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Avilés-Salas A, Cabrera-Miranda L, Hernández-Pedro N, Vargas-Lías DS, Samtani S, Muñoz-Montaño W, Motola-Kuba D, Corrales-Rodríguez L, Martín C, Cardona AF, Palomares-Palomares CB, Arrieta O. PD-L1 expression complements CALGB prognostic scoring system in malignant pleural mesothelioma. Front Oncol 2023; 13:1269029. [PMID: 38111532 PMCID: PMC10725960 DOI: 10.3389/fonc.2023.1269029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/30/2023] [Indexed: 12/20/2023] Open
Abstract
Background Programmed death ligand-1 (PD-L1) expression is a predictive biomarker in patients with lung cancer, but its role in malignant pleural mesothelioma (MPM) remains unclear. Evidence suggests that higher PD-L1 expression is correlated with worse survival. CALGB is the main scoring system used to predict the benefit of chemotherapy treatment. This study aimed to determine the prognostic value of PD-L1 expression and its addition to CALGB scoring system in patients with MPM. Methods In this retrospective analysis, we evaluated samples with confirmed locally advanced or metastatic MPM. PD-L1 Tumor Proportional Score (TPS) was determined by immunohistochemistry at diagnosis. Results 73 patients were included in this study. A cutoff value of 15 was set for a high or low PD-L1 TPS. In total, 71.2% (n=52) and 28.8% (n=21) of individuals harbored low or high PD-L1 expression, respectively. PD-L1High was associated with worse median progression-free Survival (mPFS) [4.9 vs. 10.8 months; HR 2.724, 95% CI (1.44-5.14); p = 0.002] and Overall Survival (OS) [6.0 vs. 20.9 months; HR 6.87, 95% CI (3.4-8.7); p<0.001] compared to patients with PD-L1Low. Multivariate analysis confirmed that PD-L1 expression was an independent factor for PFS and OS in patients with MPM and CALGB score of 5-6. Conclusion PD-L1 addition to CALGB scale improves its prognostic estimation of MPM survival and should be considered in future research.
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Affiliation(s)
| | - Luis Cabrera-Miranda
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Norma Hernández-Pedro
- Personalized Medicine Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | | | - Suraj Samtani
- Medical Oncology Department, Clínica Las Condes Santiago, Santiago, Chile
| | - Wendy Muñoz-Montaño
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Daniel Motola-Kuba
- Departments of Biomedical Research and Gastroenterology and Liver Unit and Hemodialysis Unit, Medica Sur Clinic and Foundation, Mexico City, Mexico
| | | | - Claudio Martín
- Department of Medicine, Western University, London, ON, Canada
| | - Andrés F. Cardona
- Thoracic Oncology Unit and Direction of Research, Science and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
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2
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Llaguno-Munive M, Villalba-Abascal W, Avilés-Salas A, Garcia-Lopez P. Near-Infrared Fluorescence Imaging in Preclinical Models of Glioblastoma. J Imaging 2023; 9:212. [PMID: 37888319 PMCID: PMC10607214 DOI: 10.3390/jimaging9100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/28/2023] Open
Abstract
Cancer is a public health problem requiring ongoing research to improve current treatments and discover novel therapies. More accurate imaging would facilitate such research. Near-infrared fluorescence has been developed as a non-invasive imaging technique capable of visualizing and measuring biological processes at the molecular level in living subjects. In this work, we evaluate the tumor activity in two preclinical glioblastoma models by using fluorochrome (IRDye 800CW) coupled to different molecules: tripeptide Arg-Gly-Asp (RGD), 2-amino-2-deoxy-D-glucose (2-DG), and polyethylene glycol (PEG). These molecules interact with pathological conditions of tumors, including their overexpression of αvβ3 integrins (RGD), elevated glucose uptake (2-DG), and enhanced permeability and retention effect (PEG). IRDye 800CW RGD gave the best in vivo fluorescence signal from the tumor area, which contrasted well with the low fluorescence intensity of healthy tissue. In the ex vivo imaging (dissected tumor), the accumulation of IRDye 800CW RGD could be appreciated at the tumor site. Glioblastoma tumors were presently detected with specificity and sensitivity by utilizing IRDye 800CW RGD, a near-infrared fluorophore combined with a marker of αvβ3 integrin expression. Further research is needed on its capacity to monitor tumor growth in glioblastoma after chemotherapy.
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Affiliation(s)
- Monserrat Llaguno-Munive
- Laboratorio de Fármaco-Oncología, Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Mexico City 14080, Mexico; (M.L.-M.); (W.V.-A.)
- Laboratorio de Física Médica, Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
| | - Wilberto Villalba-Abascal
- Laboratorio de Fármaco-Oncología, Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Mexico City 14080, Mexico; (M.L.-M.); (W.V.-A.)
| | - Alejandro Avilés-Salas
- Departamento de Patología, Instituto Nacional de Cancerología, Mexico City 14080, Mexico;
| | - Patricia Garcia-Lopez
- Laboratorio de Fármaco-Oncología, Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Mexico City 14080, Mexico; (M.L.-M.); (W.V.-A.)
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3
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Ruiz-Beltran AM, Falcon-Quispe LA, Sanchez-Toscano JA, Acosta-Calderón LA, Avilés-Salas A. Thymoma: a rare cause for an intracardiac tumour. Eur Heart J Cardiovasc Imaging 2023; 24:e96. [PMID: 36864715 DOI: 10.1093/ehjci/jead037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Affiliation(s)
- Arturo M Ruiz-Beltran
- Cardiology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Juan Badiano 1 Colonia Sección XVI, CP 14080 Mexico City, Mexico
| | - Luis A Falcon-Quispe
- Advanced Cardiac Imaging, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico
| | - Jose A Sanchez-Toscano
- Cardiology Department, Instituto Nacional de Cardiologia Ignacio Chavez, Juan Badiano 1 Colonia Sección XVI, CP 14080 Mexico City, Mexico
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Avilés-Salas A, Heredia-Jara AN, Peña-Carvajalino LF, Chanona-Vilchis JG, Arriaga-Marroquín JÁ, Candelaria M. [Primary testicular NK/T cell lymphoma. Case report and review of literature]. Rev Med Chil 2023; 151:381-386. [PMID: 38293884 DOI: 10.4067/s0034-98872023000300381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 05/16/2023] [Indexed: 02/01/2024]
Abstract
Natural killer/T cell lymphomas chiefly involving the midline facial structures including the nasal cavity or nasopharyns are a relatively rare type of non-Hodgkin's lymphoma. Apart from the upper respiratory tract, the disease occasionally presents in certain extranodal sites, such as the central nervous system, skin, gastrointestinal tract, or testes. We report a case of natural killer NK/T cell lymphoma as a testicular tumor in a 36-year-old man with a history of progressive swelling of his right testicle. Histologically, the testicular mass showed a diffuse infiltrate of medium-sized and atypical large lymphoid cells with angiocentric infiltration and areas of coagulative necrosis. Immunohistochemical studies demonstrated tumor cells staining positively with CD3, TIA-1, and Granzyme B. The Epstein-Barr virus genoma was detected by in situ hybridization. There were no abnormal findings in the nasal and nasopharyngeal regions. Classified as stage IEA, the patient received involved-field irradiation to contralateral testis (45 Gy), followed by systemic chemotherapy with a combination regimen ofL-asparaginase, methotrexate and dexamethasone. Relevant literature is reviewed, and the clinicopathologic features, natural history, and treatment options for primary testicular NK/T cell lymphoma are discussed.
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Affiliation(s)
| | | | | | | | | | - Myrna Candelaria
- Departamento de Hematología, Instituto Nacional de Cancerologia, México
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5
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Yu SL, Hsiao YJ, Cooper WA, Choi YL, Avilés-Salas A, Chou TY, Coudry R, Raskin GA, Fox SB, Huang CC, Jeon YK, Ko YH, Ku WH, Kwon GY, Leslie C, Lin MC, Lou PJ, Scapulatempo-Neto C, Mendoza Ramírez S, Savelov N, Shim HS, Lara Torres CO, Cunha IW, Zavalishina L, Chen YM. The Ring Study: an international comparison of PD-L1 diagnostic assays and their interpretation in non-small cell lung cancer, head and neck squamous cell cancer and urothelial cancer. Pathology 2023; 55:19-30. [PMID: 36319485 DOI: 10.1016/j.pathol.2022.07.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 07/11/2022] [Accepted: 07/21/2022] [Indexed: 01/11/2023]
Abstract
PD-L1 immunohistochemistry has been approved as a diagnostic assay for immunotherapy. However, an international comparison across multiple cancers is lacking. This study aimed to assess the performance of PD-L1 diagnostic assays in non-small cell lung cancer (NSCLC), head and neck squamous cell cancer (HNSCC) and urothelial cancer (UC). The excisional specimens of NSCLC, HNSCC and UC were assayed by Ventana SP263 and scored at three sites in each country, including Australia, Brazil, Korea, Mexico, Russia and Taiwan. All slides were rotated to two other sites for interobserver scoring. The same cohort of NSCLC was assessed with Dako 22C3 pharmDx PD-L1 for comparison. The PD-L1 immunopositivity was scored according to the approved PD-L1 scoring algorithms which were the percentage of PD-L1-expressing tumour cell (TC) and tumour proportion score (TPS) by Ventana SP263 and Dako 22C3 staining, respectively. In NSCLC, the comparison demonstrated the comparability of the SP263 and 22C3 assays (cut-off of 1%, κ=0.71; 25%, κ=0.75; 50%, κ=0.81). The interobserver comparisons showed moderate to almost perfect agreement for SP263 in TC staining at 25% cut-off (NSCLC, κ=0.72 to 0.86; HNSCC, κ=0.60 to 0.82; UC, κ=0.68 to 0.91) and at 50% cut-off for NSCLC (κ=0.64 to 0.90). Regarding the immune cell (IC) scoring in UC, there was a lower correlation (concordance correlation coefficient=0.10 to 0.68) and poor to substantial agreements at the 1%, 5%, 10% and 25% cut-offs (κ= -0.04 to 0.76). The interchangeability of SP263 and 22C3 in NSCLC might be acceptable, especially at the 50% cut-off. In HNSCC, the performance of SP263 is comparable across five countries. In UC, there was low concordance of IC staining, which may affect treatment decisions. Overall, the study showed the reliability and reproducibility of SP263 in NSCLC, HNSCC and UC.
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Affiliation(s)
- Sung-Liang Yu
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Yi-Jing Hsiao
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University, Taipei, Taiwan.
| | - Wendy A Cooper
- Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia; School of Medicine, Western Sydney University, Sydney, NSW, Australia.
| | - Yoon-La Choi
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | | | - Teh-Ying Chou
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Renata Coudry
- Department of Pathology, Sirio Libanes Hospital and United Health Group Brazil, Sao Paulo, Brazil.
| | - Grigory A Raskin
- A.M. Granov Russian Scientific Center of Radiological and Surgical Technologies, St Petersburg, Russia.
