggeri
- Program for Young Patients, International Breast Cancer Study Group, Bern, Switzerland
| | - Nadia Bianco
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Rossella Graffeo
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
| | - Markus Borner
- Division of Oncology (Oncocare), Klinik Engeried, Lindenhofgruppe, Bern, Switzerland
| | | | - Lorenzo Gianni
- Department of Medical Oncology, Ospedale Infermi, AUSL Della Romagna, Rimini, Italy
| | - Manuela Rabaglio
- Department of Medical Oncology, Bern University Hospital, University of Bern, Inselspital, Bern, Switzerland
| | | | - Elisabetta Cretella
- Department of Medical Oncology, Azienda Sanitaria Dell'Alto Adige, Bolzano, Italy
| | - Elena Seles
- Department of Medical Oncology, Ospedale degli Infermi, Biella, Italy
| | - Alberto Farolfi
- Department of Medical Oncology, IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Edda Simoncini
- Breast Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | | | | | - Adolfo Favaretto
- Medical Oncology Unit, Azienda ULSS2 Marca Trevigiana, Treviso, Italy
| | - Agnes Glaus
- Tumor- and Breast Center ZeTuP, St. Gallen, Switzerland
| | - Rossana Berardi
- Department of Medical Oncology, Università Politecnica Delle Marche, A.O.U. Ospedali Riuniti Di Ancona, Ancona, Italy
| | | | - Vincenzo Bagnardi
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Shari Gelber
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Aron Goldhirsch
- International Breast Cancer Study Group, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Olivia Pagani
- Swiss Group for Clinical Cancer Research (SAKK), Interdisciplinary Cancer Service Hospital Riviera-Chablais Rennaz, Vaud, Geneva University Hospitals, Lugano University, Lugano, Switzerland
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Deressa BT, Assefa M, Tafesse E, Kantelhardt EJ, Soldatovic I, Cihoric N, Rauch D, Jemal A. Contemporary treatment patterns and survival of cervical cancer patients in Ethiopia. BMC Cancer 2021; 21:1102. [PMID: 34645407 PMCID: PMC8515694 DOI: 10.1186/s12885-021-08817-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/31/2021] [Indexed: 11/24/2022] Open
Abstract
Background Cervical cancer is the second commonly diagnosed cancer and the second leading cause of cancer death in women in Ethiopia, with rates among the highest worldwide. However, there are limited data on cervical cancer treatment patterns and survival in the country. Herein, we examine treatment patterns and survival of cervical cancer patients treated in Tikur Anbessa Hospital Radiotherapy Center (TAHRC), the only hospital with radiotherapy facility in the country. Methods Women with histologically verified cervical cancer who were seen in 2014 (January 1, 2014 to December 31, 2014) at TAHRC were included. Information about clinical characteristics and treatments were extracted from the patients’ medical record files. The information on vital status was obtained from medical chart and through telephone calls. Result Among 242 patients included in the study, the median age at diagnosis was 48 years. The median waiting time for radiotherapy was 5.6 months (range 2 to 9 months). Stage migration occurred in 13% of patients while waiting for radiotherapy. Consequently, the proportion of patients with stage III or IV disease increased from 66% at first consultation to 74% at the initiation of radiotherapy. Among 151 patients treated with curative intent, only 34 (22.5%) of the patients received concurrent chemotherapy while the reaming patients received radiotherapy alone. The 5-year overall survival rate was 28.4% (20.5% in the worst-case scenario). As expected, survival was lower in patients with advanced stage at initiation of radiotherapy and in those treated as palliative care. Conclusion The survival of cervical cancer patients remains low in Ethiopia because of late presentation and delay in receipt of radiotherapy, leading to stage migration in substantial proportion of the cases. Concerted and coordinated multisectoral efforts are needed to promote early presentation of cervical cancer and to shorten the unacceptable, long waiting time for radiotherapy.
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Affiliation(s)
| | - Mathewos Assefa
- Department of Clinical Oncology, College of Health Sciences, Addis Ababa university, Addis Ababa, Ethiopia
| | - Ephrem Tafesse
- College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eva Johanna Kantelhardt
- Department of Gynaecology and Institute of Clinical Epidemiology, Martin Luther University, Halle an der Saale, Germany
| | - Ivan Soldatovic
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Beograd, Serbia
| | - Nikola Cihoric
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel Rauch
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
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Peters S, Danson S, Ejedepang D, Dafni U, Hasan B, Radcliffe HS, Bustin F, Crequit J, Coate L, Guillot M, Surmont V, Rauch D, Rudzki J, O'Mahony D, Barneto Aranda I, Scherz A, Tsourti Z, Roschitzki-Voser H, Pochesci A, Demonty G, Stahel RA, O'Brien M. Combined, patient-level, analysis of two randomised trials evaluating the addition of denosumab to standard first-line chemotherapy in advanced NSCLC - The ETOP/EORTC SPLENDOUR and AMGEN-249 trials. Lung Cancer 2021; 161:76-85. [PMID: 34543941 DOI: 10.1016/j.lungcan.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The efficacy of adding denosumab to standard first-line chemotherapy for advanced NSCLC patients has been evaluated in two separate randomised trials (SPLENDOUR and AMGEN-249). In this pooled analysis, we will assess the combination-treatment effect in the largest available population, in order to conclude about the potential impact of denosumab in NSCLC. METHODS Both trials included in this combined analysis, were randomised (SPLENDOUR 1:1, AMGEN-249 2:1) multi-centre trials stratified by histology, bone metastasis, geographical region and for SPLENDOUR only, ECOG PS. Cox proportional hazards models, were used to assess the treatment effect with respect to overall survival (OS; primary endpoint) and progression-free survival (PFS; secondary endpoint). Heterogeneity between trials was assessed, and subgroup analyses were performed. RESULTS The pooled analysis was based on 740 randomised patients (SPLENDOUR:514; AMGEN-249:226), with 407 patients in the chemotherapy-denosumab arm and 333 in the chemotherapy-alone arm. In the chemotherapy-denosumab arm, at a median follow-up of 22.0 months, 277 (68.1%) deaths were reported with median OS 9.2 months (95%CI:[8.0-10.7]), while in the chemotherapy-alone arm, with similar median follow-up of 20.3 months, 230 (69.1%) deaths with median OS 9.9 months (95%CI:[8.2-11.2]). No significant denosumab effect was found (HR = 0.98; 95%CI:[0.82-1.18]; P = 0.85). Among subgroups, interaction was found between treatment and histology subtypes (P = 0.020), with a statistically significant benefit in the squamous group (HR = 0.70; 95%CI:[0.49-0.98]; P = 0.038), from 7.6 to 9.0 months median OS. With respect to PFS, 363 (89.2%) and 298 (89.5%) events were reported in the chemotherapy-denosumab and chemotherapy-alone arms, respectively, with corresponding medians 4.8 months (95%CI:[4.4-5.3]) and 4.9 months (95%CI:[4.3-5.4]). HR for PFS was 0.97(95%CI:[0.83-1.15]; P = 0.76), indicating that no significant denosumab benefit existed for PFS. CONCLUSION In this pooled analysis, no statistically significant improvement was shown in PFS/OS with the combination of denosumab and chemotherapy for advanced NSCLC and no meaningful benefit in any of the subgroups.
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Affiliation(s)
- Solange Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
| | - Sarah Danson
- Department of Oncology and Metabolism & Sheffield Experimental Cancer Medicine Centre, University of Sheffield, Weston Park Hospital, Sheffield, United Kingdom
| | - Dunson Ejedepang
- Headquarters, European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Urania Dafni
- National and Kapodistrian University of Athens & Frontier Science Foundation-Hellas, Athens, Greece
| | - Baktiar Hasan
- Headquarters, European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | | | | | - Linda Coate
- Mid-Western Cancer Centre, University Hospital Limerick, Limerick, Ireland; Cancer Trials, Ireland
| | - Monica Guillot
- Hospital Universitari Son Espases, Palma, Spain; Spanish Lung Cancer Group (GECP), Spain
| | | | - Daniel Rauch
- Spital STS AG Thun, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Switzerland
| | - Jakob Rudzki
- Innsbruck Universitaetsklinik, Austria; Central European Cooperative Oncology Group (CECOG), Austria
| | | | - Isidoro Barneto Aranda
- Hospital Universitario Reina Sofia, Córdoba, Spain; Spanish Lung Cancer Group (GECP), Spain
| | - Amina Scherz
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Switzerland
| | - Zoi Tsourti
- Frontier Science Foundation-Hellas, Athens, Greece
| | | | - Alessia Pochesci
- Headquarters, European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | - Rolf A Stahel
- Coordinating Office, European Thoracic Oncology Platform (ETOP), Bern, Switzerland
| | - Mary O'Brien
- Department of Medical Oncology, Royal Marsden Hospital Sutton, UK
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Niro K, Gibson T, Zanger K, Rauch D, El Saleeby C. Going Virtual Amid a Pandemic: Perspectives on a Web-Based Hospital Medicine Conference. Hosp Pediatr 2020; 11:e9-e11. [PMID: 33328189 DOI: 10.1542/hpeds.2020-003152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Kathryn Niro
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, South Shore Hospital, Weymouth, Massachusetts
| | - Timothy Gibson
- Division of Pediatric Hospital Medicine, University of Massachusetts Memorial Children's Medical Center, Worcester, Massachusetts
| | - Kerstin Zanger
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts; and.,Divisions of Pediatric Hospital Medicine and
| | - Daniel Rauch
- Division of Pediatric Hospital Medicine, Tufts Children's Hospital, Boston, Massachusetts
| | - Chadi El Saleeby
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts; and .,Divisions of Pediatric Hospital Medicine and.,Pediatric Infectious Disease
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Boraschi-Diaz I, Rauch D, Kiraly O, Bista P, Nichols A, Rauch F. DMD – ANIMAL MODELS & PRECLINICAL TREATMENT. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mittal V, Shah N, Dwyer AC, O'Toole JK, Percelay J, Carlson D, Woods S, Lee V, Russo C, Black N, Rauch D, Chase L, Quinonez R, Fisher ES. Developing Content for Pediatric Hospital Medicine Certification Examination Using Practice Analysis. Pediatrics 2020; 146:peds.2019-3186. [PMID: 32727825 DOI: 10.1542/peds.2019-3186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/20/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The American Board of Pediatrics (ABP) and the Pediatric Hospital Medicine (PHM) subboard developed a content outline to serve as a blueprint for the inaugural certification examination through practice analysis. The systematic approach of practice analyses process is described in the study. METHODS A diverse, representative panel of 12 pediatric hospitalists developed the draft content outline using multiple resources (publications, textbooks, PHM Core Competencies, PHM fellow's curriculum, etc). The panel categorized practice knowledge into 13 domains and 202 subdomains. By using the ABP database self-defined practicing pediatric hospitalists were identified. Participants rated the frequency and criticality of content domains and subdomains along with providing open-ended comments. RESULTS In total, 1449 (12.1%) generalists in the ABP database self-identified as pediatric hospitalists, and 800 full-time pediatric hospitalists responded. The content domains that were rated as highly critical and frequently required in practice were weighted more heavily (ie, the percentage of examination questions associated with a domain) than the less critical and less frequently rated. Both community and noncommunity pediatric hospitalists rated domains similarly (P = .943). Subdomain and preliminary weights were rated with similar means and SDs in the majority of topics. CONCLUSIONS There was concordance in the rating of domain and universal tasks among both community and noncommunity hospitalists. The areas of significant differences, although minor, could be explained by difference in practice settings. The practice analysis approach was structured, engaged the PHM community, reflected the breadth and depth of knowledge required for PHM practice, and used an iterative process to refine the final product.
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Affiliation(s)
- Vineeta Mittal
- Division of Pediatric Hospital Medicine, Department of Pediatrics, The University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas;
| | - Neha Shah
- Hospitalist Division, Children's National Hospital and School of Medicine & Health Sciences, George Washington University, Washington, District of Columbia
| | | | - Jennifer K O'Toole
- Division of Hospital Medicine, Departments of Pediatrics and Internal Medicine, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Jack Percelay
- Division of Pediatric Hospital Medicine, Lucile Packard Children's Hospital and Stanford Medicine, Stanford University, Palo Alto, California
| | - Douglas Carlson
- Department of Pediatrics, School of Medicine, Southern Illinois University, Springfield, Illinois
| | - Suzanne Woods
- American Board of Pediatrics, Chapel Hill, North Carolina
| | - Vivian Lee
- Division of Pediatric Hospital Medicine, Lucile Packard Children's Hospital and Stanford Medicine, Stanford University, Palo Alto, California
| | - Christopher Russo
- Hospitalists, Centra Medical Group, Centra Health, Lynchburg, Virginia
| | - Nichole Black
- Hospitalist Division, Children's National Hospital and School of Medicine & Health Sciences, George Washington University, Washington, District of Columbia
| | - Daniel Rauch
- Division of Hospital Medicine, Floating Hospital for Children at Tufts Medical Center and School of Medicine, Tufts University, Boston, Massachusetts
| | - Lindsay Chase
- Section of Pediatric Hospital Medicine, North Carolina Children's Hospital and University of North Carolina, Chapel Hill, North Carolina
| | - Ricardo Quinonez
- Division of Pediatric Hospital Medicine, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas; and
| | - Erin S Fisher
- Division of Pediatric Hospital Medicine, Rady Children's Hospital-San Diego and University of San Diego, San Diego, California
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10
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Metaxas Y, Früh M, Eboulet EI, Grosso F, Pless M, Zucali PA, Ceresoli GL, Mark M, Schneider M, Maconi A, Perrino M, Biaggi-Rudolf C, Froesch P, Schmid S, Waibel C, Appenzeller C, Rauch D, von Moos R. Lurbinectedin as second- or third-line palliative therapy in malignant pleural mesothelioma: an international, multi-centre, single-arm, phase II trial (SAKK 17/16). Ann Oncol 2020; 31:495-500. [PMID: 32085891 DOI: 10.1016/j.annonc.2019.12.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/20/2019] [Accepted: 12/24/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Systemic second- and third-line therapies for malignant pleural mesothelioma (MPM) result in a median progression-free survival (mPFS) of <2 months and median overall survival (mOS) of 6-9 months. Lurbinectedin binds to the DNA of the regulatory region while inhibiting tumour-associated macrophage transcription. In early trials, encouraging outcomes occurred in patients (pts) with MPM treated with lurbinectedin. We aimed to generate lurbinectedin efficacy and safety data among pts with progressive MPM. PATIENTS AND METHODS Pts with progressing MPM treated with first-line platinum-pemetrexed chemotherapy with or without immunotherapy received lurbinectedin monotherapy. Treatment was given intravenously at 3.2 mg/m2 dose every 3 weeks until progression or unacceptable toxicity. Using Simon's two-stage design, the primary endpoint, progression-free survival (PFS) at 12 weeks (PFS12wks), was met if achieved by ≥21 pts (p0 ≤35% versus p1 ≥55%). RESULTS Forty-two pts from nine centres across Switzerland and Italy were recruited. Histology was epithelioid in 33 cases, sarcomatoid in 5, and biphasic in 4. Overall 10/42 (23.8%) underwent prior immunotherapy and 14/42 (33.3%) had progressed ≤6 months after first-line chemotherapy. At data cut-off PFS12wks was met by 22/42 pts (52.4%; 90% confidence interval (CI): 38.7% to 63.5%; P = 0.015) with an mPFS of 4.1 months and mOS of 11.1 months. The best response was complete and partial remission observed in one patient each and stable disease in 20 pts. The duration of disease control was 6.6 months (95% CI: 5.2-7.4). No significant difference in PFS12wks, mPFS, and mOS was recorded in epithelioid versus non-epithelioid cases and pts with prior immunotherapy versus those without. Similar mPFS but shorter mOS were observed among pts who progressed within ≤6 months after first-line chemotherapy. Lurbinectedin-related grade 3-4 toxicity was seen in 21 pts, mostly being neutropenia (23.8%) and fatigue (16.7%). CONCLUSIONS The primary efficacy endpoint was reached with acceptable toxicity. Lurbinectedin showed promising activity regardless of histology, prior immunotherapy, or outcome on prior treatment. CLINICALTRIALS. GOV IDENTIFIER NCT03213301.
