Publications by authors named "Sarina Piha Paul"

Purpose: BMS-986299 is a first-in-class, NOD-, LRR-, and pyrin-domain containing-3 (NLRP3) inflammasome agonist enhancing adaptive immune and T-cell memory responses.

Materials And Methods: This was a phase-I (NCT03444753) study that assessed the safety and tolerability of intra-tumoral BMS-986299 monotherapy (part 1A) and in combination (part 1B) with nivolumab, and ipilimumab in advanced solid tumors. Reported here are single-center results.

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Background: A novel anti-human epidermal growth factor receptor 2 (HER2) antibody-drug conjugate (ADC) GQ1001 was assessed in patients with previously treated HER2 positive advanced solid tumors in a global multi-center phase Ia dose escalation trial.

Methods: In this phase Ia trial, a modified 3 + 3 study design was adopted during dose escalation phase. Eligible patients were enrolled, and GQ1001 monotherapy was administered intravenously every 3 weeks.

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Introduction: Molecular alterations in the PI3K/AKT and Ras/Raf/MEK/ERK pathways are frequently observed in patients with endometrial cancers. However, mTOR inhibitors, such as temsirolimus, have modest clinical benefits. In addition to inducing metabolic changes in cells, metformin activates AMPK, which in turn inhibits the mTOR pathway.

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  • Immune checkpoint inhibitors (ICIs) have improved melanoma treatment, but finding effective drug combos with minimal side effects is essential.
  • A phase 1b study tested selinexor combined with pembrolizumab on 25 patients with advanced non-uveal melanoma, revealing high rates of adverse effects but most were manageable.
  • The results showed a 70% objective response rate in treatment-naïve patients, significantly better than the 7% response in those who had prior anti-PD-1 therapy, indicating promising antitumor activity.
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Purpose: 4-1BB (CD137) is a costimulatory immune receptor expressed on activated T cells, activated B cells, NK cells, and tumor-infiltrating lymphocytes, making it a promising target for cancer immunotherapy. Cinrebafusp alfa, a monoclonal antibody-like bispecific protein targeting HER2 and 4-1BB, aims to localize 4-1BB activation to HER2-positive tumors. This study evaluated the safety, tolerability, and preliminary efficacy of cinrebafusp alfa in patients with previously treated HER2-positive malignancies.

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Cancer cells with BRCA1/2 deficiencies are sensitive to poly (ADP-ribose) polymerase (PARP) inhibitors. We evaluated the efficacy of talazoparib in DNA-Damage Repair (DDR)-altered patients. In this phase II trial, patients were enrolled onto one of four cohorts based on molecular alterations: (1) somatic BRCA1/2, (2) other homologous recombination repair pathway, (3) PTEN and (4) germline BRCA1/2.

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  • * The study found an overall response rate of 18.1%, with a clinical benefit rate of 54.5% and more than 30% of patients experiencing durable responses lasting over 6 months.
  • * Although the median progression-free survival on the second RAF inhibitor was shorter at 2.7 months, responders had improved survival rates, with a median overall survival of 15.5 months, indicating a need for further research to confirm these findings and enhance treatment options.
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Purpose: The poly (ADP-ribose) polymerase inhibitor niraparib is indicated as maintenance treatment in patients with certain subtypes of advanced ovarian cancer, and is being investigated in patients with other solid tumors. Niraparib is available in 100-mg capsules with a starting dosage of 200 or 300 mg/d. This study assessed the relative bioavailability (BA) and bioequivalence (BE) between a 1 × 300-mg tablet relative to 3 × 100-mg niraparib capsules.

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  • Sapanisertib, a dual mTORC1/2 inhibitor, was combined with ziv-aflibercept, an anti-VEGF treatment, in a Phase 1 study to assess its safety and effectiveness in patients with advanced solid tumors.
  • Fifty-five heavily pre-treated patients participated, with the treatment showing a maximum tolerated dose of sapanisertib and ziv-aflibercept resulting in notable side effects like hypertension and fatigue but no severe (grade 5) complications.
  • The combination therapy showed promising anti-tumor activity, with 74% of patients achieving stable disease and an overall disease control rate of 78%.
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  • The study was a phase I trial focusing on the safety, pharmacokinetics, and effectiveness of tinengotinib, a multi-kinase inhibitor, in patients with advanced solid tumors.
  • Forty-eight patients participated, with a recommended daily dose established at 12 mg; common side effects included hypertension and a specific skin condition.
  • Preliminary results showed that tinengotinib was well tolerated and 30.2% of patients experienced clinical benefits, including some with specific types of cancer, suggesting potential effectiveness.
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Introduction: NUT carcinoma (NC) is an underdiagnosed and aggressive poorly differentiated or squamous cell cancer. A subset of NC is sensitive to chemotherapy, but the optimal regimen is unknown. Experts have recommended platinum- and ifosfamide-based therapy based on case reports.

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Background: Sapanisertib (CB-228/TAK-228) is a potent, selective ATP-competitive, dual inhibitor of mTORC1/2. Metformin is thought to inhibit the mTOR pathway through upstream activation of 5'-AMP-activated protein kinase (AMPK) suggesting combination therapy may enhance antitumor activity of sapanisertib. We report preliminary safety, tolerability, and efficacy from the dose-escalation study of sapanisertib in combination with metformin in patients with advanced solid tumors.

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Background: Immune checkpoint blockade has shown mixed results in advanced/recurrent gynecologic malignancies. Efficacy may be improved through costimulation with OX40 and 4-1BB agonists. The authors sought to evaluate the safety and efficacy of avelumab combined with utomilumab (a 4-1BB agonist), PF-04518600 (an OX40 agonist), and radiotherapy in patients with recurrent gynecologic malignancies.

