Publications by authors named "Gounder M"

Purpose: FHD-609, a potent, selective, heterobifunctional degrader of bromodomain-containing protein 9 (BRD9), was evaluated for treatment of patients with advanced synovial sarcoma (SS) or SMARCB1-deficient tumors.

Patients And Methods: In this multinational, open-label, phase 1 study (NCT04965753), patients received FHD609 intravenously at escalating doses either twice weekly (BIW) (5 to 80 mg; n=40) or once weekly (QW) (40 to 120 mg; n=15).

Results: Fifty-five patients received FHD-609 for a median of 43 days.

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Purpose: Survival of patients with metastatic sarcoma remains poor, and there is a pressing need for new therapies. Most sarcoma subtypes are not responsive to immune checkpoint inhibition alone. Lenvatinib, a multireceptor tyrosine kinase inhibitor targeting tumor vasculature, has an immunomodulatory activity that contributes to its antitumor effects.

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  • * The study used the E-Delphi method, where clinical experts provided feedback through multiple rounds to refine a 35-item questionnaire assessing KAP about DT, achieving majority consensus on various statements.
  • * Ultimately, 34 items were included in the final questionnaire, with sections dedicated to knowledge (15 items), attitude (8 items), and practice (11 items), demonstrating the need for improved awareness among healthcare providers about DT.
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  • Desmoid tumors (DT) are rare, aggressive growths that have historically been treated primarily with surgery, but recent trends suggest a shift towards less invasive treatment options.
  • A consensus meeting held in Milan in June 2023 aimed to update global guidelines for DT management, bringing together over 90 experts and patient advocates to discuss new strategies and treatments.
  • The updated guidelines emphasize the importance of local therapies and include information on the latest medical agents, particularly γ-secretase inhibitors, to ensure informed and effective management of DT in specialized referral centers.
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  • - Desmoid tumors (DT) are rare, locally aggressive sarcomas that often affect younger females (under 40), primarily causing high symptom burden and significant reductions in quality of life, despite having a good overall survival rate.
  • - Common symptoms include pain, fatigue, and insomnia, with some patients experiencing disfigurement or mobility issues; anxiety and depression rates in DT patients can mirror those in more severe cancers.
  • - The GOunder/Desmoid Tumor Research Foundation's DEsmoid Symptom/Impact Scale (GODDESS) evaluates patient-reported outcomes specific to DT, aiding in clinical trials to incorporate patient perspectives as new treatments are developed.
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Purpose: To assess the safety and efficacy of transzonular moxifloxacin and dexamethasone versus standard postoperative topical drug regimen in phacoemulsification.

Design: Nonrandomized prospective study.

Methods: The study included 100 eyes of 100 age and gender-matched individuals with senile cataract undergoing routine phacoemulsification.

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Despite the potential of targeted epigenetic therapies, most cancers do not respond to current epigenetic drugs. The Polycomb repressive complex EZH2 inhibitor tazemetostat was recently approved for the treatment of -deficient epithelioid sarcomas, based on the functional antagonism between PRC2 and loss of SMARCB1. Through the analysis of tazemetostat-treated patient tumors, we recently defined key principles of their response and resistance to EZH2 epigenetic therapy.

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Unlabelled: Epigenetic dependencies have become evident in many cancers. On the basis of antagonism between BAF/SWI-SNF and PRC2 in SMARCB1-deficient sarcomas, we recently completed the clinical trial of the EZH2 inhibitor tazemetostat. However, the principles of tumor response to epigenetic therapy in general, and tazemetostat in particular, remain unknown.

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Purpose: This study sought to identify β-catenin targets that regulate desmoid oncogenesis and determine whether external signaling pathways, particularly those inhibited by sorafenib (e.g., PDGFRβ), affect these targets to alter natural history or treatment response in patients.

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Unlabelled: The association between immune-related AEs (irAE) and outcome in patients with sarcoma is not known. We retrospectively reviewed a cohort of patients with advanced sarcoma treated with immune checkpoint blockade (ICB)-based therapy. Association of irAEs with survival was assessed using a Cox regression model that incorporated irAE occurrence as a time-dependent covariate.

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  • The research focused on CDK4/6 inhibitors, specifically exploring how cellular senescence affects tumor growth in humans and its implications for cancer treatment.
  • A phase II clinical trial involving 30 patients with dedifferentiated liposarcoma tested the CDK4/6 inhibitor abemaciclib, demonstrating a median progression-free survival of 33 weeks and a good safety profile.
  • The study identified ANGPTL4 as a key factor in cell senescence, highlighting its role in immune response and suggesting that combining senolytics with abemaciclib could enhance treatment effectiveness in certain patients.
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  • The GODDESS tool was created to measure the severity of Desmoid Tumor/Aggressive Fibromatosis symptoms and their effects on patients' daily lives, and the study assessed its measurement reliability and validity.
  • The study involved 142 participants from a randomized trial of nirogacestat, highlighting the tool's strong internal consistency and ability to differentiate between symptom severity groups over time.
  • Results indicated that GODDESS is a reliable and valid endpoint for clinical trials, with defined meaningful change thresholds that can help assess treatment responses in future studies.
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Unlabelled: Brigimadlin (BI 907828) is an oral MDM2-p53 antagonist that has shown encouraging antitumor activity in vivo. We present phase Ia results from an open-label, first-in-human, phase Ia/Ib study investigating brigimadlin in patients with advanced solid tumors (NCT03449381). Fifty-four patients received escalating doses of brigimadlin on day 1 of 21-day cycles (D1q3w) or days 1 and 8 of 28-day cycles (D1D8q4w).

