12 results on '"Griesinger, Frank"'
Search Results
2. Evaluation of the Prognostic Impact of SP263-Evaluated PD-L1 Expression in Patients with Stage III Non-Small Cell Lung Cancer (NSLC) Treated with Radio-Chemotherapy.
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Wagner, Jan Nicolai, Roeper, Julia, Heukamp, Lukas, Falk, Markus, Willborn, Kay, and Griesinger, Frank
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NON-small-cell lung carcinoma ,PROGRAMMED death-ligand 1 ,CHEMORADIOTHERAPY - Abstract
Background: The PACIFIC study showed that after radio-chemotherapy, patients with NSCLC derived a benefit in PFS and OS when treated with durvalumab. This effect was limited to patients with a PD-L1 expression of >1%, partly because the outcome in the observational control arm was surprisingly favorable. Thus, it could be speculated that a lack of PD-L1 expression confers a favorable outcome for patients with stage III NSCLC. Methods: Clinical data, PD-L1 expression, predictive blood markers, and the outcomes of 99 homogeneously treated patients with stage III NSCLC were retrospectively captured. Statistical analyses using the log rank test were performed. Results: The median OS of patients with an expression of PD-L1 < 1% was 20 months (CI 10.5–29.5) and the median OS of patients with an expression of PD-L1 ≥ 1% was 28 months (CI 16.5–39.2) (p = 0.734). The median PFS of patients with an expression of PD-L1 < 1% was 9 months (CI 6.3–11.6) and the median PFS of patients with an expression of PD-L1 ≥ 1% was 12 months (CI 9.8–14.2) (p = 0.112). Conclusions: The assumption that the lack of PD-L1 expression represents a favorable prognostic factor after radio-chemotherapy vs. PD-L1 expression > 1% was not confirmed. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Effectiveness of Nivolumab in Second-Line and Later in Patients with Advanced Non-Small Cell Lung Cancer in Real-Life Practice in France and Germany: Analysis of the ESME-AMLC and CRISP Cohorts.
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Chouaid, Christos, Thomas, Michael, Debieuvre, Didier, Durand-Zaleski, Isabelle, Zacharias, Stefan, Bosquet, Lise, Groth, Annika, Fleitz, Annette, Calleja, Alan, Patel, Sonya, Lacoin, Laure, Daumont, Melinda J., Penrod, John R., Carroll, Robert, Waldenberger, Daniela, Cotté, François-Emery, Audigier-Valette, Clarisse, and Griesinger, Frank
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LUNG cancer prognosis ,DRUG efficacy ,LUNG cancer ,SCIENTIFIC observation ,METASTASIS ,TREATMENT duration ,CANCER patients ,NIVOLUMAB ,DESCRIPTIVE statistics ,LONGITUDINAL method ,EVALUATION - Abstract
Simple Summary: There is a need to better understand the effectiveness of new treatments, such as the recently approved nivolumab, in patients with locally advanced or metastatic non-small cell lung cancer in clinical practice. This study aims to report the characteristics and outcomes of 2784 patients with locally advanced or metastatic non-small cell lung cancer receiving nivolumab in second-line or later in France (ESME-AMLC) and Germany (CRISP) between 2015 and 2020. Two-year survival rates were 26.7% in patients with tumors with squamous histology and 32.8% in patients with non-squamous/others histologies in ESME-AMLC, and 20.9% and 18.9%, respectively, in CRISP. Poorer performance score and shorter duration from the previous line of therapy initiation were significantly associated with shorter treatment duration with nivolumab and overall survival. These real-world data provide insight into the characteristics of patients receiving nivolumab in France and Germany and confirm the efficacy of nivolumab previously observed in clinical trials. This study reports characteristics and outcomes in patients with locally advanced or metastatic