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Cueva JF, Palacio I, Churruca C, Herrero A, Pardo B, Constenla M, Santaballa A, Manso L, Estévez P, Maximiano C, Legerén M, Marquina G, de Juan A, Quindós M, Sánchez L, Barquin A, Fernández I, Martín C, Juárez A, Martín T, García Y, Yubero A, Gallego A, Martínez Bueno A, Guerra E, González-Martín A. Real-world safety and effectiveness of maintenance niraparib for platinum-sensitive recurrent ovarian cancer: A GEICO retrospective observational study within the Spanish expanded-access programme. Eur J Cancer 2023; 182:3-14. [PMID: 36706655 DOI: 10.1016/j.ejca.2022.12.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 11/01/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
AIM To describe patient characteristics, effectiveness and safety in a real-world population treated with niraparib in the Spanish expanded-access programme. PATIENTS AND METHODS This retrospective observational study included women with platinum-sensitive recurrent high-grade serous ovarian cancer who received maintenance niraparib within the Spanish niraparib expanded-access programme. Eligible patients had received ≥2 previous lines of platinum-containing therapy, remained platinum-sensitive after the penultimate line of platinum and had responded to the most recent platinum-containing therapy. Niraparib dosing was at the treating physician's discretion (300 mg/day fixed starting dose or individualised starting dose [ISD] according to baseline body weight and platelet count). Safety, impact of dose adjustments, patient characteristics and effectiveness were analysed using data extracted from medical records. RESULTS Among 316 eligible patients, 80% had BRCA wild-type tumours and 66% received an ISD. Median niraparib duration was 7.8 months. The most common adverse events typically occurred within 3 months of starting niraparib. Median progression-free survival was 8.6 (95% confidence interval [CI] 7.6-10.0) months. One- and 2-year overall survival rates were 86% (95% CI 81-89%) and 65% (95% CI 59-70%), respectively. Dose interruptions, dose reductions, haematological toxicities and asthenia/fatigue were less common with ISD than fixed starting dose niraparib, but progression-free survival was similar irrespective of dosing strategy. Subsequent therapy included platinum in 71% of patients who received further treatment. CONCLUSION Outcomes in this large real-world dataset of niraparib-treated patients are consistent with phase III trials, providing reassuring evidence of the tolerability and activity of niraparib maintenance therapy for platinum-sensitive recurrent ovarian cancer. CLINICALTRIALS GOV REGISTRATION NCT04546373.
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Affiliation(s)
- Juan F Cueva
- Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
| | - Isabel Palacio
- Hospital Universitario Central de Asturias, Oviedo, Spain.
| | | | - Ana Herrero
- Hospital Universitario Miguel Servet, Zaragoza, Spain.
| | - Beatriz Pardo
- Institut Català d'Oncologia (ICO) Duran i Reynals, Barcelona, Spain.
| | - Manuel Constenla
- Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain.
| | - Ana Santaballa
- Hospital Universitario i Politècnic la Fe, Valencia, Spain.
| | - Luis Manso
- Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - Purificación Estévez
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain.
| | | | - Marta Legerén
- Hospital Universitario Clínico San Cecilio, Granada, Spain.
| | - Gloria Marquina
- Hospital Clínico San Carlos, Department of Medicine, School of Medicine, Complutense University (UCM), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Ana de Juan
- Hospital Universitario Marqués de Valdecilla, Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain.
| | - María Quindós
- Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | | | | | | | | | | | - Teresa Martín
- Hospital Universitario de Salamanca, Salamanca, Spain.
| | - Yolanda García
- Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Alfonso Yubero
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
| | | | | | - Eva Guerra
- Hospital Universitario Ramón y Cajal, Madrid, Spain.
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2
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López-Guerrero JA, Mendiola M, Pérez-Fidalgo JA, Romero I, Torres A, Recalde D, Molina E, Gómez-Raposo C, Levin AM, Herrero A, Alarcón J, Esteban C, Marquina G, Rubio MJ, Guerra E, Sánchez-Lorenzo L, Gálvez-Montosa F, de Juan A, Churruca C, Gallego A, González-Martín A. Prospective Real-World Gynaecological Cancer Clinical Registry with Associated Biospecimens: A Collaborative Model to Promote Translational Research between GEICO and the Spanish Biobank Network. Cancers (Basel) 2022; 14:cancers14081965. [PMID: 35454870 PMCID: PMC9031046 DOI: 10.3390/cancers14081965] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Patient registries linked to biorepositories constitute a valuable asset for clinical and translational research in oncology. The Spanish Group of Ovarian Cancer Research (GEICO), in collaboration with the Spanish Biobank Network (RNBB), has developed a multicentre, multistakeholder, prospective virtual clinical registry (VCR) associated with biobanks for the collection of real-world data and biological samples of gynaecological cancer patients. This collaborative project aims to promote research by providing broad access to high-quality clinical data and biospecimens for future research according to the needs of investigators and to increase diagnostic and therapeutic opportunities for gynaecological cancer patients in Spain. The VCR will include the participation of more than 60 Spanish hospitals entering relevant clinical information in harmonised electronic case report forms (eCRFs) in four different cohorts: ovarian, endometrial, cervical, and rare gynaecological cancers (gestational trophoblastic disease). Initial data for the cases included till December 2021 are presented. The model described herein establishes a real-world win-win collaboration between multicentre structures, promoted and supported by GEICO, that will contribute to the success of translational research in gynaecological cancer.
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Affiliation(s)
- José Antonio López-Guerrero
- Laboratorio de Biología Molecular y Biobanco, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain
- Unidad Mixta de Investigación en Cáncer IVO-CIPF, Centro de Investigación Príncipe Felipe (CIPF), 46012 Valencia, Spain
- Departamento de Patología, Facultad de Medicina, Universidad Católica de Valencia ‘San Vicente Martir’, 46001 Valencia, Spain
- Correspondence: ; Tel.: +34-961114337
| | - Marta Mendiola
- Laboratorio de Patología Molecular y Dianas Terapéuticas, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), 28029 Madrid, Spain;
- Centro de Investigación Biomédica en Red de Cáncer, CIBERONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - José Alejandro Pérez-Fidalgo
- Departamento de Oncología Médica, Hospital Clinico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universidad de Valencia, CIBERONC, 46010 Valencia, Spain;
| | - Ignacio Romero
- Department of Medical Oncology, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain;
| | - Ana Torres
- Biobanco del Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | - Delia Recalde
- Biobanco del Sistema de Salud de Aragón, 50009 Zaragoza, Spain;
| | - Elena Molina
- Biobanco del Hospital Clínico San Carlos, 28040 Madrid, Spain;
| | - César Gómez-Raposo
- Department of Medical Oncology, Hospital Universitario Infanta Sofía, 28703 Madrid, Spain;
| | - Ana M. Levin
- Grupo Español de Investigación en Cáncer de Ovario, 28003 Madrid, Spain;
| | - Ana Herrero
- Department of Medical Oncology, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain;
| | - Jesús Alarcón
- Department of Medical Oncology, Hospital Universitario Son Espases, 07120 Palma, Spain;
| | - Carmen Esteban
- Department of Medical Oncology, Hospital Virgen de la Salud, 45004 Toledo, Spain;
| | - Gloria Marquina
- Department of Medical Oncology, Hospital Clínico San Carlos, 28040 Madrid, Spain;
| | - María Jesús Rubio
- Department of Medical Oncology, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain;
| | - Eva Guerra
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | - Luisa Sánchez-Lorenzo
- Department of Medical Oncology, Clínica Universidad de Navarra, 28027 Madrid, Spain; (L.S.-L.); (A.G.-M.)
| | | | - Ana de Juan
- Department of Medical Oncology, Hospital Univeristario Marqués de Valdecilla, 39008 Santander, Spain;
| | - Cristina Churruca
- Department of Medical Oncology, Hospital Universitario Donostia, 20014 Donostia, Spain;
| | - Alejandro Gallego
- Department of Medical Oncology, Hospital Universitario La Paz, 28029 Madrid, Spain;
| | - Antonio González-Martín
- Department of Medical Oncology, Clínica Universidad de Navarra, 28027 Madrid, Spain; (L.S.-L.); (A.G.-M.)
