Publications by authors named "Spigel D"

Background: Belzutifan, a first-in-class HIF-2α inhibitor, has shown antitumour activity as monotherapy and in combination with cabozantinib in patients with previously treated advanced kidney cancer. The phase 2 LITESPARK-003 study was designed to determine the antitumour activity and safety of belzutifan in combination with cabozantinib in patients with advanced clear-cell renal cell carcinoma that was previously untreated (cohort 1) or previously treated with immunotherapy (cohort 2). Here, we report results from cohort 1 of this clinical trial.

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Background: The Wnt pathway is involved in proliferation and tissue homeostasis. Aberrant activation promotes cancer cell proliferation and survival. Inhibition of the low-density lipoprotein receptor-related protein 5/6 (LRP5/6) coreceptors that regulate Wnt signaling could prevent cancer cell proliferation.

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Background: Adavosertib (AZD1775) is a small-molecule Wee1 inhibitor. Durvalumab is a PD-L1 inhibitor.

Objective: The safety, tolerability, pharmacokinetics, and preliminary antitumor activity of adavosertib plus durvalumab were evaluated in patients with refractory solid tumors to define the maximum tolerated dose (MTD) and recommended phase II dose (RP2D).

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Background: Adavosertib is a first-in-class, selective small-molecule inhibitor of Wee1. Olaparib is an inhibitor of poly(ADP-ribose) polymerase (PARP). Preclinical data suggest that adavosertib enhances the antitumor effect of PARP inhibitors.

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Background: Adjuvant therapy with durvalumab, with or without tremelimumab, may have efficacy in patients with limited-stage small-cell lung cancer who do not have disease progression after standard concurrent platinum-based chemoradiotherapy.

Methods: In a phase 3, double-blind, randomized, placebo-controlled trial, we assigned patients to receive durvalumab at a dose of 1500 mg, durvalumab (1500 mg) plus tremelimumab at a dose of 75 mg (four doses only), or placebo every 4 weeks for up to 24 months. Randomization was stratified according to disease stage (I or II vs.

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Purpose: Cancer of unknown primary (CUP) is a syndrome comprising metastatic cancers without a clinically identified primary site. Although patients with CUP have an unfavorable prognosis, treatment with site-specific therapies guided by clinical features, standard pathology, and molecular assays can improve overall survival. The 92-gene assay (CancerTYPE ID) is a gene expression-based classifier that helps identify the tissue of origin for metastatic cancers with unknown or uncertain diagnoses.

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  • The study explores the use of a CD73 inhibitor (oleclumab) combined with durvalumab and chemotherapy in treating pancreatic ductal adenocarcinoma (PDAC), targeting immune surveillance evasion.
  • Conducted across multiple centers, the trial included patients with metastatic PDAC in two cohorts, assessing safety and response rates with various treatment combinations for the chemotherapy regimens.
  • While safety results were acceptable, the trial did not achieve its main goal of demonstrating significant treatment efficacy, although some patients with high CD73 levels showed improved outcomes.
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  • The study aimed to assess the effectiveness and safety of tislelizumab combined with chemotherapy for advanced gastric cancer compared to a placebo with chemotherapy.
  • Conducted from December 2018 to February 2023 across multiple continents, it involved 1,657 adult patients with specific cancer types who had not previously undergone systemic treatment.
  • Results indicated that patients receiving tislelizumab plus chemotherapy experienced significant improvements in overall survival compared to those on placebo and chemotherapy.
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  • The RESILIENT trial compared the effectiveness of liposomal irinotecan and topotecan as second-line treatments for small cell lung cancer (SCLC) after initial chemotherapy.
  • No significant difference in overall survival (OS) was observed, with liposomal irinotecan showing a median OS of 7.9 months and topotecan at 8.3 months.
  • Liposomal irinotecan had a higher objective response rate (ORR) of 44.1% compared to 21.6% for topotecan, but both treatments had similar safety profiles with grade ≥3 adverse events.
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Background: Standard first-line therapies for metastatic colorectal cancer (mCRC) include fluoropyrimidine-containing regimens with oxaliplatin and/or irinotecan and a biologic agent. Immunotherapy may enhance antitumor activity in combination with standard therapies in patients with mCRC. Here, we present phase 2 results of nivolumab plus standard-of-care therapy (SOC; 5-fluorouracil/leucovorin/oxaliplatin/bevacizumab) versus SOC in the first-line treatment of patients with mCRC (CheckMate 9X8).

