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Phase Ib clinical and pharmacodynamic study of the TIE2 kinase inhibitor rebastinib with paclitaxel or eribulin in HER2-negative metastatic breast cancer TIE2 激酶抑制剂瑞巴替尼与紫杉醇或艾瑞布林治疗 HER2 阴性转移性乳腺癌的 Ib 期临床和药效学研究
IF 11.5 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-12 DOI: 10.1158/1078-0432.ccr-24-2464
Jesus D. Anampa, Daniel L. Flynn, Cynthia Leary, Sun Oh, Xiaonan Xue, Maja H. Oktay, John S. Condeelis, Joseph A. Sparano
Purpose: Breast cancer cells disseminate to distant sites via Tumor Microenvironment of Metastasis (TMEM) doorways. The TIE2 inhibitor rebastinib blocks TMEM doorway function in the PyMT mouse model of breast cancer. We aimed to assess the safety and pharmacodynamics of rebastinib plus paclitaxel or eribulin in patients with HER2-negative metastatic breast cancer (MBC). Patients and Methods: This phase Ib trial enrolled 27 patients with MBC who received 50 mg or 100 mg of rebastinib PO BID in combination with weekly paclitaxel 80 mg/m2 (if ≤ 2 prior non-taxane regimens) or eribulin 1.4 mg/m2 on days 1 & 8 (if ≥ 1 prior regimen). Safety, tolerability and pharmacodynamic parameters indicating TIE2 kinase inhibition and TMEM doorway function were evaluated. Results: No dose-limiting toxicities in cycle 1 or 2 were observed among the first 12 patients at either rebastinib dose level. The most common treatment-emergent adverse events (AEs) were anemia (85%), fatigue (78%), anorexia (67%), leukopenia (67%), increased alanine aminotransferase (59%), hyperglycemia (56%), nausea (52%), and neutropenia (52%). AEs attributed to rebastinib include muscular weakness and myalgias. Intraocular pressure increased at the 100 mg rebastinib dose level, whereas angiopoietin-2 levels increased at both dose levels, providing pharmacodynamic evidence for TIE2 blockade. Circulating tumor cells decreased significantly with the combined treatment. Objective response occurred in 5/23 (22%) evaluable patients. Conclusions: In patients with MBC, the recommended phase 2 dose of rebastinib associated with pharmacodynamic evidence of TIE2 inhibition is either 50 or 100 mg PO BID in combination with paclitaxel or eribulin.
目的:乳腺癌细胞通过肿瘤转移微环境(TMEM)通道向远处扩散。在 PyMT 乳腺癌小鼠模型中,TIE2 抑制剂瑞巴替尼可阻断 TMEM 门道功能。我们旨在评估瑞巴替尼联合紫杉醇或艾瑞布林治疗HER2阴性转移性乳腺癌(MBC)患者的安全性和药效学。患者和方法:这项Ib期试验共招募了27名MBC患者,他们接受了50毫克或100毫克瑞巴替尼静脉滴注,每周与紫杉醇80毫克/平方米(如果既往接受过≤2种非他坦类药物治疗)或埃里布林1.4毫克/平方米(如果既往接受过≥1种药物治疗)在第1& 8天联合用药。对安全性、耐受性以及表明TIE2激酶抑制和TMEM门路功能的药效学参数进行了评估。结果首批12名患者在第1或第2周期接受瑞巴替尼治疗时均未出现剂量限制性毒性反应。最常见的治疗突发不良事件(AEs)为贫血(85%)、疲劳(78%)、厌食(67%)、白细胞减少(67%)、丙氨酸氨基转移酶升高(59%)、高血糖(56%)、恶心(52%)和中性粒细胞减少(52%)。瑞巴替尼引起的不良反应包括肌无力和肌痛。100毫克瑞巴替尼剂量水平的眼压升高,而两个剂量水平的血管生成素-2水平均升高,为TIE2阻断提供了药效学证据。联合治疗后,循环肿瘤细胞明显减少。5/23(22%)名可评估患者出现了客观反应。结论对于MBC患者,有药效学证据表明TIE2抑制作用的瑞巴替尼2期推荐剂量为50或100毫克,PO BID,与紫杉醇或艾瑞布林联合用药。
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引用次数: 0
Targeting T-cell costimulation to the surface of tumor cells 以肿瘤细胞表面的 T 细胞成本刺激为目标
IF 11.5 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-12 DOI: 10.1158/1078-0432.ccr-24-3003
Iñaki Eguren-Santamaría, Miguel F. Sanmamed, Paula Molero-Glez, Jose Luis Perez-Gracia, Ignacio Melero
Bispecific agents targeting tumor-cell surface antigens and activating receptors on T lymphocytes are being developed for solid tumors. Effective and safe strategies depend on target specificity and at least relative tumor-tissue confinement of T-cell activation. Novel evidence suggests that constructs targeting HER2 on tumor cells with the aim of providing costimulation (signal-2) to T lymphocytes via CD137 (4-1BB) are safe and can meaningfully invigorate antitumor responses in a proportion of patients.
目前正在开发针对肿瘤细胞表面抗原和 T 淋巴细胞活化受体的双特异性制剂,以治疗实体瘤。有效而安全的策略取决于靶点的特异性和 T 细胞激活至少在肿瘤组织间的相对封闭性。新证据表明,以肿瘤细胞上的 HER2 为靶点,通过 CD137(4-1BB)向 T 淋巴细胞提供成本刺激(信号-2)的构建物是安全的,并能有效激活一部分患者的抗肿瘤反应。
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引用次数: 0
A Phase 2 study of acimtamig (AFM13) in patients with CD30-positive, relapsed or refractory peripheral T-cell lymphomas 针对 CD30 阳性、复发或难治性外周 T 细胞淋巴瘤患者的 acimtamig (AFM13) 2 期研究
IF 11.5 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-12 DOI: 10.1158/1078-0432.ccr-24-1913
Won Seog. Kim, Jake Shortt, Pier Luigi Zinzani, Natalia Mikhailova, Dejan Radeski, Vincent Ribrag, Eva Domingo Domenech, Ahmed Sawas, Karenza Alexis, Michael Emig, Riham Elbadri, Pallavi Hajela, Paulien Ravenstijn, Sheena Pinto, Linta Garcia, Andre Overesch, Kerstin Pietzko, Steven Horwitz
Background: Patients with relapsed or refractory (R/R) peripheral T-cell lymphoma (PTCL) generally have poor prognoses and limited treatment options. Materials & Methods: This study evaluated the efficacy of a novel CD30/CD16A bispecific innate cell engager, acimtamig (AFM13), in patients with R/R PTCL. Patients included those with CD30 expression in ≥1% of tumor cells and who were R/R following ≥1 prior line of systemic therapy. Acimtamig (200 mg) was administered once weekly in 8-week cycles. The primary endpoint was overall response rate (ORR) by fluorodeoxyglucose-positron emission tomography per independent review committee; secondary and exploratory endpoints included duration of response (DoR), safety, progression-free survival, and overall survival. Results: The ORR in 108 patients was 32.4% (95% CI: 23.7, 42.1) with a complete response rate of 10.2% (95% CI: 5.2, 17.5); median DoR was 2.3 months (95% CI: 1.9, 6.5). Patients with R/R angioimmunoblastic T-cell lymphoma exhibited the greatest number of responses (53.3% [95% CI: 34.3, 71.7]). Responses were independent of CD30 expression level, prior brentuximab vedotin treatment, or steroid premedication. Acimtamig exhibited a tolerable safety profile; the most common treatment-related adverse events were infusion-related reactions in 27 patients (25.0%) and neutropenia in 11 patients (10.2%). No cases of cytokine release syndrome or acimtamig-related deaths were reported. Despite exhibiting promising clinical activity and tolerable safety in a heavily pretreated PTCL population, the study did not meet the criteria for the primary endpoint. Conclusions: The promising clinical efficacy observed warrants further investigation, and development of acimtamig for patients with R/R CD30+ lymphomas continues in combination with allogeneic natural killer cells.
