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  • 1
    In: BMC Medicine, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2023-05-05)
    Abstract: Apatinib, a highly selective VEGFR2 inhibitor, significantly improved efficacy versus placebo as a third- and later-line treatment for advanced gastric cancer in phase 2 and 3 trials. This prospective, single-arm, multicenter phase IV AHEAD study was conducted to verify the safety and efficacy of apatinib in patients with advanced or metastatic gastric or gastroesophageal adenocarcinoma after at least two lines of systematic therapy in clinical practice settings. Methods Patients with advanced gastric cancer who had previously failed at least two lines of chemotherapy received oral apatinib until disease progression, death or unacceptable toxicity. The primary endpoint was safety. The secondary endpoints included objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS). Adverse events were summarized by the incidence rate. Median OS and PFS were estimated using the Kaplan–Meier method. ORR, DCR, OS at 3 and 6 months, and PFS at 3 and 6 months were calculated, and their 95% CIs were estimated according to the Clopper-Pearson method. Results Between May 2015 and November 2019, a total of 2004 patients were enrolled, and 1999 patients who received at least one dose of apatinib were assessed for safety. In the safety population, 87.9% of patients experienced treatment-related adverse events (TRAEs), with the most common hypertension (45.2%), proteinuria (26.5%), and white blood cell count decreased (25.3%). Additionally, 51% of patients experienced grade ≥ 3 TRAEs. Fatal TRAEs occurred in 57 (2.9%) patients. No new safety concerns were reported. Among the 2004 patients included in the intention-to-treat population, the ORR was 4.4% (95% CI, 3.6–5.4%), and DCR was 35.8% (95% CI, 33.7–38.0%). The median PFS was 2.7 months (95% CI 2.2–2.8), and the median OS was 5.8 months (95% CI 5.4–6.1). Conclusions The findings in the AHEAD study confirmed the acceptable and manageable safety profile and clinical benefit of apatinib in patients with advanced gastric cancer as a third- or later-line of treatment. Trial registration This study was registered with ClinicalTrials.gov NCT02426034. Registration date was April 24, 2015.
    Type of Medium: Online Resource
    ISSN: 1741-7015
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 2
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 15_suppl ( 2021-05-20), p. e16037-e16037
    Abstract: e16037 Background: Apatinib, a highly selective VEGFR2 inhibitor, has shown a clinical benefit as third-line or further-line treatment in patients with gastric cancer in a randomized phase III study with the initial dose of 850mg. However, the study was conducted in a small scale (n = 267) under standardized conditions. Here, we assessed exposure and effectiveness of apatinib at different doses using data collected from a post-marketing phase IV study that included a broader patient population with a larger sample size. Methods: Patients with advanced or metastatic advanced gastric cancer or gastroesophageal junction adenocarcinoma who were aged 18-75 with ECOG performance status of 0-2 and failed at least two lines of chemotherapy were enrolled. Apatinib was recommended with an initial dose of 850 mg q.d orally, while the initial dose was determined at the discretion of the investigators. Administration of apatinib regarding the initial dose, duration of treatment, dose modification, average daily exposure dose (ADED) and its effect on progression-free survival (PFS) and overall survival (OS) were analyzed. Results: A total of 2004 patients were included in the intention-to-treat population. The median age was 59 (range, 19-85) years, 71.8% of patients were male, 84.2% had ECOG performance status of 0-1; 96.4% had stage IV disease, and 98.8% had metastases, among which 34.2% with more than 2 metastases. Five patients did not receive therapy. Compared to 5.5% of patients with the initial dose 〉 500mg, 94.1% was given at the initial dose≤500mg; 8.6% had ADED 〉 500mg and 91.1% had ADED ≤500mg. The median duration of treatment was 56 days. Treatment interruption and discontinuation, and dose reduction occurred in 34.4%, 24.5%, and 13.7% of patients due to adverse events, respectively. Survival analyses in the initial dose ≤500mg/ 〉 500mg subgroups showed median PFS of 2.6 months (95%CI 2.20-2.79) vs 2.7 months (95% CI 1.91-3.32), median OS of 5.6 months (95% CI 5.26-5.95) vs 5.9 months (95% CI 4.40-6.87). In the ADED ≤500mg/ 〉 500mg subgroups, the median PFS was 2.6 months (95% CI 2.14-2.76) vs 3.0 months (95% CI 2.27-3.61), and median OS was 5.7 months (95% CI 5.32-6.08) vs 6.1 months (95% CI 5.36-7.72). Conclusions: In conclusion, more than 90% of the patients received a lower dose regimen, which indicate dosage of 500mg or lower is a tolerated exposure. Furthermore, dose at 500mg or lower produced similar efficacy to that more than 500mg. Clinical trial information: NCT02426034.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
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  • 3
