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Bardia A, Bidard FC, Neven P, Streich G, Montero AJ, Forget F, Mouret-Reynier MA, Sohn JH, Taylor D, Harnden KK, Khong H, Kocsis J, Dalenc F, Dillon P, Babu S, Waters S, Deleu I, García-Sáenz JA, Bria E, Cazzaniga ME, Aftimos P, Cortés J, Tonini G, Sahmoud T, Habboubi N, Grzegorzewski K, Kaklamani V. Abstract GS3-01: GS3-01 EMERALD phase 3 trial of elacestrant versus standard of care endocrine therapy in patients with ER+/HER2- metastatic breast cancer: Updated results by duration of prior CDK4/6i in metastatic setting. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-gs3-01] [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: 03/06/2023]
Abstract
Abstract
Background: In patients (pts) with ER+/HER2− metastatic breast cancer (MBC) following progression on prior endocrine and CDK4/6i therapy, the EMERALD trial demonstrated significantly prolonged progression-free survival (PFS) and a manageable safety profile for elacestrant versus standard of care endocrine therapy (SoC). Benefit was observed in all pts and in pts with ESR1 mutant MBC (ESR1-mut). EMERALD is the only oral SERD monotherapy pivotal trial where all pts were pretreated with CDK4/6 inhibitor (CDK 4/6i). Here, we examine the impact of duration of prior CDK4/6i on PFS.
Methods: EMERALD (NCT03778931) is a randomized, open-label, phase 3 trial that enrolled pts with ER+/HER2- MBC who previously had 1-2 lines of endocrine therapy, mandatory CDK4/6i, and ≤1 chemotherapy; prior treatment with fulvestrant was allowed. Patients were randomized 1:1 to elacestrant (400 mg orally daily) or SoC (investigator’s choice of aromatase inhibitor or fulvestrant). If randomized to the control arm, patients who received prior fulvestrant were to receive an aromatase inhibitor, and vice versa. If two CDK4/6i were used in the metastatic setting (n=40), the cumulative duration was calculated.
Results: A total of 478 pts were randomized (228 with ESR1-mut) between Feb 2019 – Oct 2020 (n=239, elacestrant; n=239, SoC). Overall survival was not yet mature, as of September 2nd 2022. Updated PFS results show statistically significant results in favor of elacestrant, both in all pts and in pts with ESR1-mut. The duration of prior CDK4/6i in the metastatic setting was positively associated with PFS, the longer the duration of prior CDK4/6i in the metastatic setting (n=465), the longer the PFS on elacestrant versus SoC (Table 1).
Updated safety data were consistent with previously reported results. Most of the adverse events (AEs), including nausea, were grade 1 and 2, and only 3.4% and 0.9% of the pts discontinued trial therapy because of an AE on elacestrant and SoC, respectively. A low percentage of pts received an antiemetic; 8.0%, 3.7%, and 10.3%, on elacestrant, fulvestrant, and AI, respectively. No hematological safety signal was observed and none of the patients in either of the two treatment arms had sinus bradycardia.
Conclusions: EMERALD is the first phase 3 trial to demonstrate a significant PFS improvement versus SoC in all pts and in the subgroup with ESR1 mutations in pts with ER-positive/HER2-negative MBC with 1-2 prior lines of endocrine treatment ± one line of chemotherapy. Elacestrant demonstrated longer PFS versus SOC that was positively associated with the duration of prior treatment with CDK4/6i, which was more pronounced in pts with ESR1-mut MBC. In this 2nd and 3rd line setting, elacestrant was well tolerated with significantly longer PFS versus SoC, highlighting its potential role as a therapeutic option for pts with ER+/HER2- MBC.
Table 1: PFS estimates in the elacestrant and SoC arms based on different cut-off points for the duration of prior CDK4/6i.
