scholarly journals Stereotactic Body Radiation Therapy (SBRT) Versus Radiofrequency Ablation (RFA) for Unresectable Colorectal Cancer Hepatic Metastases: A Cost-Effectiveness Analysis

2016 ◽  
Vol 96 (2) ◽  
pp. S163
Author(s):  
V. Kirichenko ◽  
N.V. Thai ◽  
D.S. Parda
Keyword(s):  
Colorectal Cancer ◽  
Radiation Therapy ◽  
Cost Effectiveness ◽  
Radiofrequency Ablation ◽  
Stereotactic Body Radiation Therapy ◽  
Hepatic Metastases ◽  
Cost Effectiveness Analysis ◽  
Stereotactic Body Radiation ◽  
Effectiveness Analysis

A pilot study of AMP-224, a PD-L2 Fc fusion protein, in combination with stereotactic body radiation therapy (SBRT) in patients with metastatic colorectal cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 560-560 ◽  
Author(s):  
Austin G. Duffy ◽  
Oxana V. Makarova-Rusher ◽  
Drew Pratt ◽  
David E Kleiner ◽  
Suzanne Fioravanti ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
T Cells ◽  
Radiation Therapy ◽  
Fusion Protein ◽  
Metastatic Colorectal Cancer ◽  
Stereotactic Body Radiation Therapy ◽  
Hepatic Metastases ◽  
Stereotactic Body Radiation ◽  
Fc Fusion Protein ◽  
Tumor Biopsies

560 Background: AMP-224, a PD-L2 Fc fusion protein, binds to PD-1, an inhibitory receptor that is present on the cell surface of exhausted, activated, effector, and memory T cells. AMP-224 has a unique mechanism of action in that it binds specifically to PD-1HI T cells (chronically stimulated / exhausted T cells) but not PD-1LO cells which represent the normal activated T cell population. Preclinical studies have documented an increase in antitumor immunity following radiation therapy (RT), but also tumor PD-L1 expression as an escape mechanism. The aim of the study is to evaluate whether inhibition of PD-1/PDL-1 axis could improve anti-tumor immunity effects of RT. Methods: Patients with histologically confirmed metastatic colorectal cancer to liver were treated with SBRT to a site of liver metastasis at 8Gy in a single fraction (DL1) or 8Gy in 3 daily fractions (DL2). All patients received AMP-224 10mg/kg IV beginning Day 1 after SBRT preceded by cyclophosphamide 200mg/m2 (D0). Primary objective was to determine the safety and feasibility of AMP-224 in combination with stereotactic body radiation therapy (SBRT) to metastatic hepatic metastasis in patients with advanced colorectal cancer. Mandatory pre- and post-treatment biopsies were attempted on all patients. Results: N = 17 patients with refractory metastatic CRC were enrolled. N = 2 pts were unevaluable. 6pts were treated at DL1 (8Gy x 1fraction SBRT, AMP-224 10mg/kg q2-weekly) and 9pts were treated at DL2 (8Gy x 3fractions SBRT, AMP-224 10mg/kg q2-weekly) No DLT was encountered. The most common toxicity was fatigue (G1/2) in all patients in DL2. N = 3 patients experienced G2 infusion reaction which responded to standard interventions. 5/15 pts did not complete treatment due to rapid PD. No objective responses have been seen, although N = 6 pts remain on study. Pre- and post-tumor biopsies were performed on 7 of first 11 pts. Conclusions: AMP-224 in combination with SBRT to site of colorectal hepatic metastases is safe and feasible. Preliminarily no objective responses have been seen. Full clinical and correlative data including post-therapeutic radiated and non-radiated tumor biopsies will be presented. Clinical trial information: NCT02298946.

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