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Sotelo-Rodríguez C, Vallejo-Ardila D, Ruiz-Patiño A, Chamorro DF, Rodríguez J, Moreno-Pérez DA, Carranza H, Otero J, Vargas C, Archila P, Rojas L, Zuluaga J, Rubio C, Ordóñez-Reyes C, Garcia-Robledo JE, Mejía S, Jaller E, Arrieta O, Cardona AF. Molecular Tumor Board Improves Outcomes for Hispanic Patients With Advanced Solid Tumors. JCO Glob Oncol 2024; 10:e2300011. [PMID: 38237094 PMCID: PMC10805441 DOI: 10.1200/go.23.00011] [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: 01/13/2023] [Revised: 06/10/2023] [Accepted: 10/18/2023] [Indexed: 01/23/2024] Open
Abstract
PURPOSE Multidisciplinary molecular tumor boards (MTBs) decode complex genomic data into clinical recommendations. Although MTBs are well-established in the oncology practice in developed countries, this strategy needs to be better explored in developing countries. Herein, we describe the possible benefits and limitations of the first MTB established in Colombia. METHODS Demographic, clinical, and genomic information was collected between August 2020 and November 2021. By mid-2020, an MTB strategy was created to discuss clinical cases with one or more genomic alterations identified by next-generation sequencing using an open-access virtual platform. We characterized the patient population as benefiting from the recommended treatment option. We assessed the benefits and access to available targeted therapies that have the potential to change clinical management by making recommendations to treating oncologists on the basis of genomic profiling. However, we did not assess the treatment oncologists' compliance with MTB recommendations because they were not intended to replace clinical judgment/standard of care. RESULTS A total of 146 patients were included in the discussions of the MTB. The median age was 59 years, and 59.6% were women. Genomic results prompting a change in therapeutic decisions were obtained in 53.1% of patients (95% CI, 44.9 to 61.3). The most prevalent malignancy was non-small-cell lung cancer (51%). Other malignancies represented 60%, 50%, and 30% of patients with soft-tissue sarcomas, brain tumors, and breast cancer, respectively. CONCLUSION Using an open-access virtual platform, MTBs were feasible in low- and middle-income countries on the basis of the capability to provide the benefits and access to available targeted therapies that are not standard of care. Furthermore, MTB recommendations were made available to the treating oncologist in different locations across Colombia, providing the option to modify clinical management in most of these patients.
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Affiliation(s)
- Carolina Sotelo-Rodríguez
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Dora Vallejo-Ardila
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Diego F. Chamorro
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Darwin A. Moreno-Pérez
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Thoracic Oncology Unit, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
| | - Jairo Zuluaga
- Thoracic Oncology Unit, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
| | - Cladelis Rubio
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
| | - Camila Ordóñez-Reyes
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Sergio Mejía
- Thoracic Oncology Unit, Clínica Las Américas, Medellín, Colombia
| | - Elvira Jaller
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), México City, México
| | - Andrés F. Cardona
- Thoracic Oncology Unit, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
- Direction of Research, Science and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
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Rojas L, Rojas-Reyes MX, Rosselli D, Ariza JG, Ruiz-Patiño A, Cardona AF. Cost-utility analysis of genomic profiling in early breast cancer in Colombia. Cost Eff Resour Alloc 2023; 21:42. [PMID: 37430303 DOI: 10.1186/s12962-023-00449-5] [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: 11/08/2022] [Accepted: 06/14/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND In Colombia, the best strategy to establish indication for adjuvant chemotherapy in early breast cancer (EBC) remains unknown. This study aimed to identify the cost-utility of Oncotype DX™ (ODX) or Mammaprint™ (MMP) tests to establish the necessity of adjuvant chemotherapy. METHODS This study used an adapted decision-analytic model to compare cost and outcomes of care between ODX or MMP tests and routine care without ODX or MMP tests (adjuvant chemotherapy for all patients) over a 5-year time horizon from the perspective of the Colombian National Health System (NHS; payer). Inputs were obtained from national unit cost tariffs, published literature, and clinical trial database. The study population comprised women with hormone-receptor-positive (HR +), HER2-negative, lymph-node-negative (LN0) EBC with high-risk clinical criteria for recurrence. The outcome measures were discounted incremental cost-utility ratio (ICUR; 2021 United States dollar per quality-adjusted life-year [QALY] gained) and net monetary benefit (NMB). Probabilistic (PSA) and deterministic sensitivity analysis (DSA) were performed. RESULTS ODX increases QALYs by 0.05 and MMP by 0.03 with savings of $2374 and $554 compared with the standard strategy, respectively, and were cost-saving in cost-utility plane. NMB for ODX was $2203 and for MMP was $416. Both tests dominate the standard strategy. Sensitivity analysis revealed that with a threshold of 1 gross domestic product per capita, ODX will be cost-effective in 95.5% of the cases compared with 70.2% cases involving MMP.DSA showed that the variable with significant influence was the monthly cost of adjuvant chemotherapy. PSA revealed that ODX was a consistently superior strategy. CONCLUSIONS Genomic profiling using ODX or MMP tests to define the need of adjuvant chemotherapy treatment in patients with HR + and HER2 -EBC is a cost-effective strategy that allows Colombian NHS to maintain budget.
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Affiliation(s)
- Leonardo Rojas
- Thoracic and GU Unit, Fundación Centro de Tratamiento en Investigación Sobre Cáncer Luis Carlos Sarmiento Angulo (CTIC), Carrera 14 # 169 -49, Office 204, Bogotá, Colombia.
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia.
| | | | - Diego Rosselli
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | | | - Andrés F Cardona
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Direction of Research, Science and Education, Fundación Centro de Tratamiento en Investigación Sobre Cáncer Luis Carlos Sarmiento Angulo (CTIC), Bogotá, Colombia
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Chamorro DF, Cardona AF, Rodríguez J, Ruiz-Patiño A, Arrieta O, Moreno-Pérez DA, Rojas L, Zatarain-Barrón ZL, Ardila DV, Viola L, Recondo G, Blaquier JB, Martín C, Raez L, Samtani S, Ordóñez-Reyes C, Garcia-Robledo JE, Corrales L, Sotelo C, Ricaurte L, Cuello M, Mejía S, Jaller E, Vargas C, Carranza H, Otero J, Archila P, Bermudez M, Gamez T, Russo A, Malapelle U, de Miguel Perez D, de Lima VCC, Freitas H, Saldahna E, Rolfo C, Rosell R. Genomic Landscape of Primary Resistance to Osimertinib Among Hispanic Patients with EGFR-Mutant Non-Small Cell Lung Cancer (NSCLC): Results of an Observational Longitudinal Cohort Study. Target Oncol 2023; 18:425-440. [PMID: 37017806 DOI: 10.1007/s11523-023-00955-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Epidermal growth factor receptor (EGFR) mutations (EGFRm) represent one of the most common genomic alterations identified among patients with non-small cell lung cancer (NSCLC). Several targeted agents for patients with EGFRm have been proven safe and effective, including the third-generation tyrosine kinase inhibitor (TKI) osimertinib. Nonetheless, some patients will present with or develop EGFR-TKI resistance mechanisms. OBJECTIVE We characterized the genomic landscape of primary resistance to osimertinib among Hispanic patients with EGFR-mutant NSCLC. METHODS An observational longitudinal cohort study was conducted with two groups of patients, those with intrinsic resistance (cohort A) and those with long-term survival (cohort B). All patients were treated and followed between January 2018 and May 2022. All patients were assessed for Programmed Cell Death Ligand 1 (PD-L1) expression and Bcl-2-like protein 11 (BIM)/AXL mRNA expression before starting TKI. After 8 weeks of treatment, a liquid biopsy was performed to determine the presence of circulating free DNA (cfDNA), and next-generation sequencing (NGS) was used to identify mutations at the time of progression. In both cohorts, overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated. RESULTS We found a homogeneous distribution of EGFR-sensitizing mutations in both cohorts. For cohort A, exon 21 mutations were more common than exon 19 deletions (ex19dels) for cohort B (P = 0.0001). The reported ORR for osimertinib was 6.3% and 100% for cohorts A and B, respectively (P = 0.0001). PFS was significantly higher in cohort B (27.4 months vs. 3.1 months; P = 0.0001) and ex19del patients versus L858R (24.5 months, 95% confidence interval [CI] 18.2-NR), vs. 7.6 months, 95% CI 4.8-21.1; P = 0.001). OS was considerably lower for cohort A (20.1 months vs. 36.0 months; P = 0.0001) and was better for patients with ex19del, no brain metastasis, and low tumor mutation burden. At the time of progression, more mutations were found in cohort A, identifying off-target alterations more frequently, including TP53, RAS, and RB1. CONCLUSION EGFR-independent alterations are common among patients with primary resistance to osimertinib and significantly impact PFS and OS. Our results suggest that among Hispanic patients, other variables associated with intrinsic resistance include the number of commutations, high levels AXL mRNA, and low levels of BIM mRNA, T790M de novo, EGFR p.L858R presence, and a high tumoral mutational burden.
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Affiliation(s)
- Diego F Chamorro
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Andrés F Cardona
- Direction of Research, Science, and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Calle 168 # 14, 110221, Bogotá, Colombia.
- Thoracic Oncology Unit, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia.
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), México City, Mexico
| | - Darwin A Moreno-Pérez
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), México City, Mexico
| | - Zyanya Lucia Zatarain-Barrón
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), México City, Mexico
| | - Dora V Ardila
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neumológica Colombiana-FNC, Bogotá, Colombia
| | - Gonzalo Recondo
- Thoracic Oncology Unit, Centro de Educación Médica e Investigaciones Clinicas (CEMIC), Buenos Aires, Argentina
| | - Juan B Blaquier
- Thoracic Oncology Unit, Centro de Educación Médica e Investigaciones Clinicas (CEMIC), Buenos Aires, Argentina
| | - Claudio Martín
- Thoracic Oncology Unit, Alexander Fleming Institute, Buenos Aires, Argentina
| | - Luis Raez
- Thoracic Oncology Program, Memorial Cancer Institute, Florida Atlantic University (FAU), Miami, FL, USA
| | - Suraj Samtani
- Medical Oncology Department, Bradford Hill Institute, Santiago, Chile
| | - Camila Ordóñez-Reyes
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | | | - Luis Corrales
- Thoracic Oncology Unit, Centro de Investigación y Manejo del Cáncer-CIMCA, San José, Costa Rica
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | | | - Mauricio Cuello
- Medical Oncology Department, Hospital de Clínicas, Universidad de la Republica-UdeLAR, Montevideo, Uruguay
| | - Sergio Mejía
- Toracic Oncology Unit, Oncology Department, Cancer Institute, Clínica de las Américas, Medellín, Colombia
| | - Elvira Jaller
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Maritza Bermudez
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Tatiana Gamez
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Alessandro Russo
- Medical Oncology Department, Azienda Ospedaliera Papardo, Messina, Sicilia, Italy
| | - Umberto Malapelle
- Predictive Molecular Pathology Laboratory, Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Diego de Miguel Perez
- Thoracic Oncology Center, Tisch Cáncer Center, Mount Sinai Hospital System & Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | | | - Helano Freitas
- Thoracic Oncology Unit, A.C. Camargo Cancer Center, Sao Paulo, Brazil
| | - Erick Saldahna
- Thoracic Oncology Unit, A.C. Camargo Cancer Center, Sao Paulo, Brazil
| | - Christian Rolfo
- Thoracic Oncology Center, Tisch Cáncer Center, Mount Sinai Hospital System & Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Germans Trias i Pujol Research Institute (IGTP)/Dr. Rosell Oncology Institute (IOR) Quirón-Dexeus University Institute, Barcelona, Spain
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Cifuentes C, Lombana M, Vargas H, Laguado P, Ruiz-Patiño A, Rojas L, Navarro U, Vargas C, Ricaurte L, Arrieta O, Zatarain-Barron L, Zapata L, González G, Ortiz C, Bernal L, Restrepo JG, Viola L, Grosso F, Zapata R, Mantilla W, Carranza H, Bustillo I, Llinas N, Duarte R, Rodríguez J, Archila P, Ávila J, Bermúdez M, Gámez T, Sotelo C, Otero J, Forero E, Lema M, Limpias C, Ordóñez-Reyes C, Mejía S, Rolfo C, Rosell R, Cardona AF. Application of Comprehensive Genomic Profiling-Based Next-Generation Sequencing Assay to Improve Cancer Care in a Developing Country. Cancer Control 2023; 30:10732748231175256. [PMID: 37148308 PMCID: PMC10164853 DOI: 10.1177/10732748231175256] [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] [Indexed: 05/08/2023] Open
Abstract
PURPOSE Identifying actionable oncogenic mutations have changed the therapeutic landscape in different types of tumors. This study investigated the utility of comprehensive genomic profiling (CGP), a hybrid capture-based next-generation sequencing (NGS) assay, in clinical practice in a developing country. METHODS In this retrospective cohort study, CGP was performed on clinical samples from patients with different solid tumors recruited between December 2016 and November 2020, using hybrid capture-based genomic profiling, at the individual treating physicians' request in the clinical care for therapy decisions. Kaplan-Meier survival curves were estimated to characterize the time-to-event variables. RESULTS Patients median age was 61 years (range: 14-87 years), and 64.7% were female. The most common histological diagnosis was lung primary tumors, with 90 patients corresponding to 52.9% of the samples (95% CI 45.4-60.4%). Actionable mutations with FDA-approved medications for specific alterations correspondent to tumoral histology were identified in 58 cases (46.4%), whereas other alterations were detected in 47 different samples (37.6%). The median overall survival was 15.5 months (95% CI 11.7 months-NR). Patients who were subjected to genomic evaluation at diagnosis reached a median overall survival of 18.3 months (95% CI 14.9 months-NR) compared to 14.1 months (95% CI 11.1 months-NR) in patients who obtained genomic evaluation after tumor progression and during standard treatment (P = .7). CONCLUSION CGP of different types of tumors identifies clinically relevant genomic alterations that have benefited from targeted therapy and improve cancer care in a developing country to guide personalized treatment to beneficial outcomes of cancer patients.
