bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trybeca-1: A randomized, phase 3 study of eryaspase in combination with chemotherapy versus chemotherapy alone as second-line treatment in patients with pancreatic adenocarcinoma (NCT03665441).
Authors: Hammel Pascal , Berardi Rossana , Van Cutsem Eric , Feliu Jaime , Greil Richard , Wasan Harpreet Singh , Metges Jean-Philippe , Nygren Peter , Osterlund Pia J. , Parner Vibeke , Seufferlein Thomas , Gupta Anu , Salesse Sophie , Biswasbaldwin Nigel , Ibrahim Ayman , Youssoufian Hagop , El-Hariry Iman , Hidalgo Manuel 
Published: January 2019

TPS471 Background: Second-line treatment options for advanced pancreatic adenocarcinoma are currently limited. Eryaspase, asparaginase (ASNase) encapsulated in red blood cells (RBCs) is an investigational product under development. Following infusion, asparagine and glutamine are actively transported into RBCs where they are hydrolyzed by the encapsulated ASNase. We have recently reported the outcome of a randomized Phase 2b study inpatients with advanced pancreatic cancer whose disease progressed following first-line treatment(NCT02195180). Eryaspase in combination with gemcitabine monotherapy or FOLFOX combination therapy improved overall survival (OS) and progression free survival (PFS). The safety profile of eryaspase was acceptable. The results of this Phase 2b study provided a rationale for initiating this confirmatory Phase 3 pivotal trial (TRYbeCA-1). Methods: TRYbeCA-1 is an international, randomized, open-label Phase 3 trial (N = ~500) of eryaspase combined with chemotherapy in patients with adenocarcinoma of the pancreas who have failed only one prior line of systemic anti-cancer therapy for advanced pancreatic cancer and have measurable disease. Patients are randomized in a 1:1 ratio to receive gemcitabine/abraxane or irinotecan-based therapy (FOLFIRI [FOLinic acid-Fluorouracil-IRInotecan regimen] or irinotecan liposome injection/5-fluorouracil/leucovorin) with or without eryaspase, administered as IV infusion on Day 1 and Day 15 of each 4-week cycle. Key eligibility criteria include performance status 0 or 1; stage IV disease; documented evidence of disease progression; available tumor tissue; and adequate organ function. The primary endpoint is OS. Key secondary endpoints include PFS and objective response rate, safety, quality of life, pharmacokinetics and pharmacodynamics, and biomarker research. An HR in OS of 0.725 is being targeted representing a conservative estimate based on the P2b data and is viewed as being highly clinically relevant. An IDMC will be established to review safety at regular intervals and to review efficacy data at the planned interim and final analyses. Clinical trial information: NCT03665441.
A randomized clinical trial of chemotherapy with gemcitabine/cisplatin/nabpaclitaxel with or without the AXL inhibitor bemcentinib (BGB324) for patients with advanced pancreatic cancer.
Authors: Beg Muhammad Shaalan , Lowy Andrew M. , O'Dwyer Peter J. , Jameson Gayle S. , Borazanci Erkut Hasan , Patel Hitendra , Massey Clare , Schoelermann Julia , Lorens James , Fattah Farjana , Crane Kimberli , Williams Erin Fenske , Clark Jatan , Von Hoff Daniel D. , Brekken Rolf A. 
Published: January 2019