non-small cell lung cancer (aNSCLC) receiving nivolumab in second-line or later (2L+) in France and Germany between 2015 and 2020. Patients with aNSCLC (stage IIIB–C/IV) receiving nivolumab in 2L+ were included from the retrospective Epidemiological Strategy and Medical Economics of Advanced and Metastatic Lung Cancer cohort (ESME-AMLC, France; 2015–2019) and Clinical Research platform Into molecular testing, treatment and outcome of non-Small cell lung carcinoma Patients (CRISP, Germany; 2016–2020). Overall, 2262 ESME-AMLC and 522 CRISP patients were included. Median treatment duration (95% confidence intervals) was 2.8 months (2.5–3.2) in squamous and 2.5 months (2.3–2.8) in non-squamous/others patients in ESME-AMLC, and 2.3 months (1.4–3.1) and 2.3 months (2.0–2.8), respectively in CRISP. One-year and two-year overall survival (OS) were 47.2% and 26.7% in squamous and 50.8% and 32.8% in non-squamous/others patients in ESME-AMLC, and 43.1% and 20.9%, and 37.7% and 18.9%, respectively in CRISP. Poorer performance score and shorter time from start of previous line of therapy initiation were significantly associated with shorter treatment duration and OS. This study confirms, in real-world clinical databases, the efficacy of nivolumab previously observed in clinical trials. [ABSTRACT FROM AUTHOR]
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- 2022
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4. Tepotinib in non-small-cell lung cancer with MET exon 14 skipping mutations
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Paik, Paul K., Felip, Enriqueta, Veillon, Remi, Sakai, Hiroshi, Cortot, Alexis B., Garassino, Marina C., Mazieres, Julien, Viteri, Santiago, Senellart, Helene, van Meerbeeck, Jan, Raskin, Jo, Reinmuth, Niels, Conte, Pierfranco, Kowalski, Dariusz, Cho, Byoung Chul, Patel, Jyoti D., Horn, Leora, Griesinger, Frank, Han, Ji-Youn, Kim, Young-Chul, Chang, Gee-Chen, Tsai, Chen-Liang, Yang, James C. -H., Chen, Yuh-Min, Smit, Egbert F., van der Wekken, Anthonie J., Kato, Terufumi, Juraeva, Dilafruz, Stroh, Christopher, Bruns, Rolf, Straub, Josef, Johne, Andreas, Scheele, Juergen, Heymach, John V., Le, Xiuning, and Damage and Repair in Cancer Development and Cancer Treatment (DARE)
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Adult ,Male ,Lung Neoplasms ,Antineoplastic Agents ,030204 cardiovascular system & hematology ,Article ,03 medical and health sciences ,Exon ,0302 clinical medicine ,Piperidines ,Transcription (biology) ,Carcinoma, Non-Small-Cell Lung ,medicine ,Carcinoma ,Edema ,Humans ,030212 general & internal medicine ,Lung cancer ,Protein Kinase Inhibitors ,Aged ,Aged, 80 and over ,business.industry ,General Medicine ,Exons ,Middle Aged ,Proto-Oncogene Proteins c-met ,medicine.disease ,MET Exon 14 Skipping Mutation ,respiratory tract diseases ,Pyridazines ,Pyrimidines ,Multicenter study ,Mutation ,Cancer research ,Female ,Non small cell ,Human medicine ,business - Abstract
BACKGROUND A splice-site mutation that results in a loss of transcription of exon 14 in the oncogenic driverMEToccurs in 3 to 4% of patients with non-small-cell lung cancer (NSCLC). We evaluated the efficacy and safety of tepotinib, a highly selective MET inhibitor, in this patient population. METHODS In this open-label, phase 2 study, we administered tepotinib (at a dose of 500 mg) once daily in patients with advanced or metastatic NSCLC with a confirmedMETexon 14 skipping mutation. The primary end point was the objective response by independent review among patients who had undergone at least 9 months of follow-up. The response was also analyzed according to whether the presence of aMETexon 14 skipping mutation was detected on liquid biopsy or tissue biopsy. RESULTS As of January 1, 2020, a total of 152 patients had received