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396 citation(s) found for "Im, Kate".

Consensus Recommendation for Mouse Models of Ocular Hypertension to Study Aqueous Humor Outflow and Its Mechanisms
McDowell, Colleen M , Kizhatil, Krishnakumar , Elliott, Michael H. , Overby, Darryl R. , Sherwood, Joseph M. , Millar, J. Cameron , Kuehn, Markus H. , Zode, Gulab , Acott, Ted S. , Anderson, Michael G. , Bertrand, Jacques, Borrás, Terete, Bovenkamp, Diane E. , Cheng, Lin , Danias, John, Ieso, Michael L. De , Du, Yiqin , Faralli, Jennifer A., Fuchshofer, Rudolf , Ganapathy, Preethi S. , Gong, Haiyan , Hernandez, Humberto , John, Simon W. M. , Kaufman, Paul L., Keller, Kate E. , Kelley, Mary J. , Kelly, Ruth A. , Križaj, David , Kumar, Ajay , Leonard, Brian C. , Liu, Katy C., López, Navita N., Mao, Weiming , Mavlyutov, Timur, McDonnell, Fiona , Mzyk, Philip , Nartey, Andrews , Pasquale, Louis R. , Patel, Gaurang , Pattabiraman, Padmanabhan P. , Peters, Donna M. , Raghunathan, Vijaykrishna, Rao, Ponugoti Vasantha , Rayana, Naga Pradeep , Raychaudhuri, Urmimala, Reina‐Torres, Ester , Rhee, Douglas J. , Chowdhury, Uttio Roy, Samples, John R., Samples, E. Griffen, Sharif, Najam A. , Schuman, Joel S. , Stevenson, Cooper H., Soundararajan, Avinash , Subramanian, Preeti, Sugali, Chenna Kesavulu , Sun, Yang , Torrejon, Karen Y., Vahabikashi, Amir , Vranka, Janice A., Wang, Ting , Willoughby, Colin E. , Chen, Xin , Yun, Hongmin , Fautsch, Michael P. , Tamm, Ernst R. , Clark, Abbot F. , Ethier, C. Ross , Schuman, Joel S , Bhattacharya, Sanjoy K. , Bertrand, Jacques A., Herberg, Samuel , Humphries, Peter , Lieberman, Raquel L. , Liton, Paloma B. , Liu, Yutao , McLellan, Gillian J. , Raghunathan, Vijay Krishna , Rao, Ponugoti Vasantha , Ren, Ruiyi , Sheffield, Val C. , Toris, Carol B. , Zhang, Hao F. , Stamer, William Daniel

Investigative Opthalmology & Visual Science | February 7, 2022 | Volume: 63 | Issue: 2 | Pages: 12

10.1167/iovs.63.2.12 | PMID 35129590 Get It

Physical activity level and stroke risk in US population: A matched case–control study of 102,578 individuals
Ghozy, Sherief , Zayan, Ahmad Helmy , El‐Qushayri, Amr Ehab , Varney, Joseph , Morsy, Sara , Abbas, Alzhraa Salah , Diestro, Jose Danilo Bengzon , Dmytriw, Adam A. , Shah, Jaffer , Islam, Sheikh Mohammed Shariful , Parker, Kate Elizabeth , Varney, Joseph , Kallmes, Kevin M , Morsy, Sara , Abbas, Alzhraa Salah , Diestro, Jose Danilo B , Dmytriw, Adam A , Shah, Jaffer , Hassan, Ameer E , Islam, Sheikh Mohammed Shariful , Ghozy, Sherief , Hassan, Ameer E

Annals of Clinical and Translational Neurology | January 30, 2022 | Volume: 9 | Issue: 3 | Pages: 264-275

10.1002/acn3.51511 | PMID 35094505 Get It

AbstractBackgroundStroke has been linked to a lack of physical activity; however, the extent of the association between inactive lifestyles and stroke risk has yet to be characterized across large populations.PurposeThis study aimed to explore the association between activity‐related behaviors and stroke incidence.MethodsData from 1999 to 2018 waves of the concurrent cross‐sectional National Health and Nutrition Examination Survey (NHANES) were extracted. We analyzed participants characteristics and outcomes for all participants with data on whether they had a stroke or not and assessed how different forms of physical activity affect the incidence of disease.ResultsOf the 102,578 individuals included, 3851 had a history of stroke. A range of activity‐related behaviors was protective against stroke, including engaging in moderate‐intensity work over the last 30 days (OR = 0.8, 95% CI = 0.7–0.9; P = 0.001) and vigorous‐intensity work activities over the last 30 days (OR = 0.6, 95% CI = 0.5–0.8; P < 0.001), and muscle‐strengthening exercises (OR = 0.6, 95% CI = 0.5–0.8; P < 0.001). Conversely, more than 4 h of daily TV, video, or computer use was positively associated with the likelihood of stroke (OR = 11.7, 95% CI = 2.1–219.2; P = 0.022).ConclusionDifferent types, frequencies, and intensities of physical activity were associated with reduced stroke incidence, implying that there is an option for everyone. Daily or every other day activities are more critical in reducing stroke than reducing sedentary behavior duration.
Phase 3 randomized, open-label, multicenter study of tremelimumab (T) and durvalumab (D) as first-line therapy in patients (pts) with unresectable hepatocellular carcinoma (uHCC): HIMALAYA.
Kelley, Robin Kate , Furuse, Junji , Toni, Enrico N. De , Vasilyev, Alexander, Heurgué, Alexandra , Mody, Kabir , Thungappa, Satheesh Chiradoni, Negro, Alejandra , Abou‐Alfa, Ghassan K. , Chan, Stephen L. , Kudo, Masatoshi , Lau, George , Furuse, Junji , Sukeepaisarnjaroen, Wattana , Kang, Yoon‐Koo , Dao, Tu Van , Rimassa, Lorenza , Breder, Valeriy Vladimirovich , Tam, Vincent C. , He, Philip , Sangro, Bruno

