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1.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009589

ABSTRACT

Background: Complicating the pandemic are the healthcare disparities experienced by ethnic minorities, including Black and Hispanic Americans. This is further exacerbated in those ethnic subgroups, especially if they have comorbidities, including cancer. With the introduction of COVID-19 vaccines, the shift is now focused on promoting vaccination. However, vaccine hesitancy and motives of why ethnic minority cancer patients receive or do not receive vaccines have not been explored and are the focus of this study. Methods: A cross-sectional survey was administered among cancer patients to understand the knowledge and attitude towards COVID-19 vaccines at a single institution in a predominantly ethnic minority population between February 1-June 30, 2021. The participant's inclusion criteria were >18 years old and diagnosed with solid or hematologic malignancy. Descriptive statistics were used to summarize the patient characteristics, COVID-19 vaccine knowledge, and uptake motives. A composite score of COVID-19 and vaccine knowledge was derived and its role on vaccination status was assessed using a multivariable logistic regression model. Results: Of 52 patients surveyed, COVID-19 vaccination prevalence during the survey was 40.4% (95% CI: 27, 54.9). Participants' average (sd) age was 63.5 (13.6) years;42% were male, 36% were Black, and 30% Hispanic;65% were receiving active treatment for their cancer. Seventy-nine percent believed COVID-19 infection to be dangerous or harmful to them, 61% were concerned about the side effects of the COVID-19 vaccine, yet 65% considered vaccines safe. Those refusing the vaccine (n=7) cited side effects (71%) or believed that the vaccine was not needed (57%). Of those who were unvaccinated (n=31), 48.4% (n=15) got vaccinated post-survey. The odds of vaccination was 3.79 (1.63, 8.82) times higher with a 1 unit increase in COVID-19 knowledge score but was not significant in the multivariable model. The final model suggested that the odds of vaccination increased 2.9 times more for a 1 unit increase in vaccine knowledge score;Blacks were two times more likely to get vaccinated and those with more than high school education had a five-fold increase in vaccination. The model results are presented in Table. Conclusions: This exploratory study has demonstrated that there are multiple reasons why an ethnic minority cancer patient would be vaccinated and possible reasons why they would not. This information will become important in improving vaccine campaigns targeting these populations and ensuring their safety and protection against COVID-19.

2.
Magy Onkol ; 66(1):35-41, 2022.
Article in Hungarian | PubMed | ID: covidwho-1762663

ABSTRACT

The COVID-19 pandemic has had tremendous impact worldwide but possibly no other patient subset has been impacted as much as patients with a cancer diagnosis. Significantly increased morbidity and mortality was defined amongst identifiable subsets of cancer patients, such as the elderly, patients with co-morbid illnesses and certain malignancy types and therapies. In addition, major compromises in cancer care and drastic drop-offs in cancer screening rates have led to significant further setbacks in recent advances in cancer care. Emerging information as to the benefit of COVID-19 vaccinations, including booster vaccines that can benefit even the most immune suppressed along with novel anti-COVID antibodies preemptively reduce the risk of infection. Antiviral and other therapeutics mitigating the severity of COVID-19 infections now offer major insights, new and effective options and hope for being able to optimize cancer care even in the face of the ongoing pandemic.

