The relationship between occupational asbestos exposure and esophagus cancer (EC) is not fully understood. We performed a meta-analysis to quantitatively assess the association. We systematically searched databases of PubMed, EMBASE, and Web of Science for studies with quantitative estimates of asbestos exposure and EC mortality. Pooled standardized mortality ratios (SMRs) and their corresponding 95% confidence intervals (CIs) were calculated. Twenty cohort studies on EC and asbestos exposure were included in this meta-analysis. Overall, occupational exposure to asbestos was associated with an excess risk of EC (SMR = 1.24, 95% CI: 1.13-1.38, P < 0.001), with little evidence of heterogeneity among studies (I(2) = 0.0%, P = 0.682). Being male, exposure to chrysotile or mixed asbestos, working at textile industry, long study follow-up (≥20 years), Asia, Europe and America cohorts with larger cohort size (>500), and high-exposure group all contribute to significantly higher SMR. Publication bias was not detected (Egger's test P-value = 0.374). This meta-analysis suggested that occupational asbestos exposure might be associated with an increased risk of EC in male. High-exposure level of asbestos could contribute to significantly higher risk of EC mortality.
At data-cutoff, 33 pts (39% checkpoint-experienced, 3 median prior lines of therapy) were treated in Dose Escalation from 0.03 to 10 mg/kg. No MTD was defined. Treatment-related adverse events (TRAEs) occurred in 26/33 (78.8%) pts, most commonly fatigue (24%), nausea, arthralgia, pruritus, and rash (18% each). The rate of Grade 3 TRAEs was 24.2%. Immune-related SAEs included enteritis, enterocolitis, pneumonitis, and myocarditis (n¼1 each). Half-life was 12 days; full ontarget binding to circulating T cells sustained through trough was observed at doses 3.0 mg every 3 weeks. Among 25 response-evaluable pts, 4 objective responses were observed (microsatellite stable colorectal cancer, metastatic thymoma [both confirmed PRs], anti-PD-L1-refractory serous fallopian tube carcinoma [unconfirmed PR with >50% reduction of CA-125], and prostatic adenocarcinoma [confirmed CR with resolution of PSA]); 9 pts had stable disease. Dose-dependent ICOS upregulation on circulating CD4+ T cells was evident, consistent with CTLA-4 engagement. Potential correlative biomarkers are being investigated.Conclusions: MGD019 has demonstrated an acceptable safety profile and encouraging early evidence of anti-tumor activity.Clinical trial identification: NCT03761017.
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