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Affiliation(s)
- Claudia Cifuentes
- Clinical Oncology Department, Hospital Universitario Mayor de Mederi, Bogotá, Colombia
| | - Milton Lombana
- Hematology and Oncology Department, Clínica de Occidente, Cali, Colombia
| | - Henry Vargas
- Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Paola Laguado
- Clinical Research Institute, Clínica del Country, Bogotá Colombia
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Oncology Department, Clínica Colsanitas, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
- Clinical Oncology Department, Clínica del Country, Bogotá, Colombia
| | - Uriel Navarro
- Clinical Oncology Department, Clínica General del Norte, Barranquilla, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
- Clinical Oncology Department, Clínica del Country, Bogotá, Colombia
| | | | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), México City, México
| | | | - Leandro Zapata
- Oncology Department, San Vicente Fundación, Medellín, Colombia
| | - Guido González
- Centro Integral del Cáncer, Clínica de Occidente, Cali, Colombia
| | - Carlos Ortiz
- Clinical Oncology Department, Clínica del Country, Bogotá, Colombia
| | - Laura Bernal
- Oncology Department, Clínica Colsanitas, Bogotá, Colombia
- Clinical Oncology Department, Clínica Marly, Bogotá, Colombia
| | - Juan G Restrepo
- Oncology Department, Fundación Valle de Lili, Cali, Colombia
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - Fabio Grosso
- Oncology Department, Medical Plus, Bogotá, Colombia
| | - Ricardo Zapata
- Oncology Department, Clínica Cardio-VID, Medellín, Colombia
| | - William Mantilla
- Hematology and Oncology Department, Fundación Cardio Infantil, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
- Clinical Oncology Department, Clínica del Country, Bogotá, Colombia
| | - Iván Bustillo
- Oncology Department, Clínica Porto Azul, Barranquilla, Colombia
| | - Néstor Llinas
- Oncology Department, Clínica Vida, Medellín, Colombia
| | - Ricardo Duarte
- Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jenny Ávila
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Maritza Bermúdez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Tatiana Gámez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Elkin Forero
- Clinical Oncology Department, Hospital Universitario Mayor de Mederi, Bogotá, Colombia
| | - Mauricio Lema
- Hematology and Oncology Department, Clínica Astorga, Medellín, Colombia
| | | | - Camila Ordóñez-Reyes
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Sergio Mejía
- Clinical Oncology Department, San Vicente Fundación, Medellín, Colombia
| | - Christian Rolfo
- Thoracic Oncology Center, Icahn School of Medicine at Mount Sinai Tisch Cáncer Center, Mount Sinai Hospital System, New York, NY, US
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
- Direction of Research, Science and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
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Mejia S, Rodríguez J, Ruiz-Patiño A, Archila P, Chamorro D, Arrieta O, Viola L, Ordoñez-Reyes C, Garcia-Robledo J, Sotelo C, Raez L, Samtani S, Recondo G, Martín C, Corrales L, Zatarain-Barrón L, Más L, Ricaurte L, Santoyo N, Cuello M, Jaller E, Vargas C, Carranza H, Otero J, Bermudez M, Gamez T, Cordeiro de Lima V, Malapelle U, Rolfo C, Rosell R, Cardona A. EP16.03-003 Systematic Population-based Identification of NTRK Fusion Genes Among Hispanic Patients with Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1063] [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: 11/29/2022]
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Cardona A, Raez L, Arrieta O, Chamorro D, Soberanis P, Corrales L, Martín C, Cuello M, Samtani S, Recondo G, Más L, Zatarain-Barrón L, Ruiz-Patiño A, Garcia-Robledo J, Ordoñez-Reyes C, Jaller E, Dickson F, Rojas L, Rolfo C, Rosell R. EP05.01-001 Hispanic Patients with Unresectable Stage III NSCLC under PACIFIC Protocol: Evidence of Interior Outcomes and Health Inequity. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.447] [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: 11/29/2022]
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Chamorro D, Ruiz-Patiño A, Recondo G, Martín C, Raez L, Samtani S, Minata J, Blaquier J, Enrico D, Burotto M, Ordoñez-Reyes C, Garcia-Robledo J, Corrales L, Zatarain-Barrón L, Más L, Sotelo C, Ricaurte L, Santoyo N, Cuello M, Mejia S, Jaller E, Vargas C, Carranza H, Otero J, Rodríguez J, Archila P, Bermudez M, Gamez T, Cordeiro de Lima V, Freitas H, Russo A, Polo C, Malapelle U, de Miguel-Perez D, Rolfo C, Viola L, Rossell R, Arrieta O, Cardona A. EP16.03-002 Mechanisms of Resistance to First-line Osimertinib in Hispanic Patients with EGFR mutant Non-Small Cell Lung Cancer (FRESTON-CLICaP∫). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1062] [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: 11/26/2022]
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8
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Jensen LR, Maier AD, Lomstein A, Graillon T, Hrachova M, Bota D, Ruiz-Patiño A, Arrieta O, Cardona AF, Rudà R, Furtner J, Roeckle U, Clement P, Preusser M, Scheie D, Broholm H, Kristensen BW, Skjøth-Rasmussen J, Ziebell M, Munch TN, Fugleholm K, Walter MA, Mathiesen T, Mirian C. Somatostatin analogues in treatment-refractory meningioma: a systematic review with meta-analysis of individual patient data. Neurosurg Rev 2022; 45:3067-3081. [PMID: 35984552 DOI: 10.1007/s10143-022-01849-6] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/01/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022]
Abstract
Treatment-refractory meningiomas have a dismal prognosis and limited treatment options. Meningiomas express high-densities of somatostatin receptors (SSTR), thus potentially susceptible to antitumorigenic effects of somatostatin analogues (SSA). Evidence for SSA in meningiomas is scarce, and it is unclear if published literature would either (1) support wider use of SSA, if (2) more evidence is desirable, or if (3) available evidence is sufficient to discard SSA. We addressed the need for more evidence with a systematic review and meta-analysis. We performed an individual patient data (IPD) meta-analysis. Main outcomes were toxicity, best radiological response, progression-free survival, and overall survival. We applied multivariable logistic regression models to estimate the effect of SSA on the probability of obtaining radiological disease control. The predictive performance was evaluated using area under the curve and Brier scores. We included 16 studies and compiled IPD from 8/9 of all previous cohorts. Quality of evidence was overall ranked "very low." Stable disease was reported in 58% of patients as best radiological response. Per 100 mg increase in total SSA dosage, the odds ratios for obtaining radiological disease control was 1.42 (1.11 to 1.81, P = 0.005) and 1.44 (1.00 to 2.08, P = 0.05) for patients treated with SSA as monodrug therapy vs SSA in combination with everolimus, respectively. Low quality of evidence impeded exact quantification of treatment efficacy, and the association between response and treatment may represent reverse causality. Yet, the SSA treatment was well tolerated, and beneficial effect cannot be disqualified. A prospective trial without bias from inconsistent study designs is warranted to assess SSA therapy for well-defined meningioma subgroups.
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Affiliation(s)
- Lasse Rehné Jensen
- Department of Neurosurgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Andrea Daniela Maier
- Department of Neurosurgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Pathology, Center of Diagnostic Investigation, Copenhagen University Hospital, Copenhagen, Denmark
| | - Atle Lomstein
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Graillon
- Department of Neurosurgery, Hospital La Timone, Aix Marseille University, APHM, INSERM, MMG, Marseille, France
| | - Maya Hrachova
- Department of Neurosurgery, University of Oklahoma Health Science Center, Oklahoma, OK, USA
| | - Daniela Bota
- Department of Neurology, UC Irvine Medical Center, Orange, CA, USA
- Department of Neurological Surgery, UC Irvine Medical Center, Orange, CA, USA
| | | | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCaN), Mexico City, México
| | | | - Roberta Rudà
- Department of Neurology, Castelfranco Veneto/Treviso, Treviso, Italy
- Department of Neuro-Oncology, City of Health and Science Hospital and University of Turin, Turin, Italy
| | - Julia Furtner
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ulrich Roeckle
- Department of Neurology and Brain Tumor Center, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Paul Clement
- Department of Oncology, Leuven Cancer Institute, KU Leuven, Louvain, Belgium
| | - Matthias Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - David Scheie
- Department of Pathology, Center of Diagnostic Investigation, Copenhagen University Hospital, Copenhagen, Denmark
| | - Helle Broholm
- Department of Pathology, Center of Diagnostic Investigation, Copenhagen University Hospital, Copenhagen, Denmark
| | - Bjarne Winther Kristensen
- Department of Clinical Neuroscience, Section for Neurosurgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Medicine and Biotech Research and Innovation Center (BRIC), University of Copenhagen, Copenhagen, Denmark
| | - Jane Skjøth-Rasmussen
- Department of Neurosurgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Morten Ziebell
- Department of Neurosurgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Tina Nørgaard Munch
- Department of Neurosurgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Kåre Fugleholm
- Department of Neurosurgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Martin A Walter
- Department of Nuclear Medicine, University Hospital of Geneva, Geneva, Switzerland
- Gesundheitswissenschaften Und Medizin EN, University of Lucerne, Lucerne, Switzerland
| | - Tiit Mathiesen
- Department of Neurosurgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Mirian
- Department of Neurosurgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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Rojas L, Mayorga D, Ruiz-Patiño A, Rodríguez J, Cardona AF, Archila P, Avila J, Bravo M, Ricaurte L, Sotelo C, Arrieta O, Zatarain-Barrón ZL, Carranza H, Otero J, Vargas C, Barrón F, Corrales L, Martín C, Recondo G, Pino LE, Bermudez MA, Gamez T, Ordoñez-Reyes C, García-Robledo JE, de Lima VC, Freitas H, Santoyo N, Malapelle U, Russo A, Rolfo C, Rosell R. Human papillomavirus infection and lung adenocarcinoma: special benefit is observed in patients treated with immune checkpoint inhibitors. ESMO Open 2022; 7:100500. [PMID: 35753086 PMCID: PMC9434139 DOI: 10.1016/j.esmoop.2022.100500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/15/2021] [Revised: 03/27/2022] [Accepted: 04/19/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Human papilloma virus (HPV) has been associated with the development and modulation of response in a series of neoplasms. In the case of lung adenocarcinoma, its role in etiology and pathogenesis is still controversial. Considering that this infection brings foreign epitopes, it could be of prognostic significance in patients with lung adenocarcinoma treated with immunotherapy. METHODS In a retrospective cohort study we evaluated the presence of HPV genomic material in lung adenocarcinoma primary lesions with the INNO-LiPA platform. Viral replication was also evaluated by detecting the presence of oncoprotein E6/E7 messenger RNA (mRNA) by quantitative RT-PCR. To confirm possible hypotheses regarding viral oncogenesis, vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1 (HIF1) were evaluated with stromal fibrosis and immunoscore. RESULTS A total of 133 patients were included in the analysis, of whom 34 tested positive for HPV, reaching an estimated prevalence of 25.6% [95% confidence interval (CI) 18.2% to 32.9%]. E6/7 mRNA was identified in 28 out of the 34 previously positive cases (82.3%). In immune checkpoint inhibitor (ICI)-treated patients, the median overall survival reached 22.3 months [95% CI 19.4 months- not reached (NR)] for HPV-negative and was not reached in HPV-positive (HPV+) ones (95% CI 27.7-NR; P = 0.008). With regard to progression-free survival, HPV- patients reached a median of 9.2 months (95% CI 7.9-11.2 months) compared to 14.3 months (95% CI 13.8-16.4 months) when HPV was positive (P = 0.001). The overall response rate for HPV+ patients yielded 82.4% compared to 47.1% in negative ones. No differences regarding programmed death-ligand 1, VEGF, HIF1, stromal fibrosis, or immunoscore were identified. CONCLUSIONS In patients with HPV+ lung adenocarcinoma, a significant benefit in overall response and survival outcomes is observed.
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Affiliation(s)
- L Rojas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Oncology Department, Clinica Colsanitas, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - D Mayorga
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - A Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - J Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - A F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Oncology Department, Clinica Colsanitas, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia.
| | - P Archila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - J Avila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - M Bravo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - L Ricaurte
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Pathology Department, Mayo Clinic, Rochester, USA
| | - C Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - O Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - Z L Zatarain-Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - H Carranza
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Oncology Department, Clinica Colsanitas, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - J Otero
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Oncology Department, Clinica Colsanitas, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - C Vargas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Oncology Department, Clinica Colsanitas, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - F Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - L Corrales
- Medical Oncology Department, Centro de Investigación y Manejo del Cáncer - CIMCA, San José, Costa Rica
| | - C Martín
- Thoracic Oncology Unit, Alexander Fleming Institute, Buenos Aires, Argentina
| | - G Recondo
- Thoracic Oncology Unit, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - L E Pino
- Clinical Oncology Department, Institute of Oncology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - M A Bermudez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - T Gamez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - C Ordoñez-Reyes
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | | | - V C de Lima
- Medical Oncology Department, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Oncologia D'Or, São Paulo, Brazil
| | - H Freitas
- Medical Oncology Department, Thoracic Oncology Section, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - N Santoyo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - U Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - A Russo
- Medical Oncology Unit, A.O. Papardo, Messina, Italy
| | - C Rolfo
- Center for Thoracic Oncology, Tisch Cancer Center, Mount Sinai Hospital System & Icahn School of Medicine, Mount Sinai, New York, USA
| | - R Rosell
- Coyote Research Group, Pangaea Oncology, Laboratory of Molecular Biology, Quiron-Dexeus University Institute, Barcelona, Spain; Institut d'Investigació en Ciències Germans Trias i Pujol, Badalona, Spain; Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
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10
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Cordeiro de Lima VC, Corassa M, Saldanha E, Freitas H, Arrieta O, Raez L, Samtani S, Ramos M, Rojas C, Burotto M, Chamorro DF, Recondo G, Ruiz-Patiño A, Más L, Zatarain-Barrón L, Mejía S, Nicolas Minata J, Martín C, Bautista Blaquier J, Motta Guerrero R, Aliaga-Macha C, Carracedo C, Ordóñez-Reyes C, Garcia-Robledo JE, Corrales L, Sotelo C, Ricaurte L, Santoyo N, Cuello M, Jaller E, Rodríguez J, Archila P, Bermudez M, Gamez T, Russo A, Viola L, Malapelle U, de Miguel Perez D, Rolfo C, Rosell R, Cardona AF. STK11 and KEAP1 mutations in non-small cell lung cancer patients: Descriptive analysis and prognostic value among Hispanics (STRIKE registry-CLICaP). Lung Cancer 2022; 170:114-121. [PMID: 35753125 DOI: 10.1016/j.lungcan.2022.06.010] [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: 05/24/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mutations in STK11 (STK11Mut) and, frequently co-occurring, KEAP1 mutations (KEAP1Mut) are associated with poor survival in metastatic Non-small Cell Lung Cancer (mNSCLC) patients treated with immunotherapy. However, there are limited data regarding the prognostic or predictive significance of these genomic alterations among Hispanics. METHODS This retrospective study analyzed a cohort of Hispanic patients (N = 103) diagnosed with mNSCLC from the US and seven Latin American countries (LATAM) treated with immune checkpoint inhibitors (ICI) alone or in combination as first-line (Cohort A). All cases were treated in routine care between January 2016 and December 2021. The main objectives were to determine the association of mutations in STK11 or KEAP1 in these patients' tumors with overall (OS) and progression-free survival (PFS), presence of KRAS mutations, tumor mutational burden (TMB), and other relevant clinical variables. To compare outcomes with a STK11Wt/KEAP1Wt population, historical data from a cohort of Hispanic patients (N = 101) treated with first-line ICI was used, matching both groups by country of origin, gender, and Programed Death-ligand 1 (PD-L1) expression level (Cohort B). RESULTS Most tumors had mutations only in STK11 or KEAP1 (45.6%) without KRAS co-mutation or any other genomic alteration. Besides, 35%, 8.7%, 6.8%, and 3.9% were KRASMut + STK11Mut, KRASMut + STK11Mut + KEAP1Mut, STK11Mut + KEAP1Mut, and KRASMut + KEAP1Mut, respectively. Based on KRAS status, STK11 alterations were associated with significantly lower PD-L1 expression among those with KRASWt (p = 0.023), whereas KEAP1 mutations were predominantly associated with lower PD-L1 expression among KRASMut cases (p = 0.047). Tumors with KRASMut + KEAP1Mut had significantly higher median TMB when compared to other tumors (p = 0.040). For Cohort A, median PFS was 4.9 months (95%CI 4.3-5.4), slightly longer in those with KEAP1mut 6.1 months versus STK11Mut 4.7 months (p = 0.38). In the same cohort, PD-L1 expression and TMB did not influence PFS. OS was significantly longer among patients with tumors with PD-L1 ≥ 50% (30.9 months), and different from those with PD-L1 1-49% (22.0 months), and PD-L1 < 1% (12.0 months) (p = 0.0001). When we compared the cohorts A and B, OS was significantly shorter for patients carrying STK1 [STK11Mut 14.2 months versus STK11Wt 27.0 months (p = 0.0001)] or KEAP1 [KEAP1Mut 12.0 months versus KEAP1Wt 24.4 months (p = 0.005)] mutations. PD-L1 expression significantly affected OS independently of the presence of mutations in STK11, KEAP1, or KRAS. TMB-H favored better OS. CONCLUSIONS This is the first large Hispanic cohort to study the impact of STK11 and KEAP1 mutations in NSCLC patient treated with ICI. Our data suggest that mutations in the above-mentioned genes are associated with PD-L1 expression levels and poor OS.