TPS473 Background: The Axl pathway coordinately mediates immune evasion and drug resistance in pancreatic cancer. Systemic Axl inhibition can enhance the efficacy of cancer therapy by blocking tumor cell proliferation, survival and drug resistance associated with epithelial-mesenchymal transition (EMT), and targeting innate immune suppression in the tumor microenvironment. Bemcentinib (BGB324) is a first in class, selective oral inhibitor of Axl. Our group has shown that bemcentinib therapy, in combination with gemcitabine, improved survival in multiple preclinical models of pancreatic cancer. Methods: This is a multicenter, randomized, phase 1b/2 clinical trial of nab-paclitaxel/gemcitabine/cisplatin with or without bemcentinib. Patients with metastatic pancreatic cancer, good performance status and preserved liver, kidney and hematologic function are eligible. The treatment schedule is as follows: Bemcentinib 100 or 200 mg daily, nab-paclitaxel 125 mg/m2, gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 intravenously on D1, 8 every 21 days. 3 -12 patients will be recruited in part 1 following a modified 3+3 dose finding scheme. Part 2 of the study is a 1:1 randomized phase 2 design enrolling 62 patients. The primary objective is to determine complete response rate. Secondary end points are overall response rate, PFS and adverse events. A parallel biomarker study will accompany the trial analyzing blood and tissue samples to determine the effect of chemotherapy and bemcentinib on 1) Axl pathway activity in tumor tissue, 2) changes in immune landscape including upregulation of immune cytokines, and immune cell infiltration into the tumor, 3) apoptosis and decreased proliferation of tumor and 4) to identify predictive biomarkers of response. Clinical trial information: NCT03649321.
SYNERGY-AI: Artificial intelligence based precision oncology clinical trial matching and registry.
Authors: Kurnaz Selin , Loaiza-Bonilla Arturo , Freedman Jason Lawrence , Arango Belisario Augusto , Johnston Kristin , Bonilla-Reyes Paula Andrea , Culcuoglu Cagatay M ,   SYNERGY-AI Precision Oncology Group
Published: January 2019

TPS717 Background: Precision oncology encompasses the implementation of high level of evidence disease-specific and biomarker-driven diagnostic and treatment recommendations for optimized cancer care. Artificial Intelligence (AI), telemedicine and value-based care may optimize clinical trial enrollment (CTE) and overall cost-benefit. This ongoing, international registry for cancer pts evaluates the feasibility and clinical utility of an AI-based precision oncology clinical trial matching tool, powered by a virtual tumor boards (VTB) program, and its clinical impact on pts with advanced cancer to facilitate CTE, as well as the financial impact, and potential outcomes of the intervention. Methods: The SYNERGY-AI Registry is an international prospective, observational cohort study of eligible adult and pediatric pts with advanced solid and hematological malignancies, for whom the decision to consider CTE has already been made by their primary providers (PP). Using a proprietary application programming interface (API) linked to existing electronic health records (EHR) platforms, individual clinical data is extracted, analyzed and matched to a parametric database of existing institutional and non-institutional CTs. Machine learning algorithms allow for dynamic matching based on CT allocation and availability for optimized matching. Patients voluntarily enroll into registry, which is non-interventional with no protocol-mandated tests/procedures—all treatment decisions are made at the discretion of PP in consultation with their pts, based on the AI CT matching report, and VTB support. CTE will be assessed on variables including biomarkers, barriers to enrollment. Study duration anticipated as ~36 mo (~24-mo enrollment followed by 12 mo of data collection, to occur every 3 mo). The primary analysis will be performed 12 mo after last pt enrolled. The impact time to initiation of CTE on PFS and OS will be estimated by Kaplan-Meier and Cox multivariable survival analysis. Enrollment is ongoing, with a target of ≥ 1500 patients. Key inclusion criteria: Pts with solid and hematological malignancies; cancer-related biomarkers. Key exclusion criteria: ECOG PS > 2; abnormal organ function; hospice enrollment Clinical trial information: NCT03452774.
Open-label phase II/III study of nivolumab plus standard of care versus standard of care for first-line treatment of metastatic colorectal cancer: Checkmate-9X8.
Authors: Tabernero Josep , Yoshino Takayuki , Cohn Allen Lee , Kochenderfer Mark D. , Holdridge Regan C. , Couture Felix , Elez Elena , Bendell Johanna C. , Zhou Ming , Cullen Dana , Lenz Heinz-Josef 
Published: January 2019

