bluuebunny/crossref_metadata_2025_split huggingface dataset:
Next-generation sequencing in patients with lung cancer undergoing immunotherapy: Retrospective analysis.
Authors: Batra Akshee , Khosla Atulya Aman , Alejos David , Kim Jinah , Searles Sienna , Chitkara Akshit , Jatwani Karan , Vyas Abhinav , Rehman Hibba tul , Ahmed Shahid Sattar , Singh Rohit 
Published: June 2024

e15071 Background: Identifying targetable oncogenic drivers and resistance mechanisms by Next-generation sequencing (NGS) is critical in Non-Small Cell Lung Cancer (NSCLC). Methods: We conducted a retrospective study at the University of Vermont Center to assess the utilization of NGS in NSCLC. We examined the medical records of NSCLC patients who received Immune Checkpoint Inhibitors (ICIs) as a first-line therapy between January 2017 and June 2022. We collected demographic data, including age, sex, ethnicity, cancer stage, NGS, mutations and survival data. Survival analysis was performed for the most common mutation by measuring the Hazard Ratio (HR) via Cox regression of different mutations compared to the whole cohort. Results: We identified 95 NSCLC patients with 52.6% males, 94.7% whites and a mean age of 63.4 years (Standard Deviation (SD): 11.34). 67.4 % received Pembrolizumab and 30.5% got Durvalumab. Most patients had stage 4 and stage 3 cancers, with 54.7% and 35.8%, respectively. Mean ECOG of 0.9 (SD: 0.7), 34% had average body mass index, and overall mortality was 41%. PD L1 expression and NGS were reported in 81% of cases. NGS was reported in 88.5% of stage 4 and 76.5% of stage 3 categories. 41.8% had a type of KRAS mutation, with KRAS p.G12C being the most common. 24.1% of cases had no mutation. The mean survival months ranged from 7.6 months in MET to 52.4 months in RET mutation. Survival analysis showed decreased mortality in EGFR mutation, as seen in Table. Conclusions: The rate of NGS testing at our rural academic center in Vermont is on the higher side of the national average NGS testing, but the turnaround time (TAT) of 28 days is suboptimal compared to NCI centers. Strategies to reduce TAT need to be implemented to get timely essential for tailoring therapies in patients with NSCLC. Further research is needed to explore the prognostic utility of mutations in NSCLC patients undergoing ICIs. [Table: see text]
Characterizing clinical trials for CAR T targeting solid tumors from 2018 to 2023: A systematic review.
Authors: Wesson William , Ayoobkhan Fathima Shehnaz , Mahmoudjafari Zahra , Mushtaq Muhammad Umair , Abdallah Al-Ola A. , Sun Weijing , Anwer Faiz , Doolittle Gary C. , McGuirk Joseph , Al-Rajabi Raed Moh'd Taiseer , Baranda Joaquina Celebre , Ahmed Nausheen 
Published: June 2024

e15080 Background: In the last decade, there have been many advances in the treatment of solid tumors, including new chemotherapy agents, immunotherapy, and most recently, cellular therapies. Chimeric antigen receptor T-cell (CAR T) therapy, first approved for acute lymphoblastic leukemia in 2017, represented a paradigm shift in hematologic malignancies, producing response rates that dramatically outpaced alternative regimens in a relapsed/refractory patient setting. Approvals in large B-cell lymphomas and multiple myeloma followed. Excited by the potential of CAR T, investigators worldwide have initiated trials to investigate the use of CAR T in solid tumors. This review explores the trials conducted globally, evaluating the potential molecular targets and the status of current clinical trials. Methods: This systematic review identified CAR T clinical trials specifically targeting solid tumors starting in 2018 to 2023 registered at ClinicalTrials.gov as of January 8, 2024. Trial-related variables including trial phase, primary trial site location, primary endpoints, start and end dates, and molecular target were captured. Results: We screened 110 clinical trials, ultimately including 103 studies for analysis after excluding trials without a CAR T construct in the methods. The number of new clinical trials increased over time, with a significantly larger increase (440%) seen with non-US sponsors compared to US sponsors (100%), p< 0.0001. Only 19 trials (18%) are/were being conducted in the United States in the studied time period. There were 33 unique molecular targets used, with mesothelin (17%), and the claudin protein family (13%) as the most frequented targets. Conclusions: The success that CAR T has demonstrated in hematologic malignancies has created great hope in solid tumor malignancies, although tempered by differences between the two categories. Unlike hematologic cancers, solid tumors exhibit significant biomarker variation, with interpatient biomarker expression varying greatly, even within the same tissue diagnosis. To deal with this issue, the majority of clinical trials that were reviewed here were not restricted to a single disease location such as breast cancer or esophageal cancer but were rather restricted by the expression of the targeted epitope, to allow for the heterogeneity inherent in these tumors. As presented here, substantial efforts are being made worldwide to improve these technologies, but the United States appears to be lagging in clinical trial efforts, compared to other nations. Further investigation is warranted into this topic, as the usage of CAR T quickly spreads from a therapy only used in hematology to one with promise in solid tumors, infectious diseases, and beyond.
