1
|
Rodríguez-Lescure Á, Gallego J, Garcia-Alfonso P, Massuti B, Márquez R, Calvo L, Sánchez-Rovira P, Antón A, Chacón JI, Ciruelos E, Ponce JJ, Santaballa A, Valladares-Ayerbes M, Dueñas MR, Alonso V, Aparicio J, Encinas S, Robles L, Escudero MJ, Caballero R, Bezares S, de la Haba-Rodriguez J. Hypertension as predictive factor for bevacizumab-containing first-line therapy in metastatic breast and colorectal cancer in BRECOL (GEICAM/2011-04) study. Clin Transl Oncol 2024:10.1007/s12094-024-03411-w. [PMID: 38578537 DOI: 10.1007/s12094-024-03411-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/16/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Retrospective data suggest an association between bevacizumab efficacy and the incidence of arterial hypertension (AHT). Additionally, epigenetic mechanisms have been related to AHT. METHODS This prospective observational study conducted by GEICAM Spanish Breast Cancer Research Group included metastatic breast (MBC) or colorectal (mCRC) cancer patients treated with bevacizumab-containing chemotherapy as first-line treatment. Blood pressure (BP) levels were measured (conventional and 24-h Holter monitoring) at baseline and up to cycle 3. Primary endpoint assessed BP levels increase as predictive factor for progression-free survival (PFS). Germline DNA methylation profile was explored in pre-treatment blood samples; principal component analysis was used to define an epigenetic predictive score for increased BP levels. RESULTS From Oct-2012 to Jul-2016, 143 (78 MBC and 65 mCRC) patients were included. The incidence of AHT according to guidelines was neither predictive of PFS nor of best overall tumor response (BOR). No statistically significant association was observed with systolic BP nor diastolic BP increment for PFS or BOR. Grade 3 and 4 adverse events were observed in 37 and 5% of patients, respectively. We identified 27 sites which baseline methylation status was significantly associated to BP levels increase secondary to bevacizumab-containing chemotherapy. CONCLUSIONS Neither the frequency of AHT nor the increase of BP levels were predictive of efficacy in MBC and mCRC patients treated with bevacizumab-containing chemotherapy. CLINICAL TRIAL REGISTRY ClinicalTrials.gov Identifier: NCT01733628.
Collapse
Affiliation(s)
- Álvaro Rodríguez-Lescure
- Medical Oncology Department, Hospital General Universitario de Elche, Carrer Almazara, 11, 03203, Elche, Alicante, Spain.
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.
| | - Javier Gallego
- Medical Oncology Department, Hospital General Universitario de Elche, Carrer Almazara, 11, 03203, Elche, Alicante, Spain
| | - Pilar Garcia-Alfonso
- Instituto de Investigación Sanitaria Gregorio Marañón, Facultad de Medicina de la Universidad Complutense de Madrid, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Bartomeu Massuti
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitario Dr. Balmis, Alicante, Spain
| | - Raúl Márquez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- MD Anderson Cancer Center Madrid, Madrid, Spain
| | - Lourdes Calvo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Pedro Sánchez-Rovira
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Hospital Universitario de Jaén, Jaén, Spain
| | - Antonio Antón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Instituto de Investigación Sanitaria de Aragón (IISA), Hospital Universitario Miguel Servet, Universidad de Zaragoza, Saragossa, Spain
| | - José Ignacio Chacón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Hospital Universitario de Toledo, Toledo, Spain
| | - Eva Ciruelos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - Jose Juan Ponce
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitario Dr. Balmis, Alicante, Spain
| | - Ana Santaballa
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Manuel Valladares-Ayerbes
- Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | - Vicente Alonso
- Instituto de Investigación Sanitaria de Aragón (IISA), Hospital Universitario Miguel Servet, Universidad de Zaragoza, Saragossa, Spain
| | - Jorge Aparicio
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Luis Robles
- Hospital Universitario, 12 de Octubre, Madrid, Spain
| | | | | | | | - Juan de la Haba-Rodriguez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Instituto Maimónides de Investigación Biomédica (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain
| |
Collapse
|
2
|
Pascual J, Gil-Gil M, Proszek P, Zielinski C, Reay A, Ruiz-Borrego M, Cutts R, Ciruelos Gil EM, Feber A, Muñoz-Mateu M, Swift C, Bermejo B, Herranz J, Margeli Vila M, Antón A, Kahan Z, Csöszi T, Liu Y, Fernandez-Garcia D, Garcia-Murillas I, Hubank M, Turner NC, Martín M. Baseline Mutations and ctDNA Dynamics as Prognostic and Predictive Factors in ER-Positive/HER2-Negative Metastatic Breast Cancer Patients. Clin Cancer Res 2023; 29:4166-4177. [PMID: 37490393 PMCID: PMC10570672 DOI: 10.1158/1078-0432.ccr-23-0956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/06/2023] [Accepted: 07/21/2023] [Indexed: 07/27/2023]
Abstract
PURPOSE Prognostic and predictive biomarkers to cyclin-dependent kinases 4 and 6 inhibitors are lacking. Circulating tumor DNA (ctDNA) can be used to profile these patients and dynamic changes in ctDNA could be an early predictor of treatment efficacy. Here, we conducted plasma ctDNA profiling in patients from the PEARL trial comparing palbociclib+fulvestrant versus capecitabine to investigate associations between baseline genomic landscape and on-treatment ctDNA dynamics with treatment efficacy. EXPERIMENTAL DESIGN Correlative blood samples were collected at baseline [cycle 1-day 1 (C1D1)] and prior to treatment [cycle 1-day 15 (C1D15)]. Plasma ctDNA was sequenced with a custom error-corrected capture panel, with both univariate and multivariate Cox models used for treatment efficacy associations. A prespecified methodology measuring ctDNA changes in clonal mutations between C1D1 and C1D15 was used for the on-treatment ctDNA dynamic model. RESULTS 201 patients were profiled at baseline, with ctDNA detection associated with worse progression-free survival (PFS)/overall survival (OS). Detectable TP53 mutation showed worse PFS and OS in both treatment arms, even after restricting population to baseline ctDNA detection. ESR1 mutations were associated with worse OS overall, which was lost when restricting population to baseline ctDNA detection. PIK3CA mutations confer worse OS only to patients on the palbociclib+fulvestrant treatment arm. ctDNA dynamics analysis (n = 120) showed higher ctDNA suppression in the capecitabine arm. Patients without ctDNA suppression showed worse PFS in both treatment arms. CONCLUSIONS We show impaired survival irrespective of endocrine or chemotherapy-based treatments for patients with hormone receptor-positive/HER2-negative metastatic breast cancer harboring plasma TP53 mutations. Early ctDNA suppression may provide treatment efficacy predictions. Further validation to fully demonstrate clinical utility of ctDNA dynamics is warranted.
Collapse
Affiliation(s)
- Javier Pascual
- Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
- Breast Unit, Royal Marsden Hospital, London, United Kingdom
- Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Málaga, Spain
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain
| | - Miguel Gil-Gil
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Institut Català d'Oncologia (ICO), Barcelona, Spain
- IDIBELL, L'Hospitalet, Barcelona, Spain
| | - Paula Proszek
- Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
- Breast Unit, Royal Marsden Hospital, London, United Kingdom
| | - Christoph Zielinski
- Medical Oncology, Central European Cancer Center, Wiener Privatklinik Hospital, Vienna, Austria
- CECOG Central European Cooperative Oncology Group, Vienna, Austria
| | - Alistair Reay
- Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
- Breast Unit, Royal Marsden Hospital, London, United Kingdom
| | - Manuel Ruiz-Borrego
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Medical Oncology, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - Rosalind Cutts
- Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Eva M. Ciruelos Gil
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Andrew Feber
- Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
- Breast Unit, Royal Marsden Hospital, London, United Kingdom
| | - Montserrat Muñoz-Mateu
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Department of Medical Oncology and Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Claire Swift
- Ralph Lauren Centre for Breast Cancer Research, London, United Kingdom
| | - Begoña Bermejo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain
- Medical Oncology, Hospital Clínico Universitario de Valencia, Biomedical Research Institute INCLIVA, Valencia, Spain
- Medicine Department, Universidad de Valencia, Valencia, Spain
| | | | - Mireia Margeli Vila
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- B-ARGO Group, Catalan Institute of Oncology-Badalona, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Antonio Antón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain
- Medical Oncology, Hospital Universitario Miguel Servet, Medicine Department, Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - Zsuzsanna Kahan
- CECOG Central European Cooperative Oncology Group, Vienna, Austria
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - Tibor Csöszi
- CECOG Central European Cooperative Oncology Group, Vienna, Austria
- Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház-Rendelőintézet, Szolnok, Hungary
| | - Yuan Liu
- Pfizer, La Jolla, San Diego, California
| | | | - Isaac Garcia-Murillas
- Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Michael Hubank
- Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
- Breast Unit, Royal Marsden Hospital, London, United Kingdom
| | - Nicholas C. Turner
- Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
- Breast Unit, Royal Marsden Hospital, London, United Kingdom
- Ralph Lauren Centre for Breast Cancer Research, London, United Kingdom
| | - Miguel Martín
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain
- Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, Medicine Department, Universidad Complutense, Madrid, Spain
| |
Collapse
|
3
|
Martín M, Carrasco E, Rodríguez-Lescure Á, Andrés R, Servitja S, Antón A, Ruiz-Borrego M, Bermejo B, Guerrero Á, Ramos M, Santaballa A, Muñoz M, Cruz J, Lopez-Tarruella S, Chacón JI, Álvarez I, Martínez P, Miralles JJ, Polonio Ó, Jara C, Aguiar-Bujanda D. Long-term outcomes of high-risk HR-positive and HER2-negative early breast cancer patients from GEICAM adjuvant studies and El Álamo IV registry. Breast Cancer Res Treat 2023:10.1007/s10549-023-07002-1. [PMID: 37338729 PMCID: PMC10361852 DOI: 10.1007/s10549-023-07002-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/29/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE The monarchE trial showed that the addition of abemaciclib improves efficacy in patients with high-risk early breast cancer (EBC). We analyzed the long-term outcomes of a population similar to the monarchE trial to put into context the potential benefit of abemaciclib. METHODS HR-positive/HER2-negative EBC patients eligible for the monarchE study were selected from 3 adjuvant clinical trials and a breast cancer registry. Patients with ≥ 4 positive axillary lymph nodes (N +) or 1-3 N + with tumor size ≥ 5 cm and/or histologic grade 3 and/or Ki67 ≥ 20%, who had undergone surgery with curative intent and had received anthracyclines ± taxanes and endocrine therapy in the neoadjuvant and /or adjuvant setting were included. We performed analysis of Invasive Disease-Free Survival (iDFS), Distant Disease-Free Survival (dDFS) and Overall Survival (OS) at 5 and 10 years, as well as yearly (up to 10) of Invasive Relapse Rate (IRR), Distant Relapse Rate (DRR) and Death Rate (DR). RESULTS A total of 1,617 patients were analyzed from the GEICAM-9906 (312), GEICAM-2003-10 (210), and GEICAM-2006-10 (160) trials plus 935 from El Álamo IV. With a median follow-up of 10.1 years, the 5 and 10 years iDFS rates were 75.2% and 57.0%, respectively. The dDFS and OS rates at 5 years were 77.4% and 88.8% and the respective figures at 10 years were 59.7% and 70.9%. CONCLUSIONS This data points out the need for new therapies for those patients. A longer follow-up of the monarchE study to see the real final benefit with abemaciclib is warranted. TRIAL REGISTRATION ClinTrials.gov: GEICAM/9906: NCT00129922; GEICAM/ 2003-10: NCT00129935 and GEICAM/ 2006-10: NCT00543127.
Collapse
Affiliation(s)
- Miguel Martín
- Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense, Madrid, Spain.
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.
| | - Eva Carrasco
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - Álvaro Rodríguez-Lescure
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Hospital General Universitario de Elche, Elche, Spain
| | - Raquel Andrés
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Sonia Servitja
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Hospital del Mar, Barcelona, Spain
| | - Antonio Antón
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
- Hospital Universitario Miguel Servet, Universidad de Zaragoza, Instituto Investigación Sanitaria Aragón (IISA), Zaragoza, Spain
| | - Manuel Ruiz-Borrego
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Begoña Bermejo
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
- Hospital Clínico Universitario de Valencia, Biomedical Research Institute INCLIVA. Universidad de Valencia, Valencia, Spain
| | - Ángel Guerrero
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Instituto Valenciano de Oncología, Valencia, Spain
| | - Manuel Ramos
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Centro Oncológico de Galicia, A Coruña, Spain
| | - Ana Santaballa
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Hospital Universitario La Fe, Valencia, Spain
| | - Montserrat Muñoz
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Department of Medical Oncology and Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Josefina Cruz
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Sara Lopez-Tarruella
- Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense, Madrid, Spain
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
| | - Jose I Chacón
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Hospital Universitario de Toledo, Toledo, Spain
| | - Isabel Álvarez
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Hospital de Donostia, San Sebastian, Spain
| | - Purificación Martínez
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Hospital Universitario Basurto, Bilbao, Spain
| | | | | | - Carlos Jara
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - David Aguiar-Bujanda
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
- Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| |
Collapse
|
4
|
Sarasate M, González N, Córdoba-Izquierdo A, Prats E, Gonzalez-Moro JMR, Martí S, Lujan M, Calle M, Antón A, Povedano M, Farrero E. Impact of Early Non-Invasive Ventilation in Amyotrophic Lateral Sclerosis: A multicenter Randomized Controlled Trial. J Neuromuscul Dis 2023:JND221658. [PMID: 37212068 DOI: 10.3233/jnd-221658] [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: 05/23/2023]
Abstract
BACKGROUND AND OBJECTIVE Forced vital capacity (FVC) less than 50% of predicted is one of the main parameters used for Non-Invasive Ventilation (NIV) initiation in Amyotrophic Lateral Sclerosis (ALS). Recent studies suggest that higher values of FVC could be considered as a threshold. The aim of this study is to evaluate whether early use of NIV improves the prognosis of ALS patients compared with standard initiation. METHODS This is a randomized, parallel, multicenter, open-label, controlled clinical trial, with recruitment at the ALS outpatient multidisciplinary units of six Spanish hospitals. Patients were included when their FVC reached the 75% threshold and were randomized by computer, stratifying by center in an allocation ratio of 1:1 to Early NIV (FVC below 75%) or Standard NIV (FVC below 50%) initiation. The primary outcome was time to death or tracheostomy.Trial registration number ClinicalTrials.gov: NCT01641965. RESULTS Between May 2012 and June 2014, 42 patients were randomized to two groups, 20 to Early NIV and 22 to Standard NIV initiation. We found differences in survival in favor of the intervention group: an incidence of mortality (2.68 [1.87-5.50] vs. 3.33 [1.34-4.80] person-months) and a median survival (25.2 vs. 19.4 months), although without reaching statistical significance (p = 0.267). CONCLUSIONS This trial did not reach the primary endpoint of survival; nevertheless, it is the first Randomized Controlled Trial (RCT) to demonstrate the benefits of early NIV in slowing the decline of respiratory muscle strength and reducing adverse events. Although not all the results reached statistical significance, all the analyzed data favor early NIV. In addition, this study demonstrates good tolerance and compliance with early NIV without quality of sleep impairment. These data reinforce the early respiratory evaluation of ALS patients and NIV initiation with an FVC of around 75%.
Collapse
Affiliation(s)
- Mikel Sarasate
- Department of Pneumology, UFIS-Respiratoria, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Nuria González
- Department of Pneumology, Hospital Residencia Sant Camil, Consorci Sanitari Alt Pendedés-Garraf, Barcelona, Spain
| | - Ana Córdoba-Izquierdo
- Department of Pneumology, UFIS-Respiratoria, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Enric Prats
- Department of Pneumology, UFIS-Respiratoria, Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | - Sergi Martí
- Department of Respiratory Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Departament de Medicina, Universitat Autònoma deBarcelona (UAB), Barcelona, Spain
| | - Manel Lujan
- Department of Pneumology, Corporació Sanitaria Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Myriam Calle
- Department of Pneumology, Hospital Clínico San Carlos, Department of Medicine, Faculty of Medicine, Complutense University of Madrid, San Carlos Clinical Hospital Institute of Health Research (IdISSC), Madrid, Spain
| | - Antonio Antón
- Department of Respiratory Medicine, Hospital de laSanta Creu i Sant Pau, Barcelona, Spain
| | - Mónica Povedano
- Department of Neurology, Head of ALS Multidisciplinary Unit, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain
| | - Eva Farrero
- Department of Pneumology, UFIS-Respiratoria, Hospital Universitari de Bellvitge, Barcelona, Spain
| |
Collapse
|
5
|
Martínez-Jáñez N, Ezquerra MB, Henao F, Manso L, Antón A, Zamora P, Murillo SM, Tolosa P, Andrés R, Calvo L, Galve E, Lopez R, de la Peña FA, López-Tarruella S, Boronat L, Martos T, Chacón JI, Álvarez I, de la Haba-Rodríguez J, Antón FM. Abstract P4-01-28: PALBOSPAIN: OBSERVATIONAL ANALYSIS OF FIRST-LINE THERAPY WITH PALBOCICLIB IN PATIENTS WITH HR+/HER2- METASTATIC BREAST CANCER (MBC) IN REAL-LIFE CONDITIONS. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p4-01-28] [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: 03/06/2023]
Abstract
Abstract
INTRODUCTION AND OBJECTIVES Palbociclib associated with hormone therapy (HT) has shown significant benefit in progression-free survival (PFS) and response rate versus HT alone in patients with HR+, HER2- MBC. The PALBOSPAIN study evaluates the efficacy and safety of palbociclib treatment under real-life conditions. The main objective of the study was to assess PFS, and secondary objectives were overall survival (OS), response rate, time to next line of treatment, percentage of dose reduction and safety.
MATERIAL AND METHODS This is an observational, ambispective, multicenter, nation-wide study. Patients diagnosed with HR+/HER2- MBC who had started first-line treatment with palbociclib between November 2017 and November 2019 were included. Patients treated within a clinical trial were excluded, as were those who had received any previous systemic treatment for advanced disease.
RESULTS 762 patients from 35 centers were included. 79% (n=600) were postmenopausal, 54.9% (n=418) had visceral disease, and 30.6% (n=233) had de-novo metastatic disease. Palbocliclib was combined with an aromatase inhibitor in 69.6% of patients and fulvestrant in 30.2% Four groups were established to assess efficacy (table 1): overall population; patients with de-novo metastatic disease (cohort A); patients relapsing >12 months after the end of adjuvant hormonal therapy (cohort B); and patients relapsing within 12 months after the end of adjuvant hormonal therapy (cohort C). Median PFS was 24 months (CI 95%; 25-27) overall and 28 (IC 95%; 23-39), 29 (IC 95%;25-35) and 14 months (IC 95%;11-17) for cohorts a, B and C, respectively. Median overall survival was 42 months (40-NA). The most common side effects were neutropenia (71.3%, grade 3-4 in 52.5%, no episodes of febrile neutropenia), fatigue (38.6%), leucopenia (29.8%), anemia (28.9%), articular pain (19%), and thrombocytopenia (2,2%). 49% (n=385) of patients required dose reduction of palbociclib (one level in 27.6% and two levels in 21.4%).