| | - Stephen B Fox
- Molecular Pathology Laboratory, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Vic, Australia
| | - Chao-Cheng Huang
- Biobank and Tissue Bank and Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea; Cancer Research Institute, Seoul National University, Seoul, South Korea
| | - Young-Hyeh Ko
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Wen-Hui Ku
- Taipei Institute of Pathology, Taipei, Taiwan
| | - Ghee-Young Kwon
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - Mei-Chun Lin
- National Taiwan University Cancer Center, Taipei, Taiwan; Department of Otolaryngology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Pei-Jen Lou
- Department of Otolaryngology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Cristovam Scapulatempo-Neto
- Pathology and Molecular Diagnostics, Diagnósticos da América, DASA, São Paulo, Brazil; Molecular Oncology Research Center, Hospital de Amor de Barretos, Barretos, Brazil
| | | | | | - Hyo-Sup Shim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | - Isabela Werneck Cunha
- Institute of Anatomical Pathology, Rede D'Or São Luiz Hospitals Network, Rio de Janeiro and São Paulo, Brazil; D'Or Institute for Research and Education, Rio de Janeiro and São Paulo, Brazil
| | - Larisa Zavalishina
- Pathology Department of the Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Yan-Ming Chen
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University, Taipei, Taiwan
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Oñate-Ocaña LF, Herrera-Goepfert R, Avilés-Salas A, Cortés CC, González-Trejo S, Carrillo JF, Ruiz-García E, Ochoa-Carrillo FJ, Aiello-Crocifoglio V, García-Cuellar CM. Multivariate Prognostic Models for Patients with Stages I and Ii Colon Carcinoma: a Strobe-Compliant Retrospective Cohort Study. Rev Invest Clin 2023; 75:259-271. [PMID: 37918013 DOI: 10.24875/ric.23000158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/25/2023] [Indexed: 11/04/2023]
Abstract
Background Colorectal cancer is the most frequent gastrointestinal malignancy worldwide. The value of adjuvant treatment is controversial in Stages I and II. Objective The aim of this study was to construct post-operative prognostic models applicable to patients with stages I-II colon carcinoma (CC). Methods This is a retrospective cohort study of patients with Stage I-II CC treated over a 25-year period. Exposure was defined as clinical, histopathological, and immunohistochemical factors (including CDX2 and MUC2 expression). Patients were randomly allocated to either a “modeling set” or a “validation set”. Factors associated with recurrence, disease-free survival (DFS), and overall survival (OS) were defined in the “modeling set”. Their performances were tested in the “validation set”. Results From a total of 556 recruited patients, 339 (61%) were allocated to the “modeling set” and 217 (39%) to the “validation set”. Three models explaining recurrence, DFS, and OS were described. Tumor location in the left colon (Hazards ratio [HR] = 1.57; 95% Confidence interval [CI] 0.99-2.48), lymphocyte (HR = 0.46; 96% CI 0.27-0.88) and monocyte (HR = 0.99; 95% CI 0.99-1) counts, neutrophil/platelet ratio (HR = 1.3; 95% CI 0.74-2.3, and HR = 2.3; 95% CI 1.3-4.1; for second and third category, respectively), albumin/monocyte ratio (HR = 0.43; 95% CI 0.21-0.87), and microscopic residual disease after surgery (HR = 8.7; 95% CI 3.1-24) were independently associated with OS. T classification and expression of CDX2 and/or MUC2 were not independently associated with recurrence or prognosis. Conclusion These models are simple and readily available, and distinguish the risk and prognosis in patients with CC stages I and II; these models require cheaper processes than the use of more sophisticated molecular biology techniques. They may guide either the need for adjuvant therapy versus post-operative surveillance only, as well as aid in the design of clinical trials.
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Affiliation(s)
| | | | | | - Carlo C Cortés
- Microscopy Unit, Dirección de Investigación, Mexico City, Mexico
| | | | | | - Erika Ruiz-García
- Medical Oncology Department, Traslational Medicine Laboratory, Mexico City, Mexico
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7
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Avilés-Salas A, Vélez-Valle A, Bryon-Gallego A, Arrieta O. [Pulmonary lymphoepithelioma-like carcinoma with expression of Epstein-Barr virus and PD-L1]. Medicina (B Aires) 2023; 83:319-323. [PMID: 37094205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
Pulmonary lymphoepithelioma-like carcinoma is a rare type of non-small cell lung cancer, it accounts for approximately 0.7% of all cases. It is usually associated with Epstein-Barr virus infection and is more prevalent in Southeast Asia; however, it is extremely rare in Latin America. We present a 65-year-old man with a primary pulmonary lymphoepithelioma-like carcinoma, who presented with cough, dyspnoea and weight loss. Computer tomographic scan of the thorax showed a nodule localized in the right lung. A transthoracic biopsy of the lung lesion was made and the microscopic observation revealed large polygonal cells that proliferated in a nest pattern with infiltration by lymphocytes and plasma cells around the interstitium. The tumour cells were positive for citokeratin 5/6 and p63, and negative for Napsin A and thyroid transcription factor 1 (TTF-1). PD-L1 expression was positive (approximately 100%) in the immunohistochemical study, and the nuclei of the tumour cells were positive for EBV-encoded small RNA in-situ hybridization (EBER-ISH). The patient underwent six cycles of platinum-based combination (gencitabine/ carboplatin) chemotherapy plus durvalumab. He presented progression of the disease and finally he died 9 months after diagnosis.
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Affiliation(s)
- Alejandro Avilés-Salas
- Departamento de Patología, Instituto Nacional de Cancerología, México. E-mail:
- Facultad de Medicina, Universidad Nacional Autónoma de México, México
| | - Alina Vélez-Valle
- Departamento de Patología, Instituto Nacional de Cancerología, México
| | | | - Oscar Arrieta
- 2Departamento de Oncología Torácica, Instituto Nacional de Cancerología, México
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8
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Avilés-Salas A, Vélez-Valle A, Fernández-Vargas OE, Arrieta O. [Primary mediastinal myelolipoma]. Medicina (B Aires) 2023; 83:455-458. [PMID: 37379542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
Myelolipoma is a benign non-functional tumor. Most of them are asymptomatic and discovered incidentally, either through imaging studies or at autopsy. While it most commonly occurs in the adrenal gland, it has also been reported at extra-adrenal sites. We present the case of a 65-year-old woman with a primary mediastinal myelolipoma. Computer tomographic scan of the thorax showed an ovoid tumor with well-defined borders of 6.5 × 4.2 cm, located in the posterior mediastinum. A transthoracic biopsy of the lesion was made, and the microscopic observation revealed hematopoietic cells and mature adipose tissue. Although computed tomography and magnetic resonance imaging are effective in diagnosing mediastinal myelolipoma, histopathological examination is essential for the definitive diagnosis.
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Affiliation(s)
- Alejandro Avilés-Salas
- Departamento de Patología, Instituto Nacional de Cancerología, México. E-mail:
- Facultad de Medicina, Universidad Nacional Autónoma de México, México
| | - Alina Vélez-Valle
- Departamento de Patología, Instituto Nacional de Cancerología, México
| | | | - Oscar Arrieta
- Departamento de Oncología Torácica, Instituto Nacional de Cancerología, México
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Avilés-Salas A, Díaz-García DA, Lara-Mejía L, Cardona AF, Orozco-Morales M, Catalán R, Hernández-Pedro NY, Rios-Garcia E, Ramos-Ramírez M, Arrieta O. LKB1 Loss Assessed by Immunohistochemistry as a Prognostic Marker to First-Line Therapy in Advanced Non-Small-Cell Lung Cancer. Curr Oncol 2022; 30:333-343. [PMID: 36661676 PMCID: PMC9857995 DOI: 10.3390/curroncol30010027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
(1) Background: Liver kinase B1 (LKB1) is a tumor suppressor gene involved in cell growth and metabolism. However, its alterations are not routinely assessed for guiding therapy in clinical practice. We assessed LKB1 expression by immunohistochemistry as a potential biomarker. (2) Methods: This bicentric retrospective cohort study analyzed data from patients with advanced NSCLC who initiated platinum-based chemotherapy or epidermal growth factor receptor- tyrosine kinase inhibitor (EGFR-TKI) between January 2016 and December 2020. Kaplan-Meier and Cox regression models were used for survival curves and multivariate analysis. (3) Results: 110 patients were evaluated, and the clinical stage IV predominated the lung adenocarcinoma histology. LKB1 loss was observed in 66.3% of cases. LKB1 loss was associated with non-smokers, the absence of wood smoke exposure and an EGFR wild-type status. The median progression-free survival (PFS) and overall survival (OS) in the population were 11.1 and 26.8 months, respectively, in the loss group, compared with cases exhibiting a positive expression. After an adjustment by age, smoking status, Eastern Cooperative Oncology Group Performance Score (ECOG-PS), EGFR status and type of administered therapy, LKB1 loss was significantly associated with worse PFS and OS. (4) Conclusion: Patients with an LKB1 loss had worse clinical outcomes. This study warrants prospective assessments to confirm the prognostic role of the LKB1 expression in advanced NSCLC.
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Affiliation(s)
- Alejandro Avilés-Salas
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
| | - Diego A. Díaz-García
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
- Personalized Medicine Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
| | - Luis Lara-Mejía
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
| | - Andrés F. Cardona
- Direction of Research and Education, Luis Carlos Sarmeinto Angulo Cancer Treatment and Research Center—CTIC, Bogotá 110131, Colombia
| | - Mario Orozco-Morales
- Personalized Medicine Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
- Neuroimmunology Laboratory, Instituto Nacional de Neurología y Neurocirugía, Mexico City 14269, Mexico
| | - Rodrigo Catalán
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
- Personalized Medicine Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
| | - Norma Y. Hernández-Pedro
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
- Personalized Medicine Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
| | - Eduardo Rios-Garcia
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
- Personalized Medicine Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
| | - Maritza Ramos-Ramírez
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
- Personalized Medicine Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
- Personalized Medicine Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
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Garcilazo-Reyes Y, Zapata-Canto N, Cacho-Díaz B, Navarro-Fernández O, Espinoza-Zamora R, Bonilla-Navarrete A, Avilés-Salas A. P11.71.B Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) in a patient with blastic plasmacytoid dendritic cell neoplasm: a rare neurologic manifestation in a rare disease. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare aggressive myeloid hematological malignancy. Skin lesions, bone marrow, lymph nodes or visceral organs can be involved. 30% of patients will have infiltration to the nervous system,occult asymptomatic infiltration is frequent. Immunophenotype express CD4, CD56, and CD123, and flow cytometry is essential.
Material and Methods
70-yo Hispanic male with a 1-month history of multiple violaceous cutaneous nodules and adenopathies.Neurological complaints included diplopia, hypoesthesia in the left face, dysphagia, gait difficulties, and generalized weakness with distal hypoesthesia. Examination revealed multiple cranial neuropathy (bilateral VI and VII nerve palsies, left V3 and VIII palsies and IX, X involvement), global areflexia, length-dependent weakness, ataxic gait and cerebellar syndrome. An inguinal ganglionar biopsy retrieved cells positive for CD4, TCL1, CD68 and CD123, whereas CD3, CD20, CD7, CD8, CD30 and myeloperoxidase were negative. PET/CT showed multiple supra and infradiaphragmatic adenopathies, bilateral pleural, pericardial and abdominal implants. Bone marrow biopsy was negative. Brain MRI showed contrast enhancement in the cerebellar folia and in the roots of the cranial nerves clinically involved. Multiple CSFs demonstrated high protein count (281- 310mg/dl), normal glucose and cell count; CSF flow cytometry and cytology reported no blastic infiltration (negative CD4, CD56 and CD123), CSF onconeuronal antibodies were negative. Nerve conduction studies fulfilled definite electrodiagnostic EFNS criteria for CIDP. Sural nerve biopsy reported inflammatory demyelination without infiltration. Systemic chemotherapy (Cyclophosphamide/Vincristine) with intrathecal cytarbine/methotrexate was administered.
Results
Favorable initial, but brief response was noticed for the cranial nerves and gait. He had neurological relapse with gait impossibility. Neuraxis MRI showed no contrast enhancement in the brain but new contrast enhancement of lumbosacral roots. Nerve conduction studies reported severe worsening criteria of CIDP. The PET/CT demonstrated complete response. Five days of methylprednisolone (1gr IV) followed by oral prednisone were prescribed (50 mg qd). However, two weeks later he suffered clinical neurological worsening with respiratory failure. IVIg was started (.4g/kg/day for 5 days) with no improvement; palliative care decision was consented.
