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Chemotherapy dose density is prognostic for overall survival in patients with resectable pancreas cancer: A landmark analysis of SWOG 1505 化疗剂量密度是可切除胰腺癌患者总生存期的预后指标:SWOG 1505 的里程碑式分析
IF 6.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-11 DOI: 10.1002/cncr.35759
Sameer H. Patel MD, Sarah Colby PhD, Davendra Sohal MD, MPH, Katherine A. Guthrie PhD, Lisa A. Kachnic MD, E. Gabriela Chiorean MD, Andrew M. Lowy MD, Flavio G. Rocha MD, Howard S. Hochster MD, Philip A. Philip MD, PhD, Syed A. Ahmad MD

Background

Chemotherapy is required to improve the overall survival (OS) of patients with resectable pancreatic ductal adenocarcinoma (PDAC). Assessing the impact of chemotherapy dose density (DD) on survival is difficult as a result of confounding. The objective of this study was to determine the impact of chemotherapy DD on OS in patients with resectable PDAC.

Methods

This was a secondary analysis of SWOG 1505, a randomized phase 2 trial of perioperative chemotherapy in resectable PDAC. DD was defined as the percentage of chemotherapy dose received of the total planned. Two landmark time points for OS were used: after surgery and at 40 weeks (which encompassed the entire treatment period).

Results

Of the 102 eligible patients enrolled, 73 (71%) underwent surgery, and median preoperative chemotherapy DD was 89%. Patients with ≥85% DD had higher OS compared to those with <85% DD (median, 38.1 vs. 17.2 months; p = .039). Of the 82 patients who survived to 40 weeks postrandomization, 67 underwent surgery, and median DD for all perioperative chemotherapy was 67%. In this cohort, DD ≥70% was associated with better OS (median, 32.2 vs. 14.0 months; p = .017). Perioperative DD was not significantly associated with pathologic response, margin status, or lymph node negativity.

Conclusions

This is the first study to identify a prognostic association of chemotherapy DD with OS in patients undergoing perioperative chemotherapy and surgery for resectable PDAC. Patients who received ≥85% DD preoperatively and/or ≥70% DD perioperatively survived longer than those receiving a smaller proportion of protocol therapy.

{"title":"Chemotherapy dose density is prognostic for overall survival in patients with resectable pancreas cancer: A landmark analysis of SWOG 1505","authors":"Sameer H. Patel MD,&nbsp;Sarah Colby PhD,&nbsp;Davendra Sohal MD, MPH,&nbsp;Katherine A. Guthrie PhD,&nbsp;Lisa A. Kachnic MD,&nbsp;E. Gabriela Chiorean MD,&nbsp;Andrew M. Lowy MD,&nbsp;Flavio G. Rocha MD,&nbsp;Howard S. Hochster MD,&nbsp;Philip A. Philip MD, PhD,&nbsp;Syed A. Ahmad MD","doi":"10.1002/cncr.35759","DOIUrl":"https://doi.org/10.1002/cncr.35759","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chemotherapy is required to improve the overall survival (OS) of patients with resectable pancreatic ductal adenocarcinoma (PDAC). Assessing the impact of chemotherapy dose density (DD) on survival is difficult as a result of confounding. The objective of this study was to determine the impact of chemotherapy DD on OS in patients with resectable PDAC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a secondary analysis of SWOG 1505, a randomized phase 2 trial of perioperative chemotherapy in resectable PDAC. DD was defined as the percentage of chemotherapy dose received of the total planned. Two landmark time points for OS were used: after surgery and at 40 weeks (which encompassed the entire treatment period).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 102 eligible patients enrolled, 73 (71%) underwent surgery, and median preoperative chemotherapy DD was 89%. Patients with ≥85% DD had higher OS compared to those with &lt;85% DD (median, 38.1 vs. 17.2 months; <i>p</i> = .039). Of the 82 patients who survived to 40 weeks postrandomization, 67 underwent surgery, and median DD for all perioperative chemotherapy was 67%. In this cohort, DD ≥70% was associated with better OS (median, 32.2 vs. 14.0 months; <i>p</i> = .017). Perioperative DD was not significantly associated with pathologic response, margin status, or lymph node negativity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first study to identify a prognostic association of chemotherapy DD with OS in patients undergoing perioperative chemotherapy and surgery for resectable PDAC. Patients who received ≥85% DD preoperatively and/or ≥70% DD perioperatively survived longer than those receiving a smaller proportion of protocol therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388893","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}
引用次数: 0
Relationship between pain and nonopioid substance use in two national samples of cancer survivors
IF 6.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-10 DOI: 10.1002/cncr.35701
Jessica M. Powers PhD, Lisa R. LaRowe PhD, Dana Rubenstein MHS, Judith A. Paice PhD, RN, Brian Hitsman PhD, Christine M. Rini PhD

