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Mini oral session - Genitourinary tumours, prostate

576MO - Health-related quality of life (HRQoL), pain and safety outcomes in the phase III VISION study of <sup>177</sup>Lu-PSMA-617 in patients with metastatic castration-resistant prostate cancer

Date

19 Sep 2021

Session

Mini oral session - Genitourinary tumours, prostate

Topics

Tumour Site

Prostate Cancer

Presenters

Karim Fizazi

Citation

Annals of Oncology (2021) 32 (suppl_5): S626-S677. 10.1016/annonc/annonc702

Authors

K. Fizazi1, K. Herrmann2, B.J. Krause3, K. Rahbar4, K.N. Chi5, M.J. Morris6, O. Sartor7, S.T. Tagawa8, A.T. Kendi9, N.J. Vogelzang10, J. Calais11, J. Nagarajah12, X.X. Wei13, V.S. Koshkin14, J. Beauregard15, B. Chang16, M. DeSilvio17, R.A. Messmann18, J. de Bono19

Author affiliations

  • 1 Cancer Medicine Department, Gustave Roussy Institute, University of Paris Saclay, 94805 - Villejuif/FR
  • 2 Nuclear Medicine, University Hospital Essen, 45147 - Essen/DE
  • 3 Department Of Nuclear Medicine, Rostock University Medical Center, Rostock/DE
  • 4 Clinic For Nuclear Medicine, University Hospital Münster, Münster/DE
  • 5 Medical Oncology Department, British Columbia Cancer Agency, Vancouver Centre, V5Z 4E6 - Vancouver/CA
  • 6 Cancer Centre, Memorial Sloan Kettering Cancer Center, New York/US
  • 7 Medical School, Tulane Medical School, New Orleans/US
  • 8 Urology, Hematology And Medical Oncology Department, Weill Cornell Medicine, New York/US
  • 9 Radiology, Mayo Clinic, Rochester/US
  • 10 Us Oncology Research, Comprehensive Cancer Centers, 89169 - Las Vegas/US
  • 11 Department Of Molecular And Medical Pharmacology, University of California, Los Angeles/US
  • 12 Department Of Radiology And Nuclear Medicine, Radboud University Medical Center, Nijmegen/NL
  • 13 Medicine, Dana-Farber Cancer Institute, Boston/US
  • 14 Department Of Medicine, University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, 94158 - San Francisco/US
  • 15 Department Of Radiology And Nuclear Medicine, CHU de Québec - Université Laval, Quebec/CA
  • 16 Radiation Oncology Associates, Parkview Hospital, Ft Wayne/US
  • 17 Analytics Gdd/cd&a Gdd, Novartis Pharmaceuticals Corporation, East Hanover/US
  • 18 Global Clinical Development R&d, Novartis Pharmaceuticals Corporation, East Hanover/US
  • 19 Drug Development Unit, The Institute of Cancer Research and Royal Marsden Hospital, SM2 5PT - London/GB
More

Resources

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Abstract 576MO

Background

[177Lu]Lu-PSMA-617 (177Lu-PSMA-617) delivers β-particle radiation to prostate-specific membrane antigen (PSMA) expressing cells and the surrounding microenvironment. In the phase III VISION study (NCT03511664), 177Lu-PSMA-617 + protocol-permitted standard of care (SOC) prolonged radiographic progression-free survival (rPFS; HR, 0.40; 99.2% CI: 0.29, 0.57), overall survival (OS; 0.62; 95% CI: 0.52, 0.74) and time to first symptomatic skeletal event (SSE; 0.50; 95% CI: 0.40, 0.62) versus SOC (all p < 0.001).

Methods

VISION was an international, open-label study of 177Lu-PSMA-617 in adults with PSMA-positive metastatic castration-resistant prostate cancer (mCRPC) previously treated with ≥ 1 androgen receptor pathway inhibitor and 1–2 taxane regimens. Patients were randomized 2:1 to 177Lu-PSMA-617 (7.4 GBq every 6 weeks, ≤ 6 cycles) plus SOC or to SOC alone. rPFS and OS were alternate primary endpoints; time to SSE was a key secondary endpoint. Other secondary endpoints included safety and patient-reported HRQoL (Functional Assessment of Cancer Therapy – Prostate [FACT-P]) and pain (Brief Pain Inventory – Short Form [BPI-SF]). Pre-specified analyses included time to the first occurrence of HRQoL/pain worsening, disease progression or death. Ad hoc analyses included time to worsening only (non-inferential).

