Pub Date : 2025-02-01DOI: 10.1016/j.esmoop.2025.104153
J. Hou , Z. Han , M. Chang , Z. Xu
{"title":"Global inequalities in the burden of cancer in adolescents and young women from 1990 to 2021: findings from the Global Burden of Disease Study 2021","authors":"J. Hou , Z. Han , M. Chang , Z. Xu","doi":"10.1016/j.esmoop.2025.104153","DOIUrl":"10.1016/j.esmoop.2025.104153","url":null,"abstract":"","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104153"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.esmoop.2024.104130
C. Englisch , S. Nopp , F. Moik , A.M. Starzer , P. Quehenberger , M. Preusser , A.S. Berghoff , C. Ay , I. Pabinger
Background
Patients with cancer undergoing systemic therapies have a high risk for venous thromboembolism (VTE). Risk assessment models were developed to select high-risk subgroups that might benefit from primary thromboprophylaxis, yet currently available models reportedly underperform in contemporary cancer treatment populations and risk models across multiple time points throughout therapy are not available.
Patients and methods
We, therefore, aimed to validate the Vienna CATScore, a nomogram-based model including tumor type and continuous D-dimer levels, in a prospective cohort study of patients initiating contemporary systemic anticancer therapies. The validity of the model was tested at study inclusion, 3 weeks, and 3 months after start of therapy.
Results
Overall, 598 patients were included [49% women, median age 62 years (interquartile range 53-70 years)]. Most patients had stage IV disease (68.2%). The 6-month cumulative incidence of VTE was 9.2% [95% confidence interval (CI) 6.8% to 11.5%]. The Vienna CATScore demonstrated good discriminatory ability (c-statistics: 0.69, 95% CI 0.61-0.76) at study baseline and across all evaluated time points (c-statistics: 0.68, 95% CI 0.63-0.73). Applying a 6-month predicted VTE risk threshold of 8%, the CATScore effectively distinguished between low- and high-risk groups at study inclusion (7.1% versus 15.1% observed VTE risk, P = 0.004) and across all three time points (6.3% versus 13.6% observed VTE risk, P < 0.001). Assuming a 50% risk reduction with thromboprophylaxis, this threshold resulted in a number needed to treat (NNT) of 13 and 15, respectively, in the high-risk group, while the NNT was 28 and 32, respectively, in the low-risk group.
Conclusions
This external validation of the Vienna CATScore confirms its effectiveness in predicting VTE risk in the initial months of state-of-the-art systemic anticancer therapies and across multiple time points.
{"title":"The Vienna CATScore for predicting cancer-associated venous thromboembolism: an external validation across multiple time points","authors":"C. Englisch , S. Nopp , F. Moik , A.M. Starzer , P. Quehenberger , M. Preusser , A.S. Berghoff , C. Ay , I. Pabinger","doi":"10.1016/j.esmoop.2024.104130","DOIUrl":"10.1016/j.esmoop.2024.104130","url":null,"abstract":"<div><h3>Background</h3><div>Patients with cancer undergoing systemic therapies have a high risk for venous thromboembolism (VTE). Risk assessment models were developed to select high-risk subgroups that might benefit from primary thromboprophylaxis, yet currently available models reportedly underperform in contemporary cancer treatment populations and risk models across multiple time points throughout therapy are not available.</div></div><div><h3>Patients and methods</h3><div>We, therefore, aimed to validate the Vienna CATScore, a nomogram-based model including tumor type and continuous D-dimer levels, in a prospective cohort study of patients initiating contemporary systemic anticancer therapies. The validity of the model was tested at study inclusion, 3 weeks, and 3 months after start of therapy.