Pharmacodynamics of venetoclax plus cirtuvivint a first-in-class splice variant regulator.
Authors: Govindharajulu Jeevan P , Dougherty Kelly , Miner Tiffanie , Hollingshead Melinda G. , Gore Steven , Parchment Ralph E. , Doroshow James H. , Srivastava Apurva K. 
Published: June 2024

e15093 Background: NSC835563 (SM08502, cirtuvivint) is a first-in-class pan CDC-like kinase (CLK) and dual specificity tyrosine kinase (DYRK) inhibitor that targets alternative splicing of genes in multiple pathways and modifies their protein expression. Preclinical screening of hematologic malignancy models has shown sensitivity to cirtuvivint, leading to proposed clinical trials in AML in combinations with venetoclax. We performed pharmacodynamic studies to identify probable mechanisms of combination activity in AML models. Methods: In vivo tolerability, efficacy and pharmacodynamic (PD) studies were performed in two AML xenograft models, MV411 and KG1a in NSG mice, at 6.25-25 mg/kg PO cirtuvivint and 25 mg/kg PO venetoclax. Body weights (BW) and tumor volumes were recorded periodically to assess toxicity and anti-tumor efficacy. Tumor tissue samples were collected at 6 and 24 h post venetoclax to assess PD response. Multiplexed analysis of apoptosis pathway proteins/protein-protein complexes was performed by clinically validated assays (PMID 26446940). Results: Cirtuvivint alone at high doses (25 mg/kg) caused tumor regressions in MV411 but only a modest tumor growth inhibition (TGI) in KG1a, a resistant AM model. Importantly, the lowest dose of 6.25 mg/kg cirtuvivint combined with 25 mg/kg venetoclax led to tumor regression in the MV411 model and a moderate TGI in KG1a. Cirtuvivint alone caused a transient 25% reduction (p<0.05) in Mcl-1 levels at 6 h post dose in MV411. The venetoclax combination triggered a sustained (for 24 h) 50-75% disruption of Bcl-2 and Mcl-1 complexes with Bax and Bim, resulting in >20-fold increased mitochondrial Bax/Bak heterodimer and >10-fold increased cytosolic cleaved caspase-3. In KG1a, combination treatment resulted in only modest (<20%) changes in biomarkers. Overall, biomarkers provided evidence of the combination MoA. Conclusions: Venetoclax and cirtuvivint in combination effectively induced tumor regressions at low tolerable doses in an AML model. Mitochondrial Bax/Bak heterodimer provided a sensitive biomarker of combination activity. Cirtuvivint contributed its combinatorial effect primarily through disruption of Bim complexes and inhibition of Mcl-1. PD biomarkers identified in this study can confirm MoA of drug combination in ongoing clinical trials.
First-in-human study of ZG0895, a TLR8 selective agonist, as monotherapy in patients with advanced solid tumors.