Conclusion
We report the case of an adult male with multiple cranial nerve palsy, cerebellar syndrome and refractory rapidly progressive asymmetric polyneuropathy with BPDCN. CIDP in the absence of multiple attempts to demonstrate nervous system infiltration led us to consider this as a paraneoplastic phenomenon refractory to treatment. To our knowledge no CIDP has been reported in this rare disease
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Affiliation(s)
- Y Garcilazo-Reyes
- Neuro-oncology department, National Cancer Institute , Mexico City , Mexico
| | - N Zapata-Canto
- Hemato-oncology service, National Cancer Institute , Mexico City , Mexico
| | - B Cacho-Díaz
- Neuro-oncology department, National Cancer Institute , Mexico City , Mexico
| | | | - R Espinoza-Zamora
- Hemato-oncology service, National Cancer Institute , Mexico City , Mexico
| | | | - A Avilés-Salas
- Pathology service, National Cancer Institute , Mexico City , Mexico
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11
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Carrillo JF, Cruz-Romero C, Avilés-Salas A, Carrillo LC, Ramírez-Ortega MC, Herrera-Goepfert R, Vázquez-Romo R, Figueroa-González G, Altamirano-García JI, Oñate-Ocaña LF. ASO Visual Abstract: The Intensity of LKB-1 Expression, High-Risk Histopathology and TNM Stages are Independent Prognostic Factors in Oral Cavity Carcinoma. Ann Surg Oncol 2022. [PMID: 35378635 DOI: 10.1245/s10434-022-11655-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- José F Carrillo
- Departamento de Cabeza y Cuello, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Christian Cruz-Romero
- Departamento de Cabeza y Cuello, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Alejandro Avilés-Salas
- Departamento de Patología, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Liliana C Carrillo
- Subdirección de Investigación Clínica, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Margarita C Ramírez-Ortega
- Subdirección de Investigación Básica, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | | | - Rafael Vázquez-Romo
- Departamento de Cabeza y Cuello, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Gabriela Figueroa-González
- Unidad de Investigación Multidisciplinaria (UMIEZ), Facultad de Estudios Superiores Zaragoza, UNAM, Mexico City, Mexico
| | | | - Luis F Oñate-Ocaña
- Subdirección de Investigación Clínica, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
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12
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Carrillo JF, Cruz-Romero C, Avilés-Salas A, Carrillo LC, Ramírez-Ortega MC, Herrera-Goepfert R, Vázquez-Romo R, Figueroa-González G, Altamirano-García JI, Oñate-Ocaña LF. LKB-1 Expression and High-Risk Histopathology are Independent Prognostic Factors for Patients with Oral Cavity Carcinoma. Ann Surg Oncol 2022; 29:10.1245/s10434-022-11544-x. [PMID: 35320428 DOI: 10.1245/s10434-022-11544-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/14/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND The expression of liver kinase B1 (LKB-1) has been associated with prognosis in squamous cell carcinoma of the oral cavity (SCCOC). This study aimed to define the prognostic role of LKB-1 expression for patients with SCCOC and the suitability of its integration into a multivariate prognostic model. METHODS A retrospective cohort study of patients with SCCOC was conducted in a cancer center. Expression of LKB-1 was evaluated by immunohistochemistry, and multivariate analysis defined prognostic factors associated with recurrence, recurrence-free survival (RFS), and overall survival (OS). The logistic regression model was used to construct a predictive computer software program. RESULTS Of the 201 patients in this study, 104 (51.7%) experienced recurrence of their disease. Lower expression of LKB-1, high-risk histopathology, and advanced tumor-node-metastasis (TNM) stages were independent factors via multivariate analysis associated with the increased recurrence risk, poor RFS, and poor OS. If lack of LKB-1 expression is considered the reference category, the factors independently associated with recurrence were low (odds ratio [OR], 0.157; 95% confidence interval [CI], 0.044-0.557), intermediate (OR, 0.073; 95% CI, 0.017-0.319), and intense (OR, 0.047; 95% CI, 0.007-0.304) expression of LKB-1. This model permitted construction of a computer software program capable of prediction with receiver operating characteristic analysis (area under the curve, 0.925) and led to the definition of five prognostic groups with a biologic gradient. CONCLUSION These results suggest that LKB-1 expression in patients with SCCOC is of robust prognostic value and complements the TNM staging system. The proposed model requires external validation in prospective observational studies.
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Affiliation(s)
- José F Carrillo
- Departamento de Cabeza y Cuello, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Christian Cruz-Romero
- Departamento de Cabeza y Cuello, Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | - Liliana C Carrillo
- Subdirección de Investigación Clínica, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Margarita C Ramírez-Ortega
- Subdirección de Investigación Básica, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | | | - Rafael Vázquez-Romo
- Departamento de Cabeza y Cuello, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Gabriela Figueroa-González
- Unidad de Investigación Multidisciplinaria (UMIEZ), Facultad de Estudios Superiores Zaragoza, UNAM, Mexico City, Mexico
| | | | - Luis F Oñate-Ocaña
- Subdirección de Investigación Clínica, Instituto Nacional de Cancerología, Mexico City, Mexico.
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13
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Carrillo JF, Avilés-Salas A, Herrera-Goepfert R, Figueroa-González G, Oñate-Ocaña LF. ASO Author Reflections: The Pursuit of Prognostic Factors to Fine-Tune Treatment Decisions in Patients with Oral Cavity Carcinoma. Ann Surg Oncol 2022; 29:10.1245/s10434-022-11598-x. [PMID: 35318518 DOI: 10.1245/s10434-022-11598-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/18/2022]
Affiliation(s)
- José F Carrillo
- Departmento de Cabeza y Cuello, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Alejandro Avilés-Salas
- Departmento de Patología, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | | | - Gabriela Figueroa-González
- Facultad de Estudios Superiores Zaragoza, Unidad de Investigación Multidisciplinaria (UMIEZ), UNAM, Mexico City, Mexico
| | - Luis F Oñate-Ocaña
- Subdirección de Investigación Clínica, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
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14
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Arrieta O, Molina-Romero C, Cornejo-Granados F, Marquina-Castillo B, Avilés-Salas A, López-Leal G, Cardona AF, Ortega-Gómez A, Orozco-Morales M, Ochoa-Leyva A, Hernandez-Pando R. Clinical and pathological characteristics associated with the presence of the IS6110 Mycobacterim tuberculosis transposon in neoplastic cells from non-small cell lung cancer patients. Sci Rep 2022; 12:2210. [PMID: 35140255 PMCID: PMC8828834 DOI: 10.1038/s41598-022-05749-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 01/17/2022] [Indexed: 12/27/2022] Open
Abstract
Lung cancer (LC) and pulmonary tuberculosis (TB) are the deadliest neoplastic and bacterial infectious diseases worldwide, respectively. Clinicians and pathologists have long discussed the co-existence of LC and TB, and several epidemiologic studies have presented evidence indicating that TB could be associated with the development of LC, particularly adenocarcinoma. Nonetheless, this data remains controversial, and the mechanism which could underlie the association remains largely unexplored. Some bioinformatic studies have shown that human cancer biopsies have a very high frequency of bacterial DNA integration; since Mycobacterium Tuberculosis (MTb) is an intracellular pathogen, it could play an active role in the cellular transformation. Our group performed an exploratory study in a cohort of 88 LC patients treated at the Instituto Nacional de Cancelorogía (INCan) of Mexico City to evaluate the presence of MTb DNA in LC tissue specimens. For the first time, our results show the presence of the MTb IS6110 transposon in 40.9% (n = 36/88) of patients with lung adenocarcinomas. Additionally, through in-situ PCR we identified the presence of IS6110 in the nuclei of tumor cells. Furthermore, shotgun sequencing from two samples identified traces of MTb genomes present in tumor tissue, suggesting that similar Mtb strains could be infecting both patients.
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Affiliation(s)
- Oscar Arrieta
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), San Fernando #22, Section XVI, Tlalpan, 14080, Mexico City, Mexico.
| | - Camilo Molina-Romero
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), San Fernando #22, Section XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Fernanda Cornejo-Granados
- Departamento de Microbiología Molecular, Instituto de Biotecnología, Universidad Nacional Autonoma de México, Cuernavaca, Morelos, Mexico
| | - Brenda Marquina-Castillo
- Experimental Pathology Laboratory, Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Gamaliel López-Leal
- Departamento de Microbiología Molecular, Instituto de Biotecnología, Universidad Nacional Autonoma de México, Cuernavaca, Morelos, Mexico
| | - Andrés F Cardona
- Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G/ONCOLGroup), Universidad El Bosque, Bogotá, Colombia
| | - Alette Ortega-Gómez
- Translational Medicine Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Mario Orozco-Morales
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), San Fernando #22, Section XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Adrián Ochoa-Leyva
- Departamento de Microbiología Molecular, Instituto de Biotecnología, Universidad Nacional Autonoma de México, Cuernavaca, Morelos, Mexico
| | - Rogelio Hernandez-Pando
- Experimental Pathology Laboratory, Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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15
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Dalurzo ML, Avilés-Salas A, Soares FA, Hou Y, Li Y, Stroganova A, Öz B, Abdillah A, Wan H, Choi YL. Testing for EGFR Mutations and ALK Rearrangements in Advanced Non-Small-Cell Lung Cancer: Considerations for Countries in Emerging Markets. Onco Targets Ther 2021; 14:4671-4692. [PMID: 34511936 PMCID: PMC8420791 DOI: 10.2147/ott.s313669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/08/2021] [Indexed: 12/24/2022] Open
Abstract
The treatment of patients with advanced non-small-cell lung cancer (NSCLC) in recent years has been increasingly guided by biomarker testing. Testing has centered on driver genetic alterations involving the epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) rearrangements. The presence of these mutations is predictive of response to targeted therapies such as EGFR tyrosine kinase inhibitors (TKIs) and ALK TKIs. However, there are substantial challenges for the implementation of biomarker testing, particularly in emerging countries. Understanding the barriers to testing in NSCLC will be key to improving molecular testing rates worldwide and patient outcomes as a result. In this article, we review EGFR mutations and ALK rearrangements as predictive biomarkers for NSCLC, discuss a selection of appropriate tests and review the literature with respect to the global uptake of EGFR and ALK testing. To help improve testing rates and unify procedures, we review our experiences with biomarker testing in China, South Korea, Russia, Turkey, Brazil, Argentina and Mexico, and propose a set of recommendations that pathologists from emerging countries can apply to assist with the diagnosis of NSCLC.
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Affiliation(s)
- Mercedes L Dalurzo
- Department of Pathology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Yuan Li
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China
| | - Anna Stroganova
- N.N. Blokhin National Medical Research Centre of Oncology, Russian Academy of Medical Sciences, Moscow, Russia
| | - Büge Öz
- Cerrahpaşa School of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Arif Abdillah
- Takeda Pharmaceuticals International AG – Singapore Branch, Singapore, Singapore
| | - Hui Wan
- Takeda Pharmaceuticals International AG – Singapore Branch, Singapore, Singapore
| | - Yoon-La Choi
- Department of Pathology and Translational Genomics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
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16
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Muñoz-Montaño W, Muñiz-Hernández S, Avilés-Salas A, Catalán R, Lara-Mejía L, Samtani-Bassarmal S, Cardona AF, Mendoza-Desión J, Hernández-Cueto D, Maldonado A, Baay-Guzmán G, Huerta-Yepes S, Arrieta O. RRM1 and ERCC1 as biomarkers in patients with locally advanced and metastatic malignant pleural mesothelioma treated with continuous infusion of low-dose gemcitabine plus cisplatin. BMC Cancer 2021; 21:892. [PMID: 34353292 PMCID: PMC8340445 DOI: 10.1186/s12885-021-08287-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/04/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Malignant Pleural Mesothelioma (MPM) is a rare but aggressive neoplasia that usually presents at advanced stages. Even though some advances have been achieved in the management of patients with MPM, this malignancy continuous to impose a deleterious prognosis for affected patients (12-18 months as median survival, and 5-10% 5-year survival rate), accordingly, the recognition of biomarkers that allow us to select the most appropriate therapy are necessary. METHODS Immunohistochemistry semi-quantitative analysis was performed to evaluate four different biomarkers (ERCC1, RRM1, RRM2, and hENT-1) with the intent to explore if any of them was useful to predict response to treatment with continuous infusion gemcitabine plus cisplatin. Tissue biopsies from patients with locally advanced or metastatic MPM were analyzed to quantitatively asses the aforementioned biomarkers. Every included patient received treatment with low-dose gemcitabine (250 mg/m2) in a 6-h continuous infusion plus cisplatin 35 mg/m2 on days 1 and 8 every 3 weeks as first-line therapy. RESULTS From the 70 eligible patients, the mean and standard deviation (SD) for ERCC1, RRM1, RRM2 and hENT-1 were 286,178.3 (± 219, 019.8); 104,647.1 (± 65, 773.4); 4536.5 (± 5, 521.3); and 2458.7 (± 4, 983.4), respectively. Patients with high expression of RRM1 had an increased median PFS compared with those with lower expression (9.5 vs 4.8 months, p = < 0.001). Furthermore, high expression of RRM1 and ERCC1 were associated with an increased median OS compared with their lower expression counterparts; [(23.1 vs 7.2 months for RRM1 p = < 0.001) and (17.4 vs 9.8 months for ERCC1 p = 0.018)]. CONCLUSIONS ERCC1 and RRM1 are useful biomarkers that predict better survival outcomes in patients with advanced MPM treated with continuous infusion of gemcitabine plus cisplatin.