Citation Format: Aditya Bardia, Francois-Clement Bidard, Patrick Neven, Guillermo Streich, Alberto J. Montero, Frederic Forget, Marie-Ange Mouret-Reynier, Joo Hyuk Sohn, Donatienne Taylor, Kathleen K. Harnden, Hung Khong, Judit Kocsis, Florence Dalenc, Patrick Dillon, Sunil Babu, Simon Waters, Ines Deleu, Jose Angel García-Sáenz, Emilio Bria, Marina Elena Cazzaniga, Philippe Aftimos, Javier Cortés, Giulia Tonini, Tarek Sahmoud, Nassir Habboubi, Krzysztof Grzegorzewski, Virginia Kaklamani. GS3-01 EMERALD phase 3 trial of elacestrant versus standard of care endocrine therapy in patients with ER+/HER2- metastatic breast cancer: Updated results by duration of prior CDK4/6i in metastatic setting [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr GS3-01.
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Affiliation(s)
- Aditya Bardia
- 1Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | | | - Patrick Neven
- 3Universitair Ziekenhuis Leuven, Leuven, Vlaams-Brabant, Belgium
| | | | - Alberto J. Montero
- 5UH/Seidman Cancer Center and Case Western Reserve University, Cleveland, OH, USA
| | | | | | - Joo Hyuk Sohn
- 8Yonsei Cancer Center, Seoul, Republic of Korea, Republic of Korea
| | - Donatienne Taylor
- 9Universite catholique de Louvain, CHU UCL Namur—Site Sainte-Elisabeth, Namur, Belgium
| | | | - Hung Khong
- 11Moffit Cancer Center & Research Institute
| | | | - Florence Dalenc
- 13Institut Claudius Régaud, Toulouse, France, Toulouse, France
| | - Patrick Dillon
- 14University of Virginia Health System, Charlottesville, VA, USA
| | - Sunil Babu
- 15Fort Wayne Medical Oncology and Hematology
| | - Simon Waters
- 16Clinical Trials Unit, Velindre Cancer Centre, Cardiff, United Kingdom
| | | | | | - Emilio Bria
- 19Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore
| | | | | | - Javier Cortés
- 22International Breast Cancer Center (IBCC), Pangaea Oncology, Quironsalud Group, Madrid and Barcelona, Spain & Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | | | - Tarek Sahmoud
- 24Stemline Therapeutics/Menarini Group, New Hope, Pennsylvania
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Bidard FC, Kaklamani VG, Neven P, Streich G, Montero AJ, Forget F, Mouret-Reynier MA, Sohn JH, Taylor D, Harnden KK, Khong H, Kocsis J, Dalenc F, Dillon PM, Babu S, Waters S, Deleu I, García Sáenz JA, Bria E, Cazzaniga M, Lu J, Aftimos P, Cortés J, Liu S, Tonini G, Laurent D, Habboubi N, Conlan MG, Bardia A. Elacestrant (oral selective estrogen receptor degrader) Versus Standard Endocrine Therapy for Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: Results From the Randomized Phase III EMERALD Trial. J Clin Oncol 2022; 40:3246-3256. [PMID: 35584336 PMCID: PMC9553388 DOI: 10.1200/jco.22.00338] [Citation(s) in RCA: 173] [Impact Index Per Article: 86.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Patients with pretreated estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer have poor prognosis. Elacestrant is a novel, oral selective ER degrader that demonstrated activity in early studies. METHODS This randomized, open-label, phase III trial enrolled patients with ER-positive/HER2-negative advanced breast cancer who had one-two lines of endocrine therapy, required pretreatment with a cyclin-dependent kinase 4/6 inhibitor, and ≤ 1 chemotherapy. Patients were randomly assigned to elacestrant 400 mg orally once daily or standard-of-care (SOC) endocrine monotherapy. Primary end points were progression-free survival (PFS) by blinded independent central review in all patients and patients with detectable ESR1 mutations. RESULTS Patients were randomly assigned to elacestrant (n = 239) or SOC (n = 238). ESR1 mutation was detected in 47.8% of patients, and 43.4% received two prior endocrine therapies. PFS was prolonged in all patients (hazard ratio = 0.70; 95% CI, 0.55 to 0.88; P = .002) and patients with ESR1 mutation (hazard ratio = 0.55; 95% CI, 0.39 to 0.77; P = .0005). Treatment-related grade 3/4 adverse events occurred in 7.2% receiving elacestrant and 3.1% receiving SOC. Treatment-related adverse events leading to treatment discontinuations were 3.4% in the elacestrant arm versus 0.9% in SOC. Nausea of any grade occurred in 35.0% receiving elacestrant and 18.8% receiving SOC (grade 3/4, 2.5% and 0.9%, respectively). CONCLUSION Elacestrant is the first oral selective ER degrader demonstrating a significant PFS improvement versus SOC both in the overall population and in patients with ESR1 mutations with manageable safety in a phase III trial for patients with ER-positive/HER2-negative advanced breast cancer.