Significance

Pain and nonopioid substance use (tobacco, cannabis, alcohol) frequently co-occur, but have been understudied among cancer survivors. Even less work has examined whether pain and nonopioid substance use is related to other cancer treatment-related side effects, mental health, and health-related quality of life.

Methods

Two national datasets were used to assess a range of variables and confirm patterns. Study 1 included 1252 adults (88% White; 55% female; 60% aged ≥65) from Wave 6 (2021) of the Population Assessment of Tobacco and Health Study, and Study 2 included 4130 adults (83% White; 56% female; M age = 66) from the 2020 National Health Interview Survey who reported a lifetime cancer diagnosis. Regression analyses were conducted separately by study.

Results

Study 1 results indicated that past-week pain intensity was associated with greater likelihood of using cigarettes, e-cigarettes, and cannabis (ps < .003) and lower likelihood of using alcohol (p < .001). Study 2 results indicated that chronic pain (vs. no chronic pain) was associated with greater likelihood of cigarette smoking (p < .001) and lower likelihood of alcohol use (p < .001). In both studies, cigarette smoking and pain were related to fatigue, sleep difficulties, poorer mental/physical health, and lower health-related quality of life.

Conclusion

Pain is associated with greater likelihood of tobacco and cannabis use among cancer survivors. Given that substance use may impact cancer treatment and its side effects and contribute to pain chronification, there is an urgent need to develop tailored interventions for cooccurring pain and substance use in cancer survivors.

{"title":"Relationship between pain and nonopioid substance use in two national samples of cancer survivors","authors":"Jessica M. Powers PhD,&nbsp;Lisa R. LaRowe PhD,&nbsp;Dana Rubenstein MHS,&nbsp;Judith A. Paice PhD, RN,&nbsp;Brian Hitsman PhD,&nbsp;Christine M. Rini PhD","doi":"10.1002/cncr.35701","DOIUrl":"https://doi.org/10.1002/cncr.35701","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Pain and nonopioid substance use (tobacco, cannabis, alcohol) frequently co-occur, but have been understudied among cancer survivors. Even less work has examined whether pain and nonopioid substance use is related to other cancer treatment-related side effects, mental health, and health-related quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two national datasets were used to assess a range of variables and confirm patterns. Study 1 included 1252 adults (88% White; 55% female; 60% aged ≥65) from Wave 6 (2021) of the Population Assessment of Tobacco and Health Study, and Study 2 included 4130 adults (83% White; 56% female; <i>M</i> age = 66) from the 2020 National Health Interview Survey who reported a lifetime cancer diagnosis. Regression analyses were conducted separately by study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Study 1 results indicated that past-week pain intensity was associated with greater likelihood of using cigarettes, e-cigarettes, and cannabis (<i>p</i>s &lt; .003) and lower likelihood of using alcohol (<i>p</i> &lt; .001). Study 2 results indicated that chronic pain (vs. no chronic pain) was associated with greater likelihood of cigarette smoking (<i>p</i> &lt; .001) and lower likelihood of alcohol use (<i>p</i> &lt; .001). In both studies, cigarette smoking and pain were related to fatigue, sleep difficulties, poorer mental/physical health, and lower health-related quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pain is associated with greater likelihood of tobacco and cannabis use among cancer survivors. Given that substance use may impact cancer treatment and its side effects and contribute to pain chronification, there is an urgent need to develop tailored interventions for cooccurring pain and substance use in cancer survivors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380098","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}
引用次数: 0
Update on safety and feasibility of the combination of pembrolizumab and pelvic chemoradiation in locally advanced cervical cancer
IF 6.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-08 DOI: 10.1002/cncr.35757
Linda R. Duska MD, MPH, Gina R. Petroni PhD, Premal H. Thaker MD, Erin K. Crane MD, Laura L. Holman MD, MS, Debrorah K. Armstrong MD, Kara Romano MD, Jennifer Scalici MD

Background

The addition of immune checkpoint inhibitors to standard-of-care chemoradiation (CRT) is established as the new standard of care in high-risk, locally advanced cervical cancer. However, the optimal sequencing of therapies is unknown. Defining safety and feasibility of the combination was a primary objective of this study examining concurrent versus sequential schedules.