Authors: Sun Yan , Chai Xiaoli , Wang Zhen , Qu Song , Wu Lihua , Liu Linlin , Liu Yanyan , Zhu Ji 
Published: June 2024

e15103 Background: ZG0895 is a potent and novel Toll-like receptor (TLR) agonist that shows a highly selective activation of TLR8. It inhibits tumor growth by launching TLR8 downstream signal cascades, thus activating both innate and adaptive immune systems. We report preliminary results from a phase I, first-in-human, dose escalation study evaluating the safety, pharmacokinetics (PK) and antitumor activity of ZG0895 in patients with advanced solid tumors. Methods: Eligible patients previously treated with or intolerant to available standard systemic therapy(ies), received subcutaneous (s.c.) injection of ZG0895 weekly. If tolerated during the first treatment cycle (21 days per cycle), patients would continue weekly s.c. administrations of ZG0895 until disease progression, loss of clinical benefit, or development of unacceptable toxicity. Dose escalation scheme for ZG0895 was planned with eight dose levels (0.06, 0.18, 0.37, 0.75, 1.50, 2.25, 3.00, 3.75 mg/m2) according to an accelerated titration in the first two dose levels and the standard “3+3” design in the rest dose levels. Primary end points are the safety, tolerability, and recommended phase 2 dose (RP2D) of ZG0895. Secondary endpoints include overall response rate (ORR), disease control rate (DCR) and progression free survival (PFS) per the Response Evaluation Criteria in Solid Tumors version 1.1, as well as pharmacokinetics. Results: At data cut-off (December 25, 2023), 7 patients (5 males and 2 females), with the median age of 59 (range: 38-74) years old, received weekly s.c. injections of ZG0895 at the dose levels from 0.06 mg/m2 to 0.75 mg/m2 and completed the DLT observation period. Of the 7 patients, 4 (57.1%) received at least 3 lines of prior antineoplastic therapies, and 3 (42.9%) had exposed to PD-(L)1 inhibitors previously. No dose limiting toxicity events were reported. Five patients (71.4%) experienced grade 1 or 2 treatment-related adverse event (TRAE), and the most frequent events were injection site pain, hypertriglyceridaemia and proteinuria. None of patients experienced ≥grade 3 TRAE. Two patients experienced SAEs (intestinal obstruction and tumour haemorrhage), and both events were not related to ZG0895. The Cmax and AUC increased from 0.06 to 0.18 mg/m2 approximately in dose proportion. Conclusions: During the first 4 dose groups, ZG0895 was well tolerated in patients with advanced solid tumors. Phase I dose escalation of ZG0895 are underway in higher doses. Clinical trial information: NCT05877664 .
Surufatinib plus PD-1/L1 inhibitors as maintenance therapy following first line (1L) platinum-based chemotherapy combined with PD-1/L1 inhibitors in patients (pts) with extensive-stage small cell lung cancer (ES-SCLC).
Authors: Hu Yi , Chen Jianhua , Lv Dongqing , Wang Jinliang , Ma Junxun , Yi Tienan , Wu Shikai , Zhou Xiangdong , Zhang Xingxing , Chen Dongmei , Fan Songhua , Shi Michael , Su Weiguo 
Published: June 2024

e15109 Background: Pts with ES-SCLC have a poor prognosis. PD-1/L1 inhibitors combined with chemotherapy as 1L treatment has been demonstrated to improve the survival. Yet, pts are prone to progression after chemo-immunotherapy followed by anti-PD-1/L1 monotherapy. A multicenter, single-arm phase II study was conducted to evaluate the efficacy and safety of surufatinib (a small-molecule inhibitor of VEGFR 1-3, FGFR1 and CSF-1R) combined with PD-1/L1 inhibitors in pts with ES-SCLC as 1L maintenance therapy. Methods: Key inclusion criteria were cytologically or pathologically confirmed ES-SCLC, ECOG PS 0-1, no disease progression after 4-6 cycles platinum-based chemotherapy combined with PD-1/L1 inhibitors. Enrolled pts received surufatinib (250mg, po, QD) plus PD-1/L1 inhibitors (same as that in prior 1L therapy: Durvalumab, Sintilimab, Toripalimab or Serplulimab) until disease progression or intolerable toxicity. The primary endpoint is progression free survival (PFS) per RECIST 1.1 by investigator. Results: From Sept 2022 to July 2023, 21 pts were enrolled. The median age was 62 years. 