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Affiliation(s)
- Y Metaxas
- Department of Oncology/Haematology, Kantonsspital Graubünden, Chur, Switzerland.
| | - M Früh
- Department of Medical Oncology and Haematology, Kantonsspital St. Gallen, St Gallen, Switzerland; University of Bern, Bern, Switzerland
| | | | - F Grosso
- Mesothelioma Unit - Oncology, SS. Antonio and C. Arrigo Hospital, Alessandria, Italy
| | - M Pless
- Department of Medical Oncology and Haematology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - P A Zucali
- Humanitas Cancer Centre, Humanitas Research Hospital, Rozzano, Italy
| | - G L Ceresoli
- Oncology Unit, Humanitas Clinic Gavazzeni, Bergamo, Italy
| | - M Mark
- Department of Oncology/Haematology, Kantonsspital Graubünden, Chur, Switzerland
| | | | - A Maconi
- Scientific Research and Development Department, SS Antonio e Biagio e Cesare Arrigo, General Hospital, Alessandria, Italy
| | - M Perrino
- Humanitas Cancer Centre, Humanitas Research Hospital, Rozzano, Italy
| | | | - P Froesch
- Department of Oncology, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
| | - S Schmid
- Department of Medical Oncology and Haematology, Kantonsspital St. Gallen, St Gallen, Switzerland
| | - C Waibel
- Division of Haematology and Oncology, Kantonsspital Baden, Baden, Switzerland
| | - C Appenzeller
- Department of Medical Oncology and Haematology, Kantonsspital St. Gallen, St Gallen, Switzerland
| | - D Rauch
- Oncology Centre, Hospital STS AG, Thun, Switzerland
| | - R von Moos
- Department of Oncology/Haematology, Kantonsspital Graubünden, Chur, Switzerland
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Rauch D. In Reference to: "The Current State of Advanced Practice Provider Fellowships in Hospital Medicine: A Survey of Program Directors." Be Careful What We Call It. J Hosp Med 2020; 15:64. [PMID: 31869304 DOI: 10.12788/jhm.3297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 08/02/2019] [Indexed: 11/20/2022]
Affiliation(s)
- Daniel Rauch
- Tufts University School of Medicine, Boston, Massachusetts; Division of Pediatric Hospital Medicine, the Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts
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12
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Metaxas Y, Frueh M, Eboulet E, Grosso F, Pless M, Zucali P, Ceresoli G, Mark M, Schneider M, Roveta A, Perrino M, Biaggi Rudolf C, Froesch P, Schmidt S, Waibel C, Appenzeller C, Rauch D, von Moos R. SAKK 17/16 - Lurbinectedin as second or third line palliative chemotherapy in malignant pleural mesothelioma (MPM): A multi-center, single-arm phase II trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz266.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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Haddad R, Guigay J, Keilholz U, Clement PM, Fayette J, de Souza Viana L, Rolland F, Cupissol D, Geoffrois L, Kornek G, Licitra L, Melichar B, Ribaldo Nicolau U, Rauch D, Zanetta-Devauges S, Cohen EEW, Machiels JP, Tahara M, Vermorken J, Geng Y, Zografos E, Gauler T. Afatinib as second-line treatment in patients with recurrent/metastatic squamous cell carcinoma of the head and neck: Subgroup analyses of treatment adherence, safety and mode of afatinib administration in the LUX-Head and Neck 1 trial. Oral Oncol 2019; 97:82-91. [PMID: 31450171 DOI: 10.1016/j.oraloncology.2019.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/26/2019] [Accepted: 08/03/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Patients with head and neck squamous cell carcinoma (HNSCC) can experience severe symptom burden and/or difficulty swallowing, leading to problems with treatment adherence/administration. In LUX-Head and Neck 1 (LH&N1; NCT01345682), second-line afatinib improved progression-free survival (PFS) versus methotrexate in patients with recurrent/metastatic HNSCC. We report adherence and safety across pre-specified and additional subgroups potentially linked to afatinib PFS benefit in LH&N1 (p16 status, smoking history), and afatinib adherence, safety and efficacy by administration (oral versus feeding tube; post-hoc analysis). METHODS Patients were randomized (2:1) to afatinib (40 mg/day) or intravenous methotrexate (40 mg/m2/week). RESULTS Among 320 afatinib-treated and 160 methotrexate-treated patients, 83-92% and 76-92% (of patients with data available) across all subgroups took ≥80% of treatment. Across p16 status and smoking history subgroups, the most common treatment-related adverse events (AEs) were diarrhea (70-91%), rash/acne (72-84%), stomatitis (34-73%) with afatinib; and included stomatitis (39-100%), fatigue (22-50%), nausea (19-36%) with methotrexate. Dose reduction decreased AE incidence/severity. Baseline characteristics were generally similar between oral/feeding tube (n = 276/n = 46) groups. 89%/89% (of patients with data available) took ≥80% of assigned afatinib. Median PFS was 2.6 versus 2.7 months (hazard ratio: 0.997; 95% confidence interval: 0.72-1.38). The most common afatinib-related AEs were: rash/acne (74% versus 74%), diarrhea (73% versus 65%), stomatitis (40% versus 30%). CONCLUSION Subgroup analyses of LH&N1 demonstrate that afatinib has predictable and manageable safety across patient subgroups, with high treatment adherence, and is effective via oral and feeding tube administration.
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Affiliation(s)
- Robert Haddad
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School and Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
| | - Joel Guigay
- Centre Antoine Lacassagne, FHU OncoAge, Université Côte d'Azur, Nice, France
| | - Ulrich Keilholz
- Medical Department, Charité Comprehensive Cancer Center, Berlin, Germany
| | - Paul M Clement
- Department of Oncology, KU Leuven, Leuven Cancer Institute, Leuven, Belgium
| | | | - Luciano de Souza Viana
- Department of Medical Oncology, Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil
| | - Frédéric Rolland
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Nantes, France
| | - Didier Cupissol
- Institut du Cancer de Montpellier Val d'Aurelle, Montpellier, France
| | - Lionnel Geoffrois
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - Gabriela Kornek
- Klinische Abteilung für Onkologie, Universitätsklinik für Innere Medizin, Vienna, Austria
| | - Lisa Licitra
- Department of Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, and University of Milan, Milan, Italy
| | - Bohuslav Melichar
- Department of Oncology, Palacky University Medical School, Olomouc, Czech Republic
| | | | - Daniel Rauch
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | | | - Ezra E W Cohen
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Jean-Pascal Machiels
- Institut Roi Albert II, Service d'Oncologie Médicale, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (Pole MIRO), Université Catholique de Louvain, Brussels, Belgium
| | - Makoto Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Jan Vermorken
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Yuan Geng
- Boehringer Ingelheim (China) Investment Co., Ltd., Shanghai, China
| | | | - Thomas Gauler
- Department of Medicine, West German Cancer Center, University Hospital Essen of the University Duisburg-Essen, Essen, Germany
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14
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Rothschild SI, Betticher D, Zenhäusern R, Anchisi S, von Moos R, Pless M, Moosmann P, Popescu RA, Calderoni A, Dressler M, Rauch D, Pederiva S, Woelky R, Papet C, Bühler V, Borner M. Prospective, observational practice survey of applied skin care and management of cetuximab-related skin reactions: PROSKIN study. Cancer Chemother Pharmacol 2019; 84:881-889. [PMID: 31444619 PMCID: PMC6768912 DOI: 10.1007/s00280-019-03927-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/07/2019] [Indexed: 12/22/2022]
Abstract
Purpose The study aimed to investigate strategies to prevent and treat cetuximab-induced skin reactions and their perceived effectiveness in patients with metastatic colorectal cancer (mCRC) and recurrent/metastatic squamous cell cancer of the head and neck (SCCHN). Methods This open-label, prospective observational study was conducted in Switzerland. Results A total of 125 patients were included (n = 91 mCRC, n = 34 SCCHN; mean age 63.3 years; 73.6% males). The frequency of acneiform rash grade ≥ 2 increased from 12.6% at week 2 to 21.7% at week 16. The proportion of patients who reported no skin reaction decreased from 75.6% at week 2 to 43.3% at week 16. The most frequently used skin products at any time of observation were moisturizing (77.6%), lipid-regenerating (56.8%) or urea-containing products (52%), systemic antibiotics (49.6%), and vitamin K1 cream (43.2%). There was no clear effectiveness pattern for all product classes: in given patients, either the product showed no effect at all or a moderate/strong effect, consistently over time. Conclusions A great variety of low-cost general skin care products were commonly used. According to physician’s preference, systemic antibiotics and vitamin K1 cream are an appropriate approach to prevent or treat cetuximab-related skin toxicity.
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Affiliation(s)
- Sacha I Rothschild
- Departement Innere Medizin, Medizinische Onkologie, Universitätsspital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | | | | | | | - Roger von Moos
- Kantonsspital Graubünden, Medizinische Onkologie, Chur, Switzerland
| | - Miklos Pless
- Kantonsspital Winterthur, Tumorzentrum, Winterthur, Switzerland
| | - Peter Moosmann
- Kantonsspital Aarau, Medizinische Onkologie, Aarau, Switzerland
| | | | | | | | - Daniel Rauch
- Spital Thun, Medizinische Onkologie, Thun, Switzerland
| | | | - Regina Woelky
- Kantonsspital Frauenfeld STGAG, Medizinische Onkologie, Frauenfeld, Switzerland
| | - Claudia Papet
- Limmattalspital, Medizinische Onkologie, Schlieren, Switzerland
| | | | - Markus Borner
- Spitalzentrum Biel, Medizinische Onkologie, Biel, Switzerland
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15
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Burtness B, Haddad R, Dinis J, Trigo J, Yokota T, de Souza Viana L, Romanov I, Vermorken J, Bourhis J, Tahara M, Martins Segalla JG, Psyrri A, Vasilevskaya I, Nangia CS, Chaves-Conde M, Kiyota N, Homma A, Holeckova P, Del Campo JM, Asarawala N, Nicolau UR, Rauch D, Even C, Wang B, Gibson N, Ehrnrooth E, Harrington K, Cohen EEW. Afatinib vs Placebo as Adjuvant Therapy After Chemoradiotherapy in Squamous Cell Carcinoma of the Head and Neck: A Randomized Clinical Trial. JAMA Oncol 2019; 5:1170-1180. [PMID: 31194247 DOI: 10.1001/jamaoncol.2019.1146] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Locoregionally advanced head and neck squamous cell cancer (HNSCC) is treated curatively; however, risk of recurrence remains high among some patients. The ERBB family blocker afatinib has shown efficacy in recurrent or metastatic HNSCC. Objective To assess whether afatinib therapy after definitive chemoradiotherapy (CRT) improves disease-free survival (DFS) in patients with HNSCC. Design, Setting, and Participants This multicenter, phase 3, double-blind randomized clinical trial (LUX-Head & Neck 2) studied 617 patients from November 2, 2011, to July 4, 2016. Patients who had complete response after CRT, comprising radiotherapy with cisplatin or carboplatin, with or without resection of residual disease, for locoregionally advanced high- or intermediate-risk HNSCC of the oral cavity, hypopharynx, larynx, or oropharynx were included in the study. Data analysis was of the intention-to-treat population. Interventions Patients were randomized (2:1) to treatment with afatinib (40 mg/d) or placebo, stratified by nodal status (N0-2a or N2b-3) and Eastern Cooperative Oncology Group performance status (0 or 1). Treatment continued for 18 months or until disease recurrence, unacceptable adverse events, or patient withdrawal. Main Outcomes and Measures The primary end point was DFS, defined as time from the date of randomization to the date of tumor recurrence or secondary primary tumor or death from any cause. Secondary end points were DFS at 2 years, overall survival (defined as time from the date of randomization to death), and health-related quality of life. Results A total of 617 patients were studied (mean [SD] age, 58 [8.4] years; 528 male [85.6%]). Recruitment was stopped after a preplanned interim futility analysis on July 4, 2016, on recommendation from an independent data monitoring committee. Treatment was discontinued. Median DFS was 43.4 months (95% CI, 37.4 months to not estimable) in the afatinib group and not estimable (95% CI, 40.1 months to not estimable) in the placebo group (hazard ratio, 1.13; 95% CI, 0.81-1.57; stratified log-rank test P = .48). The most common grade 3 and 4 drug-related adverse effects were acneiform rash (61 [14.8%] of 411 patients in the afatinib group vs 1 [0.5%] of 206 patients in the placebo group), stomatitis (55 [13.4%] in the afatinib group vs 1 [0.5%] in the placebo group), and diarrhea (32 [7.8%] in the afatinib group vs 1 [0.5%] in the placebo group). Conclusions and Relevance This study's findings indicate that treatment with afatinib after CRT did not improve DFS and was associated with more adverse events than placebo in patients with primary, unresected, clinically high- to intermediate-risk HNSCC. The use of adjuvant afatinib after CRT is not recommended. Trial Registration ClinicalTrials.gov identifier: NCT01345669.