</div></div><div><h3>Results</h3><div>Overall, 598 patients were included [49% women, median age 62 years (interquartile range 53-70 years)]. Most patients had stage IV disease (68.2%). The 6-month cumulative incidence of VTE was 9.2% [95% confidence interval (CI) 6.8% to 11.5%]. The Vienna CATScore demonstrated good discriminatory ability (c-statistics: 0.69, 95% CI 0.61-0.76) at study baseline and across all evaluated time points (c-statistics: 0.68, 95% CI 0.63-0.73). Applying a 6-month predicted VTE risk threshold of 8%, the CATScore effectively distinguished between low- and high-risk groups at study inclusion (7.1% versus 15.1% observed VTE risk, <em>P</em> = 0.004) and across all three time points (6.3% versus 13.6% observed VTE risk, <em>P</em> < 0.001). Assuming a 50% risk reduction with thromboprophylaxis, this threshold resulted in a number needed to treat (NNT) of 13 and 15, respectively, in the high-risk group, while the NNT was 28 and 32, respectively, in the low-risk group.</div></div><div><h3>Conclusions</h3><div>This external validation of the Vienna CATScore confirms its effectiveness in predicting VTE risk in the initial months of state-of-the-art systemic anticancer therapies and across multiple time points.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104130"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.esmoop.2024.104111
X. Qiu , P. Tarantino , R. Li , A. Grinshpun , H. Gupta , M.E. Hughes , G. Kirkner , L. Scholl , B.E. Johnson , M. Meyerson , A.D. Cherniack , Y. Jiang , N. Zhou , N.U. Lin , H.W. Long , S.M. Tolaney , R. Jeselsohn
Background
The approval of trastuzumab deruxtecan has prompted the subgrouping of human epidermal growth factor receptor 2-negative (HER2−) breast cancers (BCs) to HER2 0 and HER2 low on the basis of immunohistochemistry, although the biological significance of these subgroups remains uncertain. This study is aimed to better understand the molecular and genetic differences among HER2− tumors stratified by quantitative levels of HER2.
Patients and methods
We analyzed the transcriptomic and genomic data from the Molecular Taxonomy of BC International Consortium (discovery cohort) and The Cancer Genome Atlas (independent validation cohort). HER2− BCs, including hormone receptor positive and triple negative, were divided into three subgroups based on ERBB2 messenger RNA (mRNA) levels: minimal, moderate and enhanced.
Results
We observed significant differences in mutational and transcriptional profiles across the subgroups. Tumors with enhanced ERBB2 mRNA expression had a higher prevalence of PIK3CA mutations and increased estrogen receptor signaling, while tumors with minimal ERBB2 mRNA expression displayed higher expression of proliferation and immune-related genes. We identified a distinct subgroup of BCs characterized by a large deletion of chromosome 17q12 (17q12del) with heterozygous loss of ERBB2, very low ERBB2 mRNA and HER2 protein expression. This subgroup was also enriched for heterozygous losses of TP53 and other tumor suppressor genes. Analysis of two large real-world cohorts of patients with HER2− metastatic BC (Dana-Farber Cancer Institute cohort n = 1063 and Memorial Sloan Kettering MetTropism cohort n = 1018) showed that patients with 17q12del and heterozygous loss of ERBB2 had poorer overall survival (OS).
Conclusions
We identified a biologically and clinically distinct subgroup of BCs characterized by a 17q12del with a heterozygous loss of ERBB2 and low ERBB2 mRNA and HER2 protein expression. In two large real-world cohorts of patients with HER2− metastatic BC, this subgroup was associated with poor OS, highlighting its clinical significance.