90.5% were male, 85.7% were former and current smokers and 52.4% had ECOG PS of 0, 11 pts completed 6 cycles of platinum-based chemotherapy combined with PD-1/L1 inhibitors, and 12 pts received durvalumab in 1L therapy. As of 20 Nov, 2023, the median follow-up duration was 9.2 months. Objective response rate (ORR) was 14.3% and DCR (disease control rate) was 71.4%. The mPFS of 1L maintenance therapy was 4.0 months (95%CI: 2.0-5.6). The mPFS from 1L treatment to disease progression was 8.7 months. mOS was not reached, with 3 mo- , 6 mo- and 9 mo- OS rate was 100%, 94.4% and 75.6%, respectively. 21 (100%) pts experienced treatment-emergent adverse events (TEAEs), and 8 (38.1%) pts experienced grade ≥3 TEAEs, most commonly with platelet count decreased, neutrophil count decreased and pneumonia. There was no treatment-related death. Conclusions: Surufatinib combined with PD-1/L1 inhibitors showed encouraging efficacy and tolerable safety profile as 1L maintenance therapy. Further OS follow-up is warranted. Clinical trial information: NCT05509699 .
Examination of in vitro and in vivo antitumor activity of PARP1 selective inhibitor D0112-005.
Authors: Li Li 
Published: June 2024

e15115 Background: The approved PARP inhibitors have demonstrated efficacy in ovarian, breast, prostate, and pancreatic cancers, particularly in homologous recombination repair (HRR)-deficient tumors, including BRCA mutant tumors. The severe hematological toxicity of first-generation PARPi in combination with chemotherapy is due to the lack of selectivity for PARP2. So, we developed selective PARP1 inhibitor D0112-005 with the aim to improve safety and efficacy. Methods: The selectivity of D0112-005 on PARP1, PARP2 was measured by chemiluminescent assay kit and PARP trap™ assay kit. The anti-proliferative ability of D0112-005 was evaluated by CCK-8 in BRCA mutant cell lines. In vivo anti-tumor effect of D0112-005 was evaluated in MDA-MB-436 BRCA1 mutant xenograft model. The potential for hematologic toxicity was evaluated in rats for 28 days repeat-dose and dogs for 14 days repeat-dose. Results: D0112-005 is a highly potent and selective inhibitor of PARP1 with 2000-fold selectivity for PARP1 over PARP2 and PARP3. D0112-005 trapped PARP1-DNA with an EC50 value of 6.49 nM. In contrast, the EC50 of PARP2-DNA trapping was 430μM. These data demonstrate that D0112-005 is a potent and selective PARP1 trapper. D0112-005 showed high anti-proliferation activity against BRCA mutant MDA-MB-436 and HCC1395 cell lines, with IC50 values of 2.06 nM and 2.446 nM, respectively. In the MDA-MB-436 BRCA1m xenograft model, a dose-dependent anti-tumor effect was observed after 21 days administration, with TGIs of 38.77%, 106.7% and 111.73% at the dose of 0.1, 0.3 or 1 mg/kg once daily by oral, respectively. In the 1 mg/kg group, the anti-tumor efficacy was maintained after 14 days of drug withdrawal. D0112-005 showed well tolerance without bodyweight loss. In rat 28 days repeat dose study, D0112-005 100mg/kg had less changes on hematologic parameters compared with Olaparib. The main toxic reaction of D0112-005 (10mg/kg) was reversible thrombocytopenia in dog 14 days repeated toxicity study. Conclusions: D0112-005 potently and selectively inhibits PARP1 resulting in excellent anti-tumor activity in vivo and in vitro, which also good safety profile in the repeated toxicity study in rats and dogs.
Safety and clinical efficacy of IOA-289, a novel autotaxin inhibitor, plus gemcitabine and nab-paclitaxel (GnP) in patients with previously untreated metastatic pancreatic ductal adenocarcinoma (mPDAC).