3.
Blood ; 138:2537, 2021.
Article in English | EMBASE | ID: covidwho-1736299

ABSTRACT

It is well established that COVID-19 carries a higher risk of morbidity and mortality in patients (pts) with hematologic malignancies. Emerging data suggests that despite the 3 COVID-19 vaccines with emergency use authorization (EUA) by the FDA inducing high levels of immunity in the general population, pts with hematologic malignancies have lower rates of seroconversion for the SARS-CoV-2 Spike antibody (Spike IgG) and thus possibly lower protection against severe COVID-19. We established a program of rapid vaccination and evaluation of response in an inner city minority population to help determine the factors that contribute to the poor seroconversion to COVID-19 vaccination in pts with hematologic malignancies. We conducted a cross-sectional cohort study of pts with hematologic malignancies seen at Montefiore Medical Center between March 29, 2021 and July 8, 2021 who completed their vaccination series with 1 of the 3 FDA EUA COVID-19 vaccines, Moderna, Pfizer, or Johnson & Johnson (J&J). We qualitatively measured Spike IgG production in all pts using the AdviseDx Spike IgG assay and performed quantitative analysis on pts who completed their vaccination series with at least 14 days (d) after the 2 nd dose of the Moderna or Pfizer vaccines or 28d after the single J&J vaccine. Safety data was collected via questionnaires or as part of the electronic medical record. We analyzed the characteristics of these pts using standard descriptive statistics and associations between pts characteristics, cancer subtypes, treatments, and vaccine response using a Fisher Exact test, Kruskal-Wallis Rank Sum test, or Kendall Tau-b test. A total of 121 pts with hematologic malignancies were enrolled and another 10 pts were included by retrospective chart review. Five pts did not have a Spike IgG performed after consent and excluded. Ten patients had Spike IgG testing before completion of their vaccination series and excluded from quantitative analyses. A total of 116 pts were included in immunogenicity analysis and 106 pts in quantitative analysis. Baseline characteristics and representative malignancies are listed in Table 1. Seventy pts (60%) received Pfizer, 36 pts (31%) Moderna, and 10 pts (9%) J&J. Median time from vaccination completion to Spike IgG was 40d. We observed a high-rate of seropositivity (86%) with 16 pts (14%) having a negative Spike IgG. Percent positivity was not statistically significant between vaccine types (p=0.50). We observed significantly lower seroconversion rates in pts with Non-Hodgkin lymphoma (p=0.005) and pts who received: cytotoxic chemotherapy (p=0.002), IVIG (p=0.01), CAR-T cell therapy (p=0.00002), and CD20 monoclonal antibodies (Ab) (p=0.0000008) especially within 6 mo of Spike Ab evaluation (p=0.01). All pts who received anti-CD19 (Axi-cel) CAR-T therapy (0/6) were seronegative, and 1 pt that received BCMA directed CAR-T (Cilta-cel) was seropositive with no association between timing CAR-T cell infusion and seroconversion/titer. Use of BCL2 inhibitors (p=0.04), CD20 monoclonal Ab (p=0.0009), CAR-T cell therapy (p=0.01), BTK inhibitors (p=0.04), current steroid use (p=0.002), and IVIG (p=0.003) also correlated with significantly lower Ab titers with a trend toward lower Ab titers in pts on any active cancer therapy at time of vaccination (p=0.051). Immunomodulatory drugs (p=0.01) and proteasome inhibitors (p=0.01) had significantly higher seroconversion rates, and pts with history prior COVID-19 (12/106) had significantly higher Ab titers (p=0.0003). Of 47 pts who received stem cell transplant, 43 received an autologous (37 seropositive, 6 seronegative) and 4 an allogeneic transplant (3 seropositive, 1 seronegative), with no significant association with seroconversion, Ab titer, or time since transplant (greater or less than 1 year). The majority of pts, 64% and 53%, reported no adverse effects (AE) to the 1 st and 2 nd dose respectively. The most common AE were mild in severity and included sore arm, muscle aches, fatigue, and fever. No life-threatening AE were observed. Our findings indicate hat vaccination is safe, effective, and well tolerated in the majority of pts with hematologic malignancies. We observed that pts receiving B-cell depleting therapies are unable to mount an effective serological response to COVID-19 vaccines and remain vulnerable to the disease. Novel immunization strategies (active or passive) are urgently needed in this population. [Formula presented] Disclosures: Gritsman: iOnctura: Research Funding. Shastri: Onclive: Honoraria;Kymera Therapeutics: Research Funding;Guidepoint: Consultancy;GLC: Consultancy. Halmos: Merck: Membership on an entity's Board of Directors or advisory committees, Research Funding;Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees, Research Funding;Astra-Zeneca: Membership on an entity's Board of Directors or advisory committees, Research Funding;Amgen: Membership on an entity's Board of Directors or advisory committees, Research Funding;AbbVie: Research Funding;Boehringer-Ingelheim: Membership on an entity's Board of Directors or advisory committees, Research Funding;Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding;GSK: Research Funding;Pfizer: Membership on an entity's Board of Directors or advisory committees, Research Funding;Mirati: Research Funding;Elevation: Research Funding;Blueprint: Research Funding;Advaxis: Research Funding;Eli-Lilly: Research Funding;TPT: Membership on an entity's Board of Directors or advisory committees;Apollomics: Membership on an entity's Board of Directors or advisory committees;Guardant Health: Membership on an entity's Board of Directors or advisory committees. Verma: BMS: Research Funding;GSK: Research Funding;Novartis: Consultancy;Stelexis: Consultancy, Current equity holder in publicly-traded company;Eli Lilly: Research Funding;Curis: Research Funding;Medpacto: Research Funding;Incyte: Research Funding;Acceleron: Consultancy;Stelexis: Current equity holder in publicly-traded company;Celgene: Consultancy;Throws Exception: Current equity holder in publicly-traded company.

