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1.
ChiaChi Lin TsaiSheng Yang ChiaJui Yen Rebecca Cheng Junjun Liu Chiun Hsu 《The oncologist》2020,25(12)
Lessons Learned
- The combination of ramucirumab (8 mg/kg intravenous, day 1 every 2 weeks) and FOLFOX4 as first‐line treatment in patients with advanced hepatocellular carcinoma (HCC) was not sufficiently tolerated.
- Preliminary efficacy data suggest that the combination may provide clinical benefit to patients with HCC.
- Dose modification and patient selection should be considered for the future development of ramucirumab plus FOLFOX chemotherapy for advanced HCC.
2.
Hidetoshi Hayashi Masakazu Ogura Takashi Niwa Toshihide Yokoyama Junko Tanizaki Tomohiro Ozaki Hiroshige Yoshioka Takayasu Kurata Yosuke Tamura Yasuhito Fujisaka Kaoru Tanaka Yoshikazu Hasegawa Keita Kudo Yasutaka Chiba Kazuhiko Nakagawa 《The oncologist》2021,26(1):19-e52
Lessons Learned
- The combination of cisplatin plus nab‐paclitaxel with concurrent thoracic radiotherapy in unresectable stage III non‐small cell lung cancer is a promising therapeutic strategy.
- Further investigation is warranted.
3.
Richard Kim Elaine Tan Emily Wang Amit Mahipal Dung-Tsa Chen Biwei Cao Fadzai Masawi Cindy Machado James Yu Dae Won Kim 《The oncologist》2020,25(12):e1893-e1899
Lessons Learned
- The combination of trametinib and sorafenib has an acceptable safety profile, albeit at doses lower than approved for monotherapy.
- Maximum tolerated dose is trametinib 1.5 mg daily and sorafenib 200 mg twice daily.
- The limited anticancer activity observed in this unselected patient population does not support further exploration of trametinib plus sorafenib in patients with hepatocellular carcinoma.
4.
5.
James J. Harding Robin K. Kelley Benjamin Tan Marinela Capanu Gian Kinh Do Jinru Shia Joanne F. Chou Christine S. Ferrer Chayma Boussayoud Kerri Muenkel Hooman Yarmohammadi Imane El Dika Danny N. Khalil Carmen Ruiz Mariam Rodriguez-Lee Peter Kuhn John Wilton Renuka Iyer Ghassan K. Abou-Alfa 《The oncologist》2020,25(12):e1825-e1836
Lessons Learned
- Androgen receptor as assessed by immunohistochemistry is expressed in a high proportion of patients with hepatocellular carcinoma (HCC).
- Enzalutamide at 160 mg orally daily is safe and tolerable in patients with advanced HCC but has no single‐agent antitumor activity.
- Enzalutamide, a CYP3A4 inducer, at a standard dose of 160 mg reduces the exposure of sorafenib, a CYP3A4 substrate.
- Enzalutamide and sorafenib is safe and tolerable in patients with advanced HCC, but the addition of enzalutamide to sorafenib did not enhance the antitumor activity of sorafenib.
6.
Jennifer E. Amengual Jennifer K. Lue Helen Ma Renee Lichtenstein Bijal Shah Serge Cremers Simon Jones Ahmed Sawas 《The oncologist》2021,26(3):184-e366
Lessons Learned
- Oral selective HDAC6 inhibitors could allow for decreased toxicity compared to pan‐class inhibitors, and increased ease of use.
- ACY‐1215 is well tolerated and led to disease stabilization in 50% of patients treated on a twice‐daily dosing schedule.
- Rational drug combinations with ACY‐1215 improve efficacy in patients with lymphoma.
- Biomarkers such as XBP‐1 level or HDAC6‐score may improve patient selection.
7.