背景:曲妥珠单抗德鲁西替康的批准促使人表皮生长因子受体2阴性(HER2-)乳腺癌(BCs)在免疫组化的基础上进入HER2 0和HER2低亚组,尽管这些亚组的生物学意义仍不确定。本研究旨在更好地了解通过HER2定量水平分层的HER2-肿瘤的分子和遗传差异。患者和方法:我们分析了来自BC International Consortium Molecular Taxonomy(发现队列)和the Cancer Genome Atlas(独立验证队列)的转录组和基因组数据。HER2- bc包括激素受体阳性和三阴性,根据ERBB2信使RNA (mRNA)水平分为轻度、中度和增强三个亚组。结果:我们观察到亚组间突变和转录谱的显著差异。ERBB2 mRNA表达增强的肿瘤具有更高的PIK3CA突变患病率和雌激素受体信号传导增加,而ERBB2 mRNA表达最低的肿瘤具有更高的增殖和免疫相关基因表达。我们发现了一个独特的bc亚群,其特征是染色体17q12 (17q12del)的大量缺失,ERBB2的杂合缺失,ERBB2 mRNA和HER2蛋白的表达非常低。该亚组中还存在TP53和其他肿瘤抑制基因的杂合缺失。对两大现实世界HER2转移性BC患者队列(Dana-Farber Cancer Institute队列n = 1063和Memorial Sloan Kettering MetTropism队列n = 1018)的分析显示,17q12del和ERBB2杂合缺失的患者总生存期(OS)较差。结论:我们确定了一个生物学和临床上独特的bc亚群,其特征是17q12del杂合缺失ERBB2, ERBB2 mRNA和HER2蛋白表达低。在两个现实世界的HER2转移性BC患者队列中,该亚组与不良OS相关,突出了其临床意义。
{"title":"Molecular characterization of HER2-negative breast cancers reveals a distinct patient subgroup with 17q12 deletion and heterozygous loss of ERBB2","authors":"X. Qiu , P. Tarantino , R. Li , A. Grinshpun , H. Gupta , M.E. Hughes , G. Kirkner , L. Scholl , B.E. Johnson , M. Meyerson , A.D. Cherniack , Y. Jiang , N. Zhou , N.U. Lin , H.W. Long , S.M. Tolaney , R. Jeselsohn","doi":"10.1016/j.esmoop.2024.104111","DOIUrl":"10.1016/j.esmoop.2024.104111","url":null,"abstract":"<div><h3>Background</h3><div>The approval of trastuzumab deruxtecan has prompted the subgrouping of human epidermal growth factor receptor 2-negative (HER2−) breast cancers (BCs) to HER2 0 and HER2 low on the basis of immunohistochemistry, although the biological significance of these subgroups remains uncertain. This study is aimed to better understand the molecular and genetic differences among HER2− tumors stratified by quantitative levels of HER2.</div></div><div><h3>Patients and methods</h3><div>We analyzed the transcriptomic and genomic data from the Molecular Taxonomy of BC International Consortium (discovery cohort) and The Cancer Genome Atlas (independent validation cohort). HER2− BCs, including hormone receptor positive and triple negative, were divided into three subgroups based on <em>ERBB2</em> messenger RNA (mRNA) levels: minimal, moderate and enhanced.</div></div><div><h3>Results</h3><div>We observed significant differences in mutational and transcriptional profiles across the subgroups. Tumors with enhanced <em>ERBB2</em> mRNA expression had a higher prevalence of <em>PIK3CA</em> mutations and increased estrogen receptor signaling, while tumors with minimal <em>ERBB2</em> mRNA expression displayed higher expression of proliferation and immune-related genes. We identified a distinct subgroup of BCs characterized by a large deletion of chromosome 17q12 (17q12del) with heterozygous loss of <em>ERBB2</em>, very low <em>ERBB2</em> mRNA and HER2 protein expression. This subgroup was also enriched for heterozygous losses of <em>TP53</em> and other tumor suppressor genes. Analysis of two large real-world cohorts of patients with HER2− metastatic BC (Dana-Farber Cancer Institute cohort <em>n</em> = 1063 and Memorial Sloan Kettering MetTropism cohort <em>n</em> = 1018) showed that patients with 17q12del and heterozygous loss of ERBB2 had poorer overall survival (OS).</div></div><div><h3>Conclusions</h3><div>We identified a biologically and clinically distinct subgroup of BCs characterized by a 17q12del with a heterozygous loss of <em>ERBB2</em> and low <em>ERBB2</em> mRNA and HER2 protein expression. In two large real-world cohorts of patients with HER2− metastatic BC, this subgroup was associated with poor OS, highlighting its clinical significance.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104111"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.esmoop.2025.104133
M. Brahmi , H. Vanacker , A. Dufresne , V. Isnardi , M. Dupont , A. Meurgey , M. Karanian , P. Meeus , M.-P. Sunyach , F. Tirode , J.-Y. Blay
Background
Desmoplastic small round cell tumours (DSRCTs) represent an ultra-rare subtype of soft tissue sarcoma characterized by a recurrent EWSR1::WT1 oncogenic translocation. Considered as an extremely aggressive cancer, the prognosis remains poor with a median overall survival not exceeding 24-36 months and a 5-year survival <10%.