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Affiliation(s)
| | - Marcelo Corassa
- Thoracic Oncology Unit, A.C.Camargo Cancer Center, Sao Paulo, Brazil
| | - Erick Saldanha
- Thoracic Oncology Unit, A.C.Camargo Cancer Center, Sao Paulo, Brazil
| | - Helano Freitas
- Thoracic Oncology Unit, A.C.Camargo Cancer Center, Sao Paulo, Brazil
| | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), México City, Mexico
| | - Luis Raez
- Thoracic Oncology Department, Memorial Cancer Institute, Memorial Health Care System, Miami, FL, USA
| | - Suraj Samtani
- Medical Oncology Department, Bradford Hill Clinical Research Center, Santiago, Chile
| | - Maritza Ramos
- Thoracic Oncology Unit, National Cancer Institute (INCan), México City, Mexico
| | - Carlos Rojas
- Medical Oncology Department, Bradford Hill Clinical Research Center, Santiago, Chile
| | - Mauricio Burotto
- Medical Oncology Department, Bradford Hill Clinical Research Center, Santiago, Chile
| | - Diego F Chamorro
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Gonzalo Recondo
- Thoracic Oncology Unit, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Luis Más
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas - INEN, Lima, Peru
| | | | - Sergio Mejía
- Clinical Oncology Department, Instituto de Cancerologia - Clinica las Americas - AUNA, Colombia
| | - José Nicolas Minata
- Clinical Oncology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Claudio Martín
- Thoracic Oncology Unit, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - Juan Bautista Blaquier
- Thoracic Oncology Unit, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | | | | | - Carlos Carracedo
- Clinical Oncology Department, Centro Oncológico Aliada, Lima, Peru
| | - Camila Ordóñez-Reyes
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Luis Corrales
- Thoracic Oncology Unit, Centro de Investigación y Manejo del Cáncer - CIMCA, San José, Costa Rica
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Nicolas Santoyo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Mauricio Cuello
- Medical Oncology Department, Hospital de Clínicas, Universidad de la Republica -UdeLAR, Montevideo, Uruguay
| | - Elvira Jaller
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Maritza Bermudez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Tatiana Gamez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Alessandro Russo
- Medical Oncology Department, Azienda Ospedaliera Papardo, Messina, Sicilia, Italy
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - Umberto Malapelle
- Predictive Molecular Pathology Laboratory, Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Diego de Miguel Perez
- Center for Thoracic Oncology, The Tisch Cancer Institute Icahn School of Medicine, Mount Sinai, Mount Sinai Health System, One Gustave Levy Place, NY, USA
| | - Christian Rolfo
- Center for Thoracic Oncology, The Tisch Cancer Institute Icahn School of Medicine, Mount Sinai, Mount Sinai Health System, One Gustave Levy Place, NY, USA
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Germans Trias i Pujol Research Institute (IGTP)/Dr. Rosell Oncology Institute (IOR) Quirón-Dexeus University Institute, Barcelona, Spain
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia; Direction of Research, Science and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia.
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11
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Ordóñez-Reyes C, Garcia-Robledo JE, Chamorro DF, Mosquera A, Sussmann L, Ruiz-Patiño A, Arrieta O, Zatarain-Barrón L, Rojas L, Russo A, de Miguel-Perez D, Rolfo C, Cardona AF. Bispecific Antibodies in Cancer Immunotherapy: A Novel Response to an Old Question. Pharmaceutics 2022; 14:pharmaceutics14061243. [PMID: 35745815 PMCID: PMC9229626 DOI: 10.3390/pharmaceutics14061243] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 04/24/2022] [Revised: 06/02/2022] [Accepted: 06/08/2022] [Indexed: 01/14/2023] Open
Abstract
Immunotherapy has redefined the treatment of cancer patients and it is constantly generating new advances and approaches. Among the multiple options of immunotherapy, bispecific antibodies (bsAbs) represent a novel thoughtful approach. These drugs integrate the action of the immune system in a strategy to redirect the activation of innate and adaptive immunity toward specific antigens and specific tumor locations. Here we discussed some basic aspects of the design and function of bsAbs, their main challenges and the state-of-the-art of these molecules in the treatment of hematological and solid malignancies and future perspectives.
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Affiliation(s)
- Camila Ordóñez-Reyes
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá 110111, Colombia; (C.O.-R.); (J.E.G.-R.); (D.F.C.); (A.M.); (A.R.-P.); (L.R.)
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá 110121, Colombia
| | - Juan Esteban Garcia-Robledo
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá 110111, Colombia; (C.O.-R.); (J.E.G.-R.); (D.F.C.); (A.M.); (A.R.-P.); (L.R.)
- Division of Hematology/Oncology, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Diego F. Chamorro
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá 110111, Colombia; (C.O.-R.); (J.E.G.-R.); (D.F.C.); (A.M.); (A.R.-P.); (L.R.)
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá 110121, Colombia
| | - Andrés Mosquera
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá 110111, Colombia; (C.O.-R.); (J.E.G.-R.); (D.F.C.); (A.M.); (A.R.-P.); (L.R.)
| | - Liliana Sussmann
- Department of Neurology, Fundación Universitaria de Ciencias de la Salud, Bogotá 111221, Colombia;
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá 110111, Colombia; (C.O.-R.); (J.E.G.-R.); (D.F.C.); (A.M.); (A.R.-P.); (L.R.)
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá 110121, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), Mexico City 14080, Mexico; (O.A.); (L.Z.-B.)
| | - Lucia Zatarain-Barrón
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), Mexico City 14080, Mexico; (O.A.); (L.Z.-B.)
| | - Leonardo Rojas
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá 110111, Colombia; (C.O.-R.); (J.E.G.-R.); (D.F.C.); (A.M.); (A.R.-P.); (L.R.)
| | | | - Diego de Miguel-Perez
- Center for Thoracic Oncology, Tisch Cancer Institute and Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (D.d.M.-P.); (C.R.)
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cancer Institute and Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (D.d.M.-P.); (C.R.)
| | - Andrés F. Cardona
- Foundation for Clinical and Applied Cancer Research—FICMAC, Bogotá 110111, Colombia; (C.O.-R.); (J.E.G.-R.); (D.F.C.); (A.M.); (A.R.-P.); (L.R.)
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá 110121, Colombia
- Direction of Research, Science and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá 110131, Colombia
- Correspondence: ; Tel.: +57-(1)-6190052; Fax: +57-(1)-6190053
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Cardona AF, Ruiz-Patiño A, Recondo G, Martín C, Raez L, Samtani S, Minata JN, Blaquier JB, Enrico D, Burotto M, Ordóñez-Reyes C, Chamorro DF, Garcia-Robledo JE, Corrales L, Zatarain-Barrón ZL, Más L, Sotelo C, Ricaurte L, Santoyo N, Cuello M, Mejía S, Jaller E, Vargas C, Carranza H, Otero J, Rodríguez J, Archila P, Bermudez M, Gamez T, de Lima VC, Freitas H, Russo A, Polo C, Malapelle U, Perez DDM, Rolfo C, Viola L, Rosell R, Arrieta O. Mechanisms of Resistance to first-line Osimertinib in Hispanic patients with EGFR mutant non-small cell lung cancer (FRESTON-CLICaP). Clin Lung Cancer 2022; 23:522-531. [DOI: 10.1016/j.cllc.2022.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/24/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022]
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13
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Burgos R, Cardona AF, Santoyo N, Ruiz-Patiño A, Cure-Casilimas J, Rojas L, Ricaurte L, Muñoz Á, Garcia-Robledo JE, Ordoñez C, Sotelo C, Rodríguez J, Zatarain-Barrón ZL, Pineda D, Arrieta O. Case Report: Differential Genomics and Evolution of a Meningeal Melanoma Treated With Ipilimumab and Nivolumab. Front Oncol 2022; 11:691017. [PMID: 35070950 PMCID: PMC8766339 DOI: 10.3389/fonc.2021.691017] [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] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
Primary melanocytic tumors of the CNS are extremely rare conditions, encompassing different disease processes including meningeal melanoma and meningeal melanocytosis. Its incidence range between 3-5%, with approximately 0.005 cases per 100,000 people. Tumor biological behavior is commonly aggressive, with poor prognosis and very low survivability, and a high recurrence rate, even after disease remission with multimodal treatments. Specific genetic alterations involving gene transcription, alternative splicing, RNA translation, and cell proliferation are usually seen, affecting genes like BRAF, TERT, GNAQ, SF3B1, and EIF1AX. Here we present an interesting case of a 59-year-old male presenting with neurologic symptoms and a further confirmed diagnosis of primary meningeal melanoma. Multiple therapy lines were used, including radiosurgery, immunotherapy, and chemotherapy. The patient developed two relapses and an evolving genetic makeup that confirmed the disease’s clonal origin. We also provide a review of the literature on the genetic basis of primary melanocytic tumors of the CNS.
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Affiliation(s)
- Remberto Burgos
- Neurosurgery Department, Clínica del Country/Clínica Colsanitas, Bogotá, Colombia
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia.,Direction of Research and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
| | - Nicolas Santoyo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Leonardo Rojas
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Luisa Ricaurte
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia.,Direction of Research and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
| | - Álvaro Muñoz
- Radiotherapy Department, Carlos Ardila Lulle Institute of Cancer (ICCAL), Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Camila Ordoñez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Zyanya Lucia Zatarain-Barrón
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), México City, Mexico
| | - Diego Pineda
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), México City, Mexico
| | - Oscar Arrieta
- Radiology Department, Clinica del County/Resonancia Magnética de Colombia, Bogotá, Colombia
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14
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Ruiz-Patiño A, Rodríguez J, Cardona AF, Ávila J, Archila P, Carranza H, Vargas C, Otero J, Arrieta O, Zatarain-Barrón L, Sotelo C, Ordoñez C, García-Robledo JE, Rojas L, Bermúdez M, Gámez T, Mayorga D, Corrales L, Martín C, Recondo G, Mas L, Samtani S, Ricaurte L, Malapelle U, Russo A, Barrón F, Santoyo N, Rolfo C, Rosell R. p.G12C KRAS mutation prevalence in non-small cell lung cancer: Contribution from interregional variability and population substructures among Hispanics. Transl Oncol 2021; 15:101276. [PMID: 34823093 PMCID: PMC8626684 DOI: 10.1016/j.tranon.2021.101276] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/01/2021] [Accepted: 11/04/2021] [Indexed: 11/29/2022] Open
Abstract
The identification of the KRAS G12C mutation in non-small cell lung cancer is relevant with new molecules being introduced for treatment. The variation of mutation prevalence among different regions indicate that certain populations are more prone to develop KRAS G12C mutations among lung cancer than others. Using genomic markers traditionally employed for the identification of individuals we managed to construct a model that was predictive for KRAS G12C mutational incidence, further indicating that appearance of KRAS G12C follows population substructures.
Background The KRAS exon 2 p. G12C mutation in patients with lung adenocarcinoma has been increasing in relevance due to the development and effectiveness of new treatment medications. Studies around different populations indicate that regional variability between ethnic groups and ancestries could play an essential role in developing this molecular alteration within lung cancer. Methods In a prospective and retrospective cohort study on samples from lung adenocarcinoma from 1000 patients from different administrative regions in Colombia were tested for the KRAS p.G12C mutation. An analysis of STR populations markers was conducted to identify substructure contributions to mutation prevalence. Results Included were 979 patients with a national mean frequency for the KRAS exon 2 p.G12C mutation of 7.97% (95%CI 6.27–9.66%). Variation between regions was also identified with Antioquia reaching a positivity value of 12.7% (95%CI 9.1–16.3%) in contrast to other regions such as Bogota DC (Capital region) with 5.4% (2.7–8.2%) and Bolivar with 2.4% (95%CI 0–7.2%) (p-value = 0.00262). Furthermore, Short tandem repeat population substructures were found for eight markers that strongly yielded association with KRAS exon 2 p.G12C frequency reaching an adjusted R2 of 0.945 and a p-value of < 0.0001. Conclusions Widespread identification of KRAS exon 2 p.G12C mutations, especially in cases where NGS is not easily achieved is feasible at a population based level that can characterize regional and national patterns of mutation status. Furthermore, this type of mutation prevalence follows a population substructure pattern that can be easily determined by population and ancestral markers such as STR.
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Affiliation(s)
- Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia.