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Affiliation(s)
- Wendy Muñoz-Montaño
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, San Fernando 22 Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Sae Muñiz-Hernández
- Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, San Fernando 22 Sección XVI, Tlalpan, 14080, Mexico City, Mexico.
| | | | - Rodrigo Catalán
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, San Fernando 22 Sección XVI, Tlalpan, 14080, Mexico City, Mexico.,Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, San Fernando 22 Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Luis Lara-Mejía
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, San Fernando 22 Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | | | - Andres F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Jorge Mendoza-Desión
- Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, San Fernando 22 Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Daniel Hernández-Cueto
- Molecular Markers Laboratory, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico City, Mexico
| | - Altagracia Maldonado
- Molecular Markers Laboratory, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico City, Mexico
| | - Guillermina Baay-Guzmán
- Molecular Markers Laboratory, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico City, Mexico
| | - Sara Huerta-Yepes
- Molecular Markers Laboratory, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico City, Mexico
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, San Fernando 22 Sección XVI, Tlalpan, 14080, Mexico City, Mexico. .,Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, San Fernando 22 Sección XVI, Tlalpan, 14080, Mexico City, Mexico.
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17
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Arredondo-Gálvez CG, Acuña-González D, Cantú-de-León D, Chanona-Vilchis JG, Avilés-Salas A, González-Enciso A, Bandala-Jaques A, Barquet-Muñoz SA. Association of p16 and Ki-67 with Risk of Recurrence in Previously Treated Cervical High-Grade Squamous Intraepithelial Lesions. Gynecol Obstet Invest 2021; 86:293-298. [PMID: 34111875 DOI: 10.1159/000515894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 03/14/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Our main objective was to assess the association between the markers p16 and Ki-67 and recurrence of disease in patients previously treated for cervical high-grade squamous intraepithelial lesion (HSIL). DESIGN This is a case-control study at the National Cancer Institute conducted between 2005 and 2015. Of the patients with a pathologically confirmed diagnosis of HSIL, 107 cases were selected. They were divided into 2 groups: 28 cases with recurrence after treatment and a control group of 79 patients without recurrence. We identified clinical, pathological, and treatment variables. METHODS Two experienced pathologists performed immunohistochemical analysis of biomarkers; they agreed on their interpretation, and we calculated the odds ratios (ORs) associated with recurrence. For group comparisons, we used the Wilcoxon signed-rank, χ2, or Fisher's exact test, depending on the type of variable. We conducted logistic regression models to estimate ORs and determine the factors associated with recurrence. The recurrence-free period was defined as the time frame between conization and either recurrence of disease or the last date the patient was seen. We used Kaplan-Meier plots to visualize survival curves and log-rank tests to compare the curves. We established a p value <0.05 as statistically significant. RESULTS After pathologists performed immunohistochemical analysis, they achieved an agreement level of 83.7% for p16 and 60% for Ki-67. We did not find an association between recurrence and either p16 expression (p = 0.69) or the percentage of Ki-67 expression (p = 0.71). The recurrence-free period analysis did not reveal a difference in p16 expression (p = 0.57) nor in the percentage of Ki-67 expression in the 3-tiered scale (p = 0.56). LIMITATIONS Our main limitation was a reduced sample size. CONCLUSION We found no association between p16 and Ki-67 positivity and the risk of recurrence in previously treated HSIL.
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Affiliation(s)
| | | | - David Cantú-de-León
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, Mexico City, Mexico.,Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | | | | | - Antonio Bandala-Jaques
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, Mexico City, Mexico.,Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
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18
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Oñate-Ocaña LF, Ponce-Martínez M, Taja-Chayeb L, Gutiérrez-Hernández O, Avilés-Salas A, Cantú-de-León D, Dueñas-González A, Candelaria-Hernández M. A Cohort Study of the Prognostic Impact of Exon-16 EZH2 Mutations in a Mexican-Mestizo Population of Patients with Diffuse Large B-Cell Lymphoma. Rev Invest Clin 2021; 73:362-370. [PMID: 34044429 DOI: 10.24875/ric.21000070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Novel prognostic factors in patients with diffuse large B-cell lymphoma (DLBCL) are required in the era of Rituximab. OBJECTIVE The objective of the study was to study the prognostic impact of exon-16 enhancer-of-zeste homolog-2 (EZH2) mutations in patients with DLBCL. METHODS In a cohort of patients with DLBCL treated between 2015 and 2017, we analyzed the presence of EZH2 mutations and their association with clinical response (CR), relapse, progression-free survival (PFS), and overall survival (OS). RESULTS A total of 198 patients were included; of them, 30 (15.2%) had mutations at codon 641, in exon 16 of EZH2. Response was achieved in 151 patients (76.3%), and 43 (21.7%) relapsed or progressed during follow-up. EZH2 mutations were associated with relapse/progression (risk ratio [RR] 1.18; 95% confidence interval [CI] 0.98-1.42; p = 0.031), while a trend for not achieving a complete response was observed (RR: 0.876; 95%CI 0.74-1.038; p = 0.071). Of note, Tyr641His and Tyr641Ser EZH2 mutations were associated with shorter PFS (hazard ratio 3.234; 95% CI 1.149-9.1; p = 0.026). CONCLUSION The presence of EZH2 mutations was negatively associated with relapse/progression and showed a trend for lack of complete response. Further studies are needed to define better the prognostic significance of these mutations in Mexican-Mestizo DLBCL patients.
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Affiliation(s)
- Luis F Oñate-Ocaña
- Research Division, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Mayra Ponce-Martínez
- Research Division, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Lucia Taja-Chayeb
- Research Division, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | | | - Alejandro Avilés-Salas
- Department of Pathology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - David Cantú-de-León
- Department of Pathology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Alfonso Dueñas-González
- Department of Pathology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico; Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
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19
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Cruz-Rico G, Avilés-Salas A, Popa-Navarro X, Lara-Mejía L, Catalán R, Sánchez-Reyes R, López-Sánchez D, Cabrera-Miranda L, Aquiles Maldonado-Martínez H, Samtani-Bassarmal S, Arrieta O. Association of Lung Adenocarcinoma Subtypes According to the IASLC/ATS/ERS Classification and Programmed Cell Death Ligand 1 (PD-L1) Expression in Tumor Cells. Pathol Oncol Res 2021; 27:597499. [PMID: 34257548 PMCID: PMC8262243 DOI: 10.3389/pore.2021.597499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 03/02/2021] [Indexed: 11/13/2022]
Abstract
Background: Programmed cell death-ligand 1 (PD-L1) protein expression is one of the most extensively studied biomarkers in patients with non-small cell lung cancer (NSCLC). However, there is scarce information regarding its association with distinct adenocarcinoma subtypes. This study evaluated the frequency of PD-L1 expression according to the IASLC/ATS/ERS classification and other relevant histological and clinical features. Patients and Methods: PD-L1 expression was assessed by immunohistochemistry (IHC). According to its positivity in tumor cells membrane, we stratified patients in three different tumor proportions score (TPS) cut-off points: a) <1% (negative), b) between 1 and 49%, and c) ≥50%; afterward, we analyzed the association among PD-L1 expression and lung adenocarcinoma (LADC) predominant subtypes, as well as other clinical features. As an exploratory outcome we evaluated if a PD-L1 TPS score ≥15% was useful as a biomarker for determining survival. Results: A total of 240 patients were included to our final analysis. Median age at diagnosis was 65 years (range 23-94 years). A PD-L1 TPS ≥1% was observed in 52.5% of the entire cohort; regarding specific predominant histological patterns, a PD-L1 TPS ≥1 was documented in 31.2% of patients with predominant-lepidic pattern, 46.2% of patients with predominant-acinar pattern, 42.8% of patients with a predominant-papillary pattern, and 68.7% of patients with predominant-solid pattern (p = 0.002). On the other hand, proportion of tumors with PD-L1 TPS ≥50% was not significantly different among adenocarcinoma subtypes. At the univariate survival analysis, a PD-L1 TPS cut-off value of ≥15% was associated with a worse PFS and OS. Conclusion: According to IASLC/ATS/ERS lung adenocarcinoma classification, the predominant-solid pattern is associated with a higher proportion of PD-L1 positive samples, no subtype was identified to be associated with a high (≥50%) TPS PD-L1.
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Affiliation(s)
- Graciela Cruz-Rico
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | - Xitlally Popa-Navarro
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico.,Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Luis Lara-Mejía
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Rodrigo Catalán
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico.,Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | | | | | | | | | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico.,Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico
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Ayala-Domínguez L, Pérez-Cárdenas E, Avilés-Salas A, Medina LA, Lizano M, Brandan ME. Quantitative Imaging Parameters of Contrast-Enhanced Micro-Computed Tomography Correlate with Angiogenesis and Necrosis in a Subcutaneous C6 Glioma Model. Cancers (Basel) 2020; 12:E3417. [PMID: 33217988 PMCID: PMC7698719 DOI: 10.3390/cancers12113417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 12/04/2022] Open
Abstract
The aim of this work was to systematically obtain quantitative imaging parameters with static and dynamic contrast-enhanced (CE) X-ray imaging techniques and to evaluate their correlation with histological biomarkers of angiogenesis in a subcutaneous C6 glioma model. Enhancement (E), iodine concentration (CI), and relative blood volume (rBV) were quantified from single- and dual-energy (SE and DE, respectively) micro-computed tomography (micro-CT) images, while rBV and volume transfer constant (Ktrans) were quantified from dynamic contrast-enhanced (DCE) planar images. CI and rBV allowed a better discernment of tumor regions from muscle than E in SE and DE images, while no significant differences were found for rBV and Ktrans in DCE images. An agreement was found in rBV for muscle quantified with the different imaging protocols, and in CI and E quantified with SE and DE protocols. Significant strong correlations (Pearson r > 0.7, p < 0.05) were found between a set of imaging parameters in SE images and histological biomarkers: E and CI in tumor periphery were associated with microvessel density (MVD) and necrosis, E and CI in the complete tumor with MVD, and rBV in the tumor periphery with MVD. In conclusion, quantitative imaging parameters obtained in SE micro-CT images could be used to characterize angiogenesis and necrosis in the subcutaneous C6 glioma model.
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Affiliation(s)
- Lízbeth Ayala-Domínguez
- Programa de Doctorado en Ciencias Biomédicas, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico;
- Unidad de Investigación Biomédica en Cáncer INCan/UNAM, Instituto Nacional de Cancerología, Ciudad de México 14080, Mexico;
| | - Enrique Pérez-Cárdenas
- Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Ciudad de México 14080, Mexico;
| | - Alejandro Avilés-Salas
- Departamento de Patología, Instituto Nacional de Cancerología, Ciudad de México 14080, Mexico;
| | - Luis Alberto Medina
- Unidad de Investigación Biomédica en Cáncer INCan/UNAM, Instituto Nacional de Cancerología, Ciudad de México 14080, Mexico;
- Departamento de Física Experimental, Instituto de Física, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Marcela Lizano
- Unidad de Investigación Biomédica en Cáncer INCan/UNAM, Instituto Nacional de Cancerología, Ciudad de México 14080, Mexico;
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - María-Ester Brandan
- Departamento de Física Experimental, Instituto de Física, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
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21
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Candelaria M, Oñate-Ocaña LF, Corona-Herrera J, Barrera-Carmona C, Ponce-Martínez M, Gutiérrez-Hernández O, Avilés-Salas A, Cacho-Díaz B. CLINICAL CHARACTERISTICS OF PRIMARY EXTRANODAL VERSUS NODAL DIFFUSE LARGE B-CELL LYMPHOMA: A RETROSPECTIVE COHORT STUDY IN A CANCER CENTER. Rev Invest Clin 2020; 71:349-358. [PMID: 31599881 DOI: 10.24875/ric.19003027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background The outcome of patients with primary extranodal diffuse large B-cell lymphoma (PE-DLBCL) varies according to the primary site involved. Primary gastrointestinal, breast, bone, craniofacial, and testicular DLBCL are rare extranodal manifestations of DLBCL. Objective The objective of the study was to describe the clinical course of patients with PE-DLBCL disease in a referral cancer center. Results From 637 patients, 51 (8.77%) were considered as having PE-DLBCL (25 gastrointestinal, 12 craniofacial, 6 breast, 5 bone, and 3 with primary testicular DLBCL). Complete remission was higher in all PE-DLBCL sites (100% in testicular, 92.6% craniofacial, 83.3% breast, 80% bone, and 80% gastrointestinal) compared with 73.3% in nodal DLBCL. Although 2 cases with breast PE-DLBC relapsed, they achieved a complete response with chemotherapy. The overall survival at 5 years was 100%, 80%, 78%, 58%, 58%, and 62% for patients with primary breast, primary bone, gastrointestinal, primary craniofacial, primary testicular, and nodal DLBCL, respectively. Conclusions PE-DLBCLs constitute rare, primary sites of lymphoproliferative disorders in most cases, with localized disease and good prognosis. They require a combined chemoimmunotherapy with radiotherapy in most cases to improve local and systemic disease.