Methods

Pembrolizumab was given after or during CRT in a randomized phase 2 design. Patients aged 18 years and older with locally advanced cervical cancer, stages IB–IVA (according to 2009 International Federation of Gynecology and Obstetrics staging) were randomized 1:1 to treatment regimens. CRT was identical for both arms. Pembrolizumab was administered every 3 weeks for three doses; no maintenance was allowed. Safety assessments included the incidence and severity of adverse events (AEs), and feasibility was measured by the completion of treatment in a predefined timeframe. Translational specimens (blood and tissue) were collected.

Results

In total, 94 evaluable patients completed treatment. Treatment-related grade ≥2 toxicity was experienced by 85 of 94 patients (90%); 40 patients (43%) had at least one grade 3 AE, and 22 (23%) had at least one grade 4 AE. There were no grade 5 AEs. Eighty percent of patients completed radiotherapy within 56 days, and 85% completed five or six doses of cisplatin and three doses of pembrolizumab (74 of 94 patients; 79%).

Conclusions

The final results of this study support the safety and feasibility of adding pembrolizumab to pelvic CRT, concurrently and sequentially. Progression-free and overall survival were not affected or different between treatment arms. An analysis of the translational end points is ongoing and will inform future study designs.

{"title":"Update on safety and feasibility of the combination of pembrolizumab and pelvic chemoradiation in locally advanced cervical cancer","authors":"Linda R. Duska MD, MPH,&nbsp;Gina R. Petroni PhD,&nbsp;Premal H. Thaker MD,&nbsp;Erin K. Crane MD,&nbsp;Laura L. Holman MD, MS,&nbsp;Debrorah K. Armstrong MD,&nbsp;Kara Romano MD,&nbsp;Jennifer Scalici MD","doi":"10.1002/cncr.35757","DOIUrl":"https://doi.org/10.1002/cncr.35757","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The addition of immune checkpoint inhibitors to standard-of-care chemoradiation (CRT) is established as the new standard of care in high-risk, locally advanced cervical cancer. However, the optimal sequencing of therapies is unknown. Defining safety and feasibility of the combination was a primary objective of this study examining concurrent versus sequential schedules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pembrolizumab was given after or during CRT in a randomized phase 2 design. Patients aged 18 years and older with locally advanced cervical cancer, stages IB–IVA (according to 2009 International Federation of Gynecology and Obstetrics staging) were randomized 1:1 to treatment regimens. CRT was identical for both arms. Pembrolizumab was administered every 3 weeks for three doses; no maintenance was allowed. Safety assessments included the incidence and severity of adverse events (AEs), and feasibility was measured by the completion of treatment in a predefined timeframe. Translational specimens (blood and tissue) were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 94 evaluable patients completed treatment. Treatment-related grade ≥2 toxicity was experienced by 85 of 94 patients (90%); 40 patients (43%) had at least one grade 3 AE, and 22 (23%) had at least one grade 4 AE. There were no grade 5 AEs. Eighty percent of patients completed radiotherapy within 56 days, and 85% completed five or six doses of cisplatin and three doses of pembrolizumab (74 of 94 patients; 79%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The final results of this study support the safety and feasibility of adding pembrolizumab to pelvic CRT, concurrently and sequentially. Progression-free and overall survival were not affected or different between treatment arms. An analysis of the translational end points is ongoing and will inform future study designs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370080","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}
引用次数: 0
Olaparib in treatment-refractory isocitrate dehydrogenase 1 (IDH1)– and IDH2-mutant cholangiocarcinoma: Safety and antitumor activity from the phase 2 National Cancer Institute 10129 trial
IF 6.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-07 DOI: 10.1002/cncr.35755
Michael Cecchini MD, Mary Jo Pilat PhD, MS, PA, Nataliya Uboha MD, PhD, Nilofer S. Azad MD, May Cho MD, Elizabeth J. Davis MD, Jordi Rodon Ahnert MD, PhD, Gabriel Tinoco MD, Geoffrey I. Shapiro MD, PhD, Simon Khagi MD, Benjamin Powers MD, Kristen Spencer DO, Roman Groisberg MD, Jan Drappatz MD, Li Chen PhD, Biswajit Das PhD, Xun Bao PhD, Jing Li PhD, Azeet Narayan PhD, Dennis Vu BS, Abhijit Patel MD, PhD, Monica Niger MD, Deborah Doroshow MD, PhD, Diane Durecki MS, Scott A. Boerner MS, Ranjit Bindra MD, PhD, Percy Ivy MD, Derek Shyr PhD, Yu Shyr PhD, Patricia M. LoRusso DO