- Programa de Tumores Sólidos, Centro de Investigación de Medicina Aplicada (CIMA), 31008 Pamplona, Spain
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3
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Donat-Vargas C, Guerrero-Zotano Á, Casas A, Baena-Cañada JM, Lope V, Antolín S, Garcia-Saénz JÁ, Bermejo B, Muñoz M, Ramos M, de Juan A, Jara Sánchez C, Sánchez-Rovira P, Antón A, Brunet J, Gavilá J, Salvador J, Arriola Arellano E, Bezares S, Fernández de Larrea-Baz N, Pérez-Gómez B, Martín M, Pollán M. Trajectories of alcohol consumption during life and the risk of developing breast cancer. Br J Cancer 2021; 125:1168-1176. [PMID: 34483338 PMCID: PMC8505448 DOI: 10.1038/s41416-021-01492-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/10/2021] [Accepted: 07/08/2021] [Indexed: 12/26/2022] Open
Abstract
Background Whether there are lifetime points of greater sensitivity to the deleterious effects of alcohol intake on the breasts remains inconclusive. Objective To compare the influence of distinctive trajectories of alcohol consumption throughout a woman’s life on development of breast cancer (BC). Methods 1278 confirmed invasive BC cases and matched (by age and residence) controls from the Epi-GEICAM study (Spain) were used. The novel group-based trajectory modelling was used to identify different alcohol consumption trajectories throughout women’s lifetime. Results Four alcohol trajectories were identified. The first comprised women (45%) with low alcohol consumption (<5 g/day) throughout their life. The second included those (33%) who gradually moved from a low alcohol consumption in adolescence to a moderate in adulthood (5 to <15 g/day), never having a high consumption; and oppositely, women in the third trajectory (16%) moved from moderate consumption in adolescence, to a lower consumption in adulthood. Women in the fourth (6%) moved from a moderate alcohol consumption in adolescence to the highest consumption in adulthood (≥15 g/day), never having a low alcohol consumption. Comparing with the first trajectory, the fourth doubled BC risk (OR 2.19; 95% CI 1.27, 3.77), followed by the third (OR 1.44; 0.96, 2.16) and ultimately by the second trajectory (OR 1.17; 0.86, 1.58). The magnitude of BC risk was greater in postmenopausal women, especially in those with underweight or normal weight. When alcohol consumption was independently examined at each life stage, ≥15 g/day of alcohol consumption in adolescence was strongly associated with BC risk followed by consumption in adulthood. Conclusions The greater the alcohol consumption accumulated throughout life, the greater the risk of BC, especially in postmenopausal women. Alcohol consumption during adolescence may particularly influence BC risk.
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Affiliation(s)
- Carolina Donat-Vargas
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Ana Casas
- Medical Oncology Unit, Hospital Virgen del Rocío, Sevilla, Spain
| | - José Manuel Baena-Cañada
- Medical Oncology Unit, Hospital Puerta del Mar, Cádiz, Spain.,Instituto de Investigación en Biomedicina de Cádiz (INiBICA), Cádiz, Spain
| | - Virginia Lope
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Silvia Antolín
- Medical Oncology Unit, Complejo Hospitalario Universitario, A Coruña, Spain
| | | | - Begoña Bermejo
- Medical Oncology Unit, Hospital Clínico, Valencia, Spain
| | - Montserrat Muñoz
- Medical Oncology Unit, Hospital Clinic i Provincial, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics, Institut d'Investigacions Biomèdiques Pi i Sunyer-IDIBAPS, Barcelona, Spain
| | - Manuel Ramos
- Medical Oncology Unit, Centro Oncológico de Galicia, A Coruña, Spain
| | - Ana de Juan
- Medical Oncology Unit, Hospital Marqués de Valdecilla, Santander, Spain
| | - Carlos Jara Sánchez
- Medical Oncology Unit/Departamento Especialidades Médicas, Hospital Universitario Fundación Alcorcón/Universidad Rey Juan Carlos, Madrid, Spain
| | | | - Antonio Antón
- Medical Oncology Unit, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Joan Brunet
- Medical Oncology Department, Institut Català d'Oncologia, IDIBGi, Girona, Spain.,Medical Sciences Department, Universitat de Girona, Girona, Spain
| | - Joaquín Gavilá
- Medical Oncology Unit, Instituto Valenciano de Oncología, Valencia, Spain
| | - Javier Salvador
- Medical Oncology Unit, Hospital Virgen del Rocío, Sevilla, Spain
| | | | - Susana Bezares
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Beatriz Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Miguel Martín
- Medical Oncology Unit, Instituto de Investigación Sanitaria Gregorio Marañón/Universidad Complutense, Madrid, Spain.,Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
| | - Marina Pollán
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain. .,National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. .,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.
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4
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Redondo A, Oaknin A, Rubio MJ, Barretina-Ginesta MP, de Juan A, Manso L, Romero I, Martin-Lorente C, Poveda A, Gonzalez-Martin A. Management of advanced ovarian cancer in Spain: an expert Delphi consensus. J Ovarian Res 2021; 14:72. [PMID: 34039386 PMCID: PMC8157411 DOI: 10.1186/s13048-021-00816-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/26/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To determine the state of current practice and to reach a consensus on recommendations for the management of advanced ovarian cancer using a Delphi survey with a group of Spanish gynecologists and medical oncologists specially dedicated to gynecological tumors. METHODS The questionnaire was developed by the byline authors. All questions but one were answered using a 9-item Likert-like scale with three types of answers: frequency, relevance and agreement. We performed two rounds between December 2018 and July 2019. A consensus was considered reached when at least 75% of the answers were located within three consecutive points of the Likert scale. RESULTS In the first round, 32 oncologists and gynecologists were invited to participate, and 31 (96.9%) completed the online questionnaire. In the second round, 27 (87.1%) completed the online questionnaire. The results for the questions on first-line management of advanced disease, treatment of patients with recurrent disease for whom platinum might be the best option, and treatment of patients with recurrent disease for whom platinum might not be the best option are presented. CONCLUSIONS This survey shows a snapshot of current recommendations by this selected group of physicians. Although the majority of the agreements and recommendations are aligned with the recently published ESMO-ESGO consensus, there are some discrepancies that can be explained by differences in the interpretation of certain clinical trials, reimbursement or accessibility issues.
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Affiliation(s)
- Andres Redondo
- Medical Oncology Department, Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Paseo de la Castellana, 261, 28046, Madrid, Spain.
| | - Ana Oaknin
- Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maria Jesus Rubio
- Medical Oncology Department, Hospital Universitario Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Maria-Pilar Barretina-Ginesta
- Medical Oncology Department, Girona Biomedical Research Institute (IdIBGi) and Department of Medical Sciences, Catalan Institute of Oncology (ICO), Medical School University of Girona, Girona, Spain
| | - Ana de Juan
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Luis Manso
- Medical Oncology Department, Hospital Universitario 12 de Octubre-i+12, Madrid, Spain
| | - Ignacio Romero
- Medical Oncology Department, Instituto Valenciano Oncologia, Valencia, Spain
| | - Cristina Martin-Lorente
- Medical Oncology Department, Hospital Universitario de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Andres Poveda
- Oncogynecologic Department, Initia Oncology, Hospital Quironsalud, Valencia, Spain
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5
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Moura DS, Peña‐Chilet M, Cordero Varela JA, Alvarez‐Alegret R, Agra‐Pujol C, Izquierdo F, Ramos R, Ortega‐Medina L, Martin‐Davila F, Castilla‐Ramirez C, Hernandez‐Leon CN, Romagosa C, Vaz Salgado MA, Lavernia J, Bagué S, Mayodormo‐Aranda E, Vicioso L, Hernández Barceló JE, Rubio‐Casadevall J, de Juan A, Fiaño‐Valverde MC, Hindi N, Lopez‐Alvarez M, Lacerenza S, Dopazo J, Gutierrez A, Alvarez R, Valverde C, Martinez‐Trufero J, Martín‐Broto J. A DNA damage repair gene-associated signature predicts responses of patients with advanced soft-tissue sarcoma to treatment with trabectedin. Mol Oncol 2021; 15:3691-3705. [PMID: 33983674 PMCID: PMC8637557 DOI: 10.1002/1878-0261.12996] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/13/2021] [Accepted: 05/10/2021] [Indexed: 11/29/2022] Open
Abstract
Predictive biomarkers of trabectedin represent an unmet need in advanced soft‐tissue sarcomas (STS). DNA damage repair (DDR) genes, involved in homologous recombination or nucleotide excision repair, had been previously described as biomarkers of trabectedin resistance or sensitivity, respectively. The majority of these studies only focused on specific factors (ERCC1, ERCC5, and BRCA1) and did not evaluate several other DDR‐related genes that could have a relevant role for trabectedin efficacy. In this retrospective translational study, 118 genes involved in DDR were evaluated to determine, by transcriptomics, a predictive gene signature of trabectedin efficacy. A six‐gene predictive signature of trabectedin efficacy was built in a series of 139 tumor samples from patients with advanced STS. Patients in the high‐risk gene signature group showed a significantly worse progression‐free survival compared with patients in the low‐risk group (2.1 vs 6.0 months, respectively). Differential gene expression analysis defined new potential predictive biomarkers of trabectedin sensitivity (PARP3 and CCNH) or resistance (DNAJB11 and PARP1). Our study identified a new gene signature that significantly predicts patients with higher probability to respond to treatment with trabectedin. Targeting some genes of this signature emerges as a potential strategy to enhance trabectedin efficacy.
