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Lin CC, Kim T, Desai P, Lee K, Feng YH, Ngamphaiboon N, Kim SB, Yang MH, Muzaffar J, Chmielowski B, Swiecicki P, Bowyer S, Brahmer J, Chisamore M, Goyal R, Nasrah N, Ho W, Cho B. 187P Phase I/II study of the oral CCR4 antagonist, FLX475, as monotherapy and in combination with pembrolizumab in advanced cancer. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Muro K, Kato K, Chin K, Nishino K, Satouchi M, Watanabe Y, Kawakami H, Tsushima T, Hirai H, Chisamore M, Kojima T. 1241P Phase Ib study of futibatinib plus pembrolizumab in patients with advanced or metastatic solid tumors: Tolerability results and antitumor activity in esophageal carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1359] [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: 11/01/2022] Open
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Schöffski P, Bahleda R, Wagner A, Burgess M, Junker N, Chisamore M, Peterson P, Ceccarelli M, William T. 154P Results of an open-label, phase Ia/Ib study of olaratumab plus pembrolizumab in patients with unresectable, locally advanced or metastatic soft tissue sarcoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.173] [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: 10/19/2022] Open
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Parra E, Adriani M, Freitas Pinto Lima C, Li J, Haymaker C, Parikh R, Bernicker E, Davar D, Chaudhry A, Stevenson A, Badham C, Fyvie G, Chisamore M, Pant S. 1024P Baseline biomarkers associated with clinical benefit in patients with solid tumors refractory to immune checkpoint inhibitors (ICIs) treated with live biotherapeutic MRx0518 in combination with pembrolizumab. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Laethem JLV, Borbath I, Karwal M, Verslype C, Van Vlierberghe H, Kardosh A, Zagonel V, Stal P, Sarker D, Palmer D, Vogel A, Edeline J, Cattan S, Kudo M, Cheng AL, Ogasawara S, Siegel A, Chisamore M, Wang A, Zhu A. 933P Updated results for pembrolizumab (pembro) monotherapy as first-line therapy for advanced hepatocellular carcinoma (HCC) in the phase II KEYNOTE-224 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Krebs M, Helland Å, Carcereny Costa E, Arriola Aperribay E, Dómine Gómez M, Trigo Pérez J, Thompson J, Strauss J, Ortega Granados A, Felip E, Schmidt E, Chisamore M, Madeleine N, Rayford A, Lorens K, Siddiqui A, Gabra H, Nautiyal J, Micklem D, Lorens J, Spicer J. OA01.07 A Phase II Study of the Oral Selective AXL Inhibitor Bemcentinib with Pembrolizumab in Patients with Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Le Tourneau C, Rischin D, Groenland S, Lim A, Martin-Liberal J, Moreno V, Trigo J, Mathew M, Cho D, Hansen A, Vincente Baz D, Maio M, Italiano A, Bauman J, Chisamore M, Zhou H, Ellis C, Ballas M, Hoos A, Angevin E. 1O Inducible T cell co-stimulatory (ICOS) receptor agonist, GSK3359609 (GSK609) alone and combination with pembrolizumab: Preliminary results from INDUCE-1 expansion cohorts in head and neck squamous cell carcinoma (HNSCC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.01.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Angevin E, Groenland S, Bauer T, Rischin D, Gardeazabal I, Moreno V, Trigo J, Chisamore M, Shaik J, Rigat F, Ellis C, Chen H, Gagnon R, Scherer S, Turner D, Yadavilli S, Ballas M, Hoos A, Maio M. 11P Pharmacokinetic/pharmacodynamic (PK/PD) exposure-response characterization of GSK3359609 (GSK609) from INDUCE-1, a phase I open-label study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.01.059] [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: 10/24/2022] Open
