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Meester RGS, Lansdorp-Vogelaar I, Winawer SJ, Church TR, Allen JI, Feld AD, Mills G, Jordan PA, Corley DA, Doubeni CA, Hahn AI, Lobaugh SM, Fleisher M, O'Brien MJ, Zauber AG. Projected Colorectal Cancer Incidence and Mortality Based on Observed Adherence to Colonoscopy and Sequential Stool-Based Screening. Am J Gastroenterol 2024:00000434-990000000-01027. [PMID: 38318949 DOI: 10.14309/ajg.0000000000002693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/28/2023] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Modeling supporting recommendations for colonoscopy and stool-based colorectal cancer (CRC) screening tests assumes 100% sequential participant adherence. The impact of observed adherence on the long-term effectiveness of screening is unknown. We evaluated the effectiveness of a program of screening colonoscopy every 10 years vs annual high-sensitivity guaiac-based fecal occult blood testing (HSgFOBT) using observed sequential adherence data. METHODS The MIcrosimulation SCreening ANalysis (MISCAN) model used observed sequential screening adherence, HSgFOBT positivity, and diagnostic colonoscopy adherence in HSgFOBT-positive individuals from the National Colonoscopy Study (single-screening colonoscopy vs ≥4 HSgFOBT sequential rounds). We compared CRC incidence and mortality over 15 years with no screening or 10 yearly screening colonoscopy vs annual HSgFOBT with 100% and differential observed adherence from the trial. RESULTS Without screening, simulated incidence and mortality over 15 years were 20.9 (95% probability interval 15.8-26.9) and 6.9 (5.0-9.2) per 1,000 participants, respectively. In the case of 100% adherence, only screening colonoscopy was predicted to result in lower incidence; however, both tests lowered simulated mortality to a similar level (2.1 [1.6-2.9] for screening colonoscopy and 2.5 [1.8-3.4] for HSgFOBT). Observed adherence for screening colonoscopy (83.6%) was higher than observed sequential HSgFOBT adherence (73.1% first round; 49.1% by round 4), resulting in lower simulated incidence and mortality for screening colonoscopy (14.4 [10.8-18.5] and 2.9 [2.1-3.9], respectively) than HSgFOBT (20.8 [15.8-28.1] and 3.9 [2.9-5.4], respectively), despite a 91% adherence to diagnostic colonoscopy with FOBT positivity. The relative risk of CRC mortality for screening colonoscopy vs HSgFOBT was 0.75 (95% probability interval 0.68-0.80). Findings were similar in sensitivity analyses with alternative assumptions for repeat colonoscopy, test performance, risk, age, and projection horizon. DISCUSSION Where sequential adherence to stool-based screening is suboptimal and colonoscopy is accessible and acceptable-as observed in the national colonoscopy study, microsimulation, comparative effectiveness, screening recommendations.
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Affiliation(s)
| | | | - Sidney J Winawer
- Gastroenterology, Hepatology, and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Timothy R Church
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, and Masonic Cancer Center, Minneapolis, Minnesota, USA
| | - John I Allen
- Gastroenterology and Hepatology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Andrew D Feld
- Gastroenterology Clinic, Kaiser Permanente Washington (KPWA), Seattle, Washington, USA
| | - Glenn Mills
- Feist-Weiller Cancer Center, Health Department, Louisiana State University, Shreveport, Louisiana, USA
| | - Paul A Jordan
- Feist-Weiller Cancer Center, Health Department, Louisiana State University, Shreveport, Louisiana, USA
| | - Douglas A Corley
- Division of Research, Kaiser Permanente, San Francisco, California, USA
| | | | - Anne I Hahn
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Stephanie M Lobaugh
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael J O'Brien
- Department of Pathology and Laboratory Medicine, Boston University Medical Center, Boston, Massachusetts
| | - Ann G Zauber
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Li H, Chiang C, Kwak KJ, Wang X, Doddi S, Ramanathan LV, Cho SM, Hou Y, Cheng T, Mo X, Chang Y, Chang H, Cheng W, Tsai W, Nguyen LTH, Pan J, Ma Y, Rima XY, Zhang J, Reategui E, Chu Y, Chang PM, Chang P, Huang CF, Wang C, Shan Y, Li C, Fleisher M, Lee LJ. Extracellular Vesicular Analysis of Glypican 1 mRNA and Protein for Pancreatic Cancer Diagnosis and Prognosis. Adv Sci (Weinh) 2024; 11:e2306373. [PMID: 38204202 PMCID: PMC10953589 DOI: 10.1002/advs.202306373] [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] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/01/2023] [Indexed: 01/12/2024]
Abstract
Detecting pancreatic duct adenocarcinoma (PDAC) in its early stages and predicting late-stage patient prognosis undergoing chemotherapy is challenging. This work shows that the activation of specific oncogenes leads to elevated expression of mRNAs and their corresponding proteins in extracellular vesicles (EVs) circulating in blood. Utilizing an immune lipoplex nanoparticle (ILN) biochip assay, these findings demonstrate that glypican 1 (GPC1) mRNA expression in the exosomes-rich (Exo) EV subpopulation and GPC1 membrane protein (mProtein) expression in the microvesicles-rich (MV) EV subpopulation, particularly the tumor associated microvesicles (tMV), served as a viable biomarker for PDAC. A combined analysis effectively discriminated early-stage PDAC patients from benign pancreatic diseases and healthy donors in sizable clinical from multiple hospitals. Furthermore, among late-stage PDAC patients undergoing chemotherapy, lower GPC1 tMV-mProtein and Exo-mRNA expression before treatment correlated significantly with prolonged overall survival. These findings underscore the potential of vesicular GPC1 expression for early PDAC screenings and chemotherapy prognosis.
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Sia TY, Yaari Z, Feiner R, Smith E, Da Cruz Paula A, Selenica P, Doddi S, Chi DS, Abu-Rustum NR, Levine DA, Weigelt B, Fleisher M, Ramanathan LV, Heller DA, Long Roche K. Uterine washings as a novel method for early detection of ovarian cancer: Trials and tribulations. Gynecol Oncol Rep 2024; 51:101330. [PMID: 38356691 PMCID: PMC10865230 DOI: 10.1016/j.gore.2024.101330] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
Given the tubal origin of high-grade serous ovarian cancer (HGSC), we sought to investigate intrauterine lavage (IUL) as a novel method of biomarker detection. IUL and serum samples were collected from patients with HGSC or benign pathology. Although CA-125 and HE4 concentrations were significantly higher in IUL samples compared to serum, they were similar between IUL samples from patients with HGSC vs benign conditions. In contrast, CA-125 and HE4 serum concentrations differed between HGSC and benign pathology (P =.002 for both). IUL and tumor samples from patients with HGSC were subjected to targeted panel sequencing and droplet digital PCR (ddPCR). Tumor mutations were found in 75 % of matched IUL samples. Serum CA-125 and HE4 biomarker levels allowed for better differentiation of HGSC and benign pathology compared to IUL samples. We believe using IUL for early detection of HGSC requires optimization, and current strategies should focus on prevention until early detection strategies improve.
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Affiliation(s)
- Tiffany Y Sia
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Zvi Yaari
- School of Pharmacy, Department of Medicine, Hebrew University of Jerusalem, Israel
| | - Ron Feiner
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Evan Smith
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Arnaud Da Cruz Paula
- i3S Instituto de Investigação e Inovação em Saúde, Porto, Portugal
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Pier Selenica
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sital Doddi
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dennis S Chi
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA
| | - Nadeem R Abu-Rustum
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA
| | | | - Britta Weigelt
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lakshmi V Ramanathan
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Daniel A Heller
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Pharmacology, Weill Cornell Medical College, Cornell University, New York, NY, USA
| | - Kara Long Roche
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA
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Zauber AG, Winawer SJ, O'Brien MJ, Mills GM, Allen JI, Feld AD, Jordan PA, Fleisher M, Orlow I, Meester RGS, Lansdorp-Vogelaar I, Rutter CM, Knudsen AB, Mandelson M, Shaukat A, Mendelsohn RB, Hahn AI, Lobaugh SM, Palmer BS, Serrano V, Kumar JR, Fischer SE, Chen JC, Bayuga-Miller S, Kuk D, O'Connell K, Church TR. Randomized Trial of Facilitated Adherence to Screening-Colonoscopy Versus Sequential Fecal-Based Blood Test. Gastroenterology 2023:S0016-5085(23)00505-X. [PMID: 36948424 DOI: 10.1053/j.gastro.2023.03.206] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND AND AIMS Colorectal cancer (CRC) screening guidelines include screening-colonoscopy and sequential high sensitivity fecal occult blood testing (HSgFOBT), with expectation of similar effectiveness based on the assumption of similar high adherence. However, adherence to screening-colonoscopy compared to sequential HSgFOBT has not been reported. In this randomized clinical trial, we assessed adherence and pathology findings for a single screening-colonoscopy versus sequential and non-sequential HSgFOBT. METHODS Participants aged 40-69 were enrolled in three centers, which represented different clinical settings. Participants were randomized into a single screening-colonoscopy arm versus sequential HSgFOBT arm comprised of 4-7 rounds. Initial adherence to screening-colonoscopy and sequential adherence to HSgFOBT, follow-up colonoscopy for positive HSgFOBT tests, crossover to colonoscopy, and detection of advanced neoplasia or large serrated lesions (ADN-SER) were measured. RESULTS 3,523 participants were included in the trial with 1761 and 1762 participants randomized to the screening-colonoscopy and HSgFOBT arms, respectively. Adherence was 1473 (83.6%) for the screening-colonoscopy arm versus 1288 (73.1%) for the HSgFOBT arm after one round (RR=1.14, [95% CI 1.10-1.19] P ≤0.001), but only 674 (38.3%) over four sequential HSgFOBT rounds (RR=2.19, [95% CI 2.05-2.33]). Overall adherence to any screening increased to 1558 (88.5%) in the screening-colonoscopy arm during the entire study period and 1493 in the HSgFOBT arm (84.7%) (RR=1.04, [95% CI 1.02-1.07]). 436 (24.7%) participants crossed over to screening-colonoscopy over the first four rounds. ADN-SER were detected in 121 (8.2%) of the 1473 participants in the colonoscopy arm who were adherent to protocol in the first 12 months of the study, whereas the detection of ADN-SER among those who were not sequentially adherent (N=709) to HSgFOBT was subpar (0.6%) (RR=14.72, [95% CI 5.46-39.67]) when compared to those who were sequentially adherent (3.3%) (N=647) (RR=2.52, [95% CI 1.61-3.98]) to HSgFOBT in the first four rounds. When including colonoscopies from HSgFOBT patients who were never positive yet crossed over (N=1483), 5.5% of ADN-SER were detected (RR=1.50, [95% CI 1.15-1.96]) in the first four rounds. CONCLUSIONS Observed adherence to sequential rounds of HSgFOBT was suboptimal when compared to a single screening-colonoscopy. The detection of ADN-SER was inferior when non-sequential HSgFOBT adherence was compared to sequential adherence. However, the greatest number of ADN-SER was detected among those who crossed over to colonoscopy and opted to receive a colonoscopy. The effectiveness of a HSgFOBT screening program may be enhanced if crossover to screening-colonoscopy is permitted.
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Affiliation(s)
- Ann G Zauber
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Sidney J Winawer
- Gastroenterology, Hepatology, and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael J O'Brien
- Department of Pathology and Laboratory Medicine, Boston University Medical Center, Boston, Massachusetts, USA
| | - Glenn M Mills
- Feist-Weiller Cancer Center, Shreveport, Louisiana, USA
| | - John I Allen
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Andrew D Feld
- Department of Gastroenterology, Kaiser-Permanente Washington, Seattle, Washington
| | - Paul A Jordan
- Department of Medicine, Louisiana State University Health, Shreveport, Louisiana
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | - Carolyn M Rutter
- Fred Hutchinson Cancer Research Center, Hutchinson Institute for Cancer Outcomes Research, Biostatistics Program, Public Health Sciences Division, Seattle WA
| | - Amy B Knudsen
- Institute for Technology Assessment, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Aasma Shaukat
- Division of Gastroenterology, Department of Medicine Environmental Health Sciences, University of Minnesota School of Public Health and Masonic Cancer Center, Minneapolis, Minnesota, USA; Division of Gastroenterology, Department of Medicine, NYU Langone Health, New York, New York
| | - Robin B Mendelsohn
- Gastroenterology, Hepatology, and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anne I Hahn
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Stephanie M Lobaugh
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | - Julie R Kumar
- Novartis (Investigative Initiative Trials and Compassionate Use Studies), East Hanover, NJ
| | - Sara E Fischer
- Department of Government, Georgetown University, Washington, District of Columbia, USA
| | - Jennifer C Chen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sharon Bayuga-Miller
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Kelli O'Connell
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Timothy R Church
- Division of Gastroenterology, Department of Medicine Environmental Health Sciences, University of Minnesota School of Public Health and Masonic Cancer Center, Minneapolis, Minnesota, USA
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Ramanathan LV, Fleisher M, Duffy MJ. Acknowledgments. Cancer Biomark 2022. [DOI: 10.1016/b978-0-12-824302-2.00017-5] [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: 10/17/2022]
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Diaz M, Fleisher M, Pentsova EI. Cerebrospinal fluid circulating tumor cells for diagnosis, response evaluation, and molecular profiling of leptomeningeal metastases from solid tumors. Cancer Biomark 2022. [DOI: 10.1016/b978-0-12-824302-2.00007-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Yaari Z, Yang Y, Apfelbaum E, Cupo C, Settle AH, Cullen Q, Cai W, Roche KL, Levine DA, Fleisher M, Ramanathan L, Zheng M, Jagota A, Heller DA. A perception-based nanosensor platform to detect cancer biomarkers. Sci Adv 2021; 7:eabj0852. [PMID: 34797711 PMCID: PMC8604403 DOI: 10.1126/sciadv.abj0852] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/14/2021] [Indexed: 05/15/2023]
Abstract
Conventional molecular recognition elements, such as antibodies, present issues for developing biomolecular assays for use in certain technologies, such as implantable devices. Additionally, antibody development and use, especially for highly multiplexed applications, can be slow and costly. We developed a perception-based platform based on an optical nanosensor array that leverages machine learning algorithms to detect multiple protein biomarkers in biofluids. We demonstrated this platform in gynecologic cancers, often diagnosed at advanced stages, leading to low survival rates. We investigated the detection of protein biomarkers in uterine lavage samples, which are enriched with certain cancer markers compared to blood. We found that the method enables the simultaneous detection of multiple biomarkers in patient samples, with F1-scores of ~0.95 in uterine lavage samples from patients with cancer. This work demonstrates the potential of perception-based systems for the development of multiplexed sensors of disease biomarkers without the need for specific molecular recognition elements.