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Affiliation(s)
- Barbara Burtness
- Department of Medicine and Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut
| | - Robert Haddad
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - José Dinis
- Instituto Português de Oncologia, Porto, Portugal
| | - José Trigo
- Department of Medical Oncology, Hospital Virgen de la Victoria, IBIMA, Malaga, Spain
| | - Tomoya Yokota
- Division of Gastrointestinal Oncology, Shizuoka Cancer Centre, Shizuoka, Japan
| | | | - Ilya Romanov
- Russian Oncological Research Centre, Moscow, Russia
| | - Jan Vermorken
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Jean Bourhis
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Makoto Tahara
- Department of Head and Neck Medical Oncology, National Cancer Centre Hospital East, Kashiwa, Japan
| | | | - Amanda Psyrri
- Department of Internal Medicine, National Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | | | | | | | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Kobe University Hospital Cancer Center, Kobe, Japan
| | - Akihiro Homma
- Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Petra Holeckova
- Department of Oncology and Radiotherapy, Hospital Na Bulovce and 1st Medical Faculty of Charles University, Prague, Czech Republic
| | | | - Nirav Asarawala
- Shree Krishna Hospital and Medical Research Centre, Gujarat, India
| | | | - Daniel Rauch
- Inselspital, University Hospital Bern, Bern, Switzerland
| | - Caroline Even
- Department of Head and Neck Cancer, Gustave Roussy, Villejuif, France
| | - Bushi Wang
- Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut
| | - Neil Gibson
- Boehringer Ingelheim Pharma GmbH & Co KG, Biberach, Germany
| | | | - Kevin Harrington
- Division of Radiotherapy and Imaging, The Royal Marsden Hospital/The Institute of Cancer Research, National Institute for Health Research Biomedical Research Centre, London, United Kingdom
| | - Ezra E W Cohen
- Department of Translational Science, Moores Cancer Centre, University of California at San Diego, La Jolla
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Menter T, Tzankov A, Zucca E, Kimby E, Vanazzi A, Østenstad B, Mey U, Rauch D, Wahlin B, Hitz F, Hernberg M, Johansson A, de Nully Brown P, Hagberg H, Hawle H, Hayoz S, Dirnhofer S. PROGNOSTIC IMPLICATIONS OF THE MICROENVIRONMENT IN FOLLICULAR LYMPHOMA UNDER RITUXIMAB AND RITUXIMAB+LENALIDOMIDE THERAPY. A TRANSLATIONAL STUDY OF THE SAKK35/10 TRIAL. Hematol Oncol 2019. [DOI: 10.1002/hon.107_2629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- T. Menter
- Institute of Pathology and Medical Genetics; University Hospital Basel; Basel Switzerland
| | - A. Tzankov
- Institute of Pathology and Medical Genetics; University Hospital Basel; Basel Switzerland
| | - E. Zucca
- Division of Medical Oncology; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - E. Kimby
- Division of Hematology; Department of Medicine at Huddinge, Karolinska Institutet; Stockholm Sweden
| | - A. Vanazzi
- Clinical Haemato-Oncology; Istituto Europeo di Oncologia; Milan Italy
| | - B. Østenstad
- Department of Oncology; Oslo University Hospital; Oslo Norway
| | - U.J. Mey
- Medical Oncology and Hematology; Kantonsspital Graubünden; Chur Switzerland
| | - D. Rauch
- Division of Oncology; Spital Thun Simmenthal; Thun Switzerland
| | - B. Wahlin
- Division of Hematology; Department of Medicine at Huddinge, Karolinska Institutet; Stockholm Sweden
| | - F. Hitz
- Oncology/Hematology; Kantonsspital St.Gallen; St. Gallen Switzerland
| | - M. Hernberg
- Department of Oncology; Comprehensive Cancer Center, Helsinki University Hospital; Helsinki Finland
| | - A. Johansson
- Department of Oncology; Norrlands Universitetssjukhus; Umea Sweden
| | | | - H. Hagberg
- Oncology; Uppsala University Hospital; Uppsala Sweden
| | - H. Hawle
- Coordinating Center; SAKK; Bern Switzerland
| | - S. Hayoz
- Coordinating Center; SAKK; Bern Switzerland
| | - S. Dirnhofer
- Institute of Pathology and Medical Genetics; University Hospital Basel; Basel Switzerland
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Deressa BT, Cihoric N, Badra EV, Tsikkinis A, Rauch D. Breast cancer care in northern Ethiopia - cross-sectional analysis. BMC Cancer 2019; 19:393. [PMID: 31023270 PMCID: PMC6485046 DOI: 10.1186/s12885-019-5612-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 04/12/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In Ethiopia, the incidence of new cases of breast cancer is currently increasing resulting to high rates of morbidity and mortality. Breast cancer is by far the most common cancer accounting for more than one out of three cancer cases in women and one out of every five in the general population. The study was conducted in University of Gondar Hospital cancer center, located in the North-West Ethiopia; to evaluate the clino-pathologic characteristics of breast cancer and care provided for patients. METHODS All biopsy proven breast cancer patients treated between 2016 and 2017, were identified and information regarding histology, stage, therapeutic procedure and follow up was retrospectively collected from their individual medical records and descriptive analysis was done. RESULTS Among 82 patients treated, 67 (82%) were women and 15 (18%) were men. The median age at the time of diagnosis was 45 years (25-82 years). Operation was performed for 56 (68%) patients. The predominant histology was ductal carcinoma in 61 patients (74%), followed by breast carcinoma of No Special Type (NST) in 17 (21%). The late presentation of the patients and the advanced stage at the time of presentation was observed in most of the patients. Chemotherapy was administered in 79 (96%) patients. Radiotherapy was not available in the hospital. CONCLUSION Breast cancer incidence is rising and becoming a major public health problem in Northern Ethiopia. Breast cancer care in northern-Ethiopia is limited in terms of both pathology, imaging and the offered treatment modalities, which need to be improved.
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Affiliation(s)
- Biniyam Tefera Deressa
- University of Gondar, Gondar, Ethiopia. .,Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Nikola Cihoric
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Eugenia Vlaskou Badra
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexandros Tsikkinis
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel Rauch
- Regional Hospital Thun, Thun, Switzerland.,Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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18
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Müller A, Templeton AJ, Hayoz S, Hawle H, Hasler-Strub U, Schwitter M, Pestalozzi BC, Pagani O, Bützberger P, Wehrhahn T, Rauch D, Inauen R, Betticher D, Zaman K, Bodmer A, Popescu RA, Rothschild S, Schardt J, Borner M, Fuhrer A, Schär C, Gillessen S, von Moos R. Abstract P1-18-01: Incidence of hypocalcemia in patients with metastatic breast cancer under treatment with denosumab: A non-inferiority phase III trial assessing prevention of symptomatic skeletal events (SSE) with denosumab administered every 4 weeks versus every 12 weeks: SAKK 96/12 (REDUSE). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-18-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Monthly Denosumab (DN) has shown superiority over zoledronic acid (ZA) in delaying skeletal related events. Randomized trials have shown that ZA given every 12 weeks (q12w) is non-inferior to ZA given every 4 weeks (q4w). The primary endpoint of the REDUSE-trial is non-inferiority for SSE for DN q12w versus q4w. Here we present early data for hypocalcemia (HC), a secondary endpoint.
Methods
Patients with bone metastasis from breast cancer (BC) not pretreated with DN or Bisphosphonates were randomized 1:1 to receive DN q4w (Arm A) versus q12w (Arm B) after a 3-month induction phase with q4w therapy for both arms. All patients received vitamin D 400 U (VitD) and calcium (Ca) 500 mg daily. Measurement of albumin-corrected serum-Ca was mandatory before each DN injection (HC defined as <2.0 mmol/l like in CTCAE V4.0). This safety interim analysis was performed after 3.5 years of accrual. Patients who received at least 1 dose of DN were considered evaluable.
Results
351 BC-patients are currently included (177 in Arm A, 174 in Arm B). HC was the most common side effect with a rate of 20% in the first 16 weeks (during the induction phase with DN q4w for both Arms) and 19% afterwards (combined for Arms A and B). After week 16 HC-prevalence differed between the two arms: while HC was present in 25% in Arm A (q4w), the rate was only 12% in Arm B (q12w). Grade 3 HC (i.e. corrected Ca 1.5 - 1.74 mmol/l or hospitalisation indicated) was rare (0.3%), no grade 4 HC occurred. After 1 year of treatment, the rate of HC compared to the induction phase had decreased in Arm B but not in Arm A (A: 25%, B: 12%). Since HC improved in more patients in Arm B than in Arm A whereas it worsened in more patients in Arm A than in Arm B, a remarkable difference for HC resulted between the two arms.
Rates of hypocalcemia and change of severity after week 16* Arm A (N = 177)Arm B (N = 174)Rates of hypocalcemian (%)n (%)Patients with hypocalcemia at any time49 (28%)46 (26%)Patients with hypocalcemia after week 16*44 (25%)21 (12%) Change in hypocalcemia grade after week 16*for the 49 patients with hypocalcemiafor the 46 patients with hypocalcemiaWorsening25 (51%)8 (17%)Stable10 (20%)9 (20%)Improving14 (29%)29 (63%) *week 16: i.e. the time where the schedules of DN begin to differ between Arm A and Arm BArm A: DN q4w for weeks 1 - 12 and likewise thereafter / Arm B: DN q4w for weeks 1 - 12 and q12w thereafter
Conclusions
In our trial up to 20% of all BC patients treated with DN experienced HC in the q4w induction phase despite mandatory supplementation of VitD and Ca. This rate is considerably higher than the numbers reported in the registration trials of DN (where it was 5.5% for BC). After the induction phase, HC is markedly reduced in the q12w arm compared to q4w. This suggests that DN given q12w has a more favorable long-term safety profile in terms of HC compared to DN q4w.
Citation Format: Müller A, Templeton AJ, Hayoz S, Hawle H, Hasler-Strub U, Schwitter M, Pestalozzi BC, Pagani O, Bützberger P, Wehrhahn T, Rauch D, Inauen R, Betticher D, Zaman K, Bodmer A, Popescu RA, Rothschild S, Schardt J, Borner M, Fuhrer A, Schär C, Gillessen S, von Moos R, For the Swiss Group for Clinical Cancer Research (SAKK). Incidence of hypocalcemia in patients with metastatic breast cancer under treatment with denosumab: A non-inferiority phase III trial assessing prevention of symptomatic skeletal events (SSE) with denosumab administered every 4 weeks versus every 12 weeks: SAKK 96/12 (REDUSE) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-18-01.
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Affiliation(s)
- A Müller
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - AJ Templeton
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - S Hayoz
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - H Hawle
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - U Hasler-Strub
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - M Schwitter
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - BC Pestalozzi
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - O Pagani
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - P Bützberger
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - T Wehrhahn
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - D Rauch
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - R Inauen
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - D Betticher
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - K Zaman
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - A Bodmer
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - RA Popescu
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - S Rothschild
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - J Schardt
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - M Borner
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - A Fuhrer
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - C Schär
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - S Gillessen
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
| | - R von Moos
- Kantonsspital Winterthur, Winterthur, Switzerland; St. Claraspital, Basel, Switzerland; SAKK Coordinating Center, Bern, Switzerland; Kantonsspital St. Gallen, St. Gallen, Switzerland; Kantonsspital Graubünden, Chur, Switzerland; Universitätsspital Zürich, Zürich, Switzerland; Ente Ospedaliero Cantonale Ticino, Bellinzona, Switzerland; Kantonsspital Baden, Baden, Switzerland; Kantonsspital Aarau, Aarau, Switzerland; Spital STS, Thun, Switzerland; Spital Thurgau, Münsterlingen, Switzerland; HFR Freiburg – Kantonsspital, Freiburg, Switzerland; Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland; Hospitaux Universitaires de Geneve HUG, Geneve, Switzerland; Hirslanden Medical Center, Aarau, Switzerland; Universitätsspital Basel, Basel, Switzerland; Inselspital, Universitätsspital Bern, Bern, Switzerland; Engeried & Lindenhofspital, Bern, Switzerland
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Mueller BU, Neuspiel DR, Fisher ERS, Franklin W, Adirim T, Bundy DG, Ferguson LE, Gleeson SP, Leu M, Quinonez RA, Rinke ML, Shiffman RN, Saarel EV, Tieder JS, Yin HS, Phillips SC, Quinonez R, Brown JM, Walsh KM, Jewell J, Ernst K, Hill VL, Lam V, Vinocur C, Rauch D, Hsu B. Principles of Pediatric Patient Safety: Reducing Harm Due to Medical Care. Pediatrics 2019; 143:peds.2018-3649. [PMID: 30670581 DOI: 10.1542/peds.2018-3649] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Pediatricians render care in an increasingly complex environment, which results in multiple opportunities to cause unintended harm. National awareness of patient safety risks has grown since the National Academy of Medicine (formerly the Institute of Medicine) published its report "To Err Is Human: Building a Safer Health System" in 1999. Patients and society as a whole continue to challenge health care providers to examine their practices and implement safety solutions. The depth and breadth of harm incurred by the practice of medicine is still being defined as reports continue to reveal a variety of avoidable errors, from those that involve specific high-risk medications to those that are more generalizable, such as patient misidentification and diagnostic error. Pediatric health care providers in all practice environments benefit from having a working knowledge of patient safety language. Pediatric providers should serve as advocates for best practices and policies with the goal of attending to risks that are unique to children, identifying and supporting a culture of safety, and leading efforts to eliminate avoidable harm in any setting in which medical care is rendered to children. In this Policy Statement, we provide an update to the 2011 Policy Statement "Principles of Pediatric Patient Safety: Reducing Harm Due to Medical Care."
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Affiliation(s)
- Brigitta U. Mueller
- Johns Hopkins All Children’s Hospital, St Petersburg, Florida
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | | | - Erin R. Stucky Fisher
- Department of Pediatrics, University of California San Diego and Rady Children’s Hospital San Diego, San Diego, California
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Elicin O, Sermaxhaj B, Bojaxhiu B, Shelan M, Giger R, Rauch D, Aebersold DM. Incidence of second primary cancers after radiotherapy combined with platinum and/or cetuximab in head and neck cancer patients. Strahlenther Onkol 2018; 195:468-474. [PMID: 30465265 DOI: 10.1007/s00066-018-1400-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 11/08/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE The second primary cancer (SPC) incidence after treatment with platinum-based chemotherapy and cetuximab in combination with radiotherapy has not been previously reported. Our aim was to compare SPC risk following radiotherapy in combination with these agents for the treatment of head and neck squamous cell carcinoma (HNSCC). METHODS The charts of 296 cases treated for loco-regionally advanced HNSCC between 2009 and 2015 were retrospectively reviewed for patient, tumor, and procedural characteristics. All patients were planned to undergo radiotherapy either with platinum compounds (group: Platinum) or monoclonal antibody cetuximab (group: Cetuximab). A third group of patients switched from platinum compounds to cetuximab due to toxicity (group: Switch). Treatment groups were evaluated for the incidence of SPC with log-rank test. Possible confounders were investigated with multivariate Cox's proportional hazards model. All tests were two-sided, and a p < 0.05 was set to indicate statistical significance. RESULTS Median follow-up was 36 months. Platinum, Cetuximab, and Switch groups consisted of 158, 101, and 37 patients, respectively. Three-year overall survival in the whole cohort was 70%. The rate of SPC was comparable between Platinum (9.2%) and Cetuximab (11.5%) groups (p = 0.98), whereas the patients in the Switch group were exposed to a significantly higher incidence of SPC (23.3%) in 3 years (p = 0.01). The multivariate model indicated Switch to be the only variable correlating with an increased risk for SPC. CONCLUSIONS The Switch strategy may expose the patients to an increased risk of developing SPC. The use of switch should be advocated with caution until robust pre-clinical and clinical data are available.