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Affiliation(s)
- Francois-Clement Bidard
- Institut Curie, Paris and Saint Cloud, France,Versailles Saint Quentin/Paris-Saclay University, Saint Cloud, France
| | | | - Patrick Neven
- Universitaire Ziekenhuizen (UZ)—Leuven Cancer Institute, Leuven, Belgium
| | | | - Alberto J. Montero
- University Hospitals Seidman Cancer Center-Case Western Reserve University, Cleveland, OH
| | - Frédéric Forget
- Centre Hospitalier de l'Ardenne—Site de Libramont, Libramont-Chevigny, Belgium
| | | | - Joo Hyuk Sohn
- Yonsei Cancer Center, Yonsei University Health System-Medical Oncology, Seoul, Republic of Korea
| | - Donatienne Taylor
- Université catholique de Louvain, CHU UCL Namur—Site Sainte-Elisabeth, Namur, Belgium
| | | | - Hung Khong
- Moffit Cancer Center & Research Institute, Tampa, FL
| | | | | | | | - Sunil Babu
- Fort Wayne Medical Oncology and Hematology, Fort Wayne, IN
| | | | | | - José A. García Sáenz
- Instituto de Investigación Sanitaria Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Emilio Bria
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | | | - Janice Lu
- University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA
| | - Philippe Aftimos
- Institut Jules Bordet – Université Libre de Bruxelles, Brussels, Belgium
| | - Javier Cortés
- International Breast Cancer Center (IBCC), Quironsalud Group, Barcelona, Spain,Scientific Department, Medica Scientia Innovation Research, Valencia, Spain,Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain,Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Medicine, Madrid, Spain
| | | | | | - Dirk Laurent
- Berlin Chemie AG/Menarini Group, Berlin, Germany
| | | | | | - Aditya Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA,Aditya Bardia, MD, Harvard Medical School, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; Twitter: @DrAdityaBardia; e-mail:
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Streich G, Villalba MB, Cid C, Bramuglia GF. Developing a real-world database for oncology: a descriptive analysis of breast cancer in Argentina. Ecancermedicalscience 2022; 16:1435. [PMID: 36200013 PMCID: PMC9470177 DOI: 10.3332/ecancer.2022.1435] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Registries based on Real-World Data (RWD) are those obtained outside of systematised and randomised clinical trials. They allow the collection of information from a large number of patients and enable the participation of a significant number of professionals. PrecisaXperta is a web platform developed for this purpose with more than 2 years of operation, parameterised for oncology. Its design allows the construction of an epidemiological database in real time and exportable for processing. Objective To describe the characteristics and operation of this online data recording tool, explain how it was developed and analyse the quality of the information recorded, taking as an example the data obtained for breast cancer. Materials and methods Physicians, computer scientists and data science analysts participated in the development. Patient data, history, educational level, diagnosis, staging, molecular markers, quality of life, types of treatments, progression and response, imaging, complications, adverse events are some of the fields included. Data treatment in terms of encryption, anonymisation, protection and validation is also explained. The selected breast cancer data for description were processed with medium-level statistical programmes, since the number required to apply Big Data engines is not yet available. Results From a total of 6,892 solid tumours, 1,892 were breast cancer and 1,654 were selected that complied with a data set minimum elaborated ad hoc. Cases from 13 provinces showed a geolocation bias according to the place of practice of the professionals in the collaborative network. The predominant lack of data was detected in molecular markers (ki67) and correlativity in some lines of treatment. Inconsistencies in dates and therapeutic schemes were also detected. Data curation made it possible to exclude them. The age of the patients was 55.3 ± 11.88 years. At the time of diagnosis, the predominance was in stage I: 36.48% and II 30.06%, with positive hormone receptors in 1,424 (89.96%) cases. The predominant treatments were hormonal (61.54%) and target directed with 30.85% for HER2(+) and 39.14% for HER2(−) accompanied in most cases (85.9%) by some period of chemotherapy. Immunotherapy was much less represented (0.36%). Data were processed, homogenised, pooled and presented and made accessible in a form suitable for application to RWD analyses. Conclusions PrecisaXperta fulfils this purpose of systematising the information to facilitate its loading with its simple and intuitive interface. From the analysis of the data obtained in breast cancer, it is clear that some fields should be mandatory in order to improve the quality of the information. The results describing the registered breast cancers give us a surface view of the affected population and prepare us to design future studies when we have local Big Data. This type of development, with continuous improvements and online results, will allow with its dissemination, that the participating professionals have information of what happens in the real world, having available in a democratic way, the epidemiology to be able to study, publish and investigate with these data.