背景:复发或难治性(R/R)外周T细胞淋巴瘤(PTCL)患者一般预后较差,治疗方案有限。材料与amp; 方法:本研究评估了新型 CD30/CD16A 双特异性先天性细胞吞噬因子 acimtamig (AFM13) 在 R/R PTCL 患者中的疗效。患者包括肿瘤细胞中CD30表达量≥1%、既往接受过≥1种系统疗法的R/R患者。Acimtamig(200毫克)每周给药一次,周期为8周。主要终点是独立审查委员会通过氟脱氧葡萄糖正电子发射断层扫描检测的总反应率(ORR);次要和探索性终点包括反应持续时间(DoR)、安全性、无进展生存期和总生存期。研究结果108例患者的ORR为32.4%(95% CI:23.7, 42.1),完全应答率为10.2%(95% CI:5.2, 17.5);中位应答持续时间为2.3个月(95% CI:1.9, 6.5)。R/R血管免疫母细胞T细胞淋巴瘤患者的应答率最高(53.3% [95% CI: 34.3, 71.7])。应答与CD30表达水平、先前的布仑妥昔单抗维多汀治疗或类固醇预处理无关。Acimtamig具有可耐受的安全性;最常见的治疗相关不良事件是27例患者(25.0%)出现输液相关反应,11例患者(10.2%)出现中性粒细胞减少。没有细胞因子释放综合征或阿昔替尼相关死亡病例的报道。尽管该研究在重度预处理的PTCL人群中显示出良好的临床活性和可耐受的安全性,但仍未达到主要终点的标准。结论:acimtamig与异体自然杀伤细胞联合用于R/R CD30+淋巴瘤患者的研究仍在继续。
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引用次数: 0
Personalized MRD Assessment in Peri-surgical ctDNA for Prognostic Prediction in Hepatocellular Carcinoma 用于肝细胞癌预后预测的手术前ctDNA个性化MRD评估
IF 11.5 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-11 DOI: 10.1158/1078-0432.ccr-24-1897
Jie Hu, Haoran Tang, Can-Can Jia, Xiang-Yu Zhang, Ying Xu, Jin-Peng Tan, Jia Fan, Shidong Jia, Jian Zhou
Objective: Detecting residual disease is a critical clinical requirement in the peri-surgical management of patients with resectable hepatocellular carcinoma (HCC). Previous studies focused on specific genomic regions exhibiting limited sensitivity and failed to meet the minimal residual disease (MRD) testing threshold. We introduce a next-generation sequencing (NGS) based assay, informed by baseline samples, facilitating MRD detection in hepatectomized HCC patients and offering prognostic predictions. Experimental Design: This study involved 88 HCC patients who underwent surgical resections January 2016 to May 2016 in Zhongshan Hospital Fudan University. Tumor and normal tissue samples were collected during surgery, while plasma samples were obtained both before surgery and up to seven days post-surgery. Using an NGS-based personalized circulating tumor DNA assay, we analyzed MRD in both pre-surgical and post-surgical blood samples and the correlation with prognosis. Results: With a median follow-up period of 80.7 months, our findings demonstrated significant correlations between pre-surgical ctDNA tumor fractions, post-surgical plasma MRD status, and both recurrence-free survival (RFS) and overall survival (OS). Post-surgical MRD status emerged as the most significant risk factor for cancer recurrence (HR=2.17, 95% CI: 1.09-4.30, p=0.027) compared to other clinical characteristics in multivariate Cox regression analysis. Notably, MRD status showed potential as a prognostic indicator among clinically low-recurrent-risk patients, such as those with BCLC stage 0-A, CNLC stage I-II. Conclusion: Evaluating personalized MRD provided crucial prognostic insights into RFS and OS. It efficiently identified patients at high risk of recurrence, even among those initially perceived as low-risk cases.