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2020
    In:  Pediatric Nephrology Vol. 35, No. 11 ( 2020-11), p. 2163-2171
    In: Pediatric Nephrology, Springer Science and Business Media LLC, Vol. 35, No. 11 ( 2020-11), p. 2163-2171
    Type of Medium: Online Resource
    ISSN: 0931-041X , 1432-198X
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
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  • 4
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 83, No. 8_Supplement ( 2023-04-14), p. CT075-CT075
    Abstract: Background: The ORIENT-15 study (NCT03748134) evaluated sintilimab (anti-PD-1 antibody) plus chemotherapy (Sin+Chemo) versus placebo plus chemotherapy (Chemo) as first-line (1L) treatment of unresectable locally advanced, recurrent, or metastatic esophageal squamous cell carcinoma (ESCC). At the prespecified interim analysis, this study met the primary endpoints of overall survival (OS) in all patients (pts) (hazard ratio [HR] 0.63; 95% confidence interval [CI] 0.51-0.78; P & lt;0.001) and the pts with PD-L1 combined positive score (CPS) ≥10 (HR 0.64; 95% CI 0.48-0.85; P=0.002) (Lu, et al. BMJ 2022). Here we report the updated OS results with an extended follow-up time. Methods: Eligible pts were randomized 1:1 to receive sintilimab/placebo (3 mg/kg in pts weighing & lt;60 kg or 200 mg in pts weighing ≥60 kg, IV Q3W) for up to 24 months plus chemo (paclitaxel 175 mg/m2 Q3W plus cisplatin 75 mg/m2 Q3W as TP regimen, or cisplatin 75 mg/m2 Q3W plus 5-FU 800 mg/m2 on days 1-5 Q3W as CF regimen). Stratification factors were PD-L1 expression (tumor proportion score & lt;10% or ≥10%), ECOG PS (0 vs 1), liver metastasis (presence vs absence), and chemo regimen (TP vs CF). The primary endpoints were OS in the pts with PD-L1 CPS ≥10 and all pts. Results: Overall, 690 pts (median age 63.0; 85.5% male; 93.3% Asian and 4.9% White; 24.3% liver metastasis; 90.7% TP regimen) were randomized and received Sin+Chemo (341 pts) or Chemo (349 pts). As of data cutoff date (Aug 28, 2022), the median follow-up was 32.2 months (interquartile range 28.0-35.8); 231 OS events were observed in Sin+Chemo group and 278 in Chemo group. Sin+Chemo continued to demonstrate an OS benefit vs Chemo in all pts (median OS 17.4 [95% CI 16.0-19.8] vs 12.8 [95% CI 11.3-14.5] months; HR 0.661 [95% CI: 0.554-0.788]; P & lt;0.0001), and the pts with PD-L1 CPS ≥10 (18.4 [95% CI 16.2-24.6] vs 14.5 [95% CI 11.7-16.4] months; HR 0.635 [95% CI 0.503-0.803]; P=0.0001). Estimated OS rates at 12 and 24 months for Sin+Chemo vs Chemo in all pts were 64.0% vs 53.5% and 41.4% vs 22.9%, respectively. Subgroup analyses of OS in all pts were generally consistent with the previous report, showing homogeneity in OS outcomes. The CTCAE grade ≥3 treatment-related adverse events occurred in 60.7% pts in Sin+Chemo group and 56.2% pts in Chemo group. No new or unexpected safety signals were observed. Conclusions: Sin+Chemo continued to demonstrate significant OS benefits in advanced ESCC in both overall and PD-L1 CPS ≥10 populations with an acceptable safety profile over time. These data further support the use of Sin+Chemo as a standard of care for 1L treatment in these patients. Citation Format: Zhihao Lu, Junye Wang, Yongqian Shu, Li Kong, Buhai Wang, Lei Yang, Guochun Cao, Guogui Sun, Yinghua Ji, Hu Liu, Tongjian Cui, Wensheng Qiu, Aziz Zaanan, Roberto Pazo Cid, Hui Zhou, Xing Sun, Yan Wang, Yuling Chen, Haoyuan Li, Lishi Zhang, Lin Shen. Updated overall survival outcomes from a randomized, double-blind phase III study of sintilimab versus placebo in combination with chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma (ORIENT-15) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr CT075.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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  • 5
    Online Resource
    Online Resource
    Wiley ; 2016
    In:  Polymer Engineering & Science Vol. 56, No. 10 ( 2016-10), p. 1089-1095
    In: Polymer Engineering & Science, Wiley, Vol. 56, No. 10 ( 2016-10), p. 1089-1095
    Type of Medium: Online Resource
    ISSN: 0032-3888
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2006718-5
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  • 6
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 9003-9003
    Abstract: 9003 Background: Toripalimab in combination with chemotherapy showed significant improvement over chemotherapy alone in progression-free survival (PFS) and overall survival (OS) as first-line treatment of advanced NSCLC at the final PFS analysis of the CHOICE-01 study (NCT03856411). Here we report the final OS analysis. Methods: Patients (n=465) with treatment-naïve, advanced NSCLC without EGFR/ALK mutations were randomized 2:1 to receive toripalimab 240 mg (n=309) or placebo (n=156) in combination with chemotherapy for 4-6 cycles, followed by maintenance toripalimab or placebo plus standard care until disease progression, intolerable toxicity, or completion of 2 years of treatment. Patients from the placebo arm were actively crossed-over to receive toripalimab upon disease progression. The primary endpoint was PFS. The secondary endpoints included OS and safety. Results: By