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia.
| | - Jenny Ávila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), México, Mexico
| | | | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Camila Ordoñez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | | | - Leonardo Rojas
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia; Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Maritza Bermúdez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Tatiana Gámez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Diana Mayorga
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Luis Corrales
- Oncology Department, Hospital San Juan de Dios, San José Costa Rica, Costa Rica
| | - Claudio Martín
- Medical Oncology Group, Fleming Institute, Buenos Aires, Argentina
| | - Gonzalo Recondo
- Thoracic Oncology Section, Centro de Educación Médica e Investigaciones Clínicas - CEMIC, Buenos Aires, Argentina
| | - Luis Mas
- Thoracic Oncology Unit, Instituto de Enfermedades Neoplásicas, Lima, Perú
| | - Suraj Samtani
- Medical Oncology Service, Clinica Bradford Hill, Santiago, Chile
| | - Luisa Ricaurte
- Pathology Department, Mayo Clinic, Rochester, MN, United States
| | - Umberto Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Feliciano Barrón
- Thoracic Oncology Unit, National Cancer Institute (INCan), México, Mexico
| | - Nicolas Santoyo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cáncer Center, Mount Sinai Hospital System & Icahn School of Medicine, Mount Sinai, New York, NY, United States
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Barcelona, Spain
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- Colombian Group for Clinical and Translational Cancer Research - ONCOLGroup
| | -
- Latin American Consortium for the Investigation of Lung Cancer - CLICaP
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Cardona AF, Ordóñez-Reyes C, Ruiz-Patiño A, Garcia-Robledo JE, Barron LZ, Recondo G, Rojas L, Corrales L, Martín C, Barrón F, Sotelo C, Rodríguez J, Ricaurte L, Rolfo C, Ávila J, Mayorga D, Archila P, Otero J, Mas L, Bermudez M, Gamez T, Carranza H, Vargas C, Rosell R, Arrieta O. EGFR Inhibitors Plus Bevacizumab are Superior Than EGFR Inhibitors Alone as First-Line Setting in Advanced NSCLC With EGFR Mutations and BIM Deletion Polymorphisms (BIM-CLICaP). JCO Precis Oncol 2021; 5:839-848. [DOI: 10.1200/po.20.00404] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE BIM activation is essential for epidermal growth factor receptor ( EGFR)-tyrosine kinase inhibitor (TKI)–triggered apoptosis in EGFR-mutant non–small-cell lung cancer (NSCLC). A deletion in the intron two of the BIM gene results in generation of alternatively spliced isoforms that impairs their apoptotic response to TKIs, conferring the NSCLC cells intrinsic resistance to these medications. Patients with both alterations have poor clinical evolution. The current study aimed to investigate the clinical efficacy and tolerability of EGFR-TKIs plus bevacizumab (Bev) versus EGFR-TKIs alone as first-line treatment in advanced NSCLC patients with EGFR mutations and BIM deletions ( BIMdel). MATERIALS AND METHODS A retrospective analysis was conducted. BIMdel was detected using polymerase chain reaction analysis and direct sequencing of DNA. BIM protein expression was investigated by immunohistochemistry, and BIM mRNA levels by reverse transcriptase-polymerase chain reaction. Clinical characteristics, overall survival, progression-free survival (PFS), overall response rate (ORR), and treatment-related adverse events were compared between both groups. RESULTS Thirty-three patients were included; 15 received EGFR-TKIs, and 18 received EGFR-TKIs plus Bev. The median age was 63 years, with a majority of recruited female patients. All included individuals had an Eastern Cooperative Oncology Group performance score of 2 or less. The addition of Bev resulted in a significantly higher ORR (94.4% v 40%, P > .001). Median PFS was longer with the use of the combination therapy (11.12 v 7.87 months; P = .001). Median overall survival tended to be longer in the EGFR-TKIs plus Bev (30.9 v 25.4 months; P = .06) but failed to reach statistical significance. Response in terms of both partial and complete as well as overall favorably affected PFS. CONCLUSION EGFR-TKIs plus Bev conferred a significantly higher ORR and PFS in advanced NSCLC patients with EGFR mutation and BIMdel. Further prospective studies are needed to validate these findings.
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Affiliation(s)
- Andrés F. Cardona
- Clinical and Translational Oncology Group, Clínica del Country, 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
| | - Camila Ordóñez-Reyes
- 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
| | - Alejandro Ruiz-Patiño
- 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
| | | | | | - Gonzalo Recondo
- Thoracic Oncology Section, Centro de Educación Médica e Investigaciones Clínicas—CEMIC, Buenos Aires, Argentina
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
- Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Luis Corrales
- Oncology Unit, Hospital San Juan de Dios/Centro de Investigación y Manejo del Cáncer (CIMCA), San José, Costa Rica
| | - Claudio Martín
- Medical Oncology Department, Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
| | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, México
| | - Carolina Sotelo
- 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
| | - July Rodríguez
- 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
| | - Luisa Ricaurte
- 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
- Pathology Department, Mayo Clinic, Rochester, MN
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jenny Ávila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Diana Mayorga
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Pilar Archila
- 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
| | - Jorge Otero
- 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
| | - Luis Mas
- Thoracic Oncology Department, Instituto Nacional de Enfermedades Neoplásicas—INEN, Lima, Perú
| | - Maritza Bermudez
- 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
| | - Tatiana Gamez
- 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
| | - Hernán Carranza
- Clinical and Translational Oncology Group, Clínica del Country, 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
| | - Carlos Vargas
- Clinical and Translational Oncology Group, Clínica del Country, 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
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, México
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Ruiz-Patiño A, Rodriguez J, Avila Coy J, Archila P, Cardona Zorrilla A, Sotelo C, Carranza H, Vargas C, Otero J, Bermudez M, Gamez T, Arrieta O, Rojas Puentes L, Corrales L, Martin C, Garcia-Robledo J, Santoyo Sarmiento N, Rolfo C, Rosell R. P59.14 Concordance and Performance of ddPCR Compared to NGS for The Detection of KRAS G12C Mutation. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.603] [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: 11/29/2022]
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Ruiz-Patiño A, Rodriguez J, Avila Coy J, Archila P, Cardona Zorrilla A, Sotelo C, Carranza H, Vargas C, Otero J, Bermudez M, Gamez T, Arrieta O, Zatarain Barron L, Puentes LR, Corrales L, Martin C, Garcia-Robledo J, Sarmiento NS, Rolfo C, Rosell R. P70.01 KRAS G12C Mutations Among NSCLC Patients Present With a High Intrerregional Variation, Indicating a Population Substructure. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.710] [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: 10/20/2022]
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18
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Ruiz-Patiño A, Rodriguez J, Avila Coy J, Archila P, Cardona Zorrilla A, Sotelo C, Carranza H, Vargas C, Otero J, Bermudez M, Gamez T, Arrieta O, Zatarain Barron L, Puentes LR, Corrales L, Martin C, Garcia-Robledo J, Sarmiento NS, Rolfo C, Rosell R. P70.08 Allelic Frequencies of Population Markers Correlate with KRAS G12C Prevalence: Considerations for Ancestries and Molecular Epidemiology. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.717] [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: 11/24/2022]
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Cardona AF, Jaramillo-Velásquez D, Ruiz-Patiño A, Polo C, Jiménez E, Hakim F, Gómez D, Ramón JF, Cifuentes H, Mejía JA, Salguero F, Ordoñez C, Muñoz Á, Bermúdez S, Useche N, Pineda D, Ricaurte L, Zatarain-Barrón ZL, Rodríguez J, Avila J, Rojas L, Jaller E, Sotelo C, Garcia-Robledo JE, Santoyo N, Rolfo C, Rosell R, Arrieta O. Efficacy of osimertinib plus bevacizumab in glioblastoma patients with simultaneous EGFR amplification and EGFRvIII mutation. J Neurooncol 2021; 154:353-364. [PMID: 34498213 DOI: 10.1007/s11060-021-03834-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/19/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Amplification of EGFR and its active mutant EGFRvIII are common in glioblastoma (GB). While EGFR and EGFRvIII play critical roles in pathogenesis, targeted therapy with EGFR-tyrosine kinase inhibitors or antibodies has shown limited efficacy. To improve the likelihood of effectiveness, we targeted adult patients with recurrent GB enriched for simultaneous EGFR amplification and EGFRvIII mutation, with osimertinib/bevacizumab at doses described for non-small cell lung cancer. METHODS We retrospectively explored whether previously described EGFRvIII mutation in association with EGFR gene amplification could predict response to osimertinib/bevacizumab combination in a subset of 15 patients treated at recurrence. The resistance pattern in a subgroup of subjects is described using a commercial next-generation sequencing panel in liquid biopsy. RESULTS There were ten males (66.7%), and the median patient's age was 56 years (range 38-70 years). After their initial diagnosis, 12 patients underwent partial (26.7%) or total resection (53.3%). Subsequently, all cases received IMRT and concurrent and adjuvant temozolomide (TMZ; the median number of cycles 9, range 6-12). The median follow-up after recurrence was 17.1 months (95% CI 12.3-22.6). All patients received osimertinib/bevacizumab as a second-line intervention with a median progression-free survival (PFS) of 5.1 months (95% CI 2.8-7.3) and overall survival of 9.0 months (95% CI 3.9-14.0). The PFS6 was 46.7%, and the overall response rate was 13.3%. After exposure to the osimertinib/bevacizumab combination, the main secondary alterations were MET amplification, STAT3, IGF1R, PTEN, and PDGFR. CONCLUSIONS While the osimertinib/bevacizumab combination was marginally effective in most GB patients with simultaneous EGFR amplification plus EGFRvIII mutation, a subgroup experienced a long-lasting meaningful benefit. The findings of this brief cohort justify the continuation of the research in a clinical trial. The pattern of resistance after exposure to osimertinib/bevacizumab includes known mechanisms in the regulation of EGFR, findings that contribute to the understanding and targeting in a stepwise rational this pathway.
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Affiliation(s)
- Andrés F Cardona
- Clinical and Translational Oncology Group, Brain Tumor Unit, Clínica del Country, Calle 116 No. 9 - 72, c. 318, Bogotá, Colombia. .,Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia. .,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia. .,Thoracic Oncology Unit, Clínica del Country, Bogotá, Colombia.
| | | | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Carolina Polo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Enrique Jiménez
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Fernando Hakim
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Diego Gómez
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | | | | | - Fernando Salguero
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Camila Ordoñez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Álvaro Muñoz
- Radio-Oncology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Sonia Bermúdez
- Neuroradiology Section, Radiology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Nicolas Useche
- Neuroradiology Section, Radiology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Diego Pineda
- Neuroradiology Section, Radiology Department, Clínica del Country, Bogotá, Colombia
| | | | | | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Jenny Avila
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Brain Tumor Unit, Clínica del Country, Calle 116 No. 9 - 72, c. 318, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia.,Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Elvira Jaller
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Nicolas Santoyo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cáncer Center, Mount Sinai Hospital System & Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Oscar Arrieta
- Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
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20
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Cardona AF, Ruiz-Patiño A, Zatarain-Barron ZL, Ariza S, Ricaurte L, Rolfo C, Arrieta O. Refractory Bullous Pemphigoid in a Patient with Metastatic Lung Adenocarcinoma Treated with Pembrolizumab. Case Rep Oncol 2021; 14:386-390. [PMID: 33776733 PMCID: PMC7983585 DOI: 10.1159/000514144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/28/2020] [Accepted: 12/28/2020] [Indexed: 12/25/2022] Open
Abstract
We present the case of a 73-year-old male patient with a history of tobacco use who presented with a central nervous system mass that was confirmed to be a lung adenocarcinoma metastasis. High PD-L1 expression as well as negativity to other targetable drivers led to initiation of pembrolizumab monotherapy and ablative stereotactic radiation therapy on oligo-residual disease, achieving a complete response after 2 years of therapy. Following discontinuation of systemic treatment, the patient developed widespread desquamative plaques. A skin biopsy revealed subepidermal blistering and eosinophilic infiltration in conjunction with C3 and IgG depositions on the basement membrane, detected by immunofluorescence. A diagnosis of bullous pemphigoid was obtained, and systemic corticosteroids were administered with lesion progression. Infliximab was also administered without meaningful clinical improvement. Metronomic cyclophosphamide achieved a complete resolution of skin lesions and up to this day the patient continues with tumor control and is free of dermatological findings. In conclusion, bullous pemphigoid is a very rare dermatological adverse effect related with pembrolizumab treatment. Only two cases, including this one, have been reported, especially with this medication for the treatment of non-small cell lung cancer. With more reported cases, management strategies can be optimized even in the steroid refractory setting.
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Affiliation(s)
- Andrés F Cardona
- Oncology Department, Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Oncology Department, Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | | | - Santiago Ariza
- Dermatology Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Luisa Ricaurte
- Pathology Department, Mayo Clinic, Rochester, Minnesota, USA
| | - Christian Rolfo
- Thoracic Oncology Unit, Marlene and Stewart Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland, USA
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
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21
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Cardona AF, Ruiz-Patiño A, Arrieta O, Ricaurte L, Zatarain-Barrón ZL, Rodriguez J, Avila J, Rojas L, Recondo G, Barron F, Archila P, Sotelo C, Bravo M, Zamudio N, Corrales L, Martín C, Rolfo C, Viola L, Carranza H, Vargas C, Otero J, Bermudez M, Gamez T, Pino LE, Rosell R. Genotyping Squamous Cell Lung Carcinoma in Colombia (Geno1.1-CLICaP). Front Oncol 2021; 10:588932. [PMID: 33384957 PMCID: PMC7771515 DOI: 10.3389/fonc.2020.588932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/10/2020] [Indexed: 11/29/2022] Open
Abstract
Background Lung cancer is a public health problem, and squamous cell carcinoma (SCC) is the second most prevalent subtype of this neoplasm. Compared to other subtypes, including adenocarcinoma, SCC is less well understood in terms of molecular pathogenesis, limiting therapeutic options among targeted agents approved for other disease subgroups. In this study, we sought to characterize the SCC genomic profile using a validated Next Generation Sequencing (NGS) platform. Methods The comprehensive NGS assay (TruSight Tumor 170) was used in order to target the full coding regions of 170 cancer-related genes on SCC samples. PD-L1 expression in tumor cells (TCs) was assessed using clone 22C3 (Dako). Clinical outcomes were correlated with molecular profile, including progression free survival (PFS), overall response rate (ORR), and overall survival (OS). Results A total of 26 samples were included, median age was 67 years (r, 33–83) and 53.8% were men. Tobacco consumption was identified in all subjects (mean 34-year package). For first-line treatment 80.8% of patients received cisplatin or carboplatin plus gemcitabine. In terms of molecular profile, we identified a high prevalence of inactivating mutations in TP53 (61.5%), PIK3CA (34.6%), MLL2 (34.6%), KEAP1 (38.4%), and NOTCH1 (26.9%). PD-L1 expression ranged from negative, 1, 2–49, and ≥50% in 23.1, 38.5, 26.9, and 11.5%, respectively. Interestingly, the genetic alterations did not have an effect in PFS, OS or ORR in this study. However, PDL1 expression was higher among those who had mutations in TP53 (p = 0.037) and greater expression of PDL1 was related to PIK3CA alterations (p = 0.05). Conclusions The genomic profile of SCC encompasses important genes including TP53, PIK3CA and KEAP1. TP53 mutations could be associated with PDL1 expression, generating hypothesis regarding specific treatment options.