4.
Journal of Thoracic Oncology ; 16(3):S297, 2021.
Article in English | EMBASE | ID: covidwho-1161005

ABSTRACT

Introduction: Previously reported data on patients with thoracic malignancies who develop COVID-19 have suggested a higher mortality rate compared to the general population and to other cancer types, particularly in patients over 65 years of age or suffering from active or progressive disease. Preliminary data from other studies have suggested that gender and ethnicity may also impact patient outcomes. Methods: TERAVOLT is a multi-center, international observational study composed of a cross-sectional component and a longitudinal cohort component. Eligibility criteria include the presence of any thoracic cancer and a COVID-19 diagnosis confirmed in the laboratory with RT-PCR/serology, highly suspicious radiological and clinical findings, or suspected with symptoms and known contact with a positive person. The overarching goals of this consortium are to provide data for guidance to oncology professionals on managing patients with thoracic malignancies while understanding the risk factors for morbidity and mortality from this novel virus. Clinical outcomes including hospitalization, ICU admission, oxygen requirement and mortality were collected. The association between demographic/clinical characteristics and outcomes were measured with odds ratio with 95% confidence intervals using a logistic regression model. Results: As of August 20, 2020, a total of 1,053 patients with COVID-19 and thoracic cancers from 19 countries and 130 centers have been identified, including 42% females and 84% White, 9.3% African American, 25% Hispanic. The median age of male patients was 69 compared to 66 years of age for females. While ECOG PS was similar between treatment groups, 77% of males were admitted to hospital with a mortality rate of 37% compared to 66% of females with a mortality rate of 28%. The median age of African American patients was 66 years of age compared to 68 and 69 years of age for white and Hispanic patients, respectively;26% of African American and 25% White patients had an ECOG PS ≥2 compared to 19% of Hispanics. A similar percentage of patients were admitted to the hospital and ICU, while the mortality rate for Hispanics was 36% compared to 34% for whites and 26% for African Americans. Conclusion: Similar to the general population, the mortality rate of males with thoracic cancer is higher than females. Regarding ethnicity, there is a difference in the median age of African American patients compared to Whites and Hispanics. Although the severity of COVID-19 disease, as defined by hospital admission, is similar between ethnic groups, the mortality rate in Hispanics is higher. We will present a multivariate analysis of these data according to gender and ethnicity, including the impact of cancer stage, prior cancer therapy, and COVID-19 therapy on outcomes. Keywords: TERAVOLT, international COVID-19 registry, thoracic malignancies