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Affiliation(s)
- Guillermo Streich
- Department of Oncology, Hospital Militar, Av Luis Maria Campos 726, Ciudad Autónoma de Buenos Aires (CABA), Argentina
| | - Marcelo Blanco Villalba
- Department of Oncology, Centro Médico Austral, Montevideo 955 CABA, Argentina
- Sociedad Argentina de Cancerología, CABA, Av Santa Fe 1171, Buenos Aires, Argentina
| | - Christian Cid
- Argenomics, Parque Empresarial Austral, Edificio Insignia M4 - Planta Baja - Av Sto My C Beliera 3025, Pilar, Buenos Aires, Argentina
- Fundación Investigar, Parque Empresarial Austral, Edificio Insignia M4 - Planta Baja - Av Sto My C Beliera 3025, Pilar, Buenos Aires, Argentina
| | - Guillermo F Bramuglia
- Fundación Investigar, Parque Empresarial Austral, Edificio Insignia M4 - Planta Baja - Av Sto My C Beliera 3025, Pilar, Buenos Aires, Argentina
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Kaklamani VG, Bardia A, Aftimos PG, Cortes J, Lu JM, Neven P, Streich G, Montero AJ, Forget F, Mouret-Reynier MA, Sohn J, Taylor D, Harnden KK, Khong HT, Kocsis J, Dalenc F, Dillon PM, Tonini G, Grzegorzewski K, Bidard FC. Subgroup analysis of patients with no prior chemotherapy in EMERALD: A phase 3 trial evaluating elacestrant, an oral selective estrogen receptor degrader (SERD), versus investigator’s choice of endocrine monotherapy for ER+/HER2-advanced/metastatic breast cancer (mBC). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.1100] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1100 Background: EMERALD demonstrated significantly prolonged progression-free survival (PFS) and a manageable toxicity profile for elacestrant vs standard of care endocrine therapy (SOC) in patients with ER+/HER2- mBC following progression on prior endocrine and CDK4/6 inhibitor therapy. Benefit was observed in the overall study population and in patients with ESR1 mutations (mESR1). Here, we report a subgroup analysis from EMERALD in patients with no prior chemotherapy. Methods: EMERALD (NCT03778931) is a randomized, open-label, phase 3 trial that enrolled patients with ER+/HER2− mBC who had 1–2 lines of endocrine therapy, mandatory pretreatment with a CDK4/6 inhibitor, and ≤1 chemotherapy. Patients were randomized 1:1 to elacestrant (400 mg orally daily) or SOC (investigator’s choice of fulvestrant or aromatase inhibitor). Primary endpoints were PFS in all patients and patients with mESR1. In this analysis, we compared PFS between elacestrant and SOC in patients without prior chemotherapy. Results: Among the 477 patients enrolled in the trial, 77.8% (n = 371) had not received prior chemotherapy for mBC (median age = 64). Among patients without prior chemotherapy, treatment with elacestrant was associated with significantly prolonged PFS compared to SOC in both the overall population (hazard ratio [HR] = 0.68 [95% CI, 0.52-0.89] P = 0.004; median PFS 3.7 vs 2.0; 6-mo PFS 38% vs 23%; 12-mo PFS 27% vs 12%), and patients with mESR1 (HR = 0.54 [95% CI, 0.36-0.80] P = 0.002; median PFS 5.3 vs 1.9; 6-mo PFS 44% vs 24%; 12-mo PFS 31% vs 12%). Key treatment-related adverse events (AEs) in the no prior chemotherapy elacestrant group were nausea (25.9%), fatigue (12.7%), and hot flush (11.1%). There were no treatment-related deaths in either group. Conclusions: Among patients with ER+/HER2− mBC without prior chemotherapy, elacestrant significantly prolonged PFS compared to SOC endocrine therapy and showed favorable outcomes in this subgroup. Clinical trial information: NCT03778931.