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Background: Inhibition of the adenosine 2A receptor (AR) diminishes the immunosuppressive effects of adenosine and may complement immune-targeting drugs. This phase 2 study evaluated the AR antagonist AZD4635 in combination with durvalumab or oleclumab in patients with metastatic castration-resistant prostate cancer.

Methods: Patients with histologically/cytologically confirmed disease progressing within 6 months on ≥ 2 therapy lines were randomly assigned to either Module 1 (AZD4635 + durvalumab) or Module 2 (AZD4635 + oleclumab).

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  • The purpose of this guideline is to provide updated, evidence-based treatment recommendations for patients with stage IV non-small cell lung cancer (NSCLC) who do not have specific genetic driver alterations.
  • The recommendations are based on recent systematic reviews and randomized clinical trials, focusing on both efficacy and safety, and were developed by an Expert Panel with diverse expertise.
  • The latest update identified ten new randomized clinical trials and consolidates previous recommendations, covering treatment options for first, second, and subsequent lines of therapy.
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  • The guideline aims to provide evidence-based recommendations for treating stage IV non-small cell lung cancer patients with specific driver alterations.
  • It is regularly updated based on systematic reviews of clinical trials, with the latest review covering studies from February to October 2023.
  • The latest update identified eight new randomized controlled trials and refined treatment recommendations for different stages of therapy based on targetable driver alterations.
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Purpose: Metronomic chemotherapy has the potential to offer tumor control with reduced toxicity when compared to standard dose chemotherapy in patients with metastatic breast cancer. As metronomic chemotherapy may target the tumor microvasculature, it has the potential for synergistic effects with antiangiogenic agents such as the VEGF-A inhibitor bevacizumab.

Methods: In this randomized phase II study, patients with metastatic breast cancer were randomized to receive metronomic oral cyclophosphamide and methotrexate (CM) combined with bevacizumab (Arm A) or CM alone (Arm B).

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JCO The MyPathway multiple-basket study (ClinicalTrials.gov identifier: NCT02091141) is evaluating targeted therapies in nonindicated tumors with relevant molecular alterations. We assessed pertuzumab + trastuzumab in a tissue-agnostic cohort of adult patients with human epidermal growth factor receptor 2 (HER2)-amplified and/or -overexpressed and/or -mutated solid tumors.

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Purpose: Effective treatments for resectable non-small-cell lung cancer (NSCLC) are limited and relapse rates are high. The interleukin (IL)-1β pathway has been linked with tumor development and progression, including in the Canakinumab Anti-Inflammatory Thrombosis Outcomes cardiovascular study in which IL-1β pathway inhibition with canakinumab reduced lung cancer incidence and mortality in an exploratory analysis.

Methods: CANOPY-A (ClinicalTrials.

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Unlabelled: Neoadjuvant chemoimmunotherapy improves pathologic complete response rate and event-free survival in patients with resectable non-small cell lung cancer (NSCLC) versus chemotherapy alone. NeoCOAST was the first randomized, multidrug platform trial to examine novel neoadjuvant immuno-oncology combinations for patients with resectable NSCLC, using major pathologic response (MPR) rate as the primary endpoint. Eighty-three patients received a single cycle of treatment: 26 received durvalumab (anti-PD-L1) monotherapy, 21 received durvalumab plus oleclumab (anti-CD73), 20 received durvalumab plus monalizumab (anti-NKG2A), and 16 received durvalumab plus danvatirsen (anti-STAT3 antisense oligonucleotide).