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Affiliation(s)
- Myrna Candelaria
- Clinical Research Division, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Luis F Oñate-Ocaña
- Clinical Research Division, Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | | | - Mayra Ponce-Martínez
- Clinical Research Division, Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | | | - Bernardo Cacho-Díaz
- Department of Neuro-Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico
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Lara-Mejía L, Sánchez-Reyes R, Avilés-Salas A, Arrieta O. A Patient With Newly Diagnosed, Advanced EGFR-Mutated Non-Small Cell Lung Cancer. Oncology (Williston Park) 2020; 34:21-27. [PMID: 32645202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 40-year-old woman presented with a productive cough and shortness of breath that limited her regular activities. Her past medical history was relevant for hypertension since 2016; it is well controlled and treated with enalapril 5 mg twice daily. She also revealed a past wood smoke exposure of 2 hours per day for 10 years during her childhood. A chest computed tomography (CT) scan was performed which showed a 30-mm lung nodule in the lower left lobe and mediastinal and ipsilateral pleural thickening with moderate pleural effusion and several bilateral lung metastases.
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Affiliation(s)
- Luis Lara-Mejía
- Division of Medical Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
| | | | | | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, México
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23
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Arrieta O, Barrón F, Padilla MÁS, Avilés-Salas A, Ramírez-Tirado LA, Arguelles Jiménez MJ, Vergara E, Zatarain-Barrón ZL, Hernández-Pedro N, Cardona AF, Cruz-Rico G, Barrios-Bernal P, Yamamoto Ramos M, Rosell R. Effect of Metformin Plus Tyrosine Kinase Inhibitors Compared With Tyrosine Kinase Inhibitors Alone in Patients With Epidermal Growth Factor Receptor-Mutated Lung Adenocarcinoma: A Phase 2 Randomized Clinical Trial. JAMA Oncol 2019; 5:e192553. [PMID: 31486833 PMCID: PMC6735425 DOI: 10.1001/jamaoncol.2019.2553] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/08/2019] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Metformin hydrochloride is emerging as a repurposed anticancer drug. Preclinical and retrospective studies have shown that it improves outcomes across a wide variety of neoplasms, including lung cancer. Particularly, evidence is accumulating regarding the synergistic association between metformin and epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs). OBJECTIVE To assess the progression-free survival (PFS) in patients with advanced lung adenocarcinoma who received treatment with EGFR-TKIs plus metformin compared with those who received EGFR-TKIs alone. DESIGN, SETTING, AND PARTICIPANTS Open-label, randomized, phase 2 trial conducted at the Instituto Nacional de Cancerología (INCan), Mexico City, Mexico. Eligible patients were 18 years or older, had histologically confirmed stage IIIB-IV lung adenocarcinoma with an activating EGFR mutation. INTERVENTIONS Patients were randomly allocated to receive EGFR-TKIs (erlotinib hydrochloride, afatinib dimaleate, or gefitinib at standard dosage) plus metformin hydrochloride (500 mg twice a day) or EGFR-TKIs alone. Treatment was continued until occurrence of intolerable toxic effects or withdrawal of consent. MAIN OUTCOMES AND MEASURES The primary outcome was PFS in the intent-to-treat population. Secondary outcomes included objective response rate, disease control rate, overall survival (OS), and safety. RESULTS Between March 31, 2016, and December 31, 2017, a total of 139 patients (mean [SD] age, 59.4 [12.0] years; 65.5% female) were randomly assigned to receive EGFR-TKIs (n = 70) or EGFR-TKIs plus metformin (n = 69). The median PFS was significantly longer in the EGFR-TKIs plus metformin group (13.1; 95% CI, 9.8-16.3 months) compared with the EGFR-TKIs group (9.9; 95% CI, 7.5-12.2 months) (hazard ratio, 0.60; 95% CI, 0.40-0.94; P = .03). The median OS was also significantly longer for patients receiving the combination therapy (31.7; 95% CI, 20.5-42.8 vs 17.5; 95% CI, 11.4-23.7 months; P = .02). CONCLUSIONS AND RELEVANCE To our knowledge, this is the first study to prospectively show that the addition of metformin to standard EGFR-TKIs therapy in patients with advanced lung adenocarcinoma significantly improves PFS. These results justify the design of a phase 3, placebo-controlled study. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03071705.
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Affiliation(s)
- Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | | | | | | | | | - Edgar Vergara
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | | | - Norma Hernández-Pedro
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Andrés F. Cardona
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Clinical Research and Biology Systems Department, Universidad el Bosque, Bogotá, Colombia
| | - Graciela Cruz-Rico
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Pedro Barrios-Bernal
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Masao Yamamoto Ramos
- Department of Radiology and Imaging, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Rafael Rosell
- Catalan Institute of Oncology, Germans Trias i Pujol Research Institute and Hospital Campus Can Ruti, Barcelona, Spain
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24
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Hernández-Pedro N, Soca-Chafre G, Alaez-Versón C, Carrillo-Sánchez K, Avilés-Salas A, Vergara E, Arrieta O. Mutational profile by targeted next generation sequencing of non-small cell lung cancer in the Mexican population. Salud Publica Mex 2019; 61:308-317. [PMID: 31276344 DOI: 10.21149/10113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 04/05/2019] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Targeted next-generation sequencing (t-NGS) has revolutionized clinical diagnosis allowing multiplexed detection of genomic alterations. This study evaluated the profile of somatic mutations by t-NGS in Mexican patients with nonsmall cell lung cancer (NSCLC). MATERIALS AND METHODS Genomic DNA was extracted from 90 lung adenocarcinomas and sequences were generated for a panel of 48 cancer genes. Epidermal Growth Factor Receptor (EGFR) mutations were detected in parallel by quantitative PCR. RESULTS The mutational profile of NSCLC revealed alterations in 27 genes, where TP53 (47.8%) and EGFR (36.7%) exhibited the highest mutation rates. EGFR Q787 mutations were present in 14 cases (15.6%), 10 cases had exon 19 deletions (11.1%), seven cases had L858R (7.8%). The mutational frequency for genes like EGFR, MET, HNF1A, HER2 and GUSB was different compared to caucasian population. CONCLUSIONS t-NGS improved NSCLC treatments efficacy due to its sensitivity and specificity. A distinct pattern of somatic mutations was found in Mexican population.
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Affiliation(s)
- Norma Hernández-Pedro
- Laboratorio de Medicina Personalizada, Instituto Nacional de Cancerología. Mexico City, Mexico
| | - Giovanny Soca-Chafre
- Laboratorio de Medicina Personalizada, Instituto Nacional de Cancerología. Mexico City, Mexico
| | - Carmen Alaez-Versón
- Laboratorio de Diagnóstico Genómico, Instituto Nacional de Medicina Genómica. Mexico City, Mexico
| | - Karol Carrillo-Sánchez
- Laboratorio de Diagnóstico Genómico, Instituto Nacional de Medicina Genómica. Mexico City, Mexico
| | | | - Edgar Vergara
- Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología. Mexico City, Mexico
| | - Oscar Arrieta
- Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología. Mexico City, Mexico
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25
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Arrieta O, Cardona A, Bramuglia G, Cruz-Rico G, Corrales L, Martín C, Imaz-Olguín V, Castillo O, Cuello M, Rojas-Bilbao É, Casas G, Fernández C, Arén Frontera O, Denninghoff V, Recondo G, Avilés-Salas A, Mas-Lopez LA, Oblitas G, Rojas L, Piottante A, Jiménez-García E, Sánchez-Sosa S, Sáenz-Frias J, Lupera H, Ramírez-Tirado L, Vargas C, Carranza H, Astudillo H, Wills L, Pichelbaur E, Raez L. Molecular Epidemiology of ALK Rearrangements in Advanced Lung Adenocarcinoma in Latin America. Oncology 2018; 96:207-216. [DOI: 10.1159/000493733] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 09/12/2018] [Indexed: 11/19/2022]
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26
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Cruz-Rico G, Popa Navarro X, Avilés-Salas A, Flores-Vélez K, Cardona A, Ramírez-Tirado L, Vergara E, Barron F, Cabrera-Miranda L, Arrieta O. P2.04-01 Associations Histological Subtype of Lung Adenocarcinoma and Programmed Death Ligand 1 (PD-L1) Expression in Tumor Cells. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Arrieta O, Cruz-Rico G, Avilés-Salas A, Popa-Navarro X, Flores-Vélez K, Ramírez-Tirado L, Vergara E, Barrón F, Cabrera-Miranda L. P03 Histological Subtype of Lung Adenocarcinoma and Programmed Death Ligand 1 (PD-L1) Expression in Tumor Cells. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.07.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Avilés-Salas A, Candelaria M, Ponce M, Cañavera-Constantino A, Burgos S. [Blastic plasmacytoid dendritic cell neoplasm. Report of three cases]. Rev Med Chil 2018; 145:1208-1212. [PMID: 29424411 DOI: 10.4067/s0034-98872017000901208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 09/28/2017] [Indexed: 11/17/2022]
Abstract
Blastic plasmacytoid dendritic cell neoplasm is a rare hematological malignancy derived from immature plasmacytoid dendritic cells. The tumor cells have an immature blastic appearance, and diagnosis is based on the expression of CD4, CD56 y CD123 in the absence of other lymphoid, natural killer, or myeloid antigens. The majority of affected individuals are older people with a mean age of 66 years. Male to female ratio is approximately 3:1. Common presentation includes cutaneous lesions followed by tumor dissemination. Treatment with conventional chemotherapy is ineffective and allogeneic hematopoietic stem cell transplantation is required to achieve remission. We report three male patients, aged 23, 27 and 51 years with the disease. All had multiple, infiltrated pink plaques and nodules on the skin of their face, neck and thorax, measuring 1 to 12 cm in diameter. All tumors were histologically characterized by a monotonous proliferation of medium size cells with blastic features. Tumor cells were positive for CD123, CD56, CD4 and CD7 in all cases. After a mean of follow-up of 14.6 months, one patient died of the disease, one patient is alive and the disease relapsed after 17 months of remission and one patient is alive with no evidence of the disease.