tepotinib, and 99 patients had been followed for at least 9 months. The response rate by independent review was 46% (95% confidence interval [CI], 36 to 57), with a median duration of response of 11.1 months (95% CI, 7.2 to could not be estimated) in the combined-biopsy group. The response rate was 48% (95% CI, 36 to 61) among 66 patients in the liquid-biopsy group and 50% (95% CI, 37 to 63) among 60 patients in the tissue-biopsy group; 27 patients had positive results according to both methods. The investigator-assessed response rate was 56% (95% CI, 45 to 66) and was similar regardless of the previous therapy received for advanced or metastatic disease. Adverse events of grade 3 or higher that were considered by investigators to be related to tepotinib therapy were reported in 28% of the patients, including peripheral edema in 7%. Adverse events led to permanent discontinuation of tepotinib in 11% of the patients. A molecular response, as measured in circulating free DNA, was observed in 67% of the patients with matched liquid-biopsy samples at baseline and during treatment. CONCLUSIONS Among patients with advanced NSCLC with a confirmedMETexon 14 skipping mutation, the use of tepotinib was associated with a partial response in approximately half the patients.Peripheral edema was the main toxic effect of grade 3 or higher. Abstract: BACKGROUND A splice-site mutation that results in a loss of transcription of exon 14 in the oncogenic driverMEToccurs in 3 to 4% of patients with non-small-cell lung cancer (NSCLC). We evaluated the efficacy and safety of tepotinib, a highly selective MET inhibitor, in this patient population. METHODS In this open-label, phase 2 study, we administered tepotinib (at a dose of 500 mg) once daily in patients with advanced or metastatic NSCLC with a confirmedMETexon 14 skipping mutation. The primary end point was the objective response by independent review among patients who had undergone at least 9 months of follow-up. The response was also analyzed according to whether the presence of aMETexon 14 skipping mutation was detected on liquid biopsy or tissue biopsy. RESULTS As of January 1, 2020, a total of 152 patients had received tepotinib, and 99 patients had been followed for at least 9 months. The response rate by independent review was 46% (95% confidence interval [CI], 36 to 57), with a median duration of response of 11.1 months (95% CI, 7.2 to could not be estimated) in the combined-biopsy group. The response rate was 48% (95% CI, 36 to 61) among 66 patients in the liquid-biopsy group and 50% (95% CI, 37 to 63) among 60 patients in the tissue-biopsy group; 27 patients had positive results according to both methods. The investigator-assessed response rate was 56% (95% CI, 45 to 66) and was similar regardless of the previous therapy received for advanced or metastatic disease. Adverse events of grade 3 or higher that were considered by investigators to be related to tepotinib therapy were reported in 28% of the patients, including peripheral edema in 7%. Adverse events led to permanent discontinuation of tepotinib in 11% of the patients. A molecular response, as measured in circulating free DNA, was observed in 67% of the patients with matched liquid-biopsy samples at baseline and during treatment. CONCLUSIONS Among patients with advanced NSCLC with a confirmedMETexon 14 skipping mutation, the use of tepotinib was associated with a partial response in approximately half the patients.Peripheral edema was the main toxic effect of grade 3 or higher.
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- 2020
5. A randomized, multicenter phase II study comparing efficacy, safety and tolerability of two dosing regimens of cisplatin and pemetrexed in patients with advanced or metastatic non-small-cell lung cancer.
