Development and evaluation of a secondary reference panel for BCR-ABL1 quantitation on the International Scale.

Molecular monitoring of chronic myeloid leukemia patients using robust BCR-ABL1 tests standardized to the International Scale (IS) is key to proper disease management, especially when treatment cessation is considered. Most laboratories currently utilize a time-consuming sample exchange process with reference laboratories for IS calibration. A World Health Organization (WHO) BCR-ABL1 reference panel was developed (MR(1)-MR(4)), but access to the material is limited. In this study, we describe the development of the first cell-based secondary reference panel that’s traceable to and faithfully replicates the WHO panel, with an additional MR(4.5) level. The secondary panel was calibrated to IS using digital PCR with ABL1, BCR, and GUSB as reference genes and evaluated by 44 laboratories worldwide. Interestingly, we found that >40% of BCR-ABL1 assays showed signs of inadequate optimization such as poor linearity and suboptimal PCR efficiency. Nonetheless, when optimized sample inputs were used, >60% demonstrated satisfactory IS accuracy, precision and/or MR(4.5) sensitivity, and 58% obtained IS conversion factors from the secondary reference concordant with their current ones. Correlation analysis indicated no significant alterations in %BCR-ABL1 results caused by different assay configurations. More assays achieved good precision and/or sensitivity than IS accuracy, indicating the need for better IS calibration mechanisms.Leukemia accepted article preview online, 25 April 2016. doi:10.1038/leu.2016.90.

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MUC1 (CD227): a multi-tasked molecule.

Mucin 1 (MUC1 [CD227]) is a high-molecular weight (>400 kDa), type I membrane-tethered glycoprotein that is expressed on epithelial cells and extends far above the glycocalyx. MUC1 is overexpressed and aberrantly glycosylated in adenocarcinomas and in hematological malignancies. As a result, MUC1 has been a target for tumor immunotherapeutic studies in mice and in humans. MUC1 has been shown to have anti-adhesive and immunosuppressive properties, protects against infections, and is involved in the oncogenic process as well as in cell signaling. In addition, MUC1 plays a key role in the reproductive tract, in the immune system (affecting dendritic cells, monocytes, T cells, and B cells), and in chronic inflammatory diseases. Evidence for all of these roles for MUC1 is discussed herein and demonstrates that MUC1 is truly a multitasked molecule.

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Pipeline-Ocrelizumab

Ocrelizumab is a humanized monoclonal antibody that selectively targets the CD20-positive B-cells implicated in the inflammatory and neurodegenerative processes of multiple sclerosis (MS), to effectively impact disease progression while maintaining immunosurveillance (Company Pipeline, Hoffmann-La Roche , APR 25, 2016, View Source [SID:1234511389]).

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Phase III TAILOR Landmark Study Demonstrates Significant Benefits of Erbitux in Combination with FOLFOX Over FOLFOX Alone

On April 25, 2016 Merck, a leading science and technology company, reported that the pivotal Chinese Phase III TAILOR study met its primary endpoint of significantly increasing progression-free survival (PFS) in patients with RAS wild-type metastatic colorectal cancer (mCRC) treated with Erbitux (cetuximab) plus FOLFOX chemotherapy, compared with FOLFOX alone (Press release, Merck & Co, APR 25, 2016, View Source;newsType=1 [SID:1234511390]).

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"We are thrilled with the TAILOR results that bring a major contribution to the available scientific evidence of Erbitux’s efficacy in combination with FOLFOX as a standard first-line treatment for patients with RAS wild-type metastatic colorectal cancer. This marks a significant step in the execution of our strategy in oncology, notably the expansion in growth markets like China," said Luciano Rossetti, Head of Global Research and Development of Merck’s biopharma business. "These impressive results reinforce the value and imperative of RAS biomarker testing in clinical practice, so as to provide patients with the right targeted therapy. These results also underscore why we continue to devote our efforts towards both improving testing and ensuring access to Erbitux worldwide." 1–4

The clinical benefit that Erbitux offers to RAS wild-type mCRC patients is further strengthened by the secondary endpoint results, which support the superiority shown for PFS. The safety profile of Erbitux in the TAILOR clinical trial was manageable and similar to that observed in other pivotal trials, with no unexpected safety findings. The full study results will be submitted to upcoming international scientific meetings.

Both the National Comprehensive Cancer Network (U.S.) and the European Society for Medical Oncology clinical guidelines recommend first-line treatment with Erbitux plus FOLFOX or FOLFIRI for patients with RAS wild-type mCRC.5,6

"We are excited that the TAILOR study is positive and that Erbitux in combination with chemotherapy could become a new first-line treatment option for metastatic colorectal cancer patients in China, once approved," said Professor Shukui Qin from Nanjing Bayi Hospital, China, Coordinating Investigator in the TAILOR study. "It is also reassuring that the results reflect those previously observed, and support the indicated first-line use of Erbitux plus FOLFOX in many countries."