TPS718 Background: 5-FU-containing regimens with oxaliplatin or irinotecan and a biologic agent such as the VEGF inhibitor bevacizumab (BEV) are standard-of-care (SOC) options for the treatment of first-line (1L) metastatic colorectal cancer (mCRC). However, the objective response rate (ORR) with these regimens is 38%, and median progression-free survival (PFS) and median overall survival (OS) are 9.4 months and 21.3 months, respectively (Saltz et al. JCO 2007). Thus, there is a need for therapies that will provide durable clinical responses and improved survival. mCRC tumors represent classic “cold” tumors characterized by low expression of inflammatory and immune signatures. Emerging evidence suggests that there may be subtypes of mCRC that could benefit from synergistic immunogenic stimuli with immunotherapy agents combined with other compounds. The immune checkpoint inhibitor nivolumab (NIVO) enhances antitumor T-cell activity through the inhibition of the programmed death-1 receptor. Chemotherapy and BEV may have potential synergistic immune-stimulatory effect on the tumor and its microenvironment. Therefore, combining NIVO with SOC may enhance the antitumor immune response and improve clinical activity in 1L mCRC. The international, multicenter, open-label phase 2/3 CheckMate-9X8 (NCT03414983) trial will evaluate efficacy and safety of the combination of NIVO+SOC, compared with SOC alone, in previously untreated patients with mCRC. Methods: An estimated 180 patients aged ≥ 18 years with histologically confirmed mCRC, no prior therapy for mCRC, Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, and an adequate tissue sample, will be randomized to receive either NIVO+SOC or SOC alone. Patients who have had prior treatment with a checkpoint inhibitor; have autoimmune, cardiovascular, or hepatic disease; or test positive for hepatitis B or C (indicating detectable virus) will be excluded. The primary endpoint is PFS assessed by blinded independent central review (BICR) using RECIST v1.1. Secondary endpoints include ORR, disease control rate, duration of response, and time to response, all by BICR; OS; and safety. Clinical trial information: NCT03414983.
ABT-165 plus FOLFIRI versus bevacizumab plus FOLFIRI in patients with metastatic colorectal cancer (mCRC) previously treated with fluoropyrimidine/oxaliplatin and bevacizumab.
Authors: Wainberg Zev A. , Wang Lan , Yue Huibin , Motwani Monica , Kasichayanula Sreeneeranj , Blaney Martha Elizabeth , Naumovski Louie , Strickler John H. 
Published: January 2019

TPS720 Background: Dual variable domain immunoglobulin ABT-165 targets human vascular endothelial growth factor (VEGF) and delta-like ligand 4 (DLL4). Combined VEGF and DLL4 blockade increased inhibition of subcutaneous xenograft growth of human colon cancer-derived cell lines versus blockade of either axis alone. In vivo, ABT-165 plus chemotherapy (CT) induced tumor regression with improved efficacy, vs anti-VEGF monoclonal antibody plus CT. In a phase 1 study, tolerable recommended phase 2 dose was identified for ABT-165 plus FOLFIRI and showed promising efficacy. This phase 2 trial in progress assesses efficacy/safety of ABT-165 plus FOLFIRI vs bevacizumab (bev) plus FOLFIRI in patients with second-line mCRC. Methods: This is an open-label, multicenter, phase 2 randomized (1:1) trial (NCT03368859) in patients (≥ 18 years; Eastern Cooperative performance status: 0–1) with histologically/cytologically confirmed mCRC who progressed after fluoropyrimidine/oxaliplatin and bev. ABT-165 (2.5 mg/kg) plus FOLFIRI (irinotecan: 180 mg/m2; leucovorin: 400 mg/m2; fluorouracil bolus: 400 mg/m2, infusion: 2400 mg/m2) or bev (5 mg/kg) plus FOLFIRI are given intravenously on day 1 of each 14-day cycle, until disease progression/intolerable toxicity. Primary endpoint is progression-free survival (PFS). Secondary endpoints include overall survival (OS), objective response rate (ORR), and safety. Exploratory endpoints include biomarkers predictive for efficacy/safety, correlation of DLL4 levels with PFS, OS, and ORR, pharmacodynamic effects, and efficacy/safety-exposure relationships in ABT-165 arm. Hazard ratios of PFS and OS comparing the 2 groups are estimated using Cox proportional hazard model. Kaplan-Meier methodology is used to estimate PFS and OS curves, median PFS and OS, and their 90% confidence intervals. Safety is assessed by ABT-165 exposure, adverse events (AEs), serious AEs, all deaths, and changes in laboratory data and vital signs. Archival tissue is collected and evaluated for DLL4 expression and angiogenesis signature. Approximately 100 patients are planned to be enrolled, with recruitment initiated January 2018. Clinical trial information: NCT03368859.
NSABP FR-2: Phase II study of durvalumab following neoadjuvant chemoRT in stage II-IV rectal cancer.
Authors: George Thomas J. , Yothers Greg , Lee James J. , Jacobs Samuel A. , Deutsch Melvin , Allegra Carmen Joseph , Wolmark Norman 
Published: January 2019