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Affiliation(s)
- Andrés F Cardona
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, 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), México City, México
| | - Luisa Ricaurte
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | | | - July Rodriguez
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jenny Avila
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia.,Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Gonzalo Recondo
- Thoracic Oncology Section, Centro de Educación Médica e Investigaciones Clínicas - CEMIC, Buenos Aires, Argentina
| | - Feliciano Barron
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - Pilar Archila
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Carolina Sotelo
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Melissa Bravo
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Nataly Zamudio
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Luis Corrales
- Oncology Department, Hospital San Juan de Dios, San José Costa Rica, Costa Rica
| | - Claudio Martín
- Medical Oncology Group, Fleming Institute, Buenos Aires, Argentina
| | - Christian Rolfo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - Hernán Carranza
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Carlos Vargas
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jorge Otero
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Maritza Bermudez
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Tatiana Gamez
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Luis Eduardo Pino
- Department of Medical Oncology, Fundación Santa Fé de Bogotá, Bogotá, Colombia
| | - Rafael Rosell
- Department of Medical Oncology, Catalan Institute of Oncology, Barcelona, Spain
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22
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Russo A, Cardona AF, Caglevic C, Manca P, Ruiz-Patiño A, Arrieta O, Rolfo C. Overcoming TKI resistance in fusion-driven NSCLC: new generation inhibitors and rationale for combination strategies. Transl Lung Cancer Res 2020; 9:2581-2598. [PMID: 33489820 PMCID: PMC7815353 DOI: 10.21037/tlcr-2019-cnsclc-06] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Indexed: 12/27/2022]
Abstract
During the last several years, multiple gene rearrangements with oncogenic potential have been described in NSCLC, identifying specific clinic-pathological subgroups of patients that benefit from a targeted therapeutic approach, including anaplastic lymphoma kinase (ALK), c-ros protooncogene 1 (ROS1) and, more recently, REarranged during Transfection (RET) and neurotrophic tyrosine receptor kinases (NTRK) genes. Despite initial impressive antitumor activity, the use of targeted therapies in oncogene-addicted NSCLC subgroups is invariably associated with the development of acquired resistance through multiple mechanisms that can include both on-target and off-target mechanisms. However, the process of acquired resistance is a rapidly evolving clinical scenario that constantly evolves under the selective pressure of tyrosine kinase inhibitors. The development of increasingly higher selective and potent inhibitors, traditionally used to overcome resistance to first generation inhibitors, is associated with the development of novel mechanisms of resistance that encompass complex resistance mutations, highly recalcitrant to available TKIs, and bypass track mechanisms. Herein, we provide a comprehensive overview on the therapeutic strategies for overcoming acquired resistance to tyrosine kinase inhibitors (TKIs) targeting the most well-established oncogenic gene fusions in advanced NSCLC, including ALK, ROS1, RET, and NTRK rearrangements.
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Affiliation(s)
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Christian Caglevic
- Head of Cancer Research Department, Instituto Oncologico Fundacion Arturo Lopez Perez, Santiago, Chile
| | - Paolo Manca
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), 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), México City, México
| | - Christian Rolfo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
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23
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Arrieta O, Cardona AF, Lara-Mejía L, Heredia D, Barrón F, Zatarain-Barrón ZL, Lozano F, de Lima VC, Maldonado F, Corona-Cruz F, Ramos M, Cabrera L, Martin C, Corrales L, Cuello M, Arroyo-Hernández M, Aman E, Bacon L, Baez R, Benitez S, Botero A, Burotto M, Caglevic C, Ferraris G, Freitas H, Kaen DL, Lamot S, Lyons G, Mas L, Mata A, Mathias C, Muñoz A, Patane AK, Oblitas G, Pino L, Raez LE, Remon J, Rojas L, Rolfo C, Ruiz-Patiño A, Samtani S, Viola L, Viteri S, Rosell R. Recommendations for detection, prioritization, and treatment of thoracic oncology patients during the COVID-19 pandemic: the THOCOoP cooperative group. Crit Rev Oncol Hematol 2020; 153:103033. [PMID: 32650215 PMCID: PMC7305738 DOI: 10.1016/j.critrevonc.2020.103033] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/13/2020] [Indexed: 12/16/2022] Open
Abstract
The world currently faces a pandemic due to SARS-CoV-2. Relevant information has emerged regarding the higher risk of poor outcomes in lung cancer patients. As such, lung cancer patients must be prioritized in terms of prevention, detection and treatment. On May 7th, 45 experts in thoracic cancers from 11 different countries were invited to participate. A core panel of experts regarding thoracic oncology care amidst the pandemic gathered virtually, and a total of 60 initial recommendations were drafted based on available evidence, 2 questions were deleted due to conflicting evidence. By May 16th, 44 experts had agreed to participate, and voted on each of the 58 recommendation using a Delphi panel on a live voting event. Consensus was reached regarding the recommendations (>66 % strongly agree/agree) for 56 questions. Strong consensus (>80 % strongly agree/agree) was reached for 44 questions. Patients with lung cancer represent a particularly vulnerable population during this time. Special care must be taken to maintain treatment while avoiding exposure.
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Affiliation(s)
- Oscar Arrieta
- Instituto Nacional de Cancerología, Mexico City, Mexico.
| | - Andrés F Cardona
- Thoracic Oncology Clinic, Clínica del Country, Bogotá, Colombia; Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | | | - David Heredia
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | | | | | | | | | | | - Maritza Ramos
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Luis Cabrera
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Claudio Martin
- Thoracic Oncology Unit, Alexander Fleming Institute, Buenos Aires, Argentina; Hospital Maria Ferrer, Buenos Aires, Argentina
| | - Luis Corrales
- Oncology Department, Hospital San Juan de Dios, San José Costa Rica, Costa Rica; Oncología Médica, Centro de Investigación y Manejo del Cáncer (CIMCA), San José, Costa Rica
| | - Mauricio Cuello
- Department of Oncology, Hospital de Clínicas, Universidad de la República - UDELAR, Montevideo, Uruguay
| | | | - Enrique Aman
- Clinical Oncology Unit, Swiss Medical Group, Buenos Aires, Argentina
| | - Ludwing Bacon
- Centro de Oncología, Hospital Vivián Pellas, Nicaragua
| | - Renata Baez
- National Institute for Respiratory Diseases, Mexico City, Mexico
| | - Sergio Benitez
- Coordinador de la sección Oncología, asociación Argentina de Medicina Respiratoria, Argentina
| | | | - Mauricio Burotto
- Clínica Universidad de los Andes, Centro de Estudios Clínicos Bradford Hill, Chile
| | - Christian Caglevic
- Departamento de Investigación del Cáncer- Fundación Arturo López Pérez, Santiago, Chile
| | - Gustavo Ferraris
- Centro Médico Dean Funes, Radioterapia Oncológica, Córdoba, Argentina
| | - Helano Freitas
- Departamento de Oncologia Clínica - A C Camargo Cancer Center, São Paulo, Brazil
| | | | - Sebastián Lamot
- CONCIENCIA, Instituto Oncohematológico de la Patagonia, Chile
| | - Gustavo Lyons
- Department of Thoracic Surgery, Hospital Británico, Buenos Aires, Argentina
| | - Luis Mas
- Medical Oncology Department, National Institute for Neoplastic Diseases - INEN, Lima, Peru
| | - Andrea Mata
- Hospital La Católica Goicoechea, San José, Costa Rica
| | | | | | - Ana Karina Patane
- Hospital de Rehabilitacion Respiratoria María Ferrer, Buenos Aires, Argentina
| | | | - Luis Pino
- Medical Oncology Group, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Luis E Raez
- Thoracic Oncology Program Memorial Cancer Institute, Memorial Healthcare System, Pembroke Pines, FL, United States
| | - Jordi Remon
- Medical Oncology Department, Centro Integral Oncología Clara Campal Bacelona, HM-Delfos, Barcelona, Spain
| | - Leonardo Rojas
- Medical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Christian Rolfo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | | | - Suraj Samtani
- Medical Oncology Department, Clínica Bradford Hill, Santiago, Chile
| | - Lucia Viola
- Fundación neumológica colombiana, Bogotá, Colombia
| | - Santiago Viteri
- Instituto Oncológico Dr. Rosell. Centro Médico Teknon. Grupo QuironSalud. Barcelona, España
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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24
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Ruiz-Patiño A, Barrón F, Cardona AF, Corrales L, Mas L, Martín C, Zatarain-Barrón ZL, Recondo G, Ricaurte L, Rojas L, Archila P, Rodríguez J, Sotelo C, Viola L, Vargas C, Carranza H, Otero J, Pino LE, Rolfo C, Rosell R, Arrieta O. Antibiotics impair immune checkpoint inhibitor effectiveness in Hispanic patients with non-small cell lung cancer (AB-CLICaP). Thorac Cancer 2020; 11:2552-2560. [PMID: 32705787 PMCID: PMC7471049 DOI: 10.1111/1759-7714.13573] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 05/28/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 12/11/2022] Open
Abstract
Background The intestinal microbiota is an important factor in modulating immune‐mediated tumor cell destruction. Alterations in the microbiome composition have been linked to reduced efficacy of immune checkpoint inhibitor (ICI) therapies. Therefore, antibiotic treatment (ATB), which modifies the diversity of the gut bacteria populations, could lead to a reduced efficacy of ICI treatments. Methods This was a retrospective cohort study. Patients with advanced non‐small cell lung cancer (NSCLC) treated with anti‐programmed cell death ligand‐1 (PD‐L1) alone, or in combination in three different countries in Latin America were included. After identification, patients were placed into three groups: Non‐ATB exposed (no‐ATB), exposed within 30 days of the first dose of ICI (pre‐ICI ATB) and patients receiving ATB concomitantly with ICI (ICI‐ATB). Progression‐free survival (PFS), overall survival (OS) and response rates to treatment with ICI were assessed. Results A total of 140 patients were included, of which 32 patients (23%) received ATB treatment. The most common ATB types were fluoroquinolones and B‐lactams. No differences in survival according to antibiotic type were identified. Median OS in patients not exposed to ATB was 40.6 months (95% CI: 32–67.7), compared with 20.3 months (95% CI: 12.1‐non‐reached [NR]) for patients with pre‐ICI ATB treatment and 24.7 months (95% CI: 13‐NR) for patients treated with ATB concomitantly with ICI. There were no significant differences in terms of PFS, or response rates across all treatment groups. Conclusions Antibiotic treatment was associated with reduced OS in Hispanic patients with NSCLC treated with ICIs.
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Affiliation(s)
- Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, Mexico
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Luis Corrales
- Medical Oncology Department, Hospital San Juan de Dios, San José, Costa Rica.,Thoracic Oncology Department, Centro de Investigación y Manejo del Cáncer - CIMCA, San José, Costa Rica
| | - Luis Mas
- Oncology Department, Instituto Nacional de Enfermedades Neoplásicas - IneN, Lima, Peru
| | - Claudio Martín
- Medical Oncology Department, Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
| | | | - Gonzalo Recondo
- Medical Oncology Department, Center for Medical Education and Clinical Research (CEMIC), Buenos Aires, Argentina
| | - Luisa Ricaurte
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neumológica Colombiana- FNC, Bogotá, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Luis E Pino
- Oncology Department, Institute of Oncology - ICAL, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Christian Rolfo
- Thoracic Oncology Unit, Marlene and Stewart Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland, USA
| | - Rafael Rosell
- Institut d'Investigació en Ciències Germans Trias i Pujol, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, Mexico
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25
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Ruiz-Patiño A. La plaga antonina. Medicina (B Aires) 2020. [DOI: 10.56050/01205498.1512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Galeno, médico de la línea hipocrática, nacido en Pérgamo en el siglo II después de Cristo, narraría en su estancia a Roma los casos de una enfermedad exantemática asociada a diarrea y fiebre que tomaría la vida de millones de ciudadanos del imperio romano. Esta enfermedad se diseminó por medio de los legionarios que, posteriormente a la campaña contra los Partos en oriente medio, marcharon de vuelta a la capital imperial para ver como una ola de muerte seguía su paso. El ímpetu de conquista militar perduraría en el espíritu de los emperadores, corregentes de ese entonces, llevando las tropas a la frontera germana y situando nuevamente a Galeno en el frente contra la plaga. En su regreso a Roma, posterior a la muerte del emperador Lucio Vero a manos de la enfermedad, Galeno se encargó de ser curador de la salud del hijo del emperador Marco Aurelio durante varios años, lo que le permitió continuar con sus estudios y su escritura, correspondiendo con su periodo de mayor productividad. La plaga Antonina, como se le conoció a este suceso, perduró por 23 años, tiempo durante el que se presentó en picos reincidentes y llevó el nombre de la dinastía de emperadores que vivieron durante su apogeo. Su impacto fue masivo en todas las áreas de la sociedad romana, con desenlaces fatales, debilitando la estructura misma del imperio y sembrando las bases para su colapso décadas más tarde.
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Ruiz-Patiño A, Cardona AF, Arrieta O, Rolfo C, Gómez HL, Raez LE, Lopes G, Zatarain-Barrón ZL, Ricaurte L, Zamudio-Molano N, Rangel V, Oviedo J, Solano MP, Rojas L, Corrales L, Martín C, Mas L, Cuello M, Barrón F, Otero J, Carranza H, Vargas C, Rosell R. Scientific publications in cancer: in Latin America, strong scientific networks increase productivity (the TENJIN study). J Clin Epidemiol 2020; 126:1-8. [PMID: 32540384 DOI: 10.1016/j.jclinepi.2020.05.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 04/22/2020] [Accepted: 05/11/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The objectives of this study are to evaluate the relationship between authorship networking, socioeconomic factors, and scientific productivity across Latin America. METHODS In a bibliometric analysis of cancer-related Latin-American publications, the relationship between authorship network indicators, sociodemographic factors, and number of peer-reviewed indexed publications per country was explored. A systematic review of the literature for cancer publications between 2000 and 2018 using the Scopus database limited to Latin-American authors was used for the construction of coauthorship and publication networks and their respective metrics. Sociodemographic variables including percentage of invested gross domestic product in research, population, and cancer incidence were also estimated. Multiple linear regression models were constructed to determine the relationship between productivity and the aforementioned variables. RESULTS A total of 8,528 articles across nine countries were included. Brazil was the most productive nation with 41.8% of identified references followed by Mexico (16.6%) and Argentina (12.9%). Latin America experienced a 9% growth in number of publications across the studied time frame. After analyzing networking and sociodemographic variables, number of authors in a collaboration network and percentage of invested gross domestic product were associated with high productivity yielding a multiple regression model with an R2 value of 0.983. CONCLUSIONS This study indicates that extensive authorship networking and a high investment in research strongly predict cancer-related productivity.