Background

Neomorphic isocitrate dehydrogenase (IDH) mutations lead to the accumulation of 2-hydroxyglutarate (2-HG), an oncometabolite implicated in tumor progression via inhibitory effects on alpha-ketoglutarate. Moreover, mutant IDH–dependent accumulation of 2-HG results in homologous recombination deficiency (HRD), which preclinically renders tumors sensitive to poly(adenosine diphosphate ribose) polymerase inhibitors. Here, the results of the cholangiocarcinoma (CCA) arm of the National Cancer Institute (NCI) 10129 olaparib in IDH-mutant solid tumors basket trial are reported.

Methods

Olaparib 300 mg twice daily was evaluated in an open-label, phase 2 clinical trial for treatment-refractory IDH-mutant solid tumors. Patients in the IDH-mutant CCA arm enrolled in two cohorts: (1) IDH inhibitor (IDHi) pretreated and (2) IDHi untreated, with a primary end point of overall response rate.

Results

NCI 10129 enrolled 30 patients with IDH-mutant CCA with no objective responses seen, and recruitment was closed early. Median progression-free survival (PFS) was 2.4 months (95% CI, 1.9 to 6.5 months) and median overall survival was 12.9 months (95% CI, 6.3 months to not reached). Eight patients (27%) had clinical benefit (CB), with a PFS of ≥6 months. Patients with CB had lower baseline 2-HG levels compared to those without CB (1.4 vs. 5.9 µmol/L; p = .01).

Conclusions

Olaparib does not have sufficient single-agent activity to warrant further development in IDH-mutant CCA. However, a subgroup of patients demonstrated CB, and exploratory analysis revealed this subgroup to be enriched for lower baseline 2-HG levels. Future clinical trials leveraging the HRD properties of IDH mutations are warranted with enhanced patient selection and novel combination therapies.

{"title":"Olaparib in treatment-refractory isocitrate dehydrogenase 1 (IDH1)– and IDH2-mutant cholangiocarcinoma: Safety and antitumor activity from the phase 2 National Cancer Institute 10129 trial","authors":"Michael Cecchini MD,&nbsp;Mary Jo Pilat PhD, MS, PA,&nbsp;Nataliya Uboha MD, PhD,&nbsp;Nilofer S. Azad MD,&nbsp;May Cho MD,&nbsp;Elizabeth J. Davis MD,&nbsp;Jordi Rodon Ahnert MD, PhD,&nbsp;Gabriel Tinoco MD,&nbsp;Geoffrey I. Shapiro MD, PhD,&nbsp;Simon Khagi MD,&nbsp;Benjamin Powers MD,&nbsp;Kristen Spencer DO,&nbsp;Roman Groisberg MD,&nbsp;Jan Drappatz MD,&nbsp;Li Chen PhD,&nbsp;Biswajit Das PhD,&nbsp;Xun Bao PhD,&nbsp;Jing Li PhD,&nbsp;Azeet Narayan PhD,&nbsp;Dennis Vu BS,&nbsp;Abhijit Patel MD, PhD,&nbsp;Monica Niger MD,&nbsp;Deborah Doroshow MD, PhD,&nbsp;Diane Durecki MS,&nbsp;Scott A. Boerner MS,&nbsp;Ranjit Bindra MD, PhD,&nbsp;Percy Ivy MD,&nbsp;Derek Shyr PhD,&nbsp;Yu Shyr PhD,&nbsp;Patricia M. LoRusso DO","doi":"10.1002/cncr.35755","DOIUrl":"https://doi.org/10.1002/cncr.35755","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Neomorphic isocitrate dehydrogenase (<i>IDH</i>) mutations lead to the accumulation of 2-hydroxyglutarate (2-HG), an oncometabolite implicated in tumor progression via inhibitory effects on alpha-ketoglutarate. Moreover, mutant <i>IDH</i>–dependent accumulation of 2-HG results in homologous recombination deficiency (HRD), which preclinically renders tumors sensitive to poly(adenosine diphosphate ribose) polymerase inhibitors. Here, the results of the cholangiocarcinoma (CCA) arm of the National Cancer Institute (NCI) 10129 olaparib in <i>IDH</i>-mutant solid tumors basket trial are reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Olaparib 300 mg twice daily was evaluated in an open-label, phase 2 clinical trial for treatment-refractory <i>IDH</i>-mutant solid tumors. Patients in the <i>IDH</i>-mutant CCA arm enrolled in two cohorts: (1) IDH inhibitor (IDHi) pretreated and (2) IDHi untreated, with a primary end point of overall response rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>NCI 10129 enrolled 30 patients with <i>IDH</i>-mutant CCA with no objective responses seen, and recruitment was closed early. Median progression-free survival (PFS) was 2.4 months (95% CI, 1.9 to 6.5 months) and median overall survival was 12.9 months (95% CI, 6.3 months to not reached). Eight patients (27%) had clinical benefit (CB), with a PFS of ≥6 months. Patients with CB had lower baseline 2-HG levels compared to those without CB (1.4 vs. 5.9 µmol/L; <i>p</i> = .01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Olaparib does not have sufficient single-agent activity to warrant further development in <i>IDH</i>-mutant CCA. However, a subgroup of patients demonstrated CB, and exploratory analysis revealed this subgroup to be enriched for lower baseline 2-HG levels. Future clinical trials leveraging the HRD properties of <i>IDH</i> mutations are warranted with enhanced patient selection and novel combination therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Results of Cancer and Leukemia Group B 10102 (Alliance), a Phase 1/2 Study
IF 6.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-06 DOI: 10.1002/cncr.35750
Marlise R. Luskin MD, MSCE, Jun Yin PhD, Gerard Lozanski MD, Emily Curran MD, Gregory Malnassy PhD, Krzysztof Mrózek MD, PhD, Clara D. Bloomfield MD, Spero R. Cataland MD, Noreen Fulton BA, Jonathan Kolitz MD, Betsy Laplant MS, Oudom Kour MS, Bayard L. Powell MD, Ravi Vij MD, Eunice S. Wang MD, PhD, David Grinblatt MD, Richard M. Stone MD, Geoffrey L. Uy MD, Richard A. Larson MD, Wendy Stock MD