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Affiliation(s)
- Zvi Yaari
- Memorial Sloan Kettering Cancer Center, NY, New York 10065, USA
| | - Yoona Yang
- Lehigh University, Bethlehem, PA 18015, USA
| | - Elana Apfelbaum
- Memorial Sloan Kettering Cancer Center, NY, New York 10065, USA
| | - Christian Cupo
- Memorial Sloan Kettering Cancer Center, NY, New York 10065, USA
| | - Alex H. Settle
- Memorial Sloan Kettering Cancer Center, NY, New York 10065, USA
| | - Quinlan Cullen
- Weill Cornell Medicine, 1300 York Avenue, New York, NY, 10065, USA
| | - Winson Cai
- Weill Cornell Medicine, 1300 York Avenue, New York, NY, 10065, USA
| | - Kara Long Roche
- Memorial Sloan Kettering Cancer Center, NY, New York 10065, USA
| | | | - Martin Fleisher
- Memorial Sloan Kettering Cancer Center, NY, New York 10065, USA
| | | | - Ming Zheng
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | | | - Daniel A. Heller
- Memorial Sloan Kettering Cancer Center, NY, New York 10065, USA
- Weill Cornell Medicine, 1300 York Avenue, New York, NY, 10065, USA
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Wise DR, Schneider JA, Armenia J, Febles VA, McLaughlin B, Brennan R, Thoren KL, Abida W, Sfanos KS, De Marzo AM, Yegnasubramanian S, Fox JJ, Haas M, Heath H, Kagey MH, Newman W, Sirard CA, Fleisher M, Morris MJ, Chen Y, Larson SM, Haffner MC, Nelson PS, Schultz N, Garabedian MJ, Scher HI, Logan SK, Sawyers CL. Dickkopf-1 Can Lead to Immune Evasion in Metastatic Castration-Resistant Prostate Cancer. JCO Precis Oncol 2020; 4:2000097. [PMID: 33015525 DOI: 10.1200/po.20.00097] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Metastatic castration-resistant prostate cancer (mCRPC) with low androgen receptor (AR) and without neuroendocrine signaling, termed double-negative prostate cancer (DNPC), is increasingly prevalent in patients treated with AR signaling inhibitors and is in need of new biomarkers and therapeutic targets. METHODS Candidate genes enriched in DNPC were determined using differential gene expression analysis of discovery and validation cohorts of mCRPC biopsies. Laboratory studies were carried out in human mCRPC organoid cultures, prostate cancer (PCa) cell lines, and mouse xenograft models. Epigenetic studies were carried out in a rapid autopsy cohort. RESULTS Dickkopf-1 (DKK1) expression is increased in DNPC relative to prostate-specific antigen (PSA)-expressing mCRPC in the Stand Up to Cancer/Prostate Cancer Foundation discovery cohort (11.2 v 0.28 reads per kilobase per million mapped reads; q < 0.05; n = 117) and in the University of Washington/Fred Hutchinson Cancer Research Center cohort (9.2 v 0.99 fragments per kilobase of transcript per million mapped reads; P < .0001). DKK1 expression can be regulated by activated Wnt signaling in vitro and correlates with activating canonical Wnt signaling mutations and low PSA mRNA in mCRPC biopsies (P < .05). DKK1 hypomethylation was associated with increased DKK1 mRNA expression (Pearson r = -0.66; P < .0001) in a rapid autopsy cohort (n = 7). DKK1-high mCRPC biopsies are infiltrated with significantly higher numbers of quiescent natural killer (NK) cells (P < .005) and lower numbers of activated NK cells (P < .0005). Growth inhibition of the human PCa model PC3 by the anti-DKK1 monoclonal antibody DKN-01 depends on the presence of NK cells in a severe combined immunodeficient xenograft mouse model. CONCLUSION These results support DKK1 as a contributor to the immunosuppressive tumor microenvironment of DNPC. These data have provided the rationale for a clinical trial targeting DKK1 in mCRPC (ClinicalTrials.gov identifier: NCT03837353).
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Affiliation(s)
- David R Wise
- Department of Medicine, Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY
| | | | - Joshua Armenia
- Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Victor Adorno Febles
- Department of Medicine, Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY
| | - Bridget McLaughlin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ryan Brennan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Katie L Thoren
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Wassim Abida
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Karen S Sfanos
- Sidney Kimmel Comprehensive Cancer Center, School of Medicine, Johns Hopkins University, Baltimore, MD.,Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD.,Brady Urological Institute, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Angelo M De Marzo
- Sidney Kimmel Comprehensive Cancer Center, School of Medicine, Johns Hopkins University, Baltimore, MD.,Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD.,Brady Urological Institute, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Srinivasan Yegnasubramanian
- Sidney Kimmel Comprehensive Cancer Center, School of Medicine, Johns Hopkins University, Baltimore, MD.,Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Josef J Fox
- Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | | | | | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michael J Morris
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yu Chen
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.,Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Steven M Larson
- Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michael C Haffner
- Sidney Kimmel Comprehensive Cancer Center, School of Medicine, Johns Hopkins University, Baltimore, MD.,Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Peter S Nelson
- Departments of Medicine and Pathology, University of Washington, and Divisions of Human Biology and Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Nikolaus Schultz
- Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michael J Garabedian
- Department of Urology, NYU Langone Medical Center, New York, NY.,Department of Microbiology, NYU Langone Medical Center, New York, NY
| | - Howard I Scher
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Susan K Logan
- Department of Urology, NYU Langone Medical Center, New York, NY
| | - Charles L Sawyers
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY.,Howard Hughes Medical Institute, Memorial Sloan Kettering Cancer Center, New York, NY
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von Reibnitz D, Yorke ED, Oh JH, Apte AP, Yang J, Pham H, Thor M, Wu AJ, Fleisher M, Gelb E, Deasy JO, Rimner A. Predictive Modeling of Thoracic Radiotherapy Toxicity and the Potential Role of Serum Alpha-2-Macroglobulin. Front Oncol 2020; 10:1395. [PMID: 32850450 PMCID: PMC7423838 DOI: 10.3389/fonc.2020.01395] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 07/02/2020] [Indexed: 12/25/2022] Open
Abstract
Background: To investigate the impact of alpha-2-macroglobulin (A2M), a suspected intrinsic radioprotectant, on radiation pneumonitis and esophagitis using multifactorial predictive models. Materials and Methods: Baseline A2M levels were obtained for 258 patients prior to thoracic radiotherapy (RT). Dose-volume characteristics were extracted from treatment plans. Spearman's correlation (Rs) test was used to correlate clinical and dosimetric variables with toxicities. Toxicity prediction models were built using least absolute shrinkage and selection operator (LASSO) logistic regression on 1,000 bootstrapped datasets. Results: Grade ≥2 esophagitis and pneumonitis developed in 61 (23.6%) and 36 (14.0%) patients, respectively. The median A2M level was 191 mg/dL (range: 94-511). Never/former/current smoker status was 47 (18.2%)/179 (69.4%)/32 (12.4%). We found a significant negative univariate correlation between baseline A2M levels and esophagitis (Rs = -0.18/p = 0.003) and between A2M and smoking status (Rs = 0.13/p = 0.04). Further significant parameters for grade ≥2 esophagitis included age (Rs = -0.32/p < 0.0001), chemotherapy use (Rs = 0.56/p < 0.0001), dose per fraction (Rs = -0.57/p < 0.0001), total dose (Rs = 0.35/p < 0.0001), and several other dosimetric variables with Rs > 0.5 (p < 0.0001). The only significant non-dosimetric parameter for grade ≥2 pneumonitis was sex (Rs = -0.32/p = 0.037) with higher risk for women. For pneumonitis D15 (lung) (Rs = 0.19/p = 0.006) and D45 (heart) (Rs = 0.16/p = 0.016) had the highest correlation. LASSO models applied on the validation data were statistically significant and resulted in areas under the receiver operating characteristic curve of 0.84 (esophagitis) and 0.78 (pneumonitis). Multivariate predictive models did not require A2M to reach maximum predictive power. Conclusion: This is the first study showing a likely association of higher baseline A2M values with lower risk of radiation esophagitis and with smoking status. However, the baseline A2M level was not a significant risk factor for radiation pneumonitis.
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Affiliation(s)
- Donata von Reibnitz
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Ellen D Yorke
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jung Hun Oh
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Aditya P Apte
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jie Yang
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Hai Pham
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Maria Thor
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Abraham J Wu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Emily Gelb
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Joseph O Deasy
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Andreas Rimner
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
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10
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Blouin AG, Hsu M, Fleisher M, Ramanathan LV, Pastores SM. Utility of procalcitonin as a predictor of bloodstream infections and supportive modality requirements in critically ill cancer patients. Clin Chim Acta 2020; 510:181-185. [PMID: 32679129 DOI: 10.1016/j.cca.2020.07.024] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND We evaluated the diagnostic utility of procalcitonin (PCT) in predicting bacterial bloodstream infections (BSI) in critically ill cancer patients with and without neutropenia. We also investigated the role of PCT as a prognostic marker of supportive modalities (vasopressors, invasive mechanical ventilation, and renal replacement therapy (RRT)) in the intensive care unit (ICU). METHODS We retrospectively analyzed 2200 PCT and blood cultures from adult cancer patients with suspected sepsis. Primary outcome was BSI, defined by positive blood culture, collected within 72 h of PCT collection. RESULTS Median PCT values were higher in encounters with BSI (3.2 vs 0.5 ng/ml, p < 0.001). The area under the ROC curve (AUC) was 0.726 (95%CI 0.698, 0.754). PCT > 2.0 ng/ml was significantly associated with greater likelihood of BSI and this effect was significantly stronger for neutropenic (OR 9.09, 95%CI: 4.39, 18.79) compared with non-neutropenic patients (OR 4.00 (95% CI: 3.13, 5.10), interaction p = 0.036). PCT > 2.0 was associated with vasopressor requirement on ICU admission (OR 1.82 (95% CI 1.31, 2.53), p < 0.001) and RRT (OR 2.20 (95% CI 1.24, 3.91), p = 0.007). CONCLUSIONS Procalcitonin is a fair discriminator of BSI in critically ill cancer patients with and without neutropenia and a PCT > 2.0 ng/ml was significantly more likely to require vasopressors and RRT in the ICU.
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Affiliation(s)
- Amanda G Blouin
- Center for Laboratory Medicine, New York, NY, United States.
| | - Meier Hsu
- Department of Epidemiology and Biostatistics, New York, NY, United States
| | | | | | - Stephen M Pastores
- Critical Care Center Memorial Sloan Kettering Cancer Center, New York, NY, United States
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11
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Erdman P, Ramanathan L, Fleisher M, Pessin M. Confounding Hyponatremia and Hypochloremia in a Cancer Patient. J Appl Lab Med 2020; 5:588-591. [PMID: 32445347 DOI: 10.1093/jalm/jfaa004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 09/16/2019] [Indexed: 11/13/2022]
Affiliation(s)
- Patrick Erdman
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, 327 East 64th St., New York, NY 10065
| | - Lakshmi Ramanathan
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, 327 East 64th St., New York, NY 10065
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, 327 East 64th St., New York, NY 10065
| | - Melissa Pessin
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, 327 East 64th St., New York, NY 10065
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12
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Lim M, Erdman P, Cho S, Mathew A, Fleisher M, Thoren KL. Evaluation of CisBio ELISA for Chromogranin A Measurement. J Appl Lab Med 2019; 4:11-18. [PMID: 31639703 DOI: 10.1373/jalm.2018.028027] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 01/29/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Chromogranin A (CgA) is a nonspecific marker for the presence of neuroendocrine tumors and neuroendocrine differentiation. The objective of this study was to evaluate the performance of the CisBio CgA ELISA. METHODS Precision, linearity, limit of blank, and recovery of the CisBio CgA ELISA were evaluated. Seventy waste serum samples obtained from the clinical laboratory at Memorial Sloan Kettering Cancer Center were analyzed by the CisBio CgA ELISA. Results were compared to those obtained from a reference laboratory that used a proprietary ELISA for serum CgA measurement. Paired waste plasma samples were also collected from 24 of these patients to assess possible differences between CgA in serum and plasma. Finally, a preliminary reference range study was performed with samples from healthy volunteers in serum (n = 60) and plasma (n = 60). RESULTS Within-run and between-run precision ranged from 3.0% to 5.1% and 4.8% to 12.9%, respectively. The limit of blank was 2.4 ng/mL. Recovery ranged from 88% to 102%. A statistically significant bias was observed when the CisBio CgA assay results were compared to those of a reference laboratory. Comparison of the 2 assays yielded a slope of 9.05, intercept of -18.0, and a correlation coefficient of 0.955. CgA values in serum correlated well to values measured in plasma. CONCLUSIONS The analytical performance of the CisBio CgA ELISA was acceptable. However, CgA results are method-specific owing to lack of standardization and use of different antibodies. This lack of standardization results in several challenges for the clinical laboratory when evaluating a CgA assay.