Results

HRQoL was assessed in the pre-specified rPFS analysis set comprising 581 of the 831 randomized patients (177Lu-PSMA-617 arm, n = 385; control arm, n = 196). HRQoL and pain time-to-worsening analyses favoured the 177Lu-PSMA-617 arm (Table), despite a higher incidence of grade ≥ 3 adverse events versus SOC alone. No new or unexpected safety concerns were noted, including changes in creatinine clearance. Table: 576MO

Hazard ratios for time to worsening in FACT-P and BPI-SF scores

Outcome Hazard ratio (95% confidence interval)
FACT-P
   Total Pain-related subscale Prostate cancer subscale 0.46 (0.35, 0.61)* 0.55 (0.42, 0.71)* 0.59 (0.46, 0.76)*
BPI-SF
   Pain intensity Worst pain intensity Pain interference 0.45 (0.33, 0.60)* 0.49 (0.37, 0.65)* 0.60 (0.45, 0.80)*

Time to the first occurrence of the following from baseline. ≥ 10 point decrease in FACT-P total ≥ 2 point decrease in FACT-P pain-related subscale ≥ 3 point decrease in FACT-P prostate cancer subscale ≥ 30% or ≥ 2 point increase in BPI-SF pain intensity, worst pain intensity or pain interference *p < 0.001 (nominal; non-inferential analysis)

Conclusions

177Lu-PSMA-617 plus SOC was generally well tolerated and delayed time to HRQoL and pain worsening versus SOC alone in patients with advanced mCRPC.

Clinical trial identification

PSMA-617-01. 08 July 2019. EudraCT 2018-000459-41.

Editorial acknowledgement

Under the guidance of the authors, Dr Sarah Sabir from Oxford PharmaGenesis provided medical writing support for this abstract, with funding from Advanced Accelerator Applications, a Novartis Company.

Legal entity responsible for the study

Endocyte, Inc., a Novartis company.

Funding

Endocyte, Inc., a Novartis company.