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Affiliation(s)
- Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, 3010, Bern, Switzerland.
| | - Burim Sermaxhaj
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, 3010, Bern, Switzerland
| | - Beat Bojaxhiu
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, 3010, Bern, Switzerland
| | - Mohamed Shelan
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, 3010, Bern, Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Freiburgstrasse, 3010, Bern, Switzerland
| | - Daniel Rauch
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Daniel M Aebersold
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, 3010, Bern, Switzerland
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von Moos R, Hawle H, Hayoz S, Cathomas R, Müller A, Schmid S, Pagani O, Wehrhahn T, Rauch D, Anchisi S, Hermanns T, Fehr M, Stoll S, Bützberger P, Zweifel M, Huber U, Fuhrer A, Schär C, Gillessen S, Templeton A. Incidence of hypocalcemia in a non-inferiority phase III trial assessing prevention of symptomatic skeletal events (SSE) with denosumab (DN) administered every 4 weeks (q4w) versus every 12 weeks (q12w): SAKK 96/12 (REDUSE). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Seidl E, Carlens J, Reu S, Wetzke M, Ley-Zaporozhan J, Brasch F, Wesselak T, Schams A, Rauch D, Schuch L, Kappler M, Schelstraete P, Wolf M, Stehling F, Haarmann E, Borensztajn D, van de Loo M, Rubak S, Lex C, Hinrichs B, Reiter K, Schwerk N, Griese M. Pulmonary interstitial glycogenosis – A systematic analysis of new cases. Respir Med 2018; 140:11-20. [DOI: 10.1016/j.rmed.2018.05.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 05/13/2018] [Indexed: 11/16/2022]
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Cherian MA, Olson S, Sundaramoorthi H, Cates K, Cheng X, Harding J, Martens A, Challen GA, Tyagi M, Ratner L, Rauch D. An activating mutation of interferon regulatory factor 4 (IRF4) in adult T-cell leukemia. J Biol Chem 2018. [PMID: 29540473 DOI: 10.1074/jbc.ra117.000164] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The human T-cell leukemia virus-1 (HTLV-1) oncoprotein Tax drives cell proliferation and resistance to apoptosis early in the pathogenesis of adult T-cell leukemia (ATL). Subsequently, probably as a result of specific immunoediting, Tax expression is down-regulated and functionally replaced by somatic driver mutations of the host genome. Both amplification and point mutations of interferon regulatory factor 4 (IRF4) have been previously detected in ATL., K59R is the most common single-nucleotide variation of IRF4 and is found exclusively in ATL. High-throughput whole-exome sequencing revealed recurrent activating genetic alterations in the T-cell receptor, CD28, and NF-κB pathways. We found that IRF4, which is transcriptionally activated downstream of these pathways, is frequently mutated in ATL. IRF4 RNA, protein, and IRF4 transcriptional targets are uniformly elevated in HTLV-1-transformed cells and ATL cell lines, and IRF4 was bound to genomic regulatory DNA of many of these transcriptional targets in HTLV-1-transformed cell lines. We further noted that the K59R IRF4 mutant is expressed at higher levels in the nucleus than WT IRF4 and is transcriptionally more active. Expression of both WT and the K59R mutant of IRF4 from a constitutive promoter in retrovirally transduced murine bone marrow cells increased the abundance of T lymphocytes but not myeloid cells or B lymphocytes in mice. IRF4 may represent a therapeutic target in ATL because ATL cells select for a mutant of IRF4 with higher nuclear expression and transcriptional activity, and overexpression of IRF4 induces the expansion of T lymphocytes in vivo.
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Affiliation(s)
- Mathew A Cherian
- From the Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Sydney Olson
- the Department of Biology, University of Wisconsin, Madison, Wisconsin 53706, and
| | - Hemalatha Sundaramoorthi
- From the Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Kitra Cates
- From the Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Xiaogang Cheng
- From the Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - John Harding
- From the Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Andrew Martens
- From the Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Grant A Challen
- From the Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Manoj Tyagi
- the Computational Biology Branch, National Center for Biotechnology Information, National Institutes of Health, Bethesda, Maryland 20892
| | - Lee Ratner
- From the Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110,
| | - Daniel Rauch
- From the Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
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von Moos R, Koeberle D, Schacher S, Hayoz S, Winterhalder RC, Roth A, Bodoky G, Samaras P, Berger MD, Rauch D, Saletti P, Plasswilm L, Zwahlen D, Meier UR, Yan P, Izzo P, Klingbiel D, Bärtschi D, Zaugg K. Neoadjuvant radiotherapy combined with capecitabine and sorafenib in patients with advanced KRAS-mutated rectal cancer: A phase I/II trial (SAKK 41/08). Eur J Cancer 2017; 89:82-89. [PMID: 29241084 DOI: 10.1016/j.ejca.2017.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 10/27/2017] [Accepted: 11/01/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND KRAS mutation occurs in ∼40% of locally advanced rectal cancers (LARCs). The multitarget tyrosine kinase inhibitor sorafenib has radiosensitising effects and might improve outcomes for standard preoperative chemoradiotherapy in patients with KRAS-mutated LARC. METHODS Adult patients with KRAS-mutated T3/4 and/or N1/2M0 LARC were included in this phase I/II study. The phase I dose-escalation study of capecitabine plus sorafenib and radiotherapy was followed by a phase II study assessing efficacy and safety. Primary end-points were to: establish the maximum tolerated dose of the regimen in phase I; determine the pathologic complete response (pCR) rate in phase II defined as Dworak regression grade 3 and 4. RESULTS Fifty-four patients were treated at 18 centres in Switzerland and Hungary; 40 patients were included in the single-arm phase II study. Recommended doses from phase I comprised radiotherapy (45 Gy in 25 fractions over 5 weeks) with capecitabine 825 mg/m2 twice daily × 33 plus sorafenib 400 mg/d. Median daily dose intensity in phase II was radiotherapy 100%, capecitabine 98.6%, and sorafenib 100%. The pCR rate (Dworak 3/4) was 60% (95% CI, 43.3-75.1%) by central independent pathologic review. Sphincter preservation was achieved in 89.5%, R0 resection in 94.7%, and downstaging in 81.6%. The most common grade 3 toxicities during phase II included diarrhoea (15.0%), skin toxicity outside radiotherapy field (12.5%), pain (7.5%), skin toxicity in radiotherapy field, proctitis, fatigue and cardiac ischaemia (each 5%). CONCLUSIONS Combining sorafenib and standard chemoradiotherapy with capecitabine is highly active in patients with KRAS-mutated LARC with acceptable toxicity and deserves further investigation. www.clinicaltrials.gov: NCT00869570.
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Affiliation(s)
| | | | | | | | | | - Arnaud Roth
- University Hospital Geneva, Geneva, Switzerland
| | | | | | | | | | | | - Ludwig Plasswilm
- Kantonsspital St. Gallen, St. Gallen, Switzerland; Inselspital Bern, Bern, Switzerland
| | | | - Urs R Meier
- Kantonsspital Winterthur, Winterthur, Switzerland
| | - Pu Yan
- University Hospital Zürich, Zürich, Switzerland
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25
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Gligorov J, Ataseven B, Verrill M, De Laurentiis M, Jung K, Azim H, Al-Sakaff N, Lauer S, Shing M, Pivot X, Koroveshi D, Bouzid K, Casalnuovo M, Cascallar D, Korbenfeld EP, Bastick P, Beith J, Colosimo M, Friedlander M, Ganju V, Green M, Patterson K, Redfern A, Richardson G, Ceric T, Gordana K, Beato CA, Ferrari M, Hegg R, Helena V, Ismael GF, Lessa AE, Mano M, Morelle A, Nogueira JA, Timcheva K, Tomova A, Tsakova M, Zlatareva-Petrova A, Asselah J, Assi H, Brezden-Masley C, Chia S, Freedman O, Harb M, Joy AA, Kulkarni S, Prady C, Gaete AAA, Matamala L, Torres R, Yanez E, Franco S, Urrego M, Gugić D, Vrbanec D, Melichar B, Prausová J, Vyzula R, Pilarte RG, León MI, Muñoz R, Ramos G, Azeem HA, Aziz AA, El Zawahry H, Osegueda FR, Alexandre J, Artignan X, Barletta H, Beguier E, Berdah JF, Marty CB, Bollet M, Bourgeois H, Bressac C, Burki F, Campone M, Coeffic D, Cojocarasu OZ, Dagada C, Dalenc F, Del Piano F, Desauw C, Desmoulins I, Dohollou N, Egreteau J, Ferrero JM, Foa C, Garidi R, Gasnault L, Gligorov J, Guardiola E, Hamizi S, Jarcau R, Jacquin JP, Jaubert D, Jolimoy G, Mineur HL, Largillier R, Leduc B, Martin P, Melis A, Monge J, Moullet I, Mousseau M, Nguyen S, Orfeuvre H, Petit T, Pivot X, Priou F, Bach IS, Simon H, Stefani L, Uwer L, Youssef A, Aktas B, von der Assen A, Augustin D, Balser C, Bauer LE, Bechtner C, Beyer G, Brucker C, Bückner U, Busch S, Christensen B, Deryal M, Farrokh A, Faust E, Friedrichs K, Graf H, Griesshammer M, Grischke EM, Hänle C, Heider A, Henschen S, Hesse T, Jackisch C, Kisro J, Köhler A, Kuemmel S, Lampe D, Lantzsch T, Latos K, Lex B, Liedtke C, Luedders D, Maintz C, Müller V, Overkamp F, Park-Simon TW, Paul M, Prechtl A, Ringsdorf U, Runnebaum I, Ruth S, Salat C, Scheffen I, Schilling J, Schmatloch S, Schmidt M, Schneeweiss A, Schrader I, Seipelt G, Simon E, Stefek A, Stickeler E, Thill M, Tio J, Tuczek A, Warm M, Weigel M, Wischnik A, Wojcinski S, Ziegler-Löhr K, Aravantinos G, Ardavanis A, Fountzilas G, Gogas H, Kakolyris S, Mavroudis D, Papadimitriou C, Papandreou C, Papazisis K, Castro H, Hernandez-Monroy CE, Ngan R, Yeo W, Bittner N, Boer K, Csejtei A, Horvath Z, Kocsis J, Mangel LC, Mezei K, Nagy Z, Szanto J, Atmakusuma D, Fadjari H, Kurnianda D, Prayogo N, Tanggo EH, Coate L, Hennessy B, Kelly C, Martin M, Nasim S, O'Connor M, Aieta M, Allegrini G, Amadori D, Bidoli P, Biti G, Bordonaro R, Bottini A, Carterni G, Cavanna L, Cazzaniga M, Cognetti F, Contu A, Cruciani G, Donadio M, Falcone A, Farci D, Forcignanò RC, Frassoldati A, Gaion F, Gamucci T, Giotta F, de Laurentiis M, Livi L, Lorusso V, Maiello E, Marchetti P, Mariani G, Mion M, Moscetti L, Musolino A, Pazzola A, Pedrazzoli P, Pigi A, de Placido S, Caremoli ER, Santoro A, Tienghi A, Ahn JS, Jung KH, Lee KS, Lee SH, Seo JH, Sohn JH, Cesas A, Juozaityte E, Cheah NLC, Chong FLT, Devi BC, Phua V, Teoh D, Ching LW, Yusof M, Corona J, Dominguez A, Mendoza RLG, Hernandez CA, Ramiro AJ, Santos JM, Espinosa PM, Villarreal Garza CM, Errihani H, Bakker S, van den Berkmortel F, Blaisse R, Huinink DTB, van den Bosch J, Braun J, Dercksen M, Droogendijk H, Erdkamp F, Haringhuizen A, de Jongh F, Kok T, Los M, Madretsma S, Terwogt JMM, van der Padt A, van Rossum-Schornagel QC, Smilde T, de Valk B, van der Velden A, van Warmerdam L, van de Wouw A, North R, Kersten C, Mjaaland I, Wist E, Aziz Z, Masood N, Rashid K, Shah M, Alcedo JC, Aleman D, Neciosup S, Reategui R, Valdiviezo N, Vera L, Fernando G, Roque F, Strebel HM, Krzemieniecki K, Litwiniuk M, Mruk A, Pienkowski T, Sawrycki P, Slomian G, Tomczak P, Afonso N, Cardoso F, Damasceno M, Nave M, Badulescu F, Ciule L, Curescu S, Eniu A, Filip D, Grecea D, Jinga DC, Lungulescu D, Oprean CM, Stanculeanu DL, Turdean M, Dvornichenko V, Emelyanov S, Lichinitser M, Manikhas A, Sakaeva D, Shirinkin V, Stroyakovskiy D, Abulkhair O, Zekri J, Filipovic S, Kovcin V, Nedovic J, Pesic J, Vasovic S, Ng R, Bystricky B, Leskova J, Mardiak J, Mišurová E, Wagnerova M, Takač I, Demetriou GS, Dreosti L, Govender P, Jordaan JP, Veersamy P, Romero JLA, Lopez NB, Arias CC, Chacon J, Aramburo AF, Morales LAF, Garcia M, Estevez LG, Garcia-Palomo Perez A, Garcia Saenz JA, Garcia Sanchis L, Cubells LG, Cortijo LG, Santiago SG, De Aranguiz BHF, Mañas JJI, Gallego PJ, Cussac AL, Ferrandiz CL, Garrido ML, Alvarez PL, Vega JML, Del Prado PM, Jañez NM, Murillo SM, Rosales AM, Jaso LM, Fernandez IP, Martorell AP, Carrion RP, Simon SP, Alcibar AP, Lorenzo JP, Garcia VQ, Asensio TRYC, Maicas MDT, Villanueva Silva MJ, Killander F, Svensson JH, Fehr M, Hauser N, Müller A, Pagani O, Passmann-Kegel H, Popescu R, Rabaglio M, Rauch D, Schlatter C, Zaman K, Chang TW, Huang CS, Wang HC, Yu JC, Bandidwattanawong C, Maneechavakajorn J, Seetalarom K, Dejthevaporn T(S, Somwangprasert A, Vongsaisuwon M, Akbulut H, Altundag K, Arican A, Bozcuk H, Eralp Y, Idris M, Isikdogan A, Senol CH, Sevinc A, Uygun K, Yucel E, Yucel I, Yumuk F, Shparyk Y, Voitko N, Jaloudi M, Adams J, Agrawal R, Ahmed S, Alhasso A, Allerton R, Anwar S, Archer C, Ashford R, Barraclough L, Bertelli G, Bishop J, Branson T, Butt M, Chakrabarti A, Chakraborti P, Churn M, Crowley C, Davis R, Dhadda A, Eldeeb H, Fraser J, Hall J, Hickish T, Hogg M, Howe T, Joffe J, Kelleher M, Kelly S, Kendall A, Kristeleit H, Lumsden G, Macmillan C, MacPherson I, Malik Z, Mithal N, Neal A, Panwar U, Proctor A, Proctor SJ, Raj S, Rehman S, Sandri I, Scatchard K, Sherwin E, Sims E, Singer J, Smith S, Tahir S, Taylor W, Tsalic M, Verrill M, Wardley A, Waters S, Wheatley D, Wright K, Yuille F, Alonso I, Artagaveytia N, Rodriguez R, Arbona E, Garcia Y, Lion L, Marcano D, Van Thuan T. Safety and tolerability of subcutaneous trastuzumab for the adjuvant treatment of human epidermal growth factor receptor 2-positive early breast cancer: SafeHer phase III study's primary analysis of 2573 patients. Eur J Cancer 2017. [DOI: 10.1016/j.ejca.2017.05.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Stenner F, Rothschild SI, Betticher D, Caspar C, Morant R, Popescu R, Rauch D, Huber U, Zenhäusern R, Rentsch C, Cathomas R. Quality of Life in Second-Line Treatment of Metastatic Castration-Resistant Prostate Cancer Using Cabazitaxel or Other Therapies After Previous Docetaxel Chemotherapy: Swiss Observational Treatment Registry. Clin Genitourin Cancer 2017; 16:S1558-7673(17)30244-6. [PMID: 28958629 DOI: 10.1016/j.clgc.2017.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/07/2017] [Accepted: 08/12/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND The aim was to evaluate quality of life (QoL), pain, and fatigue in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with different regimens after first-line docetaxel, as well as disease progression. PATIENTS AND METHODS Patients with mCRPC having received first-line chemotherapy with docetaxel were eligible. Second-line treatment choice was at the discretion of the local investigator. All patients had regular assessments of QoL with the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire, of fatigue with the Brief Fatigue Inventory, and of pain with the McGill Pain Questionnaire-Short Form. The primary end point was QoL maintenance defined as having a maximum decrease in 2 functional domains of the FACT-P. RESULTS One hundred thirty-eight patients were included in 36 oncology centers across Switzerland. QoL analysis was available for all patients (59 who received cabazitaxel; 79 who received other therapy [OT] including 75 who received abiraterone). No significant differences for any of the end points were found between groups. A numerically higher number of patients had QoL maintenance with OT (25 of 79 patients, 32%) compared with cabazitaxel (8 of 59 patients, 14%). QoL improvement was found in 20% of patients (12 of 59) who received cabazitaxel and 24% (19 of 79) who received OT. Mean FACT-P score did not change in a clinically relevant manner over time in either group. Pain was present in 70% of patients (96 of 138), and a pain response to treatment was noted in 22% (13 of 59) who received cabazitaxel and 29% (23 of 79) who received OT. A similar but minor improvement of fatigue was noted in both groups. CONCLUSION Some degree of QoL decrease was seen in most patients regardless of second-line treatment. No significant differences in QoL parameters between cabazitaxel or other second line treatments were found.