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Affiliation(s)
- David S. Moura
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
| | - Maria Peña‐Chilet
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
- Clinical Bioinformatics AreaFundación Progreso y Salud (FPS)CDCAHospital Virgen del RocioSevilleSpain
- Bioinformatics in Rare Diseases (BiER)Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)FPSHospital Virgen del RocioSevilleSpain
| | | | | | | | | | - Rafael Ramos
- Pathology DepartmentSon Espases University HospitalMallorcaSpain
| | | | | | | | | | - Cleofe Romagosa
- Pathology DepartmentVall d'Hebron University HospitalBarcelonaSpain
| | | | - Javier Lavernia
- Medical Oncology DepartmentInstituto Valenciano de OncologiaValenciaSpain
| | - Silvia Bagué
- Pathology ServiceHospital de la Santa Creu i Sant PauBarcelonaSpain
| | | | - Luis Vicioso
- Pathology DepartmentVirgen de la Victoria University HospitalMalagaSpain
| | | | - Jordi Rubio‐Casadevall
- Medical Oncology DepartmentHospital Josep TruetaCatalan Institute of OncologyGironaSpain
| | - Ana de Juan
- Medical Oncology DepartmentMarqués de Valdecilla University HospitalSantanderSpain
| | | | - Nadia Hindi
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
- Medical Oncology DepartmentUniversity Hospital Fundación Jimenez DiazMadridSpain
- University Hospital General de VillalbaMadridSpain
- Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD)MadridSpain
| | - Maria Lopez‐Alvarez
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
| | - Serena Lacerenza
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
| | - Joaquin Dopazo
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
- Clinical Bioinformatics AreaFundación Progreso y Salud (FPS)CDCAHospital Virgen del RocioSevilleSpain
- Bioinformatics in Rare Diseases (BiER)Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)FPSHospital Virgen del RocioSevilleSpain
- INB‐ELIXIR‐esFPSHospital Virgen del RocíoSevilleSpain
| | | | - Rosa Alvarez
- Medical Oncology DepartmentGregorio Marañon University HospitalMadridSpain
| | - Claudia Valverde
- Medical Oncology DepartmentVall d'Hebron University HospitalBarcelonaSpain
| | | | - Javier Martín‐Broto
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
- Medical Oncology DepartmentUniversity Hospital Fundación Jimenez DiazMadridSpain
- University Hospital General de VillalbaMadridSpain
- Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD)MadridSpain
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6
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Pollan M, Lope V, Guerrero-Zotano A, Casas A, Baena-Cañada JM, Bermejo B, Perez-Gomez B, Sanchez-Rovira P, Ramos Vazquez M, Anton A, Garcia-Saenz JA, Munoz M, de Juan A, Andres R, Llombart Cussac A, Hernando B, Franquesa RM, Caballero R, Martin M, Priego F. Serum phospholipids fatty acids and breast cancer risk by pathological subtype: EpiGEICAM study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e13604] [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
e13604 Background: The role of fatty acids (FA) in breast cancer (BC) etiology is unclear. Most studies are based on self-reported dietary intake, without considering their internal transformation. This analysis tries to assess whether serum levels of 26 phospholipid FA (PL-FAs) and markers of their endogenous metabolism are associated with BC risk, both globally and by pathological BC subtype. Methods: EpiGEICAM-01 is a Spanish multicenter matched case-control study. BC cases and healthy women completed a lifestyle and a food frequency questionnaire, and serum samples were collected. Serum PL-FAs percentages were measured by gas chromatography-mass spectrometry (GC–MS). Conditional and multinomial logistic regression models were used to quantify the association of PL-FAs tertiles with BC risk, overall and by pathologic BC subtypes [luminal, HER2+ and triple negative]. Models were adjusted for age and region (multinomial models), education level, body mass index (BMI), menopausal status, age at menarche and at first birth, hormone replacement therapy, alcohol consumption, last year physical activity, history of benign breast disease, family history of BC and caloric intake, and were corrected for multiple testing. Stratified analyses by BMI and menopausal status were also performed. Results: Questionnaires and serum samples were collected from 795 case-control pairs. Women with high serum levels of stearic acid [odds ratio (OR)T3vsT1= 0.44; 95% confidence interval (CI) = 0.30-0.66], linoleic acid (ORT3vsT1= 0.66; 95% CI = 0.49-0.90) and arachidonic to dihomo-γ-linolenic acids ratio (OR T3vsT1= 0.64 95%; CI = 0.48-0.84; differences were remarkable in overweight/obese women) presented lower BC risk. Participants with high concentrations of palmitoleic acid (ORT3vsT1= 1.65; 95% CI = 1.20-2.26), trans-ruminant palmitelaidic acid (ORT3vsT1= 1.51; 95% CI = 1.12-2.02; differences observed were noticeable both in postmenopausal and in overweight/obese women), trans-industrial elaidic acid (ORT3vsT1= 1.52; 95% CI = 1.14-2.03; markedly both in premenopausal and in non-obese women), and high oleic to stearic acids ratio (ORT3vsT1= 2.04; 95% CI = 1.45-2.87) showed higher risk. These associations were similar in all BC pathological subtypes. Conclusions: Our results, which should be confirmed in future studies, emphasize the importance of analyzing fatty acids individually, as well as the desaturase activity indices. A decrease in the dietary intake of trans-monounsaturated fatty acids could be a good strategy for BC prevention.