Disclosure

K. Fizazi: Financial Interests, Institutional, Advisory Role: Janssen Oncology; Financial Interests, Personal, Advisory Role: Bayer; Financial Interests, Institutional, Advisory Role: Astellas Pharma; Financial Interests, Institutional, Advisory Role: Sanofi; Financial Interests, Personal, Advisory Role: Orion Pharma GmbH; Financial Interests, Personal, Advisory Role: Curevac; Financial Interests, Institutional, Advisory Role: AstraZeneca; Financial Interests, Institutional, Advisory Role: ESSA; Financial Interests, Institutional, Advisory Role: Amgen; Financial Interests, Personal, Advisory Role: Bristol-Myers Squibb; Financial Interests, Personal, Advisory Role: Clovis Oncology; Financial Interests, Personal, Other, Travel/Accommodation/Expenses: Janssen; Financial Interests, Personal, Other, Travel/Accommodation/Expenses: MSD; Financial Interests, Institutional, Other, Honoraria: Janssen; Financial Interests, Institutional, Other, Honoraria: Sanofi; Financial Interests, Institutional, Other, Honoraria: Astellas Pharma; Financial Interests, Personal, Other, Honoraria: Bayer. K. Herrmann: Financial Interests, Personal, Advisory Role: Novartis; Financial Interests, Personal, Advisory Role: Bain Capital; Financial Interests, Personal, Advisory Role: Bayer; Financial Interests, Personal, Advisory Role: Advanced Accelerator Applications, a Novartis company; Financial Interests, Personal, Advisory Role: Amgen; Financial Interests, Personal, Advisory Role: BTG; Financial Interests, Personal, Advisory Role: Ipsen; Financial Interests, Institutional, Advisory Role: ITG; Financial Interests, Institutional, Advisory Role: ROTOP Pharmaka; Financial Interests, Personal, Advisory Role: Siemens Healthineers; Financial Interests, Personal, Advisory Role: GE Healthcare; Financial Interests, Personal, Leadership Role: SOFIE; Financial Interests, Personal, Ownership Interest: SOFIE. B.J. Krause: Financial Interests, Institutional, Funding: Advanced Accelerator Applications, a Novartis company; Financial Interests, Institutional, Funding: Endocyte, Inc., a Novartis company; Financial Interests, Institutional, Funding: Novartis. K. Rahbar: Financial Interests, Personal, Other, Honoraria: Advanced Accelerator Applications, a Novartis company; Financial Interests, Personal, Other, Honoraria: Bayer; Financial Interests, Personal, Other, Honoraria: SIRTEX; Financial Interests, Personal, Advisory Role: ABX GmbH; Financial Interests, Personal, Advisory Role: Advanced Accelerator Applications, a Novartis company; Financial Interests, Personal, Advisory Role: Bayer; Financial Interests, Personal, Advisory Role: ABX CRO. K.N. Chi: Financial Interests, Personal, Advisory Role: ESSA; Financial Interests, Personal, Advisory Role: Astellas Pharma; Financial Interests, Personal, Advisory Role: Janssen; Financial Interests, Personal, Advisory Role: Sanofi; Financial Interests, Personal, Advisory Role: Amgen; Financial Interests, Personal, Advisory Role: Bayer; Financial Interests, Personal, Advisory Role: AstraZeneca; Financial Interests, Personal, Advisory Role: Roche; Financial Interests, Personal, Advisory Role: POINT Biopharma; Financial Interests, Personal, Advisory Role: Daiichi Sankyo; Financial Interests, Personal, Advisory Role: Merck; Financial Interests, Personal, Advisory Role: Constellation Pharmaceuticals; Financial Interests, Personal, Other, Honoraria: Janssen; Financial Interests, Personal, Other, Honoraria: Astellas Pharma; Financial Interests, Personal, Other, Honoraria: Bayer; Financial Interests, Personal, Other, Honoraria: AstraZeneca; Financial Interests, Personal, Other, Honoraria: Roche; Financial Interests, Personal, Other, Honoraria: Merck; Financial Interests, Institutional, Funding: Janssen; Financial Interests, Institutional, Funding: Astellas Pharma; Financial Interests, Institutional, Funding: Bayer; Financial Interests, Institutional, Funding: Sanofi; Financial Interests, Institutional, Funding: Bristol-Myers Squibb; Financial Interests, Institutional, Funding: Merck; Financial Interests, Institutional, Funding: Roche; Financial Interests, Institutional, Funding: AstraZeneca; Financial Interests, Institutional, Funding: Novartis; Financial Interests, Institutional, Funding: Pfizer; Financial Interests, Institutional, Funding: ESSA. M.J. Morris: Financial Interests, Personal, Advisory Role: Bayer; Financial Interests, Personal, Advisory Role: Endocyte, Inc., a Novartis