Publications by authors named "Vaishampayan U"

Background: The Fast Real-time Assessment of Combination Therapies in Immuno-ONcology study in patients with aRCC (FRACTION-RCC) was designed to assess new immuno-oncology (IO) combinations in patients with advanced renal cell carcinoma (aRCC). We present results in IO-naive patients treated with nivolumab (NIVO) + relatlimab (RELA) or NIVO + ipilimumab (IPI) in track 1.

Methods: The open-label, randomised, phase II FRACTION-RCC trial enrolled patients with aRCC from 32 hospitals and cancer centres across six countries.

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Background: Nemvaleukin alfa (nemvaleukin, ALKS 4230) is a novel, engineered cytokine that selectively binds to the intermediate-affinity interleukin-2 receptor, preferentially activating CD8 T cells and natural killer cells, with minimal expansion of regulatory T cells, thereby mitigating the risk of toxicities associated with high-affinity interleukin-2 receptor activation. Clinical outcomes with nemvaleukin are unknown. ARTISTRY-1 investigated the safety, recommended phase 2 dose (RP2D), and antitumor activity of nemvaleukin in patients with advanced solid tumors.

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How cancer cells escape immune surveillance and resist immune checkpoint blockade (ICB) remains to be fully elucidated. By screening candidate genes frequently gained in cancer, we identified expression of ubiquitin-like modifier activating enzyme 1 (UBA1) as being the most negatively correlated with signatures related to effector CD8+ T-cells. High UBA1 expression was strongly predictive of treatment resistance and poor survival in ICB cohorts.

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Modern advances in systemic and localized therapies for patients with renal cell carcinoma (RCC) have significantly improved patients' outcomes. If disease progression occurs after initial treatment, clinicians often have multiple options for a first salvage therapy. Because salvage and initial treatments both may affect overall survival time, and they may interact in unanticipated ways, there is a growing need to determine sequences of initial therapy and first salvage therapy that maximize overall survival while maintaining quality of life.

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In recent years, the armamentarium of therapies for the management of advanced renal cell carcinoma (aRCC) has grown. Combination therapies, including immuno-oncology (IO) agents and tyrosine kinase inhibitors [TKIs (IO-TKI)], and IO-IO combinations, are now approved for first-line treatment of aRCC. Decisions regarding the use of these combinations, IO-IO versus IO-TKI, can be challenging, as they have not been compared in a randomized trial; each of these combinations have been compared with sunitinib alone.

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JCO Mesenchymal-epithelial transition (MET) signaling pathway plays a role in the pathogenesis of selected patients with papillary renal cell carcinoma (PRCC). In the phase II PAPMET trial (ClinicalTrials.gov identifier: NCT02761057), cabozantinib significantly prolonged progression-free survival and improved objective response rate compared with sunitinib in patients with advanced PRCC.

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ESK981 is a potent tyrosine kinase and PIKfyve lipid kinase inhibitor. This phase II trial evaluated the efficacy of ESK981 as a single agent in patients with androgen receptor-positive (AR +) metastatic castration-resistant prostate cancer (mCRPC). Eligible patients had mCRPC with progression on AR-targeted agents and without prior chemotherapy treatment.

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Background: KEYNOTE-199 (NCT02787005) is a multicohort phase 2 study evaluating pembrolizumab in patients with metastatic castration-resistant prostate cancer (mCRPC). Results from cohorts 4 (C4) and 5 (C5) are presented.

Methods: Eligible patients had not received chemotherapy for mCRPC and had responded to enzalutamide prior to developing resistance as defined by Prostate Cancer Clinical Trials Working Group 3 guidelines.

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Importance: Clinical trial data on adjuvant therapy in patients with non-clear cell renal cell carcinoma (RCC) are scant.

Objective: To evaluate the effect of adjuvant everolimus after nephrectomy on recurrence-free survival (RFS) and overall survival (OS) in patients with localized papillary and chromophobe RCC.