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Affiliation(s)
- Marina Pollan
- National Center of Epidemiology, Instituto Salud Carlos III. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Virginia Lope
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Angel Guerrero-Zotano
- Instituto Valenciano de Oncología, GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Ana Casas
- Hospital Universitario Virgen Del Rocio, GEICAM Spanish Breast Cancer Group, Seville, Spain
| | - José Manuel Baena-Cañada
- Hospital Puerta del Mar; Instituto de Investigación en Biomedicina de Cádiz (INiBICA); GEICAM Spanish Breast Cancer Group, Cádiz, Spain
| | - Begoña Bermejo
- Hospital Clinico Universitario Valencia. Biomedical Research Institute INCLIVA. CIBERONC ISCIII. GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Beatriz Perez-Gomez
- Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Manuel Ramos Vazquez
- Centro Oncologico de Galicia. GEICAM Spanish Breast Cancer Group, A Coruña, Spain
| | - Antonio Anton
- Hospital Universitario Miguel Servet, Geicam Spanish Breast Cancer Group, Zaragoza, Spain
| | | | - Montserrat Munoz
- Medical Oncology, Hospital Clínic Barcelona, GEICAM Spanish Breast Cancer Group, Barcelona, Spain
| | - Ana de Juan
- Hospital Marqués de Valdecilla; GEICAM Spanish Breast Cancer Group, Santander, Spain
| | - Raquel Andres
- Hospital Clínico Universitario Lozano Blesa, GEICAM Spanish Breast Cancer Group, Zaragoza, Spain
| | | | - Blanca Hernando
- Hospital General Yagüe, GEICAM Spanish Breast Cancer Group, Burgos, Spain
| | | | | | - Miguel Martin
- Hospital General Universitario Gregorio Marañón, Instituto Investigación Sanitaria Gregorio Marañón. Universidad Complutense, CIBERONC ISCIII, GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Feliciano Priego
- Analytical Chemistry Department. Universidad de Córdoba., Córdoba, Spain
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7
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Fernández de Larrea-Baz N, Pérez-Gómez B, Guerrero-Zotano Á, Casas AM, Bermejo B, Baena-Cañada JM, Antolin S, Sánchez-Rovira P, Ramos Vázquez M, Garcia-Sáenz JÁ, Antón A, Muñoz M, de Juan A, Jara C, Chacón JI, Arcusa A, Gil-Gil M, Adrover E, Oltra A, Brunet J, González S, Bezares S, Lope V, Martín M, Pollán M. Primary breast cancer and health related quality of life in Spanish women: The EpiGEICAM case-control study. Sci Rep 2020; 10:7741. [PMID: 32385335 PMCID: PMC7211017 DOI: 10.1038/s41598-020-63637-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 04/02/2020] [Indexed: 01/06/2023] Open
Abstract
This study evaluates the impact of breast cancer (BC) in health related quality of life (HRQL) and in psychological distress (PD) during the initial phases of the disease and looks for contributing factors. A multicentric case-control study, EpiGEICAM, was carried out. Incident BC cases and age- and residence- matched controls were included. Clinical, epidemiological, HRQL (SF-36) and PD information (GHQ-28) was collected. We used multivariable logistic regression models to estimate OR of low HRQL and of PD in cases compared to controls, and to identify factors associated with low HRQL and with PD. Among 896 BC cases and 890 control women, cases had poorer scores than both, the reference population and the control group, in all SF-36 scales. BC women with lower education, younger, active workers, never smokers, those with comorbidities, in stage IV and with surgical treatment had lower physical HRQL; factors associated with low mental HRQL were dissatisfaction with social support, being current smoker and having children. Cases had a fivefold increased odds of PD compared to controls. Managing comorbidities and trying to promote social support, especially in younger and less educated women, could improve well-being of BC patients.
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Affiliation(s)
- Nerea Fernández de Larrea-Baz
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), C/Monforte de Lemos, 5, 28029, Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), C/Monforte de Lemos, 5, 28029, Madrid, Spain.
| | - Beatriz Pérez-Gómez
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), C/Monforte de Lemos, 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), C/Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Ángel Guerrero-Zotano
- Medical Oncology Unit, Instituto Valenciano de Oncología, C/Beltrán Báguena, 8, 46009, Valencia, Spain
| | - Ana María Casas
- Medical Oncology Unit, Hospital Virgen del Rocío, Avenida de Manuel Siurot s/n, 41013, Sevilla, Spain
| | - Begoña Bermejo
- Medical Oncology Unit, Hospital Clínico / INCLIVA, Avenida Blasco Ibáñez, 17, 46010, Valencia, Spain
| | - José Manuel Baena-Cañada
- Medical Oncology Unit, Hospital Universitario Puerta del Mar, Avenida Ana de Viya, 21, 11009, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz/Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - Silvia Antolin
- Medical Oncology Unit, Complejo Hospitalario Universitario A Coruña, Jubias de Arriba, 84, 15006, A Coruña, Spain
| | - Pedro Sánchez-Rovira
- Medical Oncology Unit, Complejo Hospitalario de Jaén, Avenida del Ejército Español, 10, 23007, Jaén, Spain
| | - Manuel Ramos Vázquez
- Medical Oncology Unit, Centro Oncológico de Galicia, Doctor Camilo Veiras, 1, 15009, A Coruña, Spain
| | - José Ángel Garcia-Sáenz
- Medical Oncology Unit, Hospital Clínico Universitario San Carlos, Profesor Martín Lagos, S/N, 28040, Madrid, Spain
| | - Antonio Antón
- Medical Oncology Unit, Hospital Universitario Miguel Servet, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain
| | - Montserrat Muñoz
- Medical Oncology Unit, Hospital Clinic i Provincial, C/Villarroel, 170, 08036, Barcelona, Spain
- Translational Genomics and Targeted Therapeutics, Institut d'Investigacions Biomèdiques Pi i Sunyer-IDIBAPS, Barcelona, Spain
| | - Ana de Juan
- Medical Oncology Unit, Hospital Marqués de Valdecilla, Avenida Valdecilla, 25, 39008, Santander, Spain
| | - Carlos Jara
- Medical Oncology Unit, Hospital Universitario Fundación Alcorcón-Universidad Rey Juan Carlos, Calle Budapest, 1, 28922, Alcorcón, Madrid, Spain
| | - José Ignacio Chacón
- Medical Oncology Unit, Hospital Virgen de la Salud, Avenida Barber, 30, 45004, Toledo, Spain
| | - Angels Arcusa
- Medical Oncology Unit, Consorci Sanitari de Terrassa, Carretera Torrebonica, S/N, 08227, Terrassa, Spain
| | - Miguel Gil-Gil
- Medical Oncology Unit, Instituto Catalán de Oncología, Avenida Granvia de l'Hospitalet, 199-203, 08908, L'Hospitalet de Llobregat, Spain
| | - Encarna Adrover
- Medical Oncology Unit, Hospital General de Alicante/Complejo Hospitalario Universitario de Albacete, C/Pintor Baeza, 12, 03010, Alicante, Spain
| | - Amparo Oltra
- Medical Oncology Unit, Hospital Virgen de los Lirios, Polígono de Caramanchel, S/N, 03804, Alcoy, Alicante, Spain
| | - Joan Brunet
- Medical Oncology Unit, Instituto Catalán de Oncología, Avenida de França, S/N, 17007, Girona, Spain
| | - Sonia González
- Medical Oncology Unit, Hospital Mutua Terrassa, Plaça Dr. Robert, 5, 08221, Terrassa, Spain
| | - Susana Bezares
- GEICAM Spanish Breast Cancer Group, Avenida de los Pirineos, 7, 28703, San Sebastián de los Reyes, Madrid, Spain
| | - Virginia Lope
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), C/Monforte de Lemos, 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), C/Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Miguel Martín
- Medical Oncology Unit, Instituto de Investigación Sanitaria Gregorio Marañón, C/Doctor Esquerdo, 46, 28007, Madrid, Spain
- Complutense University of Madrid, Madrid, Spain
- Consortium for Biomedical Research in Oncology (CIBERONC-ISCIII), Madrid, Spain
| | - Marina Pollán
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), C/Monforte de Lemos, 5, 28029, Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), C/Monforte de Lemos, 5, 28029, Madrid, Spain.
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8
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Sánchez-Rovira P, Zamora P, Salvador-Bofill J, Morales S, Martínez-Jáñez N, Martínez-de-Dueñas E, Lluch A, Illarramendi JJ, Gómez-Pardo P, Gavilá Gregori J, García-Palomo A, García-Mata J, Fernández Y, Del Barco S, de Juan A, Ciruelos E, Chacón JI, Calvo L, Barnadas A, Albanell J. Broad consensus on the optimal sequence for the systemic treatment of metastatic breast cancer: results from a survey of Spanish medical oncologists. J Drug Assess 2019; 8:62-69. [PMID: 31069129 PMCID: PMC6493326 DOI: 10.1080/21556660.2019.1604375] [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: 10/09/2018] [Accepted: 03/26/2019] [Indexed: 11/24/2022] Open
Abstract
Objective: The aim of this survey conducted by 20 leading Spanish oncologists was to analyze the concurrence between Spanish clinical practice and the recently published definition of the optimal sequence for the systemic treatment of metastatic breast cancer (MBC) according to patient profiles. Methods: A self-administered questionnaire was developed, divided into five sections comprising 34 specific questions related to sequential treatments, plus three additional general questions. Respondents were asked to justify negative answers. Participants were recruited randomly by invitation out of a total of 619 oncologists. The questionnaire was sent and collected via e-mail between October 2015 and May 2016. A total of 191 completed questionnaires were received. Results: Overall, 70% of oncologists would keep the three patient profiles exactly as proposed (hormone receptor-positive and HER2-negative, HER2-positive, and triple negative breast cancer). Affirmative answers to questions regarding treatment sequences for these patient profiles (1–34) ranged from 77.8–99.5%, with an average of 90.9% of oncologists being in agreement with the recommended sequential treatments. The lowest degree of consensus was observed for endocrine treatments in pre-menopausal women and for chemotherapy options in hormone-resistant patients, whilst the highest degree of consensus was reached for targeted therapies in HER2-positive patients and for endocrine therapy in post-menopausal women. In their comments, participants revealed a number of economic constraints that prevented them from implementing some of the best treatment options. Conclusions: In conclusion, despite the complexity of MBC treatment, there is general agreement on the optimal treatment sequences.