Hironaga Satake Takeshi Kato Koji Oba Masahito Kotaka Yoshinori Kagawa Hisateru Yasui Masato Nakamura Takanori Watanabe Toshihiko Matsumoto Takayuki Kii Tetsuji Terazawa Akitaka Makiyama Nao Takano Mitsuru Yokota Yoshihiro Okita Koreatsu Matoba Hiroko Hasegawa Akihito Tsuji Yoshito Komatsu Takayuki Yoshino Kentaro Yamazaki Hideyuki Mishima Eiji Oki Naoki Nagata Junichi Sakamoto 《The oncologist》2020,25(12):e13443
Lessons Learned
- A biweekly TAS‐102 plus BEV schedule in patients with heavily pretreated mCRC showed equivalent efficacy with less toxicity compared with the current schedule of TAS‐102 plus BEV combination.
- Biweekly TAS‐102 plus BEV combination could reduce unnecessary dose reduction of TAS‐102, maintain higher doses, and possibly be effective even in cases without chemotherapy‐induced neutropenia (CIN).
- The prespecified subgroup analysis of this study showed an obvious association between CIN within the first two cycles and prognosis of biweekly TAS‐102 plus BEV.
8.
Emilie M.J. van Brummelen Sanne Huijberts Carla van Herpen Ingrid Desar Frans Opdam Robin van Geel Serena Marchetti Neeltje Steeghs Kim Monkhorst Bas Thijssen Hilde Rosing Alwin Huitema Jos Beijnen Rene Bernards Jan Schellens 《The oncologist》2021,26(4):290-e545
Lessons Learned
- Afatinib and selumetinib can be combined in continuous and intermittent dosing schedules, albeit at lower doses than approved for monotherapy.
- Maximum tolerated dose for continuous and intermittent schedules is afatinib 20 mg once daily and selumetinib 25 mg b.i.d.
- Because the anticancer activity was limited, further development of this combination is not recommended until better biomarkers for response and resistance are defined.
9.
Xiao-Dong Jiao Ke Liu Mingyan Xu Guanzhen Yu Danni Liu Tanxiao Huang Bao-Dong Qin Ming Liu Ying Wu Yan Ling Jun Liu Xi He Liangzhe Wang Yingmei Li Shifu Chen Yuan-Sheng Zang 《The oncologist》2021,26(4):e524-e529
This article reports a case of advanced metastatic low‐grade sarcoma. The patient was diagnosed with an inoperable large (14 × 12 cm) lesion on his neck in September 2015 and underwent two ineffective chemotherapies in the following 4 months. Interestingly, although several pathologists could not agree on the histopathological diagnosis, the precise molecular pathological diagnosis was obtained using next‐generation sequencing (NGS) and finally brought excellent therapeutic effects. The patient was detected to have CARS‐ALK fusion by NGS and then was successfully treated with crizotinib orally. He received surgical resection of primary and metastatic lesions after tumor shrinkage. The combined treatment brought a durable response for 40 months. Although the tumor recurred in July 2019, the patient has been responding well to the second‐line ALK tyrosine kinase inhibitor alectinib to date. We performed whole genome sequencing on the patient''s primary, metastatic, and recurrent tumors and did comprehensive genomic analysis. Furthermore, our analysis results revealed that a whole genome duplication event might have happened during tumorigenesis of this case.Key Points
- To our best knowledge, this is the first report of a very successful treatment with first‐ and second‐line ALK tyrosine kinase inhibitors for CARS‐ALK fusion–positive metastatic low‐grade sarcoma.
- Molecular pathological result can guide precision treatment for sarcoma, even when the exact histopathology cannot be obtained.
- Multiple samples from this patient were analyzed using whole genome sequencing. Results provided detailed genomic characteristics and showed tumor evolution of this low‐grade sarcoma case.
- A whole genome duplication event might have happened during tumorigenesis of this low‐grade sarcoma case.
10.
Thomas J. George Alison M. Ivey Azka Ali Ji-Hyun Lee Yu Wang Karen C. Daily Brian H. Ramnaraign Sanda A. Tan Krista P. Terracina Thomas E. Read Long H. Dang Atif Iqbal 《The oncologist》2021,26(5):362-e724
Lessons Learned
- Treatment for patients with metastatic colorectal cancer (mCRC) typically involves multiple lines of therapy with eventual development of treatment resistance.
- In this single‐arm, phase II study involving heavily pretreated patients, the combination of sorafenib and capecitabine yielded a clinically meaningful progression‐free survival of 6.2 months with an acceptable toxicity profile.