CONCLUSION In the first two years after its approval in Spain, palbociclib in first line of HR+/HER2- MBC in real-life conditions yielded PFS and safety results comparable to those of PALOMA 2 and PALOMA 3 clinical trials. OS results were poorer, although the population included in this retrospective study is heterogeneous and median survival values have not been reached in some subgroups.
Table 1. Efficay results of palbociclib in real world
Citation Format: Noelia Martínez-Jáñez, Meritxell Bellet Ezquerra, Fernando Henao, Luis Manso, Antonio Antón, Pilar Zamora, Serafin Morales Murillo, Pablo Tolosa, Raquel Andrés, Lourdes Calvo, Elena Galve, Rafael Lopez, Francisco Ayala de la Peña, Sara López-Tarruella, Laia Boronat, Tamara Martos, J. Ignacio Chacón, Isabel Álvarez, Juan de la Haba-Rodríguez, Fernando Moreno Antón. PALBOSPAIN: OBSERVATIONAL ANALYSIS OF FIRST-LINE THERAPY WITH PALBOCICLIB IN PATIENTS WITH HR+/HER2- METASTATIC BREAST CANCER (MBC) IN REAL-LIFE CONDITIONS [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-01-28.
Collapse
Affiliation(s)
- Noelia Martínez-Jáñez
- 1Medical Oncology Hospital Universitario Ramón y Cajal. Madrid. Spain. GEICAM Spanish Breast Cancer Group., TRES CANTOS, Madrid, Spain
| | - Meritxell Bellet Ezquerra
- 2Vall d’Hebron Institute of Oncology (VHIO) and Vall d’Hebron University Hospital, and SOLTI Group, Barcelona, Spain
| | - Fernando Henao
- 3Medical Oncology Hospital Virgen de la Macarena. Sevilla. Spain
| | - Luis Manso
- 4Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Antonio Antón
- 5Hospital Universitario Miguel Servet. GEICAM Spanish Breast Cancer Group., Spain
| | - Pilar Zamora
- 6Hospital Universitario de La Paz, Madrid, Spain
| | | | - Pablo Tolosa
- 8SOLTI Cancer Research Group, Barcelona, Spain/Medical Oncology Department, Hospital 12 de Octubre, Madrid., Madrid, Spain
| | - Raquel Andrés
- 9Hospital Clínico Universitario Lozano Blesa. GEICAM Spanish Breast Cancer Group., Spain
| | - Lourdes Calvo
- 10Oncology Department-Universitary Hospital A Coruña, A Coruña, Galicia, Spain
| | | | - Rafael Lopez
- 12Medical Oncology Hospital Clínico Universitario de Santiago CHUS. La Coruña Spain
| | | | - Sara López-Tarruella
- 14Hospital Universitario Gregorio Marañón. CIBERONC-ISCIII. GEICAM Spanish Breast Cancer Group., Spain
| | - Laia Boronat
- 15Medical Oncology Hospital de la Santa Creu i Sant Pau. Barcelona. Spain
| | - Tamara Martos
- 16Medical Oncology. Hospital del Mar. Barcelona. Spain
| | - J. Ignacio Chacón
- 17Hospital Universitario de Toledo. GEICAM Spanish Breast Cancer Group., Spain
| | - Isabel Álvarez
- 18Hospital Universitario Donostia-BioDonostia. GEICAM Spanish Breast Cancer Group., Spain
| | - Juan de la Haba-Rodríguez
- 19Instituto Maimonides de Investigacion Biomedica, Hospital Reina Sofia, Universidad de Córdoba. GEICAM Spanish Breast Cancer Group., Spain
| | - Fernando Moreno Antón
- 20Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), CIBERONC, Madrid, Spain
| |
Collapse
|
6
|
Novoa SA, Rodríguez CA, Cruz J, López-Tarruella S, Tibau A, Adrover E, Miguel A, Margelí M, Martínez P, Hernández M, Antón A, Rodríguez-Lescure Á, Falo C, Álvarez I, Malón D, Andrés R, Alonso-Romero JL, Gómez C, Illaramendi JJ, Campo R, Miralles JJ, Bezares S, Rojo F, Guerrero-Zotano A. Abstract P4-07-45: Treatment strategies for advanced triple negative breast cancer patients as per routine clinical practice: analysis from the observational study GEICAM/2014-03 (RegistEM). Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p4-07-45] [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: 03/06/2023]
Abstract
Abstract
Background: Triple negative breast cancer (TNBC) is well known for its more aggressive course and poorer prognosis compared to other BC subtypes. RegistEM study provides real world data to understand the distribution of BC subtypes in the advanced setting, being its primary objective. Biological samples collection is part of its procedures. This is a non-interventional cohort study and 1,907 patients (pts) have been enrolled up to now (females and males) with advanced BC (ABC), diagnosed from Jan-2016 to Dec-2019, either after recurrence or as first BC diagnosis, in 38 Spanish sites. These pts will be followed for at least 5 years.
Methods: In the current analysis (cut-off date 08/April/2022, database ongoing), we describe characteristics, treatment patterns and outcomes, including comparison between recurrent and de novo disease, of 157 pts with advanced TNBC included in the RegistEM study. Those pts represent the 10% of pts available in the database at the cut-off date and with ABC diagnosis up to December 2018 (n=1559). The BC clinical subtypes were histologically confirmed on the most recent tumor lesion (metastatic [M] or primary BC) before starting with the 1st-line therapy.
Results: At first ABC diagnosis, 73% pts had recurrent early BC (EBC), 26% de novo MBC and 1% unresectable locally ABC (ULABC). Median age was 57 years (range 30-88), all pts were women, 98% Caucasian and 65% postmenopausal. Family history of BC and/or ovarian cancer was reported in 37% pts, and a hereditary-risk genetic test was performed in 59 of 147 pts. Germline BRCA1/2 and TP53 were the most frequently mutated genes, 21% (6/28) and 47% (8/17) pts, respectively. Visceral involvement was present in 69% pts (similar between recurrent EBC and de novo ABC, although brain metastases were only present in the recurrent EBC group), and ≤ 2 metastatic locations in 59%. In 61% (70/115) pts with recurrent EBC, the subtype was assessed in metastatic lesions, and 39 pts of them also had TN subtype in primary BC. In terms of the most frequent therapies by line: 1) 1st-line: chemotherapy (CT) (60%) and CT/biological therapy (BT) (39%). Of the 87 pts with CT alone, monotherapy was the preferred option in 57% pts (capecitabine 25%, taxanes 16%, and eribulin or vinorelbine, 5% each). Bevacizumab was the most frequent BT (79%) combined with CT (single agent in 56% pts, mostly taxanes and capecitabine). Progressive disease (PD) was reported in 85% pts (similar in pts with both recurrent and de novo MBC or ULABC); 2) 2nd-line: CT (79%) (monotherapy capecitabine, eribulin, taxanes) and CT/BT (17%) (CT-containing bevacizumab 82%). Progression was reported in 92% pts; 3) 3rd-line: CT (90%) (eribulin 33%, platinum-based 25%) and CT/BT (9%) (CT-containing bevacizumab 67%). Progression was reported in 88% pts. At database cut-off date, death was reported in 133 (85%) pts, mainly because of PD. Overall survival (OS) was similar between both groups, recurrent and de novo MBC.
Conclusion: In this population of Spanish TNBC pts with ABC, three quarters had recurrent disease. De novo ABC pts had a higher proportion of non-visceral metastases, with absence of brain involvement at the first diagnosis. Single-agent CT and CT plus bevacizumab were the most frequent therapies, and OS was similar between recurrent and de novo MBC pts, although numerically higher in the later group.
Citation Format: Silvia Antolin Novoa, César A Rodríguez, Josefina Cruz, Sara López-Tarruella, Ariadna Tibau, Encarna Adrover, Ana Miguel, Mireia Margelí, Purificación Martínez, María Hernández, Antonio Antón, Álvaro Rodríguez-Lescure, Catalina Falo, Isabel Álvarez, Diego Malón, Raquel Andrés, José L Alonso-Romero, César Gómez, J. José Illaramendi, Ruth Campo, Juan José Miralles, Susana Bezares, Federico Rojo, Angel Guerrero-Zotano. Treatment strategies for advanced triple negative breast cancer patients as per routine clinical practice: analysis from the observational study GEICAM/2014-03 (RegistEM) [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-45.
Collapse
Affiliation(s)
- Silvia Antolin Novoa
- 1Complejo Hospitalario Universitario A Coruña (CHUAC). GEICAM Spanish Breast Cancer Group., Spain
| | - César A Rodríguez
- 2Hospital Universitario de Salamanca-IBSAL. GEICAM Spanish Breast Cancer Group., Spain
| | - Josefina Cruz
- 3Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Sara López-Tarruella
- 4Hospital Universitario Gregorio Marañón. CIBERONC-ISCIII. GEICAM Spanish Breast Cancer Group., Spain
| | - Ariadna Tibau
- 5Hospital de la Santa Creu i Sant Pau. GEICAM Spanish Breast Cancer Group, Spain
| | - Encarna Adrover
- 6Complejo Hospitalario Universitario de Albacete. GEICAM Spanish Breast Cancer Group., Spain
| | - Ana Miguel
- 7ALTHAIA Xarxa asistencial de Manresa. GEICAM Spanish Breast Cancer Group., Spain
| | - Mireia Margelí
- 8SOLTI Cancer Research Group. Medical Oncology Department, ICO Badalona, B-ARGO Group. GEICAM Spasnish Breast Cancer Group., Catalonia, Spain
| | | | - María Hernández
- 10Complejo Hospitalario Universitario de Gran Canaria Dr. Negrín. GEICAM Spanish Breast Cancer Group., Spain
| | - Antonio Antón
- 11Hospital Universitario Miguel Servet. GEICAM Spanish Breast Cancer Group., Spain
| | | | - Catalina Falo
- 13ICO Hospitalet. GEICAM Spanish Breast Cancer Group., Spain
| | - Isabel Álvarez
- 14Hospital Universitario Donostia-BioDonostia. GEICAM Spanish Breast Cancer Group., Spain
| | - Diego Malón
- 15Hospital Universitario Fuenlabrada. GEICAM Spanish Breast Cancer Group
| | - Raquel Andrés
- 16Hospital Clínico Universitario Lozano Blesa. GEICAM Spanish Breast Cancer Group., Spain
| | - José L Alonso-Romero
- 17Hospital Clínico Universitario Virgen de la Arrixaca. GEICAM Spanish Breast Cancer Group
| | - César Gómez
- 18Hospital Universitario Infanta Sofía. GEICAM Spanish Breast Cancer Group
| | - J. José Illaramendi
- 19Hospital Universitario de Navarra-Nafarroako Unibertsitate Ospitalea. GEICAM Spanish Breast Cancer Group
| | - Ruth Campo
- 20GEICAM Spanish Breast Cancer Group., Spain
| | | | | | | | - Angel Guerrero-Zotano
- 24Fundación Instituto Valenciano de Oncología (FIVO). GEICAM Spanish Breast Cancer Group., Spain
| |
Collapse
|
7
|
Guerrero-Zotano Á, Belli S, Zielinski C, Gil-Gil M, Fernandez-Serra A, Ruiz-Borrego M, Ciruelos Gil EM, Pascual J, Muñoz-Mateu M, Bermejo B, Margeli Vila M, Antón A, Murillo L, Nisenbaum B, Liu Y, Herranz J, Fernandez Garcia D, Caballero R, López-Guerrero JA, Bianco R, Formisano L, Turner N, Martín M. CCNE1 and PLK1 mediates resistance to palbociclib in HR+/HER2- metastatic breast cancer. Clin Cancer Res 2023; 29:1557-1568. [PMID: 36749874 PMCID: PMC10102847 DOI: 10.1158/1078-0432.ccr-22-2206] [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] [Received: 07/18/2022] [Revised: 10/10/2022] [Accepted: 02/02/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE In HR+/HER2- metastatic breast cancer (MBC) is imperative to identify patients who respond poorly to CDK4/6i and to discover therapeutic targets to reverse this resistance. Non-luminal breast cancer subtype and high levels of CCNE1 are candidate biomarkers in this setting but further validation is needed. EXPERIMENTAL DESIGN We performed mRNA gene expression profiling and correlation with progression-free-survival (PFS) on 455 tumor samples included in the phase III PEARL study, that assigned HR+/HER2- MBC patients to receive palbociclib+ET vs capecitabine. ER+/HER2- breast cancer cell lines were used to generate and characterize resistance to palbociclib+ET. RESULTS Non-luminal subtype was more prevalent in metastatic (14%) than in primary tumor samples (4%). Patients with non-luminal tumors had median PFS of 2.4months (m) with palbociclib+ET and 9.3m with capecitabine; HR:4.16, adjusted p-value<0.0001. Tumors with high CCNE1 expression (above median) had also worse median PFS with palbociclib+ET (6.2m) than with capecitabine (9.3m); HR:1.55, adjusted p-value=0.0036. In patients refractory to palbociclib+ET (PFS in the lower quartile) we found higher levels of Polo Like Kinase 1 (PLK1). In an independent data set (PALOMA3), tumors with high PLK1 show worse median PFS than those with low PLK1 expression under palbociclib+ET treatment. In ER+/HER2- cell line models we show that PLK1 inhibition reverses resistance to palbociclib+ET. CONCLUSIONS We confirm the association of non-luminal subtype and CCNE1 with resistance to CDK4/6i+ET in HR+ MBC. High levels of PLK1 mRNA identify patients with poor response to palbociclib, suggesting PLK1 could also play a role in the setting of resistance to CDK4/6i.
Collapse
Affiliation(s)
| | | | | | - Miguel Gil-Gil
- INSTITUT CATALÀ D'ONCOLOGIA Hospitalet de Llobregat, Hospitalet de Llobregat, Spain
| | | | | | | | - Javier Pascual
- Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Malaga, Spain, Malaga, Spain
| | - Montserrat Muñoz-Mateu
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | | | - Mireia Margeli Vila
- Catalan Institute of Oncology(ICO)-Badalona; B-ARGO (Badalona Applied Research group in Oncology) Research Group, Badalona, Spain
| | - Antonio Antón
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - Yuan Liu
- Pfizer Oncology, La Jolla, CA, United States
| | | | | | | | | | | | | | - Nicholas Turner
- Breast Unit, The Royal Marsden NHS Foundation Trust, and Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Miguel Martín
- Department of Medical Oncology, Hospital General Universitario Gregorio Marañón Instituto de Investigacion Sanitaria Gregorio Marañon, CIBERONC, Universidad Complutense, Madrid,, Madrid, Spain
| |
Collapse
|
8
|
Jaumandreu L, Antón A, Pazos M, Rodriguez-Uña I, Rodriguez Agirretxe I, Martinez de la Casa JM, Ayala ME, Parrilla-Vallejo M, Dyrda A, Díez-Álvarez L, Rebolleda G, Muñoz-Negrete FJ. Glaucoma progression. Clinical practice guide. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:40-57. [PMID: 36089479 DOI: 10.1016/j.oftale.2022.08.003] [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] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/19/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To provide general recommendations that serve as a guide for the evaluation and management of glaucomatous progression in daily clinical practice based on the existing quality of clinical evidence. METHODS After defining the objectives and scope of the guide, the working group was formed and structured clinical questions were formulated following the PICO (Patient, Intervention, Comparison, Outcomes) format. Once all the existing clinical evidence had been independently evaluated with the AMSTAR 2 (Assessment of Multiple Systematic Reviews) and Cochrane "Risk of bias" tools by at least two reviewers, recommendations were formulated following the Scottish Intercollegiate Guideline network (SIGN) methodology. RESULTS Recommendations with their corresponding levels of evidence that may be useful in the interpretation and decision-making related to the different methods for the detection of glaucomatous progression are presented. CONCLUSIONS Despite the fact that for many of the questions the level of scientific evidence available is not very high, this clinical practice guideline offers an updated review of the different existing aspects related to the evaluation and management of glaucomatous progression.
Collapse
Affiliation(s)
- L Jaumandreu
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - A Antón
- Institut Català de la Retina (ICR), Barcelona, Spain; Universitat Internacional de Catalunya (UIC), Barcelona, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - M Pazos
- Institut Clínic d'Oftalmologia, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - I Rodriguez-Uña
- Instituto Oftalmológico Fernández-Vega, Universidad de Oviedo, Oviedo, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - I Rodriguez Agirretxe
- Servicio de Oftalmología, Hospital Universitario Donostia, San Sebastián, Gipuzkoa, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - J M Martinez de la Casa
- Servicio de Oftalmología, Hospital Clinico San Carlos, Instituto de investigación sanitaria del Hospital Clínico San Carlos (IsISSC), IIORC, Universidad Complutense de Madrid, Madrid, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - M E Ayala
- Institut Català de la Retina (ICR), Barcelona, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - M Parrilla-Vallejo
- Servicio de Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - A Dyrda
- Institut Català de la Retina (ICR), Barcelona, Spain
| | - L Díez-Álvarez
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - G Rebolleda
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - F J Muñoz-Negrete
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Red de Oftalmología RETICS OFTARED del Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| |
Collapse
|
9
|
García M, Díaz J, Antón A. Late respiratory alkalosis during home mechanical ventilation in amyotrophic lateral sclerosis. Respir Med Case Rep 2023; 42:101828. [PMID: 36936867 PMCID: PMC10020091 DOI: 10.1016/j.rmcr.2023.101828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 01/18/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
This demonstrative case report shows how changes in the patient's ventilatory pattern can radically modify the results of home noninvasive mechanical ventilation, and can even generate complications associated with noninvasive ventilation such as ventilatory alkalosis.
Collapse
Affiliation(s)
- M.M. García
- Hospital Universitario Torrecárdenas (Almería), Spain
| | - J.M. Díaz
- Servicio de Neumología del Hospital Universitario de Getafe (HUG), Madrid, Spain
| | - A. Antón
- Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Corresponding author.
| |
Collapse
|
10
|
Villarroel PG, Padró JG, Marquina G, Jáñez NM, González EE, Antón A, Sánchez MB, Cáceres AR, López-López R, Cornejo RE, García PB, Fabregat RM, Fernández BC, Bermudo CL, Camps C. Increased quality of life in patients with breakthrough cancer pain after individualized therapy: the CAVIDIOM study. Future Oncol 2022; 18:3913-3927. [PMID: 36537885 DOI: 10.2217/fon-2022-0758] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aim: To evaluate the quality of life (QoL) in patients with breakthrough cancer pain (BTcP) in Spanish medical oncology departments. Patients & methods: In a prospective, observational, multicenter study, we assessed QoL using the EQ-5D-5L instrument at baseline and after 15 and 30 days of individualized BTcP therapy, as well as BTcP characteristics and treatment. Results: Patients (n = 118) were mainly women, over 64 years old and with advanced cancer. QoL improved at 15 (p = 0.013) and 30 days (p = 0.011) versus baseline. Individualized BTcP therapy consisted mostly of rapid-onset opioids (transmucosal fentanyl at doses of 67-800 μg) according to the physician evaluation. BTcP improved, including statistically significant reductions in intensity, duration, number of episodes in the last 24 h and time to onset of BTcP relief. Conclusion: QoL increased after individualized pain therapy in patients with advanced cancer and BTcP in medical oncology departments.