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Affiliation(s)
- Frank Stenner
- Department of Oncology, University Hospital Basel, Basel, Switzerland
| | | | - Daniel Betticher
- Department of Oncology, Cantonal Hospital, Fribourg, Switzerland
| | - Clemens Caspar
- Department of Oncology, Cantonal Hospital, Baden, Switzerland
| | - Rudolf Morant
- Center for Tumors and Prevention ZeTuP, Rapperswil-Jona, Switzerland
| | - Razvan Popescu
- Division of Oncology, Hirslanden Medical Center, Aarau, Switzerland
| | - Daniel Rauch
- Division of Oncology, Hospital Thun, Thun, Switzerland
| | - Urs Huber
- Oncology Center, Hirslanden Clinic, Zürich, Switzerland
| | | | - Cyrill Rentsch
- Department of Oncology, University Hospital Basel, Basel, Switzerland
| | - Richard Cathomas
- Department of Oncology and Hematology, Cantonal Hospital Graubünden, Chur, Switzerland.
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Chung EK, Gable EK, Golden WC, Hudson JA, Hackman NM, Andrews JP, Jackson DS, Beavers JB, Mirchandani DR, Kellams A, Krevitsky ME, Monroe K, Madlon-Kay DJ, Stratbucker W, Campbell D, Collins J, Rauch D. Current Scope of Practice for Newborn Care in Non-Intensive Hospital Settings. Hosp Pediatr 2017; 7:471-482. [PMID: 28694290 DOI: 10.1542/hpeds.2016-0206] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Esther K Chung
- Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania and Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware;
| | - E Kaye Gable
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina and Cone Health, Greensboro, North Carolina
| | - W Christopher Golden
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jennifer A Hudson
- Department of Pediatrics, Greenville Health System, Greenville, South Carolina
| | - Nicole M Hackman
- Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Jennifer P Andrews
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - DeeAnne S Jackson
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jessica B Beavers
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Dipti R Mirchandani
- Department of Pediatrics, Hofstra Northwell School of Medicine at Hofstra University, Hempstead, New York and Cohen Children's Medical Center of New York, New Hyde Park, New York
| | - Ann Kellams
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Meredith E Krevitsky
- Department of Pediatrics, Hofstra Northwell School of Medicine at Hofstra University, Hempstead, New York and Cohen Children's Medical Center of New York, New Hyde Park, New York
| | - Kimberly Monroe
- Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan
| | - Diane J Madlon-Kay
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
| | - William Stratbucker
- Department of Pediatrics, Michigan State University and Helen DeVos Children's Hospital, Grand Rapids, Michigan
| | - Deborah Campbell
- Department of Pediatrics, Albert Einstein College of Medicine, New York, New York and Children's Hospital at Montefiore, Bronx, New York
| | - Jolene Collins
- Department of Pediatrics, University of Southern California Keck School of Medicine and Children's Hospital Los Angeles, Los Angeles, California; and
| | - Daniel Rauch
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Elmhurst, New York
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28
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Rosell R, Dafni U, Felip E, Curioni-Fontecedro A, Gautschi O, Peters S, Massutí B, Palmero R, Aix SP, Carcereny E, Früh M, Pless M, Popat S, Kotsakis A, Cuffe S, Bidoli P, Favaretto A, Froesch P, Reguart N, Puente J, Coate L, Barlesi F, Rauch D, Thomas M, Camps C, Gómez-Codina J, Majem M, Porta R, Shah R, Hanrahan E, Kammler R, Ruepp B, Rabaglio M, Kassapian M, Karachaliou N, Tam R, Shames DS, Molina-Vila MA, Stahel RA. Erlotinib and bevacizumab in patients with advanced non-small-cell lung cancer and activating EGFR mutations (BELIEF): an international, multicentre, single-arm, phase 2 trial. Lancet Respir Med 2017; 5:435-444. [PMID: 28408243 DOI: 10.1016/s2213-2600(17)30129-7] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/09/2017] [Accepted: 03/09/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND The tyrosine kinase inhibitor erlotinib improves the outcomes of patients with advanced non-small-cell lung carcinoma (NSCLC) harbouring epidermal growth factor receptor (EGFR) mutations. The coexistence of the T790M resistance mutation with another EGFR mutation in treatment-naive patients has been associated with a shorter progression-free survival to EGFR inhibition than in the absence of the T790M mutation. To test this hypothesis clinically, we developed a proof-of-concept study, in which patients with EGFR-mutant NSCLC were treated with the combination of erlotinib and bevacizumab, stratified by the presence of the pretreatment T790M mutation. METHODS BELIEF was an international, multicentre, single-arm, phase 2 trial done at 29 centres in eight European countries. Eligible patients were aged 18 years or older and had treatment-naive, pathologically confirmed stage IIIB or stage IV lung adenocarcinoma with a confirmed, activating EGFR mutation (exon 19 deletion or L858R mutation). Patients received oral erlotinib 150 mg per day and intravenous bevacizumab 15 mg/kg every 21 days and were tested centrally for the pretreatment T790M resistance mutation with a peptide nucleic acid probe-based real-time PCR. The primary endpoint was progression-free survival. The primary efficacy analysis was done in the intention-to-treat population and was stratified into two parallel substudies according to the centrally confirmed pretreatment T790M mutation status of enrolled patients (T790M positive or negative). The safety analysis was done in all patients that have received at least one dose of trial treatment. This trial was registered with ClinicalTrials.gov, number NCT01562028. FINDINGS Between June 11, 2012, and Oct 28, 2014, 109 patients were enrolled and included in the efficacy analysis. 37 patients were T790M mutation positive and 72 negative. The overall median progression-free survival was 13·2 months (95% CI 10·3-15·5), with a 12 month progression-free survival of 55% (95% CI 45-64). The primary endpoint was met only in substudy one (T790M-positive patients). In the T790M-positive group, median progression-free survival was 16·0 months (12·7 to not estimable), with a 12 month progression-free survival of 68% (50-81), whereas in the T790M-negative group, median progression-free survival was 10·5 months (9·4-14·2), with a 12 month progression-free survival of 48% (36-59). Of 106 patients included in the safety analysis, five had grade 4 adverse events (one acute coronary syndrome, one biliary tract infection, one other neoplasms, and two colonic perforations) and one died due to sepsis. INTERPRETATION The BELIEF trial provides further evidence of benefit for the combined use of erlotinib and bevacizumab in patients with NSCLC harbouring activating EGFR mutations. FUNDING European Thoracic Oncology Platform, Roche.
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Affiliation(s)
- Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Urania Dafni
- Frontier Science Foundation-Hellas & National and Kapodistrian University of Athens, Athens, Greece
| | - Enriqueta Felip
- Vall d'Hebron University Hospital, Institute of Oncology, Barcelona, Spain
| | - Alessandra Curioni-Fontecedro
- University Hospital Zurich, Clinic of Oncology, Zurich, Switzerland; Swiss Group of Clinical Cancer Research, Bern, Switzerland
| | - Oliver Gautschi
- Cantonal Hospital Lucerne, Medical Oncology, Lucerne, Switzerland; Swiss Group of Clinical Cancer Research, Bern, Switzerland
| | - Solange Peters
- Centre Hospitalier Universitaire Vaudois, Département d'Oncologie, Lausanne, Switzerland; Swiss Group of Clinical Cancer Research, Bern, Switzerland
| | - Bartomeu Massutí
- Hospital General Universitario Alicante, Oncología Médica, Alicante, Spain
| | - Ramon Palmero
- Catalan Institute of Oncology, Hospital Duran i Reynals, Bellvitge, Spain
| | | | - Enric Carcereny
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Martin Früh
- Cantonal Hospital St Gallen, Oncology and Hematology, St Gallen, Switzerland; Swiss Group of Clinical Cancer Research, Bern, Switzerland
| | - Miklos Pless
- Cantonal Hospital Winterthur, Medical Oncology, Winterthur, Switzerland; Swiss Group of Clinical Cancer Research, Bern, Switzerland
| | - Sanjay Popat
- Medical Oncology, Royal Marsden Hospital, London, UK
| | - Athanasios Kotsakis
- University General Hospital of Heraklion, Medical Oncology, Heraklion, Crete, Greece
| | - Sinead Cuffe
- Cancer Trials Ireland and St James's Hospital, Medical Oncology, Dublin, Ireland
| | - Paolo Bidoli
- Ospedale San Gerardo, Oncologia Medica, Monza, Italy
| | | | - Patrizia Froesch
- Instituto Oncologica Della Svizzera Italiana, Bellinzona, Switzerland; Swiss Group of Clinical Cancer Research, Bern, Switzerland
| | - Noemí Reguart
- Hospital Clínic, Medical Oncology & Genomics and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Javier Puente
- Thoracic, Urologic & Melanoma Cancer Unit Medical Oncology Department Hospital Clinico Universitario San Carlos, Madrid, Spain
| | - Linda Coate
- University Hospital Limerick and Cancer Trials Ireland, Limerick, Ireland
| | - Fabrice Barlesi
- Aix Marseille University; Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Daniel Rauch
- Okologiezentrum Thun-Berner Oberland, Thun, Switzerland; Swiss Group of Clinical Cancer Research, Bern, Switzerland
| | - Michael Thomas
- Internistische Onkologie der Thoraxtumoren, Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research, Heidelberg, Germany
| | | | | | | | - Rut Porta
- Insitut Catalan d'Oncologia and University of Girona, Girona, Spain
| | | | - Emer Hanrahan
- Cancer Trials Ireland and St Vincent's University Hospital, Dublin, Ireland
| | - Roswitha Kammler
- European Thoracic Oncology Platform Coordinating Office, Bern, Switzerland
| | - Barbara Ruepp
- European Thoracic Oncology Platform Coordinating Office, Bern, Switzerland
| | - Manuela Rabaglio
- European Thoracic Oncology Platform Coordinating Office, Bern, Switzerland
| | | | - Niki Karachaliou
- Institute of Oncology Rosell, University Hospital Sagrat Cor, Barcelona, Spain
| | - Rachel Tam
- Oncology Biomarker Development, Genentech, South San Francisco, CA, USA
| | - David S Shames
- Oncology Biomarker Development, Genentech, South San Francisco, CA, USA
| | | | - Rolf A Stahel
- University Hospital Zurich, Clinic of Oncology, Zurich, Switzerland; Swiss Group of Clinical Cancer Research, Bern, Switzerland.
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Rothschild S, Gautschi O, Schuster N, Li Q, Savic S, Schneider M, Biaggi C, Bubendorf L, Brutsche M, Zippelius A, Zander T, Betticher D, Früh M, Stahel R, Cathomas R, Rauch D, Pless M, Ochsenbein A, Jaggi R. PUB041 HGF, VEGFA and ANGPT2 Predict Clinical Benefit from Bevacizumab and Chemotherapy in Patients with Advanced NSCLC (SAKK19/09). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.2011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gilli S, Novak U, Taleghani BM, Baerlocher GM, Leibundgut K, Banz Y, Zander T, Betticher D, Egger T, Rauch D, Pabst T. BeEAM conditioning with bendamustine-replacing BCNU before autologous transplantation is safe and effective in lymphoma patients. Ann Hematol 2016; 96:421-429. [DOI: 10.1007/s00277-016-2900-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 12/09/2016] [Indexed: 11/29/2022]
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Peters S, Stahel RA, Dafni U, Ponce Aix S, Massutí B, Gautschi O, Coate L, López Martín A, van Heemst R, Berghmans T, Meldgaard P, Cobo Dols M, Garde Noguera J, Curioni-Fontecedro A, Rauch D, Mark MT, Cuffe S, Biesma B, van Henten AMJ, Juan Vidal Ó, Palmero Sanchez R, Villa Guzmán JC, Collado Martin R, Peralta S, Insa A, Summers Y, Láng I, Horgan A, Ciardiello F, de Hosson S, Pieterman R, Groen HJM, van den Berg PM, Zielinski CC, Chittazhathu Kurian Kuruvilla Y, Gasca-Ruchti A, Kassapian M, Novello S, Torri V, Tsourti Z, Gregorc V, Smit EF. Randomized Phase III Trial of Erlotinib versus Docetaxel in Patients with Advanced Squamous Cell Non-Small Cell Lung Cancer Failing First-Line Platinum-Based Doublet Chemotherapy Stratified by VeriStrat Good versus VeriStrat Poor. The European Thoracic Oncology Platform (ETOP) EMPHASIS-lung Trial. J Thorac Oncol 2016; 12:752-762. [PMID: 28017787 DOI: 10.1016/j.jtho.2016.12.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 12/15/2016] [Accepted: 12/16/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Docetaxel and erlotinib are registered second-line treatments for wild-type EGFR NSCLC. Previous studies suggested a predictive value of the VeriStrat test in second-line therapy of NSCLC, classifying patients as either VeriStrat good or VeriStrat poor. EMPHASIS-lung aimed at exploring this predictive effect in patients with squamous cell NSCLC. The trial closed prematurely because of low accrual and results from other trials. Our analysis includes an exploratory combined analysis with results from the PROSE trial. METHODS EMPHASIS-lung was a randomized phase III multicenter trial exploring the differential effect of second-line erlotinib versus docetaxel on progression-free survival (PFS) in VeriStrat good versus VeriStrat poor patients with squamous cell NSCLC. RESULTS A total of 80 patients were randomized, with 72.5% categorized as VeriStrat good. Patient characteristics were balanced between VeriStrat status and treatment groups. The median PFS times with docetaxel and erlotinib treatment in the VeriStrat good cohort were 4.1 and 1.6 months, respectively, versus 1.9 and 2.1 months, respectively, in the VeriStrat poor cohort. The median overall survival (OS) times with docetaxel and erlotinib treatment in the VeriStrat good cohort were 7.8 and 8.4 months, respectively, and 4.4 and 5.2 months, respectively, in the VeriStrat poor cohort. An additional exploratory analysis was performed; in it, 47 patients from the squamous cell subgroup of PROSE were included in a combined analysis, contributing with 45 PFS and 41 OS events. CONCLUSIONS The final analysis of EMPHASIS-lung did not show a differential effect on PFS for erlotinib versus docetaxel stratified by VeriStrat status. Similarly, in the combined analysis, no significant treatment by VeriStrat status interaction was observed (interaction p = 0.24 for PFS and 0.45 for OS, stratified by study).