Background

Acute lymphoblastic leukemia (ALL) in adults is aggressive, with long-term outcomes impacted by treatment resistance and toxicity. CD52 is expressed in most cases of B- and T-lineage ALL. Alemtuzumab, a humanized immunoglobulin G1 monoclonal antibody that targets CD52, was identified as a potential agent to improve treatment efficacy without increasing toxicity.

Methods

In this phase 1/2 study (Cancer and Leukemia Group B [CALGB] 10102, NCT00061945), a course of single-agent alemtuzumab was intercalated into CALGB 19802 backbone chemotherapy after the third course of intensive chemotherapy in those who were CD52+ at diagnosis. Phase 1 tested three dose levels of subcutaneous alemtuzumab (10, 20, and 30 mg 3 times weekly for 4 weeks/12 doses) and demonstrated that 30 mg was tolerable. Phase 2 established feasibility.

Results

The study enrolled 295 evaluable patients (115 in phase 1, 180 in phase 2); 206 (69.8%) were CD52+. Among evaluable CD52+ patients, 43.7% (90/206) completed the first three treatment modules; 97.8% (88 of 90) were treated with alemtuzumab. Alemtuzumab was associated with cytomegalovirus viremia, which occurred in 23.3% (14 of 60) of patients during and 29.2% (19 of 65) after alemtuzumab treatment. With a median follow-up of 101.2 months, median overall survival (OS) was 26.3 months (3-year rate, 44%; 5-year rate, 36%; 10-year rate, 31%). Landmark analysis at the start of the fourth course of treatment demonstrated no difference in OS or disease-free survival between patients who did and who did not receive alemtuzumab.

Conclusion

Alemtuzumab was feasible to administer in adults with ALL receiving intensive chemotherapy, but was without evidence of benefit.

