Evidence map›Paper›PMID 28512410›Full record

ArticleCase reports in oncology

RRx-001 Priming of PD-1 Inhibition in the Treatment of Small Cell Carcinoma of the Vagina: A Rare Gynecological Tumor.

Christina Brzezniak, Bryan Oronsky, Jane Trepel, Thomas A Summers, Pedro Cabrales, Min-Jung Lee, Regina Day, Saheli Jha, Scott Caroen, Karen Zeman and 8 more

Open access · goldAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Case reports in oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 7 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 5 institutions in 2 countries.

Christina BrzezniakaWalter Reed National Medical Center, Bethesda, MD, USA.
Bryan OronskybEpicentRx, San Diego, CA, USA.
Jane TrepelcDevelopmental Therapeutics Branch, National Cancer Institute, NIH, Bethesda, MD, USA.
Thomas A SummersaWalter Reed National Medical Center, Bethesda, MD, USA.
Pedro CabralesdDepartment of Bioengineering, University of California San Diego, La Jolla, CA, USA.
Min-Jung LeecDevelopmental Therapeutics Branch, National Cancer Institute, NIH, Bethesda, MD, USA.
Regina DayeDepartment of Pharmacology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Saheli JhabEpicentRx, San Diego, CA, USA.
Scott CaroenbEpicentRx, San Diego, CA, USA.
Karen ZemanaWalter Reed National Medical Center, Bethesda, MD, USA.
Lindsey FerryaWalter Reed National Medical Center, Bethesda, MD, USA.
Cindy HarmerbEpicentRx, San Diego, CA, USA.
Neil OronskyfCFLS, San Jose, CA, USA.
Michelle LybeckbEpicentRx, San Diego, CA, USA.
Harry E LybeckgUniversity of Helsinki, Helsinki, Finland.
James F BrownbEpicentRx, San Diego, CA, USA.
Tony R ReidhMoores Cancer Center, University of California San Diego, La Jolla, CA, USA.
Corey A CarteraWalter Reed National Medical Center, Bethesda, MD, USA.
Walter Reed National Military Medical Center · USNational Cancer Institute · USUniversity of California, San Diego · USUniformed Services University of the Health Sciences · USUniversity of Helsinki · FI

Funding

Signal Transduction Events and the Regulation of Cell GrowthZICSC006743 · NCI · DIVISION OF CLINICAL SCIENCES - NCI · PI TREPEL, JANE B · 2009 to 2023
$13.8M
6 · The paper itself

Abstract

Small cell carcinoma of the vagina is rare, so rare in fact that the total number reported in English-language journals is less than 30. Due to this extremely low incidence, no specific treatment guidelines have been established, and most of what is clinically known is derived from a handful of single case reports. However, as befitting its highly aggressive histologic features, which are reminiscent of small cell lung cancer (SCLC), first-line treatment is modeled after SCLC. Herein is reported the case of a 51-year-old African-American patient with metastatic biopsy-proven small cell carcinoma of the vagina that progressed through multiple therapies: first-line cisplatin and etoposide (making it platinum-resistant) and radiotherapy, followed by the tumor macrophage-stimulating agent RRx-001 in a clinical trial called QUADRUPLE THREAT, which per protocol preceded a mandated rechallenge with cisplatin and etoposide. RECIST v.1.1 tumor progression on both RRx-001 and cisplatin/etoposide was accompanied by central necrosis in several of the enlarged lymph nodes and hepatic metastases, which may have been evidence of pseudoprogression, accounting for her ongoing longer-than-expected survival, since the necrotic tissue may have primed the activity of the PD-1 inhibitor. The lack of response to RRx-001 is hypothesized to have correlated with sparse tumor macrophage infiltration, seen on pre- and post-treatment biopsies, since the mechanism of action of RRx-001 relates to stimulation of tumor-associated macrophages.

Indexed as

ChemotherapyImmunotherapyPseudoprogressionRRx-001Small cell carcinomaTumor-associated macrophage stimulationVagina

Identifiers

PMID28512410
PMCPMC5422722
OpenAlexW2603648475

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.