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Affiliation(s)
| | | | | | | | | | | | - Ana Lluch
- Hospital ClínicUniversitari de València, València, Spain
| | | | | | | | | | | | | | | | - Ana de Juan
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Eva Ciruelos
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Lourdes Calvo
- Complejo Hospitalario Universitario de A CoruñaA Coruña, Spain
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9
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Castello A, Shivappa N, Ruiz A, Casas A, Lluch Hernandez A, Baena-Cañada JM, Antolin S, Sánchez Rovira P, Ramos Vazquez M, Garcia-Saenz JA, Anton A, Munoz M, de Juan A, Jara-Sanchez C, Vioque J, Perez-Gomez B, Hébert JR, Lope V, Martin M, Pollan M. Dietary inflammatory index and breast cancer risk by menopausal status and histological subtype. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.1521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Adela Castello
- National Center for Epidemiology, Instituto de Salud Carlos III, Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III.Faculty of Medicine, University of Alcalá, Madrid, Spain
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia.Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia. Connecting Health Innovations LLC, Columbia., Columbia, SC
| | - Amparo Ruiz
- Instituto Valenciano de Oncología, GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Ana Casas
- Hospital Universitario Virgen Del Rocio, Sevilla, Spain
| | - Ana Lluch Hernandez
- Fundación Instituto Valenciano de Oncología. Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Valencia, Spain
| | - José Manuel Baena-Cañada
- Hospital Puerta del Mar; Instituto de Investigación en Biomedicina de Cádiz (INiBICA); GEICAM Spanish Breast Cancer Group, Cádiz, Spain
| | - Silvia Antolin
- Complejo Hospitalario Universitario A Coruña. GEICAM Spanish Breast Cancer Group, A Coruña, Spain
| | | | - Manuel Ramos Vazquez
- Centro Oncologico de Galicia. GEICAM Spanish Breast Cancer Group, A Coruña, Spain
| | | | - Antonio Anton
- Hospital Universitario Miguel Servet; GEICAM Spanish Breast Cancer Group, Zaragoza, Spain
| | - Montserrat Munoz
- Hospital Clínic de Barcelona; Translational Genomics and Targeted Therapeutics; Institut d’Investigacions Biomèdiques Pi i Sunyer-IDIBAPS; GEICAM Spanish Breast Cancer Group, Barcelona, Spain
| | - Ana de Juan
- Hospital Marqués de Valdecilla; GEICAM Spanish Breast Cancer Group, Santander, Spain
| | | | - Jesus Vioque
- Department of Public Health, Universidad Miguel Hernandez. onsortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III., Sant Joan D'alacant, Spain
| | - Beatriz Perez-Gomez
- Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III., Madrid, Spain
| | - James R. Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia. Connecting Health Innovations LLC., Columbia, SC
| | - Virginia Lope
- Cancer Epidemiology Unit. National Center for Epidemiology. Instituto de Salud Carlos III. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Martin
- Instituto de Investigación Sanitaria Gregorio Marañón, Ciberonc, Geicam, Universidad Complutense, Madrid, Spain
| | - Marina Pollan
- National Center of Epidemiology, Instituto Salud Carlos III. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III, Madrid, Spain
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10
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García Del Muro X, Maurel J, Martínez Trufero J, Lavernia J, López Pousa A, de Las Peñas R, Cubedo R, Berros JP, Casado Herráez A, de Juan A, Martín Broto J. Phase II trial of ifosfamide in combination with the VEGFR inhibitor sorafenib in advanced soft tissue sarcoma: a Spanish group for research on sarcomas (GEIS) study. Invest New Drugs 2018. [PMID: 29527631 DOI: 10.1007/s10637-018-0583-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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] [Indexed: 12/18/2022]
Abstract
Background Sorafenib is a potent targeted-therapy that blockades angiogenesis and has demonstrated activity against some sarcoma subtypes. Preclinical studies suggested that treatment with sorafenib plus cytotoxic agents could result in additive efficacy. Methods Patients with advanced soft tissue sarcoma, with or without anthracycline pretreatment were included. Patients received oral sorafenib 400 mg twice daily starting on Day +2, ifosfamide 2.0 g/m2 iv infusion lasting 4 h on days 1, 2 and 3 with concurrent mesna 400 mg/m2 every three weeks until disease progression or unacceptable toxicity or up to a maximum of 6 cycles of ifosfamide (sorafenib could be continued until progressive disease or unacceptable toxicity). Primary objective was progression-free rate (PFR) at 3 and 6 months; secondary objectives were overall response rate (ORR), Progression-free survival (PFS), Overall survival (OS) and safety. This article reports the phase II part of a phase I/II clinical trial. Results Thirty-five patients were enrolled. PFR at 3 and 6 months was 66% (95% CI 48-81) and 37% (95% CI 22-55). Six patients (17%) achieved partial response and 17 (49%) stable disease. Median PFS was 4.8 months (CI 95% 1.94-6.36) and overall survival 16.2 months (95% CI 8.75-NA). Conclusion Treatment with sorafenib plus ifosfamide achieved a significant clinical benefit with an acceptable safety profile in patients with advanced soft tissue sarcoma resistant to anthracyclines, which warrants a more detailed study in randomized clinical trials.
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Affiliation(s)
| | - Joan Maurel
- Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | - Ana de Juan
- Hospital Marqués de Valdecilla, Santander, Spain
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11
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Martínez-Jañez N, Chacón I, de Juan A, Cruz-Merino L, Del Barco S, Fernández I, García-Teijido P, Gómez-Bernal A, Plazaola A, Ponce J, Servitja S, Zamora P. Anti-HER2 Therapy Beyond Second-Line for HER2-Positive Metastatic Breast Cancer: A Short Review and Recommendations for Several Clinical Scenarios from a Spanish Expert Panel. Breast Care (Basel) 2016; 11:133-8. [PMID: 27239176 DOI: 10.1159/000443601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/23/2023] Open
Abstract
BACKGROUND The aim of this project was to provide an expert opinion regarding anti-human epidermal growth factor receptor 2 (HER2) therapy beyond second-line treatment of metastatic breast cancer (mBC). METHODS A group of experts discussed specific issues concerning anti-HER2 therapy in late-line settings in mBC. RESULTS Trastuzumab emtansine (T-DM1) or dual HER2 blockade appeared to be good options for HER2-positive mBC after ≥ 2 HER2-targeted therapies. Once an objective response has been achieved with anti-HER2-containing therapy, the anti-HER2 agent can be continued until progression of the disease, unacceptable toxicity or patient decision. mBC treated with ≥ 3 consecutive lines of anti-HER therapy, ≥ 1 being a dual HER2 blockade and with early progression of disease during a fourth or later-line treatment, are clinically resistant to anti-HER therapy. For progression of metastasis in the brain after anti-HER2 therapy, lapatinib and chemotherapy appear to be a good alternative after best local treatment. CONCLUSIONS Further clinical trials are needed to provide valuable knowledge about the best treatment options in the later settings of mBC.