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Affiliation(s)
- Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Andrés Felipe Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia.
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología - INCaN, México City, Mexico
| | - Christian Rolfo
- Thoracic Medical Oncology and Early Clinical Trials Unit, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center (UMGCCC), Baltimore, MD, USA
| | - Henry L Gómez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas - INEN, Lima, Peru
| | - Luis E Raez
- Thoracic Oncology Program, Memorial Cancer Institute (MCI), Florida International University (FIU), Miami, FL, USA
| | - Gilberto Lopes
- Global Oncology Department, University of Miami, Sylvester Comprehensive Cancer Center and Miller School of Medicine, Miami, FL, USA
| | | | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Pathology Department, Mayo Clinic, Rochester, MN, USA
| | | | - Valentina Rangel
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Juan Oviedo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Maria Paula Solano
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Leonardo Rojas
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia; Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Luis Corrales
- Clinical Oncology Department, Centro de Investigaciones y Manejo del Cáncer, San José, Costa Rica
| | - Claudio Martín
- Thoracic Oncology Unit, Instituto Fleming, Buenos Aires, Argentina
| | - Luis Mas
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas - INEN, Lima, Peru
| | - Mauricio Cuello
- Medical Oncology Department, Hospital de Clínica, Universidad de la Republica - UdeLAR, Montevideo, Uruguay
| | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología - INCaN, México City, Mexico
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program Catalan Institute of Oncology; Germans Trias i Pujol Health Sciences Institute and Hospital Badalona, Barcelona, Spain
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Turcott JG, Martinez-Samano JE, Cardona AF, Bassarmal SS, Ramírez-Tirado LA, Zatarain-Barrón ZL, Barrón F, Corrales L, Martín C, Barragán-Castillo PA, Ruiz-Patiño A, Flores-Estrada D, Arrieta O. The Role of a Cachexia Grading System in Patients with Non-Small Cell Lung Cancer Treated with Immunotherapy: Implications for Survival. Nutr Cancer 2020; 73:794-801. [PMID: 32482104 DOI: 10.1080/01635581.2020.1769691] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The association between cancer-induced weight-loss (CIWL) and poor clinical outcomes in patients treated with immunotherapy is scarcely understood. We evaluated the use of a cachexia-grading system in IO-treated non-small cell lung cancer (NSCLC) patients in order to predict clinical outcomes. MATERIALS 300 patients with NSCLC, who received immunotherapy during any line of therapy, were included. All patients were graded according to a previously validated cachexia scale, which takes into consideration body mass index (BMI) and weight loss, stratifying patients into five risk categories (0 [pre-cachexia] - 4 [refractory cachexia]). Primary endpoint was overall survival (OS). RESULTS Ninety-one (30.3%) patients were classified in the low risk category, 176 (58.6%) were classified in the intermediate risk category and 33 (11%) were in the high risk category. Patients classified as low-risk had a significantly longer OS compared with those with intermediate or high risk (22.4 mo, [95%CI: 16.6-NR] vs. 17.1 [95%CI: 13.5-22.4] vs. 8.0 [3.9-18.4]; p < 0.001). In the multivariate analysis, after adjusting for age, hemoglobin and ORR, hazard of death increased as per the cachexia risk scale (Hazard ratio: 1.62 [1.22-2.16]; p = 0.001). CONCLUSION Cachexia is independently associated with worse OS in NSCLC patients who receive immunotherapy, highlighting the role for nutritional assessment.
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Affiliation(s)
- Jenny G Turcott
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | - Andrés F Cardona
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Oncology Unit, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Clinical Research and Biology Systems Department, Universidad el Bosque, Bogotá, Colombia
| | | | | | | | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Luis Corrales
- Oncology Unit, Hospital San Juan de Dios, San José de Costa Rica, Costa Rica
| | - Claudio Martín
- Medical Oncology Department, Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
| | | | - Alejandro Ruiz-Patiño
- Oncology Unit, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | | | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
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Pino LE, Triana I, Pérez C, Piotrostanalzki A, Ruiz-Patiño A, Lopes G, Cardona AF. Electronic nicotine delivery systems (ECs) and COVID-19: the perfect storm for young consumers. Clin Transl Oncol 2020; 23:5-9. [PMID: 32447647 PMCID: PMC7245506 DOI: 10.1007/s12094-020-02391-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/10/2020] [Indexed: 12/19/2022]
Abstract
The COVID-19 pandemic caused a change in our society and put health systems in crisis worldwide. Different risk factors and comorbidities have been found that increase the risk of mortality when acquiring this infection. The use of alternative devices to the cigarette like the electronic cigarettes, the vapers have been studied widely and generators of great controversy since it has been discovered that they also produce different pulmonary affections. When developing the SARS-CoV2 infection, different theories have been generated about the greater predisposition to a worse prognosis of people who use electronic cigarettes; however, the information on this continues in discovery. A group of experts made up of oncologists, infectologists, pulmonologists, and epidemiologists met to review the literature and then generate theories about the impact of electronic cigarettes on SARS-CoV2 infection.
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Affiliation(s)
- L. E. Pino
- Cancer Institute Fundación Santafé, 110121 Bogotá, Colombia
| | - I. Triana
- Cancer Institute Fundación Santafé, 110121 Bogotá, Colombia
| | - C. Pérez
- Infectious Disease Department Clínica, Marly - Hospital La Samaritana, 110121 Bogotá, Colombia
| | - A. Piotrostanalzki
- Respiratory Medicine Department, Clínica Central del Quindío, 110121 Armenia, Colombia
| | - A. Ruiz-Patiño
- Clinical and Traslational Oncology Group, Institute of Oncology, Country Clinic, 110121 Bogotá, Colombia
| | - G. Lopes
- Sylvester Comprehensive Cancer Center, Miami University, Miami, USA
| | - A. F. Cardona
- Clinical and Traslational Oncology Group, Institute of Oncology, Country Clinic, 110121 Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research - FICMAC, 110121 Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, 110121 Bogotá, Colombia
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Rojas Puentes LL, Ruiz-Patiño A, Mayorga DC, Rodríguez JK, Ávila Coy JM, Bravo Espinosa MA, Arrieta O, Zatarain-Barron ZL, Barron FB, Carranza H, Otero JM, Vargas CA, Archila P, Sotelo Rodríguez DC, Martin C, Recondo G, Pino L, Rolfo CD, Rosell R, Cardona Zorrilla AF. Histopathological prognostic markers in metastatic lung adenocarcinoma, validation of stromal fibrosis and immunoscore as easy to interpret findings and their correlation with survival. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e21566] [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
e21566 Background: Several histopathological markers have been associated with immune system activity and its relationship with clinical outcomes in lung cancer. Determination of tumor infiltrating lymphocytes as well as specific subpopulations could reveal cytotoxic potential. Additionally, changes in stromal composition and fibrosis could also reflect potential cellular interactions with the tumor lesions. In this study we validate these two findings as potential prognostic factors. Methods: A retrospective cohort analysis of patients with advanced lung adenocarcinoma treated in a reference center in Bogota, Colombia was conducted. Demographic as well as treatment variables were collected between January 2018 and December 2019. In addition to clinical outcomes, the percentage of stromal fibrosis and immunoscore were estimated for all biopsy samples by a trained oncological pathologist. Results: A total of 133 patients were included. Male predominance (51.1%) with Karnofsky performance scores (KPS) greater than 80 and 19% of prior cigarette exposure (26 patients) was identified in the cohort. Median overall survival of the cohort was 27.1 months (95%CI 22.1-NA) and progression free survival of 19.4 months (95%CI 18-24.5 months). Percentage of fibrous stroma and immunoscore were associated with a benefit in both OS and PFS. For patients who presented with a low stromal fibrosis, defined as harboring less than 10%, OS reached a median of 25.1 months (95%CI 21.5- 40.5 months) compared to 38.7 months for patients with high fibrosis (95%CI 27.7 months – NA), (p = 0.02). In terms of immunoscore, values under 40% were associated with a longer median OS (38.7 months, [95%CI 31.3- 58.6 months] vs 22.1 months [95%CI19.8- 42.3 months], p < 0.001). Immunoscore and stromal fibrosis were not codependent variables (p < 0.001), suggesting that these markers offer independent prognostic value with regards to OS. Conclusions: Stromal fibrosis and immunoscore serve as prognostic factors that could be easily interpreted and evaluated in order to offer prognostic classification of patients with metastatic adenocarcinoma of the lung.
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Affiliation(s)
| | - Alejandro Ruiz-Patiño
- Fundación para la Investigación Clínica y Molecular Aplicada del Cáncer-FICMAC, Bogotá, Colombia
| | | | | | | | | | - Oscar Arrieta
- Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Zyanya Lucía Zatarain-Barron
- Functional Unit of Thoracic Oncology and Personalized Medicine Laboratory, Instituto Nacional de Cancerología (INCan), México, EM, Mexico
| | | | - Hernan Carranza
- Fundación para la Investigación Clínica y Molecular Aplicada del Cáncer-FICMAC, Bogotá, Colombia
| | - Jorge M. Otero
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | | | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
| | | | | | | | - Luis Pino
- ICCAL Hospital Universitario Fundación Santa Fe de Bogota, Bogotá, Colombia
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Rojas Puentes LL, Ruiz-Patiño A, Mayorga Gonzalez DC, Rodríguez JK, Ávila Coy JM, Bravo Espinosa MA, Zatarain-Barron ZL, Arrieta O, Barron FB, Carranza H, Otero JM, Vargas CA, Archila P, Sotelo Rodríguez DC, Martin CM, Pino LE, Rolfo CD, Rosell R, Cardona Zorrilla AF, Recondo G. Human papillomavirus infection in metastatic lung adenocarcinoma is associated with better outcomes with immune checkpoint inhibitor treatment. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e21569] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21569 Background: Human papilloma virus (HPV) is associated with the development of several primary tumors. Recent studies have shown that HPV-positive tumors tend to be sensitive to immune checkpoint inhibitors (ICI), owing to the presence of xenobiotic genomes in cancer cells. The objective of this study was to explore this relationship in patients with lung adenocarcinoma. Methods: A retrospective cohort analysis in patients with advanced lung adenocarcinoma treated in a reference center in Bogota, Colombia was conducted. Demographic as well as treatment variables were collected between January 2018 and December 2019. Besides clinical outcomes, HPV infection status was determined by PCR amplification and reverse line hybridization directly on formalin-fixed paraffin-embedded tumor samples. Statistical analyses included stratified survival analysis based on HPV status and response. Results: A total of 133 patients were included. Male predominance (51.1%) with Karnofsky performance scores (KPS) greater than 80, and 19% of prior cigarette exposure (26 patients) was identified in the cohort. HPV positivity was identified in 25.6% of patients (33 cases, [95%CI 17.5-32.2%]), in addition to 29.8% EGFR mutation positivity (29 cases [[95%CI 14.8-28.8%]), 6% ALK positivity (8 cases [95%CI 1.9-10]) and positive PD-L1 expression in 49 samples (36.8% [95%CI 28.6-45%]). In immune checkpoint inhibitor (ICI) exposed patients, HPV+ patients had significantly higher PD-L1 expression compared with HPV- individuals (p < 0.001). In terms of overall survival, ICI treated patients achieved an OS of 27.1 months (95%CI 22.1-NA) and a PFS of 19.4 months (95%CI 18-24.5 months). HPV infection status was associated with prolonged OS (median OS not reached, [95%CI 27.7 months – no reached], p = 0.0089) and better response to ICI (p < 0.001). Conclusions: HPV infection is prevalent in patients with lung adenocarcinoma and is associated with better response to ICIs as well as better survival outcomes. Its identification could serve as a prognostic marker, especially in female non-smoker patients.
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Affiliation(s)
| | - Alejandro Ruiz-Patiño
- Fundación para la Investigación Clínica y Molecular Aplicada del Cáncer-FICMAC, Bogotá, Colombia
| | | | | | | | | | - Zyanya Lucía Zatarain-Barron
- Functional Unit of Thoracic Oncology and Personalized Medicine Laboratory, Instituto Nacional de Cancerología (INCan), México, EM, Mexico
| | - Oscar Arrieta
- Instituto Nacional de Cancerologia, Mexico City, Mexico
| | | | - Hernan Carranza
- Clinical and Traslational Oncology Group, Clinica del Country, Bogotá, Colombia
| | - Jorge Miguel Otero
- Fundación para la Investigación Clínica y Molecular Aplicada del Cáncer, Bogotá, Colombia
| | | | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
| | | | | | | | - Christian Diego Rolfo
- University of Maryland Marlene & Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD
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Ruiz-Patiño A, Arrieta O, Pino LE, Rolfo C, Ricaurte L, Recondo G, Zatarain-Barron ZL, Corrales L, Martín C, Barrón F, Vargas C, Carranza H, Otero J, Rodriguez J, Sotelo C, Viola L, Russo A, Rosell R, Cardona AF. Mortality and Advanced Support Requirement for Patients With Cancer With COVID-19: A Mathematical Dynamic Model for Latin America. JCO Glob Oncol 2020; 6:752-760. [PMID: 32469610 PMCID: PMC7268899 DOI: 10.1200/go.20.00156] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE In the midst of a global pandemic, evidence suggests that similar to other severe respiratory viral infections, patients with cancer are at higher risk of becoming infected by COVID-19 and have a poorer prognosis. METHODS We have modeled the mortality and the intensive care unit (ICU) requirement for the care of patients with cancer infected with COVID-19 in Latin America. A dynamic multistate Markov model was constructed. Transition probabilities were estimated on the basis of published reports for cumulative probability of complications. Basic reproductive number (R0) values were modeled with R using the EpiEstim package. Estimations of days of ICU requirement and absolute mortality were calculated by imputing number of cumulative cases in the Markov model. RESULTS Estimated median time of ICU requirement was 12.7 days, median time to mortality was 16.3 days after infection, and median time to severe event was 8.1 days. Peak ICU occupancy for patients with cancer was calculated at 16 days after infection. Deterministic sensitivity analysis revealed an interval for mortality between 18.5% and 30.4%. With the actual incidence tendency, Latin America would be expected to lose approximately 111,725 patients with cancer to SARS-CoV-2 (range, 87,116-143,154 patients) by the 60th day since the start of the outbreak. Losses calculated vary between < 1% to 17.6% of all patients with cancer in the region. CONCLUSION Cancer-related cases and deaths attributable to SARS-CoV-2 will put a great strain on health care systems in Latin America. Early implementation of interventions on the basis of data given by disease modeling could mitigate both infections and deaths among patients with cancer.