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Affiliation(s)
- Solange Peters
- University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
| | - Rolf A Stahel
- University Hospital Zürich, Clinic of Oncology, Zürich, Switzerland
| | - Urania Dafni
- Frontier Science Foundation-Hellas and National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Oliver Gautschi
- Swiss Group for Clinical Cancer Research and Cantonal Hospital Lucerne, Switzerland
| | - Linda Coate
- Cancer Trials Ireland and Mid-Western Regional Hospital, Limerick, Ireland
| | | | | | | | | | | | | | | | | | | | - Sinead Cuffe
- Cancer Trials Ireland and St. James's Hospital, Dublin, Ireland
| | - Bonne Biesma
- Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | | | | | | | | | | | | | | | | | - István Láng
- National Institute of Oncology, Budapest, Hungary
| | - Anne Horgan
- Cancer Trials Ireland and University Hospital Waterford, Ireland
| | | | | | | | | | | | - Christoph C Zielinski
- Central European Cooperative Oncology Group and Comprehensive Cancer Center of the Medical University, Vienna, Austria
| | | | | | | | - Silvia Novello
- University of Turin, Department of Clinical and Biological Sciences, Turin, Italy
| | - Valter Torri
- Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Zoi Tsourti
- Frontier Science Foundation-Hellas, Athens, Greece
| | - Vanesa Gregorc
- IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Egbert F Smit
- Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Cathomas R, Crabb SJ, Mark M, Winterhalder R, Rothermundt C, Elliott T, von Burg P, Kenner H, Hayoz S, Vilei SB, Rauch D, Roggero E, Mohaupt MG, Bernhard J, Manetsch G, Gillessen S. Orteronel Switch Maintenance Therapy in Metastatic Castration Resistant Prostate Cancer After First-Line Docetaxel: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial (SAKK 08/11). Prostate 2016; 76:1519-1527. [PMID: 27457964 DOI: 10.1002/pros.23236] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 07/12/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND We tested whether a switch maintenance treatment with orteronel, an oral inhibitor of androgen biosynthesis, prolongs disease control in men with metastatic castration-resistant prostate cancer (mCRPC) after documented disease stabilization with docetaxel. METHODS Men with mCRPC and non-progressive disease after a cumulative dose of ≥300 mg/m2 docetaxel for first line treatment were randomized 1:1 to receive orteronel 300 mg twice daily or placebo. The primary endpoint was event-free survival (EFS) defined as the time from randomization to death or the combination of at least two of radiographic, clinical, or PSA progression. Ninety-six patients per arm were planned to demonstrate an improvement of median EFS from 4 months on placebo to 6.7 months on orteronel (hazard ratio (HR) 0.6; type I error 5% and power 90%). RESULTS Forty-seven patients (23 orteronel, 24 placebo) were randomized before premature closure of the trial because of discontinuation of clinical development of orteronel. Median EFS was 8.5 months with orteronel and 2.9 months with placebo (P = 0.001; HR 0.32; 95%CI 0.15-0.65). Median radiographic progression-free survival (rPFS) was 8.5 and 2.8 months (P = 0.02; HR 0.42; 95%CI 0.20-0.91) in the orteronel and placebo arm, respectively. PSA decline ≥50% was seen in 57% on orteronel and 4% on placebo. Toxicity was mainly mild, one patient on orteronel developed transient grade 3 adrenal insufficiency and one grade 4 pneumonitis. CONCLUSIONS Orteronel significantly prolongs EFS in men with mCRPC who achieve disease stabilization with docetaxel. The concept of switch maintenance therapy in mCRPC warrants further research. Prostate 76:1519-1527, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Richard Cathomas
- Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland.
| | - Simon J Crabb
- Cancer Sciences Unit, University of Southampton, Southampton, United Kingdom
| | - Michael Mark
- Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | | | - Christian Rothermundt
- Department of Oncology/Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Tony Elliott
- Department of Oncology, The Christie Clinic, Manchester, United Kingdom
| | | | | | | | | | | | - Enrico Roggero
- Department of Oncology, Bellinzona IOSI, Bellinzona, Switzerland
| | - Markus G Mohaupt
- Department of Nephrology, Hypertension and Clinical Pharmacology, University of Bern, Bern, Switzerland
| | - Jürg Bernhard
- International Breast Cancer Study Group Coordinating Center Bern and University Hospital, Inselspital Bern, Switzerland
| | | | - Silke Gillessen
- Department of Oncology/Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Gautschi O, Rothschild SI, Li Q, Matter-Walstra K, Zippelius A, Betticher DC, Früh M, Stahel RA, Cathomas R, Rauch D, Pless M, Peters S, Froesch P, Zander T, Schneider M, Biaggi C, Mach N, Ochsenbein AF. Bevacizumab Plus Pemetrexed Versus Pemetrexed Alone as Maintenance Therapy for Patients With Advanced Nonsquamous Non-Small-cell Lung Cancer: Update From the Swiss Group for Clinical Cancer Research (SAKK) 19/09 Trial. Clin Lung Cancer 2016; 18:303-309. [PMID: 27993482 DOI: 10.1016/j.cllc.2016.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/07/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Pemetrexed and bevacizumab as single agents have been approved for maintenance therapy after platinum-based induction in patients with advanced nonsquamous non-small-cell lung cancer. It is currently unknown whether bevacizumab plus pemetrexed is superior to pemetrexed alone. PATIENTS AND METHODS We conducted a nonrandomized phase II trial with 2 sequential cohorts. In the first cohort, 77 patients were treated with 4 cycles of cisplatin, bevacizumab, and pemetrexed every 3 weeks, followed by bevacizumab plus pemetrexed maintenance until progression. In the second cohort, we treated 52 patients without bevacizumab, using maintenance with pemetrexed alone. Progression-free survival (PFS), overall survival (OS), overall response rate (ORR), adverse events, and the treatment costs of the 2 cohorts were compared. RESULTS The median PFS from the time of registration was 6.9 months in cohort 1 and 5.6 months in cohort 2. The ORR was 62.3% in cohort 1% and 44.2% in cohort 2. The PFS (hazard ratio, 0.7; 95% confidence interval [CI], 0.5-1.0; P = .041) and ORR (odds ratio, 2.1; 95% CI, 1.0-4.3; P = .049) were better in cohort 1 than in cohort 2. No OS difference was found (hazard ratio, 1.0; 95% CI, 0.7-1.6; P = .890) after a median follow-up period of 47 months for cohort 1 and 27 months for cohort 2. The rate of grade ≥ 3 adverse events was greater in cohort 1. The treatment costs per patient were on average 1.4 times greater for cohort 1. CONCLUSION The addition of bevacizumab increased the ORR and PFS, but not OS, in our nonrandomized trial. Furthermore, the addition of bevacizumab was associated with greater toxicity and higher costs.
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Affiliation(s)
- Oliver Gautschi
- Department of Medical Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
| | - Sacha I Rothschild
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Qiyu Li
- Swiss Group for Clinical Cancer Research Coordinating Center, Bern, Switzerland
| | - Klazien Matter-Walstra
- Swiss Group for Clinical Cancer Research Coordinating Center, Bern, Switzerland; Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland
| | - Alfred Zippelius
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Daniel C Betticher
- Department of Medical Oncology, Cantonal Hospital Fribourg, Fribourg, Switzerland
| | - Martin Früh
- Department of Medical Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Rolf A Stahel
- Department of Medical Oncology, University Hospital Zurich, Zurich, Switzerland
| | - Richard Cathomas
- Department of Medical Oncology, Cantonal Hospital Graubünden, Chur, Switzerland
| | - Daniel Rauch
- Oncology Center, Hospital Simmental-Thun-Saanenland AG, Thun, Switzerland
| | - Miklos Pless
- Tumor Center, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Solange Peters
- University Hospital Lausanne, Cancer Center, Lausanne, Switzerland
| | | | - Thilo Zander
- Department of Medical Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Martina Schneider
- Swiss Group for Clinical Cancer Research Coordinating Center, Bern, Switzerland
| | - Christine Biaggi
- Swiss Group for Clinical Cancer Research Coordinating Center, Bern, Switzerland
| | - Nicolas Mach
- Department of Medical Oncology, University Hospital Geneva, Geneva, Switzerland
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Rochlitz C, Bigler M, von Moos R, Bernhard J, Matter-Walstra K, Wicki A, Zaman K, Anchisi S, Küng M, Na KJ, Bärtschi D, Borner M, Rordorf T, Rauch D, Müller A, Ruhstaller T, Vetter M, Trojan A, Hasler-Strub U, Cathomas R, Winterhalder R. SAKK 24/09: safety and tolerability of bevacizumab plus paclitaxel vs. bevacizumab plus metronomic cyclophosphamide and capecitabine as first-line therapy in patients with HER2-negative advanced stage breast cancer - a multicenter, randomized phase III trial. BMC Cancer 2016; 16:780. [PMID: 27724870 PMCID: PMC5057418 DOI: 10.1186/s12885-016-2823-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 09/29/2016] [Indexed: 01/08/2023] Open
Abstract
Background Adding bevacizumab to chemotherapy improves response rates and progression-free survival (PFS) in metastatic breast cancer (mBC). We aimed to demonstrate decreased toxicity with metronomic chemotherapy/bevacizumab compared with paclitaxel/bevacizumab. Methods This multicenter, randomized phase III trial compared bevacizumab with either paclitaxel (arm A) or daily oral capecitabine-cyclophosphamide (arm B) as first-line treatment in patients with HER2-negative advanced breast cancer. The primary endpoint was the incidence of selected grade 3–5 adverse events (AE) including: febrile neutropenia, infection, sensory/motor neuropathy, and mucositis. Secondary endpoints included objective response rate, disease control rate, PFS, overall survival (OS), quality of life (QoL), and pharmacoeconomics. The study was registered prospectively with ClinicalTrials.gov, number NCT01131195 on May 25, 2010. Results Between September 2010 and December 2012, 147 patients were included at 22 centers. The incidence of primary endpoint-defining AEs was similar in arm A (25 % [18/71]; 95 % CI 15–35 %) and arm B (24 % [16/68]; 95 % CI 13–34 %; P = 0.96). Objective response rates were 58 % (42/73; 95 % CI 0.46–0.69) and 50 % (37/74; 95 % CI 0.39–0.61) in arms A and B, respectively (P = 0.45). Median PFS was 10.3 months (95 % CI 8.7–11.3) in arm A and 8.5 months (95 % CI 6.5–11.9) in arm B (P = 0.90). Other secondary efficacy endpoints were not significantly different between study arms. The only statistically significant differences in QoL were less hair loss and less numbness in arm B. Treatment costs between the two arms were equivalent. Conclusion This trial failed to meet its primary endpoint of a reduced rate of prespecified grade 3–5 AEs with metronomic bevacizumab, cyclophosphamide and capecitabine. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2823-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christoph Rochlitz
- Department of Oncology, University Hospital Basel, Petersgraben 4, Basel, CH-4031, Switzerland.
| | | | - Roger von Moos
- Department of Oncology, Kantonsspital Graubünden, Chur, Switzerland
| | - Jürg Bernhard
- International Breast Cancer Study (IBCSG) and Inselspital, Bern University Hospital, Bern, Switzerland
| | - Klazien Matter-Walstra
- SAKK Coordinating Center, Bern, Switzerland and European Center for Pharmaceutical Medicine, University Basel, Basel, Switzerland
| | - Andreas Wicki
- Department of Oncology, University Hospital Basel, Petersgraben 4, Basel, CH-4031, Switzerland
| | - Khalil Zaman
- Department of Oncology, University Hospital Lausanne, Lausanne, Switzerland
| | - Sandro Anchisi
- Department of Oncology, Hospital of Valais, Sion, Switzerland
| | - Marc Küng
- Department of Oncology, Kantonsspital Fribourg, Fribourg, Switzerland
| | - Kyung-Jae Na
- SAKK Coordinating Center, Bern, Switzerland.,Present Address: Novartis Pharma, Stein, Switzerland
| | | | - Markus Borner
- Department of Oncology, Spitalzentrum Biel, Biel, Switzerland
| | - Tamara Rordorf
- Department of Oncology, University Hospital Zürich, Zürich, Switzerland
| | - Daniel Rauch
- Department of Oncology, Spital STS, Thun, Switzerland
| | - Andreas Müller
- Department of Oncology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Thomas Ruhstaller
- Department of Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Marcus Vetter
- Department of Oncology, University Hospital Basel, Petersgraben 4, Basel, CH-4031, Switzerland
| | - Andreas Trojan
- Department of Oncology, OnkoZentrum Zürich, Zürich, Switzerland
| | | | - Richard Cathomas
- Department of Oncology, Kantonsspital Graubünden, Chur, Switzerland
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Colleoni M, Gray KP, Gelber S, Láng I, Thürlimann B, Gianni L, Abdi EA, Gomez HL, Linderholm BK, Puglisi F, Tondini C, Kralidis E, Eniu A, Cagossi K, Rauch D, Chirgwin J, Gelber RD, Regan MM, Coates AS, Price KN, Viale G, Goldhirsch A. Low-Dose Oral Cyclophosphamide and Methotrexate Maintenance for Hormone Receptor-Negative Early Breast Cancer: International Breast Cancer Study Group Trial 22-00. J Clin Oncol 2016; 34:3400-8. [PMID: 27325862 DOI: 10.1200/jco.2015.65.6595] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To evaluate the benefit of low-dose cyclophosphamide and methotrexate (CM) maintenance, which previously demonstrated antitumor activity and few adverse effects in advanced breast cancer, in early breast cancer. PATIENTS AND METHODS International Breast Cancer Study Group (IBCSG) Trial 22-00, a randomized phase III clinical trial, enrolled 1,086 women (1,081 intent-to-treat) from November 2000 to December 2012. Women with estrogen receptor- and progesterone receptor-negative (< 10% positive cells by immunohistochemistry) early breast cancer any nodal and human epidermal growth factor receptor 2 status, were randomly assigned anytime between primary surgery and 56 days after the first day of last course of adjuvant chemotherapy to CM maintenance (cyclophosphamide 50 mg/day orally continuously and methotrexate 2.5 mg twice/day orally on days 1 and 2 of every week for 1 year) or to no CM. The primary end point was disease-free survival (DFS), which included invasive recurrences, second (breast and nonbreast) malignancies, and deaths. RESULTS After a median of 6.9 years of follow-up, DFS was not significantly better for patients assigned to CM maintenance compared with patients assigned to no CM, both overall (hazard ratio [HR], 0.84; 95% CI, 0.66 to 1.06;P = .14) and in triple-negative (TN) disease (n = 814; HR, 0.80; 95% CI, 0.60 to 1.06). Patients with TN, node-positive disease had a nonstatistically significant reduced HR (n = 340; HR, 0.72; 95% CI, 0.49 to 1.05). Seventy-one (13%) of 542 patients assigned to CM maintenance did not start CM. Of 473 patients who received at least one CM maintenance dose (including two patients assigned to no CM), 64 (14%) experienced a grade 3 or 4 treatment-related adverse event; elevated serum transaminases was the most frequently reported (7%), followed by leukopenia (2%). CONCLUSION CM maintenance did not produce a significant reduction in DFS events in hormone receptor-negative early breast cancer. The trend toward benefit observed in the TN, node-positive subgroup supports additional exploration of this strategy in the TN, higher-risk population.