TPS727 Background: Locally advanced rectal cancer remains a clinical challenge with few improvements noted over the past few decades. Although immunotherapy has no current clinical role in microsatellite stable (MSS) colorectal cancer, preclinical models suggest that radiotherapy (RT) can enhance neoantigen presentation, modulate the microenvironment, and improve the likelihood of anti-tumor activity with checkpoint inhibitor use. This prospective phase II trial will test that hypothesis in addition to confirming safety of this approach using a “window-of-opportunity” study design with the anti-PD-L1 agent durvalumab (MEDI4736). Methods: This multi-center phase II trial is currently enrolling patients (pts) with rectal cancer who are undergoing standard NCCN guideline-compliant neoadjuvant chemoradiotherapy (CRT). Eligibility includes pts with MSS stage II-IV rectal cancer with adequate organ function and pre-treatment diagnostic tumor available for profiling who are undergoing CRT with intentions to proceed to surgical resection. Stage IV disease must be limited such that the primary pelvic tumor requires definitive management. Standard ineligibility criteria include active infections, systemic steroid use, or other conditions making immunotherapy use unsafe. Treatment includes durvalumab (750mg IV infusion once every 2 wks) for 4 total doses beginning within 3-7 days after CRT completion. Surgery must be within 8-12 wks of the final CRT dose. Primary endpoint is a demonstrated improvement in Neoadjuvant Rectal Cancer (NAR) score compared to historical controls targeting a 20% relative risk reduction in DFS and 3-4% absolute OS improvement. Secondary endpoints include OS, DFS, toxicity, pCR, cCR, therapy completion, negative surgical margins, sphincter preservation, off-target “abscopal” effects for the subset of stage IV pts, and exploratory assessments of tumor infiltrating lymphocytes, circulating immunologic profiles, and molecular predictors of response. A safety run-in phase has completed as a precedent to full enrollment. Enrollment now continues to 47 total pts to achieve 41 surgically evaluable pts. NCT03102047. Support: AstraZeneca-Medimmune, NSABP Foundation Clinical trial information: NCT03102047.
Colorectal Cancer Metastatic dMMR Immuno-Therapy (COMMIT) study (NRG- GI004/SWOG-S1610): A randomized phase III study of mFOLFOX6/bevacizumab combination chemotherapy with or without atezolizumab or atezolizumab monotherapy in the first-line treatment of patients (pts) with deficient DNA mismatch repair (dMMR) metastatic colorectal cancer (mCRC).
Authors: Lee James J. , Yothers Greg , Jacobs Samuel A. , Sanoff Hanna Kelly , Cohen Deirdre Jill , Guthrie Katherine A , Henry Norah Lynn , Ganz Patricia A. , Kopetz Scott , Lucas Peter C. , Allegra Carmen Joseph , Blanke Charles David , Wolmark Norman , Hochster Howard S. , George Thomas J. , Overman Michael J. 
Published: January 2019

TPS728 Background: Deficient DNA mismatch repair (dMMR) colorectal cancer (CRC) cells are highly immunogenic. Preclinical data showed that oxaliplatin-containing chemotherapy combined with anti-VEGF enhances antitumor activity of programmed cell death-1 (PD-1) pathway blockade in murine CRC models. Prior phase I study showed mFOLFOX6/ bevacizumab (bev) + atezolizumab (atezo) was well tolerated and enhanced intratumoral infiltration of CD8+ T cells. We hypothesize that the dMMR subset of CRC may be effectively targeted with combination of PD-1 pathway blockade and mFOLFOX6/bev to promote tumor regression. Methods: This is a prospective randomized phase III open-label trial. Pts (N=347) with mCRC dMMR will be randomized to 3 trial arms (1:1:1): mFOLFOX6/bev; atezo monotherapy; or mFOLFOX6/bev + atezo. Stratification factors include BRAFV600E status, metastatic site, and prior adjuvant CRC therapy. Primary objective is to evaluate efficacy of mFOLFOX6/bev/atezo and atezo monotherapy compared to mFOLFOX6/bev. Primary endpoint is progression-free survival (PFS) assessed by study investigator. Secondary endpoints include overall survival, objective response rate, safety profile, surgical conversion rate, disease control rate, duration of response, and PFS by retrospective central review. Health-related quality of life is an exploratory objective. Archived tumor tissue and blood samples will be collected for correlative studies. Key inclusion criteria are: mCRC without prior chemotherapy for advanced disease; tumor determined to be dMMR by local CLIA-certified IHC assay (MLH1/MSH2/MSH6/PMS2); availability of archived tumor tissue for central confirmation of dMMR status; and measurable disease per RECIST. Activated 11-7-17. As of 9-24-18, 13/347 pts have been enrolled. Clinical trial: NCT02997228. Support: U10CA180868, -180822, -180888, -180819, UG1CA189867, U24CA196067; and Genentech, Inc. Clinical trial information: NCT02997228.
Oral hormone pregnancy tests and the risks of congenital malformations: a systematic review and meta-analysis
Authors: Heneghan Carl J. , Aronson Jeffrey K. , Spencer Elizabeth , Holman Bennett , Mahtani Kamal R. , Perera Rafael , Onakpoya Igho 
Published: January 2019