6.
Journal of Clinical Oncology ; 38(29), 2020.
Article in English | EMBASE | ID: covidwho-1076196

ABSTRACT

Background: Data at our institution shows lung cancer is more prevalent and aggressive in HIV patients. A study of lung cancer patients revealed a mean age of 55.8 years in those with HIV vs. 68.0 in those without. Additionally, 67% of HIV patients had metastasis at time of diagnosis, compared to 49% in the overall population. One study found an 18.9% reduction in lung cancer mortality among HIV patients who receive NLST-recommended screening. Despite this, data from 2018 estimated only 13% of eligible HIV patients had completed screening at our institution. We pursued a quality improvement initiative to increase lung cancer screening in our HIV clinics. Methods: Our multi-disciplinary team studied charts of the 628 HIV clinic patients seen in a four-month span to identify those who had not received lung cancer screening and potential reasons why referrals were not made. We also spoke our dedicated screening coordinator, who contacts patients to arrange for CT scans. We plotted trends in appointment referrals on a run chart. Results: Areas for improvement included EMR documentation to assess screening eligibility and an occasional lack of awareness regarding criteria. Providers also cited time constraints may limit referrals. Our team identified patients that met screening criteria and generated EMR reminders for providers to refer patients to radiology. We also held sessions with providers and nursing staff to increase awareness of our screening program. Of 628 patients, 128 (20.4%) had sufficient documented smoking history to assess for screening eligibility. 81 patients (63.3%) met our criteria. Of these patients, 58 (71.6%) had not been screened or referred for screening. Through our most recent interventions, 16 (31.3%) patients have been referred to our screening coordinator, and 7 (12.1%) have received screening CT scans. Our interventions ultimately led to an increase from 23 of 81 (28.4%) patients with completed screening to a projected 46 of 81 (56.8%). Conclusions: Providing education and EMR alerts to raise awareness regarding eligibility, we substantially increased the screening rate in our clinics. Our interventions will be broadened as we return from COVID stoppages. Future interventions include increasing smoking history documentation in the EMR to allow for automated identification of screening eligibility. PDSA and interventions are ongoing with continued follow-up of efficacy.