Journal of Clinical Oncology | January 19, 2022 | Volume: 40 | Issue: 4_suppl | Pages: 379-379

10.1200/jco.2022.40.4_suppl.379 Get It

379 Background: A single priming dose of T (anti-CTLA-4) added to D (anti-PD-L1) in the STRIDE (Single T Regular Interval D) regimen, formerly T300+D, showed encouraging clinical activity and limited toxicity in a phase 2 uHCC study (Study 22, NCT02519348), suggesting single exposure to T is sufficient to improve upon D activity. HIMALAYA (NCT03298451) evaluated the efficacy and safety of STRIDE or D vs sorafenib (S) in uHCC. Methods: HIMALAYA is an open-label, multicenter, phase 3 study, in which pts with uHCC and no prior systemic therapy were initially randomized to STRIDE (T 300 mg plus D 1500 mg [one dose] plus D 1500 mg every 4 weeks [Q4W]), D (1500 mg Q4W), S (400 mg twice daily), or T 75 mg Q4W (4 doses) plus D 1500 mg Q4W (T75+D). Recruitment to T75+D ceased after a planned analysis of Study 22 showed T75+D did not meaningfully differ from D. The primary objective was overall survival (OS) for STRIDE vs S. The secondary objective was OS noninferiority (NI) of D to S (NI margin: 1.08). Secondary endpoints included progression-free survival (PFS), objective response rate (ORR; RECIST v.1.1), duration of response (DoR), and safety. Results: In total, 1171 pts were randomized to STRIDE (N=393), D (N=389), or S (N=389). At data cutoff (DCO), the primary objective was met: OS was significantly improved for STRIDE vs S (hazard ratio [HR], 0.78; 96% confidence interval [CI], 0.65–0.92; p=0.0035; Table). D met the objective of OS NI to S (HR, 0.86; 96% CI, 0.73–1.03). ORRs were higher for STRIDE (20.1%) and D (17.0%) than for S (5.1%). No new safety signals were identified. Grade 3/4 treatment-related adverse events (TRAEs) occurred in 25.8% (STRIDE), 12.9% (D), and 36.9% (S) of pts. Grade 3/4 hepatic TRAEs occurred in 5.9% (STRIDE), 5.2% (D), and 4.5% (S) of pts. No TRAE of esophageal varices hemorrhage occurred. Rates of TRAEs leading to discontinuation were 8.2% (STRIDE), 4.1% (D), and 11.0% (S). Conclusions: HIMALAYA was the first large phase 3 trial with a diverse, representative uHCC population and extensive long-term follow-up to assess both mono- and combination immunotherapy. D was noninferior to S with favorable safety. The combination of a single priming dose of T plus D in STRIDE displayed superior efficacy and a favorable benefit-risk profile vs S. STRIDE is a proposed, novel, first-line standard of care systemic therapy for uHCC. Clinical trial information: NCT03298451. [Table: see text]
Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals
Campbell, Kristin L. , Cormie, Prue , Weller, Sarah, Alibhai, Shabbir M.H. , Bolam, Kate A., Campbell, Anna , Cheville, Andrea , Dalzell, Mary-Ann, Hart, Nicolas H. , Higano, Celestia S. , Lane, Kirstin , Mansfield, Sami, Newton, Robert U. , Quist, Morten , Rauw, Jennifer, Rosenberger, Friederike , Mina, Daniel Santa , Winters-Stone, Kerri M., Wiskemann, Joachim , Goulart, Jennifer , Cheville, Andrea L , McNeely, Margaret L , Newton, Robert U , Quist, Morten , Rosenberger, Friederike , Santa Mina, Daniel , Schmitz, Kathryn H , Wiskemann, Joachim , Goulart, Jennifer , Campbell, Anna M , Campbell, Kristin L , Cormie, Prue , Weller, Sarah , Alibhai, Shabbir M. H. , Bolam, Kate A. , Dalzell, Mary-Ann, Hart, Nicolas H. , Higano, Celestia S. , Lane, Kirstin , Mansfield, Sami, Rauw, Jennifer, Winters-Stone, Kerri M.

JCO Oncology Practice | January 6, 2022 | Volume: 18 | Issue: 5 | Pages: e697-e709

