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  • American Association for Cancer Research (AACR)  (3)
  • 1
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2023
    In:  Cancer Research Vol. 83, No. 8_Supplement ( 2023-04-14), p. CT070-CT070
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 83, No. 8_Supplement ( 2023-04-14), p. CT070-CT070
    Abstract: Background: There is an unmet need for effective systemic therapy for desmoid tumors (DT, aggressive fibromatosis) that provides durable tolerability, symptom improvement, and tumor regression. Gamma secretase inhibitors (GSIs) demonstrate antitumor activity against DT. AL102 is a potent, orally available, selective GSI under investigation as an antineoplastic agent. Methods: RINGSIDE (AL-DES-01) is a 2-part Phase 2/3 study. In the open-label Phase 2 study (Part A), adults with progressing DT (≥10% unidimensional growth within 18 months or DT-related pain requiring non-opioid medication) were randomized to three dosing regimens: 1.2 mg once daily, 2 mg intermittent BIW (2 days on 5 days off), or 4 mg intermittent BIW. RINGSIDE Phase 3 (Part B) is a double-blind, placebo-controlled study evaluating the chosen dose regimen from Phase 2 (1.2 mg once daily) in adults and adolescents (≥12 years of age) with recurrent or treatment-naïve histologically confirmed progressing DT per investigator. For eligibility, progression is defined as ≥20% measured by MRI or CT scan according to RECIST v1.1 within 12 months of the screening visit. Planned enrollment is for ≈156 subjects globally to be randomized 1:1 to either AL102 1.2 mg once daily or placebo. Randomization will be stratified according to tumor location: intra-abdominal vs. extra-abdominal (including abdominal wall). Subjects will undergo MRI or CT scans (using the same modality throughout the study) every 12 weeks to assess tumor response according to RECIST v1.1 by blinded independent central review (BICR). The primary endpoint is progression-free survival (PFS) by BICR based on RECIST v1.1. Primary and secondary endpoints are summarized in Table 1. The trial is currently enrolling. Table 1. RINGSIDE Phase 3 Study Endpoints Objectives Endpoints Primary Evaluate effects of AL102 on disease progression PFS defined as time from randomization until date of assessment of progression (assessed by BICR based on RECIST v1.1) or death by any cause Secondary Evaluate additional effects of AL102 on tumor response • ORR (CR and PR) by BICR based on RECIST v1.1 • DOR defined by time from CR or PR (by BICR based on RECIST v1.1) until first documentation of disease progression or death from any cause Evaluate effects of AL102 on quality of life • Change from baseline in quality of life as determined by: • GOunder/Desmoid Tumor Research Foundation (DTRF) DEsmoid Symptom Scale and Impact Scale (GODDESS) • Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function • EuroQol 5-Dimensional (EQ-5D-3L) questionnaire • Patient’s Global Impression of Change (PGI-C) • Change from baseline in pain assessment using Brief Pain Inventory (BPI) short form Evaluate safety and tolerability of AL102 • Frequency, duration and severity of treatment-emergent adverse events (TEAEs) and serious AEs • Time to treatment discontinuation due to TEAE BICR: blinded independent central review; CR: complete response; DOR: duration of response; ORR: objective response rate; PR: partial response; PFS: progression-free survival; RECIST: Response Evaluation Criteria in Solid Tumors Citation Format: Mrinal Gounder, Robin L. Jones, Jonathan Yovell, Gary Gordon, Bernd Kasper. Double-blind placebo-controlled trial of AL102 for treatment of progressing desmoid tumors: the RINGSIDE phase 3 study design [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 CT070.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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  • 2
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 78, No. 13_Supplement ( 2018-07-01), p. 4336-4336
    Abstract: Leiomyosarcomas (LMS) are malignant tumors of smooth-muscle origin that occur across age groups. The mechanisms underlying LMS development, including clinically actionable genetic vulnerabilities, are largely unknown, and few therapeutic options exist for LMS patients. To detect somatic mutations, copy number alterations, and structural rearrangements, we performed whole-exome and transcriptome sequencing of 49 and 37 LMS tumors, respectively, and performed integrative analysis. Recurrence analysis identified TP53, RB1, and ATRX as significantly mutated genes and various other cancer-associated genes mutated at low frequency, indicating substantial mutational heterogeneity. Copy number analysis revealed widespread chromosomal gains and losses and highly rearranged genomes in all tumors. Additionally, chromothripsis and whole-genome duplication were detected in 35% and 51% of cases, respectively. Principle component analysis and unsupervised hierarchical clustering of transcriptome data revealed three distinct subgroups of patients. Furthermore, we detected multiple non-recurrent fusion transcripts resulting from chromosomal rearrangements, many of which were predicted to result in loss of TP53 and RB1 function. In-depth analysis of these loci revealed protein-damaging microdeletions, intragenic or distal inversions, and exon skipping events as additional, previously unrecognized mechanisms of TP53 and RB1 disruption. Integration of whole-exome and transcriptome data demonstrated biallelic disruption of TP53 and RB1 in 92% and 94% of cases, respectively, and tumors with wildtype RB1 displayed loss of CDKN2A expression, overexpression of CCND1, or mutation of MAX resulting in CDK4 and CCND2 overexpression as alternative mechanisms of RB1 suppression. We also detected alternative lengthening of telomeres (ALT) in 78% of cases, and identified recurrent alterations in telomere maintenance genes such as ATRX, RBL2, and SP100, providing novel insight into the genetic basis of this mechanism. Finally, most tumors displayed hallmarks of “BRCAness”, including alterations in homologous recombination DNA repair genes and enrichment of specific mutational signatures, and cultured LMS cells were sensitive towards olaparib and cisplatin. This comprehensive genomic and transcriptomic analysis has unveiled that LMS is characterized by mutational heterogeneity, genomic instability, near-universal inactivation of TP53 and RB1, and frequent whole-genome duplication. Furthermore, we have established that most LMS tumors rely on ALT to escape replicative senescence, and identified recurrent alterations in a broad spectrum of telomere maintenance genes. Finally, our findings uncover “BRCAness” as potentially actionable feature of LMS tumors, and provide a rich resource for guiding future investigations into the mechanisms underlying LMS development and the design of novel therapeutic strategies. Citation Format: Priya Chudasama, Sadaf Mughal, Mathijs Sanders, Daniel Hübschmann, Inn Chung, Aurélie Ernst, Bernd Kasper, Hans-Georg Kopp, Sebastian Bauer, Karsten Rippe, Benedikt Brors, Marcus Renner, Peter Hohenberger, Claudia Scholl, Stefan Fröhling. Integrative genomic and transcriptomic analysis of leiomyosarcoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4336.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2018
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    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 3
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2022
    In:  Clinical Cancer Research Vol. 28, No. 12 ( 2022-06-13), p. 2480-2481
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 28, No. 12 ( 2022-06-13), p. 2480-2481
    Abstract: Recent work confirms a bench-to-bedside approach that circulating tumor DNA is associated with outcome and objective response to chemotherapy in patients with advanced leiomyosarcoma. Liquid biopsies may be used for risk stratification in future trials guiding treatment decisions by identifying patients who are likely to benefit from chemotherapy. See related article by Madanat-Harjuoja et al., p. 2579
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
    detail.hit.zdb_id: 1225457-5
    detail.hit.zdb_id: 2036787-9
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