Collapse
Affiliation(s)
| | - Josep Gumà Padró
- Department of Medical Oncology, Hospital Universitari de Sant Joan de Reus, URV, IISPV, Tarragona, Spain
| | - Gloria Marquina
- Department of Medical Oncology, Hospital Clinico Universitario San Carlos. Department of Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | | | | | - Antonio Antón
- Department of Medical Oncology, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, Spain
| | - Miguel Berzosa Sánchez
- Department of Medical Oncology, Hospital Virgen de La Cinta de Tortosa, Tarragona, Spain
| | - Alberto Rodrigo Cáceres
- Department of Medical Oncology, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
| | - Rafael López-López
- Department of Medical Oncology & Health Research Institute, Hospital Clínico Universitario de Santiago de Compostela, CIBERONC, Santiago de Compostela, A Coruña, Spain
| | | | | | | | | | | | - Carlos Camps
- Department of Medical Oncology, Hospital General Universitario de Valencia, Department of Medicine, Universidad de Valencia; CIBERONC, Spain
| |
Collapse
|
11
|
Macías Paredes A, Alvarez JM, Pérez N, Puy C, Peñacoba P, Segura M, Antón A. Controlled cycles in spontaneous-timed noninvasive ventilation: Incidence and associated factors. Respir Med 2022; 204:107005. [DOI: 10.1016/j.rmed.2022.107005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 10/31/2022]
|
12
|
Boni V, Pistilli B, Braña I, Shapiro GI, Trigo J, Moreno V, Castellano D, Fernández C, Kahatt C, Alfaro V, Siguero M, Zeaiter A, Longo F, Zaman K, Antón A, Paredes A, Huidobro G, Subbiah V. Lurbinectedin, a selective inhibitor of oncogenic transcription, in patients with pretreated germline BRCA1/2 metastatic breast cancer: results from a phase II basket study. ESMO Open 2022; 7:100571. [PMID: 36037567 PMCID: PMC9588879 DOI: 10.1016/j.esmoop.2022.100571] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 05/13/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Lurbinectedin, a selective inhibitor of oncogenic transcription, has shown preclinical antitumor activity against homologous recombination repair-deficient models and preliminary clinical activity in BRCA1/2 breast cancer. PATIENTS AND METHODS This phase II basket multitumor trial (NCT02454972) evaluated lurbinectedin 3.2 mg/m2 1-h intravenous infusion every 3 weeks in a cohort of 21 patients with pretreated germline BRCA1/2 breast cancer. Patients with any hormone receptor and human epidermal growth factor receptor 2 status were enrolled. The primary efficacy endpoint was overall response rate (ORR) according to RECIST v1.1. Secondary endpoints included duration of response (DoR), progression-free survival (PFS), overall survival (OS) and safety. RESULTS Confirmed partial response (PR) was observed in six patients [ORR = 28.6%; 95% confidence interval (CI) 11.3% to 52.2%] who had received a median of two prior advanced chemotherapy lines. Lurbinectedin was active in both BRCA mutations: four PRs in 11 patients (36.4%) with BRCA2 and two PRs in 10 patients (20.0%) with BRCA1. Median DoR was 8.6 months, median PFS was 4.1 months and median OS was 16.1 months. Stable disease (SD) was observed in 10 patients (47.6%), including 3 with unconfirmed response in a subsequent tumor assessment [ORR unconfirmed = 42.9% (95% CI 21.8% to 66.0%)]. Clinical benefit rate (PR + SD ≥ 4 months) was 76.2% (95% CI 52.8% to 91.8%). No objective response was observed among patients who had received prior poly (ADP-ribose) polymerase inhibitors. The most common treatment-related adverse events (AEs) were nausea (61.9%), fatigue (38.1%) and vomiting (23.8%). These AEs were mostly grade 1/2. The most common grade 3/4 toxicity was neutropenia (42.9%: grade 4, 23.8%: with no febrile neutropenia). CONCLUSIONS This phase II study met its primary endpoint and showed activity of lurbinectedin in germline BRCA1/2 breast cancer. Lurbinectedin showed a predictable and manageable safety profile. Considering the exploratory aim of this trial as well as previous results in other phase II studies, further development of lurbinectedin in this indication is warranted.
Collapse
Affiliation(s)
- V Boni
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | | | - I Braña
- Hospital Universitario Vall D'Hebron (VHIO), Barcelona, Spain
| | | | - J Trigo
- Hospital Universitario Virgen De La Victoria, IBIMA, Málaga, Spain
| | - V Moreno
- START Madrid-FJD, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - D Castellano
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - C Kahatt
- PharmaMar, Colmenar Viejo, Madrid, Spain
| | - V Alfaro
- PharmaMar, Colmenar Viejo, Madrid, Spain
| | - M Siguero
- PharmaMar, Colmenar Viejo, Madrid, Spain
| | - A Zeaiter
- PharmaMar, Colmenar Viejo, Madrid, Spain
| | - F Longo
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - K Zaman
- University Hospital CHUV, Lausanne, Switzerland
| | - A Antón
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - A Paredes
- Hospital Universitario Donostia, Donostia-San Sebastián, Spain
| | - G Huidobro
- Hospital Universitario de Vigo Alvaro Cunqueiro, Pontevedra, Spain
| | - V Subbiah
- The University of Texas MD Anderson Cancer Center, Houston, USA.
| |
Collapse
|
13
|
Martín M, Zielinski C, Ruiz-Borrego M, Carrasco E, Ciruelos EM, Muñoz M, Bermejo B, Margelí M, Csöszi T, Antón A, Turner N, Casas MI, Morales S, Alba E, Calvo L, de la Haba-Rodríguez J, Ramos M, Murillo L, Santaballa A, Alonso-Romero JL, Sánchez-Rovira P, Corsaro M, Huang X, Thallinger C, Kahan Z, Gil-Gil M. Overall survival with palbociclib plus endocrine therapy versus capecitabine in postmenopausal patients with hormone receptor-positive, HER2-negative metastatic breast cancer in the PEARL study. Eur J Cancer 2022; 168:12-24. [DOI: 10.1016/j.ejca.2022.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/25/2022] [Accepted: 03/07/2022] [Indexed: 11/03/2022]
|
14
|
García-Sáenz JÁ, Martínez-Jáñez N, Cubedo R, Jerez Y, Lahuerta A, González-Santiago S, Ferrer N, Ramos M, Alonso-Romero JL, Antón A, Carrasco E, Chen J, Neuwirth R, Galinsky K, Vincent S, Leonard EJ, Slamon D. Sapanisertib plus Fulvestrant in Postmenopausal Women with Estrogen Receptor-Positive/HER2-Negative Advanced Breast Cancer after Progression on Aromatase Inhibitor. Clin Cancer Res 2022; 28:1107-1116. [PMID: 34980598 PMCID: PMC9365359 DOI: 10.1158/1078-0432.ccr-21-2652] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 08/05/2021] [Revised: 11/04/2021] [Accepted: 12/27/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE This phase II study investigated daily or weekly sapanisertib (a selective dual inhibitor of mTOR complexes 1 and 2) in combination with fulvestrant. PATIENTS AND METHODS Postmenopausal women with estrogen receptor-positive (ER+)/HER2-negative (HER2-) advanced or metastatic breast cancer following progression during/after aromatase inhibitor treatment were randomized to receive fulvestrant 500 mg (28-day treatment cycles), fulvestrant plus sapanisertib 4 mg daily, or fulvestrant plus sapanisertib 30 mg weekly, until progressive disease, unacceptable toxicity, consent withdrawal, or study completion. RESULTS Among 141 enrolled patients, baseline characteristics were balanced among treatment arms, including prior cyclin-dependent kinase-4/6 (CDK4/6) inhibitor treatment in 33% to 35% of patients. Median progression-free survival (PFS; primary endpoint) was 3.5 months in the single-agent fulvestrant arm, compared with 7.2 months for fulvestrant plus sapanisertib daily [HR, 0.77; 95% confidence interval (CI), 0.47-1.26] and 5.6 months for fulvestrant plus sapanisertib weekly (HR, 0.88; 95% CI, 0.53-1.45). The greatest PFS benefits were seen in patients who had previously received CDK4/6 inhibitors. The most common adverse events were nausea, vomiting, and hyperglycemia, all occurring more frequently in the combination therapy arms. Treatment discontinuation due to adverse events occurred more frequently in the two combination therapy arms than with single-agent fulvestrant (32% and 36% vs. 4%, respectively). CONCLUSIONS Fulvestrant plus sapanisertib daily/weekly resulted in numerically longer PFS in patients with ER+/HER2- advanced or metastatic breast cancer, compared with single-agent fulvestrant. The combination was associated with increased toxicity. Further development of sapanisertib using these dosing schedules in this setting is not supported by these data.
Collapse
Affiliation(s)
- José Á. García-Sáenz
- Medical Oncology, Hospital Clínico Universitario San Carlos, Madrid, Spain.,Centro de Investigación Biomédica en Red CIBERONC-ISCIII, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Corresponding Author: José Á. García-Sáenz, Medical Oncology, Hospital Clínico Universitario San Carlos, Calle del Prof Martín Lagos, Madrid 28040, Spain. Phone: 349-1330-3000, ext. 7768; E-mail:
| | - Noelia Martínez-Jáñez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Ricardo Cubedo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Medical Oncology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Yolanda Jerez
- Centro de Investigación Biomédica en Red CIBERONC-ISCIII, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Fundación de Investigación Biomédica, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Universidad Complutense de Madrid, Madrid, Spain
| | - Ainhara Lahuerta
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Medical Oncology, Onkologikoa, Gipuzkoa, Spain
| | - Santiago González-Santiago
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Medical Oncology, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain
| | - Nieves Ferrer
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Medical Oncology, Hospital Universitari Son Espases, Palma, Spain
| | - Manuel Ramos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Medical Oncology, Centro Oncológico de Galicia, A Coruña, Spain
| | - Jose L. Alonso-Romero
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Medical Oncology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
| | - Antonio Antón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Eva Carrasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Jingjing Chen
- Takeda Development Center Americas, Inc. (TDCA), Lexington, Massachusetts
| | - Rachel Neuwirth
- Takeda Development Center Americas, Inc. (TDCA), Lexington, Massachusetts
| | - Kevin Galinsky
- Takeda Development Center Americas, Inc. (TDCA), Lexington, Massachusetts
| | - Sylvie Vincent
- Takeda Development Center Americas, Inc. (TDCA), Lexington, Massachusetts
| | - E. Jane Leonard
- Takeda Development Center Americas, Inc. (TDCA), Lexington, Massachusetts
| | - Dennis Slamon
- Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| |
Collapse
|
15
|
Ocaña A, Chacón JI, Calvo L, Antón A, Mansutti M, Albanell J, Martínez MT, Lahuerta A, Bisagni G, Bermejo B, Semiglazov V, Thill M, Chan A, Morales S, Herranz J, Tusquets I, Chiesa M, Caballero R, Valagussa P, Bianchini G, Alba E, Gianni L. Derived Neutrophil-to-Lymphocyte Ratio Predicts Pathological Complete Response to Neoadjuvant Chemotherapy in Breast Cancer. Front Oncol 2022; 11:827625. [PMID: 35223459 PMCID: PMC8875201 DOI: 10.3389/fonc.2021.827625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/24/2021] [Indexed: 12/28/2022] Open
Abstract
Background Derived neutrophil-to-lymphocyte ratio (dNLR) is a biomarker associated with clinical outcome in breast cancer (BC). We analyzed the association of dNLR with pathological complete response (pCR) in triple-negative BC (TNBC) patients receiving neoadjuvant chemotherapy (CT). Methods This is a retrospective analysis of two randomized studies involving early stage/locally advanced TNBC patients receiving anthracycline/taxane-based CT+/−carboplatin (GEICAM/2006-03) or nab-paclitaxel/paclitaxel followed by anthracycline regimen (ETNA). dNLR was calculated as the ratio of neutrophils to the difference between total leukocytes and neutrophils in peripheral blood before CT (baseline) and at the end of treatment (EOT). Logistic regression analyses were used to explore dNLR association with pCR. Results In total, 308 TNBC patients were analyzed, 216 from ETNA and 92 from GEICAM/2006-03. Baseline median dNLR was 1.61 (interquartile range (IQR): 1.25–2.04) and at EOT 1.53 (IQR: 0.96–2.22). Baseline dNLR showed positive correlation with increased tumor size (p-value = 1e−04). High baseline dNLR, as continuous variable or using median cutoff, was associated with lower likelihood of pCR in univariate analysis. High EOT dNLR as continuous variable or using quartiles was also associated with lower pCR rate in uni- and multivariate analyses. Conclusions High baseline and EOT dNLR correlates with lower benefit from neoadjuvant CT in TNBC.
Collapse
Affiliation(s)
- Alberto Ocaña
- Hospital Clínico San Carlos, Madrid e Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid and Universidad de Castilla La Mancha, Albacete, Spain.,Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - Jose Ignacio Chacón
- GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain.,Oncology Department, Hospital Virgen de la Salud, Toledo, Spain
| | - Lourdes Calvo
- GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain.,Oncology Department, Complejo Hospitalario Universitario de A Coruňa, A Coruňa, Spain
| | - Antonio Antón
- GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain.,Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | | | - Joan Albanell
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain.,Cancer Research Program, Hospital del Mar Medical Research Institute (IMIM), Oncology Department, Hospital del Mar, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - María Teresa Martínez
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain.,Hospital Clínico Universitario de Valencia, Biomedical Research Institute INCLIVA, Valencia, Spain
| | - Ainhara Lahuerta
- GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain.,Oncology Department, Onkologikoa, San Sebastián, Spain
| | - Giancarlo Bisagni
- Oncology Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Begoña Bermejo
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain.,Hospital Clínico Universitario de Valencia, Biomedical Research Institute INCLIVA, Valencia, Spain
| | - Vladimir Semiglazov
- Oncology Department, NN Petrov Research Inst of Oncology, St. Petersburg, Russia
| | - Marc Thill
- Oncology Department, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany
| | - Arlene Chan
- Breast Cancer Research Center, Curtin University, Perth, WA, Australia
| | - Serafin Morales
- GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain.,Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | - Jesús Herranz
- GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - Ignacio Tusquets
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Massimo Chiesa
- GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - Rosalía Caballero
- GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | | | | | - Emilio Alba
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain.,Hospitales Universitarios Regional y Virgen de la Victoria, IBIMA, Malaga, Spain
| | | |
Collapse
|
16
|
González J, Carmona P, Gracia-Lavedan E, Benítez ID, Antón A, Balaña A, Díaz SB, Bernadich Ò, Córdoba A, Embid C, Espallargues M, Luján M, Martí S, Castillo O, Del Pilar M, Tárrega J, Barbé F, Escarrabill J. Cluster analysis of home mechanical ventilation in copd patients: a picture of the real world and its impact on mortality. Arch Bronconeumol 2022; 58:642-648. [DOI: 10.1016/j.arbres.2021.12.015] [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] [Received: 10/20/2021] [Revised: 12/10/2021] [Accepted: 12/30/2021] [Indexed: 11/02/2022]
|
17
|
Subbiah V, Paz-Ares L, Besse B, Zaman K, Sala M, Fernández C, Siguero M, Kahatt C, Lopez-Vilariño J, Zeaiter A, Arrondeau J, Delord J, Martínez M, Wannesson L, Antón A, Trigo J. MA16.01 Subsequent Systemic Therapy After Lurbinectedin Discontinuation in Patients With Small-cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.194] [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: 11/27/2022]
|
18
|
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.
Collapse
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.
| |
Collapse
|
19
|
Kahan Z, Gil-Gil M, Ruiz-Borrego M, Carrasco E, Ciruelos E, Muñoz M, Bermejo B, Margeli M, Antón A, Casas M, Csöszi T, Murillo L, Morales S, Calvo L, Lang I, Alba E, de la Haba-Rodriguez J, Ramos M, López IÁ, Gal-Yam E, Garcia-Palomo A, Alvarez E, González-Santiago S, Rodríguez CA, Servitja S, Corsaro M, Rodrigálvarez G, Zielinski C, Martín M. Health-related quality of life with palbociclib plus endocrine therapy versus capecitabine in postmenopausal patients with hormone receptor-positive metastatic breast cancer: Patient-reported outcomes in the PEARL study. Eur J Cancer 2021; 156:70-82. [PMID: 34425406 DOI: 10.1016/j.ejca.2021.07.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The PEARL study showed that palbociclib plus endocrine therapy (palbociclib/ET) was not superior to capecitabine in improving progression-free survival in postmenopausal patients with metastatic breast cancer resistant to aromatase inhibitors, but was better tolerated. This analysis compared patient-reported outcomes. PATIENTS AND METHODS The PEARL quality of life (QoL) population comprised 537 patients, 268 randomised to palbociclib/ET (exemestane or fulvestrant) and 269 to capecitabine. Patients completed the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BR23 and EQ-5D-3L questionnaires. Changes from the baseline and time to deterioration (TTD) were analysed using linear mixed-effect and stratified Cox regression models, respectively. RESULTS Questionnaire completion rate was high and similar between treatment arms. Significant differences were observed in the mean change in global health status (GHS)/QoL scores from the baseline to cycle 3 (2.9 for palbociclib/ET vs. -2.1 for capecitabine (95% confidence interval [CI], 1.4-8.6; P = 0.007). The median TTD in GHS/QoL was 8.3 months for palbociclib/ET versus 5.3 months for capecitabine (adjusted hazard ratio, 0.70; 95% CI, 0.55-0.89; P = 0.003). Similar improvements for palbociclib/ET were also seen for other scales as physical, role, cognitive, social functioning, fatigue, nausea/vomiting and appetite loss. No differences were observed between the treatment arms in change from the baseline in any item of the EQ-5D-L3 questionnaire as per the overall index score and visual analogue scale. CONCLUSION Patients receiving palbociclib/ET experienced a significant delay in deterioration of GHS/QoL and several functional and symptom scales compared with capecitabine, providing additional evidence that palbociclib/ET is better tolerated. TRIAL REGISTRATION NUMBER NCT02028507 (ClinTrials.gov). EUDRACT STUDY NUMBER 2013-003170-27.