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Reckamp K, Akerley W, Calvo E, Clarke J, Edelman M, He K, Moreno V, Neal J, Owonikoko T, Patel J, Patel S, Riess J, Sacher A, Turcotte S, Villaruz L, Zauderer M, Farsaci B, Skoura N, Chisamore M, Johnson M. Safety, tolerability and activity of autologous T-cells with enhanced T-cell receptors specific to NY ESO 1/LAGE 1a (GSK3377794) alone, or in combination with pembrolizumab, in advanced non-small cell lung cancer: A phase Ib/IIa randomised pilot study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.112] [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: 11/12/2022] Open
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Maio M, Groenland S, Bauer T, Rischin D, Gardeazabal I, Moreno V, Trigo Perez J, Chisamore M, Sadik Shaik J, Rigat F, Ellis C, Chen H, Gagnon R, Scherer S, Turner D, Yadavilli S, Ballas M, Hoos A, Angevin E. Pharmacokinetic/ pharmacodynamic (PK/PD) exposure-response characterization of GSK3359609 (GSK609) from INDUCE-1, a phase I open-label study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Rischin D, Groenland S, Lim A, Martin-Liberal J, Moreno V, Trigo Perez J, Le Tourneau C, Mathew M, Cho D, Hansen A, Vincente-Baz D, Maio M, Italiano A, Bauman J, Chisamore M, Zhou H, Ellis C, Ballas M, Hoos A, Angevin E. Inducible T cell costimulatory (ICOS) receptor agonist, GSK3359609 (GSK609) alone and in combination with pembrolizumab (pembro): Preliminary results from INDUCE-1 expansion cohorts (EC) in head and neck squamous cell carcinoma (HNSCC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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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O'Day S, Borges V, Chmielowski B, Rao R, Abu-Khalaf M, Stopeck A, Lowe J, Mattson P, Breuer K, Gargano M, Bose N, Uhlik M, Graff J, Chisamore M, Cox J, Osterwalder B. Abstract P2-09-08: Imprime PGG, a novel innate immune modulator, combined with pembrolizumab in a phase 2 multicenter, open label study in chemotherapy-resistant metastatic triple negative breast cancer (TNBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-09-08] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: CPI monotherapy provides substantial clinical benefit to patients (pts) in multiple cancers, yet response rates are limited (˜15-30%) and fails to benefit the majority. In these pts there is limited or no ongoing T cell-based immune response. Imprime PGG (Imprime), a novel beta glucan derived from Saccharomyces, may expand the clinical benefit of CPI therapy by stimulating an anti-cancer immune response. Acting as a pathogen-associated molecularpattern (PAMP), Imprime enlists innate immune functions including cytotoxic effector mechanisms, reversal of immunosuppression and cross-talk with the adaptive immune system.Imprime-mediated innate immune activation requires formation of an immune complex with naturally-occurring anti-beta glucan antibodies (ABA); sufficient ABA levels is required for complex formation. Imprime is now being studied in combination with pembrolizumab (KEYTRUDA®,Pembro), a humanized mAb against PD-1 which has been previously studied in TNBC pts.
Methods: In this study of patients who previously failed chemotherapy for metastatic TNBC, Imprime is being used in combination with Pembro in a Simon 2 stage design. Asample size of 12 evaluable pts in Stage 1 was planned.Evaluable pts received at least one dose of study treatment (tx), had measurable disease at baseline per RECIST v1.1, had at least one post-baseline scan or discontinued tx as a result of progressive disease, death, or a tx-related adverse event before the first post-baseline scan.Pts received Imprime (4 mg/kg IV days 1, 8, 15 of each 3-week cycle) + Pembro 200 mg on D1 of each cycle. Criteria to advance to Stage 2 were ≤4 grade 3/4 AEs during the first tx cycle (other than infusion reactions) and ≥1 objective response. Study primary endpoints are ORR and safety; secondary endpoints are TTR, CRR, DoR, PFS, and OS. Exploratory endpoints include ORR and PFS per irRECIST. Biopsies and blood samples are being collected to assess tx impact on immune activating events at the tumor site and in the periphery.