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Affiliation(s)
| | - Aditya Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | | | - Javier Cortes
- International Breast Cancer Center, Quironsalud Group, Barcelona, Spain and Universidad Europea de Madrid, Madrid, Spain
| | - Janice M. Lu
- University of Southern California, Los Angeles, CA
| | - Patrick Neven
- Universitaire Ziekenhuizen (UZ) - Leuven Cancer Institute, Leuven, Belgium
| | | | - Alberto J. Montero
- UH/Seidman Cancer Center and Case Western Reserve University, Cleveland, OH
| | - Frederic Forget
- Centre Hospitalier de l'Ardenne - Site de Libramont, Libramont-Chevigny, Belgium
| | | | - Joohyuk Sohn
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Donatienne Taylor
- Université Catholique de Louvain, CHU UCL Namur – Site Sainte-Elisabeth, Namur, Belgium
| | | | - Hung T. Khong
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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Bardia A, Neven P, Streich G, Montero AJ, Forget F, Mouret-Reynier MA, Sohn JH, Vuylsteke P, Harnden KK, Khong H, Kocsis J, Dalenc F, Kaklamani V, Dillon P, Babu S, Waters S, Deleu I, García-Sáenz J, Bria E, Cazzaniga M, Lu J, Aftimos P, Cortes J, Liu S, Laurent D, Conlan MG, Bidard FC. Abstract GS2-02: Elacestrant, an oral selective estrogen receptor degrader (SERD), vs investigator’s choice of endocrine monotherapy for ER+/HER2- advanced/metastatic breast cancer (mBC) following progression on prior endocrine and CDK4/6 inhibitor therapy: Results of EMERALD phase 3 trial. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-gs2-02] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: Endocrine therapy(ET) plus CDK4/6 inhibitor (i) is the mainstay for the management of estrogenreceptor-positive (ER+)/HER2- mBC. However, most patients (pts) with ER+ mBCeventually experience disease progression, including development of ESR1mutations (mESR1). Elacestrant, an oral SERD, demonstrated preclinical activity,and clinical activity in a phase 1 trial in ER+ mBC, including responses in ptswith prior fulvestrant, CDK4/6i, and mESR1tumors (Bardia JCO 2021).. Methods: EMERALD(NCT03778931), a multicenter, international, randomized, open-label, controlledphase 3 trial, enrolled postmenopausal pts with ER+/HER2- mBC who had received 1-2prior lines of ET and ≤1 line of chemotherapy in the mBC setting and had prior progressionon a ET plus CDK4/6i. Pts were randomized 1:1 to elacestrant (400 mg orallydaily) or standard of care (SOC; investigator’s choice of fulvestrant or anaromatase inhibitor). Stratification factors included mESR1 status (by central lab), priorfulvestrant exposure, and presence of visceral disease. The study had 2 primary endpoints of progression-free survival (PFS), by blindedindependent review committee, in pts withtumors harboring mESR1 and in all pts (mESR1 or mESR1 notdetected). Secondary endpoints included: overall survival (OS), safety, tolerability,and quality of life. An alpha-value of 0.0475 was used to determine statisticalsignificance (2-sided using the