Evidence map›Paper›PMID 40330144›Full record

ArticleJCO oncology advances2025

Phase II Study of Pexidartinib Plus Sirolimus in Unresectable Malignant Peripheral Nerve Sheath Tumors Identifies M2 Macrophage Activation.

Gulam A Manji, Liam J Stanton, Angela C Hirbe, Liner Ge, Sarah Sta Ana, Shiny Titus, Brian W Labadie, Michael S May, Yang Lyu, John S A Chrisinger and 9 more

Abstract read
In one paragraph

Article in JCO oncology advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
  4. Review
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

19 authors.

Gulam A ManjiColumbia University Irving Medical Center, New York, NY.ORCID https://orcid.org/0000-0001-9817-2414
Liam J StantonColumbia University Irving Medical Center, New York, NY.ORCID https://orcid.org/0000-0001-7070-7544
Angela C HirbeWashington University School of Medicine, St Louis, MO.ORCID https://orcid.org/0000-0003-1719-0771
Liner GeColumbia University Irving Medical Center, New York, NY.
Sarah Sta AnaColumbia University Irving Medical Center, New York, NY.
Shiny TitusColumbia University Irving Medical Center, New York, NY.
Brian W LabadieColumbia University Irving Medical Center, New York, NY.ORCID https://orcid.org/0000-0002-3648-4663
Michael S MayColumbia University Irving Medical Center, New York, NY.ORCID https://orcid.org/0000-0002-6187-4655
Yang LyuWashington University School of Medicine, St Louis, MO.ORCID https://orcid.org/0000-0002-4353-0082
John S A ChrisingerWashington University School of Medicine, St Louis, MO.
Naomi SenderColumbia University Irving Medical Center, New York, NY.
Varun MongaUniversity of California, San Francisco, San Francisco, CA.ORCID https://orcid.org/0000-0002-1185-5448
Mohammed MilhemUniversity of Iowa, Iowa City, IA.
Rashmi ChughUniversity of Michigan Rogel Comprehensive Cancer Center, Ann Arbor, MI.ORCID https://orcid.org/0000-0002-4633-6971
Peter SimsColumbia University Irving Medical Center, New York, NY.
Aik Choon TanHuntsman Cancer Institute at the University of Utah, Salt Lake City, UT.
Shing LeeColumbia University Irving Medical Center, New York, NY.ORCID https://orcid.org/0000-0001-8413-6869
Brian A Van TineWashington University School of Medicine, St Louis, MO.ORCID https://orcid.org/0000-0003-4572-6668
Gary K SchwartzCase Comprehensive Cancer Center, Cleveland, OH.ORCID https://orcid.org/0000-0003-1813-5061

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the preliminary efficacy and safety of the combination of pexidartinib, an inhibitor of colony-stimulating factor-1 receptor (CSF1R), and sirolimus, a mammalian target of rapamycin inhibitor, to target infiltrating M2 macrophages in malignant peripheral nerve sheath tumors (MPNSTs). PATIENTS AND

methodsThis investigator-initiated, phase II, multicenter, single-arm trial enrolled patients with unresectable MPNSTs. Patients were treated with pexidartinib 1000 mg and sirolimus 2 mg orally daily. The primary end point was progression-free survival (PFS). Secondary end points included objective response, safety profile, and overall survival (OS). Pretreatment and on-treatment tumor biopsies were obtained to evaluate changes in the tumor microenvironment (TME) using multiplex immunofluorescence and differential transcriptional profiling.

resultsFifteen patients with MPNSTs were enrolled and 14 initiated therapy. Eight had neurofibromatosis type 1, five were sporadic, and one was undetermined. Although the target sample size was 25, because of the lower-than-expected accrual during the COVID-19 pandemic, enrollment was halted on April 12, 2023. The median PFS and median OS were 6 weeks (95% CI, 6 to 19.1) and 17.9 weeks (95% CI, 13.7 to not applicable), respectively. One patient achieved confirmed stable disease. Three patients experienced PFS ≥12 weeks. Grade 3 treatment-related toxicities (rash and leukopenia) occurred in four (28.6%) patients. Although the study did not meet its primary end point, correlative analysis demonstrated that four of the five long-term survivors had an immune-rich pretreatment TME, three of whom had a reduction in M2-tumor-associated macrophage signal with treatment.

conclusionFurther studies of combination of pexidartinib and sirolimus and/or immunotherapy should be performed in the subset of patients with advanced MPNST with an immune-rich TME.

Identifiers

PMID40330144
PMCPMC12053409

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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 Socratic graph.