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  • PARP inhibitors (PARPi) are becoming standard treatments in oncology, particularly for different types of breast cancer, but there’s a need for better ways to identify which patients will respond to these treatments.
  • The case study highlights a 57-year-old woman with hormone-receptor-positive, HER2-negative metastatic breast cancer who benefited from talazoparib due to her specific genetic mutation.
  • This scenario underscores the significance of a multidisciplinary approach to manage patients with brain metastases and emphasizes the role of personalized treatment based on biomarkers.
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We sought to assess discordance of HER2 status in patients with HER2-amplified/expressing solid tumors who underwent reevaluation of HER2 status. Patients with metastatic solid tumors and HER2 expression by IHC or amplification by FISH/next-generation sequencing on local testing underwent central HER2 IHC/FISH testing with either archival or fresh biopsies and were evaluated for discordance in HER2 status. 70 patients (12 cancer types) underwent central HER2 reevaluation, including 57 (81.

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Purpose: Aberrant alterations of ERBB receptor tyrosine kinases lead to tumorigenesis. Single agent therapy targeting EGFR or HER2 has shown clinical successes, but drug resistance often develops due to aberrant or compensatory mechanisms. Herein, we sought to determine the feasibility and safety of neratinib and trametinib in patients with EGFR mutation/amplification, HER2 mutation/amplification, HER3/4 mutation and KRAS mutation.

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Background: Preclinical models suggest synergy between anti-angiogenesis therapy, mammalian target of rapamycin (mTOR), and histone deacetylase inhibitors to promote anticancer activity.

Methods: This phase I study enrolled 47 patients between April 2012 and 2018 and determined safety, maximum tolerated dose (MTD), and dose-limiting toxicities (DLTs) when combining bevacizumab, temsirolimus, and valproic acid in patients with advanced cancer.

Results: Median age of enrolled patients was 56 years.

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Purpose: SYNB1891 is a live, modified strain of the probiotic Escherichia coli Nissle 1917 (EcN) engineered to produce cyclic dinucleotides under hypoxia, leading to STimulator of INterferon Genes (STING) activation in phagocytic antigen-presenting cells in tumors and activating complementary innate immune pathways.

Patients And Methods: This first-in-human study (NCT04167137) enrolled participants with refractory advanced cancers to receive repeat intratumoral injections of SYNB1891 either alone or in combination with atezolizumab, with the primary objective of evaluating the safety and tolerability of both regimens.

Results: Twenty-four participants received monotherapy across six cohorts, and 8 participants received combination therapy in two cohorts.

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Purpose: Developing new therapeutics for any of the more than 100 sarcoma subtypes presents a challenge. After progression from standard therapies, patients with sarcoma may be referred for enrollment in early-phase trials. This study aimed to investigate whether enrollment in biomarker-matched early-phase clinical trials leads to better outcomes for patients with advanced sarcoma.

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Background: Selinexor (KPT-330) is a potent inhibitor of exportin 1 (XPO1), in turn inhibiting tumor growth. Selinexor enhances the antitumor efficacy of eribulin in triple-negative breast cancer (TNBC) in vitro and in vivo. Given the unmet medical need in TNBC and sarcoma, the authors explored the safety and efficacy of this combination.

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  • The FDA has approved combined BRAF and MEK inhibitors for treating BRAF V600E-mutant solid tumors, but colorectal cancer is excluded due to resistance mechanisms that involve various pathways.
  • A pooled analysis of the VEM-PLUS study indicated that vemurafenib alone had similar overall survival (OS) and progression-free survival (PFS) compared to combination therapies, except for poorer outcomes in patients receiving vemurafenib with carboplatin and paclitaxel.
  • Patients who had not previously been treated with BRAF inhibitors showed significantly improved OS and PFS compared to those who were refractory to BRAF therapy, highlighting the need for further research on resistance mechanisms and optimizing treatment strategies
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Introduction: We aimed to identify clinical, pathologic, and treatment factors that are predictive of response and survival in patients with cervical cancer referred to phase I clinical trials.

Methods: Patients with cervical cancer who received at least one dose of a phase I investigational agent at our institution between 2014 and 2022 were included. The log-rank test was used to analyze differences in progression-free survival (PFS) and overall survival (OS), and multivariable regression analysis was performed.

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HER2 mutations are infrequent genomic events in biliary tract cancers (BTCs). Neratinib, an irreversible, pan-HER, oral tyrosine kinase inhibitor, interferes with constitutive receptor kinase activation and has activity in HER2-mutant tumours. SUMMIT is an open-label, single-arm, multi-cohort, phase 2, 'basket' trial of neratinib in patients with solid tumours harbouring oncogenic HER2 somatic mutations (ClinicalTrials.

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Although targeting oxidative phosphorylation (OXPHOS) is a rational anticancer strategy, clinical benefit with OXPHOS inhibitors has yet to be achieved. Here we advanced IACS-010759, a highly potent and selective small-molecule complex I inhibitor, into two dose-escalation phase I trials in patients with relapsed/refractory acute myeloid leukemia (NCT02882321, n = 17) and advanced solid tumors (NCT03291938, n = 23). The primary endpoints were safety, tolerability, maximum tolerated dose and recommended phase 2 dose (RP2D) of IACS-010759.

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Purpose: Preclinical cancer models harboring amplification were more sensitive to adavosertib treatment, a WEE1 kinase inhibitor, than models without amplification. Thus, we conducted this phase II study to assess the antitumor activity of adavosertib in patients with -amplified, advanced refractory solid tumors.

Patients And Methods: Patients aged ≥ 18 years with measurable disease and refractory solid tumors harboring amplification, an Eastern Cooperative Oncology Group performance status of 0-1, and adequate organ function were studied.

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