Design, Setting, And Participants: This prespecified subgroup analysis of a phase 3 randomized clinical trial, EVEREST, included patients enrolled between April 1, 2011, and September 15, 2016.

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Article Synopsis
  • - A study assessed dietary changes and supplement use among patients with metastatic renal cell carcinoma, finding that 50.9% of respondents began using supplements post-diagnosis, with probiotics and CBD being the most popular.
  • - The survey, conducted by KCCure, gathered data from 289 patients on their dietary patterns, supplement expenses, and perceptions of alternative medicine.
  • - Results indicated that 34.9% of patients made dietary modifications, predominantly adopting the Mediterranean and ketogenic diets, highlighting the need for doctors to discuss supplement use with their patients as these practices may influence cancer treatment outcomes.
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Unlabelled: Sipuleucel-T is an autologous cellular immunotherapy that targets prostatic acid phosphatase (PAP) and is available for treatment of men with asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC). In this single-arm, two-cohort, multicenter clinical study, potential racial differences in immune responses to sipuleucel-T in men with mCRPC were explored. Patients' blood samples were obtained to assess serum cytokines, humoral responses, and cellular immunity markers before and after treatment.

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  • The EVEREST trial investigated the effectiveness of adjuvant everolimus in patients with intermediate-high to very high risk of recurrence after kidney cancer surgery, showing a significant improvement in recurrence-free survival (RFS) but not in overall survival (OS).
  • Of the 699 patients analyzed with very high-risk clear cell histology, those taking everolimus experienced a notable increase in RFS (HR 0.80) compared to placebo, although a high percentage (47%) of patients on everolimus discontinued treatment due to side effects.
  • While everolimus improved RFS, the lack of statistically significant OS benefits suggests that further examination is needed to assess its long-term survival impact
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  • The microbiome, a collection of beneficial microorganisms in our bodies, is increasingly recognized for its role in cancer development, tumor environment, and therapy response, particularly in immunotherapy for genitourinary cancers.
  • Research shows that the composition of the gut microbiome affects how patients respond to immune checkpoint inhibitors (ICIs), suggesting that optimizing the microbiome may enhance treatment effectiveness.
  • Innovative approaches, including probiotic therapy and fecal microbiota transplantation, are being studied as potential ways to improve ICI responses in patients with renal cell carcinoma, urothelial cancer, and prostate cancer.
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Purpose: CDK12 inactivation in metastatic castration-resistant prostate cancer (mCRPC) may predict immunotherapy responses. This phase 2 trial evaluated the efficacy of immune checkpoint inhibitor (ICI) therapy in patients with CDK12-altered mCRPC.

Patients And Methods: Eligible patients had mCRPC with deleterious CDK12 alterations and any prior therapies except ICI.

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  • Extragonadal germ cell tumors (EGCTs) are uncommon, making up less than 5% of all germ cell tumors, and are often more aggressive than those in the gonads.
  • The study analyzed 77 EGCT cases, finding that the anterior mediastinum was the most common site, and identified chromosomal abnormalities, notably isochromosome 12p in 26% of tumors and gain of chromosome 21 in 37%.
  • Patients with mediastinal seminomas had better survival rates compared to those with non-seminomatous tumors, and the presence of somatic-type malignancies indicated a poorer prognosis in those with EGCTs.
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Prostate cancer is an exemplar of an enhancer-binding transcription factor-driven disease. The androgen receptor (AR) enhanceosome complex comprised of chromatin and epigenetic coregulators assembles at enhancer elements to drive disease progression. The paralog lysine acetyltransferases p300 and CBP deposit histone marks that are associated with enhancer activation.

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In the phase 3 CLEAR trial, lenvatinib plus pembrolizumab (L + P) showed superior efficacy versus sunitinib in treatment-naïve patients with advanced renal cell carcinoma (aRCC). The combination treatment was associated with a robust objective response rate of 71%. Here we report tumor responses for patients in the L + P arm in CLEAR, with median follow-up of ∼4 yr at the final prespecified overall survival (OS) analysis.