Collapse
Affiliation(s)
- Zsuzsanna Kahan
- Department of Oncotherapy, University of Szeged, Szeged, Hungary.
| | - Miguel Gil-Gil
- Institut Catalá d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Manuel Ruiz-Borrego
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Eva Carrasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Eva Ciruelos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; HM Hospitales Madrid, Spain; SOLTI Group on Breast Cancer Research, Spain
| | - Montserrat Muñoz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Institut Clinic de Malalties Hemato-Oncològiques-ICHMO, Barcelona, Spain
| | - Begoña Bermejo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria-INCLIVA Valencia, Spain; Centro de Investigacion Biomedica en Red de Oncologia, CIBERONC-ISCIII, Madrid, Spain
| | - Mireia Margeli
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Badalona Applied Research Group in Oncology (ARGO Group), Institut Catalá d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Antonio Antón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigacion Biomedica en Red de Oncologia, CIBERONC-ISCIII, Madrid, Spain; Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón-IISA, Zaragoza, Spain
| | | | - Tibor Csöszi
- Department of Oncology, Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelőintezet, Szolnok, Hungary
| | - Laura Murillo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clínico de Zaragoza Lozano Blesa, Zaragoza, Spain
| | - Serafín Morales
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - Lourdes Calvo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Istvan Lang
- Istenhegyi Géndiagnosztika Private Health Center Oncology Clinic, Hungary
| | - Emilio Alba
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigacion Biomedica en Red de Oncologia, CIBERONC-ISCIII, Madrid, Spain; UGCI Medical Oncology, Hospitales Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - Juan de la Haba-Rodriguez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Instituto Maimonides de Investigacion Biomedica, Hospital Reina Sofia Hospital, Universidad de Córdoba, Córdoba, Spain
| | - Manuel Ramos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro Oncológico de Galicia, A Coruña, Spain
| | - Isabel Álvarez López
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitario Donostia-Biodonostia, San Sebastián, Spain
| | - Einav Gal-Yam
- Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Andrés Garcia-Palomo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology. Hospital de León, León, Spain
| | - Elena Alvarez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Santiago González-Santiago
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitario San Pedro de Alcantara, Cáceres, Spain
| | - César A Rodríguez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Clínico Universitario de Salamanca-IBSAL, Spain
| | - Sonia Servitja
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital del Mar, Barcelona, Spain
| | | | | | - Christoph Zielinski
- Vienna Cancer Center, Medical University Vienna and Vienna Hospital Association, Vienna, Austria; CECOG Central European Cooperative Oncology Group, Vienna, Austria
| | - Miguel Martín
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigacion Biomedica en Red de Oncologia, CIBERONC-ISCIII, Madrid, Spain; Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain
| |
Collapse
|
20
|
López-Vega JM, Álvarez I, Antón A, Illarramendi JJ, Llombart A, Boni V, García-Velloso MJ, Martí-Climent JM, Pina L, García-Foncillas J. Early Imaging and Molecular Changes with Neoadjuvant Bevacizumab in Stage II/III Breast Cancer. Cancers (Basel) 2021; 13:3511. [PMID: 34298725 PMCID: PMC8307791 DOI: 10.3390/cancers13143511] [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] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/28/2021] [Accepted: 07/05/2021] [Indexed: 11/24/2022] Open
Abstract
This prospective, phase II study evaluated novel biomarkers as predictors of response to bevacizumab in patients with breast cancer (BC), using serial imaging methods and gene expression analysis. Patients with primary stage II/III BC received bevacizumab 15 mg/kg (cycle 1; C1), then four cycles of neoadjuvant docetaxel doxorubicin, and bevacizumab every 3 weeks (C2-C5). Tumour proliferation and hypoxic status were evaluated using 18F-fluoro-3'-deoxy-3'-L-fluorothymidine (FLT)- and 18F-fluoromisonidazole (FMISO)-positron emission tomography (PET) at baseline, and during C1 and C5. Pre- and post-bevacizumab vascular changes were evaluated using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Molecular biomarkers were assessed using microarray analysis. A total of 70 patients were assessed for treatment efficacy. Significant decreases from baseline in tumour proliferation (FLT-PET), vascularity, and perfusion (DCE-MRI) were observed during C1 (p ≤ 0.001), independent of tumour subtype. Bevacizumab treatment did not affect hypoxic tumour status (FMISO-PET). Significant changes in the expression of 28 genes were observed after C1. Changes in vascular endothelial growth factor receptor (VEGFR)-2p levels were observed in 65 patients, with a > 20% decrease in VEGFR-2p observed in 13/65. Serial imaging techniques and molecular gene profiling identified several potentially predictive biomarkers that may predict response to neoadjuvant bevacizumab therapy in BC patients.
Collapse
Affiliation(s)
- José Manuel López-Vega
- Department of Medical Oncology, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - Isabel Álvarez
- Department of Medical Oncology, University Hospital Donostia, 20080 Donostia-San Sebastián, Spain;
| | - Antonio Antón
- Department of Medical Oncology, University Hospital Miguel Servet, 50009 Zaragoza, Spain;
| | | | - Antonio Llombart
- Department of Medical Oncology, Hospital Arnau de Vilanova, 46015 Lleida, Spain;
| | - Valentina Boni
- START Madrid CIOCC, Hospital Universitario HM Sanchinarro, 28050 Madrid, Spain;
| | | | - Josep María Martí-Climent
- Department of Medical Physics and Radiation Safety, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
| | - Luis Pina
- Department of Radiology, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
| | - Jesús García-Foncillas
- Translational Oncology Division, OncoHealth Institute, University Hospital “Fundación Jiménez Díaz”, Autonomous University of Madrid, 28040 Madrid, Spain
| |
Collapse
|
21
|
André T, Berton D, Curigliano G, Arkenau H, Trigo J, Ellard S, Moreno V, Abdeddaim C, Antón A, Kumar S, Guo W, Im E, Starling N. SO-9 Analysis of the immune-related endpoints of the mismatch repair–deficient non-endometrial solid cancers cohort from the GARNET study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.033] [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] Open
|
22
|
Antón A, Díaz Lobato S, Guimarães MJ, Alonso-Álvarez ML, Correia S, Gonçalves MR. Home Mechanical Ventilation Practices in Spain and Portugal. Open Respiratory Archives 2021. [PMID: 37496771 PMCID: PMC10369612 DOI: 10.1016/j.opresp.2021.100116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction Home mechanical ventilation (HMV) practice has changed with publication of new evidence and introduction of new technologies, and varies between countries. This study investigated current HMV use and practices in Spain and Portugal. Methods 94 healthcare professionals identified as regularly performing HMV-related activities were sent an e-mail link to an online questionnaire. The questionnaire included 40 items relating to responder demographics, non-invasive ventilation (NIV) care structure, ventilated patient profile, work habits, and potential future practice improvements. Results 66 questionnaires (70%) were returned (Spain, 36; Portugal, 30). The majority of respondents were physicians (Spain, 95%; Portugal, 63%). Overall, 83% of hospitals had a dedicated NIV unit (Spain, 100%; Portugal, 63%). The most common indication for HMV was neuromuscular disorders in Spain and obstructive diseases in Portugal. Homecare providers (HCPs) and pulmonologists were usually responsible for managing HMV; HCPs were involved more often in Portugal. Choice of ventilator was most often based on usage hours/day; the most important device features were 'ease of use' (Spain) and 'adjustment range' (Portugal). HMV monitoring practices varied between countries. Telemonitoring was used more often in Portugal (20%; vs. Spain, 3%). Follow-up frequency and practices also differed markedly between Spain and Portugal. Respondents highlighted identification of new patient groups and patient phenotyping to optimize treatment and personalize therapy as future HMV strategies. Conclusions Important differences in the management of HMV were observed between two similar European countries. Better understanding of clinical practices can facilitate targeted education and training to ensure optimal management of patients using HMV.
Collapse
|
23
|
Roca O, Pacheco A, Rodon J, Antón A, Vergara-Alert J, Armadans L, Segalés J, Pumarola T, Campins M, Ferrer R, Rodríguez-Garrido V. Nasal high-flow oxygen therapy in COVID-19 patients does not cause environmental surface contamination. J Hosp Infect 2021; 116:103-105. [PMID: 34082060 PMCID: PMC8166043 DOI: 10.1016/j.jhin.2021.04.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 11/25/2022]
Affiliation(s)
- O Roca
- Servei de Medicina Intensiva, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER), Madrid, Spain.
| | - A Pacheco
- Servei de Medicina Intensiva, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | - J Rodon
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Antón
- Servei de Microbiologia, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | - J Vergara-Alert
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Armadans
- Servei de Microbiologia, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | - J Segalés
- UAB, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Barcelona, Spain; Departament de Sanitat i Anatomia Animals, Facultat de Veterinària, UAB, Bellaterra (Cerdanyola del Vallès), 08193, Spain
| | - T Pumarola
- Servei de Microbiologia, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Barcelona, Spain
| | - M Campins
- Servei de Medicina Preventiva, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - R Ferrer
- Servei de Medicina Intensiva, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER), Madrid, Spain
| | - V Rodríguez-Garrido
- Servei de Microbiologia, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Barcelona, Spain
| |
Collapse
|
24
|
Riau V, Burgos L, Camps F, Domingo F, Torrellas M, Antón A, Bonmatí A. Closing nutrient loops in a maize rotation. Catch crops to reduce nutrient leaching and increase biogas production by anaerobic co-digestion with dairy manure. Waste Manag 2021; 126:719-727. [PMID: 33878676 DOI: 10.1016/j.wasman.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
Three catch crop species, ryegrass, forage rape and black oat, were grown between successive rotations of maize to reduce nitrogen leaching due to maize fertilization with digested dairy manure. Catch crops showed a high nutrient uptake, but with a wide range, depending on the year and the specie. Ensiling was shown to be a feasible storing method increasing catch crop methane production per hectare between 14-36% compared with fresh catch crop. In semi-continuous co-digestion experiments, methane production was increased between 35-48%, in comparison with anaerobic digestion of dairy manure alone. Catch crops were shown to be a good co-substrate, being a sustainable option to prevent leaching of nutrients to the environment, thus closing the loops from production to utilization by optimal recycling measures.
Collapse
Affiliation(s)
- V Riau
- GIRO, Institute of Agrifood Research and Technology (IRTA), Torre Marimon, 08140 - Caldes de Montbui, Barcelona, Catalonia, Spain
| | - L Burgos
- GIRO, Institute of Agrifood Research and Technology (IRTA), Torre Marimon, 08140 - Caldes de Montbui, Barcelona, Catalonia, Spain
| | - F Camps
- Mas Badia, Sustainable Field Crops, Institute of Agrifood Research and Technology (IRTA), 17134 - La Tallada d'Empordà, Girona, Spain
| | - F Domingo
- Mas Badia, Sustainable Field Crops, Institute of Agrifood Research and Technology (IRTA), 17134 - La Tallada d'Empordà, Girona, Spain
| | - M Torrellas
- GIRO, Institute of Agrifood Research and Technology (IRTA), Torre Marimon, 08140 - Caldes de Montbui, Barcelona, Catalonia, Spain
| | - A Antón
- GIRO, Institute of Agrifood Research and Technology (IRTA), Torre Marimon, 08140 - Caldes de Montbui, Barcelona, Catalonia, Spain
| | - A Bonmatí
- GIRO, Institute of Agrifood Research and Technology (IRTA), Torre Marimon, 08140 - Caldes de Montbui, Barcelona, Catalonia, Spain.
| |
Collapse
|
25
|
Camps C, López R, Antón A, Aranda E, Carrato A, Cruz JJ, Cunquero-Tomás AJ, Díaz-Rubio E, Feyjóo M, García-Foncillas J, Gascón P, Lugo I, Rogado Á, Guillem V. Implementation of the Quality Oncology Practice Initiative Program in Spain: First Results and Implications. JCO Oncol Pract 2021; 17:e1162-e1169. [PMID: 33621121 DOI: 10.1200/op.20.00683] [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
PURPOSE Measuring and tracking quality of care is highly relevant in today's health care. The Quality Oncology Practice Initiative (QOPI) program is a referral for evaluating oncology practices worldwide. Excellence and Quality in Oncology Foundation, a collaboration of oncology experts from major Spanish hospitals involved in cancer treatment, reached an agreement with QOPI to include Spanish hospitals in this program. METHODS We analyzed the results of the QOPI Core module measures from 19 Spanish hospitals over nine rounds (from fall 2015 to fall 2019). RESULTS Of the 19 hospitals, 15 completed more than one round; none participated in all nine (two hospitals participated in eight rounds). The highest scores were for pathology report confirming malignancy, documenting a plan of care for moderate or severe pain and chemotherapy dose, and chemotherapy administered to patients with metastatic solid tumor with performance status undocumented. Measures regarding a summary of chemotherapy treatment, tobacco use cessation counseling, and assessment of patient emotional well-being were among the lowest scored measures. Six of the 15 practices that participated repeatedly achieved a better score in their last round compared with their first. Overall, scores of Spanish hospitals improved from 67.79% in fall 2015 to 68.91% in fall 2019. CONCLUSION To our knowledge, this is the first study to evaluate QOPI scores in Spain. There was high variability in scores, with quality of care improving with repeated participation in some hospitals, but worsening in others. Excellence and Quality in Oncology Foundation will support practices to increase their participation to improve oncology care and implement strategies that address the areas for improvement.
Collapse
Affiliation(s)
- Carlos Camps
- Servicio de Oncología Médica, Hospital General de València, València, Spain; CIBERONC, Madrid, Spain.,CIBERONC, València, Spain.,Departament de Medicina, Universitat de València, València, Spain.,Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain
| | - Rafael López
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Antonio Antón
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, Spain
| | - Enrique Aranda
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Reina Sofía, Córdoba, Spain
| | - Alfredo Carrato
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Ramón y Cajal, Madrid, Spain.,IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Juan Jesús Cruz
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Alberto Jacobo Cunquero-Tomás
- Servicio de Oncología Médica, Hospital General de València, València, Spain; CIBERONC, Madrid, Spain.,Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain
| | - Eduardo Díaz-Rubio
- CIBERONC, València, Spain.,Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Real Academia Nacional de Medicina, Madrid, Spain.,IdISCC, Madrid, Spain
| | - Margarita Feyjóo
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Universitario La Moraleja, Sanitas, Madrid, Spain
| | - Jesús García-Foncillas
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Fundación Jiménez Díaz, Madrid, Spain
| | - Pere Gascón
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Hospital Universitario Clinic, Barcelona, Spain
| | - Ilse Lugo
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain
| | - Álvaro Rogado
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain
| | - Vicente Guillem
- Fundación ECO (Excelencia y Calidad en Oncología), Madrid, Spain.,Servicio de Oncología Médica, Instituto Valenciano de Oncología, València, Spain
| |
Collapse
|
26
|
Guerrero-Zotano A, Jara C, López-Tarruella S, Rodríguez CA, Adrover E, Falo C, Martínez P, Antolín S, Margeli M, Cruz J, Rodríguez-Lescure A, Iranzo V, Gómez-Raposo C, Illarramendi JJ, Malón D, Alonso JL, Antón A, Andrés R, Herranz J, Bezares S, Caballero R, Álvarez I, Rojo F. Abstract PS5-22: Mutational profile from circulating tumor DNA in triple negative breast cancer: Results from the prospective registry of unresectable locally advanced or metastatic breast cancer GEICAM/2014-03 (RegistEM). Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps5-22] [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: 11/16/2022]
Abstract
Abstract
Background: The RegistEM is a non-interventional cohort study enrolling 1,867 patients (pts) (males or females) with advanced breast cancer diagnosed from January 2016 to December 2019, either after recurrence or as first diagnosis, in 38 Spanish sites. Triple negative BC (TNBC) is clinically defined based on lack of expression of both estrogen and progesterone receptors, and HER2 overexpression, and constitutes approximately 16% of BC cases. It is a particularly proliferative and aggressive BC subtype characterized by higher rates of relapse, greater metastatic potential, and shorter overall survival compared with other BC subtypes. Recent studies have shown hormone receptor status can change from the primary (P) to the recurrence tumor (M) in a proportion of cases, inducing a switch to TNBC in the recurrence, while other remains TNBC both in the P and M setting. This feature might impact survival and treatment options. Methods: We selected TNBC pts from the RegistEM study with ctDNA plasma samples available from the relapse. TNBC pts were classified into 2 groups according to clinical subtype (CS): 1) CS-converted (CS-C), with a discordant phenotype (TN subtype in M but not in P); and 2) CS-non-converted (CS-NC), with TN phenotype in P and M. To compare the mutation profiles of the 2 groups, next-generation sequencing (NGS) was performed using the AVENIO Expanded ctDNA Analysis Kit (Roche Sequencing Solutions, Inc; 77 genes; SNPs, indels, fusions and CNVs). Genomics alterations at individual level and grouped by pathway were explored for pathogenic and probably pathogenics variants. Genomics findings were correlated with clinicopathological data and outcomes, in terms of progression-free survival (PFS) and response to first line chemotherapy treatment. Kaplan-Meier estimator and Cox regression model were used to analyze PFS, and Fisher’s test to analyze contingency tables. Bonferroni correction was used for multiple testing. Results: NGS data was available from 32 (17%) TNBC pts; 22 (69%) pts CS-NC and 10 (31%) CS-C. The time from diagnosis to relapse was 29.2 months (m) for CS-NC and 60.2m for CS-C (HR=4.81, 95% confidence interval (CI) (1.59-14.59), p=0.0055; adjusted for confounders: menopausal status, grade, stage). In the metastatic setting, CS-NC had similar PFS than CS-C (8.3m CS-C vs 5.3m CS-NC; HR=1.63, 95% CI (0.71-3.72), p=0.2442). A median of 3 genomic alterations were found, similar in both groups. The most frequent somatic alterations were TP53 (50%), MAP2K1 (25%) and APC (25%). CS-C were enriched for MAP2K1 (60% vs. 9% in CS-NC; p=0.0243). No single genomic alteration was associated with outcome. Forty-percent of tumors harbored at least 1 mutation in PI3K-AKT-mTOR pathway (PIK3CA, PIK3R1, AKT1, AKT2, PTEN or MTOR genes), with similar incidence between CS-NC and CS-C. Pts with an altered PI3K-AKT-mTOR pathway had poor PFS (3.9m mutant vs 6.7m wild-type (WT); HR=3.02, 95% CI (1.4-6.56), p=0.0033) and a trend to worse response (complete or parcial response and stable disease: 23% mutant vs 77% WT, p=0.1581). CS-C tumors presented an altered MAPK-ERK pathway (mutations in KRAS, NRAS, BRAF, MAP2K1 or RAF1 genes) more frequently in comparison to CS-NC (60% vs 23%, p=0.0557), with no differences in response or PFS. Finally tumors with a high mutation allele frequency (≥mean) showed poor PFS (HR=3.64, 95% CI (1.52-8.75), p=0.0038). Conclusion: Analysis of ctDNA reveals diverse mutational spectrum in metastatic TNBC, suggesting that the presence of PI3K-AKT-mTOR pathway alterations associates with worse outcome and poor response to standard therapies. The clinical subtype conversions from luminal primary tumor are enriched in MAPK-ERK pathway alterations.
Citation Format: Angel Guerrero-Zotano, Carlos Jara, Sara López-Tarruella, César A Rodríguez, Encarna Adrover, Catalina Falo, Purificación Martínez, Silvia Antolín, Mireia Margeli, Josefina Cruz, Alvaro Rodríguez-Lescure, Vega Iranzo, César Gómez-Raposo, Jose Juan Illarramendi, Diego Malón, Jose Luis Alonso, Antonio Antón, Raquel Andrés, Jesús Herranz, Susana Bezares, Rosalía Caballero, Isabel Álvarez, Federico Rojo. Mutational profile from circulating tumor DNA in triple negative breast cancer: Results from the prospective registry of unresectable locally advanced or metastatic breast cancer GEICAM/2014-03 (RegistEM) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS5-22.