- Author
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Metzenmacher, Martin, Kopp, Hans-Georg, Griesinger, Frank, Reinmuth, Niels, Sebastian, Martin, Serke, Monika, Waller, Cornelius Florian, Thomas, Michael, Eggert, Jochen, Schmid-Bindert, Gerald, Hoiczyk, Mathias, Christoph, Daniel Christian, Kimmich, Martin, Deuß, Burkhard, Seifert, Stephanie, Held, Swantje, Schuler, Martin, Herold, Thomas, Breitenbuecher, Frank, and Eberhardt, Wilfried Ernst Erich
- Abstract
Background: Pemetrexed and cisplatin is a first-line standard in non-squamous non-small-cell lung cancer without targetable mutations. It became the backbone of checkpoint-inhibitor–chemotherapy combinations. Single high doses of cisplatin pose toxicity risks and require hyperhydration, potentially prolonging outpatient application. The aim of this study was to compare efficacy, safety and tolerability of split-dose cisplatin with the standard schedule. Methods: Patients with metastatic non-squamous non-small-cell lung cancer were randomly assigned to up to six 21-day cycles of pemetrexed 500 mg/m
2 and cisplatin 75 mg/m2 on day 1 (arm A), or pemetrexed 500 mg/m2 (day 1) and cisplatin 40 mg/m2 (day 1 + 8, arm B), followed by pemetrexed maintenance. Primary endpoint was objective response rate. Secondary objectives were overall survival, progression-free survival, time to progression, treatment compliance, toxicity profile, and quality of life. Results: We enrolled 130 patients (129 evaluable). Median cycle numbers in A and B were six (1–6) and five (1–6). Dose intensities were comparable between arms. More patients in A received pemetrexed maintenance (24.2% versus 11.1%). With 16 (24.2%) in A and 19 (30.2%) patients in B achieving objective responses [odds ratio 0.74 (0.34–1.62), p = 0.55] the primary endpoint was met. Overall survival was not different between arms (median 14.4 versus 14.9 months); [HR = 1.07; (0.68–1.68), p = 0.78]. Median progression-free survival was 7.0 months in A and 6.2 months in B [HR = 1.63; (1.17–2.38); p = 0.01]. Adverse events of CTCAE grade ⩾3, particularly hematological, were more frequent in B. No difference in grade 4 and 5 infections between arms was noted. Treatment-related asthenia and nausea/vomiting of any grade were more frequent in A. Global health status, fatigue and constipation measured on day 1 of cycle 4 demonstrated superior scores in B. Conclusion: Pemetrexed and split-dose cisplatin is safe and effective. Advantages of split-dose cisplatin with regard to specific toxicities allow personalization of this important chemotherapy backbone. Trial Registration: European Clinical Trials Database (EudraCT) number 2011-001963-37. [ABSTRACT FROM AUTHOR]- Published
- 2021
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6. Optimizing therapy sequence to prevent patient attrition in EGFR mutation-positive advanced or metastatic NSCLC.
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Roeper, Julia, Kurz, Sylke, Grohé, Christian, and Griesinger, Frank
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THERAPEUTIC use of antineoplastic agents ,LUNG cancer ,GENETIC mutation ,PROTEIN kinase inhibitors ,LUNG tumors ,CELL receptors ,METASTASIS ,DRUG resistance in cancer cells - Abstract
Clinical trial and real-world data in non-small-cell lung cancer indicate that 10-60% of patients that progressed on first- or second-generation EGFR-targeting tyrosine kinase inhibitors (TKI) do not receive systemic second-line therapy. In our article, we discuss efficacy, safety and treatment duration with different EGFR-TKIs and stress the need for delivery of the most efficacious therapy in the first-line. We also provide our perspective on analysis of circulating tumor DNA and the role of EGFR-TKI in combined therapies. Finally, we review new therapeutic options to overcome resistance to EGFR-TKI. We believe that overall treatment duration and access to different medications in subsequent lines of therapy should be considered when planning the optimal treatment strategy. [ABSTRACT FROM AUTHOR]
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- 2021
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7. Clinical activity of a htert (vx-001) cancer vaccine as post-chemotherapy maintenance immunotherapy in patients with stage IV non-small cell lung cancer: final results of a randomised phase 2 clinical trial.