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Affiliation(s)
- Marco Colleoni
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania.
| | - Kathryn P Gray
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Shari Gelber
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - István Láng
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Beat Thürlimann
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Lorenzo Gianni
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Ehtesham A Abdi
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Henry L Gomez
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Barbro K Linderholm
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Fabio Puglisi
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Carlo Tondini
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Elena Kralidis
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Alexandru Eniu
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Katia Cagossi
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Daniel Rauch
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Jacquie Chirgwin
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Richard D Gelber
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Meredith M Regan
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Alan S Coates
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Karen N Price
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Giuseppe Viale
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
| | - Aron Goldhirsch
- Marco Colleoni, Giuseppe Viale, and Aron Goldhirsch, European Institute of Oncology; Giuseppe Viale, University of Milan, Milan; Lorenzo Gianni, Ospedale degli Infermi, Rimini; Fabio Puglisi, University Hospital of Udine, University of Udine, Udine; Carlo Tondini, Osp. Papa Giovanni XXIII, Bergamo; Katia Cagossi, Ospedale di Carpi, Carpi, Italy; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, Meredith M. Regan, and Karen N. Price, International Breast Cancer Study Group Statistical Center; Kathryn P. Gray, Shari Gelber, Richard D. Gelber, and Meredith M. Regan, Dana-Farber Cancer Institute; Kathryn P. Gray and Richard D. Gelber, Harvard T.H. Chan School of Public Health; Richard D. Gelber and Meredith M. Regan, Harvard Medical School; Richard D. Gelber and Karen N. Price, Frontier Science and Technology Foundation, Boston, MA; István Láng, National Institute of Oncology, Budapest, Hungary; Beat Thürlimann, Kantonsspital, St Gallen; Beat Thürlimann, Elena Kralidis, and Daniel Rauch, Swiss Group for Clinical Cancer Research, Bern; Elena Kralidis, Kantonsspital Aarau, Aarau; Daniel Rauch, Spital Thun, Thun, Switzerland; Ehtesham A. Abdi, The Tweed Head Hospital, Tweed Heads, New South Wales and Griffith University, Southport, Queensland; Ehtesham A. Abdi and Jacquie Chirgwin, Australia and New Zealand Breast Cancer Trials Group; Jacquie Chirgwin, Box Hill and Maroondah Hospitals and Monash University, Melbourne, Victoria; Alan S. Coates, International Breast Cancer Study Group and University of Sydney School of Public Health, Sydney, New South Wales, Australia; Henry L. Gomez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Barbro K. Linderholm, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Alexandru Eniu, Cancer Institute Ion Chiricuta, Cluj, Romania
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Ratner L, Rauch D, Abel H, Caruso B, Noy A, Barta SK, Parekh S, Ramos JC, Ambinder R, Phillips A, Harding J, Baydoun HH, Cheng X, Jacobson S. Dose-adjusted EPOCH chemotherapy with bortezomib and raltegravir for human T-cell leukemia virus-associated adult T-cell leukemia lymphoma. Blood Cancer J 2016; 6:e408. [PMID: 27015285 PMCID: PMC4817103 DOI: 10.1038/bcj.2016.21] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- L Ratner
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - D Rauch
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - H Abel
- Department of Genetics, Washington University School of Medicine, St Louis, MO, USA
| | - B Caruso
- Viral Immunology Section, Neuroimmunology and Neurovirology Division, NINDS, NIH, Bethesda, MD, USA
| | - A Noy
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S K Barta
- Division of Hematology-Oncology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - S Parekh
- Division of Hematology-Oncology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - J C Ramos
- Division of Hematology-Oncology, Department of Medicine, University of Miami School of Medicine, Miami, FL, USA
| | - R Ambinder
- Division of Hematologic Malignancies, Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - A Phillips
- Division of Hematology-Oncology, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - J Harding
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - H H Baydoun
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - X Cheng
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - S Jacobson
- Viral Immunology Section, Neuroimmunology and Neurovirology Division, NINDS, NIH, Bethesda, MD, USA
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Koeberle D, Dufour JF, Demeter G, Li Q, Ribi K, Samaras P, Saletti P, Roth AD, Horber D, Buehlmann M, Wagner AD, Montemurro M, Lakatos G, Feilchenfeldt J, Peck-Radosavljevic M, Rauch D, Tschanz B, Bodoky G. Sorafenib with or without everolimus in patients with advanced hepatocellular carcinoma (HCC): a randomized multicenter, multinational phase II trial (SAKK 77/08 and SASL 29). Ann Oncol 2016; 27:856-61. [PMID: 26884590 DOI: 10.1093/annonc/mdw054] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [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: 11/28/2015] [Accepted: 01/29/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Sorafenib (S), a multitargeted tyrosine kinase inhibitor, is the standard of care for first-line systemic treatment of advanced hepatocellular carcinoma (HCC). Everolimus (E) is a potent inhibitor of mTOR, a pathway frequently activated in HCC. Preclinical data suggest that the combination S + E has additive effects compared with single-agent S. PATIENTS AND METHODS Patients with unresectable or metastatic HCC and Child-Pugh ≤7 liver dysfunction were randomized to receive daily S 800 mg alone or with E 5 mg until progression or unacceptable toxicity. The primary end point was progression-free survival at 12 weeks (PFS12). The secondary end points included response rate, PFS, time to progression (TTP), overall survival (OS), duration of disease stabilization (DDS), safety, and quality-of-life (QoL) assessments. RESULTS A total of 106 patients were randomized: 46 patients received S and 60 patients received S + E. Ninety-three patients were assessable for the primary end point and 105 patients for the safety analysis. The PFS12 rate was 70% [95% confidence interval (CI) 54-83] and 68% (95% CI 53-81) in patients randomized to S and S + E, respectively. The RECIST (mRECIST) response rate was 0% (23%) in the S arm and 10% (35%) in the S + E arm. Median PFS (6.6 versus 5.7 months), TTP (7.6 versus 6.3 months), DDS (6.7 versus 6.7 months), and OS (10 versus 12 months) were similar in the S and S + E arms, respectively. Grade 3/4 adverse events occurred in 72% and 86% of patients in arm S and arm S + E, respectively. Patients had similar QoL scores over time, except for a greater worsening in physical well-being and mood in the arm S + E. CONCLUSIONS No evidence was found that S + E improves the efficacy compared with S alone. Combining 5 mg E with full-dose S is feasible, but more toxic than S alone. Further testing of this drug combination in molecularly unselected HCCs appears unwarranted. CLINICALTRIALSGOV NCT01005199.
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Affiliation(s)
- D Koeberle
- Department of Medical Oncology, Kantonsspital St Gallen, St Gallen
| | - J-F Dufour
- Department of Hepatology, University Hospital Bern, Bern, Switzerland
| | - G Demeter
- Department of Medical Oncology, St László Teaching Hospital, Budapest, Hungary
| | - Q Li
- SAKK Coordinating Center, Berne
| | - K Ribi
- Quality of life Office, International Breast Cancer Study Group, Bern
| | - P Samaras
- Department of Medical Oncology, University Hospital Zurich, Zürich
| | - P Saletti
- Department of Medical Oncology, Istituto Oncologico della Svizzera Italiana, Bellinzona
| | - A D Roth
- Department of Medical Oncology, University Hospital of Geneva, Geneva
| | - D Horber
- Department of Medical Oncology, Kantonsspital St Gallen, St Gallen
| | - M Buehlmann
- Department of Medical Oncology, University Hospital Bern, Bern
| | - A D Wagner
- Department of Medical Oncology, University Hospital Lausanne, Lausanne
| | - M Montemurro
- Department of Medical Oncology, University Hospital Lausanne, Lausanne
| | - G Lakatos
- Department of Medical Oncology, St László Teaching Hospital, Budapest, Hungary
| | - J Feilchenfeldt
- Department of Medical Oncology, Hôpital du Valais (RSV)-CHCVs, Lausanne, Switzerland
| | - M Peck-Radosavljevic
- Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - D Rauch
- Department of Medical Oncology, Spital STS AG, Bern, Switzerland
| | | | - G Bodoky
- Department of Medical Oncology, St László Teaching Hospital, Budapest, Hungary
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Elicin O, Schmucking M, Bromme J, Rauch D, Ambarcioglu P, Plasswilm L, Geretschlager A, Ghadjar P, Giger R, Aebersold DM. Volumetric regression ratio of the primary tumor and metastatic lymph nodes after induction chemotherapy predicts overall survival in head and neck squamous cell carcinoma: a retrospective analysis. J BUON 2016; 21:175-181. [PMID: 27061546] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE We looked for any predictive value of change in primary tumor and metastatic lymph node volumes after induction chemotherapy (IC) on oncologic outcome in head and neck squamous cell carcinoma (HNSCC). METHODS Nineteen patients with stage IVA/B HNSCC treated between 2004 and 2010 with at least one cycle of IC (docetaxel, cisplatin and 5-fluorouracil/TPF) and concomitant chemoradiotherapy (CRT) with cisplatin were retrospectively analyzed. Volumes were calculated separately for primary tumor (Vtm), lymph node metastases (Vln) and their sum (Vsum) on computed tomography (CT) images before and after IC. The effect of volumetric changes on locoregional failure (LRF), distant metastasis (DM) and overall survival (OS) was assessed. P values <0.05 were considered as statistically significant. RESULTS The median follow-up of surviving patients was 25 months (range: 10.7-83.3). The median number of cycles and duration of TPF was 3 (range: 1-4) and 44 days (range: 4-116), respectively. Empirical area under the curve (AUC) analyses for death, LRF and DM revealed optimal cut-off values of Vtm diminution (30.54%, AUC: 87%) and Vsum decrease (35.45%, AUC: 64.55%) only for OS (p <0.05). Among those, a reduction in Vsum more than 35.4% between pre- and post-IC was significantly correlated with better OS (100 vs 43% at 2 years, p <0.05). CONCLUSION Volumetric shrinkage of the tumor load after IC assessed with CT seems to predict OS. The assessment of volumetric shrinkage upon IC might be used to decide whether to offer patients alternative strategies like palliative/de-intensified treatments or more aggressive combined modalities after IC.
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Affiliation(s)
- Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
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Affiliation(s)
- Amrita Singh
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas; and
| | - Daniel Rauch
- Department of Pediatrics, Mount Sinai School of Medicine, Elmhurst, New York
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Taverna C, Martinelli G, Hitz F, Mingrone W, Pabst T, Cevreska L, Del Giglio A, Vanazzi A, Laszlo D, Raats J, Rauch D, Vorobiof DA, Lohri A, Biaggi Rudolf C, Rondeau S, Rusterholz C, Heijnen IAFM, Zucca E, Ghielmini M. Rituximab Maintenance for a Maximum of 5 Years After Single-Agent Rituximab Induction in Follicular Lymphoma: Results of the Randomized Controlled Phase III Trial SAKK 35/03. J Clin Oncol 2015; 34:495-500. [PMID: 26712227 DOI: 10.1200/jco.2015.61.3968] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Rituximab maintenance therapy has been shown to improve progression-free survival in patients with follicular lymphoma; however, the optimal duration of maintenance treatment remains unknown. PATIENTS AND METHODS Two hundred seventy patients with untreated, relapsed, stable, or chemotherapy-resistant follicular lymphoma were treated with four doses of rituximab monotherapy in weekly intervals (375 mg/m(2)). Patients achieving at least a partial response were randomly assigned to receive maintenance therapy with one infusion of rituximab every 2 months, either on a short-term schedule (four administrations) or a long-term schedule (maximum of 5 years or until disease progression or unacceptable toxicity). The primary end point was event-free survival (EFS). Progression-free survival, overall survival (OS), and toxicity were secondary end points. Comparisons between the two arms were performed using the log-rank test for survival end points. RESULTS One hundred sixty-five patients were randomly assigned to the short-term (n = 82) or long-term (n = 83) maintenance arms. Because of the low event rate, the final analysis was performed after 95 events had occurred, which was before the targeted event number of 99 had been reached. At a median follow-up period of 6.4 years, the median EFS was 3.4 years (95% CI, 2.1 to 5.3) in the short-term arm and 5.3 years (95% CI, 3.5 to not available) in the long-term arm (P = .14). Patients in the long-term arm experienced more adverse effects than did those in the short-term arm, with 76% v 50% of patients with at least one adverse event (P < .001), five versus one patient with grade 3 and 4 infections, and three versus zero patients discontinuing treatment because of unacceptable toxicity, respectively. There was no difference in OS between the two groups. CONCLUSION Long-term rituximab maintenance therapy does not improve EFS, which was the primary end point of this trial, or OS, and was associated with increased toxicity.