Collapse
Affiliation(s)
- Angel Guerrero-Zotano
- 1Fundación Instituto Valenciano de Oncología (FIVO). Spanish Breast Cancer Group, Valencia, Spain
| | - Carlos Jara
- 2Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos. Spanish Breast Cancer Group, Madrid, Spain
| | - Sara López-Tarruella
- 3Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense. CIBERONC-ISCIII. Spanish Breast Cancer Group, Madrid, Spain
| | - César A Rodríguez
- 4Hospital Clínico Universitario de Salamanca-IBSAL. Spanish Breast Cancer Group, Salamanca, Spain
| | - Encarna Adrover
- 5Complejo Hospitalario Universitario de Albacete. Spanish Breast Cancer Group, Albacete, Spain
| | - Catalina Falo
- 6Institut Català d’Oncologia (ICO)-Hospitalet-Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona. Spanish Breast Cancer Group, Barcelona, Spain
| | | | - Silvia Antolín
- 8Complejo Hospitalario Universitario A Coruña (CHUAC). Spanish Breast Cancer Group, Valencia, Spain
| | - Mireia Margeli
- 9ICO-Badalona. Hospital Germans Trias i Pujol, Badalona. Spanish Breast Cancer Group, Badalona, Barcelona, Spain
| | - Josefina Cruz
- 10Hospital Universitario de Canarias. Spanish Breast Cancer Group, Santa Cruz de Tenerife, Spain
| | | | - Vega Iranzo
- 12Consorcio Hospital General Universitario de Valencia. Spanish Breast Cancer Group, Valencia, Spain
| | - César Gómez-Raposo
- 13Infanta Sofía University Hospital. Spanish Breast Cancer Group, Madrid, Spain
| | - Jose Juan Illarramendi
- 14Complejo Hospitalario de Navarra, Servicio Navarro de Salud-Osasunbidea. Spanish Breast Cancer Group, Pamplona, Spain
| | - Diego Malón
- 15Hospital Universitario de Fuenlabrada. Spanish Breast Cancer Group, Madrid, Spain
| | - Jose Luis Alonso
- 16Hospital Clínico Universitario Virgen de la Arrixaca, (IMIB-Arrixaca), Universidad de Murcia. Spanish Breast Cancer Group, Murcia, Spain
| | - Antonio Antón
- 17Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón). Spanish Breast Cancer Group, Zaragoza, Spain
| | - Raquel Andrés
- 18Hospital Universitario Lozano Blesa. Spanish Breast Cancer Group, Zaragoza, Spain
| | | | | | | | - Isabel Álvarez
- 20Hospital Universitario Donostia-BioDonostia. Spanish Breast Cancer Group, San Sebastián, Spain
| | - Federico Rojo
- 21Hospital Universitario Fundación Jiménez Díaz. CIBERONC-ISCIII. Spanish Breast Cancer Group, Madrid, Spain
| |
Collapse
|
27
|
Guerrero- Zotano A, Zielinski C, Gil-Gil M, Ruiz-Borrego M, Ciruelos EM, Munoz M, Bermejo B, Margeli M, Antón A, Csöszi T, García-Palomo A, Santaballa A, Alonso JL, Fernández A, Corsaro M, Herranz J, López P, Caballero R, Thallinger C, Martin M. Abstract PS2-01: Plk1 expression & efficacy of palbociclib in advanced hormonal receptor-positive breast cancer patients from PEARL study (GEICAM 2012-03). Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps2-01] [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: 11/16/2022]
Abstract
Abstract
Background: CDK 4/6 inhibitors (CDK 4/6i) with endocrine therapy (ET) combination therapy have improved outcomes in patients (pts) with hormonal receptor positive (HR+)/human epidermal growth factor receptor negative (HER2-) advanced breast cancer (ABC). However, most pts eventually develop resistance to these drugs, and one third never respond. Aside from HR positivity, predictive markers of clinical benefit from CDK 4/6i remains elusive. We aimed to identify biomarkers of response to palbociclib (PAL) and analyze potential therapeutic targets to reverse resistance. Methods: PEARL trial is a multicenter phase 3 study that assigned 601 postmenopausal HR+/HER2- ABC pts, whose disease progressed on aromatase inhibitors (AIs), to receive PAL + ET vs capecitabine (CAPE). We performed a differential gene expression analysis in pre-treatment tumors in extreme responders to PAL using the HTG EdgeSeq Oncology Biomarker Panel (HTG Molecular Diagnostics, Inc.), containing 2534 cancer related genes. Samples were subset in 2 categories: refractory (progressive disease as best response) vs sensitive (progression-free survival (PFS) within the upper quartile). Cox regression and Significance Analysis of Microarrays (SAM) analysis adjusting for multiple comparisons were performed. Results: We analyzed 455 (75.7%) pts with pre-treatment tumors available [from them, PAL + ET arm: 229 (50.3%) pts; CAPE arm: 226 (49.7%) pts]. Fifty genes (false discovery rate (FDR)<0.05) were differentially expressed in pts sensitive vs refractory to PAL (E2F target genes, epithelial-to-mesenchymal transition (EMT) and cell cycle genes, mainly). Unsupervised hierarchical clustering of pts based on the expression of these genes revealed two clusters. Cluster 1 is composed mostly of resistant tumors, highly proliferative (Ki67≥20%: 70%) with a great proportion of luminal B (59%) and non-luminal tumors (19%). Cluster 2 is composed of sensitive, low proliferative (Ki67<20%: 58%), mostly luminal A tumors (75%). There was no difference in ESR1 mutations distribution between the two clusters (Table 1). Forty genes were up-regulated and associated with resistance, including CCNE1 and PLK1 (Polo Like Kinase 1). In the whole cohort, pts with high levels (> median) of PLK1 (PLK1-high) treated with PAL, had a worse PFS in a multivariate model (5.7 months (m) vs 9.3 m of median PFS in PLK1-High vs -Low; HR=1.64, 95% CI (1.25-2.34), p=0.0008; adjusted model for confounders: age, site of disease, sites of metastasis, prior chemotherapy and Ki67). There were no differences in population treated with CAPE (9.9 m vs 9.4 m, PLK1-High vs -Low; HR=0.82, 95% CI (0.56-1.21), p=0.3189). In the METABRIC cohort, PLK1-High was associated with worse overall survival in HR+/HER2- BC but not in triple negative nor in HER2+ tumors. Among HR+/HER2- tumors, PLK1 expression was higher in luminal B and HER2-enriched intrinsic subtypes. We interrogated DepMap database and found that in BC cells lines there was an inverse correlation between PLK1 expression and effect on cell viability of CDK4 CRISPR knock-out (Pearson correlation r:0.54, p=0.009), but not of CDK6 knock-out. Also, HR+/HER2-/High Ki67 BC cell lines (HCC1428, EFM19 and MCF7) showed resistance to PAL on cell proliferation assays but sensitivity to the PLK1 inhibitor BI-2536. Conclusion: High expression of PLK1 is associated with intrinsic resistance to PAL and ET, this might be overcome with PLK1 inhibition.
Table 1PATIENT CHARACTERISTICSCluster 1Cluster 2ALLn=57n=47n=104RespondersSensitive42 (73.68%)14 (29.79%)56 (53.85%)Refractory15 (26.32%)33 (70.21%)48 (46.15%)ESR1Mutated9 (15.79%)13 (27.66%)22 (21.15%)Wild type45 (78.95%)34 (72.34%)79 (75.96%)Unknown3 (5.26%)0 (0%)3 (2.88%)PriorQTN42 (73.68%)31 (65.96%)73 (70.19%)Y15 (26.32%)16 (34.04%)31 (29.81%)SubtypeLumA43 (75.44%)10 (21.28%)53 (50.96%)LumB14 (24.56%)28 (59.57%)42 (40.38%)Non Luminal0 (0%)9 (19.15%)9 (8.65%)MetastasisOne21 (36.84%)15 (31.91%)36 (34.62%)Multiple36 (63.16%)32 (68.09%)68 (65.38%)KI67 20%KI67<2033 (57.89%)7 (14.89%)40 (38.46%)KI67≥2016 (28.07%)33 (70.21%)49 (47.12%)Unknown8 (14.04%)7 (14.89%)15 (14.42%)Objective ResponseComplete1 (1.75%)0 (0%)1 (0.96%)Partial16 (28.07%)6 (12.77%)22 (21.15%)Progressive15 (26.32%)33 (70.21%)48 (46.15%)Stable25 (43.86%)8 (17.02%)33 (31.73%)
Citation Format: Angel Guerrero- Zotano, Christoph Zielinski, Miguel Gil-Gil, Manuel Ruiz-Borrego, Eva M. Ciruelos, Montserrat Munoz, Begoña Bermejo, Mireia Margeli, Antonio Antón, Tibor Csöszi, Andrés García-Palomo, Ana Santaballa, Jose Luis Alonso, Antonio Fernández, Massimo Corsaro, Jesús Herranz, Paula López, Rosalia Caballero, Christiane Thallinger, Miguel Martin. Plk1 expression & efficacy of palbociclib in advanced hormonal receptor-positive breast cancer patients from PEARL study (GEICAM 2012-03) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS2-01.
Collapse
Affiliation(s)
- Angel Guerrero- Zotano
- 1Instituto Valenciano de Oncologia (IVO). GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Christoph Zielinski
- 2Vienna Cancer Center, Medical University Vienna and Vienna Hospital Association. Central European Cooperative Oncology Group (CECOG), Vienna, Austria
| | - Miguel Gil-Gil
- 3Institut Catalá d’Oncologia (ICO), L’Hospitalet de Llobregat. GEICAM Spanish Breast Cancer Group, Barcelona, Spain
| | - Manuel Ruiz-Borrego
- 4Hospital Universitario Virgen del Rocío. GEICAM Spanish Breast Cancer Group, Sevilla, Spain
| | - Eva M. Ciruelos
- 5Hospital Universitario 12 de Octubre. HM Hospitales. SOLTI Group on Breast Cancer Research. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Montserrat Munoz
- 6Hospital Universitari Clinic.Translational Genomics and Targeted Theraputics in Solid Tumor (IDIBAPS). GEICAM Spanish Breast Cancer Group, Barcelona, Spain
| | - Begoña Bermejo
- 7Hospital Clínico Universitario de Valencia, INCLIVA. CIBERONC-ISCIII. GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Mireia Margeli
- 8ARGO Group, Catalan Institut of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona. GEICAM Spanish Breast Cancer Group, Barcelona, Spain
| | - Antonio Antón
- 9Medical Oncology Department, Miguel Servet University Hospital, Aragon Health Research Institute. GEICAM Spanish Breast Cancer Group, Zaragoza, Spain
| | - Tibor Csöszi
- 10Jász_Nagykun-Szolnok Megyei Hetényi Géza, Szolnok, Hungary
| | | | - Ana Santaballa
- 12Hospital Universitario y Politécnico La Fe. GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Jose Luis Alonso
- 13Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca. GEICAM Spanish Breast Cancer Group, Murcia, Spain
| | - Antonio Fernández
- 14Complejo Hospitalario Universitario de Albacete. GEICAM Spanish Breast Cancer Group, Albacete, Spain
| | | | | | - Paula López
- 16GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | | | | | - Miguel Martin
- 18Instituto de Investigación Sanitaria Gregorio Marañón. CIBERONC-ISCIII. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| |
Collapse
|
28
|
García-Saenz JÁ, Jáñez NM, Martin M, Martínez AL, González-Santiago S, Ferrer N, Vázquez MR, Romero JLA, Antón A, Carrasco E, Chen J, Neuwirth R, Leonard EJ, Slamon D. Abstract PD1-01: Open-label, randomized, phase 2 study of sapanisertib (TAK-228/MLN0128) in combination with fulvestrant in postmenopausal women with estrogen receptor-positive (ER+)/human epidermal growth factor receptor-2-negative (HER2-) advanced or metastatic breast cancer (MBC) that previously progressed during or after aromatase inhibitor therapy (NCT02756364). Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-pd1-01] [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: 11/16/2022]
Abstract
Abstract
Background: Sapanisertib (S) is an investigational, oral, and highly selective adenosine triphosphate (ATP)-competitive inhibitor of target of rapamycin complex 1/2 (TORC1/2). Simultaneous inhibition of ER and phosphoinositide 3kinase (PI3K)/serine/threonine-specific protein kinase (AKT)/mammalian target of rapamycin (mTOR) pathway with S may restore sensitivity to endocrine therapies in patients (pts) with breast cancer, who have progressed during or after aromatase inhibitor (AI) therapy. Here we report data from a phase 2 study of continuous once-daily or once-weekly S + fulvestrant (F) compared with single-agent F in pts with breast cancer. Methods: Postmenopausal women with ER+ and HER2- advanced or metastatic breast cancer following progression during/after AI therapy were randomized 1:1:1 to receive F (500 mg intramuscularly on day 1 of a 28-day cycle) alone (Arm A) or in combination with oral S either daily (4 mg; Arm B) or weekly (30 mg; Arm C) until progressive disease (PD), unacceptable toxicity, or consent withdrawal. Pts were stratified according to presence/absence of visceral metastases, previous sensitivity to hormonal therapy, and previous exposure to cyclin-dependent kinase (CDK) 4/6 inhibitors. Pts on Arm A could receive S at PD. Key exclusion criteria were: prior therapy with mTOR inhibitors, PI3K inhibitors, or F; >1 prior line of chemotherapy for MBC; recurrent disease or PD on >2 endocrine therapies for MBC. The primary endpoint was progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), clinical benefit rate (CBR; any duration and at 24 weeks), overall survival (OS), and safety. Results: Between Aug 2016 and May 2018, 141 pts were randomized (Arm A: 46; Arm B: 47; Arm C: 48). One patient in Arm C was not treated. Median age was 58 years (range 33-84). Stratification was well balanced across arms; overall, 65% had visceral metastases, 84% had prior sensitivity to hormonal therapy, and 34% had received prior CDK 4/6 inhibitors. Pts received a median of 4 cycles (range 1-40) of F on Arm A, 5 cycles (range 1-33) of daily S + F on Arm B, and 4 cycles (range 1-39) of weekly S + F on Arm C. The last follow-up visit was in Nov 2019. The main reasons for treatment discontinuation included PD (76%, 60%, 53%; Arm A, B, and C, respectively) and adverse events (AEs; 4%, 32%, 36%; Arm A, B, and C, respectively). Of the pts in Arm A with confirmed PD, 18 crossed over to Arm B and C (9 each); crossover was analyzed separately. Efficacy data are shown in the table; median PFS was 3.5, 7.2, and 5.6 months in Arm A, B, and C, respectively. OS data were immature at the primary data cut-off. Three pts died during the study (2 and 1 in Arm A and B, respectively); all deaths were attributed to underlying disease. Most common any-grade AEs were: asthenia (24%), hyperglycemia, fatigue, and headache (22% each) in Arm A; hyperglycemia (57%) and nausea (49%) in Arm B; nausea (87%) and vomiting (70%) in Arm C. Conclusion: Daily or weekly treatment with S + F demonstrated modest clinical benefit in ER+/HER2- advanced or MBC pts who progressed during/after AI compared with single-agent F. The S + F combinations had increased toxicity leading to more treatment discontinuations compared with single-agent F.
Table: PFS and response dataArm A Single-agent F (n = 46)Arm B S (QD) + F (n = 47)Arm C S (QW) + F (n = 48)Median PFS (95% CI), months3.5 (1.9-5.6)7.2 (3.9-10.6)5.6 (4.1-9.0)HR (95% CI)0.77 (0.47-1.26)0.88 (0.53-1.45)ORR*, n/N (%)5/46 (10.9)10/47 (21.3)†6/47 (12.8)CBR*, n/N (%)28/46 (60.9)35/47 (74.5)31/47 (66.0)CBR≥6 months*, n/N (%)15/46 (32.6)23/47 (48.9)12/47 (25.5)*Safety population †Including 2 complete responses
Citation Format: José Á García-Saenz, Noelia Martínez Jáñez, Miguel Martin, Ainhara Lahuerta Martínez, Santiago González-Santiago, Nieves Ferrer, Manuel Ramos Vázquez, José Luis Alonso Romero, Antonio Antón, Eva Carrasco, Jingjing Chen, Rachel Neuwirth, E Jane Leonard, Dennis Slamon. Open-label, randomized, phase 2 study of sapanisertib (TAK-228/MLN0128) in combination with fulvestrant in postmenopausal women with estrogen receptor-positive (ER+)/human epidermal growth factor receptor-2-negative (HER2-) advanced or metastatic breast cancer (MBC) that previously progressed during or after aromatase inhibitor therapy (NCT02756364) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PD1-01.
Collapse
Affiliation(s)
| | | | - Miguel Martin
- 3Hospital General Universitario GregorioMarañón, Madrid, Spain
| | | | | | | | | | | | - Antonio Antón
- 9Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Eva Carrasco
- 10GEICAM (Spanish Breast Cancer Group), Madrid, Spain
| | - Jingjing Chen
- 11Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA
| | - Rachel Neuwirth
- 11Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA
| | - E Jane Leonard
- 11Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA
| | - Dennis Slamon
- 12UCLA Hematology/Oncology David Geffen School of Medicine, Los Angeles, CA
| |
Collapse
|
29
|
Álvarez I, Guerrero A, López-Tarruella S, Martínez P, Mori M, Falo C, Antolín S, Rodríguez CA, Margeli M, Garau I, Tibau A, Moreno D, Cruz J, Echarri MJ, Antón A, Rodríguez-Lescure Á, Escudero MJ, Bezares S, Rojo F, Jara C. Abstract PS7-24: Characteristics of HR+/HER2- patients with recurrent disease by HER2 expression from a prospective registry of unresectable locally advanced or metastatic breast cancer: GEICAM/2014-03 (RegistEM). Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps7-24] [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: 11/16/2022]
Abstract
Abstract
Background: The RegistEM study is a non-interventional cohort study that will provide prospective data from >1,800 advanced breast cancer (ABC) patients (pts), either after recurrence or as first diagnosis in 38 Spanish sites. Primary objective is the distribution of BC subtypes. A new nomenclature has been proposed for those cases with immunohistochemistry (IHC) 1+ or 2+ and negative in situ hybridization (ISH), HER2-low BC. In clinical practice these tumors are reported as HER2 negative. This subpopulation has been identified as an interesting group from a clinical perspective. Methods: In this analysis (cut-off date 01/April/2020; database is ongoing) we describe the characteristics of 229 pts with hormone receptor (HR)+/HER2-low BC documented in a metastatic lesion after early disease recurrence and who received adjuvant endocrine therapy (ET). Three subgroups of pts have been considered for this analysis based on HER2 results: HER2 IHC 0, HER2-low, and HER2 ISH- (without IHC). Biological samples collection is part of study procedures. Results: The distribution of HER2 IHC 0, HER2-low, and HER2 ISH- subgroups was 52.4%, 42.8% and 4.8%, respectively. The median time to advance disease was 98.6, 88.8 and 106.9 mo in each group. Almost all pts were female and Caucasian (99%), and at ABC diagnosis, 75.5% were postmenopausal. Median age was 59 years (range 33-88). Fourteen (6.1%) pts had HER2+ (IHC 3+ or ISH amplified) BC subtype during their disease. Family history of BC and/or ovarian cancer was reported in 31.4% pts, an hereditary-risk genetic test was performed in 11.4% (n=26) pts in total and BRCA2 gene mutation (n=6) was the only one reported. The most frequent metastases are included in Table 1. Visceral disease was present in 63.3% pts and 76% pts had ≤2 locations. The most frequent 1st-line therapies were ET/biological therapy (BT) (46.7%) and ET (28.8%), and were equal distributed in the 3 subgroups. The most common ET/BT regimens were aromatase inhibitor (AI)/cyclin-dependent kinase 4/6 inhibitor (CDKi) (49.1%/48.9%/42.9% in each subgroup) and fulvestrant (FUL)/CDKi (35.8%/27.7%/28.6%); AIs (50%/64%/66.7%) and FUL (31.6%/20%/0%) were also the most common drugs for monotherapy ET. A 2nd-line therapy was reported in ~53% pts in HER2 IHC 0 and HER2-low, and in 36% pts in HER2 ISH-. The median time to progression (TTP) to 1st-line therapy was 11.4 mo (1.2-37.0), being similar in pts with HER2 IHC 0 and HER2-low (~11 mo), and higher in pts with HER2 ISH- (16 mo). The most frequent 2nd-line therapies were ET/BT (~34% in HER2 IHC 0 and HER2-low, and 25% in HER2 ISH-) [FUL/CDKi (36.4%/47.1%/100%), AI/CDKi (36.4%/23.5%/0%)], chemotherapy as monotherapy (17 pts out of 63 in HER2 IHC 0, 17 pts out of 53 in HER2-low and 1 pt (capecitabine) out of 4 in HER2 FISH-) (capecitabine 29.4%/52.9% in HER2 IHC 0 and HER2-low). Median duration of 2nd-line therapy was ~5 mo in HER2 IHC 0 and ~8 mo in HER2-low and HER2 ISH-; disease progression was reported in 52.4%/62.3%/50% pts, respectively. Conclusions: In this population of HR+ tumors, the proportion of HER2 IHC 0 and HER2-low groups was similar. Time to advance relapse and the distribution of distant metastases were similar among the groups. The most common first- and second-line therapy was the ET/BT combination, with AI/CDKi and FUL/CDKi, respectively.
