Jama OncologyPub Date : 2025-01-01DOI: 10.1001/jamaoncol.2024.4958
Ayse Ece Cali Daylan, Daniel Morgensztern, Saiama N Waqar
{"title":"Toripalimab for Extensive-Stage Small Cell Lung Cancer.","authors":"Ayse Ece Cali Daylan, Daniel Morgensztern, Saiama N Waqar","doi":"10.1001/jamaoncol.2024.4958","DOIUrl":"10.1001/jamaoncol.2024.4958","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"26-27"},"PeriodicalIF":28.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jama OncologyPub Date : 2025-01-01DOI: 10.1001/jamaoncol.2024.5157
Elias Jabbour, Vivian G Oehler, Paul B Koller, Omer Jamy, Elza Lomaia, Anthony M Hunter, Olga Uspenskaya, Svetlana Samarina, Sudipto Mukherjee, Jorge E Cortes, Maria R Baer, Vera Zherebtsova, Vasily Shuvaev, Anna Turkina, Igor Davydkin, Huanshan Guo, Zi Chen, Tommy Fu, Lixin Jiang, Cunlin Wang, Hengbang Wang, Dajun Yang, Yifan Zhai, Hagop Kantarjian
{"title":"Olverembatinib After Failure of Tyrosine Kinase Inhibitors, Including Ponatinib or Asciminib: A Phase 1b Randomized Clinical Trial.","authors":"Elias Jabbour, Vivian G Oehler, Paul B Koller, Omer Jamy, Elza Lomaia, Anthony M Hunter, Olga Uspenskaya, Svetlana Samarina, Sudipto Mukherjee, Jorge E Cortes, Maria R Baer, Vera Zherebtsova, Vasily Shuvaev, Anna Turkina, Igor Davydkin, Huanshan Guo, Zi Chen, Tommy Fu, Lixin Jiang, Cunlin Wang, Hengbang Wang, Dajun Yang, Yifan Zhai, Hagop Kantarjian","doi":"10.1001/jamaoncol.2024.5157","DOIUrl":"10.1001/jamaoncol.2024.5157","url":null,"abstract":"<p><strong>Importance: </strong>Patients with chronic myeloid leukemia (CML) or Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL) resistant or intolerant to BCR-ABL1 tyrosine kinase inhibitors (TKIs) have limited treatment options. Olverembatinib, which is approved in China, has only been tested in Chinese patients.</p><p><strong>Objective: </strong>To assess the pharmacokinetics, safety, efficacy, and recommended dose of olverembatinib in patients with CML or Philadelphia chromosome-positive ALL resistant or intolerant to at least 2 TKIs.</p><p><strong>Design, setting, and participants: </strong>This multicenter phase 1b randomized clinical trial was conducted from January 28, 2020, to January 2, 2024, with a median (range) follow-up of 48 (0-166) weeks. Patients with CML or Philadelphia chromosome-positive ALL were enrolled. This bridging study was performed in part to confirm that there are no racial differences in the pharmacokinetic profile of olverembatinib.</p><p><strong>Interventions: </strong>Patients were randomly assigned to 30, 40, or 50 mg of olverembatinib orally every other day in 28-day cycles.</p><p><strong>Main outcomes and measures: </strong>Pharmacokinetic profile of olverembatinib.</p><p><strong>Results: </strong>Of 80 included patients, 46 (58%) were male, and the median (range) age was 54.0 (21-80) years. The pharmacokinetic profile of olverembatinib was compatible with alternate-day dosing and similar to that in Chinese patients. Based on investigators' assessments, 60 patients (75%) experienced at least 1 treatment-related adverse event; 32 (40%) experienced grade 3 or higher treatment-related adverse events; and 12 (15%) experienced treatment-related serious adverse events, none of which were fatal. Frequently reported (10% or more) treatment-emergent adverse events included elevated blood creatine phosphokinase (all grades, 31 [39%]; grade 3 or higher, 10 [13%]) and thrombocytopenia (all grades, 23 [29%]; grade 3 or higher, 14 [18%]). Among evaluable patients with chronic-phase CML, complete cytogenetic response (CCyR) occurred in 31 of 51 patients (61%; 95% CI, 46.1-74.2), and major molecular response (MMR) occurred in 25 of 59 patients (42%; 95% CI, 29.6-55.9). Cytogenetic and molecular responses were similar in patients with or without T315I variants. A total of 15 of 26 patients with prior ponatinib treatment (58%; 95% CI, 36.9-76.6) achieved CCyR, and 11 of 30 (37%; 95% CI, 19.9-56.1) achieved MMR. A total of 4 of 8 patients with asciminib resistance (50%; 95% CI, 15.7-84.3) had CCyR, and 4 of 12 (33%; 95% CI, 9.9-65.1) had MMR. The recommended phase 3 dose of olverembatinib is 30 mg every other day in patients without T315I variants.</p><p><strong>Conclusions and relevance: </strong>In this trial, olverembatinib had a favorable pharmacokinetic profile, was generally well tolerated, and showed strong antileukemic activity in patients with heavily pretreated chronic-phase CML with or without T315I ","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"28-35"},"PeriodicalIF":28.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jama OncologyPub Date : 2025-01-01DOI: 10.1001/jamaoncol.2024.5218