truncated Hochberg procedure).. Results: EMERALD enrolled 477 pts(228 with mESR1) between Feb 2019 - Oct 2020, with 239 pts randomized toreceive elacestrant vs 238 pts to SOC. Demographics and disease characteristicswere well-balanced across treatment arms [median age: 63 yrs vs 63.5 yrs; 2prior lines: 46% vs 40.8%; prior CDK4/6i: 100% in both arms]. The study met bothprimary endpoints. There was a 30% reduction in the risk of progression ordeath in the elacestrant arm in all pts (HR=0.697 [95% CI: 0.552, 0.88]; P=0.0018),and a 45% (HR=0.546 [95% CI: 0.387, 0.768]; P=0.0005) reduction in therisk of progression or death in pts with mESR1.For both endpoints, results in key prespecified subgroups, including visceral metastases,number of prior lines of therapy, pretreatment with fulvestrant, and geographicalregion, were consistent with the overall outcome. The PFS rate at 12 months was 22.32% (95% CI: 15.24%, 29.40%)with elacestrant vs 9.42% (95% CI: 4.02%, 14.81%) with SOC in all pts, and26.76% (95% CI: 16.17%, 37.36%) vs 8.19% (95% CI: 1.26%, 15.12%) in the mESR1 subgroup. The prespecified interim OS analysis plannedat the time of the final PFS analysis (allocated2-sided alpha level of 0.0001) demonstrated a trend in favor of elacestrant inall pts (HR=0.751 [95% CI: 0.542, 1.038]; P=0.0821) and in pts with mESR1(HR=0.592 [95% CI: 0.361, 0.958]; P=0.0325). The final OS analysisis expected next year. Common (>10%) treatment-related adverse events (AEs) withelacestrant vs SOC included: nausea (25.3% vs 8.7%), vomiting (11% vs 2.6%), and fatigue (11% vs 7.9%), mostlygrade 1/2. Treatment-emergent AEs leading to discontinuation of elacestrant orSOC were infrequent in both arms (6.3% and 4.4%). Grade ≥3 treatment-relatedAEs in the elacestrant arm vs SOC were 7.2% vs 3.1%, mainly driven by nausea(2.1% vs 0.9%). There were no treatment-related deaths in either group.. Conclusions:Elacestrant is the first oral SERD to demonstrate a statistically significantand clinically meaningful improvement of PFS vs SOC in a randomized phase 3study in pts with ER+/HER2- mBC in the 2nd/3rd-linesetting, including those whose tumors harbor mESR1. Elacestrant was well tolerated and hasthe potential to become the new standard of care for pts with ER+/HER2- mBC.
Citation Format: Aditya Bardia, Patrick Neven, Guillermo Streich, Alberto J. Montero, Frédéric Forget, Marie-Ange Mouret-Reynier, Joo Hyuk Sohn, Peter Vuylsteke, Kathleen K. Harnden, Hung Khong, Judit Kocsis, Florence Dalenc, Virginia Kaklamani, Patrick Dillon, Sunil Babu, Simon Waters, Ines Deleu, José García-Sáenz, Emilio Bria, Marina Cazzaniga, Janice Lu, Philippe Aftimos, Javier Cortes, Shubin Liu, Dirk Laurent, Maureen G. Conlan, Francois-Clement Bidard. Elacestrant, an oral selective estrogen receptor degrader (SERD), vs investigator’s choice of endocrine monotherapy for ER+/HER2- advanced/metastatic breast cancer (mBC) following progression on prior endocrine and CDK4/6 inhibitor therapy: Results of EMERALD phase 3 trial [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr GS2-02.