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Affiliation(s)
| | - Myrna Candelaria
- Departamento de Hematología, Instituto Nacional de Cancerología, México
| | - Mayra Ponce
- Departamento de Hematología, Instituto Nacional de Cancerología, México
| | | | - Sebastián Burgos
- Departamento de Hematología, Instituto Nacional de Cancerología, México
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Avilés-Salas A, Candelaria M, Sevilla-Lizcano DB, Burgos S. Linfoma de células grandes B originado en enfermedad de Castleman. Reporte de un caso y revisión de la literatura. Rev Med Chil 2017; 145:945-949. [DOI: 10.4067/s0034-98872017000700945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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30
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Avilés-Salas A, Muñiz-Hernández S, Maldonado-Martínez HA, Chanona-Vilchis JG, Ramírez-Tirado LA, HernáNdez-Pedro N, Dorantes-Heredia R, RuíZ-Morales JM, Motola-Kuba D, Arrieta O. Reproducibility of the EGFR immunohistochemistry scores for tumor samples from patients with advanced non-small cell lung cancer. Oncol Lett 2016; 13:912-920. [PMID: 28356978 DOI: 10.3892/ol.2016.5512] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 08/09/2016] [Indexed: 12/25/2022] Open
Abstract
Epidermal growth factor receptor (EGFR) is overexpressed in >60% of non-small cell lung cancer (NSCLC) cases. In combination with radiotherapy or chemotherapy, first-line treatments with antibodies against EGFR, including cetuximab and necitumumab, have demonstrated benefits by increasing overall survival (OS), particularly in patients who overexpress EGFR. The present study evaluated the interobserver agreement among three senior pathologists, who were blinded to the clinical outcomes and assessed tumor samples from 85 patients with NSCLC using the H-score method. EGFR immunohistochemistry was performed using a qualitative immunohistochemical kit. The reported (mean ± standard deviation) H-scores from each pathologist were 111±102, 127±103 and 128.53±104.03. The patients with average H-scores ≥1, ≥100, ≥200 and between 250-300 were 85.9, 54.1, 28.2 and 12.9, respectively. Patients who had an average H-score >100 had a shorter OS time compared with those with lower scores. Furthermore, patients with EGFR mutations who were treated with EGFR-tyrosine kinase inhibitors (TKIs) and had an average H-score >100 had a longer OS time compared with those with an average H-score <100. The interobserver concordance for the total H-scores were 0.982, 0.980 and 0.988, and for a positive H-score ≥200, the interobserver concordance was 0.773, 0.710 and 0.675, respectively. The determination of EGFR expression by the H-score method is highly reproducible among pathologists and is a prognostic factor associated with a poor OS in all patients. Additionally, the results of the present study suggest that patients with EGFR mutations that are treated with EGFR-TKIs and present with a high H-score have a longer OS time.
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Affiliation(s)
- Alejandro Avilés-Salas
- Department of Pathology, National Cancer Institute of Mexico (INCan), 14080 Mexico City, Mexico
| | - Saé Muñiz-Hernández
- Experimental Oncology Laboratory, National Cancer Institute of Mexico (INCan), 14080 Mexico City, Mexico
| | | | - José G Chanona-Vilchis
- Department of Pathology, National Cancer Institute of Mexico (INCan), 14080 Mexico City, Mexico
| | | | - Norma HernáNdez-Pedro
- Experimental Oncology Laboratory, National Cancer Institute of Mexico (INCan), 14080 Mexico City, Mexico
| | - Rita Dorantes-Heredia
- Department of Pathology, Medica Sur Clinic and Foundation, 14050 Mexico City, Mexico
| | | | - Daniel Motola-Kuba
- Oncology Center, Medica Sur Clinic and Foundation, 14050 Mexico City, Mexico
| | - Oscar Arrieta
- Experimental Oncology Laboratory, National Cancer Institute of Mexico (INCan), 14080 Mexico City, Mexico; Thoracic Oncology Unit, National Cancer Institute of Mexico (INCan), 14080 Mexico City, Mexico
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31
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Ortega-Gómez A, Rangel-Escareño C, Molina-Romero C, Macedo-Pérez EO, Avilés-Salas A, Lara-García A, Alanis-Funes G, Rodríguez-Bautista R, Hidalgo-Miranda A, Arrieta O. Gene-expression profiles in lung adenocarcinomas related to chronic wood smoke or tobacco exposure. Respir Res 2016; 17:42. [PMID: 27098372 PMCID: PMC4839084 DOI: 10.1186/s12931-016-0346-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/10/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Tobacco-smoke is the major etiological factor related to lung cancer. However, other important factor is chronic wood smoke exposure (WSE). Approximately 30 % of lung cancer patients in Mexico have a history of WSE, and present different clinical, pathological and molecular characteristics compared to tobacco related lung cancer, including differences in mutational profiles. There are several molecular alterations identified in WSE associated lung cancer, however most studies have focused on the analysis of changes in several pathogenesis related proteins. METHODS Our group evaluated gene expression profiles of primary lung adenocarcinoma, from patients with history of WSE or tobacco exposure. Differential expression between these two groups were studied through gene expression microarrays. RESULTS Results of the gene expression profiling revealed 57 statistically significant genes (p < 0.01). The associated biological functional pathways included: lipid metabolism, biochemistry of small molecules, molecular transport, cell morphology, function and maintenance. A highlight of our analysis is that three of the main functional networks represent 37 differentially expressed genes out of the 57 found. These hubs are related with ubiquitin C, GABA(A) receptor-associated like protein; and the PI3K/AKT and MEK/ERK signaling pathways. CONCLUSION Our results reflect the intrinsic biology that sustains the development of adenocarcinoma related to WSE and show that there is a different gene expression profile of WSE associated lung adenocarcinoma compared to tobacco exposure, suggesting that they arise through different carcinogenic mechanisms, which may explain the clinical and mutation profile divergences between both lung adenocarcinomas.
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Affiliation(s)
- Alette Ortega-Gómez
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.,Translational Medicine Laboratory, INCan, Mexico City, Mexico
| | - Claudia Rangel-Escareño
- Computational Genomics Department, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico.
| | - Camilo Molina-Romero
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | | | | | | | - Gerardo Alanis-Funes
- Computational Genomics Department, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | | | | | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico. .,Postgraduate Unit, Faculty of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.
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Vega GG, Avilés-Salas A, Chalapud JR, Martinez-Paniagua M, Pelayo R, Mayani H, Hernandez-Pando R, Martinez-Maza O, Huerta-Yepez S, Bonavida B, Vega MI. P38 MAPK expression and activation predicts failure of response to CHOP in patients with Diffuse Large B-Cell Lymphoma. BMC Cancer 2015; 15:722. [PMID: 26475474 PMCID: PMC4609122 DOI: 10.1186/s12885-015-1778-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 10/12/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The p38 MAPK is constitutively activated in B-NHL cell lines and regulates chemoresistance. Accordingly, we hypothesized that activated p38 MAPK may be associated with the in vivo unresponsiveness to chemotherapy in B-NHL patients. METHODS Tissue microarrays generated from eighty untreated patients with Diffused Large B Cell Lymphoma (DLBCL) were examined by immunohistochemistry for the expression of p38 and phospho p38 (p-p38) MAPK. In addition, both Bcl-2 and NF-κB expressions were determined. Kaplan Meier analysis was assessed. RESULTS Tumor tissues expressed p38 MAPK (82 %) and p-p38 MAPK (30 %). Both p38 and p-p38 MAPK expressions correlated with the high score performance status. A significant correlation was found between the expression p-p38 and poor response to CHOP. The five year median follow-up FFS was 81 % for p38(-) and 34 % for p38(+) and for OS was 83 % for p38(-) and 47 % for p38(+). The p-p38(+) tissues expressed Bcl-2 and 90 % of p-p38(-) where Bcl-2(-). The coexpression of p-p38 and Bcl-2 correlated with pool EFS and OS. There was no correlation between the expression of p-p38 and the expression of NF-κB. CONCLUSION The findings revealed, for the first time, that a subset of patients with DLBCL and whose tumors expressed high p-p38 MAPK responded poorly to CHOP therapy and had poor EFS and OS. The expression of p38, p-p38, Bcl2 and the ABC subtype are significant risk factors both p38 and p-p38 expressions remain independent prognostic factors.
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Affiliation(s)
- Gabriel G Vega
- Oncology Research Unit, Oncology Hospital, Siglo XXI National Medical Center, IMSS, Mexico City, Mexico.
- Facultad de Medicina Programa de Posgrado, Doctorado en Ciencias Biomédicas UNAM, México City, DF, Mexico.
| | - Alejandro Avilés-Salas
- Departamento de Patología, Instituto Nacional de Cancerología, SSA, México City, México.
| | - J Ramón Chalapud
- Servicio de Hematología, Instituto Nacional de Cancerología, SSA, México City, México.
| | - Melisa Martinez-Paniagua
- Unidad de Investigación Médica en Inmunología e Infectología, CMN La Raza, IMSS, México City, México.
| | - Rosana Pelayo
- Oncology Research Unit, Oncology Hospital, Siglo XXI National Medical Center, IMSS, Mexico City, Mexico.
| | - Héctor Mayani
- Oncology Research Unit, Oncology Hospital, Siglo XXI National Medical Center, IMSS, Mexico City, Mexico.
| | - Rogelio Hernandez-Pando
- Departamento de Patología Experimental, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubiran, SSA, México City, México.
| | - Otoniel Martinez-Maza
- Department of Microbiology, Immunology and Molecular Genetics, David Geffen School of Medicine UCLA, Los Angeles, CA, USA.
| | - Sara Huerta-Yepez
- Unidad de Investigación en Enfermedades Oncológicas, Hospital Infantil de México, Federico Gómez, SSA, México City, México.
| | - Benjamin Bonavida
- Department of Microbiology, Immunology and Molecular Genetics, David Geffen School of Medicine UCLA, Los Angeles, CA, USA.
| | - Mario I Vega
- Oncology Research Unit, Oncology Hospital, Siglo XXI National Medical Center, IMSS, Mexico City, Mexico.
- Department of Microbiology, Immunology and Molecular Genetics, David Geffen School of Medicine UCLA, Los Angeles, CA, USA.
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Candelaria M, Labardini-Mendez J, Ramírez-Ibarguen AF, Avilés-Salas A, Estrada-Lobato E, Meneses-García A, Mohar A. Impact of a federal program on response rate & survival, in a cohort of patients with diffuse large B-cell lymphoma. Analysis in a single national reference institution in México. Rev Invest Clin 2014; 66:399-406. [PMID: 25695382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 06/27/2014] [Indexed: 06/04/2023]
Abstract
The actual standard of care of diffuse large B-cell lymphoma (DLBCL) includes rituximab in combination with chemotherapy, with response rates up to 76%. However, this treatment may not be accessible to many patients, particularly in developing countries, where most of the treatment must be paid from the pocket of patients or their families. In México, since 2011 a federal program has fully covered this treatment of patients with DLBCL. At the Instituto Nacional de Cancerología (INCan) in Mexico City, 214 new cases with this disease were treated without cost with the standard of care in 20 months. The mean age at diagnosis was 56.7 ± 15.9 (22-91). This series of cases was compared with a retrospective analysis of cases with DLBCL attended at the INCan between 2006-2009. A total of 264 cases were retrospectively analyzed. No differences were found in demographic and clinical characteristics at time of diagnosis. However a clear positive impact was found in the group that received full treatment thanks to this new social coverage by this new social security program. The follow-up and completion of treatment was 99 %. In contrast; from 264 in the retrospective group (79%) were treated, but only 29 (10.9%) were able to receive an optimal treatment, including rituximab. These differences in treatments had a clearly impact on the response rate: 66.8 vs. 50.7% global response (full treatment vs. retrospective group, respectively). These results demonstrate the importance of social programs that may accessible standard treatment options in countries with limited resources.
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Avilés-Salas A, Cruz Torres-Lucatero J, Fernandez-Soto X, Candelaria-Hernández M. [Spindle and epithelioid hemangio-endothelioma of the lymph node. Report of one case]. Rev Med Chil 2013; 141:260-3. [PMID: 23732501 DOI: 10.4067/s0034-98872013000200017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 10/10/2012] [Indexed: 11/17/2022]
Abstract
Primary vascular tumors of lymph nodes are extremely rare with the exception of AlDS-related Kaposi's sarcoma. The diagnosis of epithelioid hemangio-endothelioma (EH) is difficult to make without ancillary studies, since it is devoid of morphological features indicating its vascular nature and it may be overlooked when it appears as a primary tumor of lymph nodes. Spindle and epithelioid hemangio-endothelioma (SEH) is considered to be a variant of EH, which has been reported to occur exclusively in lymph nodes and the spleen. We report a 70-year-old male with chronic lymphocytic leukemia (CLL) and left cervical lymphadenopathy. An excisional biopsy was performed, and microscopically the lymph node showed effacement of nodal architecture by a tumor composed of spindle cells disposed in intersecting fascicles, and characterized by abundant eosinophilic cytoplasm, elongated nuclei and conspicuous nucleoli. A second population of cells had an epithelioid appearance with intracyto-plasmic vacuoles containing red blood cells. lmmunohistochemically, the tumor cells were positive for CD31 and CD34. The final diagnosis was SEH of the lymph node.