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Affiliation(s)
| | - Ignacio Chacón
- Medical Oncology Department, Hospital Virgen de la Salud, Toledo, Spain
| | - Ana de Juan
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Luis Cruz-Merino
- Medical Oncology Department, Hospital Virgen de la Macarena, Sevilla, Spain
| | - Sònia Del Barco
- Instituto Catalán de Oncología, Hospital Universitario Doctor Josep Trueta, Gerona, Spain
| | | | | | | | | | - José Ponce
- Hospital General Universitario de Alicante, Alicante, Spain
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12
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Barnadas A, Manso L, de la Piedra C, Meseguer C, Crespo C, Gómez P, Calvo L, Martinez P, Ruiz-Borrego M, Perelló A, Antón A, Codes M, Margelí M, Murias A, Salvador J, Seguí MÁ, de Juan A, Gavilá J, Luque M, Pérez D, Zamora P, Arizcuma A, Chacón JI, Heras L, Martin-Fernández M, Mahillo-Fernández I, Tusquets I. Bone turnover markers as predictive indicators of outcome in patients with breast cancer and bone metastases treated with bisphosphonates: results from a 2-year multicentre observational study (ZOMAR study). Bone 2014; 68:32-40. [PMID: 25108081 DOI: 10.1016/j.bone.2014.07.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 07/15/2014] [Accepted: 07/21/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND We evaluated the evolution and predictive value of bone turnover markers (BTMs) and circulating tumor cells (CTCs) with respect to mortality, disease progression (DP) and skeletal-related events (SREs), in patients with bone metastatic breast cancer (BmBCa). The correlation between BTMs and CTCs was also studied. METHODS In a 2-year observational, multicenter study, the levels of three BTMs (N- and C-terminal telopeptides of collagen I [NTX and αα-CTX], and bone-specific alkaline phosphatase [BSAP]) and CTCs were analyzed every three months. Patients received zoledronic acid (4mg every 28days) from the baseline visit. RESULTS 234 patients were analyzed. The levels of the BTMs were increased at baseline and significantly decreased after 3months (P<0.05). In the Cox regression univariate analyses significant hazard ratios (HRs) for death were found for pathological BSAP values at baseline (5.03 [95% CI: 1.214-20.839; P=0.0259]) and at 3months (3.41 [95% CI: 1.367-8.498; P=0.0085]). HRs >2 were found for increased baseline and 3-month levels of NTX and CTC (P<0.05). Only increased baseline BSAP levels were associated with DP (HR=2.25 [95% CI: 1.391-3.626; P=0.0009]). No biomarker was associated with SREs. In the multivariate analysis, pathologic levels at 3months of NTX and BSAP were significantly associated with mortality (HRs=3.59 [95% CI: 1.375-9.382; P=0.0091] and 3.25 [95% CI: 1.293-8.189; P=0.0120], respectively). CTC and BSAP were correlated during all study timepoints (P<0.05). CONCLUSIONS Baseline levels of NTX, BSAP and CTCs, and changes after treatment initiation with bisphosphonates, may be useful for the prognostic assessment of patients with BmBCa. BSAP showed the strongest prognostic value.
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Affiliation(s)
- Agustí Barnadas
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Luis Manso
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Avda. de Córdoba, s/n, 28041 Madrid, Spain.
| | - Concepción de la Piedra
- Bioquímica Investigación, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Avda. Reyes Católicos, 2, 28040 Madrid, Spain.
| | - Cristina Meseguer
- Medical Department, Novartis Farmacéutica S.A., Gran Via de les Corts Catalanes, 764, 08013 Barcelona, Spain.
| | - Carmen Crespo
- Medical Oncology Department, Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, Km. 9100, 28034 Madrid, Spain.
| | - Patricia Gómez
- Oncology Department, Hospital Vall d'Hebrón, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Lourdes Calvo
- Oncology Department, Complejo Hospitalario Universitario de A Coruña, As Xubias, 84, 15006 A Coruña, Spain.
| | - Purificación Martinez
- Oncology Department, Hospital Universitario Basurto, Avda. de Montevideo, 18, 48013 Bilbao, Spain.
| | - Manuel Ruiz-Borrego
- Oncology Department, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot, 0, 41013 Sevilla, Spain.
| | - Antonia Perelló
- Medical Oncology Service, Hospital Universitari Son Dureta, Andrea Doria, 55, 07014 Palma de Mallorca, Spain.
| | - Antonio Antón
- Medical Oncology Department, Hospital Universitario Miguel Servet, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain.
| | - Manuel Codes
- Medical Oncology Department, Hospital Virgen Macarena, Avda. Dr. Fedriani, 3, 41007 Sevilla, Spain.
| | - Mireia Margelí
- Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Crta. Canyet, 08916 Badalona, Spain.
| | - Adolfo Murias
- Oncology Department, Hospital Insular de Gran Canaria, Plaza Doctor Pasteur, s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Javier Salvador
- Medical Oncology Department, Hospital Universitario Nuestra Señora de Valme, Avda. de Bellavista, s/n, 41014 Sevilla, Spain.
| | - Miguel Ángel Seguí
- Medical Oncology Department, Corporació Sanitària Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Spain.
| | - Ana de Juan
- Oncology Department, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla, s/n, 39008 Santander, Spain.
| | - Joaquín Gavilá
- Medical Oncology Department, Fundación Instituto Valenciano de Oncología, Profesor Beltrán Bàguena, 8, 46009 Valencia, Spain.
| | - María Luque
- Medical Oncology Department, Hospital Universitario Central de Asturias, Celestino Villamil, s/n, 33006 Oviedo, Spain.
| | - Diego Pérez
- Oncology Department, Hospital Costa del Sol, Autovía A-7, Km. 187, 29603 Marbella, Málaga, Spain.
| | - Pilar Zamora
- Medical Oncology Service, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain.
| | - Alberto Arizcuma
- Oncology Department, Hospital General Río Carrión, Avda. Donantes de Sangre, s/n, 34005 Palencia, Spain.
| | - José Ignacio Chacón
- Medical Oncology Department, Hospital Virgen de la Salud, Avda. de Barber, 30, 45071 Toledo, Spain.
| | - Lucía Heras
- Oncology Service, Hospital de la Creu Roja, Avinguda Josep Molins, 29-41, 08906 L'Hospitalet de Llobregat, Spain.
| | - Marta Martin-Fernández
- Bioquímica Investigación, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Avda. Reyes Católicos, 2, 28040 Madrid, Spain.
| | - Ignacio Mahillo-Fernández
- Epidemiology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Avda. Reyes Católicos, 2, 28040 Madrid, Spain.
| | - Ignacio Tusquets
- Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain; Medical Oncology Department, Hospital del Mar, Passeig Marítim de la Barceloneta, 25-29, 08003 Barcelona, Spain.