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Affiliation(s)
- Aditya Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Patrick Neven
- Universitaire Ziekenhuizen (UZ) - Leuven Cancer Institute, Leuven, Belgium
| | | | - Alberto J. Montero
- University Hospitals Seidman Cancer Center- Case Western Reserve University, Cleveland, OH
| | - Frédéric Forget
- Centre Hospitalier de l'Ardenne - Site de Libramont, Libramont-Chevigny, Belgium
| | | | - Joo Hyuk Sohn
- Yonsei Cancer Center, Yonsei University Health System -Medical Oncology, Seoul, Korea, Republic of
| | | | | | - Hung Khong
- Moffit Cancer Center & Research Institute, Tampa, FL
| | | | | | | | - Patrick Dillon
- University of Virginia Cancer Center, Charlottesville, VA
| | - Sunil Babu
- Fort Wayne Medical Oncology and Hematology, Fort Wayne, IN
| | | | | | - José García-Sáenz
- Instituto de Investigación Sanitaria Hospital Clinico San Carlos (IdISSC), Madrid, Spain
| | - Emilio Bria
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | | | - Janice Lu
- University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA
| | - Philippe Aftimos
- Institut Jules Bordet – Université Libre de Bruxelles, Brussels, Belgium
| | - Javier Cortes
- International Breast Cancer Center (IBCC), Quiron Group, Barcelona, Spain
| | | | - Dirk Laurent
- Berlin Chemie AG/Menarini Ricerche S.p.A, Berlin, Germany
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Sanguinetti JM, Martínez D, Dimase F, Streich G, Castro P, Vega V, Batagelj E. Patient Safety and Satisfaction in Home Chemotherapy. Home Healthc Now 2021; 39:139-144. [PMID: 33955927 DOI: 10.1097/nhh.0000000000000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Chemotherapy is increasingly being administered in patients' homes, improving quality of life and patient comfort as well as reducing use of inpatient facilities and costs. This article describes outcomes of home chemotherapy administered by trained nurses to adult patients with solid tumors or hematological diseases. This descriptive study was conducted between February 2018 and May 2020. Variables examined included age, sex, diagnosis, routes of administration, adverse effects, tolerance, and patient satisfaction. One hundred forty-seven patients (57.14% male) with an average age of 67.8 years agreed to participate. A total of 1018 chemotherapy sessions were examined. The most common diagnoses were prostate cancer, colon cancer, and high-risk myelodysplastic syndromes. Thirty-five percent (n = 356) of the sessions were conducted with: Azacytidine, 5-Fluoruracil, Oxaliplatin + Docetaxel + Leucovorin + Fluorouracil, and Leuprolide Acetate. The routes of administration included: intravenous (69.25%), intramuscular (13.75%), subcutaneous (15.32%), and intravesical (1.66%). Very good tolerance was reported after 87.81% of sessions and good after 8.45%. Adverse events during administration occurred in 7 sessions (0.7%); all were considered minor events. In the 24 hours following administration, 62 adverse events (6.1%) were reported, again all considered minor. All patients reported feeling just as safe as in the hospital. Our results contribute to the feasibility and safety of home chemotherapy.
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Streich G, Batagelj E, Dimase F, Martinez D, Sanguinetti J. Home chemotherapy in colorectal cancer: First experience in Argentina. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.368] [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: 11/13/2022] Open
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Villalba MB, Pini A, Streich G, Molinas E, Puyol J, Bramajo M, Batagelj E. Economic Burden of Costly Cancer Drugs in a Healthcare Service. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33949-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Pini A, Villalba MB, Streich G, Dimase F, Re J, Bramajo M. 3606 POSTER Incidence of Costly Cancer Treatment in Two Health Care Services. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71203-5] [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: 11/24/2022]
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Re JP, Blanco Villalba M, Streich G. Breast cancer overall survival: Local statistics versus international statistics. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e12059] [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: 11/20/2022] Open
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Mittenzwey KH, Sinn G, Hiersigk R, Krause M, Lenz P, Pfeil L, Rauchfuss J, Streich G. A portable absorption-fluorometer for detection of organic substances in fluids. Anal Bioanal Chem 1996; 355:742-4. [PMID: 15045360 DOI: 10.1007/s0021663550742] [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] [Received: 09/25/1995] [Accepted: 11/10/1995] [Indexed: 11/25/2022]
Abstract
Using the method of multipath-saturation fluorescence, which considers both fluorescent as well as nonfluorescent substances, the total absorption coefficient can be determined with high sensitivity. This new fluorescence method is appropriate, e.g. for in-situ applications. Thus a portable absorption-fluorometer has been constructed. The main part of the device is a multireflection cell based on a design of Herriott with a 1 cm quartz-cuvette. Two pairs of spherical dielectric mirrors are used to realize the multireflection of the excitation radiation in the UV and blue spectral range. The combination of a cylindrical and a convace mirror leads to a long pathway of the excitation radiation and, thus, to a full absorption by the fluid. A first experiment has been performed with drinking water samples defined polluted by non-fluorescent p-nitrophenol and 2-nitroaniline. Based on the method of multipath-saturation fluorescence a good correlation to the substance concentration was achieved, whereas the conventional absorption failed.
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Affiliation(s)
- K H Mittenzwey
- Gesellschaft für Mess- und Systemtechnik mbH, Rudower Chaussee 5, D-12489, Berlin, Germany
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