Patients and methods
We analysed ERBB2/human epidermal growth factor receptor 2 (HER2) expression levels in a series of 13 DSRCT patients, using whole-exome RNA sequencing on formalin-fixed paraffin-embedded samples from a local biopathological database. In addition, a retrospective case series describes the clinical outcome of three successive DSRCT patients treated with trastuzumab deruxtecan (T-DXd).
Results
The gene expression analysis demonstrated a consistent high RNA expression level of ERBB2 in DSRCT, with elevated levels [>5 log2(transcripts per million + 1)] across all samples of the cohort and the expression level was the highest compared with all other sarcoma subtypes. In addition to these results, T-DXd showed a marked activity in all three DSRCT patients who presented with metastatic disease refractory to previous standard chemotherapy. So far, the treatment has been overall well tolerated and is currently pursued in the three patients (duration of response >3 months for all three), which warrants additional investigation.
Conclusions
This case series presents a major information, suggesting that HER2 is a therapeutic target in DSRCT and T-DXd might represent a novel therapeutic option. Those results require to be rapidly shared with the scientific community and confirmed in a prospective clinical trial in this context of very poor prognosis disease and urgent unmet need.
{"title":"High expression level of ERBB2 and efficacy of trastuzumab deruxtecan in desmoplastic small round cell tumour: a monocentric case series report","authors":"M. Brahmi , H. Vanacker , A. Dufresne , V. Isnardi , M. Dupont , A. Meurgey , M. Karanian , P. Meeus , M.-P. Sunyach , F. Tirode , J.-Y. Blay","doi":"10.1016/j.esmoop.2025.104133","DOIUrl":"10.1016/j.esmoop.2025.104133","url":null,"abstract":"<div><h3>Background</h3><div>Desmoplastic small round cell tumours (DSRCTs) represent an ultra-rare subtype of soft tissue sarcoma characterized by a recurrent <em>EWSR1::WT1</em> oncogenic translocation. Considered as an extremely aggressive cancer, the prognosis remains poor with a median overall survival not exceeding 24-36 months and a 5-year survival <10%.</div></div><div><h3>Patients and methods</h3><div>We analysed <em>ERBB2/</em>human epidermal growth factor receptor 2 (<em>HER2</em>) expression levels in a series of 13 DSRCT patients, using whole-exome RNA sequencing on formalin-fixed paraffin-embedded samples from a local biopathological database. In addition, a retrospective case series describes the clinical outcome of three successive DSRCT patients treated with trastuzumab deruxtecan (T-DXd).</div></div><div><h3>Results</h3><div>The gene expression analysis demonstrated a consistent high RNA expression level of <em>ERBB2</em> in DSRCT, with elevated levels [>5 log2(transcripts per million + 1)] across all samples of the cohort and the expression level was the highest compared with all other sarcoma subtypes. In addition to these results, T-DXd showed a marked activity in all three DSRCT patients who presented with metastatic disease refractory to previous standard chemotherapy. So far, the treatment has been overall well tolerated and is currently pursued in the three patients (duration of response >3 months for all three), which warrants additional investigation.</div></div><div><h3>Conclusions</h3><div>This case series presents a major information, suggesting that HER2 is a therapeutic target in DSRCT and T-DXd might represent a novel therapeutic option. Those results require to be rapidly shared with the scientific community and confirmed in a prospective clinical trial in this context of very poor prognosis disease and urgent unmet need.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104133"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.esmoop.2024.104095
R.-D. Hofheinz , F. Herrle , T. Dechow , L.F. von Weikersthal , M. Welslau , S. Lettmaier , C. Burkart , S. Kubicka , L. Kochen , K. Merx , K. Krause , M. Ebert , C. Rödel , E. Fokas , M. Ghadimi , C. Reissfelder , T. Gaiser