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Affiliation(s)
- Maili Lim
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Patrick Erdman
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sun Cho
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Anu Mathew
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Katie L Thoren
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
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13
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Morikawa A, de Stanchina E, Pentsova E, Kemeny MM, Li BT, Tang K, Patil S, Fleisher M, Van Poznak C, Norton L, Seidman AD. Phase I Study of Intermittent High-Dose Lapatinib Alternating with Capecitabine for HER2-Positive Breast Cancer Patients with Central Nervous System Metastases. Clin Cancer Res 2019; 25:3784-3792. [PMID: 30988080 PMCID: PMC6773251 DOI: 10.1158/1078-0432.ccr-18-3502] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [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: 12/21/2018] [Revised: 02/25/2019] [Accepted: 04/09/2019] [Indexed: 01/17/2023]
Abstract
PURPOSE Lapatinib and capecitabine cross the blood-tumor barrier in breast cancer brain metastasis but have modest clinical efficacy. Administration of high-dose tyrosine kinase inhibitor has been evaluated in brain metastases and primary brain tumors as a strategy to improve drug exposure in the central nervous system (CNS). We derived a rational drug scheduling of intermittent high-dose lapatinib alternating with capecitabine based on our preclinical data and Norton-Simon mathematical modeling. We tested this intermittent, sequential drug schedule in patients with breast cancer with CNS metastasis. PATIENTS AND METHODS We conducted a phase I trial using an accelerated dose escalation design in patients with HER2-positive (HER2+) breast cancer with CNS metastasis. Lapatinib was given on day 1-3 and day 15-17 with capecitabine on day 8-14 and day 22-28 on an every 28-day cycle. Lapatinib dose was escalated, and capecitabine given as a flat dose at 1,500 mg BID. Toxicity and efficacy were evaluated. RESULTS Eleven patients were enrolled: brain only (4 patients, 36%), leptomeningeal (5 patients, 45%), and intramedullary spinal cord (2 patients, 18%). Grade 3 nausea and vomiting were dose-limiting toxicities. The MTD of lapatinib was 1,500 mg BID. Three patients remained on therapy for greater than 6 months. CONCLUSIONS High-dose lapatinib is tolerable when given intermittently and sequentially with capecitabine. Antitumor activity was noted in both CNS and non-CNS sites of disease. This novel administration regimen is feasible and efficacious in patients with HER2+ breast cancer with CNS metastasis and warrants further investigation.
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Affiliation(s)
- Aki Morikawa
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Elisa de Stanchina
- Antitumor Assessment Core Facility, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elena Pentsova
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Margaret M Kemeny
- Queens Cancer Center of New York City Health and Hospitals, Queens, New York
| | - Bob T Li
- Breast Cancer Medicine Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kendrick Tang
- Breast Cancer Medicine Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sujata Patil
- Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martin Fleisher
- Clinical Chemistry Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Catherine Van Poznak
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Larry Norton
- Breast Cancer Medicine Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrew D Seidman
- Breast Cancer Medicine Service, Memorial Sloan Kettering Cancer Center, New York, New York.
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14
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Pulvirenti A, Rao D, Mcintyre CA, Gonen M, Tang LH, Klimstra DS, Fleisher M, Ramanathan LV, Reidy-Lagunes D, Allen PJ. Limited role of Chromogranin A as clinical biomarker for pancreatic neuroendocrine tumors. HPB (Oxford) 2019; 21:612-618. [PMID: 30366884 PMCID: PMC8720376 DOI: 10.1016/j.hpb.2018.09.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/09/2018] [Accepted: 09/27/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Serum Chromogranin A (CgA) is widely used as a biomarker for pancreatic neuroendocrine tumors (PanNETs). The aim of this study was to investigate the value of CgA as a diagnostic and prognostic marker for well-differentiated PanNETs. METHODS Patients with well-differentiated PanNET and a baseline CgA measurement, between 2011 and 2016 were reviewed. The diagnostic value was determined by comparing CgA values from patients with PanNETs to those with other pancreatic neoplasms and healthy controls. The Kaplan-Meier method was used to investigate the CgA prognostic significance. RESULTS Ninety-nine patients met inclusion criteria. As a diagnostic marker, CgA had a sensitivity of 66%, specificity of 95%, and overall accuracy of 71%. The use of PPIs was associated with a higher CgA level (p = 0.015). When excluding patients on PPIs, CgA accuracy in distinguishing PanNETs from other pancreatic neoplasms was 66%, the sensitivity and specificity were 60% and 75% respectively. Elevated CgA (p = 0.004), Ki67% (p < 0.001), tumor grade (p < 0.001) and stage of disease (p = 0.036) were associated with disease-specific survival. CONCLUSION CgA has a limited role as a diagnostic biomarker for well-differentiated PanNETs. An elevated CgA level may have prognostic value but its role should be further investigated with respect to other known pathological factors.
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Affiliation(s)
| | - Deepthi Rao
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Caitlin A Mcintyre
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mithat Gonen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Laura H Tang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David S Klimstra
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lakshmi V Ramanathan
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Diane Reidy-Lagunes
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter J Allen
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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15
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Scher HI, Mccormack RT, Molina A, Smith MR, Dreicer R, Saad F, De Wit R, Fizazi K, Aftab DT, Limon A, Fleisher M, De Bono JS, Kelloff GJ, Heller G. Assessment of circulating tumor cell number as a transitional surrogate endpoint for survival in phase II trials for metastatic castration-resistant prostate cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
143 Background: Short-term measures of response that reflect clinical benefit are a critical unmet need for clinical trials for mCRPC. Using data from 5 randomized mCRPC trials, we showed that a response endpoint (RE) based on a change in CTC number using the FDA cleared CellSearch® (Menarini) platform from any, (≥ 1, CTC any) to 0 (CTC0) per 7.5 ml of blood was associated strongly with overall survival (OS). Here we explored whether different CTC and PSA REs could serve as “transitional surrogates” defined as a biomarker validated in phase 2 but not in phase 3 trials for overall survival (OS), using the baseline and week 13 prostate-specific antigen (PSA) level and CTC counts. Methods: Four 13-week REs were studied: (i) PSA50 (≥ 50% PSA decline from baseline), (ii) CTC0 (≥ 1 CTC/7.5 ml of blood at baseline and 0 CTCs at week 13), (iii) both PSA50 and CTC0, and (iv) either PSA50 or CTC0. The relative effectiveness of these REs as transitional surrogates for OS was evaluated at the patient level by discrimination, the separation between responder and non-responder survival curves, and at the trial level using explained variation, the accuracy in predicting k-month survival in a trial with the response proportion. Results: A total of 6081 pts were enrolled of whom 5660 (93%) survived until week 13 and among these patients 3080 (54%) had a baseline CTC count ≥ 1 and baseline PSA ≥ 5 ng/ml. At the patient level, separation between responder and non-responder survival curves over time was greater using CTC0 than PSA50 (average difference in survival probability 0.35 vs. 0.29, respectively). At the trial level, explained variation in survival over time was also greater for CTC0 than PSA50 (average R-squared 0.67 vs. 0.58, respectively). CTC/PSA combination REs did not improve on CTC0 at either level. Conclusions: The CTC0 RE provides stronger discrimination than PSA50 at the patient level and greater observed explained variation at the trial level. The results suggest that for the individual patient, a decrease in CTCs to zero at week 13 is a stronger indicator of longer term OS than the more widely used PSA50 and serves as a reasonably likely surrogate for OS in clinical trials.
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Affiliation(s)
| | | | | | | | | | - Fred Saad
- Centre Hospitalier de l’Université de Montréal, Université de Montréal, Montréal, QC, Canada
| | - Ronald De Wit
- Erasmus University Medical Center, Rotterdam, Netherlands
| | - Karim Fizazi
- Gustave Roussy, University of Paris Sud, Villejuif, France
| | | | | | | | - Johann S. De Bono
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | - Glenn Heller
- Memorial Sloan Kettering Cancer Center, New York, NY
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16
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Kirilova EM, Puckins AI, Romanovska E, Fleisher M, Belyakov SV. Novel amidine derivatives of benzanthrone: Effect of bromine atom on the spectral parameters. Spectrochim Acta A Mol Biomol Spectrosc 2018; 202:41-49. [PMID: 29777933 DOI: 10.1016/j.saa.2018.05.029] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 05/05/2018] [Accepted: 05/08/2018] [Indexed: 06/08/2023]
Abstract
Several new substituted amidine derivatives of benzanthrone were synthesized by condensation reaction from 2-bromo-3-aminobenzo[de]anthracen-7-one and appropriate aromatic or aliphatic amides. The novel benzanthrone derivatives were characterized by TLC analysis, NMR, IR, MS, UV/Vis, and fluorescence spectroscopy. The obtained derivatives have yellow or orange fluorescence in organic solvents. The solvent effect on photophysical behaviors of these dyes was investigated, and the results showed that the introduction of a bromine atom causes a blue-shift of the absorption and emission bands and decrease in the fluorescent quantum yield in comparison with unbromated analogues. The difference in the excited state and the ground state dipole moments was estimated by using the variation of Stokes shift and by semiempirical molecular calculations. The crystal structure and packing of four novel dyes has been revealed by the X-ray single crystal structure analysis.
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Affiliation(s)
- E M Kirilova
- Institute of Life Sciences and Technology, Daugavpils University, Daugavpils, Latvia.
| | - A I Puckins
- Institute of Life Sciences and Technology, Daugavpils University, Daugavpils, Latvia
| | - E Romanovska
- Institute of Life Sciences and Technology, Daugavpils University, Daugavpils, Latvia
| | - M Fleisher
- Latvian Institute of Organic Synthesis, Aizkraukles str. 21, Riga LV-1006, Latvia
| | - S V Belyakov
- Latvian Institute of Organic Synthesis, Aizkraukles str. 21, Riga LV-1006, Latvia
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17
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Scher HI, Graf RP, Schreiber NA, Jayaram A, Winquist E, McLaughlin B, Lu D, Fleisher M, Orr S, Lowes L, Anderson A, Wang Y, Dittamore R, Allan AL, Attard G, Heller G. Assessment of the Validity of Nuclear-Localized Androgen Receptor Splice Variant 7 in Circulating Tumor Cells as a Predictive Biomarker for Castration-Resistant Prostate Cancer. JAMA Oncol 2018; 4:1179-1186. [PMID: 29955787 PMCID: PMC6139066 DOI: 10.1001/jamaoncol.2018.1621] [Citation(s) in RCA: 169] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/19/2018] [Indexed: 11/14/2022]
Abstract
Importance A blood test to determine whether to treat patients with metastatic castration-resistant prostate cancer (mCRPC) with an androgen receptor signaling (ARS) inhibitor or taxane is an unmet medical need. Objective To determine whether a validated assay for the nuclear-localized androgen receptor splice variant 7 (AR-V7) protein in circulating tumor cells can determine differential overall survival among patients with mCRPC treated with taxanes vs ARS inhibitors. Design, Setting, and Participants This blinded correlative study conducted from December 31, 2012, to September 1, 2016, included 142 patients with histologically confirmed mCRPC and who were treated at Memorial Sloan Kettering Cancer Center, The Royal Marsden, or the London Health Sciences Centre. Blood samples were obtained prior to administration of ARS inhibitors or taxanes as a second-line or greater systemic therapy for progressing mCRPC. Main Outcomes and Measures Overall survival after treatment with an ARS inhibitor or taxane in relation to pretherapy AR-V7 status. Results Among the 142 patients in the study (mean [SD] age, 69.5 [9.6] years), 70 were designated as high risk by conventional prognostic factors. In this high-risk group, patients positive for AR-V7 who were treated with taxanes had superior overall survival relative to those treated with ARS inhibitors (median overall survival, 14.3 vs 7.3 months; hazard ratio, 0.62; 95% CI, 0.28-1.39; P = .25). Patients negative for AR-V7 who were treated with ARS inhibitors had superior overall survival relative to those treated with taxanes (median overall survival, 19.8 vs 12.8 months; hazard ratio, 1.67; 95% CI, 1.00-2.81; P = .05). Conclusions and Relevance This study suggests that nuclear-localized AR-V7 protein in circulating tumor cells can identify patients who may live longer with taxane chemotherapy vs ARS inhibitor treatment.