8.
Annals of Oncology ; 31:S1204-S1205, 2020.
Article in English | EMBASE | ID: covidwho-804086

ABSTRACT

Background: Patients with thoracic malignancies may have increased risk for COVID-19 mortality. This risk may be attributable to age, comorbidities, smoking history, pulmonary disease burden and cancer-directed therapies. Methods: TERAVOLT is a global consortium examining outcomes and assessing risk factors associated with mortality of patients with thoracic malignancies and COVID-19 infection. Results: As of July 15, 2020, 1012 patients from 20 countries have been entered;median age was 68 with 58 % male, 80% current/former smokers, most common comorbidities of HTN (49%) & COPD (26%);82% NSCLC, 68 % patients with stage IV disease at COVID diagnosis, 65% on treatment (38% chemotherapy, 26% immune checkpoint inhibitor (ICI), 16 % targeted tyrosine kinase inhibitor (TKI). Of these, 72% were hospitalized;56% of patients developed complications, most frequently pneumonia (40%) and 47% who did not have prior oxygen therapy required it. 32% of patients died during their COVID-19 infection. Only 33 % of patients continued their oncology treatment after infection. Patients presenting with pneumonia (OR 2.7 2-3.5), consolidation (OR 2 CI 1,5-2,8), bilateral lung abnormalities (OR 2,8 CI 2-3,9) and pleural effusion (OR 2,7 CI 1,8-4) were at increased risk of mortality. In multivariate analysis age ≥ 65 (OR 1,53 CI 1,11-2,1), active smoking (OR 2 CI 1,3-3), higher stage of cancer (OR 1,9 CI 1,3-2,7), ECOG PS ≥2 (OR 3,7 CI 2,7-5), steroids prior to COVID diagnosis (OR 1,8 CI 1,2-2,7), were associated with increased risk of death, while chemotherapy and TKI therapy use were not and interestingly patients on immunotherapy appeared to be at decreased risk for mortality (OR 0,6 CI 0,5-0,97). Conclusions: Facing this ongoing global pandemic, TERAVOLT is the largest thoracic malignancy database confirming the high risk for COVID-19 mortality in this specific patient group. Physicians need to evaluate the risk of mortality from COVID-19 based on age, smoking status, stage of cancer, performance status, need for steroids and specific therapy in order to determine the appropriateness for cancer therapy and tailor patient care taking into account patients’ wishes and status of pandemic in the country. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: J. Baena Espinar: Advisory/Consultancy: AstraZeneca;Honoraria (self), Travel/Accommodation/Expenses: Angelini. F.R. Hirsch: Advisory/Consultancy: AstraZeneca;Advisory/Consultancy: BMS;Advisory/Consultancy: Merck;Advisory/Consultancy: Daiichi;Advisory/Consultancy: Genentech/Roche;Advisory/Consultancy: Lilly/Loxo;Advisory/Consultancy: Boehringer-Ingelheim. M. Tiseo: Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): AstraZeneca;Advisory/Consultancy, Research grant/Funding (institution): Boehringer Ingelheim;Advisory/Consultancy: Novartis;Advisory/Consultancy: MSD;Advisory/Consultancy: BMS;Advisory/Consultancy: Takeda. E. Felip: Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: AbbVie;Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: AstraZeneca;Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Blue Print Medicines;Advisory/Consultancy, Advisory role or speaker's bureau: Boehringer Ingelheim;Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Bristol-Myers Squibb;Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: GSK;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Eli Lilly;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Guardant Health;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Janssen;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Medscape;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Merck KGaA;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Spea er's bureau: Merck Sharp and Dohme;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Novartis;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Pfizer;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: prIME Oncology;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Roche;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Samsung;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Springer;Advisory/Consultancy, Speaker Bureau/Expert testimony, Advisory role or Speaker's bureau: Takeda;Advisory/Consultancy, Advisory role or Speaker's bureau: Touchime;Research grant/Funding (self), Research Funding: Fundacion Merck Salud;Research grant/Funding (institution), Research Funding: Grant for Oncology Innovation;Full/Part-time employment, Board (Independent Member: Grifols Boards. H.A. Wakelee: Research grant/Funding (institution), Clinical Research grant: Gilead;Honoraria (self), Advisory/ Consultancy, advisor or consultant honoraria: AstraZeneca;Advisory/Consultancy, Research grant/Funding (institution), advisor or consultant, research: Xcovery;Advisory/Consultancy, advisor or consultant: Jassen;Advisory/Consultancy, advisor or consultant: Daiichi Sankyo, INC;Advisory/Consultancy, advisor or consultant: Helsinn;Advisory/Consultancy, advisor or consultant: Mirati;Advisory/Consultancy, advisor or consultant (not: Takeda;Advisory/Consultancy, advisor or consultant (not: Cellworks;Advisory/Consultancy, Research grant/Funding (institution), advisor or consultant (not: Genentech/Roche;Advisory/Consultancy, Research grant/Funding (institution), advisor or consultant (not: Merck;Travel/Accommodation/Expenses, CME presentation (travel funding): Clinical care options oncology, LLC;Travel/Accommodation/Expenses, CME presentation (travel funding): Fishawack facilitate LTD;Travel/Accommodation/Expenses, CME presentation (travel funding): Medscape;Travel/Accommodation/Expenses, CME presentation (travel funding): Onclive/intellisphere LLC;Travel/Accommodation/Expenses, CME presentation (travel funding): Philips Gillmore Oncology 2018;Travel/Accommodation/Expenses, CME presentation (travel