10.1200/op.21.00454 | PMID 34990293 Get It

PURPOSE: Exercise has been underutilized in people with advanced or incurable cancer despite the potential to improve physical function and reduce psychosocial morbidity, especially for people with bone metastases because of concerns over skeletal complications. The International Bone Metastases Exercise Working Group (IBMEWG) was formed to develop best practice recommendations for exercise programming for people with bone metastases on the basis of published research, clinical experience, and expert opinion. METHODS: The IBMEWG undertook sequential steps to inform the recommendations: (1) modified Delphi survey, (2) systematic review, (3) cross-sectional survey to physicians and nurse practitioners, (4) in-person meeting of IBMEWG to review evidence from steps 1-3 to develop draft recommendations, and (5) stakeholder engagement. RESULTS: Recommendations emerged from the contributing evidence and IBMEWG discussion for pre-exercise screening, exercise testing, exercise prescription, and monitoring of exercise response. Identification of individuals who are potentially at higher risk of exercise-related skeletal complication is a complex interplay of these factors: (1) lesion-related, (2) cancer and cancer treatment–related, and (3) the person-related. Exercise assessment and prescription requires consideration of the location and presentation of bone lesion(s) and should be delivered by qualified exercise professionals with oncology education and exercise prescription experience. Emphasis on postural alignment, controlled movement, and proper technique is essential. CONCLUSION: Ultimately, the perceived risk of skeletal complications should be weighed against potential health benefits on the basis of consultation between the person, health care team, and exercise professionals. These recommendations provide an initial framework to improve the integration of exercise programming into clinical care for people with bone metastases.
The MDM2 antagonist idasanutlin in patients with polycythemia vera: results from a single-arm phase 2 study
Mascarenhas, John , Passamonti, Francesco , Burbury, Kate , El‐Galaly, Tarec Christoffer , Gerds, Aaron T. , Gupta, Vikas , Higgins, Brian , Wonde, Kathrin, Jamois, Candice , Kovic, Bruno, Huw, Ling‐Yuh, Katakam, Sudhakar Babu, Maffioli, Margherita , Palmer, Jeanne , Bellini, Marta, Yacoub, Abdulraheem , Gerds, Aaron T , Mesa, Ruben , Ross, David M , Vannucchi, Alessandro M , Yacoub, Abdulraheem , Mascarenhas, John , Gupta, Vikas , Passamonti, Francesco , El-Galaly, Tarec C , Mesa, Ruben A. , Vannucchi, Alessandro M.

Blood Advances | December 21, 2021 | Volume: 6 | Issue: 4 | Pages: 1162-1174

10.1182/bloodadvances.2021006043 | PMID 34933330 Get It

Abstract Idasanutlin, an MDM2 antagonist, showed clinical activity and a rapid reduction in JAK2 V617F allele burden in patients with polycythemia vera (PV) in a phase 1 study. This open-label phase 2 study evaluated idasanutlin in patients with hydroxyurea (HU)-resistant/-intolerant PV, per the European LeukemiaNet criteria, and phlebotomy dependence; prior ruxolitinib exposure was permitted. Idasanutlin was administered once daily on days 1 through 5 of each 28-day cycle. The primary end point was composite response (hematocrit control and spleen volume reduction &gt; 35%) in patients with splenomegaly and hematocrit control in patients without splenomegaly at week 32. Key secondary end points included safety, complete hematologic response (CHR), patient-reported outcomes, and molecular responses. All patients (n = 27) received idasanutlin; 16 had response assessment (week 32). Among responders with baseline splenomegaly (n = 13), 9 (69%) attained any spleen volume reduction, and 1 achieved composite response. Nine patients (56%) achieved hematocrit control, and 8 patients (50%) achieved CHR. Overall, 43% of evaluable patients (6/14) showed a ≥50% reduction in the Myeloproliferative Neoplasm Symptom Assessment Form Total Symptom Score (week 32). Nausea (93%), diarrhea (78%), and vomiting (41%) were the most common adverse events, with grade ≥ 3 nausea or vomiting experienced by 3 patients (11%) and 1 patient (4%), respectively. Reduced JAK2 V617F allele burden occurred early (after 3 cycles), with a median reduction of 76%, and was associated with achieving CHR and hematocrit control. Overall, the idasanutlin dosing regimen showed clinical activity and rapidly reduced JAK2 allele burden in patients with HU-resistant/- intolerant PV but was associated with low-grade gastrointestinal toxicity, leading to poor long-term tolerability. This trial was registered at www.clinincaltrials.gov as #NCT03287245.
Shared Decision Making in Cardiac Electrophysiology Procedures and Arrhythmia Management
Chung, Mina K. , Fagerlin, Angela , Wang, Paul J. , Ajayi, Tinuola B. , Allen, Larry A. , Baykaner, Tina , Benjamin, Emelia J. , Branda, Megan E. , Cavanaugh, Kerri L. , Delaney, Rebecca K. , Eckhardt, Lee L. , Hargraves, Ian , Hills, Mellanie True , Kalscheur, Matthew M. , Kramer, Daniel B. , Kunneman, Marleen , Lampert, Rachel , Lewis, Krystina B. , Lü, Ying , Matlock, Daniel D. , McCarthy, Sarah , Orland, Kate M. , Pundi, Krishna , Roden, Dan M. , Saarel, Elizabeth V. , Schmidt, Monika M. , Sears, Samuel F. , Stafford, Randall S. , Wass, Sojin Y. , Wright, Jennifer M. , McCarthy, Sarah R. , Branda, Megan , Chen, Lin Y , Delaney, Rebecca K , Eckhardt, Lee L , Grady, Kathleen L , Hargraves, Ian G, True Hills, Mellanie , Kalscheur, Matthew M , Kramer, Daniel B , Kunneman, Marleen , Lampert, Rachel , Langford, Aisha T , Lewis, Krystina B , Lu, Ying , Mandrola, John M , Martinez, Kathryn , Matlock, Daniel D , McCarthy, Sarah R , Montori, Victor M , Noseworthy, Peter A , Orland, Kate M , Ozanne, Elissa M , Passman, Rod , Pundi, Krishna , Roden, Dan M. , Saarel, Elizabeth V , Schmidt, Monika M , Sears, Samuel F , Stacey, Dawn , Stafford, Randall S , Steinberg, Benjamin A , Youn Wass, Sojin , Wright, Jennifer M , Cavanaugh, Kerri , Benjamin, Emelia J , Fagerlin, Angela , Chen, Lin Y. , Crossley, George , Martinez, Kathryn A. , Montori, Víctor M. , Noseworthy, Peter A. , Ozanne, Elissa M. , Passman, Rod , Stacey, Dawn , Steinberg, Benjamin A. , McCarthy, Sarah R.