Authors: Melisi Davide , Quinzii Alberto , Valente Monica , Di Giacomo Anna Maria , Amato Giovanni , Simonetti Elena , Zecchetto Camilla , Casallino Simona , Leta Luigi , Messineo Luisa , Mendo Lucia , Hammett Tracey , Deken Marcel , Di Conza Giusy , Kaur Paramjit , Lahn Michael M. F. , Maio Michele 
Published: June 2024

e15130 Background: Autotaxin (ATX) plays a critical role in inflammation and resistance mechanisms in a wide range of malignancies. IOA-289 is a novel inhibitor of ATX, with anti-fibrotic, immune-enhancing and anti-tumour activity. This first-in-human trial evaluated safety and tolerability, pharmacokinetic (PK)/pharmacodynamic (PD) profile of IOA-289 in combination with GnP. Methods: IOA-289 was investigated, in untreated mPDAC, in a dose escalation study evaluating the continuous twice daily dosing (BID). IOA-289 was initially administered for 7 days as a monotherapy (Cycle 0) before adding GnP at standard doses in 3 weekly schedule followed by 1 week pause (Cycle 1 onwards). Primary objective: Safety and tolerability. Secondary objectives: PK; PD (e.g., plasma LPA and serum CA19-9); radiographic responses (RECIST 1.1); PFS and OS. Results: Cohort 1 assessed the safety at 100 mg BID (n = 4), cohort 2 at 200 mg (n = 4), and cohort 3 at 400 mg (n = 5). Safety assessment shows no treatment-emergent adverse events led to study drug discontinuation, or a dose limiting toxicity. Most toxicities were consistent with the known toxicity profile of GnP. Median time on treatment for cohort 1 was 4.8 months, for cohort 2 and cohort 3 patients are still under treatment and clinical outcomes are not yet established but are projected to surpass the observation from cohort 1. Five patients are currently remain active on treatment No clinical responses were observed in cohort 1. In cohort 2, 2 out of 4 patients (50%) achieved a Partial Response (PR) at cycle 5 and 7 respectively, which was confirmed and durable. No mature data is available yet for later cohorts. Exposure to the compound resulted in reductions in multiple LPA species, with a protocol-defined inhibition of > 50% for over 24 hrs. Consistent reductions in levels of CA19-9 have been observed since cohort 2 (200 mg BID), with > 50% reduction already from cycle 2, with durable reductions lasting longer than 4 months. No mature data is available for later cohorts. Conclusions: IOA-289 is well tolerated at all dose levels in combination with standard GnP. Patients in the higher dose cohorts are experiencing robust CA19-9 reductions consistent with ORR. Occurrence of PRs occurred later than compared to historical controls and were durable, suggesting a differentiated mode of action. Clinical trial information: NCT05586516 .
Serabelisib, sapanisertib (PIKTOR) and paclitaxel: A combinatorial approach to improve PI3K/mTOR/AKT pathway inhibition and treatment response in solid tumors.
Authors: Starks David , Tyrakis Petros A , Steele Georgie , Kampjut Domen , Chirnomas Deborah , Williams Casey B. , Maddocks Oliver D. K. 
