Difference between revisions of "Editing test page"

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m (Replaced content with "==Carboplatin & Paclitaxel (CP) & Nivolumab {{#subobject:3a6hg7|Regimen=1}}== CP & Nivolumab: '''<u>C</u>'''arboplatin, '''<u>P</u>'''aclitaxel, Nivolumab <div class="tocc...")
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==Thalidomide monotherapy {{#subobject:ff02e1|Regimen=1}}==
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==Carboplatin & Paclitaxel (CP) & Nivolumab {{#subobject:3a6hg7|Regimen=1}}==
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<div class="toccolours" style="background-color:#8dd3c7">
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CP & Nivolumab: '''<u>C</u>'''arboplatin, '''<u>P</u>'''aclitaxel, Nivolumab
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===Synopsis===
 
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'''Historical Background of Thalidomide'''
 
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Originally developed and marketed in the late 1950s as a sedative and remedy for morning sickness in pregnant women, thalidomide led to catastrophic birth defects when taken during pregnancy. Due to these teratogenic effects, its usage was banned in many countries by the early 1960s.
 
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'''Rediscovery and Anticancer Properties'''
 
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During the late 1990s, the anti-angiogenic and immunomodulatory effects of thalidomide were explored. Researchers hypothesized that these properties could be harnessed against cancers that rely on angiogenesis.
 
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Singhal et al., 1999 ([https://pubmed.ncbi.nlm.nih.gov/10564685/] Singhal S, Mehta J, Desikan R, et al. Antitumor activity of thalidomide in refractory multiple myeloma. New England Journal of Medicine. 1999;341:1565-71): This seminal study reported the effects of thalidomide in patients with refractory multiple myeloma. Thalidomide showed significant antitumor activity, leading to renewed interest in the drug.
 
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'''Development of Analogues'''
 
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The success of thalidomide spurred the development of its analogues, designed to retain its therapeutic benefits while minimizing side effects. Lenalidomide and pomalidomide are two such analogues that have shown significant efficacy in multiple myeloma with a better side effect profile.
 
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'''Current Role in Therapy'''
 
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While newer agents and combinations have emerged in the treatment landscape of multiple myeloma, thalidomide and its derivatives remain vital components in various treatment regimens, especially in certain settings and geographies.
 
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'''Conclusion'''
 
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The repositioning of thalidomide for multiple myeloma is a testament to the importance of re-evaluating existing drugs for new therapeutic indications. Its successful transition from a notorious drug to a vital component in the multiple myeloma treatment arsenal underscores the ever-evolving nature of drug development and therapy.
 
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<br><small>''The draft for this synopsis was generated by a large language model and then manually edited by the page editor for accuracy and style. See [[Large language model pilot|this page]] for more information about this pilot project.''</small>
 
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</div><br>
 
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
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===Regimen {{#subobject:43a4e3|Variant=1}}===
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===Regimen variant #1, 5/175/360 {{#subobject:59hhq7|Variant=1}}===
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{| class="wikitable sortable" style="width: 60%; text-align:center;"  
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{| class="wikitable sortable" style="width: 100%; text-align:center;"  
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!style="width: 33%"|Study
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!style="width: 20%"|Study
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!style="width: 33%"|Dates of enrollment
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!style="width: 20%"|Dates of enrollment
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!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
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!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
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!style="width: 20%"|Comparator
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!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
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|[https://doi.org/10.1056/NEJM199911183412102 Singhal et al. 1999]
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|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844511/ Forde et al. 2022 (CheckMate 816)]
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|1997-1998
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{| class="wikitable" style="margin:auto; color:black; background-color:#d3d3d3"
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|style="background-color:#91cf61"|Non-randomized
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|[[File:HopeAI.png|link=https://hemonc.org|alt=Alt text|Title=text|frameless|150px|center]]
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|-
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|Click to learn more!
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|-
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|}
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|2017-2019
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| style="background-color:#1a9851" |Phase 3 (E-RT-esc)
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|1a. [[#Carboplatin_.26_Paclitaxel_.28CP.29|CP]]<br>1b. [[#Cisplatin_.26_Vinorelbine_.28CVb.29|CVb]]<br>1c. [[#Cisplatin_.26_Docetaxel_.28DC.29|DC]]
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| style="background-color:#1a9850" |Superior EFS (co-primary endpoint)<br>Median EFS: 31.6 vs 20.8 mo<br>(HR 0.63, 97.38% CI 0.43-0.91)<br><br>Superior pCR rate (co-primary endpoint)<br>pCR rate: 24% vs 2.2%<br>(OR 13.94, 99% CI 3.49-55.75)
 
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<div class="toccolours" style="background-color:#b3e2cd">
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''Note: there were additional comparator options depending on histology; see the respective histology-specific pages for more details.''
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====Targeted therapy====
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<div class="toccolours" style="background-color:#fdcdac">
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*[[Thalidomide (Thalomid)]] 200 mg PO once per day, increased by 200 mg every two weeks for six weeks, to final dose of 800 mg per day
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====Biomarker eligibility criteria====
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'''Continued indefinitely'''
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*CheckMate 816: No sensitizing EGFR or ALK mutations
 
</div></div>
 
</div></div>
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===References===
 
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# Singhal S, Mehta J, Desikan R, Ayers D, Roberson P, Eddlemon P, Munshi N, Anaissie E, Wilson C, Dhodapkar M, Zeldis J, Siegel D, Crowley J, Barlogie B. Antitumor activity of thalidomide in refractory multiple myeloma. N Engl J Med. 1999 Nov 18;341(21):1565-71. Erratum in: N Engl J Med 2000 Feb 3;342(5):364. [https://doi.org/10.1056/NEJM199911183412102 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/10564685/ PubMed]
 
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# Yakoub-Agha I, Mary JY, Hulin C, Doyen C, Marit G, Benboubker L, Voillat L, Moreau P, Berthou C, Stoppa AM, Maloisel F, Rodon P, Dib M, Pegourie B, Casassus P, Slama B, Damaj G, Zerbib R, Harousseau JL, Mohty M, Facon T; Intergroupe Francophone du Myélome (IFM). Low-dose vs. high-dose thalidomide for advanced multiple myeloma: a prospective trial from the Intergroupe Francophone du Myélome. Eur J Haematol. 2012 Mar;88(3):249-59. Epub 2012 Jan 4. [https://doi.org/10.1111/j.1600-0609.2011.01729.x link to original article] [https://pubmed.ncbi.nlm.nih.gov/22023551/ PubMed]
 

Latest revision as of 12:58, 18 July 2024

Carboplatin & Paclitaxel (CP) & Nivolumab

CP & Nivolumab: Carboplatin, Paclitaxel, Nivolumab

Regimen variant #1, 5/175/360

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Forde et al. 2022 (CheckMate 816)
Alt text
Click to learn more!
2017-2019 Phase 3 (E-RT-esc) 1a. CP
1b. CVb
1c. DC 		Superior EFS (co-primary endpoint)
Median EFS: 31.6 vs 20.8 mo
(HR 0.63, 97.38% CI 0.43-0.91)

Superior pCR rate (co-primary endpoint)
pCR rate: 24% vs 2.2%
(OR 13.94, 99% CI 3.49-55.75)

Note: there were additional comparator options depending on histology; see the respective histology-specific pages for more details.

Biomarker eligibility criteria

  • CheckMate 816: No sensitizing EGFR or ALK mutations
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