Circulation: Arrhythmia and Electrophysiology | December 6, 2021 | Volume: 14 | Issue: 12 | Pages: No page available

10.1161/circep.121.007958 | PMID 34865518 Get It

Shared decision making (SDM) has been advocated to improve patient care, patient decision acceptance, patient-provider communication, patient motivation, adherence, and patient reported outcomes. Documentation of SDM is endorsed in several society guidelines and is a condition of reimbursement for selected cardiovascular and cardiac arrhythmia procedures. However, many clinicians argue that SDM already occurs with clinical encounter discussions or the process of obtaining informed consent and note the additional imposed workload of using and documenting decision aids without validated tools or evidence that they improve clinical outcomes. In reality, SDM is a process and can be done without decision tools, although the process may be variable. Also, SDM advocates counter that the low-risk process of SDM need not be held to the high bar of demonstrating clinical benefit and that increasing the quality of decision making should be sufficient. Our review leverages a multidisciplinary group of experts in cardiology, cardiac electrophysiology, epidemiology, and SDM, as well as a patient advocate. Our goal is to examine and assess SDM methodology, tools, and available evidence on outcomes in patients with heart rhythm disorders to help determine the value of SDM, assess its possible impact on electrophysiological procedures and cardiac arrhythmia management, better inform regulatory requirements, and identify gaps in knowledge and future needs.
Abstract P02-02: First results of RLY-4008, a potent and highly selective FGFR2 inhibitor in a first-in-human study in patients with FGFR2-altered cholangiocarcinoma and multiple solid tumors
Mody, Kabir , Kelley, Robin Katie, Sahai, Vaibhav , Schmidt‐Kittler, Oleg , Shen, Jinshan , Jen, Kai Yu , Deary, Alicia, Padval, Mahesh V. , Sherwin, Cori Ann , Ferté, Charles , Wolf, Beni B. , Sahai, Vaibhav , Goyal, Lipika , Borad, Mitesh J. , Subbiah, Vivek , Mahipal, Amit , Kamath, Suneel Deepak , Kelley, Robin Kate , Kim, Richard D. , El-Khoueiry, Anthony B. , Dotan, Efrat , Guo, Wei, Schram, Alison M.

Molecular Cancer Therapeutics | December 3, 2021 | Volume: 20 | Issue: 12_Supplement | Pages: P02-02-P02-02

10.1158/1535-7163.targ-21-p02-02 Get It

Abstract INTRODUCTION: Oncogenic FGFR2 alterations (fusions/rearrangements, amplifications, mutations) are key drivers in cholangiocarcinoma (CCA) and multiple solid tumors. Current pan-FGFR inhibitor (FGFRi) therapy is limited by off-isoform toxicity and acquired FGFR2 kinase domain resistance mutations. RLY-4008 is a highly selective and potent oral inhibitor designed to target both FGFR2 driver and resistance mutations. We initiated a first-in-human study in advanced solid tumors patients (pts) to define the safety, pharmacokinetics (PK) and efficacy of RLY-4008 (NCT04526106). METHODS: Adult pts received RLY-4008 QD or BID on a 4-week cycle following a BOIN escalation design. Adverse events (AEs), PK, ctDNA and anti-tumor activity (RECIST 1.1) were assessed. RESULTS: As of 16AUG21, 45 pts (35 CCA; 10 other) have been treated with RLY-4008 at total daily doses of 30-200 mg (18 pts BID; 27 pts QD). 44 pts had oncogenic FGFR2 alterations (26 fusions/13 mutations/5 amplifications). The median number of prior anti-neoplastic therapies was 3 (range 1-15). 94% (33/35) of CCA pts had prior chemotherapy and 69% (24/35) had prior FGFRi. 56% (9/16) CCA pts with prior FGFRi and evaluable ctDNA had ≥1 FGFR2 resistance mutation at baseline, most commonly at positions 549 (8/9), 617 (3/9), or 564 (2/9). RLY-4008 had rapid absorption (Tmax 1-7h), half-life to support QD dosing (18-34 h), dose-dependent exposure (AUC; Cmax) and predicted FGFR2 occupancy &gt;85% across dose levels. The MTD has not been defined, and QD dose exploration continues to select the optimal biologically efficacious dose. AEs occurring in &gt;20% of pts include stomatitis (49%), palmar-plantar erythrodysesthesia (PPE, 38%), dry mouth (29%), and nail toxicities (22%), majority of which were ≤Gr 2. 6 pts had Gr 1-2 retinopathy, which resolved in all cases. 5 AEs were considered dose limiting toxicities: 4 in BID (rash/PPE/mucositis/hyperbilirubinemia) and 1 in QD (retinopathy). No Gr 4/5 drug-related AEs were seen. 25 pts remain on treatment (range 1-37 weeks). RLY-4008 showed broad anti-tumor activity across dose levels and FGFR2 alterations with radiographic tumor reductions of ≥10% in 59% pts (19/32; -11% to -83%). Activity was seen in FGFRi-naïve, FGFR2-fusion+ CCA with PRs in 50% of pts (3/6, 2 confirmed and 1 pending confirmation; -56% to -83%). Activity was also seen in FGFRi pre-treated FGFR2-fusion+ CCA pts (N=16) with 16 SD, including 9 pts with tumor reduction ≥10% (from -12% to -35%). Of the FGFRi pre-treated FGFR2-fusion+ CCA patients with detectable FGFR2 resistance mutations in ctDNA at baseline, 78% (7/9) were undetectable at C2D1. CONCLUSION: RLY-4008 demonstrates promising safety, tolerability, and clinical activity in FGFR2-altered solid tumor pts, including those who progressed on prior FGFRi therapy. Consistent with the FGFR2-selective mechanism, minimal off-isoform toxicity (FGFR1-hyperphosphatemia; FGFR4-diarrhea) was seen. These encouraging data validate selective targeting of FGFR2 and suggest that RLY-4008 has potential to overcome resistance to FGFRi. Citation Format: Lipika Goyal, Mitesh Borad, Vivek Subbiah, Amit Mahipal, Suneel Kamath, Kabir Mody, Robin Katie Kelley, Richard Kim, Vaibhav Sahai, Anthony El-Khoueiry, Efrat Dotan, Oleg Schmidt-Kittler, Jinshan Shen, Kai Yu Jen, Alicia Deary, Wei Guo, Mahesh Padval, Cori Ann J. Sherwin, Charles Ferte, Beni Wolf, Alison M. Schram. First results of RLY-4008, a potent and highly selective FGFR2 inhibitor in a first-in-human study in patients with FGFR2-altered cholangiocarcinoma and multiple solid tumors [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2021 Oct 7-10. Philadelphia (PA): AACR; Mol Cancer Ther 2021;20(12 Suppl):Abstract nr P02-02.
Hepatobiliary Cancers, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology
Benson, Al B. , D’Angelica, Michael I. , Abbott, Daniel E. , Anaya, Daniel A. , Are, Chandrakanth , Brown, Daniel B. , Burgoyne, Adam M. , Chahal, Prabhleen , Chang, Daniel T. , Cloyd, Jordan M. , Covey, Anne M. , Iyer, Renuka , Jacob, Rojymon, Kelley, Robin Kate , Kim, Robin D. , Palta, Manisha , Park, James O. , Reddy, Sanjay S. , Sahai, Vaibhav , Schefter, Tracey E., Singh, Gagandeep , Stein, Stacey , Yopp, Adam C. , McMillian, Nicole R., Hochstetler, Cindy, Darlow, Susan, Sahai, Vaibhav , Anders, Robert A. , Bachini, Melinda , Borad, Mitesh J. , Glazer, Evan S. , Goyal, Lipika , Hawkins, William G , Levine, Matthew H , Raman, Steven S. , Vauthey, Jean‐Nicolas , Venook, Alan P.