the cutoff date of August 31, 2022, when 283 events triggered the final OS analysis, the median survival follow up was 19.4 months. A significant improvement in OS was observed for the toripalimab arm over the placebo arm: HR=0.73 (95% CI: 0.57-0.93), two-sided p=0.0108, median OS 23.8 vs 17.0 months. A consistent effect on OS, favoring the toripalimab arm, was observed all PD-L1 expression subgroups. The OS benefit is greater in non-squamous NSCLC, HR=0.50 (95% CI: 0.36-0.70), median OS 27.8 vs 15.9 months, whereas no significant difference was found in the squamous subgroup (mOS 19.6 vs 18.1 months) despite a significant PFS improvement. The squamous subgroup had a high 70% crossover rate. No new safety signal was identified since the interim report. The incidence of Grade ≥3 adverse events (AEs) (78.9% vs 82.1%) was similar between the two arms. AEs leading to discontinuation of toripalimab/placebo (14.3% vs 3.2%), fatal AEs (5.5% vs 2.6%), and immune-related (irAEs) (50.6% vs. 21.2%) were more frequent in the toripalimab arm. Whole exome sequencing results indicated patients with mutations in the FAK-PI3K-Akt pathway achieved significantly better OS from the toripalimab arm. Conclusions: The addition of toripalimab to chemotherapy in patients with advanced NSCLC provided significant OS benefit than chemotherapy alone with a manageable safety profile. These results support the use of toripalimab with chemotherapy as 1 st line therapy for advanced NSCLC patients without EGFR/ALK mutations. Clinical trial information: NCT03856411 .
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 7
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2013
    In:  Tumor Biology Vol. 34, No. 3 ( 2013-6), p. 1409-1419
    In: Tumor Biology, Springer Science and Business Media LLC, Vol. 34, No. 3 ( 2013-6), p. 1409-1419
    Type of Medium: Online Resource
    ISSN: 1010-4283 , 1423-0380
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2013
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    detail.hit.zdb_id: 1483579-4
    SSG: 12
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  • 8
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2013
    In:  Pathology & Oncology Research Vol. 19, No. 4 ( 2013-10), p. 685-693
    In: Pathology & Oncology Research, Springer Science and Business Media LLC, Vol. 19, No. 4 ( 2013-10), p. 685-693
    Type of Medium: Online Resource
    ISSN: 1219-4956 , 1532-2807
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2013
    detail.hit.zdb_id: 2002501-4
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  • 9
    Online Resource
    Online Resource
    American Chemical Society (ACS) ; 2019
    In:  Journal of the American Chemical Society Vol. 141, No. 46 ( 2019-11-20), p. 18492-18499
    In: Journal of the American Chemical Society, American Chemical Society (ACS), Vol. 141, No. 46 ( 2019-11-20), p. 18492-18499
    Type of Medium: Online Resource
    ISSN: 0002-7863 , 1520-5126
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    Language: English
    Publisher: American Chemical Society (ACS)
    Publication Date: 2019
    detail.hit.zdb_id: 1472210-0
    detail.hit.zdb_id: 3155-0
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  • 10
    Online Resource
    Online Resource
    Frontiers Media SA ; 2022
    In:  Frontiers in Cell and Developmental Biology Vol. 10 ( 2022-10-19)
    In: Frontiers in Cell and Developmental Biology, Frontiers Media SA, Vol. 10 ( 2022-10-19)
    Abstract: Emerging evidence indicates that the cellular electromagnetic field regulates the fundamental physics of cell biology. The electromagnetic oscillations and synchronization of biomolecules triggered by the internal and external pulses serve as the physical basis of the cellular electromagnetic field. Recent studies have indicated that centrosomes, a small organelle in eukaryotic cells that organize spindle microtubules during mitosis, also function as a nano-electronic generator in cells. Additionally, cellular electromagnetic fields are defined by cell types and correlated to the epigenetic status of the cell. These interactions between tissue-specific electromagnetic fields and chromatin fibers of progenitor cells regulate cell differentiation and organ sizes. The same mechanism is implicated in the regulation of tissue homeostasis and morphological adaptation in evolution. Intercellular electromagnetic interactions also regulate the migratory behaviors of cells and the morphogenesis programs of neural circuits. The process is closely linked with centrosome function and intercellular communication of the electromagnetic fields of microtubule filaments. Clearly, more and more evidence has shown the importance of cellular electromagnetic fields in regulatory processes. Furthermore, a detailed understanding of the physical nature of the inter- and intracellular electromagnetic interactions will better our understanding of fundamental biological questions and a wide range of biological processes.
    Type of Medium: Online Resource
    ISSN: 2296-634X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2737824-X
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