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Affiliation(s)
- Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Luis E. Pino
- Oncology Department, Institute of Oncology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Christian Rolfo
- Marlene and Stewart Comprehensive Cancer Center, Experimental Therapeutics Program, School of Medicine, University of Maryland, Baltimore, MD
| | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
| | - Gonzalo Recondo
- Center for Medical Education and Clinical Research, Buenos Aires, Argentina
| | | | - Luis Corrales
- Department of Oncology, Centro de Investigación y Manejo del Cáncer, San José, Costa Rica
| | - Claudio Martín
- Thoracic Oncology Unit, Alexander Fleming Institute, Buenos Aires, Argentina
| | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - July Rodriguez
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neurmológica Colombiana, Bogotá, Colombia
| | - Alessandro Russo
- Marlene and Stewart Comprehensive Cancer Center, Experimental Therapeutics Program, School of Medicine, University of Maryland, Baltimore, MD
- Medical Oncology Unit, Azienda Ospedaliera Papardo, Messina, Italy
| | - Rafael Rosell
- Coyote Research Group, Pangaea Oncology, Laboratory of Molecular Biology, Quiron-Dexeus University Institute, Barcelona, Spain
- Institut d’Investigació en Ciències Germans Trias i Pujol, and Institut Català d’Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Andrés F. Cardona
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
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Cardona AF, Ruiz-Patiño A, Ricaurte L, Zatarain-Barrón ZL, Barrón F, Arrieta O. Chronic and Severe Non-Lichenoid Oral Ulcers Induced by Nivolumab - Diagnostic and Therapeutic Challenge: A Case Report. Case Rep Oncol 2020; 13:314-320. [PMID: 32308598 PMCID: PMC7154263 DOI: 10.1159/000505968] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 01/14/2020] [Indexed: 12/17/2022] Open
Abstract
Due to the widespread use of immune checkpoint inhibitors and the growing research efforts in this area, immune-mediated toxicity is well recognized. Nonetheless, few severe cases of oral or upper gastrointestinal tract mucosal involvement have been documented. Early recognition and prompt treatment are key to the adequate management of these patients. We present a male 93-year-old patient with an advanced head and neck tumor treated with nivolumab who developed severe oral ulcers. After discontinuation of nivolumab, he received initial steroid treatment without any significant improvement. Histopathologic analysis of the lesions revealed a pattern similar to graft versus host disease. Extrapolating the results of colchicine mouth washing in patients with active oral ulcers and Behçet's disease, this strategy was implemented with concomitant metronomic cyclophosphamide, achieving complete ulcer resolution. Metagenomic oral bacterial sequencing during instauration of the lesions and highest extension revealed a significant decrease in microbiomic diversity and expansion of Haemophilus parainfluenzae similar to patients with active Behçet's disease. In conclusion, oral ulcers associated with immune checkpoint inhibitors correspond to a difficult-to-treat entity that could physiopathologically be related to both graft versus host disease and Behçet's disease.
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Affiliation(s)
- Andrés F Cardona
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Feliciano Barrón
- Thoracic Oncology Unit, National Cancer Institute (INCan), Mexico City, Mexico
| | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), Mexico City, Mexico
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Bravo-Linares D, Acevedo-Melo AM, Ruiz-Patiño A, Ricaurte L, Lucio-Arias D, Cardona AF. Scientific Productivity and Cancer-Related Mortality: A Case Study of a Positive Association in Colombia. J Glob Oncol 2020; 5:1-10. [PMID: 31433711 PMCID: PMC6733203 DOI: 10.1200/jgo.19.00164] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Cancer morbidity represents an increasing public health issue; this worldwide phenomenon also is true for emerging upper-middle-income countries, such as Colombia. The main purpose of this study was to uncover the relationship between scientific productivity and cancer-related mortality in our setting. METHODS We conducted a temporal-trend ecologic study by means of bibliometric analysis from records of publications from SCOPUS database with Colombian institutional affiliations between 2000 and 2015. Productivity and overall mortality were estimated and compared using econometric modeling to identify potential correlations. Additional exploratory analyses per six most frequent cancer sites were performed. RESULTS Of 2,645 publication records retrieved, 1,464 (55.3%) met selection criteria to be classified as Colombian scientific production (interobserver agreement, 92.96%; κ = 0.859; 95% CI, 0.800 to 0.918). Overall, 79.6% of the records corresponded to original or in-press articles; furthermore, almost half (49.7%) embodied descriptive study designs. Selected records reported a median of five authors and three different affiliations per publication; 66% had been cited at least once up to September 2017. The most-studied cancer-specific locations were cervix (16.1%), breast (11.5%), and stomach (9.8%), but nonspecific locations had the largest combined participation (23.4%). An increasing trend in scientific productivity was correlated to decreasing trend in overall cancer mortality, which was reported as an inverse proportional relationship in the linear regression modeling (r = -0.958; P < .001). Graphic analyses per cancer-specific sites revealed heterogeneous behaviors of this relationship. CONCLUSION Colombian cancer-specific scientific productivity demonstrated a steady growth as opposed to a decreasing mortality trend in the recent years. The research output is predominantly descriptive with relatively low interinstitutional partnership and low impact in the international scientific community.
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Affiliation(s)
| | | | | | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | | | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Clínica del Country, Bogotá, Colombia.,Universidad El Bosque, Bogotá, Colombia
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Cardona AF, Arrieta O, Ruiz-Patiño A, Sotelo C, Zamudio-Molano N, Zatarain-Barrón ZL, Ricaurte L, Raez L, Álvarez MPP, Barrón F, Rojas L, Rolfo C, Karachaliou N, Molina-Vila MA, Rosell R. Precision medicine and its implementation in patients with NTRK fusion genes: perspective from developing countries. Ther Adv Respir Dis 2020; 14:1753466620938553. [PMID: 32643553 PMCID: PMC7350048 DOI: 10.1177/1753466620938553] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022] Open
Abstract
Precision oncology is the field that places emphasis on the diagnosis and treatment of tumors that harbor specific genomic alterations susceptible to inhibition or modulation. Although most alterations are only present in a minority of patients, a substantial effect on survival can be observed in this subgroup. Mass genome sequencing has led to the identification of a specific driver in the translocations of the tropomyosin receptor kinase family (NTRK) in a subset of rare tumors both in children and in adults, and to the development and investigation of Larotrectinib. This medication was granted approval by the US Food and Drug Administration for NTRK-positive tumors, regardless of histology or age group, as such, larotrectinib was the first in its kind to be approved under the premise that molecular pattern is more important than histology in terms of therapeutic approach. It yielded significant results in disease control with good tolerability across a wide range of diseases including rare pediatric tumors, salivary gland tumors, gliomas, soft-tissue sarcomas, and thyroid carcinomas. In addition, and by taking different approaches in clinical trial design and conducting allocation based on biomarkers, the effects of target therapies can be isolated and quantified. Moreover, and considering developing nations and resource-limited settings, precision oncology could offer a tool to reduce cancer-related disability and hospital costs. In addition, developing nations also present patients with rare tumors that lack a chance of treatment, outside of clinical trials. This, in turn, offers the possibility for international collaboration, and contributes to employment, education, and health service provisions. The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Andrés F. Cardona
- Clinical and Translational Oncology Group, Clínica del Country, Calle 116 No. 9-72, c. 318, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCaN), México city, México
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | | | | | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
- Pathology Department, Mayo Clinic, Rochester, Minnesota, Estados Unidos
| | - Luis Raez
- Thoracic Oncology Program, Memorial Cancer Institute (MCI), Florida International University (FIU), Miami, Florida
| | | | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCaN), México city, México
| | - Leonardo Rojas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Christian Rolfo
- Thoracic Medical Oncology and Early Clinical Trials Unit, University of Maryland, Baltimore, MD, USA
| | | | - Miguel Angel Molina-Vila
- Pangaea Oncology, Laboratory of Molecular Biology, Quirón-Dexeus University Institute, Barcelona, Catalunya, Spain
| | - Rafael Rosell
- Germans Trias i Pujol Research Institute and Hospital (IGTP), Badalona, Catalunya, Spain
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Ruiz-Patiño A, Arrieta O, Cardona AF, Martín C, Raez LE, Zatarain-Barrón ZL, Barrón F, Ricaurte L, Bravo-Garzón MA, Mas L, Corrales L, Rojas L, Lupinacci L, Perazzo F, Bas C, Carranza O, Puparelli C, Rizzo M, Ruiz R, Rolfo C, Archila P, Rodríguez J, Sotelo C, Vargas C, Carranza H, Otero J, Pino LE, Ortíz C, Laguado P, Rosell R. Immunotherapy at any line of treatment improves survival in patients with advanced metastatic non-small cell lung cancer (NSCLC) compared with chemotherapy (Quijote-CLICaP). Thorac Cancer 2019; 11:353-361. [PMID: 31828967 PMCID: PMC6996989 DOI: 10.1111/1759-7714.13272] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 02/06/2023] Open
Abstract
Background To compare survival outcomes of patients with advanced or metastatic non‐small cell lung cancer (NSCLC) who received immunotherapy as first‐, second‐ or beyond line, versus matched patients receiving standard chemotherapy with special characterization of hyperprogressors. Methods A retrospective cohort study of 296 patients with unresectable/metastatic NSCLC treated with either, first‐, second‐, third‐ or fourth‐line of immunotherapy was conducted. A matched comparison with a historical cohort of first‐line chemotherapy and a random forest tree analysis to characterize hyperprogressors was conducted. Results Median age was 64 years (range 34–90), 40.2% of patients were female. A total of 91.2% of patients had an Eastern Cooperative Oncology Group (ECOG) performance score ≤ 1. Immunotherapy as first‐line was given to 39 patients (13.7%), second‐line to 140 (48.8%), and as third‐line and beyond to 108 (37.6%). Median overall survival was 12.7 months (95% CI 9.67–14 months) and progression‐free survival (PFS) of 4.27 months (95% CI 3.97–5.0). Factors associated with increased survival included treatment with immunotherapy as first‐line (P < 0.001), type of response (P < 0.001) and PD‐L1 status (P = 0.0039). Compared with the historical cohort, immunotherapy proved to be superior in terms of OS (P = 0.05) but not PFS (P = 0.2). A total of 44 hyperprogressors were documented (19.8%, [95% CI 14.5–25.1%]). Leukocyte count over 5.300 cells/dL was present in both hyperprogressors and long‐term responders. Conclusions Patients who receive immune‐checkpoint inhibitors as part of their treatment for NSCLC have better overall survival (OS) compared with matched patients treated with standard chemotherapy, regardless of the line of treatment.