Company; Financial Interests, Personal, Advisory Role: Advanced Accelerator Applications, a Novartis Company; Financial Interests, Personal, Advisory Role: ORIC Pharmaceuticals; Financial Interests, Personal, Advisory Role: Johnson & Johnson; Financial Interests, Personal, Advisory Role: Curium Pharma; Financial Interests, Personal, Advisory Role: Athenex; Financial Interests, Personal, Other, Travel/Accommodation/Expenses: Endocyte, Inc., a Novartis Company; Financial Interests, Personal, Other, Travel/Accommodation/Expenses: Fujifilm; Financial Interests, Institutional, Funding: Bayer; Financial Interests, Institutional, Funding: Sanofi; Financial Interests, Institutional, Funding: Endocyte, Inc., a Novartis Company; Financial Interests, Institutional, Funding: Progenics; Financial Interests, Institutional, Funding: Corcept Therapeutics; Financial Interests, Institutional, Funding: Roche/Genentech; Financial Interests, Institutional, Funding: Janssen. O. Sartor: Financial Interests, Personal, Advisory Role: Bayer; Financial Interests, Personal, Advisory Role: Sanofi; Financial Interests, Personal, Advisory Role: AstraZeneca; Financial Interests, Personal, Advisory Role: Dendreon; Financial Interests, Personal, Advisory Role: Constellation Pharmaceuticals; Financial Interests, Personal, Advisory Role: Advanced Accelerator Applications, a Novartis company; Financial Interests, Personal, Advisory Role: Pfizer; Financial Interests, Personal, Advisory Role: Bristol-Myers Squibb; Financial Interests, Personal, Advisory Role: Bavarian Nordic; Financial Interests, Personal, Advisory Role: EMD Serono; Financial Interests, Personal, Advisory Role: Astellas Pharma; Financial Interests, Personal, Advisory Role: Progenics; Financial Interests, Personal, Advisory Role: Blue Earth Diagnostics; Financial Interests, Personal, Advisory Role: Myovant Sciences; Financial Interests, Personal, Advisory Role: Myriad Genetics; Financial Interests, Personal, Advisory Role: Novartis; Financial Interests, Personal, Advisory Role: Clarity Pharmaceuticals; Financial Interests, Personal, Advisory Role: Fusion Pharmaceuticals; Financial Interests, Personal, Advisory Role: Isotopen Technologien; Financial Interests, Personal, Advisory Role: Janssen; Financial Interests, Personal, Advisory Role: Noxopharm; Financial Interests, Personal, Advisory Role: Clovis Oncology; Financial Interests, Personal, Advisory Role: Noria Therapeutics; Financial Interests, Personal, Advisory Role: Point Biopharma; Financial Interests, Personal, Advisory Role: TeneoBio; Financial Interests, Personal, Advisory Role: Telix Pharmaceuticals; Financial Interests, Personal, Advisory Role: Theragnostics; Financial Interests, Personal, Other, Travel/Accommodation/Expenses: Bayer; Financial Interests, Personal, Other, Travel/Accommodation/Expenses: Johnson & Johnson; Financial Interests, Personal, Other, Travel/Accommodation/Expenses: Sanofi; Financial Interests, Personal, Other, Travel/Accommodation/Expenses: AstraZeneca; Financial Interests, Personal, Other, Travel/Accommodation/Expenses: Progenics; Financial Interests, Personal, Expert Testimony: Sanofi; Financial Interests, Personal, Ownership Interest: Lilly; Financial Interests, Personal, Ownership Interest: GlaxoSmithKline; Financial Interests, Personal, Ownership Interest: Abbvie; Financial Interests, Personal, Ownership Interest: Cardinal Health; Financial Interests, Personal, Ownership Interest: United Health Group; Financial Interests, Personal, Ownership Interest: PSMA Therapeutics; Financial Interests, Personal, Ownership Interest: Clarity Pharmaceuticals; Financial Interests, Personal, Ownership Interest: Noria Therapeutics; Financial Interests, Personal, Ownership Interest: Clovis Oncology; Financial Interests, Institutional, Funding: Bayer; Financial Interests, Institutional, Funding: Sanofi; Financial Interests, Institutional, Funding: Endocyte Inc., a Novartis company; Financial Interests, Institutional, Funding: Merck; Financial Interests, Institutional, Funding: InVitae; Financial Interests, Institutional, Funding: Constellation Pharmaceuticals; Financial Interests, Institutional, Funding: Advanced Accelerator Applications, a Novartis company; Financial Interests, Institutional, Funding: AstraZeneca; Financial Interests, Institutional, Funding: Dendreon; Financial Interests, Personal, Funding: SOTIO; Financial Interests, Personal, Funding: Janssen; Financial Interests, Personal, Funding: Progenics; Financial Interests, Personal, Advisory Role: Amgen; Financial Interests, Personal, Advisory Role: Endocyte Inc., a Novartis company; Financial Interests, Personal, Advisory Role: Taiho; Financial Interests, Institutional, Funding: Arvinas. S.T. Tagawa: Financial Interests, Personal, Advisory Role: Medivation; Financial Interests, Personal, Advisory Role: Astellas Pharma; Financial Interests, Personal, Advisory Role: Dendreon; Financial Interests, Personal, Advisory Role: Janssen; Financial Interests, Personal, Advisory Role: Bayer; Financial Interests, Personal, Advisory Role: Genentech; Financial Interests, Personal, Advisory Role: Endocyte Inc., a Novartis company; Financial Interests, Personal, Advisory Role: Immunomedics; Financial Interests, Personal, Advisory Role: Karyopharm Therapeutics; Financial Interests, Personal, Advisory Role: Abbvie; Financial Interests, Personal, Advisory Role: Tolmar; Financial Interests, Personal, Advisory Role: QED Therapeutics; Financial Interests, Personal, Advisory Role: Amgen; Financial Interests, Personal, Advisory Role: Sanofi; Financial Interests, Personal, Advisory Role: Pfizer; Financial Interests, Personal, Advisory Role: Clovis Oncology; Financial Interests, Personal, Advisory Role: Novartis; Financial Interests, Personal, Advisory Role: POINT Biopharma; Financial Interests, Personal, Advisory Role: Blue Earth Diagnostics; Financial Interests, Personal, Advisory Role: AIkido Pharma; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Sanofi; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Immunomedics; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Amgen; Financial Interests, Institutional, Funding: Lilly; Financial Interests, Institutional, Funding: Sanofi; Financial Interests, Institutional, Funding: Janssen; Financial Interests, Institutional, Funding: Astellas Pharma; Financial Interests, Institutional, Funding: Progenics; Financial Interests, Institutional, Funding: Millennium; Financial Interests, Institutional, Funding: Amgen; Financial Interests, Institutional, Funding: Bristol-Myers Squibb; Financial Interests, Institutional, Funding: Dendreon; Financial Interests, Institutional, Funding: Rexahn Pharmaceuticals; Financial Interests, Institutional, Funding: Bayer; Financial Interests, Institutional, Funding: Genentech; Financial Interests, Institutional, Funding: Newlink Genetics; Financial Interests, Institutional, Funding: Inovio Pharmaceuticals; Financial Interests, Institutional, Funding: AstraZeneca; Financial Interests, Institutional, Funding: Immunomedics; Financial Interests, Institutional, Funding: Novartis; Financial Interests, Institutional, Funding: AVEO; Financial Interests, Institutional, Funding: Boehringer Ingelheim; Financial Interests, Institutional, Funding: Merck; Financial Interests, Institutional, Funding: Stem CentRx; Financial Interests, Institutional, Funding: Karyopharm Therapeutics; Financial Interests, Institutional, Funding: Abbvie; Financial Interests, Institutional, Funding: Medivation; Financial Interests, Institutional, Funding: Endocyte Inc., a Novartis company; Financial Interests, Institutional, Funding: Exelixis; Financial Interests, Institutional, Funding: Clovis Oncology; Non-Financial Interests, Personal, Other: Telix Pharmaceuticals; Non-Financial Interests, Personal, Other: ATLAB Pharma; Non-Financial Interests, Personal, Other: Phosplatin Therapeutics; Financial Interests, Institutional, Funding: POINT Biopharma; Financial Interests, Institutional, Funding: Gilead Sciences. A.T. Kendi: Other, Personal, Principal Investigator, PI at Mayo Clinic Rochester for VISION trial: Endocyte, Inc., a Novartis Company. N.J. Vogelzang: Financial Interests, Personal, Advisory Role: Novartis; Financial Interests, Personal, Speaker’s Bureau: Bayer; Financial Interests, Personal, Advisory Board: Bayer; Financial Interests, Personal, Speaker’s Bureau: Sanofi adventis; Financial Interests, Personal, Advisory Board: Sanofi adventis; Financial Interests, Personal, Speaker’s Bureau: Janssen; Financial Interests, Personal, Advisory Board: Janssen; Financial Interests, Personal, Speaker’s Bureau: Pfizer; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Exelixis; Financial Interests, Personal, Speaker’s Bureau: Dendreon; Financial Interests, Personal, Advisory Board: Dendreon. J. Calais: Financial Interests, Personal, Other, Honoraria: Advanced Accelerator Applications, a Novartis