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Background: Overexpression of metabotropic glutamate receptor 1 (GRM1) has been implicated in the pathogenesis of multiple cancers. Riluzole, an inhibitor of glutamate release, showed synergistic antitumor activity in combination with the multi-kinase inhibitor sorafenib in preclinical models. This phase I trial identified the toxicity profile, dose-limiting toxicities, maximum tolerated dose (MTD), and pharmacokinetic and pharmacodynamic properties of riluzole combined with sorafenib in patients with advanced cancers.

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Purpose: Epacadostat, an indole 2,3 dioxygenase 1 (IDO1) inhibitor, proposed to shift the tumor microenvironment toward an immune-stimulated state, showed early promise in melanoma but has not been studied in sarcoma. This study combined epacadostat with pembrolizumab, which has modest activity in select sarcoma subtypes.

Patients And Methods: This phase II study enrolled patients with advanced sarcoma into five cohorts including (i) undifferentiated pleomorphic sarcoma (UPS)/myxofibrosarcoma, (ii) liposarcoma (LPS), (iii) leiomyosarcoma (LMS), (iv) vascular sarcoma, including angiosarcoma and epithelioid hemangioendothelioma (EHE), and (v) other subtypes.

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  • * ! The trial showed that nirogacestat significantly improved progression-free survival (76% event-free at 2 years) compared to placebo (44%), with a higher rate of objective responses (41% vs. 8%).
  • * ! While nirogacestat had notable benefits, it also caused common side effects like diarrhea (84%) and nausea (54%), and 75% of women of childbearing potential experienced issues related to ovarian function.
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Essential epigenetic dependencies have become evident in many cancers. Based on the functional antagonism between BAF/SWI/SNF and PRC2 in SMARCB1-deficient sarcomas, we and colleagues recently completed the clinical trial of the EZH2 inhibitor tazemetostat. However, the principles of tumor response to epigenetic therapy in general, and tazemetostat in particular, remain unknown.

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Purpose: To describe the long-term outcomes of transcutaneous retrobulbar amphotericin B (TRAMB) in COVID-19-associated mucormycosis.

Methods: In total, 18 cases of COVID-19-associated mucormycosis were reviewed. In addition to the recommended treatment protocol, all patients were to be given 3.

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Purpose: This study evaluated the safety, pharmacokinetics, pharmacodynamics, and preliminary efficacy of milademetan, a small-molecule murine double minute-2 (MDM2) inhibitor, in patients with advanced cancers.

Patients And Methods: In this first-in-human phase I study, patients with advanced solid tumors or lymphomas received milademetan orally once daily as extended/continuous (days 1-21 or 1-28 every 28 days) or intermittent (days 1-7, or days 1-3 and 15-17 every 28 days) schedules. The primary objective was to determine the recommended phase II dose and schedule.

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SMARCB1 biallelic inactivation resulting in SMARCB1/INI1 deficiency drives a wide range of malignancies, including many mesenchymal tumors. However, the specific types of SMARCB1 alterations and spectrum of cooperating mutations among various types of sarcomas has not been well investigated. We profiled SMARCB1 genetic alterations by targeted DNA sequencing and fluorescence in situ hybridization (FISH) in a large cohort of 118 soft tissue and bone tumors, including SMARCB1-deficient sarcomas (78, 66%): epithelioid sarcomas, epithelioid peripheral nerve sheath tumors, poorly differentiated chordomas, malignant rhabdoid tumors, and soft tissue myoepithelial tumors, as well as non-SMARCB1-deficient sarcomas (40, 34%) with various SMARCB1 genetic alterations (mutations, copy number alterations).

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Background: In ultra-rare sarcomas (URS) the conduction of prospective, randomized trials is challenging. Data from retrospective observational studies (ROS) may represent the best evidence available. ROS implicit limitations led to poor acceptance by the scientific community and regulatory authorities.

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The management of desmoid tumors (DT) is shifting toward conservative and patient-tailored strategies. Active surveillance is currently considered the first line of treatment for most DT patients, according to international guidelines. When active treatment is required, several systemic and local treatments are considered.

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PD-1 blockade (nivolumab) efficacy remains modest for metastatic sarcoma. In this paper, we present an open-label, non-randomized, non-comparative pilot study of bempegaldesleukin, a CD122-preferential interleukin-2 pathway agonist, with nivolumab in refractory sarcoma at Memorial Sloan Kettering/MD Anderson Cancer Centers (NCT03282344). We report on the primary outcome of objective response rate (ORR) and secondary endpoints of toxicity, clinical benefit, progression-free survival, overall survival, and durations of response/treatment.

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The genetic, biologic, and clinical heterogeneity of sarcomas poses a challenge for the identification of therapeutic targets, clinical research, and advancing patient care. Because there are > 100 sarcoma subtypes, in-depth genetic studies have focused on one or a few subtypes. Herein, we report a comparative genetic analysis of 2,138 sarcomas representing 45 pathological entities.

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