{"title":"Results of Cancer and Leukemia Group B 10102 (Alliance), a Phase 1/2 Study","authors":"Marlise R. Luskin MD, MSCE,&nbsp;Jun Yin PhD,&nbsp;Gerard Lozanski MD,&nbsp;Emily Curran MD,&nbsp;Gregory Malnassy PhD,&nbsp;Krzysztof Mrózek MD, PhD,&nbsp;Clara D. Bloomfield MD,&nbsp;Spero R. Cataland MD,&nbsp;Noreen Fulton BA,&nbsp;Jonathan Kolitz MD,&nbsp;Betsy Laplant MS,&nbsp;Oudom Kour MS,&nbsp;Bayard L. Powell MD,&nbsp;Ravi Vij MD,&nbsp;Eunice S. Wang MD, PhD,&nbsp;David Grinblatt MD,&nbsp;Richard M. Stone MD,&nbsp;Geoffrey L. Uy MD,&nbsp;Richard A. Larson MD,&nbsp;Wendy Stock MD","doi":"10.1002/cncr.35750","DOIUrl":"https://doi.org/10.1002/cncr.35750","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute lymphoblastic leukemia (ALL) in adults is aggressive, with long-term outcomes impacted by treatment resistance and toxicity. CD52 is expressed in most cases of B- and T-lineage ALL. Alemtuzumab, a humanized immunoglobulin G1 monoclonal antibody that targets CD52, was identified as a potential agent to improve treatment efficacy without increasing toxicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this phase 1/2 study (Cancer and Leukemia Group B [CALGB] 10102, NCT00061945), a course of single-agent alemtuzumab was intercalated into CALGB 19802 backbone chemotherapy after the third course of intensive chemotherapy in those who were CD52+ at diagnosis. Phase 1 tested three dose levels of subcutaneous alemtuzumab (10, 20, and 30 mg 3 times weekly for 4 weeks/12 doses) and demonstrated that 30 mg was tolerable. Phase 2 established feasibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study enrolled 295 evaluable patients (115 in phase 1, 180 in phase 2); 206 (69.8%) were CD52+. Among evaluable CD52+ patients, 43.7% (90/206) completed the first three treatment modules; 97.8% (88 of 90) were treated with alemtuzumab. Alemtuzumab was associated with cytomegalovirus viremia, which occurred in 23.3% (14 of 60) of patients during and 29.2% (19 of 65) after alemtuzumab treatment. With a median follow-up of 101.2 months, median overall survival (OS) was 26.3 months (3-year rate, 44%; 5-year rate, 36%; 10-year rate, 31%). Landmark analysis at the start of the fourth course of treatment demonstrated no difference in OS or disease-free survival between patients who did and who did not receive alemtuzumab.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Alemtuzumab was feasible to administer in adults with ALL receiving intensive chemotherapy, but was without evidence of benefit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35750","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362269","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}
引用次数: 0
Financial toxicity: A ubiquitous condition in patients with cancer
IF 6.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-06 DOI: 10.1002/cncr.35748
Joseph M. Unger PhD
{"title":"Financial toxicity: A ubiquitous condition in patients with cancer","authors":"Joseph M. Unger PhD","doi":"10.1002/cncr.35748","DOIUrl":"https://doi.org/10.1002/cncr.35748","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Community-engaged adaptation of ACCESS: A navigator-led early palliative care intervention for Black and Latina women with advanced breast cancer
IF 6.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-06 DOI: 10.1002/cncr.35745
Melissa Mazor PhD, MS, RN, Jenny J. Lin MD, MPH, Cardinale Smith MD, PhD, William E. Rosa PhD, MBE, MS, Dolores Moorehead APCC, Rebecca M. Boorstin BA, Jordan Karpin BS, Alex Nelson BS, Marie A. Bakitas DNSc, RN, AOCN, FPCN, FAAN, Sarah Miller PsyD, J. Nicholas Odom PhD, RN, ACHPN, FPCN, FAAN

Introduction

Disparities in early palliative care (PC) access for Black and Latina women with advanced breast cancer (ABC) persist. This study elicited qualitative feedback from patients with ABC and health professionals to adapt a community navigator-led early PC program called ACCESS to improve PC access and supportive care outcomes for Black and Latina women with ABC.

Methods

This was a formative evaluation study using a community-engaged approach. Guided by a community advisory board, qualitative interviews were conducted with Black and Latina women with ABC (N = 20) and interdisciplinary health professionals and patient navigators (N = 20) to elicit feedback on the content, delivery, and format of ACCESS, a navigator-delivered early PC intervention to improve PC access and outcomes. Thematic analysis was conducted using inductive coding followed by deductive analysis using the Consolidated Framework for Implementation Research framework to guide intervention adaptation.