{"title":"Corrigendum to “mFOLFOX6 versus mFOLFOX6 + aflibercept as neoadjuvant treatment in MRI-defined T3-rectal cancer: a randomized phase-II-trial of the German Rectal Cancer Study Group (CAO/ARO/AIO 0214) and the ABCSG (R-06)”","authors":"R.-D. Hofheinz , F. Herrle , T. Dechow , L.F. von Weikersthal , M. Welslau , S. Lettmaier , C. Burkart , S. Kubicka , L. Kochen , K. Merx , K. Krause , M. Ebert , C. Rödel , E. Fokas , M. Ghadimi , C. Reissfelder , T. Gaiser","doi":"10.1016/j.esmoop.2024.104095","DOIUrl":"10.1016/j.esmoop.2024.104095","url":null,"abstract":"","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104095"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.esmoop.2024.104110
F. Piscaglia , G. Masi , E. Martinelli , G. Cabibbo , M. Di Maio , A. Gasbarrini , M. Iavarone , L. Antonuzzo , V. Mazzaferro , A. Ballestrero , C. Garufi , F. Bergamo , C. Celsa , D. Marino , F. Tovoli , F.R. Ponziani , T. Pressiani , C. Astolfi , G.C. Gazzoli , F. Ciardiello , L. Rimassa
Background
The treatment of advanced hepatocellular carcinoma (HCC) with atezolizumab and bevacizumab led to significant improvements in overall survival (OS), progression-free survival (PFS), and response rate compared with sorafenib in the phase III IMbrave150 trial. The etiology of background liver disease can differ between Eastern and Western populations, leading to a potentially different impact of systemic therapies; therefore the unequal representation must be considered in the IMbrave150 trial. To provide further data on the safety and effectiveness of atezolizumab and bevacizumab, the phase IIIb AMETHISTA (Atezolizumab plus bevacizumab in METastatic HCC Italian Safety TriAl) ran in a Western (Italian) population of patients with advanced HCC. The results of the interim analysis are presented in this paper.
Methods
AMETHISTA is a multicenter, phase IIIb, single-arm study evaluating the safety and effectiveness of atezolizumab and bevacizumab in an Italian population of patients with systemic treatment-naive HCC (ClinicalTrials.gov: NCT04487067). The primary objective was safety (incidence of grade 3-5 bleeding/hemorrhages). The main secondary objective was effectiveness.
Results
A total of 152 patients were enrolled and 149 were treated. At the cut-off date, the median observation time was 13.4 months (interquartile range 8.3-15.5 months). The incidence of grade 3-5 bleeding/hemorrhages was 11.4%. Besides, results of other safety endpoints were consistent with the safety profile of atezolizumab plus bevacizumab, and the underlying disease, without any new safety observation. The median OS was 18.2 months (95% confidence interval 15.4 months to not evaluable); the median PFS was 8.5 months (95% confidence interval 7.5-11.2 months).
Conclusion
Results from the interim analysis are consistent with data from the IMbrave150 trial, and further confirm first-line atezolizumab plus bevacizumab as a standard of care for patients with systemic treatment-naive advanced and unresectable HCC.
{"title":"Atezolizumab plus bevacizumab as first-line treatment of unresectable hepatocellular carcinoma: interim analysis results from the phase IIIb AMETHISTA trial","authors":"F. Piscaglia , G. Masi , E. Martinelli , G. Cabibbo , M. Di Maio , A. Gasbarrini , M. Iavarone , L. Antonuzzo , V. Mazzaferro , A. Ballestrero , C. Garufi , F. Bergamo , C. Celsa , D. Marino , F. Tovoli , F.R. Ponziani , T. Pressiani , C. Astolfi , G.C. Gazzoli , F. Ciardiello , L. Rimassa","doi":"10.1016/j.esmoop.2024.104110","DOIUrl":"10.1016/j.esmoop.2024.104110","url":null,"abstract":"<div><h3>Background</h3><div>The treatment of advanced hepatocellular carcinoma (HCC) with atezolizumab and bevacizumab led to significant improvements in overall survival (OS), progression-free survival (PFS), and response rate compared with sorafenib in the phase III IMbrave150 trial. The etiology of background liver disease can differ between Eastern and Western populations, leading to a potentially different impact of systemic therapies; therefore the unequal representation must be considered in the IMbrave150 trial. To provide further data on the safety and effectiveness of atezolizumab and bevacizumab, the phase IIIb AMETHISTA (Atezolizumab plus bevacizumab in METastatic HCC Italian Safety TriAl) ran in a Western (Italian) population of patients with advanced HCC. The results of the interim analysis are presented in this paper.