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Affiliation(s)
- Howard I. Scher
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | | | - Nicole A. Schreiber
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anuradha Jayaram
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden National Health Service Foundation Trust, London, United Kingdom
| | - Eric Winquist
- Department of Oncology, Western University, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
| | - Brigit McLaughlin
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David Lu
- Epic Sciences, San Diego, California
| | - Martin Fleisher
- Clinical Chemistry Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sarah Orr
- Epic Sciences, San Diego, California
| | - Lori Lowes
- Department of Oncology, Western University, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
| | | | | | | | - Alison L. Allan
- Department of Oncology, Western University, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
| | - Gerhardt Attard
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden National Health Service Foundation Trust, London, United Kingdom
| | - Glenn Heller
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
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18
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Heller G, McCormack R, Kheoh T, Molina A, Smith MR, Dreicer R, Saad F, de Wit R, Aftab DT, Hirmand M, Limon-Carrera A, Fizazi K, Fleisher M, de Bono JS, Scher HI. Reply to C. Ren et al. J Clin Oncol 2018; 36:2354-2356. [PMID: 29894273 DOI: 10.1200/jco.2018.78.2672] [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: 11/20/2022] Open
Affiliation(s)
- Glenn Heller
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Robert McCormack
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Thian Kheoh
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Arturo Molina
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Matthew R Smith
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Robert Dreicer
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Fred Saad
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Ronald de Wit
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Dana T Aftab
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Mohammed Hirmand
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Ana Limon-Carrera
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Karim Fizazi
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Martin Fleisher
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Johann S de Bono
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | - Howard I Scher
- Glenn Heller, Memorial Sloan Kettering Cancer Center, New York, NY; Robert McCormack and Thian Kheoh, Janssen Research & Development, Raritan, NJ; Arturo Molina, Janssen Research & Development, Los Angeles, CA; Matthew R. Smith, Massachusetts General Hospital, Boston, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, Netherlands; Dana T. Aftab, Exelixis, South San Francisco, CA; Mohammed Hirmand, Medivation, San Francisco, CA; Ana Limon-Carrera, Takeda Oncology, Cambridge, MA; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom; and Howard I. Scher, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
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Lin X, Fleisher M, Rosenblum M, Lin O, Boire A, Briggs S, Bensman Y, Hurtado B, Shagabayeva L, DeAngelis LM, Panageas KS, Omuro A, Pentsova EI. Cerebrospinal fluid circulating tumor cells: a novel tool to diagnose leptomeningeal metastases from epithelial tumors. Neuro Oncol 2018; 19:1248-1254. [PMID: 28821205 PMCID: PMC5570249 DOI: 10.1093/neuonc/nox066] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [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: 12/27/2022] Open
Abstract
Background Diagnosis of leptomeningeal metastasis (LM) remains challenging due to low sensitivity of CSF cytology and infrequent unequivocal MRI findings. In a previous pilot study, we showed that rare cell capture technology (RCCT) could be used to detect circulating tumor cells (CTC) in the CSF of patients with LM from epithelial tumors. To establish the diagnostic accuracy of CSF-CTC in the diagnosis of LM, we applied this technique in a distinct, larger cohort of patients. Methods In this institutional review board-approved prospective study, patients with epithelial tumors and clinical suspicion of LM underwent CSF-CTC evaluation and standard MRI and CSF cytology examination. CSF-CTC enumeration was performed through an FDA-approved epithelial cell adhesion molecule-based RCCT immunomagnetic platform. LM was defined by either positive CSF cytology or imaging positive for LM. ROC analysis was utilized to define an optimal cutoff for CSF-CTC enumeration. Results Ninety-five patients were enrolled (36 breast, 31 lung, 28 others). LM was diagnosed in 30 patients (32%) based on CSF cytology (n = 12), MRI findings (n = 2), or both (n = 16). CSF-CTC were detected in 43/95 samples (median 19.3 CSF-CTC/mL, range 0.3 to 66.7). Based on ROC analysis, 1 CSF-CTC/mL provided the best threshold to diagnose LM, achieving a sensitivity of 93%, specificity of 95%, positive predictive value 90%, and negative predictive value 97%. Conclusions We defined ≥1 CSF-CTC/mL as the optimal cutoff for diagnosis of LM. CSF-CTC enumeration through RCCT is a robust tool to diagnose LM and should be considered in the routine LM workup in solid tumor patients.
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Affiliation(s)
- Xuling Lin
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martin Fleisher
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marc Rosenblum
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Oscar Lin
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Adrienne Boire
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Samuel Briggs
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yevgeniya Bensman
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Brenda Hurtado
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Larisa Shagabayeva
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lisa M DeAngelis
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Katherine S Panageas
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Antonio Omuro
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elena I Pentsova
- Department of Neurology, Department of Laboratory Medicine, Department of Pathology, and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
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Pietanza MC, Waqar SN, Krug LM, Dowlati A, Hann CL, Chiappori A, Owonikoko TK, Woo KM, Cardnell RJ, Fujimoto J, Long L, Diao L, Wang J, Bensman Y, Hurtado B, de Groot P, Sulman EP, Wistuba II, Chen A, Fleisher M, Heymach JV, Kris MG, Rudin CM, Byers LA. Randomized, Double-Blind, Phase II Study of Temozolomide in Combination With Either Veliparib or Placebo in Patients With Relapsed-Sensitive or Refractory Small-Cell Lung Cancer. J Clin Oncol 2018; 36:2386-2394. [PMID: 29906251 PMCID: PMC6085179 DOI: 10.1200/jco.2018.77.7672] [Citation(s) in RCA: 260] [Impact Index Per Article: 43.3] [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: 12/12/2022] Open
Abstract
Purpose Both temozolomide (TMZ) and poly (ADP-ribose) polymerase (PARP) inhibitors are active in small-cell lung cancer (SCLC). This phase II, randomized, double-blind study evaluated whether addition of the PARP inhibitor veliparib to TMZ improves 4-month progression-free survival (PFS). Patients and Methods A total of 104 patients with recurrent SCLC were randomly assigned 1:1 to oral veliparib or placebo 40 mg twice daily, days 1 to 7, and oral TMZ 150 to 200 mg/m2/day, days 1 to 5, of a 28-day cycle until disease progression, unacceptable toxicity, or withdrawal of consent. Response was determined by imaging at weeks 4 and 8, and every 8 weeks thereafter. Improvement in PFS at 4 months was the primary end point. Secondary objectives included overall response rate (ORR), overall survival (OS), and safety and tolerability of veliparib with TMZ. Exploratory objectives included PARP-1 and SLFN11 immunohistochemical expression, MGMT promoter methylation, and circulating tumor cell quantification. Results No significant difference in 4-month PFS was noted between TMZ/veliparib (36%) and TMZ/placebo (27%; P = .19); median OS was also not improved significantly with TMZ/veliparib (8.2 months; 95% CI, 6.4 to 12.2 months; v 7.0 months; 95% CI, 5.3 to 9.5 months; P = .50). However, ORR was significantly higher in patients receiving TMZ/veliparib compared with TMZ/placebo (39% v 14%; P = .016). Grade 3/4 thrombocytopenia and neutropenia more commonly occurred with TMZ/veliparib: 50% versus 9% and 31% versus 7%, respectively. Significantly prolonged PFS (5.7 v 3.6 months; P = .009) and OS (12.2 v 7.5 months; P = .014) were observed in patients with SLFN11-positive tumors treated with TMZ/veliparib. Conclusion Four-month PFS and median OS did not differ between the two arms, whereas a significant improvement in ORR was observed with TMZ/veliparib. SLFN11 expression was associated with improved PFS and OS in patients receiving TMZ/veliparib, suggesting a promising biomarker of PARP-inhibitor sensitivity in SCLC.
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Affiliation(s)
- M Catherine Pietanza
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Saiama N Waqar
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lee M Krug
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Afshin Dowlati
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Christine L Hann
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Alberto Chiappori
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Taofeek K Owonikoko
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kaitlin M Woo
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Robert J Cardnell
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Junya Fujimoto
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lihong Long
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lixia Diao
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jing Wang
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Yevgeniva Bensman
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Brenda Hurtado
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Patricia de Groot
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Erik P Sulman
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ignacio I Wistuba
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Alice Chen
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Martin Fleisher
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - John V Heymach
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mark G Kris
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Charles M Rudin
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lauren Averett Byers
- M. Catherine Pietanza, Lee M. Krug, Mark G. Kris, and Charles M. Rudin, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College; Kaitlin M. Woo, Yevgeniva Bensman, Brenda Hurtado, and Martin Fleisher, Memorial Sloan Kettering Cancer Center, New York, NY; Saiama N. Waqar, Washington University School of Medicine in St. Louis, St Louis, MO; Afshin Dowlati, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, OH; Christine L. Hann, Johns Hopkins University, Baltimore; Alice Chen, National Institutes of Health, Bethesda, MD; Alberto Chiappori, H. Lee Moffitt Cancer Center, Tampa, FL; Taofeek K. Owonikoko, Emory University, Atlanta, GA; and Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, John V. Heymach, and Lauren Averett Byers, The University of Texas MD Anderson Cancer Center, Houston, TX
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Morikawa A, Pentsova E, Kemeny M, Patil S, Li BT, Tang K, Fleisher M, Van Poznak CH, Norton L, Seidman AD. Phase I study of intermittent high-dose lapatinib alternating with capecitabine for HER2-positive breast cancer with central nervous system metastases. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e14016] [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: 11/20/2022] Open
Affiliation(s)
| | | | | | - Sujata Patil
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Bob T. Li
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kendrick Tang
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Larry Norton
- Memorial Sloan Kettering Cancer Center, New York, NY
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Scher HI, Graf RP, Schreiber NA, Winquist E, McLaughlin B, Lu D, Orr S, Fleisher M, Lowes L, Anderson AKL, Wang Y, Dittamore RV, Allan AL, Attard G, Heller G. Validation of nuclear-localized AR-V7 on circulating tumor cells (CTC) as a treatment-selection biomarker for managing metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.273] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
273 Background: A previous analysis of 161 patients (pts) tested for nuclear-localized AR-V7(+) CTCs showed a therapy interaction between AR-V7 positivity and improved overall survival (OS) on taxane chemotherapy vs. androgen receptor signaling inhibitors (ARSI). To validate the use of the biomarker result for physician decision making, we prospectively analyzed an independent, multicenter, blinded, cross-sectional cohort (n = 225) to confirm a therapy interaction with AR-V7. We corrected for possible pt selection bias by the treating physician by analyzing the association of therapy to OS in low and high risk groups defined by the test cohort. Methods: Two analyses were performed: (1) the validation of a therapy interaction between AR-V7 positivity and superior OS benefit for pts treated with taxanes in the context of use for 2nd+ line pts; and (2) as the choice between ARSI or taxanes was at the discretion of the attending physician, pt risk was incorporated into the predictive biomarker assessment. A pt-specific risk score was developed from line of therapy and other covariates to stratify pts as low and high risk, and the association of AR-V7 status and OS was performed within each risk group to correct for physician decision making and address possible confounding with treatment assignment. Results: (1) A therapy interaction between AR-V7(+) pts and lower risk of death on taxanes vs. ARSI (HR: 0.23, p = 0.003, 95% CI: 0.09 – 0.61) was validated. (2) In the validation cohort, high risk AR-V7(+) pts had an OS benefit when treated with taxanes (p = 0.02) and the AR-V7(-) pts had an improved OS with ARSI therapy (p = 0.02). AR-V7 incidence was low in the low risk pts, precluding the analysis for this sub-cohort. Conclusions: The results validate that the nuclear-localized AR-V7(+) biomarker has an interaction with therapy and improved survival on taxanes. Further, when adjusting for pt risk, the biomarker is predictive of OS in the high risk group. Nuclear-localized AR-V7 protein in CTCs can aid in the decision between ARSI and taxane chemotherapy in the 2nd or greater line of therapy for mCRPC.