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Gridelli, Cesare, Ciuleanu, Tudor, Domine, Manuel, Szczesna, Aleksandra, Bover, Isabel, Cobo, Manuel, Kentepozidis, Nikolaos, Zarogoulidis, Konstantinos, Kalofonos, Charalabos, Kazarnowisz, Andrzej, Korozan, Magdalena, de las Penas, Ramon, Majem, Margarita, Chella, Antonio, Griesinger, Frank, Bournakis, Evangelos, Sadjadian, Parvis, Kotsakis, Athanasios, Chinet, Thierry, and Syrigos, Kostantinos N.
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LUNG cancer treatment ,LUNG cancer ,RESEARCH ,RESEARCH methodology ,EVALUATION research ,MEDICAL cooperation ,PLACEBOS ,TUMOR classification ,COMPARATIVE studies ,RANDOMIZED controlled trials ,TRANSFERASES ,IMMUNITY ,DRUG therapy ,CANCER vaccines ,T cells ,STATISTICAL sampling ,IMMUNOTHERAPY - Abstract
Background: The cancer vaccine Vx-001, which targets the universal tumour antigen TElomerase Reverse Transcriptase (TERT), can mount specific Vx-001/TERT572 CD8 + cytotoxic T cells; this immune response is associated with improved overall survival (OS) in patients with advanced/metastatic non-small cell lung cancer (NSCLC).Methods: A randomised, double blind, phase 2b trial, in HLA-A*201-positive patients with metastatic, TERT-expressing NSCLC, who did not progress after first-line platinum-based chemotherapy were randomised to receive either Vx-001 or placebo. The primary endpoint of the trial was OS.Results: Two hundred and twenty-one patients were randomised and 190 (101 and 89 patients in the placebo and the Vx-001 arm, respectively) were analysed for efficacy. There was not treatment-related toxicity >grade 2. The study did not meet its primary endpoint (median OS 11.3 and 14.3 months for the placebo and the Vx-001, respectively; p = 0.86) whereas the median Time to Treatment Failure (TTF) was 3.5 and 3.6 months, respectively. Disease control for >6months was observed in 30 (33.7%) and 26 (25.7%) patients treated with Vx-001 and placebo, respectively. There was no documented objective CR or PR. Long lasting TERT-specific immune response was observed in 29.2% of vaccinated patients who experienced a significantly longer OS compared to non-responders (21.3 and 13.4 months, respectively; p = 0.004).Conclusion: Vx-001 could induce specific CD8+ immune response but failed to meet its primary endpoint. Subsequent studies have to be focused on the identification and treatment of subgroups of patients able to mount an effective immunological response to Vx-001.Clinical Trial Registration: NCT01935154. [ABSTRACT FROM AUTHOR]- Published
- 2020
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8. Real-world treatment and survival of patients with advanced non-small cell lung Cancer: a German retrospective data analysis.