目的:检测残留疾病是对可切除肝细胞癌(HCC)患者进行围手术期管理的一项关键临床要求。以往的研究侧重于特定的基因组区域,但灵敏度有限,无法达到最小残留病(MRD)检测阈值。我们介绍了一种基于下一代测序(NGS)的检测方法,该方法以基线样本为依据,有助于肝切除的 HCC 患者的 MRD 检测并提供预后预测。实验设计:本研究涉及复旦大学附属中山医院 2016 年 1 月至 2016 年 5 月接受手术切除的 88 例 HCC 患者。肿瘤和正常组织样本在手术过程中采集,血浆样本在手术前和手术后七天内采集。我们使用基于NGS的个性化循环肿瘤DNA检测方法,分析了手术前和手术后血液样本中的MRD及其与预后的相关性。结果中位随访时间为 80.7 个月,我们的研究结果表明,手术前 ctDNA 肿瘤分数、手术后血浆 MRD 状态与无复发生存期(RFS)和总生存期(OS)之间存在显著相关性。在多变量考克斯回归分析中,与其他临床特征相比,手术后的MRD状态是癌症复发的最重要风险因素(HR=2.17,95% CI:1.09-4.30,p=0.027)。值得注意的是,MRD状态在临床低复发风险患者(如BCLC 0-A期、CNLC I-II期患者)中显示出作为预后指标的潜力。结论评估个体化MRD为RFS和OS提供了重要的预后见解。它能有效识别高复发风险患者,即使是最初被认为是低风险病例的患者也不例外。
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引用次数: 0
A tumor-naive ctDNA assay detects minimal residual disease in resected stage II or III colorectal cancer and predicts recurrence: subset analysis from the GALAXY study in CIRCULATE-Japan 无肿瘤ctDNA测定可检测切除的II期或III期结直肠癌中的极小残留病并预测复发:日本CIRCULATE的GALAXY研究子集分析
IF 11.5 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-08 DOI: 10.1158/1078-0432.ccr-24-2396
Yoshiaki Nakamura, Kristiyana Kaneva, Christine Lo, Daniel Neems, Jonathan E. Freaney, Hala Boulos, Seung Won Hyun, Farahnaz Islam, Jason Yamada-Hanff, Terri M. Driessen, Anne Sonnenschein, Dana F. DeSantis, Daisuke Kotani, Jun Watanabe, Masahito Kotaka, Saori Mishima, Hideaki Bando, Kentaro Yamazaki, Hiroya Taniguchi, Ichiro Takemasa, Takeshi Kato, Chithra Sangli, Robert Tell, Richard Blidner, Takayuki Yoshino, Kate Sasser, Eiji Oki, Halla Nimeiri
Purpose: Analysis of circulating tumor DNA (ctDNA) may enable early identification of patients likely to relapse, presenting an opportunity for early interventions and improved outcomes. Tumor-naïve plasma-only approaches for molecular residual disease (MRD) assessment accelerate turnaround time, enabling rapid treatment decisions and ongoing surveillance. Experimental Design: Plasma samples were obtained from 80 study participants with stage II or III colorectal cancer (CRC) selected from CIRCULATE-Japan GALAXY. MRD status was assessed using a tumor-naïve ctDNA assay (xM) that integrates methylation and genomic variant data, delivering a binary call. MRD was assessed at 4 weeks post-surgery (landmark timepoint (LMT)) using methylation and genomic variant data and longitudinally (median 22.1 months) using only methylation data. Results: At LMT, 69/80 study participants were evaluable (36 recurrent; 33 non-recurrent). Of recurrent study participants, 22/36 had detectable ctDNA (MRD+) at LMT and 29/33 non-recurrent study participants had undetectable ctDNA (MRD-), yielding clinical sensitivity of 61.1% and specificity of 87.9%. Additionally, 74 study participants were evaluable for longitudinal performance with a clinical sensitivity of 83.3% and specificity of 89.5%. Median lead time from first MRD+ result to recurrence was 4.77 months overall, and 5.30 months for study participants with no adjuvant treatment. At 12 weeks post-surgery, MRD status strongly correlated with disease-free survival (DFS) [adj. HR 9.69], outperforming carcinoembryonic antigen (CEA) correlation [HR 2.13]. Conclusions: This tumor-naïve MRD assay demonstrated clinically meaningful performance at LMT and longitudinally, accurately predicting clinical recurrence. MRD status was a stronger prognostic biomarker to DFS compared to standard of care CEA.
目的:循环肿瘤 DNA(ctDNA)分析可及早识别可能复发的患者,为早期干预和改善预后提供机会。用于分子残留病(MRD)评估的纯肿瘤血浆方法可加快周转时间,从而实现快速治疗决策和持续监测。实验设计:从 CIRCULATE-Japan GALAXY 中挑选的 80 名 II 期或 III 期结直肠癌 (CRC) 研究参与者采集血浆样本。MRD 状态是通过一种整合了甲基化和基因组变异数据并提供二元调用的肿瘤免疫ctDNA测定(xM)来评估的。使用甲基化和基因组变异数据在术后4周(标志性时间点(LMT))评估MRD,仅使用甲基化数据纵向评估MRD(中位22.1个月)。结果:在里程碑时间点,69/80 名研究参与者可进行评估(36 名复发;33 名非复发)。在复发性研究参与者中,22/36 在 LMT 检测到 ctDNA(MRD+),29/33 非复发性研究参与者检测不到 ctDNA(MRD-),临床敏感性为 61.1%,特异性为 87.9%。此外,74 名研究参与者可进行纵向表现评估,临床灵敏度为 83.3%,特异性为 89.5%。从首次MRD+结果到复发的中位时间为4.77个月,未接受辅助治疗的研究参与者的中位时间为5.30个月。术后12周时,MRD状态与无病生存期(DFS)密切相关[adj. HR 9.69],优于癌胚抗原(CEA)相关性[HR 2.13]。结论:这种对肿瘤不敏感的 MRD 检测方法在 LMT 和纵向上都表现出了有临床意义的性能,能准确预测临床复发。与标准疗法 CEA 相比,MRD 状态是更强的 DFS 预后生物标志物。
{"title":"A tumor-naive ctDNA assay detects minimal residual disease in resected stage II or III colorectal cancer and predicts recurrence: subset analysis from the GALAXY study in CIRCULATE-Japan","authors":"Yoshiaki Nakamura, Kristiyana Kaneva, Christine Lo, Daniel Neems, Jonathan E. Freaney, Hala Boulos, Seung Won Hyun, Farahnaz Islam, Jason Yamada-Hanff, Terri M. Driessen, Anne Sonnenschein, Dana F. DeSantis, Daisuke Kotani, Jun Watanabe, Masahito Kotaka, Saori Mishima, Hideaki Bando, Kentaro Yamazaki, Hiroya Taniguchi, Ichiro Takemasa, Takeshi Kato, Chithra Sangli, Robert Tell, Richard Blidner, Takayuki Yoshino, Kate Sasser, Eiji Oki, Halla Nimeiri","doi":"10.1158/1078-0432.ccr-24-2396","DOIUrl":"https://doi.org/10.1158/1078-0432.ccr-24-2396","url":null,"abstract":"Purpose: Analysis of circulating tumor DNA (ctDNA) may enable early identification of patients likely to relapse, presenting an opportunity for early interventions and improved outcomes. Tumor-naïve plasma-only approaches for molecular residual disease (MRD) assessment accelerate turnaround time, enabling rapid treatment decisions and ongoing surveillance. Experimental Design: Plasma samples were obtained from 80 study participants with stage II or III colorectal cancer (CRC) selected from CIRCULATE-Japan GALAXY. MRD status was assessed using a tumor-naïve ctDNA assay (xM) that integrates methylation and genomic variant data, delivering a binary call. MRD was assessed at 4 weeks post-surgery (landmark timepoint (LMT)) using methylation and genomic variant data and longitudinally (median 22.1 months) using only methylation data. Results: At LMT, 69/80 study participants were evaluable (36 recurrent; 33 non-recurrent). Of recurrent study participants, 22/36 had detectable ctDNA (MRD+) at LMT and 29/33 non-recurrent study participants had undetectable ctDNA (MRD-), yielding clinical sensitivity of 61.1% and specificity of 87.9%. Additionally, 74 study participants were evaluable for longitudinal performance with a clinical sensitivity of 83.3% and specificity of 89.5%. Median lead time from first MRD+ result to recurrence was 4.77 months overall, and 5.30 months for study participants with no adjuvant treatment. At 12 weeks post-surgery, MRD status strongly correlated with disease-free survival (DFS) [adj. HR 9.69], outperforming carcinoembryonic antigen (CEA) correlation [HR 2.13]. Conclusions: This tumor-naïve MRD assay demonstrated clinically meaningful performance at LMT and longitudinally, accurately predicting clinical recurrence. MRD status was a stronger prognostic biomarker to DFS compared to standard of care CEA.","PeriodicalId":10279,"journal":{"name":"Clinical Cancer Research","volume":"196 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genomic, epigenomic and transcriptomic inter- and intra-tumor heterogeneity in desmoid tumors 脱模瘤的基因组、表观基因组和转录组肿瘤间和肿瘤内异质性
IF 11.5 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-08 DOI: 10.1158/1078-0432.ccr-24-1240
Chelsea De Bellis, Sujay Vennam, Christopher Eeles, Pegah Rahimizadeh, Justin Cates, Thomas Stricker, Jenny Hoffman, Kristen Ganjoo, Gregory W. Charville, Benjamin Haibe-Kains, Matt van de Rijn, Joanna Przybyl