Results: A review of efficacy and safety data was conducted at the end of Stage 1. Thirteen pts (12 evaluable) were enrolled into Stage 1. Safety review noted 2 grade 3 adverse events that met protocol definition of Stage 1 events (1 pt: cellulitis and 1 pt: pleural infusion; both unrelated to treatment). Two events lead to 2 pts discontinuing treatment (infusion reaction and pancreatitis) and only 1 autoimmune event was observed (pancreatitis). Observed efficacy responses in the evaluable pts included 1 complete response (CR; ongoing) and 2 partial responses (PR; ongoing). Secondary efficacy endpoints have not been assessed. Early translational results support proposed MOA and analysis of Stage 1 translational data is ongoing.
Conclusion: The use of Imprime with Pembro was well tolerated and met both safety and efficacy requirements to move forward with Stage 2 of the study. No significant safety concerns were identified in Stage 1. Further investigation is thus warranted and enrollment into Stage 2 is ongoing. Updated data will be presented.
Citation Format: O'Day S, Borges V, Chmielowski B, Rao R, Abu-Khalaf M, Stopeck A, Lowe J, Mattson P, Breuer K, Gargano M, Bose N, Uhlik M, Graff J, Chisamore M, Cox J, Osterwalder B. Imprime PGG, a novel innate immune modulator, combined with pembrolizumab in a phase 2 multicenter, open label study in chemotherapy-resistant metastatic triple negative breast cancer (TNBC) [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 P2-09-08.
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Affiliation(s)
- S O'Day
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - V Borges
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - B Chmielowski
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - R Rao
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - M Abu-Khalaf
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - A Stopeck
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - J Lowe
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - P Mattson
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - K Breuer
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - M Gargano
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - N Bose
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - M Uhlik
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - J Graff
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - M Chisamore
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - J Cox
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
| | - B Osterwalder
- John Wayne Cancer Institute, Santa Monica, CA; UCHealth University of Colorado, Aurora, CO; Ronald Reagan UCLA Medical Center, Los Angeles, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center, Philadelphia, PA; SUNY Stony Brook Cancer Center, Stony Brook, NY; Biothera Pharmaceuticals, Inc., Eagan, MN; Merck & Co., Inc., Kenilworth, NJ; B.O. Consulting GmbH, Riehen, Switzerland
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Long G, Milhem M, Amin A, Hoimes C, Medina T, Conry R, Lao C, Daniels G, Reddy S, Mehmi I, Andtbacka R, Barve M, Shaheen M, Tueting T, Chisamore M, Xing B, Candia A, Gamelin E, Janssen R, Ribas A. Phase Ib/II, open label, multicenter, study of the combination of SD-101 and pembrolizumab in patients with advanced melanoma who are naïve to anti-PD-1 therapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Arce-Lara C, Arriola E, Brunsvig P, Carcereny E, Domine M, Dragnev K, Felip E, García Campelo R, Krebs M, Paz-Ares L, Ponce Aix S, Spicer J, Trigo J, Vinolas Segarra N, Holt R, Micklem D, Brown A, Chisamore M, Lorens J. P2.04-27 Ph II Study of Oral Selective AXL Inhibitor Bemcentinib (BGB324) in Combination with Pembrolizumab in Patients with Advanced NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1251] [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: 11/25/2022]
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Cohen E, Algazi A, Laux D, Wong D, Amin A, Nabell L, Chisamore M, Gamelin E, Janssen R, Bishnoi S. Phase Ib/II, open label, multicenter study of intratumoral SD-101 in combination with pembrolizumab in anti-PD-1 treatment naïve patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Riess J, Bennouna J, Paz-Ares L, Chisamore M, Lybeck Lind C, Sadrolhefazi B, Levy B. P2.04-010 Afatinib in Combination with Pembrolizumab in Patients with Stage IIIB/IV Squamous Cell Carcinoma (SCC) of the Lung. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.11.023] [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: 11/17/2022]
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Albain KS, Czerlanis C, Rajan P, Zlobin A, Godellas C, Bova D, Lo SS, Robinson P, Sarker S, Gaynor ER, Cooper R, Aranha G, Czaplicki K, Busby B, Rizzo P, Chisamore M, Demuth T, Blackman S, Watters J, Stiff P, Fuqua SAW, Miele L. Abstract PD05-12: Combination of Notch Inhibitor MK-0752 and Endocrine Therapy for Early Stage ERα + Breast Cancer in a Presurgical Window Pilot Study. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-pd05-12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Breast tumor initiating cells (TIC) use Notch receptors/ligands with other pathways for self renewal, resulting in tumor proliferation and progression. We showed that Notch inhibition with gamma secretase inhibitors (GSI) potentiates the effects of tamoxifen (tam) in xenografts (Rizzo et al. Cancer Res 2008). It is unknown whether GSIs plus endocrine therapy result in modulation of Notch and other proliferation markers in human breast cancer. Our objective was to add short exposure of the GSI MK-0752 to ongoing tam or letrozole (letr) during the presurgical window to determine 1) feasibility, 2) safety/tolerance, and 3) impact on biomarkers. We report the initial cohort of this pilot study (ClinTrials. gov NCT00756717).