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Hardtstock, Fränce, Myers, David, Li, Tracy, Cizova, Diana, Maywald, Ulf, Wilke, Thomas, and Griesinger, Frank
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NON-small-cell lung carcinoma ,DATA analysis ,LONGITUDINAL method ,LUNG cancer ,LUNG tumors ,PROGNOSIS ,SURVIVAL analysis (Biometry) ,TUMOR classification ,RELATIVE medical risk ,RETROSPECTIVE studies - Abstract
Background: The objective of this study was to describe the real-world treatment and overall survival (OS) of German patients with a diagnosis of advanced non-small cell lung cancer (aNSCLC), and to explore factors associated with the real-world mortality risk.Methods: This was a retrospective German claims data analysis of incident aNSCLC patients. Data were available from 01/01/2011 until 31/12/2016. Identification of eligible patients took place between 01/01/2012-31/12/2015, to allow for at least 1-year pre-index and follow-up periods. Inpatient and outpatient mutation test procedures after aNSCLC diagnosis were observed. Further, prescribed treatments and OS since first (incident) aNSCLC diagnosis and start of respective treatment lines were described both for all patients and presumed EGFR/ALK/ROS-1-positive patients. Factors associated with OS were analyzed in multivariable Cox regression analysis.Results: Overall, 1741 aNSCLC patients were observed (mean age: 66·97 years, female: 29·87%). The mutation test rate within this population was 26·31% (n = 458), 26·6% of these patients (n = 122) received a targeted treatment and were assumed to have a positive EGFR/ALK/ROS-1 test result. Most often prescribed treatments were pemetrexed monotherapy as 1 L (21·23% for all and 11·11% for mutation-positive patients) and erlotinib monotherapy as 2 L (25·83%/38·54%). Median OS since incident diagnosis was 351 days in all and 571 days in mutation-positive patients. In a multivariable Cox regression analysis, higher age, a stage IV disease, a higher number of chronic drugs in the pre-index period and no systemic therapy increased the risk of early death since first aNSCLC diagnosis. On the other hand, female gender and treatment with therapies other than chemotherapy were associated with a lower risk of early death.Conclusions: Despite the introduction of new treatments, the real-world survival prognosis for aNSCLC patients remains poor if measured based on an unselected real-world population of patients. Still, the majority of German aNSCLC patients do not receive a mutation test. [ABSTRACT FROM AUTHOR]- Published
- 2020
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9. Afatinib in Non-Small Cell Lung Cancer Harboring Uncommon EGFR Mutations Pretreated With Reversible EGFR Inhibitors.
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Heigener, David F., Schumann, Christian, Sebastian, Martin, Sadjadian, Parvis, Stehle, Ingo, Märten, Angela, Lüers, Anne, Griesinger, Frank, Scheffler, Matthias, Abdollahi, A., Ammon, A., Aries, S.P., Arntzen, C., Achenbach, H.J., Atanackovic, D., Atmaca, A., Basara, N., Binder, D., Borchard, B., and Bos, M.
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LUNG cancer & genetics ,CANCER chemotherapy ,CELL receptors ,CONFIDENCE intervals ,EPIDERMAL growth factor ,LUNG cancer ,GENETIC mutation ,RESEARCH funding ,SURVIVAL analysis (Biometry) ,DATA analysis software ,DESCRIPTIVE statistics ,PROTEIN kinase inhibitors ,THERAPEUTICS - Abstract
Background. Afatinib, an irreversible ErbB family blocker, is approved for treatment of patients with previously untreated non-small cell lung cancer (NSCLC) harboring activating epidermal growth factor receptor (EGFR) mutations. Efficacy of afatinib in EGFR tyrosine kinase inhibitor-naï ve (TKI-naïve) patients with uncommon EGFR mutations (other than exon 19 deletions or exon 21 point mutations) has been reported; however, efficacy in TKI-pretreated patients with uncommon EGFR mutations is unknown. Materials and Methods. In the afatinib compassionate use program (CUP), patients with advanced or metastatic, histologically confirmed NSCLC progressing after at least one line of chemotherapy and one line of EGFR-TKI treatment were enrolled. Demographic data, mutation type, response rates, time to treatment failure (TTF), and safety in patients harboring uncommon EGFR mutations were reported. Results. In 60 patients (63% female, median age 63 years [range: 30-84 years]), a total of 66 uncommon EGFR mutations including 30 T790M mutations were reported (18.4% and 11%, respectively, of known EGFR mutations within the CUP). Most patients (67%) received afatinib as third- or fourth-line treatment. Median TTF was 3.8 months (range: 0.2 to >24.6 months; p = .244) in patients with uncommon mutations compared with 5.1 months (range: 0.1 to >21.1 months) in patients with common mutations (n = 165). Pronounced activity was observed with E709X mutations (TTF >12 months). No new safety signals were detected. Conclusion. Afatinib is clinically active and well tolerated in many TKI-pretreated NSCLC patients harboring uncommon EGFR mutations. Compared with results reported in TKI-naTve patients, activity was also indicated in patients with T790M and exon 20 insertion mutations. [ABSTRACT FROM AUTHOR]
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- 2015
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10. Trial on Refinement of Early stage non-small cell lung cancer. Adjuvant chemotherapy with pemetrexed and cisplatin versus vinorelbine and cisplatin: The TREAT protocol.