Purpose: Desmoid tumors are bland fibroblastic tumors that do not metastasize but have a high rate of local recurrence. Previously published studies proposed two different transcriptomic signatures to predict relapse. Molecular heterogeneity has been well established in high-grade sarcomas but little is known about molecular variability within locally aggressive tumors such as desmoids. Experimental Design: We performed transcriptomic profiling of 31 specimens from 20 primary desmoid tumors to identify genes predictive of relapse. We also performed multi-omic analysis including DNA methylation, copy number alterations, point mutations and gene expression on 24 specimens from different regions of primary and recurrent desmoid tumors from 3 patients (7-9 specimens per patient). Results: We observed highly variable expression of transcriptomic prognostic signatures, both in patients who did or did not progress. Signatures associated with favorable and unfavorable outcome were detected in different regions within the same tumor. Further multi-omic studies showed remarkable intra- and inter-tumor heterogeneity of genomic, epigenomic and transcriptomic patterns. The transcriptomic profiles showed the highest degree of variability within tumors and between primary and recurrent tumors from the same patient. Conclusions: This study shows an unexpected degree of intra- and inter-tumor heterogeneity in desmoid tumors. Our analysis indicates that molecular analysis of a single tumor biopsy may underestimate the magnitude of molecular alterations in desmoid tumors. Our study also shows that recurrent desmoid tumors acquire multiple new molecular alterations. Thus, molecular heterogeneity is an important consideration in drug development and validation of prognostic and predictive biomarkers for desmoid tumors.
目的:蝶形细胞瘤是一种不会转移但局部复发率很高的平滑纤维肿瘤。以前发表的研究提出了两种不同的转录组特征来预测复发。分子异质性在高级别肉瘤中已得到充分证实,但对局部侵袭性肿瘤(如类肉瘤)的分子变异性却知之甚少。实验设计:我们对来自 20 个原发性去瘤细胞的 31 份标本进行了转录组分析,以确定可预测复发的基因。我们还对 3 名患者(每名患者 7-9 份标本)不同区域的 24 份原发性和复发性类脂膜肿瘤标本进行了多组学分析,包括 DNA 甲基化、拷贝数改变、点突变和基因表达。结果:我们观察到转录组预后特征的表达变化很大,无论是在病情进展还是未进展的患者中。在同一肿瘤的不同区域检测到了与有利和不利预后相关的特征。进一步的多组学研究显示,基因组、表观基因组和转录组模式在肿瘤内和肿瘤间存在显著的异质性。转录组图谱显示肿瘤内部以及同一患者的原发肿瘤和复发肿瘤之间的变异程度最高。结论:这项研究显示,类脂膜瘤在肿瘤内和肿瘤间存在着意想不到的异质性。我们的分析表明,对单个肿瘤活检的分子分析可能低估了类苔藓瘤分子改变的程度。我们的研究还表明,复发的类苔藓瘤会出现多种新的分子改变。因此,分子异质性是开发药物和验证类脂膜瘤预后和预测生物标志物的一个重要考虑因素。
{"title":"Genomic, epigenomic and transcriptomic inter- and intra-tumor heterogeneity in desmoid tumors","authors":"Chelsea De Bellis, Sujay Vennam, Christopher Eeles, Pegah Rahimizadeh, Justin Cates, Thomas Stricker, Jenny Hoffman, Kristen Ganjoo, Gregory W. Charville, Benjamin Haibe-Kains, Matt van de Rijn, Joanna Przybyl","doi":"10.1158/1078-0432.ccr-24-1240","DOIUrl":"https://doi.org/10.1158/1078-0432.ccr-24-1240","url":null,"abstract":"Purpose: Desmoid tumors are bland fibroblastic tumors that do not metastasize but have a high rate of local recurrence. Previously published studies proposed two different transcriptomic signatures to predict relapse. Molecular heterogeneity has been well established in high-grade sarcomas but little is known about molecular variability within locally aggressive tumors such as desmoids. Experimental Design: We performed transcriptomic profiling of 31 specimens from 20 primary desmoid tumors to identify genes predictive of relapse. We also performed multi-omic analysis including DNA methylation, copy number alterations, point mutations and gene expression on 24 specimens from different regions of primary and recurrent desmoid tumors from 3 patients (7-9 specimens per patient). Results: We observed highly variable expression of transcriptomic prognostic signatures, both in patients who did or did not progress. Signatures associated with favorable and unfavorable outcome were detected in different regions within the same tumor. Further multi-omic studies showed remarkable intra- and inter-tumor heterogeneity of genomic, epigenomic and transcriptomic patterns. The transcriptomic profiles showed the highest degree of variability within tumors and between primary and recurrent tumors from the same patient. Conclusions: This study shows an unexpected degree of intra- and inter-tumor heterogeneity in desmoid tumors. Our analysis indicates that molecular analysis of a single tumor biopsy may underestimate the magnitude of molecular alterations in desmoid tumors. Our study also shows that recurrent desmoid tumors acquire multiple new molecular alterations. Thus, molecular heterogeneity is an important consideration in drug development and validation of prognostic and predictive biomarkers for desmoid tumors.","PeriodicalId":10279,"journal":{"name":"Clinical Cancer Research","volume":"33 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Randomized Phase II Study of Durvalumab with or without Tremelimumab in Patients with Metastatic Castration Resistant Prostate Cancer. 转移性阉割抗性前列腺癌患者使用或不使用特瑞莫司单抗治疗 Durvalumab 的随机 II 期研究。
IF 11.5 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-08 DOI: 10.1158/1078-0432.ccr-24-1612
Eric Winquist, Sebastien J. Hotte, Kim Chi, Srikala Sridhar, Susan Ellard, Michael Ong, Nayyer Iqbal, Muhammad Salim, Urban Emmenegger, Joel R. Gingerich, Aly-Khan Lalani, Pierre Major, Christian Kollmannsberger, Steven Yip, Aaron Hansen, Daygen Finch, Christina Canil, James Hutchenreuther, Francisco Vera-Badillo, Martin Smoragiewicz, Michael Cabanero, Ming-Sound Tsao, Elie Ritch, Alexander W. Wyatt, Lesley Seymour
PURPOSE: Programmed death-ligand 1 (PD-L1) is overexpressed by dendritic cells in patients with metastatic castration-resistant prostate cancer (mCRPC) progressing on androgen receptor pathway inhibitors. We tested whether checkpoint blockade could enhance antitumor activity in mCRPC. METHODS: In a multicenter open-label non-comparative randomized phase II study, patients with mCRPC treated with £ 1 prior cytotoxic chemotherapy, with measurable disease and progression on abiraterone and/or enzalutamide were randomized to durvalumab (D) 1500mg IV Q4 weeks ± 4 doses of tremelimumab (T) 75mg IV. The primary endpoint was objective response (OR) by iRECIST using a Simon 2-stage design. Correlative testing included PD-L1/CD8 immunohistochemistry on baseline tumour biopsies and deep targeted sequencing of plasma cell-free DNA. RESULTS: 52 patients were enrolled. Median age was 70 years (range, 50-83 years) and 52% had prior taxane therapy for mCRPC. In stage 1, 13 patients were randomized to D with no OR observed. D+T advanced to stage 2 with 39 patients enrolled (receiving a median 3 cycles, range 1-53). D+T related adverse events (AEs) were mainly £ grade 2 but led to discontinuation in 7 patients . There were seven OR (19.4% [95% confidence interval: 8.2-36.0%]; intention to treat (ITT) 17.9% [95% confidence interval: 7.5-33.5%]). Five responding tumours were PD-L1 positive and two exhibited DNA damage repair defects. Responses were observed without high tumour mutational burden or other genomic indices of immunotherapy sensitivity. CONCLUSION: D+T is active in mCRPC but patient selection remains a challenge. Further studies to develop predictive biomarkers are warranted.