Methods: Patients (pts) with early stage ERα + breast cancer were treated with 25 days of tam or letr. On day 15 MK-0752 was added to endocrine therapy (350 mg orally 3 days on, 4 days off, 3 days on), with definitive surgery day 25. Formalin fixed, paraffin embedded biopsies were obtained at baseline, day 14 and final surgery, with histologic confirmation of tumor content >50% and RNA extraction by standard methods. Q-PCR was done for Notch1, Notch3, Notch4, Deltex, Jagged1, c-myc, HEY1, HEY2, HES1, PS2, C-Myc, Cyclin A2, NOXA (pro-apoptotic protein), Ki67, Dicer-1, RPL13 (internal control). Ct averages for 3 replicates were used and mRNA levels were calculated by the 2ΔΔCt method. Baseline gene expression levels were used as comparators for days 14 and 25 levels in each pt. The first cohort of 10 pts was analyzed to determine if enough signals were present to justify expanding the cohort at this dose to 20 pts and possibly test a second cohort on an alternate MK-0752 dose/schedule. Results: The initial cohort of 10 pts completed all therapy (4 tam, 6 letr), all biopsies and definitive surgery on schedule. One other pt withdrew prior to starting MK-0752 due to hypertension. Toxicity was minimal: grade 1 periorbital edema/cough, nausea, and axillary paresthesias in 1 pt each; grade 1 facial rash, 2 pts; and grade 2 fatigue, 1 pt. There was no diarrhea or surgical complications. Significant changes occurred in molecular marker levels after MK-0752 plus tam/letr (day 25) vs. end of tam/letr alone (day 14) as follows: Ki67 mRNA decreased in 9/10 pts; Notch4 decreased, 10/10; NOXA increased, 6/10; and Notch1 decreased, 6/10. Other markers showed inter-individual variations and will be presented, along with results of the global gene expression profiling (in progress). Conclusions: The addition of a short exposure of the GSI MK-0752 to ongoing endocrine therapy was feasible, safe, and well tolerated in pts with ERα + early breast cancer prior to definitive surgery. It results in anti-proliferative and pro-apoptotic effects at the molecular level. Notch4, which plays a key role in breast TIC, was the most consistent molecular marker of response in this setting. This suggests a potential anti-TIC effect of this combination and a role in overcoming endocrine resistance. Accrual to the expanded cohort is underway. If findings are confirmed, the second study with alternate MK-0752 dose/schedule may commence. Funding: Swim Across America, Inc. (clinical trial costs); Merck (drug supply, profiling)
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD05-12.