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Affiliation(s)
| | | | | | | | | | - David Lu
- Epic Sciences, Inc., San Diego, CA
| | | | | | - Lori Lowes
- London Health Sciences Centre, London, ON, Canada
| | | | | | | | - Alison L Allan
- London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada
| | - Gerhardt Attard
- Institute of Cancer Research and The Royal Marsden Hospital, Sutton, United Kingdom
| | - Glenn Heller
- Memorial Sloan Kettering Cancer Center, New York, NY
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Colón-Franco JM, Bossuyt PMM, Algeciras-Schimnich A, Bird C, Engstrom-Melnyk J, Fleisher M, Kattan M, Lambert-Messerlian G. Current and Emerging Multianalyte Assays with Algorithmic Analyses-Are Laboratories Ready for Clinical Adoption? Clin Chem 2018; 64:885-891. [PMID: 29343536 DOI: 10.1373/clinchem.2017.275677] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 12/12/2017] [Indexed: 11/06/2022]
Affiliation(s)
| | - Patrick M M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, Academic Medical Center, Amsterdam, the Netherlands
| | | | - Christopher Bird
- Medical and Scientific Affairs, Roche Diagnostics Corporation, Indianapolis, Indiana
| | - Julia Engstrom-Melnyk
- Medical and Scientific Affairs, Roche Diagnostics Corporation, Indianapolis, Indiana
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, New York City, New York
| | - Michael Kattan
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Geralyn Lambert-Messerlian
- Department of Pathology and Laboratory Medicine, Women and Infants' Hospital of Rhode Island, The Warren Alpert Medical School of Brown, Providence, Rhode Island
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Heller G, McCormack R, Kheoh T, Molina A, Smith MR, Dreicer R, Saad F, de Wit R, Aftab DT, Hirmand M, Limon A, Fizazi K, Fleisher M, de Bono JS, Scher HI. Circulating Tumor Cell Number as a Response Measure of Prolonged Survival for Metastatic Castration-Resistant Prostate Cancer: A Comparison With Prostate-Specific Antigen Across Five Randomized Phase III Clinical Trials. J Clin Oncol 2017; 36:572-580. [PMID: 29272162 DOI: 10.1200/jco.2017.75.2998] [Citation(s) in RCA: 161] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose Measures of response that are clinically meaningful and occur early are an unmet need in metastatic castration-resistant prostate cancer clinical research and practice. We explored, using individual patient data, week 13 circulating tumor cell (CTC) and prostate-specific antigen (PSA) response end points in five prospective randomized phase III trials that enrolled a total of 6,081 patients-COU-AA-301, AFFIRM, ELM-PC-5, ELM-PC-4, and COMET-1- ClinicalTrials.Gov identifiers: NCT00638690, NCT00974311, NCT01193257, NCT01193244, and NCT01605227, respectively. Methods Eight response end points were explored. CTC nonzero at baseline and 0 at 13 weeks (CTC0); CTC conversion (≥ 5 CTCs at baseline, ≤ 4 at 13 weeks-the US Food and Drug Administration cleared response measure); a 30%, 50%, and 70% decrease in CTC count; and a 30%, 50%, and 70% decrease in PSA level. Patients missing week-13 values were considered nonresponders. The discriminatory strength of each end point with respect to overall survival in each trial was assessed using the weighted c-index. Results Of the eight response end points, CTC0 and CTC conversion had the highest weighted c-indices, with smaller standard deviations. For CTC0, the mean (standard deviation) was 0.81 (0.04); for CTC conversion, 0.79 (0.03); for 30% decrease in CTC count, 0.72 (0.06); for 50% decrease in CTC count, 0.72 (0.06); for 70% decrease in CTC count, 0.73 (0.05); for 30% decrease in PSA level, 0.71 (0.03); for 50% decrease in PSA level, 0.72 (0.06); and for 70% decrease in PSA level, 0.74 (0.05). Seventy-five percent of eligible patients could be evaluated with the CTC0 end point, compared with 51% with the CTC conversion end point. Conclusion The CTC0 and CTC conversion end points had the highest discriminatory power for overall survival. Both are robust and meaningful response end points for early-phase metastatic castration-resistant prostate cancer clinical trials. CTC0 is applicable to a significantly higher percentage of patients than CTC conversion.
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Affiliation(s)
- Glenn Heller
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Robert McCormack
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Thian Kheoh
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Arturo Molina
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Matthew R Smith
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Robert Dreicer
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Fred Saad
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Ronald de Wit
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Dana T Aftab
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Mohammad Hirmand
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Ana Limon
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Karim Fizazi
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Martin Fleisher
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Johann S de Bono
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
| | - Howard I Scher
- Glenn Heller, Martin Fleisher, and Howard I. Scher, Memorial Sloan Kettering Cancer Center; Howard I. Scher, Weill Cornell Medical College, New York, NY; Robert McCormack, Janssen Research & Development, Raritan, NJ; Thian Kheoh and Arturo Molina, Janssen Research & Development, Los Angeles; Dana T. Aftab, Exelixis, South San Francisco; Mohammad Hirmand, Medivation, San Francisco, CA; Matthew R. Smith, Massachusetts General Hospital, Boston; Ana Limon, Takeda Oncology, Cambridge, MA; Robert Dreicer, University of Virginia Medical School, Charlottesville, VA; Fred Saad, University of Montreal, Montreal, Quebec, Canada; Ronald de Wit, Erasmus Medical Center, Rotterdam, the Netherlands; Karim Fizazi, Institut Gustave Roussy, Villejuif, and University of Paris Sud, Orsay, France; and Johann S. de Bono, The Institute of Cancer Research, and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
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Malani R, Fleisher M, Lin X, Omuro A, Groves MD, Lin N, Melisko M, Lassman AB, Jeyapalan S, Briggs S, DeAngelis L, Raizer J, Pentsova E. CMET-04. CEREBROSPINAL FLUID CIRCULATING TUMOR CELLS (CSF CTC) FOR PATIENT MONITORING AND RESPONSE TO TREATMENT. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox168.153] [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: 11/13/2022] Open
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Carroll BL, Fleisher M, Pessin MS, Ramanathan LV. Elevated Alkaline Phosphatase in a Cancer Patient: Think You Know the Source? J Appl Lab Med 2017; 2:440-443. [DOI: 10.1373/jalm.2017.024141] [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] [Received: 05/26/2017] [Accepted: 07/15/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Brittany L Carroll
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Melissa S Pessin
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Lakshmi V Ramanathan
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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Scher HI, Graf RP, Schreiber NA, McLaughlin B, Jendrisak A, Wang Y, Lee J, Greene S, Krupa R, Lu D, Bamford P, Louw JE, Dugan L, Vargas HA, Fleisher M, Landers M, Heller G, Dittamore R. Phenotypic Heterogeneity of Circulating Tumor Cells Informs Clinical Decisions between AR Signaling Inhibitors and Taxanes in Metastatic Prostate Cancer. Cancer Res 2017; 77:5687-5698. [PMID: 28819021 PMCID: PMC5666339 DOI: 10.1158/0008-5472.can-17-1353] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/07/2017] [Accepted: 08/09/2017] [Indexed: 01/25/2023]
Abstract
The heterogeneity of an individual patient's tumor has been linked to treatment resistance, but quantitative biomarkers to rapidly and reproducibly evaluate heterogeneity in a clinical setting are currently lacking. Using established tools available in a College of American Pathologists-accredited and Clinical Laboratory Improvement Amendments-certified clinical laboratory, we quantified digital pathology features on 9,225 individual circulating tumor cells (CTC) from 179 unique metastatic castration-resistant prostate cancer (mCRPC) patients to define phenotypically distinct cell types. Heterogeneity was quantified on the basis of the diversity of cell types in individual patient samples using the Shannon index and associated with overall survival (OS) in the 145 specimens collected prior to initiation of the second or later lines of therapy. Low CTC phenotypic heterogeneity was associated with better OS in patients treated with androgen receptor signaling inhibitors (ARSI), whereas high heterogeneity was associated with better OS in patients treated with taxane chemotherapy. Overall, the results show that quantifying CTC phenotypic heterogeneity can help inform the choice between ARSI and taxanes in mCRPC patients. Cancer Res; 77(20); 5687-98. ©2017 AACR.
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Affiliation(s)
- Howard I Scher
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | | | - Nicole A Schreiber
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Brigit McLaughlin
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | | | | | | | - David Lu
- Epic Sciences, La Jolla, California
| | | | | | | | - Hebert A Vargas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martin Fleisher
- Clinical Chemistry Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Glenn Heller
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
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Moskowitz A, Schöder H, Gavane S, Thoren K, Fleisher M, Yahalom J, McCall S, Fox S, Gerecitano J, Grewal R, Hamlin P, Horwitz S, Kumar A, Matasar M, Ni A, Noy A, Palomba M, Perales M, Portlock C, Sauter C, Straus D, Younes A, Zelenetz A, Moskowitz C. BASELINE METABOLIC TUMOR VOLUME IS AN INDEPENDENT PROGNOSTIC FACTOR FOR RELAPSED AND REFRACTORY HODGKIN LYMPHOMA PATIENTS RECEIVING PET-ADAPTED SALVAGE THERAPY WITH BRENTUXIMAB VEDOTIN AND AUGMENTED ICE. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A.J. Moskowitz
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - H. Schöder
- Nuclear Medicine; Memorial Sloan Kettering Cancer Center; New York USA
| | - S. Gavane
- Nuclear Medicine; Mt. Sinai Hospital; New York USA
| | - K.L. Thoren
- Clinical Chemistry Service; Memorial Sloan Kettering Cancer Center; New York USA
| | - M. Fleisher
- Clinical Chemistry Service; Memorial Sloan Kettering Cancer Center; New York USA
| | - J. Yahalom
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - S.J. McCall
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - S.Y. Fox
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - J. Gerecitano
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - R. Grewal
- Nuclear Medicine; Memorial Sloan Kettering Cancer Center; New York USA
| | - P.A. Hamlin
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - S. Horwitz
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - A. Kumar
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - M. Matasar
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - A. Ni
- Biostatistics; Memorial Sloan Kettering Cancer Center; New York USA
| | - A. Noy
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - M.L. Palomba
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - M. Perales
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - C.S. Portlock
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - C. Sauter
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - D. Straus
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - A. Younes
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - A.D. Zelenetz
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
| | - C.H. Moskowitz
- Lymphoma; Memorial Sloan Kettering Cancer Center; New York USA
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Malani R, Fleisher M, Lin X, Omuro AMP, Groves MD, Lin NU, Melisko ME, Lassman AB, Jeyapalan SA, Briggs S, DeAngelis LM, Raizer JJ, Pentsova E. Cerebrospinal fluid circulating tumor cells (CSF CTC) for real-time patient monitoring and response to treatment. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.11549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11549 Background: The validated CellSearch system (Janssen Diagnostics, LLC), utilizing an immunomagnetic CTC selection method based on EPCAM antibody conjugated ferroparticles, is an FDA-approved methodology for enumerating CTC from blood in pts with breast, prostate and colon cancers. The CellSearch system has been used to evaluate CSF CTC of pts with leptomeningeal metastasis (LM) and has demonstrated potential as a diagnostic marker and response to cancer treatment. We explored the use of CSF CTC enumeration in the follow-up of pts with LM from HER2+ cancers receiving intrathecal (IT) therapy, aimed at characterizing changes over time as a potential biomarker of treatment response. Methods: CSF from pts participating in an IRB-approved phase I/II dose escalation trial of IT trastuzumab for LM in HER2+ cancer (NCT01325207) was evaluated by CellSearch system. 3 ml CSF from a ventricular reservoir was collected for CSF CTC enumeration at pre-treatment Day 1 of each cycle and correlated with CSF cytology from the same sample, and with clinical and radiographic response. LM progression was defined as clinical, CSF cytologic or radiographic worsening. Results: 15 pts with HER2+ LM (14 breast, 1 colon) were enrolled; 13 were women. At baseline 7 pts had positive CSF cytology, the other patients had a diagnosis by MRI. Of the 15 pts, 10 had greater than 1 cycle of treatment to be evaluable; 5 pts progressed during cycle 1 (Table). Mean CSF CTC at baseline was 82 per 3ml (range 0-200); 2 pts had no detectable CSF CTCs. A numerical decrease in CSF CTC was observed in 5 pts after cycle 1 and remained low (mean =9.5, range 0-92) while disease was stable. 3 pts (pts.3, 4 and 7) demonstrated a rise in CSF CTCs roughly 1 month prior to disease progression. Conclusions: Changes in CSF CTCs enumeration in response to treatment may allow quantitative surveillance of treatment response. CSF CTCs may serve as a platform to assess treatment response or as an early biomarker of LM progression and should be further investigated. Clinical trial information: NCT01325207. [Table: see text]
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Affiliation(s)
- Rachna Malani
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Xuling Lin
- National Neuroscience Institute, Singapore, Singapore
| | | | | | | | - Michelle E. Melisko
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | | | | | - Samuel Briggs
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | | | - Jeffrey J. Raizer
- Robert H. Lurie Cancer Center of Northwestern University, Chicago, IL
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Scher HI, Jendrisak A, Schreiber NA, McLaughlin B, Graf RP, Rodriguez A, Fleisher M, Lee J, Kelvin J, Wang Y, Landers MA, Dittamore RV. Baseline CTC subtype to predict outcomes on mCRPC patients (pts) receiving enzalutamide (E) compared to abiraterone (A). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.5070] [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
5070 Background: Prior response to A or E does not predict sensitivity to E following A or A following E. The detection of AR-V7 predicts insensitivity to either drug, but identifies only a portion of non-responders. We previously identified 15 CTC subtypes based on unique phenotypic features in mCRPC pts, each with unique biology and different degree of likelihood of predicting resistance to either drug. Here we explored the relationship between individual subtypes and sensitivity to A vs. E, but not both. Methods: 107 pre-treatment blood samples from mCRPC pts starting A (n = 47) or E (n = 60) as a 1st or 2nd line of Tx were analyzed for CTCs utilizing the Epic Sciences platform. Samples were assayed for CTC subtypes based upon 15 pre-defined phenotypic CTC classifiers (Type A-O). Treatment outcomes were assessed by serial PSA changes and landmarked percent time of therapy progression on radiographs, and overall survival following either A or E. Cell type prevalence was also analyzed in relation to clinical outcomes, and subsets of the CTC subtypes subject to single cell NGS to ascertain genomic drivers common to each subtype. Results: CTCs were identified in 94% (101/107) of pt samples. One, cell Type K, found in 25% (27/107) of pts, was associated with a statistically significant inferior outcomes on E for all measures. Whereas similar outcomes were seen between K+ & K- pts treated with A. The distinct features of Cell Type K include a large nucleus, high nuclear entropy and high Nuclear/cytoplasmic AR terminal ratio; and a unique genomic profile enriched for cell cycle and DNA repair alterations relative to other CTC subtypes. Conclusions: The presence of specific CTC subtypes in pre-Rx phlebotomy samples associated with outcomes on A or E. A CTC subtype (Cell Type K) helped to identify pts with poor outcomes on E but not A vs. those without the cell type. Further biologic interrogation of K cells and ongoing clincial validation of the CTC subtype is planned. [Table: see text]
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Dittamore RV, Jendrisak A, Schreiber NA, McLaughlin B, Graf R, Rodriguez A, Fleisher M, Lee J, Kelvin J, Wang Y, Landers MA, Scher HI. Changes in CTC burden and prevalence of specific CTC subtypes in mCRPC patients (pts) receiving alpharadin (Ra-223) as single agent or in combination with other therapuetics (Tx). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.5076] [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
5076 Background: Ra-223 prolongs life in mCRPC pts with symptomatic osseous metastasis with inconsistent effects on PSA. Survival times are prolonged further when combined with Abi/Enza. Data from preclinical studies suggest that Ra-223 may sensitize tumors to DDR agents and/or biologic therapies. But predictive biomarkers of benefit to each or both combinationso are lacking. We studied CTC counts and the prevelance of specific CTC subtypes in patients before and following Ra-223 therapy, both as a single agent and in combination, to identify biomarkers of sensitivity and treatement efficacy, and effects of Ra-223 on tumor biology. Methods: Pre and ~4 week post RA-223 therapy blood samples were collected from 35 pts (2 samples each) given as a single agent (n = 20 pts) or in combination with other therapies (n = 15 pts, 9 w/ Enza, 5 w/ Abi, 1 w/ Taxane). Samples were processed and CTCs analyzed using the Epic Sciences platform. Total CTC count and the prevalence of specific CTC phenotypes present pre and post Rx were identified utilizing high content digital pathology and associated with therapy type and post-treatment change. Results: CTC declines were observed in 55% (11/20) and 60% (9/15) of pts treated with single agent and combination respectively. In Ra-223 alone pts, a novel CTC subtype (high N/C ratio, high nuclear area) was identified at baseline 11/20 samples (med = 33% of CTCs). Which was no longer detected in 10 (90%) of the pts treated. This contrasts with a second novel CTC subtype present at baseline in 4 pts (med CTC = 9%) that increased to 9 cases (med CTC = 18%) at follow-up. Conclusions: A subset of pts demonstrate post-therapy CTC declines following Ra-223 alone or in combination. A novel CTC subtype resolved by RA-223 in conjunction with total CTC kinetics may indicate pt benefit from Ra-223. A novel emergent CTC subtype has also been identified in pts already receiving Ra-223. Single CTC sequencing and protein analysys of these CTC subtypes are ongoing, and may help describe tumor evolution and sensitization to novel therapuetics.