Table 1Location of metastatic lesionsIHC 0HER2-lowISH- non IHCN=120 N (%)N=98 N (%)N=11 N (%)Bone74 (61.7)55 (56.1)6 (54.5)Liver36 (30.0)37 (37.8)3 (27.3)Lung27 (22.5)21 (21.4)5 (45.5)Lymph Node27 (22.5)21 (21.4)2 (18.2)Soft Tissue6 (5.0)11 (11.2)0CNS3 (2.5)4 (4.1)0Other43 (35.8)31 (31.6)5 (45.5)
Citation Format: Isabel Álvarez, Angel Guerrero, Sara López-Tarruella, Purificación Martínez, Marta Mori, Catalina Falo, Silvia Antolín, César A Rodríguez, Mireia Margeli, Isabel Garau, Ariadna Tibau, Diana Moreno, Josefina Cruz, María José Echarri, Antonio Antón, Álvaro Rodríguez-Lescure, María José Escudero, Susana Bezares, Federico Rojo, Carlos Jara. Characteristics of HR+/HER2- patients with recurrent disease by HER2 expression from a prospective registry of unresectable locally advanced or metastatic breast cancer: GEICAM/2014-03 (RegistEM) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-24.
Collapse
Affiliation(s)
- Isabel Álvarez
- 1Hospital Universitario Donostia-BioDonostia. GEICAM Spanish Breast Cancer Group, San Sebastián, Spain
| | - Angel Guerrero
- 2Fundación Instituto Valenciano de Oncología (FIVO). GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Sara López-Tarruella
- 34.Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense. CIBERONC-ISCIII. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | | | - Marta Mori
- 5Complejo Hospitalario Universitario de Gran Canaria Dr. Negrín. GEICAM Spanish Breast Cancer Group, Las Palmas de Gran Canaria, Spain
| | - Catalina Falo
- 6ICO Hospitalet. GEICAM Spanish Breast Cancer Group, Barcelona, Spain
| | - Silvia Antolín
- 7Complejo Hospitalario Universitario A Coruña (CHUAC). GEICAM Spanish Breast Cancer Group, A Coruña, Spain
| | - César A Rodríguez
- 8Hospital Universitario de Salamanca-IBSAL. GEICAM Spanish Breast Cancer Group, Salamanca, Spain
| | - Mireia Margeli
- 9ICO-Badalona. Hospital Germans Trias i Pujol. GEICAM Spanish Breast Cancer Group, Badalona, Barcelona, Spain
| | - Isabel Garau
- 10Hospital Son Llátzer. GEICAM Spanish Breast Cancer Group, Palma de Mallorca, Spain
| | - Ariadna Tibau
- 11Hospital de la Santa Creu i Sant Pau. GEICAM Spanish Breast Cancer Group, Barcelona, Spain
| | - Diana Moreno
- 12Hospital Universitario Fundación Alcorcón. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Josefina Cruz
- 13Hospital Universitario de Canarias. GEICAM Spanish Breast Cancer Group, Tenerife, Spain
| | - María José Echarri
- 14Hospital Universitario Severo Ochoa. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Antonio Antón
- 15Medical Oncology Department, Miguel Servet University Hospital, Aragon Health Research Institute. GEICAM Spanish Breast Cancer Group, Zaragoza, Spain. GEICAM Spanish Breast Cancer Group, Zaragoza, Spain
| | | | | | | | - Federico Rojo
- 18Hospital Universitario Fundación Jiménez Díaz. CIBERONC-ISCIII GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Carlos Jara
- 19Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| |
Collapse
|
30
|
Sands J, Paz-Ares L, Besse B, Peters S, Sala M, López-Vilariño J, Fernández C, Kahatt C, Zeaiter A, Nieto A, Siguero M, Zaman K, Arrondeau J, Delord JP, Martínez M, Antón A, Awada A, Kristeleit R, Olmedo M, Rubio M, Sarantopoulos J, Mosquera-Martinez J, D’Arcangelo M, Santoro A, Trigo JM, Subbiah V, Arrondeau J. MO01.09 Phase 2 Basket Trial of Lurbinectedin in Small-Cell Lung Cancer (SCLC): Analysis of Efficacy by Baseline Characteristics. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.057] [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: 10/22/2022]
|
31
|
Subbiah V, Paz-Ares L, Besse B, Moreno V, Peters S, Sala M, López-Vilariño J, Fernández C, Kahatt C, Zeaiter A, Zaman K, Delord JP, Martínez M, Antón A, Awada A, Kristeleit R, Olmedo M, Rubio M, Sarantopoulos J, D’Arcangelo M, Santoro A, Trigo JM, Sands J. MO01.08 Phase 2 Basket Trial of Lurbinectedin in Second-line SCLC: Characteristics and Outcomes in Treatment Responders. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.056] [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: 10/22/2022]
|
32
|
Gonzalez-Bermejo J, Hajage D, Durand-Zaleski I, Arnal JM, Cuvelier A, Grassion L, Jaffre S, Lamia B, Pontier S, Prigent A, Rabec C, Raherison-Semjen C, Saint Raymond C, Soler J, Trzepizur W, Winck JC, Aguiar M, Chaves H, Conde B, Guimarães MJ, Lopes P, Mineiro A, Moreira S, Pamplona P, Rodrigues CM, Sousa S, Antón A, Córdoba-Izquierdo A, Embid C, Esteban González C, Ezzine F, Garcia P, González M, Guerassimova I, López D, Lujan M, Martí Beltran S, Martinez JM, Masa F, Pascual N, Peñacoba N, Resano P, Rey L, Rodríguez Jerez F, Roncero A, Sancho Chinesta J, Sayas Catalán J. Respiratory support in COPD patients after acute exacerbation with monitoring the quality of support (Rescue2-monitor): an open-label, prospective randomized, controlled, superiority clinical trial comparing hospital- versus home-based acute non-invasive ventilation for patients with hypercapnic chronic obstructive pulmonary disease. Trials 2020; 21:877. [PMID: 33092618 PMCID: PMC7578582 DOI: 10.1186/s13063-020-04672-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/12/2020] [Indexed: 12/03/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is expected to be the 3rd leading cause of death worldwide by 2020. Despite improvements in survival by using acute non-invasive ventilation (NIV) to treat patients with exacerbations of COPD complicated by acute hypercapnic respiratory failure (AHRF), these patients are at high risk of readmission and further life-threatening events, including death. Recent studies suggested that NIV at home can reduce readmissions, but in a small proportion of patients, and with a high level of expertise. Other studies, however, do not show any benefit of home NIV. This could be related to the fact that respiratory failure in patients with stable COPD and their response to mechanical ventilation are influenced by several pathophysiological factors which frequently coexist in the same patient to varying degrees. These pathophysiological factors might influence the success of home NIV in stable COPD, thus long-term NIV specifically adapted to a patient's "phenotype" is likely to improve prognosis, reduce readmission to hospital, and prevent death. In view of this conundrum, Rescue2-monitor (R2M), an open-label, prospective randomized, controlled study performed in patients with hypercapnic COPD post-AHRF, will investigate the impact of the quality of nocturnal NIV on the readmission-free survival. The primary objective is to show that any of 3 home NIV strategies ("rescue," "non-targeted," and "targeted") will improve readmission-free survival in comparison to no-home NIV. The "targeted" group of patients will receive a treatment with personalized (targeted) ventilation settings and extensive monitoring. Furthermore, the influence of comorbidities typical for COPD patients, such as cardiac insufficiency, OSA, or associated asthma, on ventilation outcomes will be taken into consideration and reasons for non-inclusion of patients will be recorded in order to evaluate the percentage of ventilated COPD patients that are screening failures. ClinicalTrials.gov NCT03890224 . Registered on March 26, 2019.
Collapse
|
33
|
Lopez R, Antón A, Aranda E, Carrato A, Constenla M, Cruz-Hernández JJ, Díaz-Rubio E, Feyjóo M, García-Foncillas J, Gascón P, Guillem V, Lugo I, Camps C. Evaluation of Spanish hospitals participating in the Quality Oncology Practice Initiative program. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.29_suppl.222] [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
222 Background: Measuring and tracking quality of care is highly relevant in today’s healthcare. The Quality Oncology Practice Initiative (QOPI) program is a referral for evaluating oncology practices worldwide. The ECO Foundation (Excellence and Quality in Oncology), a collaboration of oncology experts from the major Spanish hospitals involved in cancer treatment, reached an agreement with ASCO (American Society of Clinical Oncology) to include Spanish hospitals in its QOPI program. Methods: We analyzed the results of the QOPI core module measures from 19 Spanish hospitals submitting their data in nine rounds (from Fall 2015 to Fall 2019). Results: Of the 19 hospitals, 15 participated more than once; none participated in all 9 rounds (2 hospitals participated in 8 rounds). The highest scores were for pathology report confirming malignancy, documenting plan of care for moderate/severe pain and chemotherapy dose, and chemotherapy administered to patients with metastatic solid tumor with performance status undocumented. Measures regarding a summary of chemotherapy treatment, tobacco use cessation counseling, and assessment of patient emotional well-being were among the lowest scored measures. Six of the 15 practices who participated repeatedly achieved a better score in their last round compared to their first. Overall, scores of Spanish hospitals improved from 67.79% in Fall 2015 to 68.91% in Fall 2019. Conclusions: This is the first study to evaluate QOPI scores in Spain; it showed that repeated participation enhances quality of care, although there is room for improvement. The ECO Foundation will continue supporting and engaging with practices to increase their participation in order to improve oncology care and implement strategies that address the areas for improvement.
Collapse
Affiliation(s)
- Rafael Lopez
- Fundación ECO, Medical Oncology Service, Hospital Clínico Universitario de Santiago de Compostela, Santiago De Compostela, Spain
| | - Antonio Antón
- Fundación ECO, Medical Oncology Service, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Enrique Aranda
- Fundación ECO, Medical Oncology Service, Hospital Reina Sofía, Córdoba, Spain
| | - Alfredo Carrato
- Fundación ECO, Medical Oncology Service, Hospital Ramón y Cajal, Madrid, Spain
| | - Manuel Constenla
- Fundación ECO, Medical Oncology Service, Complejo Hospitalario Universitario Pontevedra, Pontevedra, Spain
| | - Juan J. Cruz-Hernández
- Fundación ECO, Medical Oncology Service, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Eduardo Díaz-Rubio
- Fundación ECO, Vicepresidencia de la Real Academia Nacional de Medicina, IdISCC, CIBERONC, Madrid, Spain
| | - Margarita Feyjóo
- Fundación ECO, Medical Oncology Service, Hospital Universitario La Moraleja, Sanitas, Madrid, Spain
| | | | - Pere Gascón
- Fundación ECO, Laboratory of Molecular & Translational Oncology-CELLEX, Barcelona, Spain
| | - Vicente Guillem
- Fundación ECO, Medical Oncology Service, Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Carlos Camps
- Fundación ECO, Medical Oncology Service, Hospital General de Valencia, CIBERONC, Departament de Medicina, Universitat de Valencia, Valencia, Spain
| |
Collapse
|
34
|
Subbiah V, Paz-Ares L, Besse B, Moreno V, Peters S, Sala MA, López-Vilariño JA, Fernández C, Kahatt C, Alfaro V, Siguero M, Zeaiter A, Zaman K, López R, Ponce S, Boni V, Arrondeau J, Delord JP, Martínez M, Wannesson L, Antón A, Valdivia J, Awada A, Kristeleit R, Olmedo ME, Rubio MJ, Sarantopoulos J, Chawla SP, Mosquera-Martinez J, D' Arcangelo M, Santoro A, Villalobos VM, Sands J, Trigo J. Antitumor activity of lurbinectedin in second-line small cell lung cancer patients who are candidates for re-challenge with the first-line treatment. Lung Cancer 2020; 150:90-96. [PMID: 33096421 DOI: 10.1016/j.lungcan.2020.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 08/21/2020] [Accepted: 10/05/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The National Comprehensive Cancer Network guidelines recommend re-challenge with the first-line treatment for relapsed small cell lung cancer (SCLC) with chemotherapy-free interval (CTFI)≥180 days. A phase II study (NCT02454972) showed remarkable antitumor activity in SCLC patients treated with lurbinectedin 3.2 mg/m2 1 -h intravenous infusion every 3 weeks as second-line therapy. We report results for the pre-planned subset of patients with CTFI ≥ 180 days. MATERIAL AND METHODS Twenty patients aged ≥18 years with pathologically proven SCLC diagnosis, pretreated with only one prior platinum-containing line, no CNS metastases, and with CTFI ≥ 180 days were evaluated. The primary efficacy endpoint was the overall response rate (ORR) assessed by the Investigators according to RECIST v1.1. RESULTS ORR was 60.0 % (95 %CI, 36.1-86.9), with a median duration of response of 5.5 months (95 %CI, 2.9-11.2) and disease control rate of 95.0 % (95 %CI, 75.1-99.9). Median progression-free survival was 4.6 months (95 %CI, 2.6-7.3). With a censoring of 55.0 %, the median overall survival was 16.2 months (95 %CI, 9.6-upper level not reached). Of note, 60.9 % and 27.1 % of patients were alive at 1 and 2 years, respectively. The most common grade 3/4 adverse events and laboratory abnormalities were hematological disorders (neutropenia, 55.0 %; anemia; 10.0 % thrombocytopenia, 10.0 %), fatigue (10.0 %) and increased liver function tests (GGT, 10 %; ALT and AP, 5.0 % each). No febrile neutropenia was reported. CONCLUSION Lurbinectedin is an effective treatment for platinum-sensitive relapsed SCLC, especially in patients with CTFI ≥ 180 days, with acceptable safety and tolerability. These encouraging results suggest that lurbinectedin can be another valuable therapeutic option rather than platinum re-challenge.
Collapse
Affiliation(s)
- Vivek Subbiah
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Luis Paz-Ares
- Hospital Universitario Doce de Octubre, Madrid, Spain
| | | | - Victor Moreno
- START Madrid-FJD, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | - Rafael López
- Hospital Clínico Universitario de Santiago de Compostela, Santiago De Compostela, Spain
| | | | - Valentina Boni
- START Madrid-CIOCC, Hospital Universitario Sanchinarro, Madrid, Spain
| | | | | | | | | | - Antonio Antón
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Ahmad Awada
- Institut Jules Bordet, Université Libre De Bruxelles, Brussels, Belgium
| | | | | | | | - John Sarantopoulos
- Institute for Drug Development, Mays Cancer Center at University of Texas Health San Antonio MD Anderson Cancer Center, San Antonio, TX, USA
| | | | | | | | | | | | - Jacob Sands
- Dana-Farber Cancer Institute, Boston, MA, USA
| | - José Trigo
- Hospital Universitario Virgen de la Victoria, Málaga, Spain
| |
Collapse
|
35
|
Ciruelos EM, Montaño A, Rodríguez CA, González-Flores E, Lluch A, Garrigós L, Quiroga V, Antón A, Malón D, Chacón JI, Velasco M, Gonzalez-Cortijo L, Jolis L, Echarri MJ, Muñoz M, Pascual T, Amigo Y, Casas M, Carrasco E, Casas A. Phase III study to evaluate patient's preference of subcutaneous versus intravenous trastuzumab in HER2-positive metastatic breast cancer patients: Results from the ChangHER study (GEICAM/2012-07). Eur J Cancer Care (Engl) 2020; 29:e13253. [PMID: 32578279 DOI: 10.1111/ecc.13253] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 01/08/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We compared patients' preferences for intravenous (IV-t) versus subcutaneous (SC-t) trastuzumab administration. METHODS Phase III, open-label, multicentre study in HER2-positive metastatic breast cancer. Patients were receiving IV-t for at least 4 months without progression. Randomisation was 1:1 to administer 2 cycles of SC-t with vial followed by 2 cycles with single injection device (SID) or the reverse sequence (600mg SC-t every 3 weeks for 4 cycles). PRIMARY OBJECTIVE patients' preference for IV-t versus SC-t; secondary objectives: patients' preference for vial versus SID, healthcare professional (HCP) preference and safety. RESULTS We randomised 166 patients in 26 sites. Median number of previous lines of chemotherapy and/or endocrine therapy was 1 (1-7). Median duration of prior IV-t was 1.8 years (0.3-14). Of the159 patients completing the questionnaires, 86.2% preferred SC-t, 6.9% preferred IV-t, and 6.9% had no preference. Patients preferred SID (59.2%) over vial (26.3%). Most (87.2%) HCP preferred SC-t of whom 51.3% and 28.2% preferred SID and vial respectively. Related adverse events included G1-2 injection site reactions in 18 patients (10.8%), G1 pain in 8 (4.8%), G1-2 allergic reaction in 2 (1.2%), one G3 heart failure and 1 G2 ejection fraction decrease. CONCLUSIONS SC-t is preferred with no safety impact.
Collapse
Affiliation(s)
- Eva M Ciruelos
- Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain.,SOLTI Breast Cancer Research Group, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Alvaro Montaño
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - César A Rodríguez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain
| | - Encarnación González-Flores
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Ana Lluch
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain.,Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
| | - Laia Garrigós
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital del Mar, Barcelona, Spain.,Oncology Department, Hospital Valle de Hebrón, Barcelona, Spain
| | - Vanesa Quiroga
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Badalona-Applied Research Group in Oncology: B-ARGO Group, Catalan Institut of Oncology, Barcelona, Spain
| | - Antonio Antón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Diego Malón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Jose I Chacón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Virgen de la Salud, Toledo, Spain
| | - Montserrat Velasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital de Mataró (Consorci Sanitari del Maresme), Barcelona, Spain
| | - Lucía Gonzalez-Cortijo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Quirón de Madrid, Madrid, Spain
| | - Laura Jolis
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital General de Granollers, Barcelona, Spain
| | - María J Echarri
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Severo Ochoa, Madrid, Spain
| | - Montse Muñoz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Clinic i Provincial, Barcelona, Spain
| | - Tomás Pascual
- Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain.,Oncology Department, Hospital Clinic i Provincial, Barcelona, Spain
| | | | | | - Eva Carrasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Ana Casas
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| |
Collapse
|
36
|
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.