Journal of the National Comprehensive Cancer Network | November 26, 2021 | Volume: 19 | Issue: 5 | Pages: 541-565

10.6004/jnccn.2021.0022 | PMID 34030131 Get It

The NCCN Guidelines for Hepatobiliary Cancers focus on the screening, diagnosis, staging, treatment, and management of hepatocellular carcinoma (HCC), gallbladder cancer, and cancer of the bile ducts (intrahepatic and extrahepatic cholangiocarcinoma). Due to the multiple modalities that can be used to treat the disease and the complications that can arise from comorbid liver dysfunction, a multidisciplinary evaluation is essential for determining an optimal treatment strategy. A multidisciplinary team should include hepatologists, diagnostic radiologists, interventional radiologists, surgeons, medical oncologists, and pathologists with hepatobiliary cancer expertise. In addition to surgery, transplant, and intra-arterial therapies, there have been great advances in the systemic treatment of HCC. Until recently, sorafenib was the only systemic therapy option for patients with advanced HCC. In 2020, the combination of atezolizumab and bevacizumab became the first regimen to show superior survival to sorafenib, gaining it FDA approval as a new frontline standard regimen for unresectable or metastatic HCC. This article discusses the NCCN Guidelines recommendations for HCC.
CLR 131 (Iopofosine I-131) Treatment in Triple Class Refractory and Beyond Multiple Myeloma Patients: Preliminary Efficacy and Safety Results from the Phase 2 Clover-1 Trial
Stiff, Patrick J. , Ibrahim, Emad, Cull, Elizabeth H., Friend, John, Longcor, Jarrod , Oliver, Kate , Ailawadhi, Sikander , Green, Damian J , Lipe, Brea , Callander, Natalie S. , Oliver, Kate

