Among patients with advanced cutaneous squamous-cell carcinoma, cemiplimab induced a response in approximately half the patients and was associated with adverse events that usually occur with immune checkpoint inhibitors. (Funded by Regeneron Pharmaceuticals and Sanofi; ClinicalTrials.gov numbers, NCT02383212 and NCT02760498 .).
Summary
Somatic mutations of ERBB2 (HER2) and
ERBB3 (HER3) are found in a wide range of cancers.
Preclinical modelling suggests that a subset lead to constitutive HER2
activation, but most remain biologically uncharacterized. We sought to
prospectively define the biologic and therapeutic significance of known
oncogenic HER2 and HER3 mutations and variants of unknown biological
significance by conducting a multi-histology, genomically selected,
‘basket’ study utilizing the pan-HER kinase inhibitor neratinib
(SUMMIT; Clinicaltrials.gov NCT01953926). Efficacy in HER2-mutant cancers varied
as a function of both tumour type and mutant allele to a degree not predicted by
preclinical models, with the greatest activity seen in breast, cervical and
biliary cancers and with tumours harbouring kinase domain missense mutations.
This study demonstrates how a molecularly driven clinical trial can be used to
further refine our biological understanding of both characterized and novel
genomic alterations with potential broad applicability for advancing the
paradigm of genome-driven oncology.
Banerji, U. et al. (2019) Trastuzumab duocarmazine in locally advanced and metastatic solid tumours and HER2-expressing breast cancer: a phase 1 dose-escalation and dose-expansion study.
Purpose: This first-in-human dose-escalation trial evaluated the safety, tolerability, maximal-tolerated dose (MTD), doselimiting toxicities (DLT), pharmacokinetics, pharmacodynamics, and preliminary clinical activity of pictilisib (GDC-0941), an oral, potent, and selective inhibitor of the class I phosphatidylinositol-3-kinases (PI3K).Patients and Methods: Sixty patients with solid tumors received pictilisib at 14 dose levels from 15 to 450 mg once-daily, initially on days 1 to 21 every 28 days and later, using continuous dosing for selected dose levels. Pharmacodynamic studies incorporated 18 F-FDG-PET, and assessment of phosphorylated AKT and S6 ribosomal protein in platelet-rich plasma (PRP) and tumor tissue.Results: Pictilisib was well tolerated. The most common toxicities were grade 1-2 nausea, rash, and fatigue, whereas the DLT was grade 3 maculopapular rash (450 mg, 2 of 3 patients; 330 mg, 1 of 7 patients). The pharmacokinetic profile was dose-proportional and supported once-daily dosing. Levels of phosphorylated serine-473 AKT were suppressed >90% in PRP at 3 hours after dose at the MTD and in tumor at pictilisib doses associated with AUC >20 hÁmmol/L. Significant increase in plasma insulin and glucose levels, and >25% decrease in 18 F-FDG uptake by PET in 7 of 32 evaluable patients confirmed target modulation. A patient with V600E BRAF-mutant melanoma and another with platinumrefractory epithelial ovarian cancer exhibiting PTEN loss and PIK3CA amplification demonstrated partial response by RECIST and GCIG-CA125 criteria, respectively.Conclusion: Pictilisib was safely administered with a doseproportional pharmacokinetic profile, on-target pharmacodynamic activity at dose levels !100 mg and signs of antitumor activity. The recommended phase II dose was continuous dosing at 330 mg once-daily.
Introduction: Nivolumab monotherapy is approved in the United States for third-line or later metastatic small cell lung cancer based on pooled data from nonrandomized and randomized cohorts of the multicenter, open-label, phase 1/ 2 trial of nivolumab ± ipilimumab (CheckMate 032; NCT01928394). We report updated results, including longterm overall survival (OS), from the randomized cohort. Ó 2019 International Association for the Study of Lung Cancer. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/). Progression-free 90 days after completion of platinum-based chemotherapy.cProgression-free <90 days after completion of platinum-based chemotherapy. d TMB categories (low, medium, high) were defined according to the baseline tertile of pooled TMB-evaluable patients from the randomized cohort, and percentages calculated based on the total TMB-evaluable population. ECOG PS, Eastern Cooperative Oncology Group performance status; TMB, tumor mutational burden.
March 2020Nivolumabipilimumab in recurrent SCLC 429
We propose to study the problem of few-shot learning with the prism of inference on a partially observed graphical model, constructed from a collection of input images whose label can be either observed or not. By assimilating generic message-passing inference algorithms with their neural-network counterparts, we define a graph neural network architecture that generalizes several of the recently proposed few-shot learning models. Besides providing improved numerical performance, our framework is easily extended to variants of few-shot learning, such as semi-supervised or active learning, demonstrating the ability of graph-based models to operate well on 'relational' tasks.
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