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Forero et al January 10, 2015 TBCRC 019: A phase II trial of nab-PAC with or without the anti-death receptor 5 monoclonal antibody tigatuzumab in patients with triple negative breast cancer Authors: Andres Forero-Torres1*, Katherine E. Varley2, Vandana Gupta Abramson3, Yufeng Li1, Christos Vaklavas1, Nancy U. Lin4, Minetta C. Liu5, Hope S. Rugo6, Rita Nanda7, Anna Maria Storniolo8, Tiffany A. Traina9, Sujata Patil9, Catherine H. Van Poznak10, Julie R. Nangia11, William Johnson Irvin Jr.12, Helen Krontiras1, Jennifer F. De Los Santos1, Paul Haluska13, William Grizzle1, Richard M. Meyers2, Antonio C. Wolff14, on behalf of the Translational Breast Cancer Research Consortium (TBCRC) Authors Affiliations: 2 1 University of Alabama at Birmingham, Birmingham, AL; HudsonAlpha Institute for Biotechnology, Huntsville, AL; 3Vanderbilt-Ingram Cancer Center, Nashville, TN; 4Dana-Farber Cancer Institute, Boston, MA; 5Georgetown University Hospital, Washington, DC; 6University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; 7The University of Chicago, Chicago, IL; 8Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; 9Memorial Sloan-Kettering Cancer Center, New York, NY; 10University of Michigan, Ann Arbor, MI; 11Baylor College of Medicine, Houston, TX; North Carolina, Chapel Hill, NC; 14 13 12 University of Mayo Clinic College of Medicine, Rochester, MN; Johns Hopkins Kimmel Comprehensive Cancer Center, Baltimore, MD. * To whom Correspondence should be sent: Andres Forero-Torres, M.D. 1 Forero et al January 10, 2015 University of Alabama at Birmingham Comprehensive Cancer Center NP2510; 1530 3rd Avenue South Birmingham, AL 35294 Phone #: 205-9347167; FAX #: 205-9969995 [email protected] Conflict of interest: A.F.T. received research support from Daiichi Sankyo and Celgene to conduct clinical and laboratory research (paid to the University of Alabama at Birmingham). The following authors have the following conflict of interest to disclose: M.C.L. and T.A.T. have received research support from Celgene. The remaining authors have no conflict of interest to disclose. Presentation / Publications: Data from this work have been partially reported at the ASCO Annual Meeting in 2011 and 2013 (Abstract # TPS 128 and 1052 respectively). Running Head: Phase 2 trial of Tigatuzumab/nab-PAC in Patients with TNBC Keywords: Tigatuzumab, nab-PAC, Monoclonal, Antibody, Triple negative, Breast Cancer Financial Support: This study was supported by the Susan G Komen for the Cure Promise Grant (KG090969), the University of Alabama at Birmingham Breast Cancer Specialized Program of Research Excellence Award # NCI P50CA089019 from the National Cancer Institute, Daiichi Sankyo and Celgene. The Translational Breast Cancer 2 Forero et al January 10, 2015 Research Consortium is supported by the Breast Cancer Research Foundation, the Avon Foundation, and Susan G. Komen for the Cure. Title: 159 characters. Statement: 150 words. Abstract: 250 words. Text: 4056 words. References: 41. Tables: 4. Figures: 2. 3 Forero et al January 10, 2015 Supplementary Data (for publication only) 1. Definition of Drug related Toxicities for the Interim Safety Cohort: Drug related toxicities in the first 6 patients enrolled in the TIG/nab-PAC arm of the study were defined as: a) any grade 3 or 4 non-hematologic toxicity (except anorexia, alopecia, nausea, fatigue, fever without neutropenia); b) failure to recover to baseline (except alopecia) after delaying the next dose by more than 2 weeks; c) grade 3 or 4 neutropenia complicated by fever > 38.5 oC or infection, or grade 4 neutropenia of a least 7 days duration; or d) grade 4 thrombocytopenia, or grade 3 thrombocytopenia complicated by hemorrhage. Enrollment in the arm was scheduled to stop if more than 3 of the first 6 patients experienced drug related toxicities. 2. Definition of Adequate Organ and Bone Marrow Function for Eligibility: Adequate organ and bone marrow function was defined in the protocol as hemoglobin > 9.0 g/dL; absolute neutrophil count > 1.5 X 109/L; a platelet count > 100 X 109/L; serum creatinine < 2 mg/dL; aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (AP) < 2.5 times the upper limit of normal (ULN) in subjects with no liver metastasis and < 5 times the ULN in subjects with liver metastasis, and total bilirubin < 1.5 times the ULN. 3. Supplemental Figure 1: Graphs depicting the seven genes whose expression in patient tumors were significantly associated with response to therapy (FDR<0.05). For each of the seven genes the log2 (relative expression) is plotted on the y-axis, and the patients’ responses to therapy are plotted on the x-axis. 4 Forero et al January 10, 2015 Supplemental Figure 1 Seven genes whose expression in patient tumors were significantly associated with response to therapy (FDR<0.05) 5