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Carroll B, Fleisher M, Pessin MS, Richardson S, Ramanathan LV. Pseudohypocalcemia in Cancer Patients: A Recommendation for the Postanalytical Correction of Serum Calcium in Patients with Hypoalbuminemia. Clin Chem 2017; 63:1302-1304. [PMID: 28515104 DOI: 10.1373/clinchem.2017.272997] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Brittany Carroll
- Department of Laboratory Medicine Memorial Sloan Kettering Cancer Center New York, NY
| | - Martin Fleisher
- Department of Laboratory Medicine Memorial Sloan Kettering Cancer Center New York, NY
| | - Melissa S Pessin
- Department of Laboratory Medicine Memorial Sloan Kettering Cancer Center New York, NY
| | - Shaun Richardson
- Department of Laboratory Medicine Memorial Sloan Kettering Cancer Center New York, NY
| | - Lakshmi V Ramanathan
- Department of Laboratory Medicine Memorial Sloan Kettering Cancer Center New York, NY
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Mendu DR, Sternlicht H, Ramanathan LV, Pessin MS, Fleisher M, Dalbagni G, Jaimes EA, Kaltsas A, Glezerman IG. Two cases of spontaneous remission of non-parasitic chyluria. Clin Biochem 2017; 50:886-888. [PMID: 28478046 DOI: 10.1016/j.clinbiochem.2017.05.002] [Citation(s) in RCA: 4] [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] [Received: 04/20/2017] [Revised: 05/03/2017] [Accepted: 05/03/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Chyluria is a medical condition with presence of chyle in urine. The disease is most prevalent in South East Asian countries mostly caused by parasitic (Wuchereria bancrofti) infections. Our objective was to investigate the spontaneous remission of non-parasitic chyluria. DESIGN AND METHODS The spontaneous remission of non-parasitic chyluria cases were worked up with diagnostic investigations, clinical assessment and studied in detail with respect to their natural evolution. RESULTS We present two patients who were evaluated in the nephrology clinic with symptoms of milky urine and painless hematuria. Midnight blood smear was negative for filarial parasites. Urine culture was without mycobacteria. Urine cytology and IgG western blot for cysticercus were negative. Imaging for a lymphatic leak by lymphoscintigraphy was unrevealing. Chyluria resolved spontaneously in both patients. CONCLUSIONS In our cases, radiologic visualization via lymphoscintigraphy was unrevealing. The patients were managed conservatively and fortunately underwent spontaneous remission marked by the disappearance of chyluria within several months of her initial diagnosis. In our opinion this spontaneous remission could be due to unrevealed lymphatico-renal fistula collapse or sclerosis of lymphatics caused by contrast media.
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Affiliation(s)
- Damodara Rao Mendu
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Hillel Sternlicht
- Division of Nephrology, Department of Medicine, Lenox Hill Hospital, New York, NY, United States
| | - Lakshmi V Ramanathan
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Melissa S Pessin
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Guido Dalbagni
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Edgar A Jaimes
- Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medical College, New York, NY, United States; Renal Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Anna Kaltsas
- Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medical College, New York, NY, United States; Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Ilya G Glezerman
- Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medical College, New York, NY, United States; Renal Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
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Tecleab A, Miller L, Brewster A, Fleisher M, Ramanathan L. Unexpected Interference on Alere Triage B-Type Natriuretic Peptide Measurement. J Appl Lab Med 2017; 1:568-571. [PMID: 33379789 DOI: 10.1373/jalm.2016.021519] [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] [Received: 08/26/2016] [Accepted: 10/17/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Awet Tecleab
- Department of Pathology and Laboratory Medicine, Staten Island University Hospital, Staten Island, NY
| | - Lawrence Miller
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Aiden Brewster
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Lakshmi Ramanathan
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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Scher HI, Graf R, Jendrisak A, Schreiber NA, McLaughlin B, Greene S, Rodriguez A, Fleisher M, Lee J, Kelvin J, Wang Y, Landers MA, Dittamore RV. Single cell phenogenomic subtyping of circulating tumor cells (CTCs) identify intercellular tumor heterogeneity (het) and multiple resistance mechansisms in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.6_suppl.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
139 Background: Genomic profiling of metastatic tumors can identify mCRPC pts w/ “actionable” targets. However, responses from this approach are infrequent and not durable, broadly attributed to intra-tumor and intrer-cellular het. We sought to understand relationships between single CTC phenotypic and genomic patterns present when starting ARSi or taxane therapy (Tx) to develop more effective biomarker-directed treatment approaches. Methods: 9225 CTCs from 319 blood samples from 179 mCRPC pts were detected and digital phenotypically profiled using the Epic Sciences platform. Unsupervised clustering revealed 15 phenotypic CTC subtypes based on digital pathology features (Type ‘A’-‘O’). Phenotypic diversity was determined by a Shannon index of these subtypes in pt samples. Next, 856 CTCs representing each subtype were individually whole genome sequenced for copy number variation and genomic instability, to define phenogenomic single cell profile and taxonomy. Tx outcomes were associated with CTC profiles. Results: Pre-therapy identification of certain CTC phenotypic subtypes was associated with poor overall survival (OS) following ARSi and/or taxanes. 5/15 subtypes existed primarily in pts w/ high CTC het (84-94%, Bonferroni adjusted p < 0.05, permutation test), and linked to amp of AR and cMYC, and loss of TP53 and PTEN. Clusters of genomic events were linked to phenotypic features (i.e. small cell CTC w/AuroraK & nMYC amp) and provide single cell phenogenomic associations with pathways such as AR/PTEN feedback and DNA repair machinery. Conclusions: Presence ofspecific CTC subtypes was associated w/ poor survival on ARSi and/or taxanes and may inform Tx selection. Identifying CTC subtypes present in high het samples can provide insight into individual pt disease evolution and potential approaches to maximize benefit. Longitudinal monitoring of CTC phenogenomics is being studied in novel Tx trials.[Table: see text]
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Scher HI, Lu D, Schreiber NA, Louw J, Graf RP, Vargas HA, Johnson A, Jendrisak A, Bambury R, Danila D, McLaughlin B, Wahl J, Greene SB, Heller G, Marrinucci D, Fleisher M, Dittamore R. Association of AR-V7 on Circulating Tumor Cells as a Treatment-Specific Biomarker With Outcomes and Survival in Castration-Resistant Prostate Cancer. JAMA Oncol 2017; 2:1441-1449. [PMID: 27262168 DOI: 10.1001/jamaoncol.2016.1828] [Citation(s) in RCA: 485] [Impact Index Per Article: 69.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Importance A critical decision in the management of metastatic castration-resistant prostate cancer (mCRPC) is when to administer an androgen receptor signaling (ARS) inhibitor or a taxane. Objective To determine if pretherapy nuclear androgen-receptor splice variant 7 (AR-V7) protein expression and localization on circulating tumor cells (CTCs) is a treatment-specific marker for response and outcomes between ARS inhibitors and taxanes. Design, Setting, and Participants For this cross-sectional cohort study at Memorial Sloan Kettering Cancer Center, 265 men with progressive mCRPC undergoing a change in treatment were considered; 86 were excluded because they were not initiating ARS or taxane therapy; and 18 were excluded for processing time constraints, leaving 161 patients for analysis. Between December 2012 and March 2015, blood was collected and processed from patients with progressive mCRPC immediately prior to new line of systemic therapy. Patients were followed up to 3 years. Main Outcomes and Measures Prostate-specific antigen (PSA) response, time receiving therapy, radiographic progression-free survival (rPFS), and overall survival (OS). Results Overall, of 193 prospectively collected blood samples from 161 men with mCRPC, 191 were evaluable (128 pre-ARS inhibitor and 63 pretaxane). AR-V7-positive CTCs were found in 34 samples (18%), including 3% of first-line, 18% of second-line, and 31% of third- or greater line samples. Patients whose samples had AR-V7-positive CTCs before ARS inhibition had resistant posttherapy PSA changes (PTPC), shorter rPFS, shorter time on therapy, and shorter OS than those without AR-V7-positive CTCs. Overall, resistant PTPC were seen in 65 of 112 samples (58%) without detectable AR-V7-positive CTCs prior to ARS inhibition. There were statistically significant differences in OS but not in PTPC, time on therapy, or rPFS for patients with or without pretherapy AR-V7-positive CTCs treated with a taxane. A multivariable model adjusting for baseline factors associated with survival showed superior OS with taxanes relative to ARS inhibitors when AR-V7-positive CTCs were detected pretherapy (hazard ratio, 0.24; 95% CI, 0.10-0.57; P = .035). Conclusions and Relevance The results validate CTC nuclear expression of AR-V7 protein in men with mCRPC as a treatment-specific biomarker that is associated with superior survival on taxane therapy over ARS-directed therapy in a clinical practice setting. Continued examination of this biomarker in prospective studies will further aid clinical utility.