目的:在使用雄激素受体通路抑制剂的转移性去势抵抗性前列腺癌(mCRPC)患者中,树突状细胞过度表达程序性死亡配体1(PD-L1)。我们测试了检查点阻断是否能增强 mCRPC 的抗肿瘤活性。方法:在一项多中心开放标签非比较随机II期研究中,既往接受过1次细胞毒性化疗的mCRPC患者,在阿比特龙和/或恩杂鲁胺治疗后出现可测量的疾病和进展,随机接受durvalumab (D) 1500mg IV Q4周±4次tremelimumab (T) 75mg IV治疗。主要终点是采用西蒙两阶段设计的iRECIST客观反应(OR)。相关检测包括基线肿瘤活检的PD-L1/CD8免疫组化和血浆细胞游离DNA深度靶向测序。结果:52 名患者入组。中位年龄为70岁(50-83岁),52%的患者曾因mCRPC接受过类固醇治疗。在第一阶段,13名患者被随机分配到D组,未观察到OR。D+T进入第二阶段,39名患者接受了治疗(中位3个周期,范围1-53)。与D+T相关的不良事件(AEs)主要为2级,但有7名患者因此停药。有 7 例 OR(19.4% [95% 置信区间:8.2-36.0%];意向治疗 (ITT) 17.9% [95% 置信区间:7.5-33.5%])。五例应答的肿瘤PD-L1阳性,两例表现出DNA损伤修复缺陷。在没有高肿瘤突变负荷或其他免疫疗法敏感性基因组指标的情况下,也观察到了反应。结论:D+T对mCRPC有积极作用,但患者选择仍是一项挑战。有必要进一步研究开发预测性生物标志物。
{"title":"Randomized Phase II Study of Durvalumab with or without Tremelimumab in Patients with Metastatic Castration Resistant Prostate Cancer.","authors":"Eric Winquist, Sebastien J. Hotte, Kim Chi, Srikala Sridhar, Susan Ellard, Michael Ong, Nayyer Iqbal, Muhammad Salim, Urban Emmenegger, Joel R. Gingerich, Aly-Khan Lalani, Pierre Major, Christian Kollmannsberger, Steven Yip, Aaron Hansen, Daygen Finch, Christina Canil, James Hutchenreuther, Francisco Vera-Badillo, Martin Smoragiewicz, Michael Cabanero, Ming-Sound Tsao, Elie Ritch, Alexander W. Wyatt, Lesley Seymour","doi":"10.1158/1078-0432.ccr-24-1612","DOIUrl":"https://doi.org/10.1158/1078-0432.ccr-24-1612","url":null,"abstract":"PURPOSE: Programmed death-ligand 1 (PD-L1) is overexpressed by dendritic cells in patients with metastatic castration-resistant prostate cancer (mCRPC) progressing on androgen receptor pathway inhibitors. We tested whether checkpoint blockade could enhance antitumor activity in mCRPC. METHODS: In a multicenter open-label non-comparative randomized phase II study, patients with mCRPC treated with £ 1 prior cytotoxic chemotherapy, with measurable disease and progression on abiraterone and/or enzalutamide were randomized to durvalumab (D) 1500mg IV Q4 weeks ± 4 doses of tremelimumab (T) 75mg IV. The primary endpoint was objective response (OR) by iRECIST using a Simon 2-stage design. Correlative testing included PD-L1/CD8 immunohistochemistry on baseline tumour biopsies and deep targeted sequencing of plasma cell-free DNA. RESULTS: 52 patients were enrolled. Median age was 70 years (range, 50-83 years) and 52% had prior taxane therapy for mCRPC. In stage 1, 13 patients were randomized to D with no OR observed. D+T advanced to stage 2 with 39 patients enrolled (receiving a median 3 cycles, range 1-53). D+T related adverse events (AEs) were mainly £ grade 2 but led to discontinuation in 7 patients . There were seven OR (19.4% [95% confidence interval: 8.2-36.0%]; intention to treat (ITT) 17.9% [95% confidence interval: 7.5-33.5%]). Five responding tumours were PD-L1 positive and two exhibited DNA damage repair defects. Responses were observed without high tumour mutational burden or other genomic indices of immunotherapy sensitivity. CONCLUSION: D+T is active in mCRPC but patient selection remains a challenge. Further studies to develop predictive biomarkers are warranted.","PeriodicalId":10279,"journal":{"name":"Clinical Cancer Research","volume":"18 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142596895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pathogenic variants in cancer susceptibility genes predispose to Ductal Carcinoma In situ of the breast 癌症易感基因中的致病变异易导致乳腺导管原位癌
IF 11.5 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-08 DOI: 10.1158/1078-0432.ccr-24-1884
Huaizhi Huang, Ronan E. Couch, Rachid Karam, Chunling Hu, Nicholas Boddicker, Eric C. Polley, Jie Na, Christine B. Ambrosone, Song Yao, Amy Trentham-Dietz, A. Heather Eliassen, Kathryn Penney, Kristen Brantley, Clara Bodelon, Lauren R. Teras, James Hodge, Alpa Patel, Christopher A. Haiman, Esther M. John, Susan L. Neuhausen, Elena Martinez, James V. Lacey, Katie M. O'Brien, Dale P. Sandler, Clarice R. Weinberg, Julie R. Palmer, Kimberly A. Bertrand, Celine M. Vachon, Janet E. Olson, Kathryn E. Ruddy, Hoda Anton-Culver, Argyrios Ziogas, David E. Goldgar, Katherine L. Nathanson, Susan M. Domchek, Jeffrey N. Weitzel, Peter Kraft, Jill S. Dolinsky, Tina Pesaran, Marcy E. Richardson, Siddhartha Yadav, Fergus J. Couch
Purpose: To determine the relationship between germline pathogenic variants (PVs) in cancer predisposition genes and the risk of ductal carcinoma in situ (DCIS). Methods: Germline PV frequencies in breast cancer predisposition genes (ATM, BARD1, BRCA1, BRCA2, CDH1, CHEK2, PALB2, RAD51C, and RAD51D) were compared between DCIS cases and unaffected controls, and between DCIS and infiltrating ductal carcinoma (IDC) cases from a clinical-testing cohort (n=9,887), a population-based cohort (n=3,876) and the UK Biobank (n=2421). The risk of contralateral breast cancer for DCIS cases with PVs was estimated in the population-based cohort. Results: Germline PVs were observed in 6.5% and 4.6% of women with DCIS in the clinical-testing and population-based cohorts, respectively. BRCA1, BRCA2, and PALB2 PVs frequencies were significantly lower among women with DCIS than IDC (clinical cohort: 