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Candelaria M, Cervera-Ceballos E, Meneses-García A, Avilés-Salas A, Lome-Maldonado C, Zárate-Osorno A, Ortiz-Hidalgo C, Rodríguez-Moguel L, Quiñónez-Urrego EE, Ramos-Salazar P, Romero-Guadarrama MB, Lara-Torres C, Ramírez-Aceves R, López-Navarro O, Rivas-Vera S, Díaz-Meneses IE, Estrada-Lobato E, Cervera-Ceballos J, Rojas-Marín CE, Hernández-Rodriguez JM, Pérez-López B, Gómez-Almaguer D, Altamirano-Ley J, Baz P, Valero-Saldaña LM, Navarrete-Herrera JR, Torres-Salgado FG, Solano-Murillo P, Nambo-Lucio MDJ, Rivas-Llamas R, Aquino-Salgado JL, Avila-Arreguín EV, Cortês-Esteban P, Chongo-Alfaro ML, Pérez-Ramírez ODJ, Toledano-Cuevas DV, Lobato-Mendizábal E, Martínez-Ramírez MA, Morales-Maravilla A, Sosa-Camas RE, Agreda-Vásquez GP, Camacho-Hernández A, Aguayo-González A, Espinoza-Zamora JR, Sánchez-Guerrero SA, Lozano-Zavaleta V, Selva-Pallares JE, Hernádez-Rodríguez JM, Cardiel-Silva M, Castillo-Rivera MH, Villela L, Loarca-Piña LM, Zurita-Martínez H, Graham-Casassus J, Azaola-Espinosa P, Silva-López S, Armenta-San Sebastián JA, Mijangos-Huesca F, Pérez-Osorio JE, Aldaco-Sarvide F, Castellanos G, Ramírez-Ibarguen AF, Zapata-Canto N, Labardini-Méndez JR. [National guidelines of diagnosis and treatment of the non-Hodgkin lymphoma]. Rev Invest Clin 2013; 65 Suppl 2:s5-s27. [PMID: 24459777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Non-Hodgkin lymphoma comprises a heterogeneous group of haematological malignancies, classified according to their clinic, anatomic-pathological features and, lately, to their molecular biomarkers. Despite the therapeutic advances, nearly half of the patients will die because of this disease. The new diagnostic tools have been the cornerstone to design recent therapy targets, which must be included in the current treatment guidelines of this sort of neoplasms by means of clinical trials and evidence-based medicine. In the face of poor diagnoses devices in most of the Mexican hospitals, we recommend the present diagnose stratification, and treatment guidelines for non-Hodgkin lymphoma, based on evidence. They include the latest and most innovative therapeutic approaches, as well as specific recommendations for hospitals with limited framework and therapy resources.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ramón Rivas-Llamas
- Departamento de Hematologia, Banco de Sangre y Unidad de Aféresis Hospital General de Culiacán SSA, Culiacin, Sinaloa
| | - Jorge Luis Aquino-Salgado
- Departamento de Hematologia, Banco de Sangre y Unidad de Aféresis Hospital General de Culiacán SSA, Culiacin, Sinaloa
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Mariela Cardiel-Silva
- Centenario Hospital Miguel Hidalgo, ISSSTE Hospital General Núm. 26 RAC, Aguascalientes
| | | | - Luis Villela
- Centro Médico Zambrano Hellion de Tec Salud, Teciológico de Monterrey, Monterrey, NL
| | | | | | | | | | | | | | | | | | - Fernando Aldaco-Sarvide
- Servicio de Oncología Médica del Centro Médico Nacional 20 de Noviembre, ISSSTE, México, D.F
| | - Guillermo Castellanos
- Anatomía Patológica-Citopatología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS
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Arrieta O, Guzmán-de Alba E, Alba-López LF, Acosta-Espinoza A, Alatorre-Alexander J, Alexander-Meza JF, Allende-Pérez SR, Alvarado-Aguilar S, Araujo-Navarrete ME, Argote-Greene LM, Aquino-Mendoza CA, Astorga-Ramos AM, Austudillo-de la Vega H, Avilés-Salas A, Barajas-Figueroa LJ, Barroso-Quiroga N, Blake-Cerda M, Cabrera-Galeana PA, Calderillo-Ruíz G, Campos-Parra AD, Cano-Valdez AM, Capdeville-García D, Castillo-Ortega G, Casillas-Suárez C, Castillo-González P, Corona-Cruz JF, Correa-Acevedo ME, Cortez-Ramírez SS, de la Cruz-Vargas JA, de la Garza-Salazar JG, de la Mata-Moya MD, Domínguez-Flores ME, Domínguez-Malagón HR, Domínguez-Parra LM, Domínguez-Peregrina A, Durán-Alcocer J, Enríquez-Aceves MI, Elizondo-Ríos A, Escobedo-Sánchez MD, de Villafranca PEM, Flores-Cantisani A, Flores-Gutiérrez JP, Franco-Marina F, Franco-González EE, Franco-Topete RA, Fuentes-de la Peña H, Galicia-Amor S, Gallardo-Rincón D, Gamboa-Domínguez A, García-Andreu J, García-Cuéllar CM, García-Sancho-Figueroa MC, García-Torrentera R, Gerson-Cwilich R, Gómez-González A, Green-Schneeweiss L, Guillén-Núñez MDR, Gutiérrez-Velázquez H, Ibarra-Pérez C, Jiménez-Fuentes E, Juárez-Sánchez P, Juárez-Ramiro A, Kelly-García J, Kuri-Exsome R, Lázaro-León JM, León-Rodríguez E, Llanos-Osuna S, Llanos-Osuna S, Loyola-García U, López-González JS, López y de Antuñano FJ, Loustaunau-Andrade MA, Macedo-Pérez EO, Machado-Villarroel L, Magallanes-Maciel M, Martínez-Barrera L, Martínez-Cedillo J, Martínez-Martínez G, Medina-Esparza A, Meneses-García A, Mohar-Betancourt A, Morales Blanhir J, Morales-Gómez J, Motola-Kuba D, Nájera-Cruz MP, Núñez-Valencia CDC, Ocampo-Ocampo MA, Ochoa-Vázquez MD, Olivares-Torres CA, Palomar-Lever A, Patiño-Zarco M, Pérez-Padilla R, Peña-Alonso YR, Pérez-Romo AR, Aquilino Pérez M, Pinaya-Ruíz PM, Pointevin-Chacón MA, Poot-Braga JJ, Posadas-Valay R, Ramirez-Márquez M, Reyes-Martínez I, Robledo-Pascual J, Rodríguez-Cid J, Rojas-Marín CE, Romero-Bielma E, Rubio-Gutiérrez JE, Sáenz-Frías JA, Salazar-Lezama MA, Sánchez-Lara K, Sansores Martínez R, Santillán-Doherty P, Alejandro-Silva J, Téllez-Becerra JL, Toledo-Buenrostro V, Torre-Bouscoulet L, Torecillas-Torres L, Torres M, Tovar-Guzmán V, Turcott-Chaparro JG, Vázquez-Cortés JJ, Vázquez-Manríquez ME, Vilches-Cisneros N, Villegas-Elizondo JF, Zamboni MM, Zamora-Moreno J, Zinser-Sierra JW. [National consensus of diagnosis and treatment of non-small cell lung cancer]. Rev Invest Clin 2013; 65 Suppl 1:S5-S84. [PMID: 24459776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Mexican specialists in oncology, oncologic surgery, thoracic surgery, pneumology, pathology, molecular biology, anesthesiology, algology, psychology, nutrition, and rehabilitation (all of them experts in lung cancer treatment) in order to develop the National Consensus on Lung Cancer. The consensus has been developed as an answer to the need of updated Mexican guidelines for the optimal treatment of the disease, as well as to the requirements that such guidelines be established by multidisciplinary panel, depicting the current attention given to cancer lung cases in Mexico. Thus, this paper analyses the epidemiological review, screening, diagnosis, staging, pathology, translational medicine, and the suitable therapies for early, locally advanced, and metastatic disease in the first, second, and third lines of management, as well as rehabilitation and palliative measures.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Mauro M Zamboni
- Asociación Latinoamericana de Tórax, Instituto Nacional de Cáncer, Brasil
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Avilés-Salas A, Cuéllar-Mendoza ME. [Submucosal lipoma of the colon with intussusception]. Acta Gastroenterol Latinoam 2012; 42:216-219. [PMID: 23214352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Lipomas are the most frequent benign tumours of the digestive tract and 50% are localized in the colon. Most are found in the submucosa and may vary in their incidence, localization, symptoms and pathogenesis. We present the case of a 49-year-old female with intermittent intestinal subocclusion, abdominal distention and intussusception. Colonoscopy disclosed a submucous tumour in the descending colon. Laparoscopic sigmoidectomy was performed with resection of the lesion. Definitive pathology revealed a submucous colon lipoma. It is important to know the different presentations of these tumours because they can be mistaken for a malignant lesion.
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Avilés-Salas A, Chanona-Vilchis JG, Candelaria-Hernández MG, Peña-Torres MDL, Cuéllar-Mendoza ME. [Plasmoblastic lymphoma initially recognized as ovarian tumor]. Ginecol Obstet Mex 2012; 80:430-434. [PMID: 22826973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Plasmablastic lymphoma is an uncommon B-cell lymphoma representing <3% of all non-Hodgkin lymphoma associated with human immunodeficiency virus infection. It displays a distinctive affinity for extranodal presentation in the oral cavity. The case of a plasmablastic lymphoma present in the ovary, cervix and soft thigh tissues of a 27-year-old woman with human immunodeficiency infection is reported.
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Affiliation(s)
- Alejandro Avilés-Salas
- Departamento de Patologia, Instituto Nacional de Cancerologia Av. San Fernando, DF México.
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Avilés-Salas A, Alvarez-Reyes J, de Lourdes Peña-Torres M, Candelaria-Hernández M, Vega-González T. [Cutaneous hyalohyphomycosis in a patient with acute lymphoblastic leukemia]. Medicina (B Aires) 2012; 72:481-483. [PMID: 23241292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Invasive fungal infections most frequently caused by Aspergillus sp. and Candida sp. are significant causes of morbidity and mortality in severely immunocompromised patients, especially those who are neutropenic or who have undergone bone marrow or solid-organ transplant. We report a case of cutaneous hyalohyphomycosis in a 24-year-old female with acute lymphoblastic leukemia.
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Avilés-Salas A, Cornejo-Juárez P, Sobrevilla-Calvo PDJ. Coexistencia de linfoma plasmablástico, sarcoma de Kaposi y enfermedad de Castleman en un paciente con infección por virus de inmunodeficiencia humana. Rev Chilena Infectol 2011. [DOI: 10.4067/s0716-10182011000100015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Avilés-Salas A, Cornejo-Juárez P, Sobrevilla-Calvo PDJ. [Coexistence of plasmablastic lymphoma, Kaposi sarcoma and Castleman disease in a patient with HIV infection]. Rev Chilena Infectol 2011; 28:76-80. [PMID: 21526292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Plasmablastic lymphoma (PL) is an uncommon B-cell lymphoma that is strongly associated with human immunodeficiency virus (HIV) infection, and displays distinctive affinity for extranodal presentation in the oral cavity. We report the case of a PL involving the stomach in a 36 year-old man HIV+ patient, associated with Kaposi sarcoma (KS) in sections adjacent to lymphoma. He had a positive history of Castleman disease and KS in a lymphoid node biopsy.
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Avilés-Salas A, Herrera-Goepfert R, Aguilar-León D, Candelaria-Hernández M, Martínez-Cordero E, Corti M. [Plasmablastic lymphoma of the gastrointestinal tract in AIDS patients]. Medicina (B Aires) 2011; 71:536-541. [PMID: 22167727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
The risk of developing non-Hodgkin lymphoma (NHL) is 200 times higher in HIV-positive patients than otherwise healthy persons. Plasmablastic lymphoma (PL) represents < 3% of all NHL associated with HIV infection. The aim of this study was to review the clinical-pathologic features of PL of the gastrointestinal tract in 5 patients with HIV/aids disease. We performed a retrospective study of PL of the gastrointestinal tract diagnosed at the National Institute of Cancer at Mexico City, from 2000 to 2009. Clinical and pathological information was obtained and immunohistochemical studies were performed in paraffin-embedded tissue sections. The presence of Epstein-Barr Virus (EBV) was examined by in situ polymerase chain reaction (PCR). Four male and 1 female were included with a median of age of 29 years. Three tumors involved the ano-rectal area, one tumor the ascendant colon and one tumor the stomach. All tumors were histologically characterized by a monotonous proliferation of large lymphoid cell with plasmablastic features. Tumor cells were CD 138 / MUM-1 positive and CD 20 / PAX-5 negative in all cases. EVB genome was detected by in situ PCR in 4 cases. The median of follow-up was 18 months, and revealed that three patients are alive with neoplasm disease and two patients are still alive with no evidence of the neoplasm. Recognition of this entity by pathologists and clinicians is important in order to establish the correct diagnosis and the early treatment of these patients.