company; Financial Interests, Personal, Advisory Role: Blue Earth Diagnostics; Financial Interests, Personal, Advisory Role: Curium Pharma; Financial Interests, Personal, Advisory Role: GE Healthcare; Financial Interests, Personal, Invited Speaker: IBA RadioPharma; Financial Interests, Personal, Advisory Role: Janssen Pharmaceuticals; Financial Interests, Personal, Advisory Role: POINT biopharma; Financial Interests, Personal, Advisory Role: Progenics / Lantheus; Financial Interests, Personal, Principal Investigator: Progenics / Lantheus; Financial Interests, Personal, Other, Honoraria: Radiomedix; Financial Interests, Personal, Invited Speaker: Telix Pharmaceuticals; Financial Interests, Personal, Other, Honoraria: Progenics / Lantheus. J. Nagarajah: Financial Interests, Institutional, Principal Investigator: Novartis; Financial Interests, Personal, Advisory Role: Curium. X.X. Wei: Financial Interests, Institutional, Principal Investigator: BMS; Financial Interests, Institutional, Funding: BMS. V.S. KOSHKIN: Financial Interests, Personal, Advisory Role: AstraZeneca; Financial Interests, Personal, Advisory Role: Clovis; Financial Interests, Personal, Advisory Role: Janssen; Financial Interests, Personal, Advisory Role: Pfizer; Financial Interests, Personal, Advisory Role: EMD Serono; Financial Interests, Personal, Advisory Role: Seattle Genetics / Astellas; Financial Interests, Personal, Advisory Role: Dendreon; Financial Interests, Institutional, Funding: Endocyte Inc., a Novartis company; Financial Interests, Institutional, Funding: Nektar; Financial Interests, Institutional, Funding: Clovis; Financial Interests, Institutional, Funding: Janssen; Financial Interests, Institutional, Funding: Taiho; Other, Personal, Other: Prostate Cancer Foundation. J. Beauregard: Non-Financial Interests, Personal and Institutional, Principal Investigator: Advanced Accelerator Applications, a Novartis company; Non-Financial Interests, Personal and Institutional, Principal Investigator: Ipsen; Non-Financial Interests, Personal, Advisory Role: Ipsen. M. DeSilvio: Financial Interests, Personal, Full or part-time Employment: Novartis Pharmaceuticals; Financial Interests, Personal, Ownership Interest: Novartis Pharmaceuticals. R.A. Messmann: Financial Interests, Personal, Full or part-time Employment: Novartis Pharmaceuticals; Financial Interests, Personal, Ownership Interest: Novartis Pharmaceuticals. J. de Bono: Financial Interests, Personal, Full or part-time Employment: Institute of Cancer Research; Financial Interests, Personal, Advisory Role: AstraZeneca; Financial Interests, Personal, Advisory Role: Sanofi; Financial Interests, Personal, Advisory Role: Genentech/Roche; Financial Interests, Personal, Advisory Role: Astellas Pharma; Financial Interests, Personal, Advisory Role: Bayer; Financial Interests, Personal, Advisory Role: Pfizer; Financial Interests, Personal, Advisory Role: Merck Sharp & Dohme; Financial Interests, Personal, Advisory Role: Merck Serono; Financial Interests, Personal, Advisory Role: Boehringer Ingelheim; Financial Interests, Personal, Advisory Role: Sierra Oncology; Financial Interests, Personal, Advisory Role: Menarini Silicon Biosystems; Financial Interests, Personal, Advisory Role: Taiho Pharmaceutical; Financial Interests, Personal, Advisory Role: Daiichi Sankyo; Financial Interests, Personal, Advisory Role: Janssen Oncology; Financial Interests, Personal, Advisory Role: Genmab; Financial Interests, Personal, Advisory Role: GlaxoSmithKline; Financial Interests, Personal, Advisory Role: Orion Pharma GmbH; Financial Interests, Personal, Advisory Role: Eisai; Financial Interests, Personal, Advisory Role: BioXCel therapeutics; Financial Interests, Personal, Advisory Role: Amgen; Financial Interests, Personal, Advisory Role: Astellas Pharma; Financial Interests, Personal, Advisory Role: CellCentric; Financial Interests, Personal, Advisory Role: Harpoon; Financial Interests, Personal, Advisory Role: Qiagen; Financial Interests, Personal, Advisory Role: Terumo; Financial Interests, Personal, Advisory Role: Sanofi Aventis GmbH; Financial Interests, Personal, Advisory Role: Vertex; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: AstraZeneca; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Astellas Pharma; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: GlaxoSmithKline; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Orion Pharma