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Affiliation(s)
- Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), 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), México City, Mexico
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Claudio Martín
- Medical Oncology Department, Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
| | - Luis E Raez
- Thoracic Oncology Program, Memorial Cancer Institute/Florida International University, Miami, Florida, USA
| | | | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, Mexico
| | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | | | - Luis Mas
- Oncology Department, Instituto Nacional de Enfermedades Neoplásicas - IneN, Lima, Peru
| | - Luis Corrales
- Medical Oncology Department, Hospital San Juan de Dios, San José, Costa Rica
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia.,Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Lorena Lupinacci
- Thoracic Oncology Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Carlos Bas
- Oncology Department, Hospital Alemán, Buenos Aires, Argentina
| | - Omar Carranza
- Oncology Department, Hospital Privado de la Comunidad de Mar del Plata, Mar del Plata, Argentina
| | - Carmen Puparelli
- Medical Oncology Department, Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
| | - Manglio Rizzo
- Oncology Department, Hospital Austral de Buenos Aires, Buenos Aires, Argentina
| | - Rossana Ruiz
- Hematology and Oncology Department, Hospital Militar Central, Bogotá, Colombia
| | - Christian Rolfo
- Thoracic Oncology Unit, Marlene and Stewart Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Luis E Pino
- Oncology Department, Institute of Oncology - ICAL, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Carlos Ortíz
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Paola Laguado
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Rafael Rosell
- Coyote Research Group, Pangaea Oncology, Laboratory of Molecular Biology, Quiron-Dexeus University Institute, Barcelona, Spain.,Institut d'Investigació en Ciències Germans Trias i Pujol, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
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Barrón F, Cardona A, Ruiz-Patiño A, Barron LZ, Corrales-Rodriguez L, Martín C, Sotelo C, Rodríguez J, Ávila J, Mayorga D, Archila P, Mas L, Freitas H, De Lima VC, Otero J, Carranza H, Vargas C, Rosell R. PD1.05 Relevance of Antibiotic Use on Clinical Activity of Immune Checkpoint Inhibitors in Hispanic Patients with Advanced Non-small-cell Lung Cancer (CLICAP-ABs). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.125] [Citation(s) in RCA: 1] [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: 10/25/2022]
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Cardona A, Arrieta O, Ruiz-Patiño A, Barron LZ, Corrales-Rodriguez L, Martín C, Barrón F, Sotelo C, Rodríguez J, Ricaurte L, Ávila J, Mayorga D, Archila P, Otero J, Freitas H, De Lima VC, Mas L, Carranza H, Vargas C, Rosell R. PD2.06 EGFR Inhibitors + Bevacizumab Demonstrated Superior Efficacy Compared with EGFR Inhibitors Alone as First-line Treatment in Advanced NSCLC Patients with EGFR Mutations and BIM Deletion Polymorphisms. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.133] [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: 11/16/2022]
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Cardona A, Arrieta O, Ruiz-Patiño A, Barron LZ, Corrales-Rodriguez L, Martín C, Barrón F, Sotelo C, Rodríguez J, Ricaurte L, Freitas H, De Lima VC, Mas L, Ávila J, Mayorga D, Archila P, Otero J, Carranza H, Vargas C, Rosell R. PD2.03 Exploration of Factors Relating to Immune Response in Patients Treated with Immune Checkpoint Inhibitors for Non-small Cell Lung Cancer (NSCLC). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.130] [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: 10/25/2022]
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Cardona A, Arrieta O, Ruiz-Patiño A, Barron LZ, Corrales-Rodriguez L, Martín C, Barrón F, Sotelo C, Rodríguez J, Ricaurte L, Ávila J, Mayorga D, Archila P, Freitas H, De Lima VC, Mas L, Otero J, Carranza H, Vargas C, Rosell R. P2.22 Immunotherapy-related Thrombosis: Considerations and Associated Factors in Non-small Cell Lung Cancer (NSCLC) Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.187] [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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Mas L, Patane A, Arrieta O, Soria T, Cardona A, Martín C, Ruiz-Patiño A, Ruiz R, Rioja P, Lozano S, Barron LZ, Barrón F, Corassa M, Freitas H, De Lima VC, Corrales-Rodriguez L, Sotelo C, Rodríguez J, Ricaurte L, Ávila J, Mayorga D, Bravo M, Archila P, Otero J, Carranza H, Vargas C, Rosell R, Remon J. P1.12 Real World Characterization and Treatment Patterns of Patients with Thymic Carcinoma: Lessons from a Latin American Collaborative Study (CLICaP-LATimus). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.147] [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: 11/16/2022]
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Cardona A, Ruiz-Patiño A, Arrieta O, Martín C, Raez L, Barron LZ, Barrón F, Ricaurte L, Bravo-Garzón M, Mas L, Corrales-Rodriguez L, Rojas L, Lupinacci L, Perazzo F, Bas C, Carranza O, Pupareli C, Rizzo M, Mendoza RR, Rolfo C, Archila P, Rodríguez J, Sotelo C, Vargas C, Carranza H, Otero J, Pino L, Ortíz C, Laguado P, Rosell R. P2.25 Immunotherapy at Any Line of Treatment Improves Survival in Hispanic Patients with Advanced Metastatic Non-Small Cell Lung Cancer (NSCLC) Compared with Chemotherapy (Quijote-CLICaP). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.190] [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: 11/26/2022]
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Cardona A, Ruiz-Patiño A, Ricaurte L, Rojas L, Barrón ZZ, Barrón F, Arrieta O. EP1.04-47 Chronic and Severe Non-Lichenoid Oral Ulcers Induced by Nivolumab: Diagnostic and Therapeutic Challenge. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2164] [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: 10/25/2022]
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Cardona A, Arrieta O, Ruiz-Patiño A, Barrón ZZ, Rojas L, Corrales L, Martin C, Barrón F, Sotelo C, Rodriguez J, Ricaurte L, Ávila J, Mayorga D, Archila P, Otero J, Freitas H, De Lima VC, Mas L, Carranza H, Vargas C, Rosell R. P1.14-61 EGFR Inhibitors Plus Bevacizumab Are Superior Compared to EGFR Inhibitor Monotherapy in Advanced EGFR+ NSCLC Patients with BIM Deletions. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1212] [Citation(s) in RCA: 1] [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: 10/25/2022]
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Turcott J, Cardona A, Ramírez-Tirado L, Barrón ZZ, Barrón F, Corrales L, Martin C, Castillo PB, Flores-Estrada D, Ruiz-Patiño A, Arrieta O. MA07.08 The Role of a Cachexia Grading System in Patients with NSCLC Treated with Immunotherapy: Implications for Response and Survival. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.552] [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: 10/25/2022]
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Mas L, Patané A, Arrieta O, Soria T, Cardona A, Martin C, Ruiz-Patiño A, Rojas L, Ruiz R, Rioja P, Lozano S, Barrón ZZ, Corassa M, Freitas H, De Lima VC, Corrales L, Sotelo C, Rodriguez J, Ricaurte L, Ávila J, Mayorga D, Bravo M, Archila P, Otero J, Carranza H, Vargas C, Rosell R, Remon J. EP1.15-28 Survival of Thymoma Is Extensive in Latin-American Patients: Results from Over 10 Years of Experience (CLICaP-LATimus). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2363] [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: 11/28/2022]
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Barrón F, Arrieta O, Cardona A, Ruiz-Patiño A, Barrón ZZ, Rojas L, Corrales L, Martin C, Sotelo C, Rodriguez J, Ávila J, Bravo M, Mayorga D, Archila P, Mas L, Freitas H, De Lima VC, Otero J, Carranza H, Vargas C, Rosell R. EP1.04-45 Relevance of Antibiotic Use on Clinical Activity of Immune Checkpoint Inhibitors in Hispanic Patients with Advanced NSCLC (CLICAP-ABs). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cardona A, Ruiz-Patiño A, Arrieta O, Martin C, Raez L, Barrón ZZ, Barrón F, Ricaurte L, Bravo-Garzón M, Mas L, Corrales L, Rojas L, Lupinacci L, Perazzo F, Bas C, Carranza O, Puparelli C, Rizzo M, Ruiz R, Rolfo C, Archila P, Rodriguez J, Sotelo C, Vargas C, Carranza H, Otero J, Pino L, Ortiz C, Laguado P, Rosell R. EP1.04-46 Immunotherapy at Any Line Improves Survival in Hispanic Patients with Advanced Metastatic NSCLC Compared to Chemotherapy (Quijote-CLICaP). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cardona AF, Ruiz-Patiño A, Zatarain-Barrón ZL, Hakim F, Jiménez E, Mejía JA, Ramón JF, Useche N, Bermúdez S, Pineda D, Cifuentes H, Rojas L, Ricaurte L, Pino LE, Balaña C, Arrieta O. Systemic management of malignant meningiomas: A comparative survival and molecular marker analysis between Octreotide in combination with Everolimus and Sunitinib. PLoS One 2019; 14:e0217340. [PMID: 31220093 PMCID: PMC6586269 DOI: 10.1371/journal.pone.0217340] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 05/10/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose To compare the effectiveness of octreotide/everolimus vs. sunitinib for the systemic treatment of recurrent aggressive meningiomas. Methods 31 patients with recurrent or refractory WHO II or WHO III meningiomas were examined in two reference centers in Colombia. Patients who had systemic treatment (sunitinib, everolimus/octreotide) and a complete follow-up were included. Overall survival (OS), progression-free survival (PFS) and toxicities were evaluated. Additionally, tissue samples were examined for PDGFRβ and VEGFR2, their expression was correlated with outcomes. Results Twenty-two patients (72%) were female with a median age of 55 years (SD±15.3). The most prevalent histology was anaplastic meningioma in 20 patients (65%) with 48% of patients suffering from three previous relapses before the start of systemic treatment. A total of 14 patients received combination therapy with octreotide/everolimus, 11 received sunitinib and the remaining 6 received other second-line agents. Median OS was 37.3 months (95%CI 28.5–42.1) and the PFS during the treatment with everolimus/octreotide (EO) and sunitinib (Su) was 12.1 months (95%CI 9.2–21.1) and 9.1 months (95%CI 6.8–16.8); p = 0.43), respectively. The OS of the group treated with the EO→Su→Bev sequence (1st/2nd/3rd line) was 6.5 months longer than the Su→EO→Bev sequence (36.0 vs. 29.5 months) (p = 0.0001). When analyzing molecular markers, the positive PDGFRβ and negative VEGFR2 expression were associated with longer survival both in OS and PFS. Conclusion Sunitinib and octreotide/everolimus have similar efficacy and safety in the systemic management of refractory meningioma. VEGFR2 and PDGFRβ expression are associated with better outcomes.
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Affiliation(s)
- Andrés F. Cardona
- Brain Tumor Section, Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research–FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Group (G-FOX), Universidad El Bosque, Bogotá, Colombia
- * E-mail: ,
| | | | | | - Fernando Hakim
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
| | - Enrique Jiménez
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
| | - Juan Armando Mejía
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
| | - Juan Fernando Ramón
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
| | - Nicolás Useche
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
- Neuroradiology Section, Radiology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Sonia Bermúdez
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
- Neuroradiology Section, Radiology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Diego Pineda
- Brain Tumor Section, Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Neuroradiology Section, Clínica del Country, Bogotá, Colombia
| | | | - Leonardo Rojas
- Brain Tumor Section, Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research–FICMAC, Bogotá, Colombia
- Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research–FICMAC, Bogotá, Colombia
| | - Luis Eduardo Pino
- Clinical Oncology Group, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Carmen Balaña
- Neuro-Oncology Section, Oncology Department, Hospital Germans Trias I Pujol, Catalan Institute of Oncology–ICO, Barcelona, Spain
| | - Oscar Arrieta
- Laboratory of Experimental Oncology, Instituto Nacional de Cancerología (INCaN), México City, México
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Cardona Zorrilla AF, Ruiz-Patiño A, Arrieta O, Martin C, Raez LE, Zatarain Barrón ZL, Barron FB, Ricaurte L, Bravo M, Mas L, Rojas L, Lupinacci L, Perazzo F, Puparelli C, Rizzo MM, Rolfo CD, Rodriguez J, Sotelo Rodríguez DC, Carranza H, Rosell R. Effect of immunotherapy at any line of treatment on survival in Hispanic patients with advanced metastatic non-small cell lung cancer (NSCLC) compared with chemotherapy (Quijote-CLICaP). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e20637] [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
e20637 Background: To compare survival outcomes of patients with advanced or metastatic NSCLC who received immunotherapy at first, second or beyond versus matched patients receiving standard chemotherapy. Methods: A retrospective multicenter international cohort study of 296 patients with unresectable/ metastatic NSCLC treated with immunotherapy either as first, second, third or fourth line was conducted. A matched comparison with a historical cohort of first line chemotherapy was conducted. Results: Median age was 64 years (Range 34-90) and 40.2% were female patients. 91.2% of patients had an ECOG performance score ≤ 1. Immunotherapy as first line was given to 39 patients (13.7%), second line to 140 (48.8%), and as third line and beyond to 108 (37.6%). Median overall survival was 12.7 months (95% CI 9.67-14 months) and progression-free survival was 4.27 months (95% CI 3.97-5.0). Factors associated with increased survival included treatment as first-line (p < 0.001), type of response (p < 0.001) and PD-L1 status (p = 0.0039). Compared to the historical cohort, immunotherapy proved to be superior in terms of OS (p = 0.05) but not PFS (p = 0.2). Conclusions: Patients who receive immune checkpoint inhibitors as part of their treatment for NSCLC have better OS compared with matched patients treated with standard chemotherapy, regardless treatment line.
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Affiliation(s)
| | - Alejandro Ruiz-Patiño
- Fundación para la Investigación Clínica y Molecular Aplicada del Cáncer - FICMAC, Bogotá, Colombia
| | - Oscar Arrieta
- Instituto Nacional de Cancerologia-INCAN, Mexico City, Mexico
| | | | - Luis E. Raez
- Memorial Cancer Institute, Florida International University, Miami, FL
| | | | | | - Luisa Ricaurte
- Fundación Para La Investigación Clínica y Molecular Aplicada del Cáncer FICMAC, Bogotá, Colombia
| | - Maria Bravo
- Universidad Militar Nueva Granada, Bogotá, Colombia
| | - Luis Mas
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Leonardo Rojas
- Institute of Oncology, Clínica del Country, Bogota, Colombia
| | | | | | - Carmen Puparelli
- Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
| | | | | | - July Rodriguez
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogota, Colombia
| | | | - Hernan Carranza
- Clinical and Traslational Oncology Group, Clinica del Country, Bogota, Colombia
| | - Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain and Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain and Institute of Oncology Rosell (IOR), University Hospital Sagrat Cor, Badalona, Barcelona, Spain
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50
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Cardona AF, Rojas L, Zatarain-Barrón ZL, Ruiz-Patiño A, Ricaurte L, Corrales L, Martín C, Freitas H, Cordeiro de Lima VC, Rodriguez J, Avila J, Bravo M, Archila P, Carranza H, Vargas C, Otero J, Barrón F, Karachaliou N, Rosell R, Arrieta O. Multigene Mutation Profiling and Clinical Characteristics of Small-Cell Lung Cancer in Never-Smokers vs. Heavy Smokers (Geno1.3-CLICaP). Front Oncol 2019; 9:254. [PMID: 31058075 PMCID: PMC6481272 DOI: 10.3389/fonc.2019.00254] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/20/2019] [Indexed: 12/14/2022] Open
Abstract
Objectives: Lung cancer is a heterogeneous disease. Presentation and prognosis are known to vary according to several factors, such as genetic and demographic characteristics. Small-cell lung cancer incidence is increasing in never-smokers. However, the disease phenotype in this population is different compared with patients who have a smoking history. Material and Methods: To further investigate the clinical and genetic characteristics of this patient subgroup, a cohort of small cell lung cancer patients was divided into smokers (n = 10) and never/ever-smokers (n = 10). A somatic mutation profile was obtained using a comprehensive NGS assay. Clinical outcomes were compared using the Kaplan-Meier method and Cox proportional models. Results: Median age was 63 years (46–81), 40% were men, and 90% had extended disease. Smoker patients had significantly more cerebral metastases (p = 0.04) and were older (p = 0.03) compared to their non-smoker counterparts. For never/ever smokers, the main genetic mutations were TP53 (80%), RB1 (40%), CYLD (30%), and EGFR (30%). Smoker patients had more RB1 (80%, p = 0.04), CDKN2A (30%, p = 0.05), and CEBPA (30%, p = 0.05) mutations. Response rates to first-line therapy with etoposide plus cisplatin/carboplatin were 50% in smokers and 90% in never/ever smokers (p = 0.141). Median overall survival was significantly longer in never smokers compared with smokers (29.1 months [23.5–34.6] vs. 17.3 months [4.8–29.7]; p = 0.0054). Never/ever smoking history (HR 0.543, 95% CI 0.41–0.80), limited-stage disease (HR 0.56, 95% CI 0.40–0.91) and response to first-line platinum-based chemotherapy (HR 0.63, 95% CI 0.60–0.92) were independently associated with good prognosis. Conclusion: Our data supports that never/ever smoker patients with small-cell lung cancer have better prognosis compared to their smoker counterparts. Further, patients with never/ever smoking history who present with small-cell lung cancer have a different mutation profile compared with smokers, including a high frequency of EGFR, MET, and SMAD4 mutations. Further studies are required to assess whether the differential mutation profile is a consequence of a diverse pathological mechanism for disease onset.
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Affiliation(s)
- Andrés F Cardona
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | | | | | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | - Luis Corrales
- Department of Oncology, Hospital San Juan de Dios, San José, Costa Rica
| | - Claudio Martín
- Medical Oncology Group, Fleming Institute, Buenos Aires, Argentina
| | - Helano Freitas
- Department of Oncology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | | | - July Rodriguez
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | - Jenny Avila
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | - Melissa Bravo
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | - Hernán Carranza
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Carlos Vargas
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Jorge Otero
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Feliciano Barrón
- Thoracic Oncology Unit, National Cancer Institute (INCan), Mexico City, Mexico
| | - Niki Karachaliou
- Instituto Oncológico Dr. Rosell (IOR), Quirón-Dexeus University Institute, Barcelona, Spain.,Instituto Oncológico Dr. Rosell (IOR), Sagrat Cor Hospital, Barcelona, Spain
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), Mexico City, Mexico
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