Published: June 2024

e15134 Background: Despite high mutation rates in genes of the PI3K/mTOR/AKT pathway in cancer, therapeutic strategies to inhibit this pathway featuring single targeted therapies have achieved limited clinical success. An alternate approach inhibiting multiple parts of the pathway simultaneously demonstrated improved activity (Starks et al, GynOnc 2022). The Phase 1 study combined the targeted PI3K-alpha and mTOR inhibitors serabelisib and sapanisertib (PIKTOR) with paclitaxel showing reasonable safety and promising clinical efficacy in patients with advanced endometrial, breast and ovarian tumors that had progressed on prior taxane. The ORR was 47% including 3 complete responses, with a PFS of 11 months in 15 evaluable subjects (NCT03154294). We sought to better understand the mechanistic basis for the efficacy of this triplet drug combination in models of endometrial and breast cancer to support successful clinical development of this regimen. Methods: Signaling activity in PI3K/mTOR/AKT pathway was probed by western blot for phospho-S6 and phospho-4EBP1 in human endometrial and breast cancer cell lines with PI3K/mTOR/AKT mutations. Single and combinatorial dose-response curves were established for serabelisib, sapanisertib and paclitaxel versus FDA-approved pathway inhibitors. Mechanisms of cytotoxicity and paclitaxel sensitization were probed with cell death assays. The impact of single and combined agents on tumor growth was assessed with in vivo xenograft studies. Results: In human endometrial and breast cancer cell lines, the combination of serabelisib and sapanisertib achieved markedly improved PI3K/mTOR/AKT pathway inhibition versus FDA-approved single agents. Serabelisib and sapanisertib increased the cytotoxicity of paclitaxel, supporting prior work that identifies PI3K/mTOR/AKT pathway activation as a key mediator of taxane resistance. Further, interrogation of a range of clinically relevant doses and scheduling led to an optimized regimen in which serabelisib and sapanisertib substantially improved the response to paclitaxel in vivo. Conclusions: Simultaneous inhibition of PI3K-alpha, mTORC1 and mTORC2 with PIKTOR offers potential for superior PI3K/mTOR/AKT pathway inhibition, suggesting that rational drug combination approaches may offer two important benefits: (1) more complete PI3K/mTOR/AKT pathway inhibition by targeting multiple signaling nodes, and (2) greater tumor cell cytotoxicity by sensitization to taxanes. These data, combined with the promising efficacy and safety signal from PIKTOR plus paclitaxel in a Phase 1 trial (NCT03154294), provide a compelling rationale for further clinical investigation. Future studies will focus on tumors known to have high rates of PI3K mutations including gynecologic tumors where there is a high unmet need.
Prevalence of NTRK gene fusions in solid tumors in northeastern Mexico.
Authors: Cerda-Contreras Christopher , Oyervides Victor , Vidal-Gutiérrez Oscar , Noriega Maria Fernanda , Lozano Aguilar Mario 
Published: June 2024

e15145 Background: Gene fusions (GF) are among the intricate hallmarks of cancer that lead to abnormal cell proliferation and survival. Neurotrophic tropomyosin receptor kinase (NTRK) gene fusions are frequent in rare solid tumors but less frequent in common ones. Scarce literature has evaluated the prevalence of this aberration estimated to be from 0.5 to 1% globally. For these particular type of tumors, multikinase inhibitors is an option aside from chemotherapy with good responses. Objective: To determine the prevalence of NTRK gene fusions in a Mexican population. Methods: Sociodemographic, clinical, and histopathological data were collected in a single center from databases of Pathology and Oncology Departments of Hospital Universitario Dr. José E. González in Northeastern Mexico. Patients of all ages with solid tumors were included if tested positive for Pan-TRK by immunohistochemistry (IHC). Confirmation for gene fusion was made using Next Generation Sequencing (NGS) technology in formalin-fixed paraffin-embedded tissue. Results: A total of 156 patients from 2021 to 2023 were included for analysis. 67 (42.9%) did test positive for IHC. Of these, 52.2% were male and 20.8% were pediatric. Adult and pediatric median age of 57 and 13 years, respectively. Most frequent tumors locations were central nervous system & extremities. Gene fusion anomaly was confirmed in 6 patients. Among these, 83.3% were male and 16.7% pediatric population. Only NTRK1 and NTRK3 were found in gene fusions. Four translocations were prevalent TPM3:NTRK1 and ETV6:NTRK3 with 2 cases (33.3%), respectively. Followed by LMNA:NTRK1 and EML4:NTRK3 each with one patient. For location, arranged in descending order, head and neck (33.3%), extremities (33.3%), central nervous system and occult primary tumors both 16.6%. The only non-adult tumor reported was infantile fibrosarcoma. Prevalence was estimated to be 3.8% in our population. Conclusions: Understanding the molecular biology of tumor cells enables the development of targeted treatments other than chemotherapy. In our population, NTRK gene fusions were a little more prevalent (~4%) than global estimation. Unfortunately, in Mexico there's a lack of access to multikinase inhibitors. Further studies with large samples are required in Mexico and all over the world to afford access to these tumor-agnostic therapies.