GmbH; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Sanofi; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Genmab; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Taiho Pharmaceutical; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Qiagen; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Vertex; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Amgen; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Bayer; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Bioexcel Therapeutics; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Boehringer Ingelheim; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Cellcentric; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Daiichi Sankyo; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Eisai; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Genentech/Roche; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Harpoon; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Janssen; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Menarini Silicon Biosystems; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Merck Serono; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Merck Sharp & Dohme; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Pfizer; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Qiagen; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Sierra Oncology; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Terumo; Financial Interests, Personal, Other, Honoraria: AstraZeneca; Financial Interests, Personal, Other, Honoraria: Sanofi; Financial Interests, Personal, Other, Honoraria: Astellas Pharma; Financial Interests, Personal, Other, Honoraria: Pfizer; Financial Interests, Personal, Other, Honoraria: Genentech/Roche; Financial Interests, Personal, Other, Honoraria: Janssen Oncology; Financial Interests, Personal, Other, Honoraria: Menarini Silicon Biosystems; Financial Interests, Personal, Other, Honoraria: Daiichi Sankyo; Financial Interests, Personal, Other, Honoraria: Sierra Oncology; Financial Interests, Personal, Other, Honoraria: BioExcel; Financial Interests, Personal, Other, Honoraria: Amgen; Financial Interests, Personal, Other, Honoraria: Bayer; Financial Interests, Personal, Other, Honoraria: Boehringer Ingelheim; Financial Interests, Personal, Other, Honoraria: CellCentric; Financial Interests, Personal, Other, Honoraria: Eisai; Financial Interests, Personal, Other, Honoraria: Genmab; Financial Interests, Personal, Other, Honoraria: GlaxoSmithKline; Financial Interests, Personal, Other, Honoraria: Harpoon; Financial Interests, Personal, Other, Honoraria: Merck Serono; Financial Interests, Personal, Other, Honoraria: Merck Sharp & Dohme; Financial Interests, Personal, Other, Honoraria: Orion; Financial Interests, Personal, Other, Honoraria: Qiagen; Financial Interests, Personal, Other, Honoraria: Taiho Pharmaceutical; Financial Interests, Personal, Other, Honoraria: Terumo; Financial Interests, Personal, Other, Honoraria: Vertex; Financial Interests, Personal, Other, Honoraria: Celgene; Financial Interests, Personal, Other, Honoraria: Astex Pharmaceuticals; Financial Interests, Personal, Other, Honoraria: Medivation; Financial Interests, Personal, Funding: AstraZeneca; Financial Interests, Personal, Funding: Sanofi; Financial Interests, Personal, Funding: Taiho Pharmaceutical; Financial Interests, Personal, Funding: Daiichi Sankyo; Financial Interests, Personal, Funding: Merck Serono; Financial Interests, Personal, Funding: Astex Pharmaceuticals; Financial Interests, Personal, Funding: Merck Sharp & Dohme; Financial Interests, Personal, Funding: Orion Pharma GmbH; Financial Interests, Personal, Funding: GlaxoSmithKline; Financial Interests, Personal, Funding: CellCentric; Financial Interests, Personal, Funding: Sierra Oncology; Financial Interests, Personal, Funding: Bayer; Financial Interests, Personal, Funding: Amgen; Financial Interests, Personal, Funding: Astellas Pharma; Financial Interests, Personal, Funding: Genmab; Financial Interests, Personal, Funding: Harpoon; Financial Interests, Personal, Funding: Janssen; Financial Interests, Personal, Funding: Menarini Silicon Biosystems; Financial Interests, Personal, Funding: Pfizer; Financial Interests, Personal, Funding: Vertex; Financial Interests, Personal, Funding: Genentech/Roche; Financial Interests, Personal, Funding: Sanofi Aventis GmbH. All other authors have declared no conflicts of interest.

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