funding): Physician education resource, LLC/MJH;Travel/Accommodation/Expenses, CME presentation (travel funding): Potomac center for medical education;Travel/Accommodation/Expenses, CME presentation (travel funding): Prime Oncology LLC (2018);Travel/Accommodation/Expenses, CME presentation (travel funding): Primo (2018);Travel/Accommodation/Expenses, CME presentation (travel funding): Research to practice;Travel/Accommodation/Expenses, CME presentation (travel funding): UpToDate;Travel/Accommodation/Expenses, CME presentation (travel funding): WebMdHealth;Honoraria (self), Research grant/Funding (institution), honoraria, research funding to: Novartis;Travel/Accommodation/Expenses, International professional society: RGCON- Rajiv gand conference;Travel/Accommodation/Expenses, International professional society: JLCS - japanese lung cancer society;Travel/Accommodation/Expenses, International professional society: KSMO - korean society of medical oncology;Full/Part-time employment, professor of medicine: Stanford university;Travel/Accommodation/Expenses, Scientific advisory committe - travel: ITMIG;Research grant/Funding (institution), research funding to institution: ACEA biosciences. M.C. Garassino: Honoraria (self): Boehringer Ingelheim;Honoraria (self), Local PI, Enrollment in clinical Trials in: Otsuka Pharma;Honoraria (self), Research grant/Funding (institution), PI, Enrollment and Steering: AstraZeneca;Honoraria (self), Research grant/Funding (institution), PI, Enrollment in clinical Trials in: Novartis;Honoraria (self), Research grant/Funding (institution), PI, Enrollment in clinical Trials in: BMS;Honoraria (self), Research grant/Funding (institution), PI, Enrollment in clinic l Trials in: Roche;Honoraria (self), Research grant/Funding (institution), PI, MISP in Thimic malignancies: Pfizer;Honoraria (self), Research grant/Funding (institution), PI, Enrollment in clinical Trials in: Celgene;Research grant/Funding (institution): Incyte;Research grant/Funding (institution): Inivata;Research grant/Funding (self): Takeda;Honoraria (self), PI, Enrollment in clinical Trials Thimic: Tiziana Sciences;Honoraria (self), PI, Enrollment in clinical Trials in: Clovis;Honoraria (self), PI, Enrollment in clinical Trials in: Merck Serono;Honoraria (self), Research grant/Funding (self), PI, Enrollment in clinical Trials in: Bayer;Honoraria (self), Research grant/Funding (institution), PI, Enrollment in clinical Trials in: MSD;Honoraria (self), Local PI, Enrollment and Steering: GlaxoSmithKline S.p.A.;Research grant/Funding (institution): Sanofi-Aventis;Honoraria (self), PI, Enrollment in clinical Trials: Spectrum Pharmaceutcials;Honoraria (self), PI, Enrollment in clinical Trials: Blueprint Medicine;Research grant/Funding (institution): Seattle Genetics;Research grant/Funding (institution): Daiichi Sankyo;Honoraria (self), PI, MISP in Thimic malignancies: Eli Lilly. S. Peters: Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: AbbVie;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: Amgen;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: AstraZeneca;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: Bayer;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: Biocartis;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: Boehringer-Ingelheim;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium: Bistrol-Myers Squibb;Honoraria (self), Advisory/Consultancy, Advisory board + honorarium:Clovis;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Daiichi Sankyo;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Debiopharm;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Eli Lilly;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: F. Hoffmann-La Roche;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Foundation Medicine;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Illumina;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Janssen;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Merck Sharp and Dohme;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Merck Serono;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Merrimack;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Novartis;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Pharma Mar;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Pfizer;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Regeneron;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Sanofi;Honoraria (self), Advisory/Consultancy, Advisory Board + honorarium: Seattle Genetics and Takeda;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: AstraZeneca;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: Boehringer-Ingelheim;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: Bristol-Myers Squibb;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: Eli Lilly;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: F. Hoffmann-La Roche;Honoraria (self), Speaker Bureau/Expert testimony, Talk + honorarium: Merck Sharp and Dohme. L. Horn: Advisory/Consultancy, Consulting: AstraZeneca;Advisory/Consultancy, Consulting: Genentech-Roche;Advisory/Consultancy, Consulting: Incyte;Advisory/Consultancy, Consulting: Merck;Advisory/Consultancy, Consulting: Pfizer;Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses, Consulting and travel to meeting: Xcovery;dvisory/Consultancy, Consulting: EMD Serono;Advisory/Consultancy, Consulting: Tesaro;Advisory/Consultancy, Consulting: AbbVie;Research grant/Funding (self): Boehringer Ingelheim;Research grant/Funding (self), Travel/Accommodation/Expenses, Honorarium: BMS;Honoraria (self), Honorarium: Medscape;Honoraria (self), Honorarium: PER;Honoraria (self), Honorarium: Research to Practice;Honoraria (self), Honorarium: OncLive;Advisory/Consultancy, Consulting: Amgen;Advisory/Consultancy, Consulting: Bayer. All other authors have declared no conflicts of interest.

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