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Background: Adavosertib (AZD1775) is a first-in-class, selective, small-molecule inhibitor of Wee1.

Objective: The safety, tolerability, pharmacokinetics, and efficacy of adavosertib monotherapy were evaluated in patients with various solid-tumor types and molecular profiles.

Patients And Methods: Eligible patients had the following: confirmed diagnosis of ovarian cancer (OC), triple-negative breast cancer (TNBC), or small-cell lung cancer (SCLC); previous treatment for metastatic/recurrent disease; and measurable disease.

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  • Predictive biomarkers are important for guiding targeted cancer treatments, and the ATR inhibitor camonsertib shows promise for tumors with specific DNA damage response gene alterations.
  • In a phase 1 trial involving 120 patients with advanced solid tumors, camonsertib demonstrated good tolerance, with the most common side effect being anemia.
  • Preliminary results showed a recommended phase 2 dose of 160 mg weekly, with some patients experiencing clinical and molecular responses, particularly those with ovarian cancer and specific genetic alterations.
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  • The immune phenotype of tumors plays a crucial role in predicting how well they will respond to immunotherapy, with immune-inflamed tumors typically having better responses due to high T cell infiltration.
  • Not all inflamed tumors are effective against therapy, and tumors lacking T cells (immune desert) or pushing T cells to the edges (immune excluded) show even lower response rates.
  • The new technique called skin tumor array by microporation (STAMP) allows researchers to study the development and dynamics of tumor immune phenotypes in real-time, revealing that local factors and T cell recruitment are key to understanding tumor rejection and therapy success.
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Adavosertib selectively inhibits Wee1, which regulates intra-S and G2/M cell-cycle checkpoints. This study investigated dosing schedules for adavosertib monotherapy, determining the maximum tolerated dose (MTD) and recommended Phase II dose (RP2D) in patients with advanced solid tumors.Patients received oral adavosertib qd or bid on a 5/9 schedule (5 days on treatment, 9 days off) in 14-day cycles, or qd on one of two 5/2 schedules (weekly, or for 2 of 3 weeks) in 21-day cycles.

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Background: This was an open-label, multicenter, single-arm phase Ib dose-escalation study of oral LCL161 administered in combination with oral topotecan in patients with relapsed/refractory small cell lung cancer (SCLC) and select gynecological cancers.

Methods: Cohorts of 3-6 patients initiated treatment with LCL161 and topotecan in escalating doses. LCL161 was administered orally on days 1, 8, and 15 of each 21-day cycle; topotecan was administered orally for the first 5 days of each 21-day cycle.

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Background: CheckMate 817, a phase 3B study, evaluated flat-dose nivolumab plus weight-based ipilimumab in patients with metastatic non-small cell lung cancer (NSCLC). Here, in this research, we report on first-line treatment in patients with Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1 (cohort A) and special populations (cohort A1: ECOG PS 2; or ECOG PS 0-1 with untreated brain metastases, renal impairment, hepatic impairment, or controlled HIV infection).

Methods: Cohorts A and A1 received nivolumab 240 mg every 2 weeks plus ipilimumab 1 mg/kg every 6 weeks.

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Background: For patients with advanced non-small cell lung carcinoma (NSCLC), immune checkpoint inhibitor (ICPI) and chemotherapy (chemo) ICPI represent two distinct first-line standard-of-care regimens without clear and established biomarkers to inform the optimal choice for individual patients. Here, we examined the complementary roles of tumor mutational burden (TMB) and programmed death ligand-1 (PD-L1) immunohistochemistry (IHC) to inform first-line therapy using a large real-world (rw) data set.

Materials And Methods: The study included patients with NSCLC from an rw de-identified clinico-genomic database.

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