2.8% vs. 5.7%; population-based cohort: 1.7% vs. 3.7%), whereas the PV frequencies for ATM and CHEK2 were similar. ATM, BRCA1, BRCA2, CHEK2, and PALB2 PVs were significantly associated with an increased risk of DCIS (OR>2.0), but only BRCA2 PVs were associated with high-risk (OR>4) in both cohorts. The cumulative incidence of contralateral breast cancer among carriers of PVs in high penetrance genes with DCIS was 23% over 15 years. Conclusions: The enrichment of PVs in ATM, BRCA1, BRCA2, CHEK2 and PALB2 among women with DCIS suggests that multigene panel testing may be appropriate for women with DCIS. Elevated risks of contralateral breast cancer in carriers of PVs in high penetrance genes with DCIS confirmed the utility of testing for surgical decision-making.
目的:确定癌症易感基因中的种系致病变体 (PV) 与导管原位癌 (DCIS) 风险之间的关系。方法:研究乳腺癌易感基因中的种系致病变异(PVs)频率:比较DCIS病例与未受影响的对照组之间,以及DCIS与浸润性导管癌(IDC)病例之间的种系乳腺癌易感基因(ATM、BARD1、BRCA1、BRCA2、CDH1、CHEK2、PALB2、RAD51C和RAD51D)的PV频率,这些基因来自临床检测队列(n=9887)、人口队列(n=3876)和英国生物库(n=2421)。在基于人群的队列中估算了有PV的DCIS病例罹患对侧乳腺癌的风险。结果显示在临床检测队列和基于人群的队列中,分别有 6.5% 和 4.6% 的 DCIS 妇女观察到了种系 PV。在 DCIS 妇女中,BRCA1、BRCA2 和 PALB2 的 PV 频率明显低于 IDC(临床队列:2.8% 对 5.7%;人群队列:1.7% 对 3.7%),而 ATM 和 CHEK2 的 PV 频率相似。在两个队列中,ATM、BRCA1、BRCA2、CHEK2 和 PALB2 PV 与 DCIS 风险增加显著相关(OR>2.0),但只有 BRCA2 PV 与高风险相关(OR>4)。在 15 年的时间里,高渗透性基因中的 PV 携带者患 DCIS 的对侧乳腺癌的累积发病率为 23%。结论在患有 DCIS 的妇女中,ATM、BRCA1、BRCA2、CHEK2 和 PALB2 中的 PVs 的富集表明,多基因小组检测可能适合患有 DCIS 的妇女。在患有 DCIS 的高穿透基因 PV 携带者中,患对侧乳腺癌的风险升高,这证实了检测对手术决策的作用。
{"title":"Pathogenic variants in cancer susceptibility genes predispose to Ductal Carcinoma In situ of the breast","authors":"Huaizhi Huang, Ronan E. Couch, Rachid Karam, Chunling Hu, Nicholas Boddicker, Eric C. Polley, Jie Na, Christine B. Ambrosone, Song Yao, Amy Trentham-Dietz, A. Heather Eliassen, Kathryn Penney, Kristen Brantley, Clara Bodelon, Lauren R. Teras, James Hodge, Alpa Patel, Christopher A. Haiman, Esther M. John, Susan L. Neuhausen, Elena Martinez, James V. Lacey, Katie M. O'Brien, Dale P. Sandler, Clarice R. Weinberg, Julie R. Palmer, Kimberly A. Bertrand, Celine M. Vachon, Janet E. Olson, Kathryn E. Ruddy, Hoda Anton-Culver, Argyrios Ziogas, David E. Goldgar, Katherine L. Nathanson, Susan M. Domchek, Jeffrey N. Weitzel, Peter Kraft, Jill S. Dolinsky, Tina Pesaran, Marcy E. Richardson, Siddhartha Yadav, Fergus J. Couch","doi":"10.1158/1078-0432.ccr-24-1884","DOIUrl":"https://doi.org/10.1158/1078-0432.ccr-24-1884","url":null,"abstract":"Purpose: To determine the relationship between germline pathogenic variants (PVs) in cancer predisposition genes and the risk of ductal carcinoma in situ (DCIS). Methods: Germline PV frequencies in breast cancer predisposition genes (ATM, BARD1, BRCA1, BRCA2, CDH1, CHEK2, PALB2, RAD51C, and RAD51D) were compared between DCIS cases and unaffected controls, and between DCIS and infiltrating ductal carcinoma (IDC) cases from a clinical-testing cohort (n=9,887), a population-based cohort (n=3,876) and the UK Biobank (n=2421). The risk of contralateral breast cancer for DCIS cases with PVs was estimated in the population-based cohort. Results: Germline PVs were observed in 6.5% and 4.6% of women with DCIS in the clinical-testing and population-based cohorts, respectively. BRCA1, BRCA2, and PALB2 PVs frequencies were significantly lower among women with DCIS than IDC (clinical cohort: 2.8% vs. 5.7%; population-based cohort: 1.7% vs. 3.7%), whereas the PV frequencies for ATM and CHEK2 were similar. ATM, BRCA1, BRCA2, CHEK2, and PALB2 PVs were significantly associated with an increased risk of DCIS (OR>2.0), but only BRCA2 PVs were associated with high-risk (OR>4) in both cohorts. The cumulative incidence of contralateral breast cancer among carriers of PVs in high penetrance genes with DCIS was 23% over 15 years. Conclusions: The enrichment of PVs in ATM, BRCA1, BRCA2, CHEK2 and PALB2 among women with DCIS suggests that multigene panel testing may be appropriate for women with DCIS. Elevated risks of contralateral breast cancer in carriers of PVs in high penetrance genes with DCIS confirmed the utility of testing for surgical decision-making.","PeriodicalId":10279,"journal":{"name":"Clinical Cancer Research","volume":"244 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Re-irradiation plus pembrolizumab: Phase II study for recurrent glioblastoma patients 再放疗加 pembrolizumab:针对复发性胶质母细胞瘤患者的 II 期研究
IF 11.5 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-08 DOI: 10.1158/1078-0432.ccr-24-1629
Fabio M. Iwamoto, Shyam K. Tanguturi, Lakshmi Nayak, Tony J. Wang, Arati Desai, Robert A. Lustig, Stephen Bagley, Eric T. Wong, Lauren M. Hertan, Christine McCluskey, Julia Hayden, Alona Muzikansky, Shreya Nakhawa, Julia Japo, Connor C. Bossi, Maxime Meylan, Ye Tian, Graham L. Barlow, Paul Speliakos, Georges Ayoub, David M. Meredith, Keith L. Ligon, Daphne Haas-Kogan, Kun Huang, Kai W. Wucherpfennig, Patrick Y. Wen, David A. Reardon