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Affiliation(s)
- Howard I Scher
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York2Department of Medicine, Weill Cornell Medical College, New York, New York
| | - David Lu
- Epic Sciences, La Jolla, California
| | - Nicole A Schreiber
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | - Hebert A Vargas
- Body Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York5Department of Radiology, Weill Cornell Medical College, New York, New York
| | | | | | - Richard Bambury
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York6Cancer Services, Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Daniel Danila
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York2Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Brigit McLaughlin
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | - Glenn Heller
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Martin Fleisher
- Clinical Chemistry Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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Byers LA, Krug L, Waqar S, Dowlati A, Hann C, Chiappori A, Owonikoko T, Woo K, Bensman Y, Hurtado B, Cardnell R, Diao L, Fan Y, Fujimoto J, Rodriguez-Canales J, Long L, Sulman E, Wistuba I, Wang J, Travis W, Chen A, Rudin C, Kris M, Fleisher M, Heymach J, Pietanza MC. MA11.07 Improved Small Cell Lung Cancer (SCLC) Response Rates with Veliparib and Temozolomide: Results from a Phase II Trial. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.466] [Citation(s) in RCA: 10] [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] [Indexed: 11/27/2022]
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Scher HI, Graf RP, Schreiber NA, McLaughlin B, Lu D, Louw J, Danila DC, Dugan L, Johnson A, Heller G, Fleisher M, Dittamore R. Nuclear-specific AR-V7 Protein Localization is Necessary to Guide Treatment Selection in Metastatic Castration-resistant Prostate Cancer. Eur Urol 2016; 71:874-882. [PMID: 27979426 DOI: 10.1016/j.eururo.2016.11.024] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [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: 09/28/2016] [Accepted: 11/16/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Circulating tumor cells (CTCs) expressing AR-V7 protein localized to the nucleus (nuclear-specific) identify metastatic castration-resistant prostate cancer (mCRPC) patients with improved overall survival (OS) on taxane therapy relative to the androgen receptor signaling inhibitors (ARSi) abiraterone acetate, enzalutamide, and apalutamide. OBJECTIVE To evaluate if expanding the positivity criteria to include both nuclear and cytoplasmic AR-V7 localization ("nuclear-agnostic") identifies more patients who would benefit from a taxane over an ARSi. DESIGN, SETTING, AND PARTICIPANTS The study used a cross-sectional cohort. Between December 2012 and March 2015, 193 pretherapy blood samples, 191 of which were evaluable, were collected and processed from 161 unique mCRPC patients before starting a new line of systemic therapy for disease progression at the Memorial Sloan Kettering Cancer Center. The association between two AR-V7 scoring criteria, post-therapy prostate-specific antigen (PSA) change (PTPC) and OS following ARSi or taxane treatment, was explored. One criterion required nuclear-specific AR-V7 localization, and the other required an AR-V7 signal but was agnostic to protein localization in CTCs. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSES Correlation of AR-V7 status to PTPC and OS was investigated. Relationships with survival were analyzed using multivariable Cox regression and log-rank analyses. RESULTS AND LIMITATIONS A total of 34 (18%) samples were AR-V7-positive using nuclear-specific criteria, and 56 (29%) were AR-V7-positive using nuclear-agnostic criteria. Following ARSi treatment, none of the 16 nuclear-specific AR-V7-positive samples and six of the 32 (19%) nuclear-agnostic AR-V7-positive samples had ≥50% PTPC at 12 weeks. The strongest baseline factor influencing OS was the interaction between the presence of nuclear-specific AR-V7-positive CTCs and treatment with a taxane (hazard ratio 0.24, 95% confidence interval 0.078-0.79; p=0.019). This interaction was not significant when nuclear-agnostic criteria were used. CONCLUSIONS To reliably inform treatment selection using an AR-V7 protein biomarker in CTCs, nuclear-specific localization is required. PATIENT SUMMARY We analyzed outcomes for patients with metastatic castration-resistant prostate cancer on androgen receptor signaling inhibitors and standard chemotherapy. Patients with circulating tumor cells that had AR-V7 protein in the cellular nuclei were very likely to survive longer on taxane-based chemotherapy, and tests unable to distinguish where the protein is located in the cell are not as predictive of benefit.
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MESH Headings
- Aged
- Aged, 80 and over
- Androgen Antagonists/therapeutic use
- Antineoplastic Agents, Phytogenic/therapeutic use
- Biomarkers, Tumor/blood
- Cell Nucleus/chemistry
- Cell Nucleus/pathology
- Chi-Square Distribution
- Cross-Sectional Studies
- Humans
- Kaplan-Meier Estimate
- Liquid Biopsy
- Male
- Middle Aged
- Multivariate Analysis
- Neoplastic Cells, Circulating/chemistry
- Neoplastic Cells, Circulating/pathology
- Patient Selection
- Predictive Value of Tests
- Prognosis
- Proportional Hazards Models
- Prostatic Neoplasms, Castration-Resistant/blood
- Prostatic Neoplasms, Castration-Resistant/drug therapy
- Prostatic Neoplasms, Castration-Resistant/mortality
- Prostatic Neoplasms, Castration-Resistant/pathology
- Protein Isoforms
- Receptors, Androgen/blood
- Taxoids/therapeutic use
- Time Factors
- Treatment Outcome
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Affiliation(s)
- Howard I Scher
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
| | | | - Nicole A Schreiber
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Brigit McLaughlin
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David Lu
- Epic Sciences, La Jolla, CA, USA
| | | | - Daniel C Danila
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | | | | | - Glenn Heller
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Martin Fleisher
- Clinical Chemistry Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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von Reibnitz D, Yorke E, Oh J, Apte A, Wu A, Fleisher M, Gelb E, Deasy J, Rimner A. Alpha-2-Macroglobulin as a Radioprotective Factor in Patients Undergoing Thoracic Radiation. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Scher H, Graf R, Schreiber N, Lu D, Louw J, Alvarez HV, Bambury R, Danila D, McLaughlin B, Heller G, Fleisher M, Dittamore R. Impact of AR-V7 protein localization in the prediction of therapeutic benefit of taxanes over androgen receptor signaling inhibitors (ARSi) in metastatic castration resistant prostate cancer (mCRPC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.12] [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: 11/13/2022] Open
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Pandit-Taskar N, O'Donoghue JA, Ruan S, Lyashchenko SK, Carrasquillo JA, Heller G, Martinez DF, Cheal SM, Lewis JS, Fleisher M, Keppler JS, Reiter RE, Wu AM, Weber WA, Scher HI, Larson SM, Morris MJ. First-in-Human Imaging with 89Zr-Df-IAB2M Anti-PSMA Minibody in Patients with Metastatic Prostate Cancer: Pharmacokinetics, Biodistribution, Dosimetry, and Lesion Uptake. J Nucl Med 2016; 57:1858-1864. [PMID: 27516450 DOI: 10.2967/jnumed.116.176206] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 06/01/2016] [Indexed: 11/16/2022] Open
Abstract
We conducted a phase I dose-escalation study with 89Zr-desferrioxamine-IAB2M (89Zr-IAB2M), an anti-prostate-specific membrane antigen minibody, in patients with metastatic prostate cancer. METHODS Patients received 185 MBq (5 mCi) of 89Zr-IAB2M and Df-IAB2M at total mass doses of 10 (n = 6), 20 (n = 6), and 50 mg (n = 6). Whole-body and serum clearance, normal-organ and lesion uptake, and radiation absorbed dose were estimated, and the effect of mass escalation was analyzed. RESULTS Eighteen patients were injected and scanned without side effects. Whole-body clearance was monoexponential, with a median biologic half-life of 215 h, whereas serum clearance showed biexponential kinetics, with a median biologic half-life of 3.7 (12.3%/L) and 33.8 h (17.9%/L). The radiation absorbed dose estimates were 1.67, 1.36, and 0.32 mGy/MBq to liver, kidney, and marrow, respectively, with an effective dose of 0.41 mSv/MBq (1.5 rem/mCi). Both skeletal and nodal lesions were detected with 89Zr-IAB2M, most visualized by 48-h imaging. CONCLUSION 89Zr-IAB2M is safe and demonstrates favorable biodistribution and kinetics for targeting metastatic prostate cancer. Imaging with 10 mg of minibody mass provides optimal biodistribution, and imaging at 48 h after injection provides good lesion visualization. Assessment of lesion targeting is being studied in detail in an expansion cohort.
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Affiliation(s)
- Neeta Pandit-Taskar
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York .,Department of Radiology, Weill Cornell Medical College, New York, New York
| | | | - Shutian Ruan
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Serge K Lyashchenko
- Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jorge A Carrasquillo
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Radiology, Weill Cornell Medical College, New York, New York
| | - Glenn Heller
- Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Danny F Martinez
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sarah M Cheal
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Radiology, Weill Cornell Medical College, New York, New York.,Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, New York.,Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martin Fleisher
- Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | - Anna M Wu
- ImaginAb, Inc., Inglewood, California; and
| | - Wolfgang A Weber
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Radiology, Weill Cornell Medical College, New York, New York
| | - Howard I Scher
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Steven M Larson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Radiology, Weill Cornell Medical College, New York, New York.,Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael J Morris
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weill Cornell Medical College, New York, New York
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Scher HI, Lu D, Schreiber NA, Louw J, Graf RP, Johnson A, Jendrisak A, Heller G, Bambury R, Vargas Alverez HA, McLaughlin B, Wahl J, Greene S, Fleisher M, Dittamore R. Abstract 4954: Nuclear localized AR-V7 protein as a predictive biomarker for treatment selection in metastatic castration resistant prostate cancer (mCRPC). Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-4954] [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: A critical decision in the management of patients (pts) with mCRPC is when to administer an androgen receptor signaling (ARS) directed or a taxane therapy. The detection of AR-V7 mRNA in CTCs has been shown to predict for resistance to ARS,but not to taxane chemotherapy. We evaluated the relationship between AR-V7 protein expression and localization on CTCs to treatment outcomes in a separate, larger cohort as a predictive biomarker for clinical decision making.
Methods: 193 prospectively collected blood samples from 161 unique pts with progressive mCRPC about to start an ARS or taxane therapy were evaluated with an Epic Sciences CTC immunoflorescent assay that assesses CTC AR-V7 protein expression and localization in individual
cells. Associations between the presence AR-V7(+) CTCs pre-therapy and anti-tumor effects post-therapy included prostate-specific antigen (PSA) changes, radiographic progression free survival (rPFS), time on therapy, and overall survival (OS).
Results: 130 pre-ARS inhibitor and 63 pre-taxane samples were assessed of which 191 (99%) were evaluable. AR-V7(+) CTCs were found in 34 (18%) samples including 3% of the 1st, 18% of the 2nd and 31% of the 3rd+ line baseline pre-therapy samples. Patients with AR-V7 positive CTCs in a pre-ARS sample showed no PSA response and had shorter rPFS, time on therapy, and OS than those without AR-V7(+) CTCs. PSA resistance to ARS was also seen in 65 of 112 (58%) of the AR-V7(-) samples. There was no association between PSA response, rPFS, and time on therapy between AR-V7(+) and AR-V7(-) pts treated with taxane therapy. In a multivariate model adjusting for age, type of therapy, line of therapy, and pre-therapy LDH, Hgb, and presence of visceral metastasis, AR-V7(+) pts had a superior OS on taxane therapy relative to ARS (HR: 0.242, CI: 0.103 to 0.569, p = 0.0350). Conclusions: The results validate the expression of the AR-V7 protein in the nucleus of CTCs in men with mCRPC as a treatment specific biomarker that predicts resistance to ARS inhibitor therapy and separately, clinical benefit with taxane therapy over ARS-directed therapy in a clinical practice setting. Continued examination of this biomarker in prospective studies will further determine its clinical utility.
Citation Format: Howard I. Scher, David Lu, Nicole A. Schreiber, Jessica Louw, Ryon P. Graf, Ann Johnson, Adam Jendrisak, Glenn Heller, Richard Bambury, Herbert A. Vargas Alverez, Brigit McLaughlin, Justin Wahl, Stephanie Greene, Martin Fleisher, Ryan Dittamore. Nuclear localized AR-V7 protein as a predictive biomarker for treatment selection in metastatic castration resistant prostate cancer (mCRPC). [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4954.
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Affiliation(s)
| | - David Lu
- 2Epic Sciences, Inc., San Diego, CA
| | | | | | | | | | | | - Glenn Heller
- 1Memorial Sloan Kettering Cancer Center, New York, NY
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Lorente D, Olmos D, Mateo J, Bianchini D, Seed G, Fleisher M, Danila DC, Flohr P, Crespo M, Figueiredo I, Miranda S, Baeten K, Molina A, Kheoh T, McCormack R, Terstappen LWMM, Scher HI, de Bono JS. Decline in Circulating Tumor Cell Count and Treatment Outcome in Advanced Prostate Cancer. Eur Urol 2016; 70:985-992. [PMID: 27289566 PMCID: PMC5568108 DOI: 10.1016/j.eururo.2016.05.023] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [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: 01/02/2016] [Accepted: 05/16/2016] [Indexed: 01/08/2023]
Abstract
Background Treatment response biomarkers are urgently needed for castration-resistant prostate cancer (CRPC). Baseline and post-treatment circulating tumor cell (CTC) counts of ≥5 cells/7.5 ml are associated with poor CRPC outcome. Objective To determine the value of a ≥30% CTC decline as a treatment response indicator. Design, setting, and participants We identified patients with a baseline CTC count ≥5 cells/7.5 ml and evaluable post-treatment CTC counts in two prospective trials. Intervention Patients were treated in the COU-AA-301 (abiraterone after chemotherapy) and IMMC-38 (chemotherapy) trials. Outcome measures and statistical analysis The association between a ≥30% CTC decline after treatment and survival was evaluated using univariable and multivariable Cox regression models at three landmark time points (4, 8, and 12 wk). Model performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and c-indices. Results Overall 486 patients (122 in IMMC-38 and 364 in COU-AA-301) had a CTC count ≥5 cells/7.5 ml at baseline, with 440, 380, and 351 patients evaluable at 4, 8, and 12 wk, respectively. A 30% CTC decline was associated with increased survival at 4 wk (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.36–0.56; p < 0.001), 8 wk (HR 0.41, 95% CI 0.33–0.53; p < 0.001), and 12 wk (HR 0.39, 95% CI 0.3–0.5; p < 0.001) in univariable and multivariable analyses. Stable CTC count (<30% fall or <30% increase) was not associated with a survival benefit when compared with increased CTC count. The association between a 30% CTC decline after treatment and survival was independent of baseline CTC count. CTC declines significantly improved the AUC at all time-points. Finally, in the COU-AA-301 trial, patients with CTC ≥5 cells/7.5 ml and a 30% CTC decline had similar overall survival in both arms. Conclusions A 30% CTC decline after treatment from an initial count ≥5 cells/7.5 ml is independently associated with CRPC overall survival following abiraterone and chemotherapy, improving the performance of a multivariable model as early as 4 wk after treatment. This potential surrogate must now be prospectively evaluated. Patient summary Circulating tumor cells (CTCs) are cancer cells that can be detected in the blood of prostate cancer patients. We analyzed changes in CTCs after treatment with abiraterone and chemotherapy in two large clinical trials, and found that patients who have a decline in CTC count have a better survival outcome.