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Arrieta O, Michel Ortega RM, Angeles-Sánchez J, Villarreal-Garza C, Avilés-Salas A, Chanona-Vilchis JG, Aréchaga-Ocampo E, Luévano-González A, Jiménez MA, Aguilar JL. Serum human chorionic gonadotropin is associated with angiogenesis in germ cell testicular tumors. J Exp Clin Cancer Res 2009; 28:120. [PMID: 19709439 PMCID: PMC2745378 DOI: 10.1186/1756-9966-28-120] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Accepted: 08/27/2009] [Indexed: 11/10/2022] Open
Abstract
Background Germ cell testicular tumors have survival rate that diminishes with high tumor marker levels, such as human chorionic gonadotropin (hCG). hCG may regulate vascular neoformation through vascular endothelial growth factor (VEGF). Our purpose was to determine the relationship between hCG serum levels, angiogenesis, and VEGF expression in germ cell testicular tumors. Methods We conducted a retrospective study of 101 patients. Serum levels of hCG, alpha-fetoprotein (AFP), and lactate dehydrogenase were measured prior to surgery. Vascular density (VD) and VEGF tissue expression were determined by immunohistochemistry and underwent double-blind analysis. Results Histologically, 46% were seminomas and 54%, non-seminomas. Median follow-up was 43 ± 27 months. Relapse was present in 7.5% and mortality in 11.5%. Factors associated with high VD included non-seminoma type (p = 0.016), AFP ≥ 14.7 ng/mL (p = 0.0001), and hCG ≥ 25 mIU/mL (p = 0.0001). In multivariate analysis, the only significant VD-associated factor was hCG level (p = 0.04). When hCG levels were stratified, concentrations ≥ 25 mIU/mL were related with increased neovascularization (p < 0.0001). VEGF expression was not associated with VD or hCG serum levels. Conclusion This is the first study that relates increased serum hCG levels with vascularization in testicular germ cell tumors. Hence, its expression might play a role in tumor angiogenesis, independent of VEGF expression, and may explain its association with poor prognosis. hCG might represent a molecular target for therapy.
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Affiliation(s)
- Oscar Arrieta
- Department of Medical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico.
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Sobrevilla-Calvo PDJ, Avilés-Salas A, Cortés-Padilla DE, Rivas-Vera S. [Clinical and pathological features of Castleman's disease: experience at the Instituto Nacional de Cancerología, Mexico City]. CIR CIR 2009; 77:187-192. [PMID: 19671270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Castleman's disease (CD) is a rare, poorly understood pathological entity. We report our experience with this clinicopathological entity. METHODS We retrospectively analyzed records of all patients with CD from 1996 to 2003. The disease was classified as unicentric if a solitary mass was present or multicentric if generalized lymphadenopathy was present. We further subdivided the disease into hyaline vascular (HV) and plasma cell (PC) histological variants. RESULTS We found 11 patients with CD. Six patients had unicentric disease and five had multicentric disease. Median follow-up was 40 months. All patients with unicentric disease had the HV variant. Of the five patients with multicentric disease, four had the PC variant and one had the HV. Five patients with unicentric disease were treated surgically with complete resection, and only one patient was treated with chemotherapy. All remain alive without disease. Three patients with multicentric disease were treated with chemotherapy, and two patients received chemotherapy plus radiotherapy for residual disease. Two patients received second-line chemotherapy with a favorable outcome. Two patients with a comorbid condition had a poor outcome. CONCLUSIONS Clinical characteristics, pathological features and treatment results are similar to that reported in other populations.
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Avilés-Salas A, Peña-Torres MDL, Molina-Cruz A, Rivas-Vera S. [Histiocytic sarcoma of the small intestine: Report of one case]. Rev Med Chil 2009; 137:269-274. [PMID: 19543651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Histiocytic sarcoma (HS) is a rare malignant neoplasm of the lymphohematopoietic system, that occurs in lymph nodes, skin and at extranodal sites, particularly the gastrointestinal tract. Although it shows characteristics histological and immunohistochemical features, it may be misdiagnosed. We report a 67 year-old female patient presenting with colicky abdominal pain and vomiting. A CT scan of the abdomen revealed a tumor in the ileum, that was surgically removed. On pathology, the neoplastic cells displayed large abundant eosinophilic cytoplasm, with bizarre-shaped nuclei, that expressed CD 45, CD 68 and lisozyme. The diagnosis of HS requires the use of a panel of immunohistochemical markers and may be supported by ultrastructural findings.
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Avilés-Salas A, Peña-Torres MDL, Molina-Cruz A, Rivas-Vera S. Sarcoma histiocítico de intestino delgado: Reporte de un caso y revisión de la literatura. Rev Med Chil 2009. [DOI: 10.4067/s0034-98872009000200013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cornejo-Juárez P, Volkow-Fernández P, Avilés-Salas A, Calderón-Flores E. AIDS and non-Hodgkin's lymphoma. Experience at an oncological center in Mexico. Rev Invest Clin 2008; 60:375-381. [PMID: 19227434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Non-Hodgkin lymphoma (NHL) associated with HIV became an AIDS-defining condition early in the epidemic and remains the second most common malignancy in patients with AIDS. With the advent of highly active antiretroviral therapy (HAART), the incidence and mortality of AIDS-related opportunistic infections and Kaposi's sarcoma has fallen dramatically, this trend is not observed so clearly for NHL. Our objective was to review the clinical spectrum of patients with AIDS-associated NHL and to analyze the impact of HAART on survival at an oncological tertiary center. MATERIAL AND METHODS We reviewed all medical records and histopathologic tissue of patients with HIV-associated NHL seen from January 1990 to September 2007 at the Instituto Nacional de Cancerologia in Mexico City. Survival or follow-up time was calculated from date of diagnosis to death, or to the date on which the patient was last seen. RESULTS Eighty seven HIV-positive patients were diagnosed with NHL (diffuse large B-cell lymphoma n=69; Burkitt-like n=8; pleomorphic large cell n=7; low-grade n=2, and angiocentric n=1). Twenty eight patients never received HAART, and 59 received HAART. Overall, 38 patients (43.7%) achieved complete response to NHL therapy, including only 14.3% patients in the non-HAART compared with 57.6% in the HAART group (p < or = 0.0001). Two patients (7.1%) in the non-HAART were alive compared with 37 (63.8%) in the HAART group (p < or = 0.0001). Mean survival time for all patients was 11 +/- 16.8 months. Survival was significantly shorter in patients not receiving HAART (4.8 +/- 7.6 months) as compared with those who did (14 +/- 19.2) (p=0.01). CONCLUSIONS Patients with NHL-HIV who were able to receive treatment with HAART and were sufficiently healthy to receive optimal chemotherapy treatment showed a significantly better prognosis.
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Rodríguez-Enríquez S, Gallardo-Pérez JC, Avilés-Salas A, Marín-Hernández A, Carreño-Fuentes L, Maldonado-Lagunas V, Moreno-Sánchez R. Energy metabolism transition in multi-cellular human tumor spheroids. J Cell Physiol 2008; 216:189-97. [PMID: 18264981 DOI: 10.1002/jcp.21392] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
It is thought that glycolysis is the predominant energy pathway in cancer, particularly in solid and poorly vascularized tumors where hypoxic regions develop. To evaluate whether glycolysis does effectively predominate for ATP supply and to identify the underlying biochemical mechanisms, the glycolytic and oxidative phosphorylation (OxPhos) fluxes, ATP/ADP ratio, phosphorylation potential, and expression and activity of relevant energy metabolism enzymes were determined in multi-cellular tumor spheroids, as a model of human solid tumors. In HeLa and Hek293 young-spheroids, the OxPhos flux and cytochrome c oxidase protein content and activity were similar to those observed in monolayer cultured cells, whereas the glycolytic flux increased two- to fourfold; the contribution of OxPhos to ATP supply was 60%. In contrast, in old-spheroids, OxPhos, ATP content, ATP/ADP ratio, and phosphorylation potential diminished 50-70%, as well as the activity (88%) and content (3 times) of cytochrome c oxidase. Glycolysis and hexokinase increased significantly (both, 4 times); consequently glycolysis was the predominant pathway for ATP supply (80%). These changes were associated with an increase (3.3 times) in the HIF-1alpha content. After chronic exposure, both oxidative and glycolytic inhibitors blocked spheroid growth, although the glycolytic inhibitors, 2-deoxyglucose and gossypol (IC(50) of 15-17 nM), were more potent than the mitochondrial inhibitors, casiopeina II-gly, laherradurin, and rhodamine 123 (IC(50) > 100 nM). These results suggest that glycolysis and OxPhos might be considered as metabolic targets to diminish cellular proliferation in poorly vascularized, hypoxic solid tumors.
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Cornejo-Juárez P, Volkow-Fernández P, Avilés-Salas A, Calderón-Flores E. Survival among AIDS patients with and without non-Hodgkin's lymphoma, and NHL-HIV-negative patients. BMC Cancer 2007. [PMCID: PMC1796586 DOI: 10.1186/1471-2407-7-s1-a40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sobrevilla-Calvo P, Jaramillo-Restrepo M, Rivas-Vera S, Avilés-Salas A, Acosta-Barreda A, Cervera-Ceballos E, Labardini-Méndez J. The relevance of performing a bone marrow aspirate and biopsy in breast cancer patients with suspected bone marrow metastasis. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.18605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18605 Background: Patients with breast cancer often presents hematological abnormalities during the disease evolution, frequently it is difficult to define if these are due to bone marrow infiltartion or are due to drug toxicity or a new hematological disorder. To determine the proportion of patients with bone marrow metastasis we reviewed the bone marrow aspirates and biopsies of patients with histological proven breast cancer and an abnormal peripheral blood count referred to the Hematology Department. Methods: We reviewed the medical records of 88 patients referred to our Department from april 1998 to april 2005 with breast cancer and with bone marrow smears and biopsies. The BM smears were interpreted blindly by one of us. The BM biopsies were reviewed independently by a hematopatologist. A statistician analysed the data and estimated frequencies and rates, survival analysis was estimated by means of the Kaplan-Meier method. Results: Median age 47.7 years (range 28–80), clinical stage at diagnosis was: II, 19 (21.1%); IIIA, 19 (21.1%); IIIB, 16 (17.8%); IV, 34 (40%). The hematological abnormality that triggered the referral was: Thrombocytopenia, 61 (67.8%); anemia, 53 (58.9%); leucopenia, 47 (53.4%); thrombocytopenia and anemia, 39 (43.3%). The median time from the initial diagnosis to the BM biopsy was 12.8 months (range 1 to 176.7). Regarding the BM aspirates interpretatrion: 17 were not evaluable, 53 were negative for infiltration, 17 were positive for carcinoma and 1 with plasma cell infiltration (this patients had concurrent Breast cancer and myeloma). BM biopsies: 19 were not evaluable, 48 were negative, 20 positive and 1 with myeloma. The sensitivity of the BM aspirates was 75% (12/16) and the specificity 95% (41/43). The median survival of the patients with BM metastais was 109 months, and 104 of the patients without BM metastasis (p = 0.9767) Conclusions: Most of the patients with hematological abnormalities do not have BM infiltration, bone marrow biopsies have more sensitivity than aspirates. The presence of BM metastasis does not necessarily predicts a short survival period. No significant financial relationships to disclose.
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Affiliation(s)
| | | | - S. Rivas-Vera
- Instituto Nacional de Cancerologia, Mexico DF, Mexico
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