Background: Oral hormone pregnancy tests (HPTs), such as Primodos, containing ethinylestradiol and high doses of norethisterone, were given to over a million women from 1958 to 1978, when Primodos was withdrawn from the market because of concerns about possible teratogenicity. We aimed to study the association between maternal exposure to oral HPTs and congenital malformations. Methods: We have performed a systematic review and meta-analysis of case-control and cohort studies that included data from pregnant women and were exposed to oral HPTs within the estimated first three months of pregnancy, if compared with a relevant control group. We used random-effects meta-analysis and assessed the quality of each study using the Newcastle–Ottawa Scale for non-randomized studies. Results: We found 16 case control studies and 10 prospective cohort studies, together including 71 330 women, of whom 4,209 were exposed to HPTs. Exposure to oral HPTs was associated with a 40% increased risk of all congenital malformations: pooled odds ratio (OR) = 1.40 (95% CI 1.18 to 1.66; P<0.0001; I2 = 0%). Exposure to HPTs was associated with an increased risk of congenital heart malformations: pooled OR = 1.89 (95% CI 1.32 to 2.72; P = 0.0006; I2=0%); nervous system malformations OR = 2.98 (95% CI 1.32 to 6.76; P = 0.0109 I2 = 78%); gastrointestinal malformations, OR = 4.50 (95% CI 0.63 to 32.20; P = 0.13; I2 = 54%); musculoskeletal malformations, OR = 2.24 (95% CI 1.23 to 4.08; P= 0.009; I2 = 0%); the VACTERL syndrome (Vertebral defects, Anal atresia, Cardiovascular anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal anomalies, and Limb defects), OR = 7.47 (95% CI 2.92 to 19.07; P < 0.0001; I2 = 0%). Conclusions: This systematic review and meta-analysis shows that use of oral HPTs in pregnancy is associated with increased risks of congenital malformations.
The effect of an electronic module about drug abuse prevention on teachers’ beliefs in Indonesia
Authors: Ghozali Ghozali , Azuhairi A Ahmad , Mohd Zulkefli Nor Afiah , Ibrahim Faisal 
Published: January 2019

Background: Drug abuse is a serious global health problem. Globally, 210 million people use illicit drugs each year, of which 200,000 die from drugs. Evidence shows that most drug addicts start using drugs in adolescence (<15-years-old). Adolescents need role models who are able to guide them; teachers have important roles as they are primary role models for students. Therefore, teachers should have positive beliefs to guide students effectively, i.e. they should have good awareness about the threat of drug abuse and high confidence to implement required prevention. This research developed an alternative electronic delivery method of learning material to empower teachers in preventing drug abuse. This study aimed to compare the effect of the electronic and a printed teaching module on teachers’ beliefs about drug abuse prevention. Methods: 260 junior high school teachers were selected randomly. These teachers were split into intervention and control groups. Before intervention, a questionnaire was completed by both groups. The teachers then completed the learning material: electronic module in intervention group and printed module in control group. One month later, data was collected from both groups using the same questionnaire to assess the beliefs of the teachers Results: There was significant positive effect on teachers’ beliefs, both in the intervention and control groups. All categories of beliefs at one month after intervention were significantly higher than those at baseline (P<0.001). Based on between group comparison analysis of mean changes, perceived susceptibility in the intervention group was significantly higher than the control group (P<0.001), while perceived severity, benefits, barriers and efficacy were not significantly different (P>0.05). Conclusions: Electronic and printed module intervention significantly increased teachers’ beliefs in drug abuse prevention. The printed module was still effective to be used as learning media, while the electronic module was an alternative with some advantages.