Results

Findings indicate that ACCESS addresses the early PC needs of Black and Latina women with ABC, yet needs to embed flexibility per patient preferences. Additionally, PC should be introduced as supportive care to enhance acceptability. Navigators emphasized fostering awareness and access to resources, which are crucial for patients' well-being. Strong interdisciplinary relationships and care coordination are essential for embedding ACCESS. Recognizing patient individuality, addressing historical and cultural factors, and ensuring navigators are empathetic, well-trained, and culturally aligned with patients were highlighted as pivotal for the intervention's success.

Conclusions

These findings will inform the adaptation of ACCESS for feasibility and preliminary efficacy testing.

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引用次数: 0
Reply to “Toward a reduction in the burden of therapy in patients with rhabdomyosarcoma. How much is enough?”
IF 6.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-06 DOI: 10.1002/cncr.35744
Henry C. Mandeville MBChB, MD(Res), Gianni Bisogno MD, PhD, Veronique Minard-Colin MD, PhD, Rita Alaggio MD, Myriam Ben-Arush MD, Cyrus Chargari MD, PhD, Beatrice Coppadoro BSc, Ross Craigie MBChB, Christine Devalck MD, Sima Ferman MD, PhD, Andrea Ferrari MD, Heidi Glosli MD, Raquel Hladun Alvaro MD, Marinka Hol MD, PhD, Peter Mudry MD, Daniel Orbach MD, Monica Ramos Albiac MD, Johannes H. M. Merks MD, PhD, Meriel E. M. Jenney MBChB, MD
{"title":"Reply to “Toward a reduction in the burden of therapy in patients with rhabdomyosarcoma. How much is enough?”","authors":"Henry C. Mandeville MBChB, MD(Res),&nbsp;Gianni Bisogno MD, PhD,&nbsp;Veronique Minard-Colin MD, PhD,&nbsp;Rita Alaggio MD,&nbsp;Myriam Ben-Arush MD,&nbsp;Cyrus Chargari MD, PhD,&nbsp;Beatrice Coppadoro BSc,&nbsp;Ross Craigie MBChB,&nbsp;Christine Devalck MD,&nbsp;Sima Ferman MD, PhD,&nbsp;Andrea Ferrari MD,&nbsp;Heidi Glosli MD,&nbsp;Raquel Hladun Alvaro MD,&nbsp;Marinka Hol MD, PhD,&nbsp;Peter Mudry MD,&nbsp;Daniel Orbach MD,&nbsp;Monica Ramos Albiac MD,&nbsp;Johannes H. M. Merks MD, PhD,&nbsp;Meriel E. M. Jenney MBChB, MD","doi":"10.1002/cncr.35744","DOIUrl":"https://doi.org/10.1002/cncr.35744","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
EXPRESSION OF CONCERN: Mechanisms of Synthetic Serine Protease Inhibitor (FUT-175)-Mediated Cell Death
IF 6.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-06 DOI: 10.1002/cncr.35718

EXPRESSION OF CONCERN: T. Uwagawa, Z. Li, Z. Chang, Q. Xia, B. Peng, G. M. Sclabas, S. Ishiyama, M.-C. Hung, D. B. Evans, J. L. Abbruzzese, and P. J. Chiao, “Mechanisms of Synthetic Serine Protease Inhibitor (FUT-175)-Mediated Cell Death,” Cancer 109, no. 10 (2007): 2142-2153, https://doi.org/10.1002/cncr.22658.

This Expression of Concern is for the above article, published online on 04 April 2007 in Wiley Online Library (wileyonlinelibrary.com), and has been published by agreement between the journal Editor-in-Chief, Suresh S. Ramalingam; the American Cancer Society; and Wiley Periodicals LLC. The Expression of Concern has been published due to concerns raised by a third party regarding inconsistencies identified between Figure 1D and Figure 2D. The figures depict bands from the same experimental conditions and while the band of IκBα lane – 80 µg/ml FUT175 is identical in both figures, the corresponding β-actin loading control band is different.

The authors were informed about the concerns, but due to the time elapsed since publication, the raw data was not available. Without an explanation of the anomaly in the figure and in the absence of the original raw data, the journal team could not verify the authenticity of this figure. Although the inconsistencies found in the figures likely do not affect the results and the conclusions of this publication, the journal has decided to issue an Expression of Concern to inform the readers.