Collapse
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.
| |
Collapse
|
37
|
Pérez-García JM, Salgado AC, Miranda EL, Antón A, Rovira PS, Fernández BC, González AL, Garau I, Martínez A, Aparicio MC, Barco SD, Sampayo M, Riva F, Malfettone A, Llombart-Cussac A, Cortés J. Abstract OT2-09-01: A multicenter, randomized, phase II trial evaluating the efficacy of eribulin monotherapy and eribulin plus endocrine therapy in locally-recurrent or metastatic breast cancer patients after progression on endocrine therapy (REVERT study). Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-ot2-09-01] [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: 11/16/2022]
Abstract
Abstract
BACKGROUND: Previous studies have shown prolonged overall survival (OS) in patients with metastatic breast cancer (MBC) treated with eribulin, without a clear improvement in progression-free survival (PFS), which might indicate an eribulin-mediated suppression of further spread of metastasis. In addition, it was shown that 44.1% of patients with luminal B-like tumors who received neoadjuvant eribulin converted to the luminal A-like subtype, which might be associated to a more endocrine-sensitive behavior. The aim of this trial is to explore the efficacy of eribulin in combination with the same drug administered in the last endocrine therapy (ET) regimen in hormone receptor (HR)-positive (+) / human epidermal growth factor receptor 2 (HER2)-negative (-), locally-recurrent or MBC patients who had previously shown progression while on an aromatase inhibitor (AI)-containing regimen in the metastatic setting or within six months from their last AI dose in the adjuvant setting. TRIAL DESIGN: This is an open-label, randomized, multicenter phase II trial. Patients will be randomized 1:1 to receive either eribulin alone (Arm A) or eribulin in combination with the last AI administered either in the metastatic or adjuvant setting (Arm B). Patients will receive eribulin intravenously on days 1 and 8 of every 21-day cycle, alone or in combination with exemestane, letrozole, or anastrozole, until disease progression or unacceptable toxicity. Main selection criteria are: (1) Pre- or post-menopausal women, who received an AI +/- gonadotropin-releasing hormone analogue in the last ET regimen; (2) HR+ / HER2-, unresectable locally advanced or MBC; (3) Measurable disease according to the Response Evaluation Criteria In Solid Tumors (RECIST) criteria v. 1.1; (4) At least one taxane or anthracycline regimen in either the neoadjuvant or adjuvant setting; (5) Patients with no prior line of chemotherapy in the metastatic setting; (6) At least 1 and up to 3 prior lines of ET in the metastatic setting. The primary objective of the study is to assess the overall response rate (ORR) in treatment Arm B, defined as the proportion of patients with confirmed complete or partial response according to the RECIST criteria v.1.1. Secondary objectives include: (1) PFS, PFS-2, OS, clinical benefit rate, duration of response, change in maximum tumor shrinkage in both arms, and ORR in Arm A; (2) Safety-related outcome as per Common Terminology Criteria for Adverse Events v. 5.0. Patients will be accrued in a Simon’s two-stage admissible design. In stage I, the accrual goal will be a total of 22 patients. If there are at least 2 responders out of 11 in Arm B, accrual will continue to stage II until completion. Assuming an ORR of 10% in Arm A and 30% in Arm B, a sample size of 60 subjects will provide the necessary statistical precision for the observed differences between treatment arms. ClinicalTrials.gov identifier: NCT03795012.First patient enrolled on June 24th, 2019.
Citation Format: José Manuel Pérez-García, Alfonso Cortés Salgado, Elena López Miranda, Antonio Antón, Pedro Sánchez Rovira, Beatriz Castelo Fernández, Ana López González, Isabel Garau, Alejandro Martínez, Miguel Corbellas Aparicio, Sonia Del Barco, Miguel Sampayo, François Riva, Andrea Malfettone, Antonio Llombart-Cussac, Javier Cortés. A multicenter, randomized, phase II trial evaluating the efficacy of eribulin monotherapy and eribulin plus endocrine therapy in locally-recurrent or metastatic breast cancer patients after progression on endocrine therapy (REVERT study) [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr OT2-09-01.
Collapse
Affiliation(s)
- José Manuel Pérez-García
- 1IOB, Institute of Oncology, QuironSalud Group, Barcelona, Spain; Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| | | | - Elena López Miranda
- 3Hospital Universitario Ramón y Cajal, Madrid, Spain; Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| | - Antonio Antón
- 4Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | | | | | | | | | | | - Miguel Sampayo
- 12Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| | - François Riva
- 12Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| | - Andrea Malfettone
- 12Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| | - Antonio Llombart-Cussac
- 13Hospital Arnau de Vilanova, FISABIO, Valencia, Spain; Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| | - Javier Cortés
- 14IOB, Institute of Oncology, QuironSalud Group, Madrid & Barcelona, Spain; Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain; Medica Scientia Innovation Research (MedSIR), New Jersey, USA, and Barcelona, Spain
| |
Collapse
|
38
|
de la Haba J, Morales-Ruiz T, García-Alfonso P, Lorenzo JP, Calvo L, Antón A, Marquez R, Sánchez-Rovira P, Santaballa A, Ciruelos E, García-Ortiz MV, Roldán-Arjona T, Herranz J, Chiesa M, Caballero R, Gallego J, Rodríguez-Lescure Á. Abstract P4-10-28: Identification of a specific epigenetic signature in patients showing secondary hypertension upon anti-VEGF treatment from the GEICAM/2011-04 (BRECOL) study. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p4-10-28] [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: 11/16/2022]
Abstract
Abstract
BACKGROUND The appearance of secondary hypertension (HTN) is one of the most common side effects of anti-angiogenic agents since it emerges in over 50% of the patients with these therapies. Independently of tumor type, in most clinical trials it was possible to observe a positive association between secondary HTN and better clinical outcome, including Progression Free Survival (PFS) and Overall Survival (OS). Preeclampsia is one of the biological models that better resembles the anti-VEGF/VEGFR action of these therapies. DNA methylation is one of the epigenetic mechanisms potentially related to variation in susceptibility to gestational HTN. The objective of our study is to define a specific epigenetic signature that could predict secondary HTN to anti-angiogenic treatment in patients that received bevacizumab in combination with chemotherapy (CT) from the BRECOL study. METHODS Patients (n=113) from BRECOL study (NCT01733628) received bevacizumab in combination with oxaliplatin or irinotecan + fluoropyrimidines for metastatic colorectal cancer (n=49), and with paclitaxel or capecitabine for metastatic breast cancer (n=64). Blood pressure (BP) was recorded with a Holter measurement (24 hours registration starting 2 hours after treatment administration). A methylation analysis was carried out on DNA obtained from pretreatment peripheral blood samples in 32 patients (28%) distributed in 4 experimental groups (8 patients / each) and classified according to their HTN history and to their BP variation upon bevacizumab plus CT: • Group A: patients with HTN history and with BP increase • Group B: patients with HTN history and with no BP increase • Group C: patients without HTN history and with BP increase • Group D: patients without HTN history and with no BP increase Analysis was realized with the “Infinium Human Methylation EPIC BeadChip” array (Illumina®) on bisulfite-converted DNA and differentially methylated sites were identified with the LIMMA (“Linear Models for Microarray Analysis”) bioinformatics tool (Bioconductor®). RESULTS Upon analysis of 850000 different methylation sites distributed all over the genome, we identified 27 (18 localized in the coding regions of the genes: FMNL2, METTL3, ACOT6, SCARNA20, PREX1, DNAI2, RAET1G, KCNJ8, GDF7, SYNPO2, CUGBP1, FRMD8, MKL2, HIF1A, TMEM177, UTP23, PXK and TNPO1; 9 localized in intergenic regions) that are differentially methylated in patients that showed secondary HTN to bevacizumab plus CT, independently of HTN history (Groups A + C vs. B + D). Based on Principal Components (PC) analysis, we defined a methylation score predictive of elevated BP. First PC (PC1) explains the 83.2% of the variability of the 27 identified methylation sites and allows to distinguish between patients that do and do not show secondary HTN. CONCLUSIONS High BP upon anti-angiogenic treatment is associated to specific DNA methylation profiles. We identified an epigenetic methylation signature putative predictive of secondary HTN to bevacizumab treatment in metastatic breast and colorectal cancer.
Citation Format: Juan de la Haba, Teresa Morales-Ruiz, Pilar García-Alfonso, Jose Ponce Lorenzo, Lourdes Calvo, Antonio Antón, Raul Marquez, Pedro Sánchez-Rovira, Ana Santaballa, Eva Ciruelos, María Victoria García-Ortiz, Teresa Roldán-Arjona, Jesús Herranz, Massimo Chiesa, Rosalía Caballero, Javier Gallego, Álvaro Rodríguez-Lescure. Identification of a specific epigenetic signature in patients showing secondary hypertension upon anti-VEGF treatment from the GEICAM/2011-04 (BRECOL) study [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-10-28.
Collapse
Affiliation(s)
- Juan de la Haba
- 1Instituto Maimónides de Investigación Biomédica de Córdoba. Hospital Reina Sofía. CIBERONC. GEICAM Spanish Breast Cancer Group, Córdoba, Spain
| | - Teresa Morales-Ruiz
- 2Instituto Maimónides de Investigación Biomédica de Córdoba. Hospital Reina Sofía, Córdoba, Spain
| | | | - Jose Ponce Lorenzo
- 4Hospital General de Alicante. GEICAM Spanish Breast Cancer Group, Alicante, Spain
| | - Lourdes Calvo
- 5Complejo Hospitalario Universitario A Coruña. GEICAM Spanish Breast Cancer Group, A Coruña, Spain
| | - Antonio Antón
- 6Hospital Universitario Miguel Servet. GEICAM Spanish Breast Cancer Group, Zaragoza, Spain
| | - Raul Marquez
- 7Centro Oncológico MD Anderson. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | | | - Ana Santaballa
- 9Hospital de la Fe de Valencia. GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Eva Ciruelos
- 10Hospital Universitario 12 de Octubre. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | | | - Teresa Roldán-Arjona
- 2Instituto Maimónides de Investigación Biomédica de Córdoba. Hospital Reina Sofía, Córdoba, Spain
| | | | | | | | - Javier Gallego
- 6Hospital Universitario Miguel Servet. GEICAM Spanish Breast Cancer Group, Zaragoza, Spain
| | | |
Collapse
|
39
|
Aranda E, Polo E, Camps C, Carrato A, Díaz-Rubio E, Guillem V, López R, Antón A. Treatment patterns for metastatic colorectal cancer in Spain. Clin Transl Oncol 2020; 22:1455-1462. [PMID: 31974819 PMCID: PMC7381444 DOI: 10.1007/s12094-019-02279-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 12/19/2019] [Indexed: 11/27/2022]
Abstract
Purpose The primary aim of this retrospective study was to describe the treatment patterns according to the type of treatment received by patients with metastatic colorectal cancer (mCRC) in Spain. Methods This was a retrospective, observational, multicenter study performed by 33 sites throughout Spain that included consecutive patients aged 18 years or older who had received or were receiving treatment for mCRC. Results At the time of inclusion, of the 873 evaluable patients, 507 (58%) had received two lines, 235 (27%) had received three lines, 106 (12%) had received four lines, and the remaining patients had received up to ten lines. The most frequent chemotherapy schemes were the FOLFOX or CAPOX regimens (66%) for first-line treatment, FOLFOX, CAPOX or FOLFIRI (70%) for second-line treatment, and FOLFOX, FOLFIRI or other fluoropyrimidine-based regimens for third- and fourth-line (over 60%) treatment. Sixty percent of patients received targeted therapy as part of their first-line treatment, and this proportion increased up to approximately 70% of patients as part of the second-line of treatment. A relevant proportion of patients were treated with unknown KRAS, and especially the BRAF, mutation statuses. Conclusions This study reveals inconsistencies regarding adherence to the recommendations of the ESMO guidelines for the management of mCRC in Spain. Improved adherence to the standard practice described in such guidelines for the determination of RAS and BRAF mutation statuses and the use of targeted therapies in first-line treatment should be considered to guarantee that patients can benefit from the best therapeutic approaches available.
Collapse
Affiliation(s)
- E Aranda
- Oncology Department, Maimonides Institute of Biomedical Research (IMIBIC), Reina Sofía Hospital, University of Córdoba, Córdoba, Spain. .,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain. .,Oncology Dapartment, Hospital Universitario Reina Sofía, Av. Menendez Pidal, s/n, 14004, Córdoba, Spain.
| | - E Polo
- Medical Oncology Department, Miguel Servet University Hospital, IIS Aragón, Zaragoza, Spain
| | - C Camps
- Molecular Oncology Laboratory, Fundación Investigación Hospital General Universitario de Valencia, Valencia, Spain.,CIBERONC, Valencia, Spain.,Department of Medical Oncology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.,Department of Medicine, Universitat de Valencia, Valencia, Spain
| | - A Carrato
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.,Medical Oncology, Ramón y Cajal Universtity Hospital, IRYCIS, Alcalá University, Madrid, Spain
| | - E Díaz-Rubio
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.,Medical Oncology, Hospital Clínico San Carlos, Madrid, Spain
| | - V Guillem
- Medical Oncology Department, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - R López
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Oncología Médica y Grupo de Oncología Médica Traslacional (Oncomet), Hospital Clínico Universitario e Instituto de Investigación Sanitaria (IDIS) de Santiago, Santiago de Compostela, Spain
| | - A Antón
- Medical Oncology Department, Miguel Servet University Hospital, IIS Aragón, Zaragoza, Spain
| |
Collapse
|
40
|
Hayes A, Nguyen D, Andersson M, Antón A, Bailly JL, Beard S, Benschop KSM, Berginc N, Blomqvist S, Cunningham E, Davis D, Dembinski JL, Diedrich S, Dudman SG, Dyrdak R, Eltringham GJA, Gonzales-Goggia S, Gunson R, Howson-Wells HC, Jääskeläinen AJ, López-Labrador FX, Maier M, Majumdar M, Midgley S, Mirand A, Morley U, Nordbø SA, Oikarinen S, Osman H, Papa A, Pellegrinelli L, Piralla A, Rabella N, Richter J, Smith M, Söderlund Strand A, Templeton K, Vipond B, Vuorinen T, Williams C, Wollants E, Zakikhany K, Fischer TK, Harvala H, Simmonds P. A European multicentre evaluation of detection and typing methods for human enteroviruses and parechoviruses using RNA transcripts. J Med Virol 2020; 92:1065-1074. [PMID: 31883139 PMCID: PMC7496258 DOI: 10.1002/jmv.25659] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 12/24/2019] [Indexed: 12/28/2022]
Abstract
Polymerase chain reaction (PCR) detection has become the gold standard for diagnosis and typing of enterovirus (EV) and human parechovirus (HPeV) infections. Its effectiveness depends critically on using the appropriate sample types and high assay sensitivity as viral loads in cerebrospinal fluid samples from meningitis and sepsis clinical presentation can be extremely low. This study evaluated the sensitivity and specificity of currently used commercial and in-house diagnostic and typing assays. Accurately quantified RNA transcript controls were distributed to 27 diagnostic and 12 reference laboratories in 17 European countries for blinded testing. Transcripts represented the four human EV species (EV-A71, echovirus 30, coxsackie A virus 21, and EV-D68), HPeV3, and specificity controls. Reported results from 48 in-house and 15 commercial assays showed 98% detection frequencies of high copy (1000 RNA copies/5 µL) transcripts. In-house assays showed significantly greater detection frequencies of the low copy (10 copies/5 µL) EV and HPeV transcripts (81% and 86%, respectively) compared with commercial assays (56%, 50%; P = 7 × 10-5 ). EV-specific PCRs showed low cross-reactivity with human rhinovirus C (3 of 42 tests) and infrequent positivity in the negative control (2 of 63 tests). Most or all high copy EV and HPeV controls were successfully typed (88%, 100%) by reference laboratories, but showed reduced effectiveness for low copy controls (41%, 67%). Stabilized RNA transcripts provide an effective, logistically simple and inexpensive reagent for evaluation of diagnostic assay performance. The study provides reassurance of the performance of the many in-house assay formats used across Europe. However, it identified often substantially reduced sensitivities of commercial assays often used as point-of-care tests.