</div></div><div><h3>Methods</h3><div>AMETHISTA is a multicenter, phase IIIb, single-arm study evaluating the safety and effectiveness of atezolizumab and bevacizumab in an Italian population of patients with systemic treatment-naive HCC (ClinicalTrials.gov: <span><span>NCT04487067</span><svg><path></path></svg></span>). The primary objective was safety (incidence of grade 3-5 bleeding/hemorrhages). The main secondary objective was effectiveness.</div></div><div><h3>Results</h3><div>A total of 152 patients were enrolled and 149 were treated. At the cut-off date, the median observation time was 13.4 months (interquartile range 8.3-15.5 months). The incidence of grade 3-5 bleeding/hemorrhages was 11.4%. Besides, results of other safety endpoints were consistent with the safety profile of atezolizumab plus bevacizumab, and the underlying disease, without any new safety observation. The median OS was 18.2 months (95% confidence interval 15.4 months to not evaluable); the median PFS was 8.5 months (95% confidence interval 7.5-11.2 months).</div></div><div><h3>Conclusion</h3><div>Results from the interim analysis are consistent with data from the IMbrave150 trial, and further confirm first-line atezolizumab plus bevacizumab as a standard of care for patients with systemic treatment-naive advanced and unresectable HCC.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104110"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.esmoop.2024.104126
P.G. Casali , H. Antoine-Poirel , S. Berrocoso , J.-Y. Blay , T. Dubois , A. Ferrari , A. Fullaondo , E. Hovig , P. Jagodzińska-Mucha , I. Ługowska , S. Kaasa , D. Nicoară , V. Pletsa , S. Provenzano , M. Santoro , M. Šekerija , W. Van Hoof , M. Vyas , A. Trama , Malvika Vyas
Health networking is in principle a formidable instrument to address many challenges posed by cancer, one of the two most common and most lethal non-communicable chronic diseases. The European Union (EU)’s Beating Cancer Plan foresaw the addition of new health networks to the four already existing European Reference Networks on rare cancers: the Network of Comprehensive Cancer Centres and several networks of expertise (NoEs), which will be shortly deployed on items as complex and poor-prognosis cancers, palliative care, survivorship, personalised primary and secondary prevention, omic technologies, hi-tech medical resources, and cancers in adolescents and young adults. The community of experts of the EU Joint Action, due to build such NoEs, has drafted this ‘green paper’, incorporating 13 open questions, in an effort to foster discussion on some open questions about health networking on cancer in the EU. These affect highly diverse issues such as the following: how gaps in research into the instrument of health networking may be filled; which items lend themselves more to health networking in the EU; what degree of cooperation and harmonisation should be required of EU member states to best exploit health networking and give rise to European networks of national/regional networks; how the idea of subsidiarity may be best interpreted to support health networking in the context of EU treaties, which basically do not include health; how health networks should be funded and with what degree of cooperation between the EU and national levels; whether EU health networks should be shaped as legal entities or could give rise to secondary legal entities, also with a view to fundraising; how health networks should be best shaped to advance cancer research and how the EU regulatory system should be updated to exploit such impulse to health networks, in view of the EU General Data Protection Regulation and the new EU Health Data Space; how artificial intelligence can be exploited today within health networks and to what extent it will be able to overcome challenges such as the current lack of interoperability of electronic health records and the language barrier across the EU; and how health networks should involve patients and their groups, with regard to their formal role within EU health networks as well as their ability to have a say in items such as production of clinical practice guidelines, the design of investigator-driven clinical trials, EU regulatory decisions on medicines and devices, health service data governance, and identification of unmet needs.