Blood | November 23, 2021 | Volume: 138 | Issue: Supplement 1 | Pages: 1652-1652

10.1182/blood-2021-152682 Get It

Abstract Background: Phospholipid ethers (PLE) provide a novel mechanism to target tumor cells. Tumor cells contain increased amounts of lipid rafts in their cell membranes, which are thought to enhance signaling and resist apoptosis. Phospholipid drug conjugates (PDC) are specifically designed to have high affinity for lipid rafts which upon binding results in trans-membrane inversion with the ability to deliver an attached therapeutic directly to the cytosol. Iopofosine I-131 (formerly identified as CLR 131) is a novel PDC delivering I-131 as a targeted tumor cell radiotherapy. Iopofosine I-131 is being examined in relapsed or refractory multiple myeloma (RRMM) patients through an open-label, Phase 2 trial, CLOVER-1 (NCT02952508). Methods: The primary objective of this study is to determine the safety and efficacy of Iopofosine I-131 in heavily pretreated MM patients. Eligibility criteria for MM patients include progression or relapsed disease that is refractory to at least 1 proteasome inhibitor and 1 immunomodulatory agent unless intolerable/ineligible to receive such agents with no upper limit to the number of prior lines of therapy. Iopofosine I-131 is administered in up to 4 IV infusions (15-20 min) over 3 months, with doses given 1-2 weeks apart each cycle for a maximum of 2 cycles, along with dexamethasone 40 mg weekly (20 mg in patients &gt; 75), for up to 12 weeks. Following iopofosine I-131 administration, no other antineoplastic or targeted therapy was given until clinically indicated by the investigator. Adverse events (AEs) are graded by NCI-CTCAE v4.03; responses are assessed by the 2016 International Myeloma Working Group criteria. Results: Eleven patients with at least triple class refractory (immunomodulatory agent, proteasome inhibitor and monoclonal antibody) MM have been enrolled in this Phase 2 study with data current as of 28 May 2021. Patients had a median age of 72 (range 34-77), mean prior regimens of 7.2 (range 3-17) and received a mean total body dose of 75.4 mCi (range 59.7-118.7) of iopofosine I-131. The overall response rate (ORR) was 45.5% (5/11), the clinical benefit rate (CBR) was 72.7% (8/11) and disease control rate (DCR) was 100%. Median progression free survival (PFS) was 3.4 months. In a subset of patients who are quad/penta drug refractory, efficacy increased with an ORR of 80.0% (4/5) and CBR of 100% (5/5). The primary treatment emergent AEs in patients with MM included cytopenias (87.5%), in line with prior experience with iopofosine I-131. The most commonly observed cytopenias included Grade 3 or 4 thrombocytopenia (62.5%), anemia (62.5%), neutropenia (62.5%) and decreased white blood cell count (50%). There were no infusion-related reactions or AEs. Conclusions: Initial results for iopofosine I-131 show efficacy with a promising ORR of 45.5% and a CBR or 72.7% in heavily pretreated triple class refractory multiple myeloma patients. Interestingly, iopofosine I-131 showed its highest efficacy in patients that were quad/penta drug refractory with ORR of 80%, highlighting its potential as a later line therapy. Iopofosine I-131 is a novel cancer radiotherapeutic that may provide benefit to patients that are refractory/unresponsive to traditional MM therapies. CLOVER-1 is actively enrolling MM patients that are at least triple class refractory across the United States. Disclosures Ailawadhi: AbbVie: Consultancy; Pharmacyclics: Consultancy, Research Funding; Ascentage: Research Funding; Cellectar: Research Funding; GSK: Consultancy, Research Funding; Genentech: Consultancy; BMS: Consultancy, Research Funding; Karyopharm: Consultancy; Sanofi: Consultancy; Medimmune: Research Funding; Janssen: Consultancy, Research Funding; Amgen: Consultancy, Research Funding; Xencor: Research Funding; Takeda: Consultancy; Beigene: Consultancy. Stiff: CRISPR: Consultancy; Gamida-Cell, Atara, Amgen, Incyte, Takeda, Macrogenetics, Eisai: Research Funding; Cellectar: Research Funding. Green: Seagen Inc.: Research Funding; bristol myers squibb: Membership on an entity's Board of Directors or advisory committees, Patents & Royalties, Research Funding; Cellectar Biosciences: Research Funding; GSK: Membership on an entity's Board of Directors or advisory committees; Janssen Biotech: Membership on an entity's Board of Directors or advisory committees, Research Funding; Juno Therapeutics: Patents & Royalties, Research Funding; Legend Biotech: Consultancy; Neoleukin Therapeutics: Membership on an entity's Board of Directors or advisory committees; Seattle Genetics: Membership on an entity's Board of Directors or advisory committees, Research Funding; SpringWorks Therapeutics: Research Funding. Lipe: Seagen Inc.: Research Funding; BMS: Consultancy, Research Funding; Janssen: Consultancy, Research Funding; sanofi: Consultancy; GlaxoSmithKline: Consultancy; amgen: Research Funding; Cellectar: Research Funding; Karyopharm: Research Funding; Harpoon: Research Funding. Cull: Aptevo: Research Funding. Friend: Cellectar: Current Employment. Longcor: Cellectar: Current Employment. Oliver: Cellectar: Current Employment.
High-Dose Methotrexate Is Not Associated with Reduction in CNS Relapse in Patients with Aggressive B-Cell Lymphoma: An International Retrospective Study of 2300 High-Risk Patients
Villa, Diego , Bobillo, Sabela , Smedby, Karin Ekstroem, Eyre, Toby A. , Cwynarski, Kate , Caporn, Paris L., Zyl, Joan Van, Puckrin, Robert , Stewart, Douglas A. , Thanarajasingam, Gita , Joffe, Erel , Eloranta, Sandra , Maliske, Seth , Poonsombudlert, Kittika , Guo, Xiao, Hapgood, Greg , Manos, Kate , Gilbertson, Michael , Streit, Isaac T, Scott, Hamish W , Ku, Matthew , Mel, Sanjay De , Yong, Kar Ying , Liu, Xin , Mokoonlall, Mridula , McVilly, Nicholas L., Johnston, Anna , Brunner, Matthew, Ku, Matthew , Lewis, Katharine L. , Jakobsen, Lasse Hjort , Savage, Kerry J. , Klánová, Magdalena , Trněný, Marek , Bishton, Mark , Fox, Christopher P. , Tun, Aung M. , Djebbari, Faouzi , Harrysson, Sara , Sehn, Laurie H. , Hawkes, Eliza A. , Khwaja, Jahanzaib , Minson, Adrian , Dickinson, Michael , Øvlisen, Andreas Kiesbye , Gregory, Gareth P. , Streit, Isaac T., Talaulikar, Dipti , Brunner, Matthew J, Pophali, Priyanka A. , Maurer, Matthew J. , El‐Galaly, Tarec Christoffer , Cheah, Chan Y.