- This oral doublet therapy is worthy of continued investigation for clinical use in patients with mCRC.
11.
Na Zhou Chuantao Zhang Dong Liu Kewei Liu Guanqun Wang Hua Zhu Jianli Zhang Man Jiang Ning Liu Xiaochun Zhang 《The oncologist》2021,26(3):e374-e381
Lessons Learned
- Apatinib combined with S‐1 was not superior to other chemotherapy regimens as first‐line therapy for advanced gastric cancer.
- There was a tendency for patients with lymph node metastasis to have prolonged median progression‐free survival and median overall survival, compared with patients with liver metastasis.
12.
Afsaneh Barzi April Choi Denice Tsao-Wei Syma Iqbal Anthony El-Khoueiry Dana Raluca Agafitei Kyle G Cologne Heinz-Josef Lenz 《The oncologist》2020,25(12):e1879-e1885
Lessons Learned
- Neoadjuvant bevacizumab with modified FOLFOX7 without radiation failed to meet the goal of pathological complete response rate; however, the low number of recurrence and disease‐free survival in this population, with predominantly stage III, is encouraging and worth further exploration.
- The racial distribution of the patient population, as well as a wait time of more than 4 weeks after last chemotherapy, may have contributed to the findings.
13.
Margaret E. Gatti-Mays Fatima H. Karzai Sanaz N. Soltani Alexandra Zimmer Jeffrey E. Green Min-Jung Lee Jane B. Trepel Akira Yuno Stanley Lipkowitz Jayakumar Nair Ann McCoy Jung-Min Lee 《The oncologist》2020,25(12):1013-e1824
Lessons Learned
- Monotherapy with prexasertib demonstrated modest activity in BRCA wild‐type, recurrent triple‐negative breast cancer, highlighting the unmet need for combination treatment strategies.
- Neutropenia, anemia, and thrombocytopenia are common with the use of prexasertib but are manageable with supportive care measures. Prophylactic use of granulocyte colony stimulating factor should be considered to avoid dose reductions or treatment delays.
- Pharmacodynamic studies showed prexasertib treatment induced DNA damage in peripheral immune cells.
14.
Ghassan K. Abou-Alfa Robert Mayer Alan P. Venook Allison F. O'Neill Muhammad S. Beg Michael LaQuaglia Peter T. Kingham Rachel Kobos Olca Basturk Cameron Brennan Adam Yopp James J. Harding Stephen Leong John Crown Emir Hoti Gregory Leonard Michele Ly Mikaela Bradley Emily Valentino David Markowitz Alexander Zukiwski Ken Ren John D. Gordan 《The oncologist》2020,25(12):e1837-e1845
15.
Fei Xu Qiufan Zheng Wen Xia Quchang Ouyang Danmei Pang Zhongyu Yuan Yanxia Shi Roujun Peng Qianyi Lu Shusen Wang 《The oncologist》2021,26(5):e742-e748
Lessons Learned
- Fulvestrant 500 mg maintenance therapy showed a clinical benefit rate of 76% and median progression‐free survival of 16.1 months in patients who achieved objective responses or disease control after first‐line chemotherapy.
- Adverse events with fulvestrant maintenance therapy were consistent with the known safety profile of the drug.
16.
Yuxiang Ma Wenfeng Fang Hongyun Zhao Sai Praneeth Bathena Amol Tendolkar Jennifer Sheng Li Zhang 《The oncologist》2021,26(4):e549-e566
Lessons Learned
- The overall safety profiles of ipilimumab 3 mg/kg and 10 mg/kg administered every 3 weeks, were consistent between Chinese patients with solid tumors in the current study and patients from previous U.S. ipilimumab monotherapy studies. No new safety signals were identified.
- The mean systemic exposures to ipilimumab (assessed by first dose area under the curve during the dosing interval and maximum serum concentration) were numerically lower in the Chinese patient population than in U.S. patients for both 3 mg/kg and 10 mg/kg doses; however, the range of serum concentrations in the Chinese and U.S. populations overlapped (3 mg/kg and 10 mg/kg), suggesting that ipilimumab pharmacokinetics was ethnically insensitive in this study.
17.