{"title":"Health networking on cancer in the European Union: a ‘green paper’ by the EU Joint Action on Networks of Expertise (JANE)","authors":"P.G. Casali , H. Antoine-Poirel , S. Berrocoso , J.-Y. Blay , T. Dubois , A. Ferrari , A. Fullaondo , E. Hovig , P. Jagodzińska-Mucha , I. Ługowska , S. Kaasa , D. Nicoară , V. Pletsa , S. Provenzano , M. Santoro , M. Šekerija , W. Van Hoof , M. Vyas , A. Trama , Malvika Vyas","doi":"10.1016/j.esmoop.2024.104126","DOIUrl":"10.1016/j.esmoop.2024.104126","url":null,"abstract":"<div><div>Health networking is in principle a formidable instrument to address many challenges posed by cancer, one of the two most common and most lethal non-communicable chronic diseases. The European Union (EU)’s Beating Cancer Plan foresaw the addition of new health networks to the four already existing European Reference Networks on rare cancers: the Network of Comprehensive Cancer Centres and several networks of expertise (NoEs), which will be shortly deployed on items as complex and poor-prognosis cancers, palliative care, survivorship, personalised primary and secondary prevention, omic technologies, hi-tech medical resources, and cancers in adolescents and young adults. The community of experts of the EU Joint Action, due to build such NoEs, has drafted this ‘green paper’, incorporating 13 open questions, in an effort to foster discussion on some open questions about health networking on cancer in the EU. These affect highly diverse issues such as the following: how gaps in research into the instrument of health networking may be filled; which items lend themselves more to health networking in the EU; what degree of cooperation and harmonisation should be required of EU member states to best exploit health networking and give rise to European networks of national/regional networks; how the idea of subsidiarity may be best interpreted to support health networking in the context of EU treaties, which basically do not include health; how health networks should be funded and with what degree of cooperation between the EU and national levels; whether EU health networks should be shaped as legal entities or could give rise to secondary legal entities, also with a view to fundraising; how health networks should be best shaped to advance cancer research and how the EU regulatory system should be updated to exploit such impulse to health networks, in view of the EU General Data Protection Regulation and the new EU Health Data Space; how artificial intelligence can be exploited today within health networks and to what extent it will be able to overcome challenges such as the current lack of interoperability of electronic health records and the language barrier across the EU; and how health networks should involve patients and their groups, with regard to their formal role within EU health networks as well as their ability to have a say in items such as production of clinical practice guidelines, the design of investigator-driven clinical trials, EU regulatory decisions on medicines and devices, health service data governance, and identification of unmet needs.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104126"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.esmoop.2024.104107
G. Ku , G.M. Haag , H. Park , V.K. Lam , T.J. George , S.S. Kim , M. Gutierrez , V. Shankaran , S. Stein , C.S. Denlinger , E. Elimova , A. Nagrial , A.R. He , M.B. Sawyer , H.H. Yoon , R. Geva , J. Starr , G. Curigliano , T. Golan , R. von Moos , M. Di Bartolomeo
Background
Nivolumab-based therapies are efficacious with acceptable safety in patients with gastric cancer (GC) and gastroesophageal junction cancer (GEJC). Novel nivolumab-based combination immunotherapies may offer enhanced efficacy in these indications. FRACTION-GC was a signal-seeking, randomized, open-label, phase II adaptive-design trial assessing efficacy and safety of nivolumab in combination with ipilimumab [cytotoxic T lymphocyte antigen-4 (CTLA-4) antibody], relatlimab (lymphocyte-activation gene 3 antibody), or IDO1i (BMS986205, an indoleamine-2,3-dioxygenase-1 inhibitor) in patients with unresectable, advanced/metastatic GC/GEJC.
Patients and methods
Previously treated patients with GC/GEJC were randomized to receive nivolumab + ipilimumab, nivolumab + relatlimab, or nivolumab + IDO1i across two tracks: anti-programmed death-(ligand) 1/anti-CTLA-4-naïve (track 1) and -experienced (track 2). Primary endpoints were objective response rate (ORR) by investigator per RECIST v1.1, duration of response, and progression-free survival (PFS) rate at 24 weeks. Secondary endpoint was safety.