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Affiliation(s)
- Christian Taverna
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa.
| | - Giovanni Martinelli
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Felicitas Hitz
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Walter Mingrone
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Thomas Pabst
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Lidija Cevreska
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Auro Del Giglio
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Anna Vanazzi
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Daniele Laszlo
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Johann Raats
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Daniel Rauch
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Daniel A Vorobiof
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Andreas Lohri
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Christine Biaggi Rudolf
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Stéphanie Rondeau
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Corinne Rusterholz
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Ingmar A F M Heijnen
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Emanuele Zucca
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
| | - Michele Ghielmini
- Christian Taverna, Kantonsspital Münsterlingen, Münsterlingen; Felicitas Hitz, Kantonsspital St Gallen, St Gallen; Walter Mingrone, Kantonsspital Aarau/Olten, Olten; Thomas Pabst, Inselspital Bern; Christine Biaggi Rudolf, Stéphanie Rondeau, and Corinne Rusterholz, Swiss Group for Clinical Cancer Research SAKK, Bern; Daniel Rauch, Spital Thun Simmental, Thun; Andreas Lohri, Kantonsspital Liestal, Liestal; Ingmar A.F.M. Heijnen, University Hospital Basel, Basel; Emanuele Zucca and Michele Ghielmini, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Giovanni Martinelli, Anna Vanazzi, and Daniele Laszlo, Istituto Europeo di Oncologia, Milan, Italy; Lidija Cevreska, University Clinic for Hematology, Skopje, Macedonia; Auro del Giglio, ABC Fondation School of Medicine, Sao Paulo, Brazil; Johann Raats, Panorama Oncology Unit, Cape Town; and Daniel A. Vorobiof, Sandton Oncology Center, Johannesburg, South Africa
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Mueller BU, Keller S, Seipel K, Mansouri Taleghani B, Rauch D, Betticher D, Egger T, Pabst T. Stem cell mobilization chemotherapy with gemcitabine is effective and safe in myeloma patients with bortezomib-induced neurotoxicity. Leuk Lymphoma 2015; 57:1122-9. [DOI: 10.3109/10428194.2015.1079315] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pless M, Stupp R, Ris HB, Stahel RA, Weder W, Thierstein S, Gerard MA, Xyrafas A, Früh M, Cathomas R, Zippelius A, Roth A, Bijelovic M, Ochsenbein A, Meier UR, Mamot C, Rauch D, Gautschi O, Betticher DC, Mirimanoff RO, Peters S. Induction chemoradiation in stage IIIA/N2 non-small-cell lung cancer: a phase 3 randomised trial. Lancet 2015; 386:1049-56. [PMID: 26275735 DOI: 10.1016/s0140-6736(15)60294-x] [Citation(s) in RCA: 241] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND One of the standard options in the treatment of stage IIIA/N2 non-small-cell lung cancer is neoadjuvant chemotherapy and surgery. We did a randomised trial to investigate whether the addition of neoadjuvant radiotherapy improves outcomes. METHODS We enrolled patients in 23 centres in Switzerland, Germany and Serbia. Eligible patients had pathologically proven, stage IIIA/N2 non-small-cell lung cancer and were randomly assigned to treatment groups in a 1:1 ratio. Those in the chemoradiotherapy group received three cycles of neoadjuvant chemotherapy (100 mg/m(2) cisplatin and 85 mg/m(2) docetaxel) followed by radiotherapy with 44 Gy in 22 fractions over 3 weeks, and those in the control group received neoadjuvant chemotherapy alone. All patients were scheduled to undergo surgery. Randomisation was stratified by centre, mediastinal bulk (less than 5 cm vs 5 cm or more), and weight loss (5% or more vs less than 5% in the previous 6 months). The primary endpoint was event-free survival. Analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00030771. FINDINGS From 2001 to 2012, 232 patients were enrolled, of whom 117 were allocated to the chemoradiotherapy group and 115 to the chemotherapy group. Median event-free survival was similar in the two groups at 12·8 months (95% CI 9·7-22·9) in the chemoradiotherapy group and 11·6 months (8·4-15·2) in the chemotherapy group (p=0·67). Median overall survival was 37·1 months (95% CI 22·6-50·0) with radiotherapy, compared with 26·2 months (19·9-52·1) in the control group. Chemotherapy-related toxic effects were reported in most patients, but 91% of patients completed three cycles of chemotherapy. Radiotherapy-induced grade 3 dysphagia was seen in seven (7%) patients. Three patients died in the control group within 30 days after surgery. INTERPRETATION Radiotherapy did not add any benefit to induction chemotherapy followed by surgery. We suggest that one definitive local treatment modality combined with neoadjuvant chemotherapy is adequate to treat resectable stage IIIA/N2 non-small-cell lung cancer. FUNDING Swiss State Secretariat for Education, Research and Innovation (SERI), Swiss Cancer League, and Sanofi.
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Affiliation(s)
- Miklos Pless
- Department of Medical Oncology, Kantonsspital Winterthur, Winterthur, Switzerland.
| | - Roger Stupp
- Department of Medical Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland; Department of Oncology and Cancer Centre, University Hospital Zurich, Zurich Switzerland
| | - Hans-Beat Ris
- Department of Thoracic Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Rolf A Stahel
- Department of Medical Oncology, University Hospital Zurich, Zurich Switzerland
| | - Walter Weder
- Department of Thoracic Surgery, University Hospital Zurich, Zurich Switzerland
| | | | | | | | - Martin Früh
- Department of Medical Oncology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Richard Cathomas
- Department of Medical Oncology, Kantonsspital Graubünden, Chur, Switzerland
| | - Alfred Zippelius
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Arnaud Roth
- Department of Medical Oncology, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Milorad Bijelovic
- Department of Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Adrian Ochsenbein
- Department of Medical Oncology, University Hospital Bern, Bern, Switzerland
| | - Urs R Meier
- Department of Radiation Oncology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Christoph Mamot
- Department of Medical Oncology, Kantonsspital Aarau, Aarau, Switzerland
| | - Daniel Rauch
- Department of Medical Oncology, Regional Hospital, Thun, Switzerland
| | - Oliver Gautschi
- Department of Medical Oncology, Kantonsspital Luzern, Lucerne, Switzerland
| | - Daniel C Betticher
- Department of Medical Oncology, HFR Fribourg-Hôpital cantonal, Fribourg, Switzerland
| | - René-Olivier Mirimanoff
- Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Solange Peters
- Department of Medical Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
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Gautschi O, Mach N, Rothschild SI, Li Q, Stahel RA, Zippelius A, Cathomas R, Früh M, Betticher DC, Peters S, Rauch D, Feilchenfeldt J, Bubendorf L, Savic S, Jaggi R, Leibundgut EO, Largiadèr C, Brutsche M, Pilop C, Stalder L, Pless M, Ochsenbein AF. Bevacizumab, Pemetrexed, and Cisplatin, or Bevacizumab and Erlotinib for Patients With Advanced Non–Small-Cell Lung Cancer Stratified by Epidermal Growth Factor Receptor Mutation: Phase II Trial SAKK19/09. Clin Lung Cancer 2015; 16:358-65. [DOI: 10.1016/j.cllc.2015.02.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 02/18/2015] [Accepted: 02/26/2015] [Indexed: 01/30/2023]
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Helbling D, Bodoky G, Gautschi O, Hayoz S, Bosman F, Madlung A, Gloor B, Burkhard R, Rauch D, Winterhalder RC, Saletti P, Widmer L, Borner MM, Baertschi D, Yan P, Koeberle D. Neoadjuvant chemoradiation (CRT) with or without panitumumab (Pan) in patients with K-ras unmutated, locally advanced rectal cancer (LARC): Final results of a randomized multicenter phase II trial (SAKK 41/07). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.3_suppl.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
762 Background: We conducted a randomized phase II multicenter trial evaluate the anti-epidermal growth factor receptor (EGFR) panitumumab (P) in combination with CRT with standard-dose capecitabine as neoadjuvant treatment for wild-type KRAS LARC. Methods: Patients with wild-type KRAS, T3-4 and/or N+ LARC were randomly assigned to receive CRT either with or without P (6 mg/kg). The primary end-point was pathological near-complete or complete tumor response (pNC/CR), defined as grade 3 (pNCR) or 4 (pCR) histological regression by Dworak classification (DC). Secondary end-points were pathological response, R0-resection, sphincter preservation, downstaging, time to local relapse, time to distant failure and disease-free survival (DFS). Results: Patients with wild-type KRAS, T3-4 and/or N+ LARC were randomly assigned to receive CRT either with or without P (6 mg/kg). The primary end-point was pathological near-complete or complete tumor response (pNC/CR), defined as grade 3 (pNCR) or 4 (pCR) histological regression by Dworak classification (DC). Secondary end-points were pathological response, R0-resection, sphincter preservation, downstaging, time to local relapse, time to distant failure and disease-free survival (DFS). Conclusions: An addition of panitumumab to neoadjuvant CRT in patients with KRAS wild-type LARC resulted in a high pNC/CR rate, mostly grade 3 DC. Up to date no local recurrence occurred and DFS compared favorably to other trials. Clinical trial information: NCT00814619.
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Affiliation(s)
| | | | - Oliver Gautschi
- Department of Medical Oncology, Luzerner Kantonsspital, Luzern, Switzerland
| | - Stefanie Hayoz
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - Fred Bosman
- Department of Pathology, Lausanne, Switzerland
| | - Axel Madlung
- Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Beat Gloor
- Department of Visceral Surgery and Medicine, University Hospital Bern, Bern, Switzerland
| | | | | | | | | | | | | | | | - Pu Yan
- Department of Pathology CHUV, Lausanne, Switzerland
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Pless M, Stupp R, Ris H, Stahel R, Weder W, Thierstein S, Xyrafas A, Früh M, Cathomas R, Zippelius A, Roth A, Ochsenbein A, Meier U, Mamot C, Rauch D, Gautschi O, Gerard M, Betticher D, Mirimanoff R, Peters S. Final Results of the Sakk 16/00 Trial: a Randomized Phase III Trial Comparing Neoadjuvant Chemoradiation to Chemotherapy Alone in Stage Iiia/N2 Non-Small Cell Lung Cancer (Nsclc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu348.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Elicin O, Schmücking M, Brömme J, Giger R, Rauch D, Leiser D, Ambarcioglu P, Plasswilm L, Geretschläger A, Ghadjar P, Aebersold D. Volumetric Regression Ratio of Tumor and Involved Lymph Nodes After Induction Chemotherapy Predicts the Overall Survival in Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Koeberle D, Dufour JF, Demeter G, Samaras P, Saletti P, Li Q, Roth A, Horber D, Buehlmann M, Wagner AD, Montemurro M, Lakatos G, Ribi K, Feilchenfeld J, Peck-Radosavljevic M, Rauch D, Cvijetic I, Tschanz B, Bodoky G. Sorafenib with or without everolimus in patients with unresectable hepatocellular carcinoma (HCC): A randomized multicenter phase II trial (SAKK 77/08 and SASL 29). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.4099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | - Qiyu Li
- SAKK - Swiss Group for Clinical Cancer Research, Coordinating Center, Bern, Switzerland
| | - Arnaud Roth
- University Hospital Geneva, Geneva, Switzerland
| | | | | | - Anna Dorothea Wagner
- Multidisciplinary Oncology Center, Lausanne University Hospital, Lausanne, Switzerland
| | | | | | - Karin Ribi
- International Breast Cancer Study Group, Bern, Switzerland
| | | | - Markus Peck-Radosavljevic
- Department of Gastroenterology and Hepatology, Vienna General Hospital and Medical University, Vienna, Austria
| | | | - Ivana Cvijetic
- SAKK - Swiss Group for Clinical Cancer Research, Coordinating Center, Bern, Switzerland
| | - Britta Tschanz
- SAKK - Swiss Group for Clinical Cancer Research, Coordinating Center, Bern, Switzerland
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Rochlitz C, von Moos R, Bigler M, Zaman K, Anchisi S, Küng M, Na KJ, Baertschi D, Borner MM, Rordorf T, Rauch D, Mueller A, Ruhstaller T, Vetter M, Bernhard J, Trojan A, Hasler-Strub U, Cathomas R, Winterhalder RC. SAKK 24/09: Safety and tolerability of bevacizumab plus paclitaxel versus bevacizumab plus metronomic cyclophosphamide and capecitabine as first-line therapy in patients with HER2-negative advanced stage breast cancer—A multicenter, randomized phase III trial. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.518] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Martin Bigler
- SAKK - Swiss Group for Clinical Cancer Research, Coordinating Center, Bern, Switzerland
| | - Khalil Zaman
- Breast Center, University Hospital CHUV, Lausanne, Switzerland
| | - Sandro Anchisi
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - Marc Küng
- Kantonsspital Fribourg, Fribourg, Switzerland
| | - Kyung Jae Na
- Novartis Pharma Stein AG, Switzerland, Basel, Switzerland
| | | | | | | | | | - Andreas Mueller
- Med Onkologie, Kantonsspital Winterthur, Winterthur, Switzerland
| | | | - Marcus Vetter
- Department of Oncology, University Hospital Basel, Basel, Switzerland
| | - Juerg Bernhard
- International Breast Cancer Study Group, Bern, Switzerland
| | | | | | - Richard Cathomas
- Department of Medical Oncology, Kantonsspital Graubuenden, Chur, Switzerland
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49
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Cinieri S, Chan A, Altundag K, Vandebroek A, Tubiana-Mathieu N, Barnadas A, Dodyk P, Lazzarelli S, Botha M, Rauch D, Khasanov R, Slabber CF, Bougnoux P, Cardenas JS, Castellanos Diez J, Schmidt M, Godes MJ, Chen DR, Villanova G, Coskun U. Three-arm randomized phase II study evaluating oral vinorelbine plus capecitabine versus paclitaxel plus gemcitabine versus docetaxel plus gemcitabine as first-line chemotherapy in patients with metastatic breast cancer: Final results (NorCap-CA223 trial). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.1044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Saverio Cinieri
- Medical Oncology & Breast Unit, Senatore Antonio Perrino Hospital, Brindisi, Italy
| | - Arlene Chan
- Mount Hospital, Curtin University, Perth, Australia
| | - Kadri Altundag
- Hacettepe University Cancer Institute, Department of Medical Oncology, Ankara, Turkey
| | | | | | | | | | | | | | | | | | | | | | | | | | - Marcus Schmidt
- Department of Obstetrics and Gynecology, Johannes Gutenberg University, Mainz, Germany
| | | | | | | | - Ugur Coskun
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
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50
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Von Moos R, Koeberle D, Schacher S, Hayoz S, Winterhalder RC, Roth A, Bodoky G, Samaras P, Berger MD, Rauch D, Saletti P, Plasswilm L, Thum P, Meier UR, Yan P, Izzo P, Klingbiel D, Baertschi D, Zaugg K. Neoadjuvant radiotherapy (RT) combined with capecitabine (Cape) and sorafenib (Sor) in patients (pts) with locally advanced, k-ras-mutated rectal cancer (LARC): A phase I/II trial SAKK 41/08. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.3531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Stefanie Hayoz
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | | | - Arnaud Roth
- University Hospital Geneva, Geneva, Switzerland
| | - Gyorgy Bodoky
- Fovarosi Egyesitett Szt. Laszlo es Szt. Istvan Kh., Budapest, Hungary
| | | | | | | | | | - Ludwig Plasswilm
- Department of Radio-Oncology, Kantonsspital, St Gallen, Switzerland
| | - Peter Thum
- Radio-Oncology Cantonal Hospital Luzern, Luzern, Switzerland
| | - Urs R. Meier
- Department of Radio-Oncology, Kantonsspital, Winterthur, Switzerland
| | - Pu Yan
- Department of Pathology CHUV, Lausanne, Switzerland
| | | | - Dirk Klingbiel
- SAKK - Swiss Group for Clinical Cancer Research, Coordinating Center, Bern, Switzerland
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