Purpose: Radiation therapy may enhance anti-tumor immune responses by several mechanisms including induction of immunogenic cell death. We performed a phase 2 study of pembrolizumab with re-irradiation in patients with recurrent glioblastoma. Methods: Sixty recurrent glioblastoma patients received pembrolizumab with re-irradiation alone (cohort A, bevacizumab-naïve; n=30) or with bevacizumab continuation (cohort B, n=30). Dual primary endpoints including overall response rate (ORR) and overall survival at either 12 (OS-12; cohort A) or six months (OS-6; cohort B) were assessed per cohort relative to historical benchmarks. Paired paraffin-embedded formalin-fixed tumor samples were assessed for immunologic biomarkers by immunohistochemistry using digital quantification and Co-Detection-by-InDEXing (CODEX). Results: Study therapy was well tolerated with most toxicities being grade ≤ 3. For cohort B, the primary endpoint of OS-6 was achieved (57%), however survival was not improved for cohort A patients. The ORR was 3.3% and 6.7% for cohorts A and B, respectively. CODEX analysis of paired tumor samples from 5 patients revealed an increase of activated T cells in the tumor microenvironment after study therapy. Conclusions: Compared to historical controls, re-irradiation plus pembrolizumab appeared to improve survival among bevacizumab-refractory patients but not among bevacizumab-naïve patients. CODEX revealed evidence of intratumoral infiltration of activated immune effector cells. A randomized, properly controlled trial of PD-1 blockade plus re-irradiation is warranted to further evaluate this regimen for bevacizumab refractory patients, but alternative approaches are needed for bevacizumab-naïve patients.
目的:放射治疗可通过多种机制(包括诱导免疫原性细胞死亡)增强抗肿瘤免疫反应。我们对复发性胶质母细胞瘤患者进行了pembrolizumab联合再放疗的2期研究。研究方法60名复发性胶质母细胞瘤患者接受了pembrolizumab联合再照射单独治疗(队列A,贝伐珠单抗无效;人数=30)或贝伐珠单抗继续治疗(队列B,人数=30)。相对于历史基准,对每个队列进行了双重主要终点评估,包括总反应率(ORR)和 12 个月(OS-12;队列 A)或 6 个月(OS-6;队列 B)的总存活率。使用数字量化和CODEX(Co-Detection-by-InDEXing)免疫组化技术对配对石蜡包埋福尔马林固定的肿瘤样本进行免疫生物标记物评估。研究结果研究治疗耐受性良好,大多数毒性反应≤3级。B组患者达到了OS-6的主要终点(57%),但A组患者的生存率并没有提高。A组和B组的ORR分别为3.3%和6.7%。对5名患者的配对肿瘤样本进行的CODEX分析显示,研究治疗后肿瘤微环境中的活化T细胞有所增加。结论与历史对照组相比,再照射加pembrolizumab似乎能提高贝伐珠单抗难治患者的生存率,但不能提高贝伐珠单抗无效患者的生存率。CODEX显示了活化免疫效应细胞在瘤内浸润的证据。有必要对PD-1阻断+再照射进行随机、适当的对照试验,以进一步评估贝伐珠单抗难治性患者的这一治疗方案,但对于贝伐珠单抗无效患者,则需要采用其他方法。
{"title":"Re-irradiation plus pembrolizumab: Phase II study for recurrent glioblastoma patients","authors":"Fabio M. Iwamoto, Shyam K. Tanguturi, Lakshmi Nayak, Tony J. Wang, Arati Desai, Robert A. Lustig, Stephen Bagley, Eric T. Wong, Lauren M. Hertan, Christine McCluskey, Julia Hayden, Alona Muzikansky, Shreya Nakhawa, Julia Japo, Connor C. Bossi, Maxime Meylan, Ye Tian, Graham L. Barlow, Paul Speliakos, Georges Ayoub, David M. Meredith, Keith L. Ligon, Daphne Haas-Kogan, Kun Huang, Kai W. Wucherpfennig, Patrick Y. Wen, David A. Reardon","doi":"10.1158/1078-0432.ccr-24-1629","DOIUrl":"https://doi.org/10.1158/1078-0432.ccr-24-1629","url":null,"abstract":"Purpose: Radiation therapy may enhance anti-tumor immune responses by several mechanisms including induction of immunogenic cell death. We performed a phase 2 study of pembrolizumab with re-irradiation in patients with recurrent glioblastoma. Methods: Sixty recurrent glioblastoma patients received pembrolizumab with re-irradiation alone (cohort A, bevacizumab-naïve; n=30) or with bevacizumab continuation (cohort B, n=30). Dual primary endpoints including overall response rate (ORR) and overall survival at either 12 (OS-12; cohort A) or six months (OS-6; cohort B) were assessed per cohort relative to historical benchmarks. Paired paraffin-embedded formalin-fixed tumor samples were assessed for immunologic biomarkers by immunohistochemistry using digital quantification and Co-Detection-by-InDEXing (CODEX). Results: Study therapy was well tolerated with most toxicities being grade ≤ 3. For cohort B, the primary endpoint of OS-6 was achieved (57%), however survival was not improved for cohort A patients. The ORR was 3.3% and 6.7% for cohorts A and B, respectively. CODEX analysis of paired tumor samples from 5 patients revealed an increase of activated T cells in the tumor microenvironment after study therapy. Conclusions: Compared to historical controls, re-irradiation plus pembrolizumab appeared to improve survival among bevacizumab-refractory patients but not among bevacizumab-naïve patients. CODEX revealed evidence of intratumoral infiltration of activated immune effector cells. A randomized, properly controlled trial of PD-1 blockade plus re-irradiation is warranted to further evaluate this regimen for bevacizumab refractory patients, but alternative approaches are needed for bevacizumab-naïve patients.","PeriodicalId":10279,"journal":{"name":"Clinical Cancer Research","volume":"5 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Utilizing Patient-derived Xenografts to Model Precision Oncology for Biliary Tract Cancer 利用患者衍生异种移植物建立胆道癌精准肿瘤学模型
IF 11.5 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-08 DOI: 10.1158/1078-0432.ccr-24-1233