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Affiliation(s)
- David Lorente
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK; Medical Oncology Service, Hospital Universitario La Fe, Valencia, Spain
| | - David Olmos
- Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain; CNIO-IBIMA Genitourinary Cancer Unit, Department of Medical Oncology, Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga, Spain
| | - Joaquin Mateo
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Diletta Bianchini
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - George Seed
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | | | | | - Penny Flohr
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Mateus Crespo
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Ines Figueiredo
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Susana Miranda
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - Kurt Baeten
- Medical Affairs, Janssen Diagnostics, Beerse, Belgium
| | | | - Thian Kheoh
- Janssen Research & Development, La Jolla, CA, USA
| | | | - Leon W M M Terstappen
- MIRA Research Institute for Biomedical Technology and Technical Medicine, University of Twente, Twente, The Netherlands
| | - Howard I Scher
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Johann S de Bono
- Prostate Cancer Targeted Therapy Group, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK.
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Scher HI, Jendrisak A, Graf R, Schreiber NA, McLaughlin B, Greene S, Rodriguez A, Louw J, Dugan L, Leitz L, Fleisher M, Lee J, Wang Y, Landers MA, Dittamore RV. CTC phenotype classifier to identify mCRPC patients (pts) with high genomic instability CTCs and to predict failure of androgen ecreptor signaling (AR Tx) and taxane (T) systemic therapies. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.5044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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)
- Howard I. Scher
- Sidney Kimmel Center for Prostate and and Urologic Cancers and Memorial Sloan-Kettering Cancer Center, New York, NY
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Danila DC, Thomas S, Rajpurohit YR, Herkal A, Gormley M, Dayan ES, Schreiber NA, Fleisher M, Ricci DS, Scher HI. Prostate cancer enhanced mRNA detection assay in whole blood as predictive biomarker of tumor sensitivity to targeted androgen inhibition for men with metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.5038] [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: 11/20/2022] Open
Affiliation(s)
- Daniel Costin Danila
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
| | | | | | - Amrita Herkal
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | | | | | - Howard I. Scher
- Sidney Kimmel Center for Prostate and and Urologic Cancers and Memorial Sloan-Kettering Cancer Center, New York, NY
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Pietanza MC, Krug LM, Waqar SN, Dowlati A, Hann CL, Chiappori A, Owonikoko TK, Woo K, Bensman Y, Hurtado B, Fujimoto J, Wistuba II, Travis WD, Chen AP, Heymach J, Kris MG, Fleisher M, Rudin CM, Byers LA. A multi-center, randomized, double-blind phase II study comparing temozolomide (TMZ) plus either veliparib (ABT-888), a PARP inhibitor, or placebo as 2nd or 3rd-line therapy for patients (Pts) with relapsed small cell lung cancers (SCLCs). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.8512] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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)
| | - Lee M. Krug
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Afshin Dowlati
- University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH
| | | | | | | | - Kaitlin Woo
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Junya Fujimoto
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Alice P. Chen
- Early Clinical Trials Development Program, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | - John Heymach
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mark G. Kris
- Memorial Sloan Kettering Cancer Center, New York, NY
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Scher HI, Graf R, Schreiber NA, McLaughlin B, Lu D, Louw J, Jendrisak A, Greene S, Rodriguez A, Dugan L, Fleisher M, Lee J, Wang Y, Landers MA, Dittamore RV. AR-V7 and CTC heterogeneity biomarkers additively to predict patient (pt) outcomes with taxanes relative to approved AR targeted therapy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.5013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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)
- Howard I. Scher
- Sidney Kimmel Center for Prostate and and Urologic Cancers and Memorial Sloan-Kettering Cancer Center, New York, NY
| | | | | | | | - David Lu
- Epic Sciences, Inc., San Diego, CA
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Belani CP, Dahlberg SE, Rudin CM, Fleisher M, Chen HX, Takebe N, Velasco MR, Tester WJ, Sturtz K, Hann CL, Shanks JC, Monga M, Ramalingam SS, Schiller JH. Vismodegib or cixutumumab in combination with standard chemotherapy for patients with extensive-stage small cell lung cancer: A trial of the ECOG-ACRIN Cancer Research Group (E1508). Cancer 2016; 122:2371-8. [PMID: 27163943 DOI: 10.1002/cncr.30062] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [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: 02/23/2016] [Revised: 03/30/2016] [Accepted: 04/01/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Preclinical targeting of the hedgehog pathway by vismodegib and of insulin-like growth factor 1 receptor by cixutumumab enhances the efficacy of chemotherapy and also demonstrates activity against the tumor cell fraction responsible for disease recurrence in small cell lung cancer. METHODS Patients with newly diagnosed extensive-stage small cell lung cancer (SCLC-ED) were randomized to receive four 21-day cycles of cisplatin and etoposide alone (cisplatin at 75 mg/m(2) on day 1 and etoposide at 100 mg/m(2) on days 1-3; arm A) or in combination with either vismodegib (150 mg/d by mouth; arm B) or cixutumumab (6 mg/kg/wk intravenously on day 1; arm C). The primary endpoint was progression-free survival (PFS). Circulating tumor cells (CTCs) were isolated/enumerated with the Veridex CellSearch platform at the baseline. RESULTS One hundred fifty-two eligible patients were treated. Patient demographics and disease characteristics were well balanced between the 3 arms except for the higher rate with a performance status of 0 in arm B (P = .03). The median PFS times in arms A, B, and C were 4.4, 4.4, and 4.6 months, respectively; the median overall survival (OS) times were 8.8, 9.8, and 10.1 months, respectively; and the response rates were 48%, 56%, and 50%, respectively. None of the comparisons of these outcomes were statistically significant. The median OS was 10.5 months for those with low CTC counts (≤100/7.5 mL) at baseline and 7.2 months for those with high CTC counts (hazard ratio, 1.74; P = .006). CONCLUSIONS There was no significant improvement in PFS or OS with the addition of either vismodegib or cixutumumab to chemotherapy in patients with SCLC-ED. A low baseline CTC count was associated with a favorable prognosis. Cancer 2016;122:2371-2378. © 2016 American Cancer Society.
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Affiliation(s)
| | - Suzanne E Dahlberg
- ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | | | | | | | | | | | - Keren Sturtz
- Colorado Cancer Research Program, Denver, Colorado
| | | | | | - Manish Monga
- West Virginia University, Morgantown, West Virginia
| | | | - Joan H Schiller
- University of Texas Southwestern Medical Center, Dallas, Texas
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Pentsova EI, Shah RH, Tang J, Boire A, You D, Briggs S, Omuro A, Lin X, Fleisher M, Grommes C, Panageas KS, Meng F, Selcuklu SD, Ogilvie S, Distefano N, Shagabayeva L, Rosenblum M, DeAngelis LM, Viale A, Mellinghoff IK, Berger MF. Evaluating Cancer of the Central Nervous System Through Next-Generation Sequencing of Cerebrospinal Fluid. J Clin Oncol 2016; 34:2404-15. [PMID: 27161972 PMCID: PMC4981784 DOI: 10.1200/jco.2016.66.6487] [Citation(s) in RCA: 263] [Impact Index Per Article: 32.9] [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: 12/22/2022] Open
Abstract
PURPOSE Cancer spread to the central nervous system (CNS) often is diagnosed late and is unresponsive to therapy. Mechanisms of tumor dissemination and evolution within the CNS are largely unknown because of limited access to tumor tissue. MATERIALS AND METHODS We sequenced 341 cancer-associated genes in cell-free DNA from cerebrospinal fluid (CSF) obtained through routine lumbar puncture in 53 patients with suspected or known CNS involvement by cancer. RESULTS We detected high-confidence somatic alterations in 63% (20 of 32) of patients with CNS metastases of solid tumors, 50% (six of 12) of patients with primary brain tumors, and 0% (zero of nine) of patients without CNS involvement by cancer. Several patients with tumor progression in the CNS during therapy with inhibitors of oncogenic kinases harbored mutations in the kinase target or kinase bypass pathways. In patients with glioma, the most common malignant primary brain tumor in adults, examination of cell-free DNA uncovered patterns of tumor evolution, including temozolomide-associated mutations. CONCLUSION The study shows that CSF harbors clinically relevant genomic alterations in patients with CNS cancers and should be considered for liquid biopsies to monitor tumor evolution in the CNS.
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Affiliation(s)
- Elena I Pentsova
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Ronak H Shah
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Jiabin Tang
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Adrienne Boire
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Daoqi You
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Samuel Briggs
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Antonio Omuro
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Xuling Lin
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Martin Fleisher
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Christian Grommes
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Katherine S Panageas
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Fanli Meng
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - S Duygu Selcuklu
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Shahiba Ogilvie
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Natalie Distefano
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Larisa Shagabayeva
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Marc Rosenblum
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Lisa M DeAngelis
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Agnes Viale
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
| | - Ingo K Mellinghoff
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY.
| | - Michael F Berger
- Elena I. Pentsova, Ronak H. Shah, Jiabin Tang, Adrienne Boire, Daoqi You, Samuel Briggs, Antonio Omuro, Xuling Lin, Martin Fleisher, Christian Grommes, Katherine S. Panageas, Fanli Meng, S. Duygu Selcuklu, Shahiba Ogilvie, Natalie Distefano, Larisa Shagabayeva, Marc Rosenblum, Lisa M. DeAngelis, Agnes Viale, Ingo K. Mellinghoff, and Michael F. Berger, Memorial Sloan Kettering Cancer Center; Ingo K. Mellinghoff, Weill-Cornell Graduate School of Biomedical Sciences; and Michael F. Berger, Weill-Cornell Medical College, New York, NY
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Pietanza MC, Litvak AM, Varghese AM, Krug LM, Fleisher M, Teitcher JB, Holodny AI, Sima CS, Woo KM, Ng KK, Won HH, Berger MF, Kris MG, Rudin CM. A phase I trial of the Hedgehog inhibitor, sonidegib (LDE225), in combination with etoposide and cisplatin for the initial treatment of extensive stage small cell lung cancer. Lung Cancer 2016; 99:23-30. [PMID: 27565909 DOI: 10.1016/j.lungcan.2016.04.014] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/15/2016] [Accepted: 04/23/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The Hedgehog pathway has been implicated in small cell lung cancer (SCLC) tumor initiation and progression. Pharmacologic blockade of the key Hedgehog regulator, Smoothened, may inhibit these processes. We performed a phase I study to determine the maximum tolerated dose (MTD) of sonidegib (LDE225), a selective, oral Smoothened antagonist, in combination with etoposide/cisplatin in newly diagnosed patients with extensive stage SCLC. MATERIALS AND METHODS Patients received 4-6 21-day cycles of etoposide/cisplatin with daily sonidegib. Patients with response or stable disease were continued on sonidegib until disease progression or unacceptable toxicity. Two dose levels of sonidegib were planned: 400mg and 800mg daily, with 200mg daily de-escalation if necessary. Next generation sequencing was performed on available specimens. Circulating tumor cells (CTCs) were quantified at baseline and with disease evaluation. RESULTS Fifteen patients were enrolled. 800mg was established as the recommended phase II dose of sonidegib in combination with etoposide/cisplatin. Grade 3 or greater toxicities included: anemia (n=5), neutropenia (n=8), CPK elevation (n=2), fatigue (n=2), and nausea (n=2). Toxicity led to removal of one patient from study. Partial responses were confirmed in 79% (11/14; 95% CI: 49-95%). One patient with SOX2 amplification remains progression-free on maintenance sonidegib after 27 months. CTC count, at baseline, was associated with the presence of liver metastases and after 1 cycle of therapy, with overall survival. CONCLUSIONS Sonidegib 800mg daily was the MTD when administered with EP. Further genomic characterization of exceptional responders may reveal clinically relevant predictive biomarkers that could tailor use in patients most likely to benefit.
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Affiliation(s)
- M Catherine Pietanza
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, United States.
| | - Anya M Litvak
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, United States
| | - Anna M Varghese
- Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Lee M Krug
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, United States
| | - Martin Fleisher
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jerrold B Teitcher
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Andrei I Holodny
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Cami S Sima
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Kaitlin M Woo
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Kenneth K Ng
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, United States
| | - Helen H Won
- Human Oncology & Pathogenesis Program (HOPP), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Michael F Berger
- Human Oncology & Pathogenesis Program (HOPP), Memorial Sloan Kettering Cancer Center, New York, NY, United States; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Mark G Kris
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, United States
| | - Charles M Rudin
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, United States
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