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Stacey SN, Sulem P, Zanon C, Gudjonsson SA, Thorleifsson G, Helgason A, Jonasdottir A, Besenbacher S, Kostic JP, Fackenthal JD, Huo D, Adebamowo C, Ogundiran T, Olson JE, Fredericksen ZS, Wang X, Look MP, Sieuwerts AM, Martens JWM, Pajares I, Garcia-Prats MD, Ramon-Cajal JM, de Juan A, Panadero A, Ortega E, Aben KKH, Vermeulen SH, Asadzadeh F, van Engelenburg KCA, Margolin S, Shen CY, Wu PE, Försti A, Lenner P, Henriksson R, Johansson R, Enquist K, Hallmans G, Jonsson T, Sigurdsson H, Alexiusdottir K, Gudmundsson J, Sigurdsson A, Frigge ML, Gudmundsson L, Kristjansson K, Halldorsson BV, Styrkarsdottir U, Gulcher JR, Hemminki K, Lindblom A, Kiemeney LA, Mayordomo JI, Foekens JA, Couch FJ, Olopade OI, Gudbjartsson DF, Thorsteinsdottir U, Rafnar T, Johannsson OT, Stefansson K. Ancestry-shift refinement mapping of the C6orf97-ESR1 breast cancer susceptibility locus. PLoS Genet 2010; 6:e1001029. [PMID: 20661439 PMCID: PMC2908678 DOI: 10.1371/journal.pgen.1001029] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [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: 01/22/2010] [Accepted: 06/16/2010] [Indexed: 12/31/2022] Open
Abstract
We used an approach that we term ancestry-shift refinement mapping to investigate an association, originally discovered in a GWAS of a Chinese population, between rs2046210[T] and breast cancer susceptibility. The locus is on 6q25.1 in proximity to the C6orf97 and estrogen receptor α (ESR1) genes. We identified a panel of SNPs that are correlated with rs2046210 in Chinese, but not necessarily so in other ancestral populations, and genotyped them in breast cancer case∶control samples of Asian, European, and African origin, a total of 10,176 cases and 13,286 controls. We found that rs2046210[T] does not confer substantial risk of breast cancer in Europeans and Africans (OR = 1.04, P = 0.099, and OR = 0.98, P = 0.77, respectively). Rather, in those ancestries, an association signal arises from a group of less common SNPs typified by rs9397435. The rs9397435[G] allele was found to confer risk of breast cancer in European (OR = 1.15, P = 1.2×10−3), African (OR = 1.35, P = 0.014), and Asian (OR = 1.23, P = 2.9×10−4) population samples. Combined over all ancestries, the OR was 1.19 (P = 3.9×10−7), was without significant heterogeneity between ancestries (Phet = 0.36) and the SNP fully accounted for the association signal in each ancestry. Haplotypes bearing rs9397435[G] are well tagged by rs2046210[T] only in Asians. The rs9397435[G] allele showed associations with both estrogen receptor positive and estrogen receptor negative breast cancer. Using early-draft data from the 1,000 Genomes project, we found that the risk allele of a novel SNP (rs77275268), which is closely correlated with rs9397435, disrupts a partially methylated CpG sequence within a known CTCF binding site. These studies demonstrate that shifting the analysis among ancestral populations can provide valuable resolution in association mapping. In genome-wide association studies of disease susceptibility, there is no particular expectation that a genotyped SNP showing an association is itself a pathogenic variant. Rather, it is more likely that a SNP giving a signal does so because it is in linkage disequilibrium (LD) with a pathogenic variant. When the analysis is shifted to a population of another ancestry, the tagging relationship between the genotyped SNP and the pathogenic variant may be disrupted, due to differing patterns of LD between populations. Thus, it is not straightforward to determine whether a susceptibility locus identified in one ancestral population is also associated with risk in another. Moreover, the differing patterns of LD between ancestral populations can be used to gain resolution in genetic mapping. We refer to this approach as ancestry-shift refinement mapping. Here, we apply it to a breast cancer risk variant near the estrogen receptor α gene that was initially described in a Chinese population. We show that the tagging relationship between the originally described SNP rs2046210 and the pathogenic variant(s) is not maintained in Europeans and Africans. We identify a SNP, rs9397435, that is associated with breast cancer risk in populations of Asian, European, and African ancestry.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - James D. Fackenthal
- Department of Medicine and Center for Clinical Cancer Genetics, University of Chicago, Chicago, Illinois, United States of America
| | - Dezheng Huo
- Department of Medicine and Center for Clinical Cancer Genetics, University of Chicago, Chicago, Illinois, United States of America
| | - Clement Adebamowo
- Division of Oncology, Department of Surgery, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Oyo, Nigeria
| | - Temidayo Ogundiran
- Division of Oncology, Department of Surgery, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Oyo, Nigeria
| | - Janet E. Olson
- Department of Laboratory Medicine and Pathology and Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Zachary S. Fredericksen
- Department of Laboratory Medicine and Pathology and Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Xianshu Wang
- Department of Laboratory Medicine and Pathology and Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Maxime P. Look
- Department of Medical Oncology, Erasmus MC Rotterdam, Josephine Nefkens Institute and Cancer Genomics Center, Rotterdam, The Netherlands
| | - Anieta M. Sieuwerts
- Department of Medical Oncology, Erasmus MC Rotterdam, Josephine Nefkens Institute and Cancer Genomics Center, Rotterdam, The Netherlands
| | - John W. M. Martens
- Department of Medical Oncology, Erasmus MC Rotterdam, Josephine Nefkens Institute and Cancer Genomics Center, Rotterdam, The Netherlands
| | - Isabel Pajares
- Division of Medical Oncology, University Hospital, Zaragoza, Spain
| | | | - Jose M. Ramon-Cajal
- Divisions of Surgical Pathology and Gynecology, San Jorge Hospital, Huesca, Spain
| | - Ana de Juan
- Division of Medical Oncology, Marques de Valdecilla University Hospital, Santander, Spain
| | - Angeles Panadero
- Division of Medical Oncology, Hospital Ciudad de Coria, Coria, Spain
| | - Eugenia Ortega
- Division of Medical Oncology, University Hospital, Lérida, Spain
| | - Katja K. H. Aben
- Comprehensive Cancer Centre IKO, Nijmegen, The Netherlands
- Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Sita H. Vermeulen
- Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Fatemeh Asadzadeh
- Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | | | - Sara Margolin
- Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
| | - Chen-Yang Shen
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- Graduate Institute of Environmental Science, China Medical University, Taichung, Taiwan
| | - Pei-Ei Wu
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
- Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
| | - Per Lenner
- Department of Oncology, Norrlands University Hospital, Umeå, Sweden
| | - Roger Henriksson
- Department of Oncology, Norrlands University Hospital, Umeå, Sweden
| | - Robert Johansson
- Department of Oncology, Norrlands University Hospital, Umeå, Sweden
| | - Kerstin Enquist
- Department of Public Health and Clinical Medicine/Nutritional Research, Umeå University, Umeå, Sweden
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine/Nutritional Research, Umeå University, Umeå, Sweden
| | - Thorvaldur Jonsson
- Departments of Oncology, Surgery, and The Cancer Center, Landspitali-University Hospital, Reykjavik, Iceland
| | - Helgi Sigurdsson
- Departments of Oncology, Surgery, and The Cancer Center, Landspitali-University Hospital, Reykjavik, Iceland
| | - Kristin Alexiusdottir
- deCODE Genetics, Reykjavik, Iceland
- Departments of Oncology, Surgery, and The Cancer Center, Landspitali-University Hospital, Reykjavik, Iceland
| | | | | | | | | | | | | | | | | | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
- Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Lambertus A. Kiemeney
- Comprehensive Cancer Centre IKO, Nijmegen, The Netherlands
- Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Jose I. Mayordomo
- Division of Medical Oncology, University Hospital, Zaragoza, Spain
- Health Science Institute, Nanotechnology Institute of Aragon, Zaragoza, Spain
| | - John A. Foekens
- Department of Medical Oncology, Erasmus MC Rotterdam, Josephine Nefkens Institute and Cancer Genomics Center, Rotterdam, The Netherlands
| | - Fergus J. Couch
- Department of Laboratory Medicine and Pathology and Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Olufunmilayo I. Olopade
- Department of Medicine and Center for Clinical Cancer Genetics, University of Chicago, Chicago, Illinois, United States of America
| | | | | | | | - Oskar T. Johannsson
- Departments of Oncology, Surgery, and The Cancer Center, Landspitali-University Hospital, Reykjavik, Iceland
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Fernández Y, Cueva J, Palomo AG, Ramos M, de Juan A, Calvo L, García-Mata J, García-Teijido P, Peláez I, García-Estévez L. Novel therapeutic approaches to the treatment of metastatic breast cancer. Cancer Treat Rev 2009; 36:33-42. [PMID: 19883980 DOI: 10.1016/j.ctrv.2009.10.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 09/30/2009] [Accepted: 10/02/2009] [Indexed: 01/22/2023]
Abstract
Metastatic breast cancer is ultimately an incurable disease, although recent data have shown that its incidence is decreasing and that patients with metastatic breast cancer live longer. This improvement in survival seems to be linked with the introduction of new therapeutic agents, novel combinations of existing therapies and targeted therapies. Our increasing understanding of the molecular biology of metastatic disease has allowed the development of therapies aimed at specific molecular targets. Some of these have already been approved for the treatment of metastatic breast cancer in combination with cytotoxics, and others have shown promising results regarding disease-free survival, overall response rates and time to disease progression. Given the enormous amount of information about drug discovery in cancer, it is important to be familiar with the present state of the treatment of metastatic breast cancer. The purpose of this review is to provide an update on the development of some of the most promising novel agents and treatment strategies in metastatic breast cancer.