Timothy P. DiPeri, Kurt W. Evans, Stephen Scott, Xiaofeng Zheng, Kaushik Varadarajan, Lawrence N. Kwong, Michael Kahle, Hop S. Tran Cao, Ching-Wei Tzeng, Thuy Vu, Sunhee Kim, Fei Su, Maria Gabriela Raso, Yasmeen Rizvi, Ming Zhao, Huamin Wang, Sunyoung S. Lee, Timothy A. Yap, Jordi Rodon, Milind Javle, Funda Meric-Bernstam
Purpose: Biliary tract cancers (BTCs), which are rare and aggressive malignancies, are rich in clinically actionable molecular alterations. A major challenge in the field is the paucity of clinically relevant BTC models which recapitulate the diverse molecular profiles of these tumors. The purpose of this study was to curate a collection of patient-derived xenograft (PDX) models that reflect the spectrum of genomic alterations present in BTCs to create a resource for modeling precision oncology. Experimental Design: PDXs were derived from BTC collected from surgical resections or metastatic biopsies. Alterations present in the PDXs were identified by whole exome sequencing and RNASeq. PDXs were treated with approved and investigational agents. Efficacy was assessed by change in tumor volume from baseline. Event-free survival was defined as time to tumor doubling from baseline. Responses were categorized at day 21: >30% decrease=partial response; >20% increase in tumor volume=progressive disease, and any non-PR/PD was considered stable disease. Results: Genomic sequencing demonstrated key actionable alterations across this cohort, including alterations in FGFR2, IDH1, ERRB2, PIK3CA, PTEN and KRAS. RNAseq demonstrated fusions and expression of antibody drug conjugate targets including TROP2, HER2 and Nectin4. Therapeutic matching revealed objective responses to approved and investigational agents that have been shown to have antitumor activity clinically. Conclusions: Here, we developed a catalog of BTC PDXs which underwent comprehensive molecular profiling and therapeutic modeling. To date, this is one of the largest collections of BTC PDX models and will facilitate the development of personalized treatments for patients with these aggressive malignancies.
目的:胆道癌(BTC)是一种罕见的侵袭性恶性肿瘤,富含可用于临床的分子改变。该领域面临的一大挑战是缺乏能再现这些肿瘤不同分子特征的临床相关 BTC 模型。本研究的目的是收集能反映 BTCs 基因组改变谱的患者衍生异种移植(PDX)模型,为精准肿瘤建模提供资源。实验设计:PDX 来源于手术切除或转移活检收集的 BTC。通过全外显子组测序和 RNASeq 鉴定 PDX 中存在的基因改变。用已获批准的药物和研究药物治疗 PDX。疗效根据肿瘤体积与基线相比的变化进行评估。无事件生存期定义为肿瘤从基线翻倍的时间。第21天时对反应进行分类:肿瘤体积减少30%=部分反应;肿瘤体积增加20%=疾病进展;任何非PR/PD均视为疾病稳定。结果:基因组测序显示该队列中存在关键的可操作改变,包括FGFR2、IDH1、ERRB2、PIK3CA、PTEN和KRAS的改变。RNAseq 显示了抗体药物共轭靶点的融合和表达,包括 TROP2、HER2 和 Nectin4。治疗匹配显示了对已获批准和正在研究的药物的客观反应,这些药物在临床上已被证明具有抗肿瘤活性。结论:在这里,我们建立了一个 BTC PDX 目录,并对其进行了全面的分子谱分析和治疗建模。这是迄今为止收集的最多的 BTC PDX 模型之一,将有助于开发针对这些侵袭性恶性肿瘤患者的个性化治疗方法。
{"title":"Utilizing Patient-derived Xenografts to Model Precision Oncology for Biliary Tract Cancer","authors":"Timothy P. DiPeri, Kurt W. Evans, Stephen Scott, Xiaofeng Zheng, Kaushik Varadarajan, Lawrence N. Kwong, Michael Kahle, Hop S. Tran Cao, Ching-Wei Tzeng, Thuy Vu, Sunhee Kim, Fei Su, Maria Gabriela Raso, Yasmeen Rizvi, Ming Zhao, Huamin Wang, Sunyoung S. Lee, Timothy A. Yap, Jordi Rodon, Milind Javle, Funda Meric-Bernstam","doi":"10.1158/1078-0432.ccr-24-1233","DOIUrl":"https://doi.org/10.1158/1078-0432.ccr-24-1233","url":null,"abstract":"Purpose: Biliary tract cancers (BTCs), which are rare and aggressive malignancies, are rich in clinically actionable molecular alterations. A major challenge in the field is the paucity of clinically relevant BTC models which recapitulate the diverse molecular profiles of these tumors. The purpose of this study was to curate a collection of patient-derived xenograft (PDX) models that reflect the spectrum of genomic alterations present in BTCs to create a resource for modeling precision oncology. Experimental Design: PDXs were derived from BTC collected from surgical resections or metastatic biopsies. Alterations present in the PDXs were identified by whole exome sequencing and RNASeq. PDXs were treated with approved and investigational agents. Efficacy was assessed by change in tumor volume from baseline. Event-free survival was defined as time to tumor doubling from baseline. Responses were categorized at day 21: >30% decrease=partial response; >20% increase in tumor volume=progressive disease, and any non-PR/PD was considered stable disease. Results: Genomic sequencing demonstrated key actionable alterations across this cohort, including alterations in FGFR2, IDH1, ERRB2, PIK3CA, PTEN and KRAS. RNAseq demonstrated fusions and expression of antibody drug conjugate targets including TROP2, HER2 and Nectin4. Therapeutic matching revealed objective responses to approved and investigational agents that have been shown to have antitumor activity clinically. Conclusions: Here, we developed a catalog of BTC PDXs which underwent comprehensive molecular profiling and therapeutic modeling. To date, this is one of the largest collections of BTC PDX models and will facilitate the development of personalized treatments for patients with these aggressive malignancies.","PeriodicalId":10279,"journal":{"name":"Clinical Cancer Research","volume":"2 1","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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