Blood | November 23, 2021 | Volume: 138 | Issue: Supplement 1 | Pages: 181-181

10.1182/blood-2021-146737 Get It

Abstract Introduction Central nervous system relapse (secondary central nervous system lymphoma -SCNS) is an uncommon but devastating complication of aggressive B-cell lymphoma. Patients (Pts) with CNS-IPI 4-6 are at greatest risk (10.2% at 2 years). Intravenous high-dose methotrexate (HD-MTX) is widely used to mitigate SCNS risk but data supporting this practice are limited. Methods We performed a multicentre, retrospective study at 21 sites in Australia, Asia, North America and Europe. Chart or registry review was performed for consecutively diagnosed pts with diffuse large B-cell lymphoma (DLBCL) and CNS-IPI 4-6, high grade B-cell lymphoma (HGBL) with rearrangements of MYC+BCL2 and/or BCL6 and primary breast/testicular DLBCL irrespective of CNS-IPI. Pts were diagnosed between 2000-2020, 18-80 years at diagnosis, and treated with curative intent anti-CD20 based chemo-immunotherapy. Pts with CNS involvement at diagnosis were excluded. HD-MTX was defined as at least one cycle of intravenous MTX at any dose. Time to SCNS was calculated from date of diagnosis (all-pts), and from the end of frontline systemic lymphoma therapy, defined as 6x21 days from diagnosis (complete response (CR-pts)), until SCNS, systemic relapse, death, or censoring, whichever came first. Cumulative risk of SCNS was computed using the Aalen-Johansen estimator treating death and systemic relapses as competing events. Adjusted cumulative risks were obtained by using an inverse probability of treatment weighting approach. The average treatment effect was computed as the difference in adjusted 5-year risk of SCNS. Results - 2300 and 1455 pts were included in the all-pts and CR-pts analyses, respectively. Baseline demographics and details of therapy are summarised in Table 1. Except for a predominance of males, pts ≤60 years and pts with ECOG 0-1 in the HD-MTX vs no HD-MTX groups, the demographics and treatments were well balanced. At a median follow up of 5.9 years (range 0.0-19.1) and 5.5 years from diagnosis (range 0.0-18.7), 201/2300 and 84/1455 pts experienced CNS events in the all-pts and CR-pts analyses respectively. For all-pts(n=2300), CNS-IPI was 4-6 in 2052(89.2%), with R-CHOP-like therapy given to 93.8%. 410 pts (17.8%) received HD-MTX (265 HD-MTX alone, 145 in combination with intrathecal methotrexate (IT-MTX);435 received IT-MTX alone;1455 received neither. There were 32/410 and 169/1890 SCNS events, with median time from diagnosis to SCNS of 8.8 and 6.7 months in the HD-MTX and no HD-MTX groups respectively. 5-year OS was 70% (95% CI, 65-76%) and 55% (95% CI 53-57%) in HD-MTX and no HD-MTX groups respectively. There was no difference in the adjusted 5-year risk of SCNS between the HD-MTX and no HD-MTX groups (8.4% vs 9.1%, adjusted hazard ratio [HR] 0.71, p=0.100) (Figure 1). For CR-pts(n=1455), CNS-IPI was 4-6 in 1267(87.0%), with R-CHOP-like therapy given to 93.3%. 284 pts (19.5%) received HD-MTX (170 HD-MTX alone, 114 with IT-MTX);298 received IT-MTX alone;873 received neither. There were 16/284 and 68/1171 SCNS events, with median time from diagnosis to SCNS of 11.0 and 10.3 months in the HD-MTX and no HD-MTX groups respectively. 5-year OS was 74%(95% CI 67-81%) and 75%(95% CI 72-78%) in the HD-MTX groups and no HD-MTX groups respectively (adjusted HR 1.08, p=0.622). There was no difference in the 5-year risk of CNS relapse between the HD-MTX and no HD-MTX groups 5.0% vs 6.0% (adjusted HR 1.03, p=0.903) (Figure 2). Exploratory analysis of the impact of HD-MTX among the highest risk groups CNS IPI 5 (n=368), CNS-IPI 6 (n=59) and CNS-IPI 6 plus all pts with testicular, renal or adrenal involvement (n=349) did not reveal differences in SCNS rates in HD-MTX treated pts. Additional subgroup analyses will be presented at the meeting. Conclusions To our knowledge, this is the largest study of the efficacy of HD-MTX in reducing SCNS events focusing exclusively on high-risk pts. The overall incidence of CNS relapse observed was consistent with previous reports in similar patient cohorts at 9%. The use of HD-MTX did not lower SCNS rates overall or when analysis was confined to CR pts at completion of curative intent therapy to compensate for potential immortal bias associated with HD-MTX therapy. Despite the limitations of the non-randomized and retrospective design, it appears unlikely that HD-MTX is associated with a clinically meaningful reduction in SCNS rates in pts with high risk for SCNS. Figure 1 Figure 1. Disclosures Lewis: AstraZeneca: Consultancy, Honoraria; Novartis: Patents & Royalties: Conference attendance; Janssen: Honoraria, Patents & Royalties: Conference attendance; Roche: Consultancy, Honoraria. Villa: Janssen: Honoraria; Gilead: Honoraria; AstraZeneca: Honoraria; AbbVie: Honoraria; Seattle Genetics: Honoraria; Celgene: Honoraria; Lundbeck: Honoraria; Roche: Honoraria; NanoString