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Mammalian switch/sucrose nonfermentable (mSWI/SNF) ATPase degraders have been shown to be effective in enhancer-driven cancers by functioning to impede oncogenic transcription factor chromatin accessibility. Here, we developed AU-24118, an orally bioavailable proteolysis-targeting chimera (PROTAC) degrader of mSWI/SNF ATPases (SMARCA2 and SMARCA4) and PBRM1. AU-24118 demonstrated tumor regression in a model of castration-resistant prostate cancer (CRPC) which was further enhanced with combination enzalutamide treatment, a standard of care androgen receptor (AR) antagonist used in CRPC patients.

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Article Synopsis
  • ModraDoc006 is an oral version of docetaxel aimed at treating metastatic castration-resistant prostate cancer (mCRPC) when combined with ritonavir, and its efficacy and safety were tested against standard intravenous docetaxel in a phase II trial.
  • The study involved 103 chemotherapy-naïve mCRPC patients who were randomly assigned to receive either intravascular docetaxel or the oral ModraDoc006/r for comparison, measuring the primary outcome of radiographic progression-free survival (rPFS).
  • The results showed no significant difference in rPFS between the two treatments, but ModraDoc006/r had a better safety profile with fewer and milder side effects, suggesting it may be
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Mivavotinib (TAK-659/CB-659), a dual SYK/FLT3 inhibitor, reduced immunosuppressive immune cell populations and suppressed tumor growth in combination with anti-PD-1 therapy in cancer models. This dose-escalation/expansion study investigated the safety, pharmacokinetics, pharmacodynamics, and preliminary efficacy of mivavotinib plus nivolumab in patients with advanced solid tumors. Patients received oral mivavotinib 60-100 mg once-daily plus intravenous nivolumab 3 mg/kg on days 1 and 15 in 28-day cycles until disease progression or unacceptable toxicity.

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  • VHL disease and some kidney cancers (RCC) are linked to a problem with a gene called Von Hippel-Lindau, which causes issues with tumor growth due to HIF-2α.
  • Belzutifan is the only medicine approved to block HIF-2α but might not always work for everyone, so scientists are looking for new ways to improve treatment.
  • Researchers are also studying other medicines and combinations that could make HIF-2α blockers more effective and are exploring new HIF-2α inhibitors to see if they can help treat advanced kidney cancer better.
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  • A study explored the prevalence of hereditary factors in renal cell carcinoma (RCC) by analyzing the presence of pathogenic or likely pathogenic (P/LP) germline variants in patients who underwent genetic testing.
  • Out of 321 analyzed patients, 13.1% had P/LP variants, with notable mutations found in specific genes, and nearly half of these patients had mutations that could be targeted for treatment.
  • The research found that bilateral or multifocal tumors were linked to P/LP variants, but factors like age and family cancer history did not significantly affect genetic testing outcomes, emphasizing the need for better genetic evaluation methods in RCC patients.
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Importance: The therapeutic landscape of advanced renal cell carcinoma (RCC) has rapidly evolved in the past 2 decades, with the advent of cytokines therapy followed by targeted therapies and novel immune checkpoint inhibitors (ICI). This article aims to review the current evidence and ongoing trials of neoadjuvant or prenephrectomy ICI therapy in patients with locally advanced and metastatic RCC.

Observations: A literature search was performed using the Cochrane Central Register of Controlled Trials, ClinicalTrials.

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There is a need to optimize the treatment of clear cell renal cell carcinoma (ccRCC) patients at high recurrence risk after nephrectomy. We sought to elucidate the tumor immune microenvironment (TIME) of localized ccRCC and understand the prognostic and predictive characteristics of certain features. The discovery cohort was clinically localized patients in the TCGA-Kidney Renal Clear Cell Carcinoma (KIRC) project ( = 382).

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