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Kreuter, Michael, Vansteenkiste, Johan, Griesinger, Frank, Hoffmann, Hans, Dienemann, Hendrik, De Leyn, Paul, and Thomas, Michael
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LUNG cancer ,CANCER chemotherapy ,ADJUVANT treatment of cancer ,ANTINEOPLASTIC agents ,ONCOLOGY - Abstract
Background: Adjuvant chemotherapy has been proven to be beneficial for patients with early stage non-small cell lung cancer. However, toxicity and insufficient dose delivery have been critical issues with the chemotherapy used. Doublet regimens with pemetrexed, a multi-target folate inhibitor, and platin show clear activity in non-small cell lung cancer and are well tolerated with low toxicity rates and excellent delivery. Methods/Design: In this prospective, multi-center, open label randomized phase II study, patients with pathologically confirmed non-small cell lung cancer, stage IB, IIA, IIB, T3N1 will be randomized after complete tumor resection either to 4 cycles of the standard adjuvant vinorelbine and cisplatin regimen from the published phase III data, or to 4 cycles of pemetrexed 500 mg/m2 d1 and cisplatin 75 mg/m2 d1, q 3 weeks. Primary objective is to compare the clinical feasibility of these cisplatin doublets defined as non-occurrence of grade 4 neutropenia and/or thrombocytopenia > 7 days or bleeding, grade 3/4 febrile neutropenia and/or infection, grade 3/4 non-hematological toxicity, nonacceptance leading to premature withdrawal and no cancer or therapy related death. Secondary parameters are efficacy (time to relapse, overall survival) and drug delivery. Parameters of safety are hematologic and non-hematologic toxicity of both arms. Discussion: The TREAT trial was designed to evaluate the clinical feasibility, i.e. rate of patients without dose limiting toxicities or premature treatment withdrawal or death of the combination of cisplatin and pemetrexed as well as the published phase III regimen of cisplatin and vinorelbine. Hypothesis of the study is that reduced toxicities might improve the feasibility of drug delivery, compliance and the convenience of treatment for the patient and perhaps survival. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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11. Comparison of Resistance Spectra after First and Second Line Osimertinib Treatment Detected by Liquid Biopsy.
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Jóri, Balázs, Schatz, Stefanie, Kaller, Len, Kah, Bettina, Roeper, Julia, Ramdani, Hayat O., Diehl, Linda, Hoffknecht, Petra, Grohé, Christian, Griesinger, Frank, Tiemann, Markus, Heukamp, Lukas C., and Falk, Markus
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THERAPEUTIC use of antineoplastic agents ,LUNG cancer ,DISEASE progression ,SEQUENCE analysis ,GENETICS ,GENETIC mutation ,METASTASIS ,DRUG resistance ,MOLECULAR pathology ,PROTEIN-tyrosine kinase inhibitors ,BODY fluid examination - Abstract
Simple Summary: Since the recent approval of osimertinib, a third generation tyrosine kinase inhibitor (TKI) targeting EGFR in non-small cell lung cancer (NSCLC), tracing the resistance mechanisms that yield to failure of osimertinib has become of interest. As the spectrum of osimertinib-resistance related genomic alterations appears significantly more diverse compared to first and second generation TKI, comprehensive, and preferably non-invasive molecular diagnostic methods are required for the detection of resistance mechanisms. In this study, we present molecular results of 56 NSCLC patients during disease progression on first and second line osimertinib treatment using a hybrid capture (HC) next generation sequencing (NGS) based liquid biopsy approach. We show examples of polyclonal resistance development which leads to the presence of multiple resistance mechanisms in the same patient, and highlight the clinical utility of HC NGS over single gene testing. Since 2009, several first, second, and third generation EGFR tyrosine kinase inhibitors (TKI) have been approved for targeted treatment of EGFR mutated metastatic non-small lung cancer (NSCLC). A vast majority of patients is improving quickly on treatment; however, resistance is inevitable and typically occurs after one year for TKI of the first and second generation. Osimertinib, a third generation TKI, has recently been approved for first line treatment in the palliative setting and is expected to become approved for the adjuvant setting as well. Progression-free survival (PFS) under osimertinib is superior to its predecessors but its spectrum of resistance alterations appears significantly more diverse compared to first and second generation EGFR TKI. As resistance mechanisms to osimertinib are therapeutically targetable in some cases, it is important to comprehensively test for molecular alterations in the relapse scenario. Liquid biopsy may be advantageous over tissue analysis as it has the potential to represent tumor heterogeneity and clonal diversification. We have previously shown high concordance of hybrid capture (HC) based next generation sequencing (NGS) in liquid biopsy versus solid tumor biopsies. In this study, we now present real-word data from 56 patients with metastatic NSCLC that were tested by liquid biopsy at the time of disease progression on mostly second line treated osimertinib treatment. We present examples of single and multiple TKI resistance mechanisms, including mutations in multiple pathways, copy number changes and rare fusions of RET, ALK, FGFR3 and BRAF. In addition, we present the added value of HC based NGS to reveal polyclonal resistance development at the DNA level encoding multiple EGFR C797S and PIK3CA mutations. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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12. Integration of Tumor Mutation Burden and PD-L1 Testing in Routine Laboratory Diagnostics in Non-Small Cell Lung Cancer.
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Schatz, Stefanie, Falk, Markus, Jóri, Balázs, Ramdani, Hayat O., Schmidt, Stefanie, Willing, Eva-Maria, Menon, Roopika, Groen, Harry J. M., Diehl, Linda, Kröger, Matthias, Wesseler, Claas, Griesinger, Frank, Hoffknecht, Petra, Tiemann, Markus, and Heukamp, Lukas C.
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ANTINEOPLASTIC agents ,LUNG cancer & genetics ,CANCER patients ,STATISTICAL correlation ,GENE expression ,GENETIC techniques ,IMMUNOTHERAPY ,LUNG cancer ,MEMBRANE proteins ,GENETIC mutation ,TUMOR markers ,ROUTINE diagnostic tests - Abstract
In recent years, Non-small cell lung cancer (NSCLC) has evolved into a prime example for precision oncology with multiple FDA-approved "precision" drugs. For the majority of NSCLC lacking targetable genetic alterations, immune checkpoint inhibition (ICI) has become standard of care in first-line treatment or beyond. PD-L1 tumor expression represents the only approved predictive biomarker for PD-L1/PD-1 checkpoint inhibition by therapeutic antibodies. Since PD-L1-negative or low-expressing tumors may also respond to ICI, additional factors are likely to contribute in addition to PD-L1 expression. Tumor mutation burden (TMB) has emerged as a potential candidate; however, it is the most complex biomarker so far and might represent a challenge for routine diagnostics. We therefore established a hybrid capture (HC) next-generation sequencing (NGS) assay that covers all oncogenic driver alterations as well as TMB and validated TMB values by correlation with the assay (F1CDx) used for the CheckMate 227 study. Results of the first consecutive 417 patients analyzed in a routine clinical setting are presented. Data show that fast reliable comprehensive diagnostics including TMB and targetable alterations are obtained with a short turn-around time. Thus, even complex biomarkers can easily be implemented in routine practice to optimize treatment decisions for advanced NSCLC. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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