{"title":"EXPRESSION OF CONCERN: Mechanisms of Synthetic Serine Protease Inhibitor (FUT-175)-Mediated Cell Death","authors":"","doi":"10.1002/cncr.35718","DOIUrl":"https://doi.org/10.1002/cncr.35718","url":null,"abstract":"<p><b>EXPRESSION OF CONCERN</b>: T. Uwagawa, Z. Li, Z. Chang, Q. Xia, B. Peng, G. M. Sclabas, S. Ishiyama, M.-C. Hung, D. B. Evans, J. L. Abbruzzese, and P. J. Chiao, “Mechanisms of Synthetic Serine Protease Inhibitor (FUT-175)-Mediated Cell Death,” <i>Cancer</i> 109, no. 10 (2007): 2142-2153, https://doi.org/10.1002/cncr.22658.</p><p>This Expression of Concern is for the above article, published online on 04 April 2007 in Wiley Online Library (wileyonlinelibrary.com), and has been published by agreement between the journal Editor-in-Chief, Suresh S. Ramalingam; the American Cancer Society; and Wiley Periodicals LLC. The Expression of Concern has been published due to concerns raised by a third party regarding inconsistencies identified between Figure 1D and Figure 2D. The figures depict bands from the same experimental conditions and while the band of IκBα lane – 80 µg/ml FUT175 is identical in both figures, the corresponding β-actin loading control band is different.</p><p>The authors were informed about the concerns, but due to the time elapsed since publication, the raw data was not available. Without an explanation of the anomaly in the figure and in the absence of the original raw data, the journal team could not verify the authenticity of this figure. Although the inconsistencies found in the figures likely do not affect the results and the conclusions of this publication, the journal has decided to issue an Expression of Concern to inform the readers.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35718","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362268","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}
引用次数: 0
Pembrolizumab with chemoradiotherapy followed by pembrolizumab for stage III–IVa cervical cancer: is the ENGOT-cx11/GOG-3047/KEYNOTE-A18 trial practice changing?
IF 6.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-06 DOI: 10.1002/cncr.35749
Bart M. F. Penninx MD, Michael J. Samson MD, John-John B. Schnog MD, PhD

At the second interim analysis, the ENGOT-cx11/GOG-3047/KEYNOTE-A18 demonstrated an overall survival (OS) benefit after 36 months in stage III–IVa cervical cancer patients treated with chemoradiotherapy and concurrent pembrolizumab followed by 90 weeks of pembrolizumab as compared to placebo (82.6% vs. 74.8%, hazard ratio for death, 0.67 [confidence interval, 0.50–0.90]). Only 51 of 193 progressing patients in the control arm were exposed to immunotherapy after progressing. The reported OS benefit could be explained by suboptimal post-progression treatment in the control group. Even if pembrolizumab as administered in the ENGOT-cx11/GOG-3047/KEYNOTE-A18 was efficacious, the treatment duration is excessively long. The associated costs render it unattainable in the regions where burden of cervical cancer is highest. Based on these concerns, the findings at the interim analysis of the ENGOT-cx11/GOG-3047/KEYNOTE-A18 RCT should not change practice.

{"title":"Pembrolizumab with chemoradiotherapy followed by pembrolizumab for stage III–IVa cervical cancer: is the ENGOT-cx11/GOG-3047/KEYNOTE-A18 trial practice changing?","authors":"Bart M. F. Penninx MD,&nbsp;Michael J. Samson MD,&nbsp;John-John B. Schnog MD, PhD","doi":"10.1002/cncr.35749","DOIUrl":"https://doi.org/10.1002/cncr.35749","url":null,"abstract":"<p>At the second interim analysis, the ENGOT-cx11/GOG-3047/KEYNOTE-A18 demonstrated an overall survival (OS) benefit after 36 months in stage III–IVa cervical cancer patients treated with chemoradiotherapy and concurrent pembrolizumab followed by 90 weeks of pembrolizumab as compared to placebo (82.6% vs. 74.8%, hazard ratio for death, 0.67 [confidence interval, 0.50–0.90]). Only 51 of 193 progressing patients in the control arm were exposed to immunotherapy after progressing. The reported OS benefit could be explained by suboptimal post-progression treatment in the control group. Even if pembrolizumab as administered in the ENGOT-cx11/GOG-3047/KEYNOTE-A18 was efficacious, the treatment duration is excessively long. The associated costs render it unattainable in the regions where burden of cervical cancer is highest. Based on these concerns, the findings at the interim analysis of the ENGOT-cx11/GOG-3047/KEYNOTE-A18 RCT should not change practice.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
期刊
Cancer
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