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Rivera F, Vega-Villegas ME, López-Brea MF, García-Castaño A, de Juan A, Ramos FJ, Collado A, Galdós P, Rubio A, del Valle A, Rama J, Mayorga M, Sanz-Ortiz J. Long term results of a phase II trial of induction chemotherapy with uracil-ftegafur (UFT), vinorelbine and cisplatin (UFTVP) followed by radiotherapy concomitant with UFT and carboplatin (RT/UFTJ) in non-resectable locally advanced (stage IV-B) squamous cell head and neck carcinoma and peripheral blood stem cell support (PBSCS) with febrile neutropenia. Clin Transl Oncol 2007; 9:40-7. [PMID: 17272229 DOI: 10.1007/s12094-007-0008-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the response of advanced squamous cell head and neck carcinoma to a combination of induction chemotherapy and radiotherapy. METHODS We present long-term results of a phase II trial of Induction Chemotherapy with UFT 200 mg/m(2) p.o. days 1 to 21, Vinorelbine 25 mg/m(2) i.v. days 1 and 8 and Cisplatin 100 mg/m(2) i.v. day 1 (UFTVP) each 21 days for 4 courses, followed by Radiotherapy concomitant with UFT 100 mg/m(2) p.o. daily and Carboplatin AUC = 0.5 i.v. weekly (RT/UFTJ) in patients (pts) with Non-Resectable Locally Advanced (Stage IV-B) Squamous Cell Head and Neck Carcinoma (IV-B-SCHNC). Primary endpoint was Complete Response to induction UFTVP and secondary endpoints were Disease Free Status Rate after locoregional treatment and long-term Overall Survival. Between 1994 and 1997, 32 pts were included. RESULTS Complete Response to Induction UFTVP was 59% (95% CI: 48%-70%). Main toxicity of UFTVP was G 3,4 neutropenia (94% of pts; 25% developed febrile neutropenia and 1 of this pts dead). After Induction Chemotherapy with UFTVP, 30 pts received radiotherapy and 25 of them received concomitant Carboplatin and UFT (RT/UFTJ): main toxicity was mucositis (G3-4: 72%) and one patient died during RT/UFTJ because pneumonia. Twenty-five pts (78%) were alive and disease free at the end of the whole treatment. Actuarial 5 year Overall survival is 32%. CONCLUSION Although toxicity is important, this approach has interesting activity and deserves further investigation.
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Affiliation(s)
- Fernando Rivera
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
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Real PJ, Benito A, Cuevas J, Berciano MT, de Juan A, Coffer P, Gomez-Roman J, Lafarga M, Lopez-Vega JM, Fernandez-Luna JL. Blockade of epidermal growth factor receptors chemosensitizes breast cancer cells through up-regulation of Bnip3L. Cancer Res 2005; 65:8151-7. [PMID: 16166289 DOI: 10.1158/0008-5472.can-05-1134] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Epidermal growth factor receptor-1 (EGFR) and EGFR-2 (HER2) have become major targets for cancer treatment. Blocking antibodies and small-molecule inhibitors are being used to silence the activity of these receptors in different tumors with varying efficacy. Thus, a better knowledge on the signaling pathways activated by EGFR and HER2 may help unravel novel therapeutic targets and molecular markers of response. Here, we show that treatment of breast cancer cell lines with blocking antibodies against EGFR (cetuximab) or HER2 (trastuzumab) promotes the specific induction of proapoptotic Bnip3L and chemosensitization. Moreover, we found that the Bnip3L gene is transcriptionally activated by FoxO3a. Trastuzumab-mediated induction of Bnip3L and nuclear translocation of FoxO3a was also shown in pleural effusion cells from a breast cancer patient. Transfection of breast cancer cells with constitutively active FoxO3a or with Bnip3L promotes sensitization to chemotherapy-induced apoptosis. On the contrary, blockade of Bnip3L expression by a small interfering RNA strategy significantly diminished the chemosensitizing effect of cetuximab. We found also an inverse correlation between EGFR and Bnip3L expression in surgical specimens from patients with breast cancer. Therefore, blockading EGFR or HER2 specifically up-regulates Bnip3L, which is required for chemosensitization of breast cancer cells. This novel pathway provides also the rationale for therapeutic strategies aimed to induce the expression of Bnip3L.
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Affiliation(s)
- Pedro J Real
- Unidad de Genetica Molecular, Hospital Universitario Marques de Valdecilla, Servicio Cantabro de Salud, Santander, Spain
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Novoa N, Benito P, Jiménez MF, de Juan A, Luis Aranda J, Varela G. Reconstruction of chest wall defects after resection of large neoplasms: ten-year experience. Interact Cardiovasc Thorac Surg 2005; 4:250-5. [PMID: 17670403 DOI: 10.1510/icvts.2004.103432] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We review our experience in the treatment of complex large chest-wall defects needing a multidisciplinary approach due to primary or secondary neoplasms. Non-small cell lung cancer with chest-wall invasion cases are excluded. Fifteen patients underwent whole thickness resection of the chest wall due to lesions affecting at least three ribs, sternum, clavicle or thoracic spine and the surrounding soft tissue. Previously operated breast cancer and sarcoma were the most frequent diagnoses. Partial or total sternectomy plus rib resection was performed in 8 patients. Immediate closure of the defects was performed in all cases: 12 with single prosthesis placement and 3 with a rigid one of methylmethacrylate. Coverage was achieved using myocutaneous flaps in most cases and, in one case, using the greater omentum that supported a free split-thickness skin graft. No 30-days mortality was recorded. Three patients had a post-operative complication. Mean hospital stay was 11.7+/-9 days. All cases of primary tumours were alive at the time of review (range: 6-126 months). In conclusion, resection and immediate reconstruction of large chest wall defects can be accomplished without operative mortality and low morbidity whenever close cooperation between plastic and thoracic teams exists.
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Affiliation(s)
- Nuria Novoa
- Section of Thoracic Surgery, Salamanca University Hospital, 37007 Salamanca, Spain.
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Rivera F, Vega-Villegas ME, López-Brea MF, García-Castaño A, de Juan A, Collado A, Galdós P, Rubio A, del Valle A, Rama J, Sanz-Ortiz J. Long-Term Results of a Phase II Trial of Induction Chemotherapy with Uracil-Ftegafur (UFT), Vinorelbine, and Cisplatin (UFTVP) followed by Radiotherapy Concomitant with UFT and Carboplatin (RT/UFTJ) in a Primary Site Preservation Setting for Resectable Locally Advanced Squamous Cell Carcinoma of Larynx and Hypopharynx. Laryngoscope 2004; 114:1163-9. [PMID: 15235341 DOI: 10.1097/00005537-200407000-00006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We present long-term results of a phase II trial of induction chemotherapy (IC) with uracilftegafur (UFT) 200 mg/m orally days 1 to 21, vinorelbine 25 mg/m intravenously (IV) days 1 and 8, and cisplatin 100 mg/m IV day 1 (UFTVP) each for 21 days for 4 courses, followed by radiotherapy concomitant with UFT 100 mg/m orally daily and carboplatin (area under the curve [AUC] = 0.5 IV weekly) (RT/ UFTJ), without surgery to the primary site if response, in patients (pts) with resectable locally advanced squamous cell carcinoma of the larynx and hypopharynx. The primary endpoint was clinical complete response (CR) to induction UFTVP, and secondary endpoints were long-term overall survival (OS) and survival with primary site preservation (SPP). RESULTS Between 1994 and 1997, 37 pts were included. CR to IC was 54% (95% confidence interval [CI] 43-65%). Main toxicity of UFTVP was G 3,4 neutropenia (73% of pts, 16% developed febrile neutropenia). After IC, primary site was treated with RT in 29 pts: 20 of them received RT/UFTJ (main toxicity mucositis G 3,4 70%). No pt died during treatment. Actuarial 5-year OS and SPP were 57% and 37%, respectively. CONCLUSIONS This approach has significant activity and acceptable toxicity for achieving promising long-term OS and SPP and deserves further investigation.
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Affiliation(s)
- Fernando Rivera
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
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