Results
Eighty-one patients in track 1 and 81 in track 2 received one combination therapy. With a median follow-up of 50.2 months, ORR [95% confidence interval (CI)] by investigator for nivolumab + ipilimumab, nivolumab + relatlimab, and nivolumab + IDO1i in track 1 was 4% (0.1% to 21.9%), 5% (0.1% to 24.9%), and 13% (4.4% to 28.1%), and for track 2 was 9% (1.1% to 28.0%), 6% (0.7% to 18.7%), and 0% (0% to 15.4%), respectively. PFS rate at 24 weeks (95% CI) was 24% (11% to 39%) for nivolumab + IDO1i track 1, 17% (16% to 32%) for nivolumab + relatlimab track 2, and not estimable for other treatment arms. Grade 3/4 treatment-related adverse events were reported in 22%, 5%, and 18% of patients receiving nivolumab + ipilimumab, nivolumab + relatlimab, and nivolumab + IDO1i in track 1 and in 35%, 11%, and 18% of patients in track 2, respectively. No treatment-related deaths were reported.
Conclusions
While ORR did not meet prespecified expansion criteria in any treatment arm, the safety profile of the combinations was manageable. FRACTION-GC represents a novel adaptive protocol for testing multiple combination immunotherapies.
{"title":"Nivolumab combination therapies in patients with advanced gastric and gastroesophageal junction cancer: the phase II FRACTION gastric cancer study","authors":"G. Ku , G.M. Haag , H. Park , V.K. Lam , T.J. George , S.S. Kim , M. Gutierrez , V. Shankaran , S. Stein , C.S. Denlinger , E. Elimova , A. Nagrial , A.R. He , M.B. Sawyer , H.H. Yoon , R. Geva , J. Starr , G. Curigliano , T. Golan , R. von Moos , M. Di Bartolomeo","doi":"10.1016/j.esmoop.2024.104107","DOIUrl":"10.1016/j.esmoop.2024.104107","url":null,"abstract":"<div><h3>Background</h3><div>Nivolumab-based therapies are efficacious with acceptable safety in patients with gastric cancer (GC) and gastroesophageal junction cancer (GEJC). Novel nivolumab-based combination immunotherapies may offer enhanced efficacy in these indications. FRACTION-GC was a signal-seeking, randomized, open-label, phase II adaptive-design trial assessing efficacy and safety of nivolumab in combination with ipilimumab [cytotoxic T lymphocyte antigen-4 (CTLA-4) antibody], relatlimab (lymphocyte-activation gene 3 antibody), or IDO1i (BMS986205, an indoleamine-2,3-dioxygenase-1 inhibitor) in patients with unresectable, advanced/metastatic GC/GEJC.</div></div><div><h3>Patients and methods</h3><div>Previously treated patients with GC/GEJC were randomized to receive nivolumab + ipilimumab, nivolumab + relatlimab, or nivolumab + IDO1i across two tracks: anti-programmed death-(ligand) 1/anti-CTLA-4-naïve (track 1) and -experienced (track 2). Primary endpoints were objective response rate (ORR) by investigator per RECIST v1.1, duration of response, and progression-free survival (PFS) rate at 24 weeks. Secondary endpoint was safety.</div></div><div><h3>Results</h3><div>Eighty-one patients in track 1 and 81 in track 2 received one combination therapy. With a median follow-up of 50.2 months, ORR [95% confidence interval (CI)] by investigator for nivolumab + ipilimumab, nivolumab + relatlimab, and nivolumab + IDO1i in track 1 was 4% (0.1% to 21.9%), 5% (0.1% to 24.9%), and 13% (4.4% to 28.1%), and for track 2 was 9% (1.1% to 28.0%), 6% (0.7% to 18.7%), and 0% (0% to 15.4%), respectively. PFS rate at 24 weeks (95% CI) was 24% (11% to 39%) for nivolumab + IDO1i track 1, 17% (16% to 32%) for nivolumab + relatlimab track 2, and not estimable for other treatment arms. Grade 3/4 treatment-related adverse events were reported in 22%, 5%, and 18% of patients receiving nivolumab + ipilimumab, nivolumab + relatlimab, and nivolumab + IDO1i in track 1 and in 35%, 11%, and 18% of patients in track 2, respectively. No treatment-related deaths were reported.</div></div><div><h3>Conclusions</h3><div>While ORR did not meet prespecified expansion criteria in any treatment arm, the safety profile of the combinations was manageable. FRACTION-GC represents a novel adaptive protocol for testing multiple combination immunotherapies.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104107"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}