Technologies: Honoraria. Bobillo: F. Hoffmann-La Roche Ltd: Consultancy, Speakers Bureau; Gilead: Speakers Bureau. Ekstroem Smedby: Takeda: Consultancy; Janssen Cilag: Research Funding. Savage: Merck: Consultancy, Honoraria, Other: Institutional clinical trial funding; BMS: Consultancy, Honoraria, Other: Institutional clinical trial funding; AbbVie: Consultancy, Honoraria; Roche: Research Funding; Takeda: Other: Institutional clinical trial funding; Servier: Consultancy, Honoraria; Seattle Genetics: Consultancy, Honoraria; Astra-Zeneca: Consultancy, Honoraria; Beigene: Other: Institutional clinical trial funding; Genentech: Research Funding. Eyre: Beigene: Honoraria, Research Funding; Incyte: Consultancy; Secura Bio: Consultancy, Honoraria; Janssen: Honoraria; Gilead/KITE: Honoraria, Other: Travel support for conferences, Research Funding, Speakers Bureau; Loxo Oncology: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Abbvie: Consultancy, Honoraria, Other: Travel to conferences; AstraZeneca: Honoraria, Research Funding; Roche: Consultancy, Honoraria. Cwynarski: Incyte: Consultancy, Speakers Bureau; Gilead: Consultancy, Speakers Bureau; Atara: Consultancy; Celgene: Consultancy; Takeda: Consultancy, Other: travel to scientific conferences, Speakers Bureau; Kite, a Gilead Company: Consultancy, Other: travel to scientific conferences, Speakers Bureau; Janssen: Consultancy, Other: travel to scientific conferences; Roche: Consultancy, Other: travel to scientific conferences, Speakers Bureau; BMS/Celgene: Other: travel to scientific conferences. Stewart: Teva: Honoraria; Sandoz: Honoraria; Amgen: Honoraria; AstraZeneca: Honoraria; Novartis: Honoraria; Celgene: Honoraria; Gilead: Honoraria; Abbvie: Honoraria; Janssen: Honoraria; Roche: Honoraria. Bishton: Gilead: Honoraria, Other: Travel grants; AbbVie: Honoraria, Other: Travel grants; Celgene/BMS: Honoraria, Other: travel grants; Celltrion: Honoraria, Other: Travel grants; Takeda.: Honoraria, Other: Travel grants . Fox: F. Hoffmann-La Roche Ltd: Consultancy, Membership on an entity's Board of Directors or advisory committees. Joffe: Epizyme: Consultancy; AstraZeneca: Consultancy. Eloranta: Janssen Pharmaceutical NV: Other: NV. Sehn: Genmab: Consultancy; Novartis: Consultancy; Debiopharm: Consultancy. Manos: Bristol-Myers Squibb: Other: Travel and meetings. Hawkes: Specialised Therapeutics: Consultancy; Gilead: Membership on an entity's Board of Directors or advisory committees; Merck Sharpe Dohme: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees; Antigene: Membership on an entity's Board of Directors or advisory committees; Regeneron: Speakers Bureau; Bristol Myers Squib/Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding; Merck KgA: Research Funding; Astra Zeneca: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Roche: Membership on an entity's Board of Directors or advisory committees, Other: Travel and accommodation expenses, Research Funding, Speakers Bureau; Janssen: Speakers Bureau. Minson: Novartis: Research Funding; Hoffman La Roche: Research Funding. Dickinson: Celgene: Research Funding; Amgen: Honoraria; Takeda: Research Funding; Gilead Sciences: Consultancy, Honoraria, Speakers Bureau; MSD: Consultancy, Honoraria, Research Funding, Speakers Bureau; Janssen: Consultancy, Honoraria; Bristol-Myers Squibb: Consultancy, Honoraria; Roche: Consultancy, Honoraria, Other: travel, accommodation, expenses, Research Funding, Speakers Bureau; Novartis: Consultancy, Honoraria, Research Funding, Speakers Bureau. Øvlisen: Abbvie: Other: Travel expenses. Gregory: Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel fees, Speakers Bureau; Janssen: Consultancy; Novartis: Consultancy. Ku: Roche: Consultancy; Antegene: Consultancy; Genor Biopharma: Consultancy. Talaulikar: Roche: Honoraria, Research Funding; Jansenn: Honoraria, Research Funding; Amgen: Honoraria, Research Funding; Takeda: Honoraria, Research Funding; EUSA Pharma: Honoraria, Research Funding. Maurer: Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees; Celgene: Research Funding; Genentech: Research Funding; Kite Pharma: Membership on an entity's Board of Directors or advisory committees; Morphosys: Membership on an entity's Board of Directors or advisory committees, Research Funding; Nanostring: Research Funding. El-Galaly: Abbvie: Other: Speakers fee; ROCHE Ltd: Ended employment in the past 24 months. Cheah: Roche: Consultancy, Honoraria, Other: advisory and travel expenses, Research Funding; Janssen: Consultancy, Honoraria, Other: advisory; MSD: Consultancy, Honoraria, Other: advisory, Research Funding; Gilead: Consultancy, Honoraria, Other: advisory; Ascentage pharma: Consultancy, Honoraria, Other: advisory; Beigene: Consultancy, Honoraria, Other: advisory; AbbVie: Research Funding; Celgene: Research Funding; AstraZeneca: Consultancy, Honoraria, Other: advisory; Loxo/Lilly: Consultancy, Honoraria, Other: advisory; TG Therapeutics: Consultancy, Honoraria, Other: advisory.