Jyoti Malhotra, Isa Mambetsariev, Gregory Gilmore, Jeremy Fricke, Arin Nam, Natalie Gallego, Bihong T Chen, Mike Chen, Arya Amini, Rimas V Lukas, Ravi Salgia
{"title":"Targeting CNS Metastases in Non-Small Cell Lung Cancer With Evolving Approaches Using Molecular Markers: A Review.","authors":"Jyoti Malhotra, Isa Mambetsariev, Gregory Gilmore, Jeremy Fricke, Arin Nam, Natalie Gallego, Bihong T Chen, Mike Chen, Arya Amini, Rimas V Lukas, Ravi Salgia","doi":"10.1001/jamaoncol.2024.5218","DOIUrl":"10.1001/jamaoncol.2024.5218","url":null,"abstract":"<p><strong>Importance: </strong>Central nervous system (CNS) metastases presenting as either brain parenchymal metastases or leptomeningeal metastases are diagnosed in up to 50% of patients with advanced non-small cell lung cancer during their disease course. While historically associated with a poor prognosis due to limited treatment options, the availability of an increasing number of targeted therapies with good CNS penetration has significantly improved clinical outcomes for these patients. This has occurred in parallel with a more nuanced understanding of prognostic factors.</p><p><strong>Observations: </strong>Multiple clinical trials have reported that disease control can be observed with targeted therapies with adequate CNS penetration, particularly for patients with molecular alterations in EGFR, ALK, ROS1, and RET. For these tumors, systemic targeted therapy may be used first for the management of CNS metastases, prior to considering radiation therapy (RT). At the time of isolated progression in the CNS, RT may be considered for the progressing lesions with continuation of the same systemic therapy. For other molecular alterations as well as for patients treated with checkpoint inhibitors, data are not yet clear if systemic therapy is sufficient for untreated CNS metastases, and early RT may need to be integrated into the treatment planning. An increasing number of studies investigate the role that emerging techniques, such as the sequencing of tumor DNA from resected brain metastases tissue or cerebrospinal fluid or radiomics-based analysis of CNS imaging, can play in guiding treatment approaches.</p><p><strong>Conclusions and relevance: </strong>With multiple generations of targeted therapies now available, the treatment for CNS metastases should be tailored to the patients with consideration given to molecular testing results, CNS penetrance of systemic therapy, patient characteristics, and multidisciplinary review. More research is needed in understanding the clonal evolution of CNS metastases, and the development of novel therapeutics with CNS efficacy.</p>","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"60-69"},"PeriodicalIF":28.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jama OncologyPub Date : 2025-01-01DOI: 10.1001/jamaoncol.2024.5174
Marinde J G Bond, Karen Bolhuis, Olaf J L Loosveld, Jan Willem B de Groot, Helga Droogendijk, Helgi H Helgason, Mathijs P Hendriks, Joost M Klaase, Geert Kazemier, Mike S L Liem, Arjen M Rijken, Cornelis Verhoef, Johannes H W de Wilt, Koert P de Jong, Michael F Gerhards, Martinus J van Amerongen, Marc R W Engelbrecht, Krijn P van Lienden, John J Hermans, I Quintus Molenaar, Dirk J Grünhagen, Bart de Valk, Brigitte C M Haberkorn, Emile D Kerver, Frans Erdkamp, Robbert J van Alphen, Daniëlle Mathijssen-van Stein, Aysun Komurcu, Anne M May, Rutger-Jan Swijnenburg, Cornelis J A Punt
{"title":"First-Line Systemic Treatment for Initially Unresectable Colorectal Liver Metastases: Post Hoc Analysis of the CAIRO5 Randomized Clinical Trial.","authors":"Marinde J G Bond, Karen Bolhuis, Olaf J L Loosveld, Jan Willem B de Groot, Helga Droogendijk, Helgi H Helgason, Mathijs P Hendriks, Joost M Klaase, Geert Kazemier, Mike S L Liem, Arjen M Rijken, Cornelis Verhoef, Johannes H W de Wilt, Koert P de Jong, Michael F Gerhards, Martinus J van Amerongen, Marc R W Engelbrecht, Krijn P van Lienden, John J Hermans, I Quintus Molenaar, Dirk J Grünhagen, Bart de Valk, Brigitte C M Haberkorn, Emile D Kerver, Frans Erdkamp, Robbert J van Alphen, Daniëlle Mathijssen-van Stein, Aysun Komurcu, Anne M May, Rutger-Jan Swijnenburg, Cornelis J A Punt","doi":"10.1001/jamaoncol.2024.5174","DOIUrl":"10.1001/jamaoncol.2024.5174","url":null,"abstract":"<p><strong>Importance: </strong>In patients with colorectal cancer and unresectable liver-only metastases (CRLM), treatment with folinic acid, fluorouracil, and oxaliplatin (FOLFOX) plus irinotecan (FOLFOXIRI) and bevacizumab vs FOLFOX/folinic acid, fluorouracil, and irinotecan (FOLFIRI) plus bevacizumab increased progression-free survival, response, and R0/R1 resection/ablation rates, as well as toxic effects in RAS/BRAFV600E-variant and/or right-sided tumors. FOLFOX/FOLFIRI-panitumumab vs FOLFOX/FOLFIRI-bevacizumab increased response at the cost of more toxic effects in RAS/BRAFV600E wild-type, left-sided tumors.