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Affiliation(s)
- KS Albain
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - C Czerlanis
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - P Rajan
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - A Zlobin
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - C Godellas
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - D Bova
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - SS Lo
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - P Robinson
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - S Sarker
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - ER Gaynor
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - R Cooper
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - G Aranha
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - K Czaplicki
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - B Busby
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - P Rizzo
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - M Chisamore
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - T Demuth
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - S Blackman
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - J Watters
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - P Stiff
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - SAW Fuqua
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
| | - L. Miele
- Loyola University Chicago Cardinal Bernardin Cancer Center, Maywood, IL; Merck Oncology, North Wales, PA; Baylor Breast Center, Houston, TX; University of Mississippi Cancer Institute, Jackson, MS
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18
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Fournier DB, Chisamore M, Lurain JR, Rademaker AW, Jordan VC, Tonetti DA. Protein Kinase C Alpha Expression Is Inversely Related to ER Status in Endometrial Carcinoma: Possible Role in AP-1-Mediated Proliferation of ER-Negative Endometrial Cancer. Gynecol Oncol 2001; 81:366-72. [PMID: 11371124 DOI: 10.1006/gyno.2001.6164] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Tamoxifen is the most widely used antiestrogen to treat all stages of estrogen-receptor (ER)-positive breast cancers. However, tamoxifen acts as a partial estrogen in the uterus and is known to increase the risk of endometrial cancer by two- to threefold. Recent evidence indicates that there is a connection between tamoxifen resistance and activation of the activator protein-1 (AP-1) pathway. We have previously reported a possible role for overexpression of protein kinase C alpha (PKCalpha), an upstream activator of the AP-1 pathway, in hormone-independent breast cancer and antiestrogen-stimulated endometrial tumors. We hypothesize that alterations of the PKC isozyme profile of endometrial carcinomas are similar to that of hormone-independent breast cancer and determine whether specific PKC isozyme alterations correlated with known clinicopathological features of endometrial cancer. METHODS The PKC isozyme profile of endometrial carcinomas from 42 patients who were not previously exposed to antiestrogens was examined by Western blot. The relationship between PKC isozyme expression and key prognostic factors for endometrial carcinoma including hormone receptor status, tumor grade, stage, size, and depth of myometrial invasion was examined using the Spearman's rho correlation coefficient. RESULTS As previously found in breast cancers, PKCalpha and estrogen receptor alpha (ERalpha) expression are inversely related (r(s) = -0.35, P = 0.046). We report significant inverse correlations among ER/progesterone receptor (PR) expression and tumor grade (r(s) = -0.49, P = 0.001 and r(s) = -0.44, P = 0.004, respectively), ER, and depth of myometrial invasion (r(s) = -0.40, P = 0.009). There were no other significant correlations between PKC isozyme expression and other key prognostic factors examined. CONCLUSION This study indicates that, similar to what was previously observed in breast cancer, PKCalpha and ER expression is inversely related in endometrial cancer. PKCalpha expression may be a useful prognostic indicator in endometrial cancers. A model is offered which describes the putative role of PKCalpha overexpression in activation of the AP-1 pathway and increased proliferation of ER negative endometrial cancers.
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Affiliation(s)
- D B Fournier
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University Medical School, Chicago, Illinois 60611, USA
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Hills MD, Lindsey AE, Chisamore M, Bassett-Smith J, Abbott K, Fournier-Chalmers J. University-College Collaboration: Rethinking Curriculum Development in Nursing Education. J Nurs Educ 1994; 33:220-5. [PMID: 8051573 DOI: 10.3928/0148-4834-19940501-07] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The behavioral approach to curriculum development is inadequate to educate nurses to practice in the future health care system. As a result of a government initiative, a Canadian university and four community colleges had an opportunity to collaborate on development of a nursing program and thereby consider alternative approaches to curriculum development. This paper describes the process used to develop this curriculum and provides an overview of the curriculum development model that emerged. A community development process characterized by a commitment to be futuristic and visionary about nursing while making curriculum decisions was established. The curriculum model that emerged used a phenomenological exploration of our common vision for nursing in the future. The resulting curriculum is based on a human science paradigm that encourages nurses to work from a health promotion perspective with an ethic of caring.
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Affiliation(s)
- M D Hills
- Collaborative Nursing Program, University of Victoria, British Columbia, Canada
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