Erbitux has obtained marketing authorization in over 90 countries worldwide. In Europe, Erbitux is indicated as first-line therapy for patients with RAS wild-type mCRC tumors, together with the oxaliplatin-containing regimen FOLFOX in treatment-naïve patients or together with regimens containing irinotecan (e.g. FOLFIRI).7 More than 442,000 patients with mCRC have been treated with Erbitux.

About the TAILOR study
The TAILOR study is a Phase III, open-label, randomized, controlled, multicenter trial designed to compare Erbitux in combination with FOLFOX-4 versus FOLFOX-4 alone in the first-line treatment of Chinese patients with RAS wild-type mCRC. All randomized subjects were planned to receive treatment until the occurrence of progressive disease (PD) or unacceptable toxicity. The study enrolled 397 patients with RAS wild-type mCRC. The primary endpoint of the trial is progression-free survival. Secondary endpoints include: overall survival, best overall response rate, time to treatment failure and rate of curative surgery for liver metastases.

About mCRC
Approximately half of patients with mCRC have RAS wild-type tumors and half have RAS mutant tumors.8 Results from studies assessing RAS mutation status in patients with mCRC have shown that antiepidermal growth factor receptor (EGFR) monoclonal antibody therapies, such as Erbitux (cetuximab), can improve outcomes in patients with RAS wild-type mCRC.1-4 Colorectal cancer (CRC) is the third most common cancer worldwide, with an estimated incidence of more than 1.36 million new cases annually.9 An estimated 694,000 deaths from CRC occur worldwide every year, accounting for 8.5% of all cancer deaths and making it the fourth most common cause of death from cancer.9 Almost 55% of CRC cases are diagnosed in developed regions of the world, and incidence and mortality rates are substantially higher in men than in women.9

About Erbitux
Erbitux is a highly active IgG1 monoclonal antibody targeting the epidermal growth factor receptor (EGFR). As a monoclonal antibody, the mode of action of Erbitux is distinct from standard nonselective chemotherapy treatments in that it specifically targets and binds to the EGFR. This binding inhibits the activation of the receptor and the subsequent signal-transduction pathway, which results in reducing both the invasion of normal tissues by tumor cells and the spread of tumors to new sites. It is also believed to inhibit the ability of tumor cells to repair the damage caused by chemotherapy and radiotherapy and to inhibit the formation of new blood vessels inside tumors, which appears to lead to an overall suppression of tumor growth.
The most commonly reported side effect with Erbitux is an acne-like skin rash that seems to be correlated with a good response to therapy. In approximately 5% of patients, hypersensitivity reactions may occur during treatment with Erbitux; about half of these reactions are severe.
Erbitux has already obtained market authorization in over 90 countries world-wide for the treatment of colorectal cancer and for the treatment of squamous cell carcinoma of the head and neck (SCCHN). Merck licensed the right to market Erbitux outside the US and Canada from ImClone LLC, a wholly-owned subsidiary of Eli Lilly and Company, in 1998. Merck has an ongoing commitment to the advancement of oncology treatment and is currently investigating novel therapies in highly targeted areas.

Delay in initiation of adjuvant trastuzumab therapy leads to decreased overall survival and relapse-free survival in patients with HER2-positive non-metastatic breast cancer.

Trastuzumab reduces the risk of relapse in women with HER2-positive non-metastatic breast cancer, but little information exists on the timing of trastuzumab initiation. The study investigated the impact of delaying the initiation of adjuvant trastuzumab therapy for >6 months after the breast cancer diagnosis on time to relapse, overall survival (OS), and relapse-free survival (RFS) among patients with non-metastatic breast cancer. Adult women with non-metastatic breast cancer who initiated trastuzumab adjuvant therapy without receiving any neoadjuvant therapy were selected from the US Department of Defense health claims database from 01/2003 to 12/2012. Two study cohorts were defined based on the time from breast cancer diagnosis to trastuzumab initiation: >6 months and ≤6 months. The impact of delaying trastuzumab initiation on time to relapse, OS, and RFS was estimated using Cox regression models adjusted for potential confounders. Of 2749 women in the study sample, 79.9 % initiated adjuvant trastuzumab within ≤6 months of diagnosis and 20.1 % initiated adjuvant trastuzumab >6 months after diagnosis. After adjusting for confounders, patients who initiated trastuzumab >6 months after the breast cancer diagnosis had a higher risk of relapse, death, or relapse/death than those who initiated trastuzumab within ≤6 months of diagnosis (hazard ratios [95 % CIs]: 1.51 [1.22-1.87], 1.54 [1.12-2.12], and 1.43 [1.16-1.75]; respectively). The results of this population-based study suggest that delays of >6 months in the initiation of trastuzumab among HER2-positive non-metastatic breast cancer patients are associated with a higher risk of relapse and shorter OS and RFS.

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