</p><p><strong>Objective: </strong>To present long-term outcomes of treatment with FOLFOXIRI plus bevacizumab vs FOLFOX/FOLFIRI plus bevacizumab and FOLFOX/FOLFIRI plus panitumumab vs FOLFOX/FOLFIRI + bevacizumab.</p><p><strong>Design, setting, and participants: </strong>The randomized phase 3 CAIRO5 trial included patients with initially unresectable CRLM in 46 Dutch centers and 1 Belgian center between November 2014 and January 2022. A liver expert panel repeatedly evaluated resectability.</p><p><strong>Intervention: </strong>Patients with RAS/BRAFV600E-variant and/or right-sided tumors randomly received FOLFOX/FOLFIRI-bevacizumab (group 1) or FOLFOXIRI-bevacizumab (group 2), and those with RAS/BRAFV600E wild-type, left-sided tumors received FOLFOX/FOLFIRI-bevacizumab (group 3) or FOLFOX/FOLFIRI-panitumumab (group 4). Adjuvant chemotherapy (ACT) after complete local treatment was recommended but not standard.</p><p><strong>Main outcomes and measures: </strong>Overall survival (OS) was analyzed as a secondary outcome. Other outcomes were post hoc analyses.</p><p><strong>Results: </strong>A total of 530 patients (327 male [62%] and 203 female individuals [38%]; median age, 62 [IQR, 54-69] years) were randomized: 148 in group 1, 146 in group 2, 118 in group 3, and 118 in group 4. The median OS in group 1 was 23.6 (95% CI, 20.1-27.5) vs 24.1 (95% CI, 21.0-30.9) months in group 2 (hazard ratio [HR], 0.90; 95% CI, 0.70-1.17; P = .44), and 39.9 (95% CI, 30.7-44.6) in group 3 vs 38.3 (95% CI, 35.3-51.3) months in group 4 (HR, 0.95; 95% CI, 0.68-1.32; P = .75). OS was longest after complete local treatment without early (≤6 months) recurrence (64.3 months; 95% CI, 57.6 to not reached) and salvage local treatment options after early recurrence (58.9; 95% CI, 47.3 to not reached), followed by patients without salvage local treatment after early recurrence (30.5; 95% CI, 24.4-33.4) and with incomplete local treatment (28.7; 95% CI, 25.9-38.3), and worst in patients with continued unresectability (18.3; 95% CI, 15.7-20.0). After confounder adjustment, ACT was associated with longer OS (HR, 0.66; 95% CI, 0.44-0.98) and relapse-free survival (HR, 0.65; 95% CI, 0.48-0.88) and less early recurrence without salvage local treatment (odds ratio, 0.46; 95% CI, 0.25-0.85).</p><p><strong>Conclusions and relevance: </strong>These results support using FOLFOX","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"36-45"},"PeriodicalIF":28.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jama OncologyPub Date : 2025-01-01DOI: 10.1001/jamaoncol.2024.5364
Michael V Gormally, Monica F Chen, Anne Marie Noronha, Kristalla Panageas, Maggie Reynolds, Kaelyn Kohlasch, Bryan Novak, Tatiana Kee-Velez, Nikeysha Clarke, Michael Eubank, Cynthia Chu, Clare Wilhelm, Amanda Blouin, Chrisann Kyi, Claire Friedman, Charles M Rudin, Mark G Kris, Ronak Shah, David Aggen, Sandra D'Angelo, Alexander N Shoushtari, Michael F Berger, Chaitanya Bandlamudi, Christopher A Klebanoff, Alexander Drilon, Adam J Schoenfeld, Mark T A Donoghue
{"title":"Next-Generation Sequencing for HLA Genotype Screening and Matching to HLA-Restricted Therapies.","authors":"Michael V Gormally, Monica F Chen, Anne Marie Noronha, Kristalla Panageas, Maggie Reynolds, Kaelyn Kohlasch, Bryan Novak, Tatiana Kee-Velez, Nikeysha Clarke, Michael Eubank, Cynthia Chu, Clare Wilhelm, Amanda Blouin, Chrisann Kyi, Claire Friedman, Charles M Rudin, Mark G Kris, Ronak Shah, David Aggen, Sandra D'Angelo, Alexander N Shoushtari, Michael F Berger, Chaitanya Bandlamudi, Christopher A Klebanoff, Alexander Drilon, Adam J Schoenfeld, Mark T A Donoghue","doi":"10.1001/jamaoncol.2024.5364","DOIUrl":"10.1001/jamaoncol.2024.5364","url":null,"abstract":"","PeriodicalId":48661,"journal":{"name":"Jama Oncology","volume":" ","pages":"74-76"},"PeriodicalIF":28.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}