PMID- 27354481 OWN - NLM STAT- MEDLINE DCOM- 20170721 LR - 20221207 IS - 1527-7755 (Electronic) IS - 0732-183X (Print) IS - 0732-183X (Linking) VI - 34 IP - 25 DP - 2016 Sep 1 TI - Nivolumab in Combination With Platinum-Based Doublet Chemotherapy for First-Line Treatment of Advanced Non-Small-Cell Lung Cancer. PG - 2969-79 LID - 10.1200/JCO.2016.66.9861 [doi] AB - PURPOSE: Nivolumab, a fully human immunoglobulin G4 programmed death-1 immune checkpoint inhibitor antibody, has demonstrated improved survival in previously treated patients with advanced non-small-cell lung cancer (NSCLC). CheckMate 012, a phase I, multicohort study, was conducted to explore the safety and efficacy of nivolumab as monotherapy or combined with current standard therapies in first-line advanced NSCLC. Here, we report results for nivolumab plus platinum-based doublet chemotherapy (PT-DC). PATIENTS AND METHODS: Patients (N = 56) received nivolumab (intravenously) plus PT-DC concurrently every 3 weeks for four cycles followed by nivolumab alone until progression or unacceptable toxicity. Regimens were nivolumab 10 mg/kg plus gemcitabine-cisplatin (squamous) or pemetrexed-cisplatin (nonsquamous) or nivolumab 5 or 10 mg/kg plus paclitaxel-carboplatin (all histologies). The primary objective was to assess safety and tolerability. Secondary objectives included objective response rate and 24-week progression-free survival rate (per Response Evaluation Criteria in Solid Tumors version 1.1); exploratory objectives included overall survival (OS) and response by tumor programmed death ligand-1 expression. RESULTS: No dose-limiting toxicities occurred during the first 6 weeks of treatment. Forty-five percent of patients (25 of 56 patients) reported grade 3 or 4 treatment-related adverse events (AEs); 7% of patients (n = 4) had pneumonitis. Twenty-one percent of patients (n = 12) discontinued all study therapy as a result of treatment-related AEs. Objective response rates for nivolumab 10 mg/kg plus gemcitabine-cisplatin, nivolumab 10 mg/kg plus pemetrexed-cisplatin, nivolumab 10 mg/kg plus paclitaxel-carboplatin, and nivolumab 5 mg/kg plus paclitaxel-carboplatin were 33%, 47%, 47%, and 43%, respectively; 24-week progression-free survival rates were 51%, 71%, 38%, and 51%, respectively; 2-year OS rates were 25%, 33%, 27%, and 62%, respectively. Responses were achieved regardless of tumor programmed death ligand-1 expression. CONCLUSION: The safety profile of nivolumab plus PT-DC was consistent with that expected for individual agents; however, treatment discontinuation related to AEs was greater with the combination. Encouraging activity was observed, especially for the nivolumab 5 mg/kg plus paclitaxel-carboplatin group, with a 2-year OS rate of 62%. CI - (c) 2016 by American Society of Clinical Oncology. FAU - Rizvi, Naiyer A AU - Rizvi NA AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. nar2144@cumc.columbia.edu. FAU - Hellmann, Matthew D AU - Hellmann MD AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Brahmer, Julie R AU - Brahmer JR AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Juergens, Rosalyn A AU - Juergens RA AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Borghaei, Hossein AU - Borghaei H AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Gettinger, Scott AU - Gettinger S AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Chow, Laura Q AU - Chow LQ AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Gerber, David E AU - Gerber DE AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Laurie, Scott A AU - Laurie SA AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Goldman, Jonathan W AU - Goldman JW AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Shepherd, Frances A AU - Shepherd FA AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Chen, Allen C AU - Chen AC AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Shen, Yun AU - Shen Y AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Nathan, Faith E AU - Nathan FE AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Harbison, Christopher T AU - Harbison CT AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. FAU - Antonia, Scott AU - Antonia S AD - Naiyer A. Rizvi and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center, New York, NY; Julie R. Brahmer, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Rosalyn A. Juergens, Juravinski Cancer Centre at McMaster University, Hamilton; Scott A. Laurie, Ottawa Hospital Cancer Centre, Ottawa; Frances A. Shepherd, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Hossein Borghaei, Fox Chase Cancer Center, Philadelphia, PA; Scott Gettinger, Yale Cancer Center, New Haven, CT; Laura Q. Chow, University of Washington, Seattle, WA; David E. Gerber, University of Texas Southwestern Medical Center, Dallas, TX; Jonathan W. Goldman, University of California, Los Angeles, Los Angeles, CA; Allen C. Chen, Yun Shen, Faith E. Nathan, and Christopher T. Harbison, Bristol-Myers Squibb, Princeton, NJ; and Scott Antonia, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. LA - eng SI - ClinicalTrials.gov/NCT01454102 GR - P30 CA008748/CA/NCI NIH HHS/United States PT - Clinical Trial, Phase I PT - Journal Article DEP - 20160627 PL - United States TA - J Clin Oncol JT - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JID - 8309333 RN - 0 (Antibodies, Monoclonal) RN - 0 (B7-H1 Antigen) RN - 0 (CD274 protein, human) RN - 0 (KRAS protein, human) RN - 04Q9AIZ7NO (Pemetrexed) RN - 0W860991D6 (Deoxycytidine) RN - 31YO63LBSN (Nivolumab) RN - BG3F62OND5 (Carboplatin) RN - EC 2.7.10.1 (EGFR protein, human) RN - EC 2.7.10.1 (ErbB Receptors) RN - EC 3.6.5.2 (Proto-Oncogene Proteins p21(ras)) RN - Q20Q21Q62J (Cisplatin) RN - 0 (Gemcitabine) SB - IM CIN - J Clin Oncol. 2016 Sep 1;34(25):2953-5. PMID: 27382094 CIN - Nat Rev Clin Oncol. 2016 Oct;13(10 ):595-6. PMID: 27620712 CIN - J Thorac Dis. 2016 Oct;8(10 ):E1254-E1256. PMID: 27867601 MH - Aged MH - Antibodies, Monoclonal/*administration & dosage/*adverse effects MH - Antineoplastic Combined Chemotherapy Protocols/*adverse effects/*therapeutic use MH - B7-H1 Antigen/biosynthesis MH - Carboplatin/administration & dosage/adverse effects MH - Carcinoma, Non-Small-Cell Lung/*drug therapy/genetics/metabolism MH - Cisplatin/administration & dosage/adverse effects MH - Cohort Studies MH - Deoxycytidine/administration & dosage/adverse effects/analogs & derivatives MH - Disease-Free Survival MH - Dose-Response Relationship, Drug MH - ErbB Receptors/genetics MH - Female MH - Humans MH - Lung Neoplasms/*drug therapy/genetics/metabolism MH - Male MH - Middle Aged MH - Nivolumab MH - Pemetrexed/administration & dosage/adverse effects MH - Proto-Oncogene Proteins p21(ras)/genetics MH - Survival Rate MH - Gemcitabine PMC - PMC5569693 COIS- Authors' disclosures of potential conflicts of interest are found in the article online at www.jco.org. Author contributions are found at the end of this article. EDAT- 2016/06/30 06:00 MHDA- 2017/07/22 06:00 PMCR- 2016/10/01 CRDT- 2016/06/30 06:00 PHST- 2016/06/30 06:00 [entrez] PHST- 2016/06/30 06:00 [pubmed] PHST- 2017/07/22 06:00 [medline] PHST- 2016/10/01 00:00 [pmc-release] AID - JCO.2016.66.9861 [pii] AID - 669861 [pii] AID - 10.1200/JCO.2016.66.9861 [doi] PST - ppublish SO - J Clin Oncol. 2016 Sep 1;34(25):2969-79. doi: 10.1200/JCO.2016.66.9861. Epub 2016 Jun 27.