Shumei Kato Thomas McFall Kenta Takahashi Kasey Bamel Sadakatsu Ikeda Ramez N. Eskander Steven Plaxe Barbara Parker Edward Stites Razelle Kurzrock 《The oncologist》2021,26(4):e530-e536
We report on a woman with aggressive estrogen receptor‐positive, KRAS‐mutated ovarian cancer who achieved a remarkable response to combination therapy with the MEK inhibitor (trametinib) and the aromatase inhibitor (letrozole), even though the disease had failed to respond to a combination of a PI3K inhibitor and different MEK inhibitor, as well as to trametinib and the estrogen modulator, tamoxifen, and to letrozole by itself. The mechanism of action for exceptional response was elucidated by in vitro experiments that demonstrated that the fact that tamoxifen can have an agonistic effect in addition to antagonist activity, whereas letrozole results only in estrogen depletion was crucial to the response achieved when letrozole was combined with an MEK inhibitor. Our current observations indicate that subtle variations in mechanisms of action of outwardly similar regimens may have a major impact on outcome and that such translational knowledge is critical for optimizing a precision medicine strategy.Key Points
- This report describes the remarkable response of a patient with KRAS‐mutated, estrogen receptor‐positive low‐grade serous ovarian cancer treated with trametinib (MEK inhibitor) and letrozole (aromatase inhibitor), despite prior progression on similar agents including tamoxifen (estrogen modulator).
- In vitro investigation revealed that tamoxifen can have agonistic in addition to antagonistic effects, which could be the reason for the patient not responding to the combination of trametinib and tamoxifen.
- The current observations suggest that drugs with different mechanisms of action targeting the same receptor may have markedly different anticancer activity when used in combinations.
18.
Chun A. Changou Her-Shyong Shiah Li-Tzong Chen Servina Liu Frank Luh Shwu-Huey Liu Yung-Chi Cheng Yun Yen 《The oncologist》2021,26(3):e367-e373
Lessons Learned
- A PHY906 and capecitabine combination could be effective as a salvage therapy for patients with hepatocellular carcinoma (HCC) previously treated with multiple systemic therapies.
- This traditional Chinese medicine formulation can work with Western cancer chemotherapeutic agents to improve clinical outcomes or alleviate side effects for patients with advanced HCC.
19.
Patients with non‐small cell lung cancer (NSCLC) containing ROS1 fusions can have a marked response to the ROS1‐targeted tyrosine kinase inhibitors (TKIs), such as crizotinib. Common resistance mechanisms of ROS1‐fusion targeted therapy are acquired mutations in ROS1. Along with the use of next‐generation sequencing in the clinical management of patients with NSCLC during sequential targeted therapy, many mechanisms of acquired resistance have been discovered in patients with activated tyrosine kinase receptors. Besides acquired resistance mutations, bypass mechanisms of resistance to epidermal growth factor receptor (EGFR)‐TKI treatment are common in patients with EGFR mutations. Here we describe a patient with metastatic lung adenocarcinoma with CD74‐ROS1 fusion who initially responded to crizotinib and then developed resistance by the acquired mutation of D1228N in the MET kinase domain, which showed short‐term disease control for cabozantinib.Key Points
- The D1228N point mutation of MET is an acquired mutation for crizotinib resistance.
- The patient obtained short‐term clinical benefit from cabozantinib therapy after resistance to crizotinib.
- The clinical use of next‐generation sequencing could maximize the benefits of precision medicine in patients with cancer.
20.
Zhenhuan Zhao Yixue Wen Dongbiao Liao Jidong Miao Yan Gui Hongwei Cai Yang Chen Min Wei Qiang Jia Honggang Tian Mingqiang Sun Yu Zhang Gang Feng Xiaobo Du 《The oncologist》2020,25(12):e13492
Lessons Learned
- The efficacy of single‐agent chemotherapy was not significantly different from that of double‐agent chemotherapy in concurrent chemoradiotherapy for inoperable esophageal squamous cell carcinoma.
- Single‐agent concurrent chemoradiotherapy had lower gastrointestinal and hematologic toxicity.
- Overall survival and progression‐free survival were not significantly different between single‐ and double‐agent concurrent chemoradiotherapy.