Collapse
Affiliation(s)
- A Hayes
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - D Nguyen
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - M Andersson
- Microbiology Laboratory, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK
| | - A Antón
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron, Barcelona, Spain
| | - J-L Bailly
- Université Clermont Auvergne, LMGE UMR CNRS, UFR Médecine, Clermont-Ferrand, France.,CHU Clermont-Ferrand, National Reference Center for EV and Parechovirus-Associated Laboratory, Clermont-Ferrand, France
| | - S Beard
- Enteric Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - K S M Benschop
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - N Berginc
- Department for Public Health Virology, National Laboratory of Health, Environment and Food, Ljubljana, Slovenia
| | - S Blomqvist
- National Institute for Health and Welfare, Mannerheimintie, Helsinki, Finland
| | - E Cunningham
- Viapath Infection Sciences, St. Thomas' Hospital, London, UK
| | - D Davis
- Microbiology, Virology and infection Prevention & Control, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - J L Dembinski
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - S Diedrich
- National Reference Center for Poliomyelitis and Enteroviruses, Robert Koch Institute, Berlin, Germany
| | - S G Dudman
- Department of Microbiology, Oslo University Hospital Rikshospitalet, Inst. Clinical Medicine, University of Oslo, Oslo, Norway
| | - R Dyrdak
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.,Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - G J A Eltringham
- Molecular Diagnostics Laboratory, Microbiology, Freeman Hospital, Newcastle Upon Tyne, UK
| | - S Gonzales-Goggia
- Public Health England Poliovirus Reference Laboratory, National Infection Service, Public Health England, London, UK
| | - R Gunson
- West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, UK
| | - H C Howson-Wells
- Nottingham University Hospitals NHS Trust, Clinical Microbiology, Queens Medical Centre, Nottingham, UK
| | - A J Jääskeläinen
- University of Helsinki and Helsinki University Hospital, HUSLAB, Virology and Immunology, Helsinki, Finland
| | - F X López-Labrador
- Virology Laboratory, Joint Units in Genomics and Health and Infection and Health, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Public Health)/Universitat de València, Av. Catalunya, València, Spain.,CIBEResp, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - M Maier
- Institute of Virology, Leipzig University Hospital, Leipzig, Germany
| | - M Majumdar
- The National Institute for Biological Standards and Control, Hertfordshire, UK
| | - S Midgley
- Department of Virus and Special Microbiological Diagnostics, Virus Surveillance and Research Section, Statens Serum Institut, Copenhagen, Denmark
| | - A Mirand
- CHU Clermont-Ferrand, Laboratoire de Virologie-Centre National de Référence des Entérovirus et Parechovirus, Laboratoire Associé-Clermont-Ferrand, France
| | - U Morley
- UCD National Virus Reference Laboratory, University College Dublin, Belfield, Dublin, Ireland
| | - S A Nordbø
- Department of Medical Microbiology, St. Olavs University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - S Oikarinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - H Osman
- Public Health England Birmingham Public Health Laboratory, Heartlands Hospital, Birmingham, UK
| | - A Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - L Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - A Piralla
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - N Rabella
- Virology Section, Santa Creu i Sant Pau University Hospital, Barcelona, Spain
| | - J Richter
- Department of Molecular Virology, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - M Smith
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,King's College Hospital, Bessemer Wing, Denmark Hill, London, UK
| | - A Söderlund Strand
- Laboratory Medicine, Department of Clinical Microbiology, Lund University Hospital, Sölvegatan, Lund, Sweden
| | - K Templeton
- Edinburgh Specialist Virology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - B Vipond
- Public Health England, South West Regional Laboratory, Pathology Sciences Building, Science Quarter, Southmead Hospital, Bristol, UK
| | - T Vuorinen
- Clinical Microbiology, Turku University Hospital and Institute of Biomedicine University of Turku, Turku, Finland
| | - C Williams
- Microbiology, Royal Oldham Hospital, Oldham, UK
| | - E Wollants
- Clinical and Epidemiological Virology, KU Leuven, REGA Institute, Clinical and Epidemiological Virology, Leuven, Belgium
| | - K Zakikhany
- Katherina Zakikhany-Gilg, Public Health Agency of Sweden, Department of Microbiology, Unit of Laboratory Surveillance of Viral Pathogens and Vaccine Preventable Diseases, Stockholm, Sweden
| | - T K Fischer
- CIBEResp, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain.,Department of Virus and Special Microbiological Diagnostics, Virus Surveillance and Research Section, Statens Serum Institut, Copenhagen, Denmark
| | - H Harvala
- NHS Blood and Transplant, Colindale, London, UK
| | - P Simmonds
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| |
Collapse
|
41
|
Lopez-Tarruella S, Escudero MJ, Pollan M, Martín M, Jara C, Bermejo B, Guerrero-Zotano A, García-Saenz J, Santaballa A, Alba E, Andrés R, Martínez P, Calvo L, Fernández A, Batista N, Llombart-Cussac A, Antón A, Lahuerta A, de la Haba J, López-Vega JM, Carrasco E. Survival impact of primary tumor resection in de novo metastatic breast cancer patients (GEICAM/El Alamo Registry). Sci Rep 2019; 9:20081. [PMID: 31882586 PMCID: PMC6934456 DOI: 10.1038/s41598-019-55765-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 12/02/2019] [Indexed: 01/14/2023] Open
Abstract
The debate about surgical resection of primary tumor (PT) in de novo metastatic breast cancer (MBC) patients persists. We explored this approach's outcomes in patients included in a retrospective registry, named El Álamo, of breast cancer patients diagnosed in Spain (1990-2001). In this analysis we only included de novo MBC patients, 1415 of whom met the study's criteria. Descriptive, Kaplan-Meier and Cox regression analyses were carried out. Median age was 63.1 years, 49.2% of patients had single-organ metastasis (skin/soft tissue [16.3%], bone [33.8%], or viscera [48.3%]). PT surgery (S) was performed in 44.5% of the cases. S-group patients were younger, had smaller tumors, higher prevalence of bone and oligometastatic disease, and lower prevalence of visceral involvement. With a median follow-up of 23.3 months, overall survival (OS) was 39.6 versus 22.4 months (HR = 0.59, p < 0.0001) in the S- and non-S groups, respectively. The S-group OS benefit remained statistically and clinically significant regardless of metastatic location, histological type, histological grade, hormone receptor status and tumor size. PT surgery (versus no surgery) was associated with an OS benefit suggesting that loco-regional PT control may be considered in selected MBC patients. Data from randomized controlled trials are of utmost importance to confirm these results.
Collapse
Affiliation(s)
- Sara Lopez-Tarruella
- Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.
| | - M J Escudero
- GEICAM, Spanish Breast Cancer Research Group, Madrid, Spain
| | - Marina Pollan
- Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Miguel Martín
- Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
| | - Carlos Jara
- Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain
| | - Begoña Bermejo
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
- Hospital Clínico Universitario, Valencia. Biomedical Research Institute INCLIVA, Universidad de Valencia, Valencia, Spain
| | | | - José García-Saenz
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
- Servicio de Oncología Médica, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | - Emilio Alba
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
- Complejo Hospitalario Virgen de la Victoria, Málaga, Spain
| | - Raquel Andrés
- Hospital Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Lourdes Calvo
- Complejo Hospitalario Juan Canalejo, A Coruña, Spain
| | | | | | | | - Antonio Antón
- Hospital General Universitario Miguel Servet, Zaragoza, Spain
| | | | - Juan de la Haba
- Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
- Complejo Hospitalario Reina Sofía, Córdoba, Spain
| | | | - E Carrasco
- GEICAM, Spanish Breast Cancer Research Group, Madrid, Spain
| |
Collapse
|
42
|
Lluch A, Barrios CH, Torrecillas L, Ruiz-Borrego M, Bines J, Segalla J, Guerrero-Zotano Á, García-Sáenz JA, Torres R, de la Haba J, García-Martínez E, Gómez HL, Llombart A, Bofill JS, Baena-Cañada JM, Barnadas A, Calvo L, Pérez-Michel L, Ramos M, Fernández I, Rodríguez-Lescure Á, Cárdenas J, Vinholes J, Martínez de Dueñas E, Godes MJ, Seguí MA, Antón A, López-Álvarez P, Moncayo J, Amorim G, Villar E, Reyes S, Sampaio C, Cardemil B, Escudero MJ, Bezares S, Carrasco E, Martín M. Phase III Trial of Adjuvant Capecitabine After Standard Neo-/Adjuvant Chemotherapy in Patients With Early Triple-Negative Breast Cancer (GEICAM/2003-11_CIBOMA/2004-01). J Clin Oncol 2019; 38:203-213. [PMID: 31804894 PMCID: PMC6968797 DOI: 10.1200/jco.19.00904] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [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: 12/23/2022] Open
Abstract
PURPOSE Operable triple-negative breast cancers (TNBCs) have a higher risk of relapse than non-TNBCs with standard therapy. The GEICAM/2003-11_CIBOMA/2004-01 trial explored extended adjuvant capecitabine after completion of standard chemotherapy in patients with early TNBC. PATIENTS AND METHODS Eligible patients were those with operable, node-positive—or node negative with tumor 1 cm or greater—TNBC, with prior anthracycline- and/or taxane-containing chemotherapy. After central confirmation of TNBC status by immunohistochemistry, patients were randomly assigned to either capecitabine or observation. Stratification factors included institution, prior taxane-based therapy, involved axillary lymph nodes, and centrally determined phenotype (basal v nonbasal, according to cytokeratins 5/6 and/or epidermal growth factor receptor positivity by immunohistochemistry). The primary objective was to compare disease-free survival (DFS) between both arms. RESULTS Eight hundred seventy-six patients were randomly assigned to capecitabine (n = 448) or observation (n = 428). Median age was 49 years, 55.9% were lymph node negative, 73.9% had a basal phenotype, and 67.5% received previous anthracyclines plus taxanes. Median length of follow-up was 7.3 years. DFS was not significantly prolonged with capecitabine versus observation [hazard ratio (HR), 0.82; 95% CI, 0.63 to 1.06; P = .136]. In a preplanned subgroup analysis, nonbasal patients seemed to derive benefit from the addition of capecitabine with a DFS HR of 0.53 versus 0.94 in those with basal phenotype (interaction test P = .0694) and an HR for overall survival of 0.42 versus 1.23 in basal phenotype (interaction test P = .0052). Tolerance of capecitabine was as expected, with 75.2% of patients completing the planned 8 cycles. CONCLUSION This study failed to show a statistically significant increase in DFS by adding extended capecitabine to standard chemotherapy in patients with early TNBC. In a preplanned subset analysis, patients with nonbasal phenotype seemed to obtain benefit with capecitabine, although this will require additional validation.
Collapse
Affiliation(s)
- Ana Lluch
- Hospital Clínico Universitario de Valencia and Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red de Oncología ISCIII, Madrid, Spain.,GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - Carlos H Barrios
- Centro de Pesquisa Clínica Hospital São Lucas da PUCRS, Porto Alegre, Brazil.,LACOG, Latin American Cooperative Oncology Group, Porto Alegre, Brazil
| | - Laura Torrecillas
- Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | - Manuel Ruiz-Borrego
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Jose Bines
- LACOG, Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Jose Segalla
- LACOG, Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Hospital Amaral Carvalho, Sao Paolo, Brazil
| | - Ángel Guerrero-Zotano
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Instituto Valenciano de Oncología, Valencia, Spain
| | - Jose A García-Sáenz
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital Clínico San Carlos, Madrid, Spain
| | | | - Juan de la Haba
- Centro de Investigación Biomédica en Red de Oncología ISCIII, Madrid, Spain.,GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Elena García-Martínez
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Henry L Gómez
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú.,GECOPERU, Peruvian Oncological Clinical Studies Group, Lima, Peru
| | - Antonio Llombart
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital Arnau de Vilanova, Lleida, Spain
| | - Javier Salvador Bofill
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital Universitario Na Sa de Valme, Sevilla, Spain
| | - José M Baena-Cañada
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital Universitario Puerta del Mar and Instituto de Investigación e Innovación Biomédica de Cádiz, Cádiz, Spain
| | - Agustí Barnadas
- Centro de Investigación Biomédica en Red de Oncología ISCIII, Madrid, Spain.,GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital de la Santa Creu i Sant Pau, Medicine Department Universitat Autonoma, Institut Recerca Biomedica Sant Pau, Barcelona, Spain
| | - Lourdes Calvo
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | | | - Manuel Ramos
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Centro Oncológico de Galicia, A Coruña, Spain
| | - Isaura Fernández
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Álvaro Rodríguez-Lescure
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital General Universitario de Elche, Alicante, Spain
| | | | - Jeferson Vinholes
- LACOG, Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Unidade de Novos Tratamentos CliniOnco, Porto Alegre, Brazil
| | - Eduardo Martínez de Dueñas
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Consorcio Hospitalario Provincial de Castellón, Castellón, Spain
| | - Maria J Godes
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital General Universitario de Valencia, Valencia, Spain
| | - Miguel A Seguí
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Corporació Sanitaria Parc Taulí de Sabadell, Barcelona, Spain
| | - Antonio Antón
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Instituto de Investigación Sanitaria Aragon, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Pilar López-Álvarez
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - Jorge Moncayo
- Social S Hospital Teodoro Maldonado Carbo, Guayaquil, Ecuador
| | - Gilberto Amorim
- LACOG, Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Oncologistas Associados-Oncologia D'Or, Rio de Janeiro, Brazil
| | - Esther Villar
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - Salvador Reyes
- Hospital Beneficiencia Española, San Luis de Potosí, México
| | - Carlos Sampaio
- LACOG, Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Clínica Amo Itaigara, Salvador, Brazil
| | | | | | | | - Eva Carrasco
- GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - Miguel Martín
- Centro de Investigación Biomédica en Red de Oncología ISCIII, Madrid, Spain.,GEICAM, Spanish Breast Cancer Group, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | | | | | | |
Collapse
|
43
|
Ocaña A, Chacón JILM, Calvo L, Antón A, Mansutti M, Alba E, Lluch A, Lahuerta A, Bisagni G, Bermejo B, Semiglazov V, Thill M, Chan A, Morales S, Albanell J, Herranz J, Trias Bes IT, Valagussa P, Chiesa M, Gianni L. Association of derived neutrophil-to-lymphocyte ratio (dNLR) with pathological complete response (pCR) after neoadjuvant chemotherapy (CT). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.094] [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: 11/13/2022] Open
|
44
|
Salvador J, Ciruelos E, Jiménez-Rodríguez B, De La Cruz L, Villanueva Vázquez R, De Toro R, Antón A, Moreno F, Álvarez I, Quiroga V, de la Haba J, González-Santiago S, Díaz N, Barnadas A, Cantos B, Delgado Mingorance I, Bellet Ezquerra M, Martín M, Martínez N, Vicente E. Interim results from CompLEEment-1 (A phase IIIb study of ribociclib and letrozole as first-line therapy for advanced breast cancer in an expanded population): Spanish cohort results. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.031] [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: 11/13/2022] Open
|
45
|
Aranda Aguilar E, Garcia Foncillas J, Antón A, Camps Herrero C, Carrato Mena A, Constenla Figueiras M, Cruz Hernandez J, Diaz Rubio E, Gascon P, Guillem Porta V, López R, Feyjóo M, Puente J. Clinical practice evaluation of opioids induced constipation management in cancer patients: The EIO-Praxis project. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.064] [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: 11/13/2022] Open
|
46
|
Pérez-Mañá L, Cardona G, Pardo Cladellas Y, Pérez-Mañá C, Wolffsohn JS, Antón A. Translation and cultural adaptation into Spanish of the Low Vision Quality of Life Questionnaire. Arch Soc Esp Oftalmol (Engl Ed) 2019; 94:384-390. [PMID: 31155239 DOI: 10.1016/j.oftal.2019.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/19/2019] [Accepted: 02/26/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The purpose of the present study was to provide a translation into Spanish, as well as a cross-cultural adaptation, of the English version of the Low Vision Quality of Life Questionnaire (LVQOL). There are currently some questionnaires designed to assess vision related quality of life in Spanish, although none of them specifically examines the quality of life of patients with visual disability. METHOD The LVQOL consists of 25 items and examines 4 different dimensions: distance vision; mobility and ilumination; adaptation, reading and precision work, and daily life activities. The process of translation and cross-cultural adaptation was conducted following the recommendations of the International Society for Pharmacoeconomics and Outcomes. This included, amongst other variables, a direct translation, a back-translation, and a cognitive debriefing with a small sample of patients with visual impairment. Work was supervised by an expert committee consisting of an ophthalmologist, a psychologist with expertise in Patient Reported Outcomes, and an optician-optometrist with experience in the field of low vision. RESULTS A total of 46 phrases were considered for translation of which, 41 (89.1%) had excellent equivalence, 3 (6.5%) moderate equivalence, and 2 poor equivalence. The cognitive debriefing phase showed a high degree of acceptance of the questionnaire by the sample of participants with visual impairment. CONCLUSIONS The results obtained suggest that the Spanish version of this tool is understandable for patients with visual impairment. Its properties as a measuring tool will be evaluated in a later study to determine its validity, reliability, and sensitivity to changes.
Collapse
Affiliation(s)
- L Pérez-Mañá
- Unidad de Oftalmología, Hospital de la Esperanza en Parc de Salut Mar, Barcelona, España
| | - G Cardona
- Facultat d'Òptica i Optometria de Terrassa, Universitat Politècnica de Catalunya, Terrassa, Barcelona, España
| | - Y Pardo Cladellas
- Grupo de Investigación en Servicios Sanitarios, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España; Grupo de Redes del Centro de Investigación Biomédica, Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, España; Departamento de Psiquiatría y Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, España
| | - C Pérez-Mañá
- Servicio de Farmacología Clínica, Hospital Universitari Germans Trias i Pujol, Departamento de Farmacología, Terapéutica y Toxicología, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - J S Wolffsohn
- Aston University, Ophtalmic Research Group (ORG), Birmingham, Reino Unido
| | - A Antón
- Unidad de Oftalmología, Hospital de la Esperanza en Parc de Salut Mar, Barcelona, España; Instituto Catalán de Retina, Barcelona, España; Universidad Internacional de Cataluña, Barcelona, España.
| |
Collapse
|
47
|
Martínez-Trufero J, de Lobera AR, Lao J, Puértolas T, Artal-Cortés A, Zorrilla M, Alonso V, Pazo R, Valero MI, Ríos-Mitchell MJ, Calderero V, Herrero A, Antón A. Serum Markers and Prognosis in Locally Advanced Breast Cancer. Tumori 2019; 91:522-30. [PMID: 16457152 DOI: 10.1177/030089160509100613] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 11/17/2022]
Abstract
Background Locally advanced breast cancer (LABC) represents a heterogeneous subgroup of breast cancer with an often dismal outcome. Identifying prognostic factors has acquired great significance for the selection of optimal treatment in individual patients. Methods Between January 1993 and December 1997, 103 patients were treated in our institution with multimodality treatment consisting of neoadjuvant chemotherapy followed by surgery, adjuvant chemotherapy and radiotherapy; tamoxifen was added in hormone receptor-positive cases. In the search for prognostic factors well-established parameters (clinical, pathological and treatment-related) as well as new features with potential value (c-erbB-2, baseline serum levels of CA 15.3 and CEA) were included in the univariate and multivariate analysis. Results At a median follow-up of 92 months (range, 8-130), the estimated five-year cancer-specific overall survival (OS) and disease-free survival (DFS) were 71.34% and 57.7%, respectively. Among the 22 different variables studied, only 10 were significantly correlated with OS and DFS. In multivariate analysis five retained independent prognostic value for both OS and DFS: tumor grade, serum markers, features of inflammatory breast cancer (IBC), response to neoadjuvant chemotherapy and lymph node status. With cutoff values of 35 U/mL for CA 15.3 and 5 ng/mL for CEA, the probability of five-year OS (Cox hazard ratio 3.91, P = 0.0009) and DFS (Cox hazard ratio 2.40, P = 0.02) decreased from 78% to 52% and from 68% to 47%, respectively, when at least one of these markers was abnormal. Conclusions Baseline serum levels of CEA and CA 15.3 emerged from this study as strong independent predictors of outcome in LABC, whose value adds to other established prognostic factors such as postoperative nodal status, IBC, histological grade and response to neoadjuvant chemotherapy.
Collapse
Affiliation(s)
- Javier Martínez-Trufero
- Department of Medical Oncology, Hospital Universitario Miguel Servet, C/Isabel la Católica 1-3, 50009 Zaragoza, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Cussac AL, Pérez-García J, Guerrero Á, Bermejo B, Gil M, Carañana V, Morales S, Haba JDL, Fernández M, Alba E, Urruticoechea A, Calvo L, Margeli M, Antón A, Borrego MR, Albanell J, Rovira PS, Bellet M, Braga S, Coelho P, Abreu M, Cortés J. Abstract CT219: Neoadjuvant letrozole and palbociclib in stage II-IIIB HR[+]/HER2[-] breast cancer with Oncotype DX Recurrence Score® (RS) 18-25 or 26-100. Analysis of RS changes at surgery (DxCARTES trial). Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-ct219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: The combination of a CDK4/6 inhibitor (palbociclib, abemaciclib, or ribociclib) with an aromatase inhibitor (AI) significantly reduces Ki67 compared to single-agent AI in the neoadjuvant setting, but the rates of pathological complete response (pCR) or residual cancer burden (RCB) 0-I remain modest. Despite this inadequate pathological downstaging, to date, there is no data about the efficacy of this treatment in terms of molecular downstaging detected by a more refined genomic signature than Ki67, such as the Oncotype DX Breast Recurrence Score® (RS) test. The aim of this trial is to validate the ability of neoadjuvant palbociclib plus letrozole to modify two initial intermediate or high RS tumor cohorts.
TRIAL DESIGN: This is an international, multicenter, open-label, non-comparative, phase II trial. Main selection criteria include: (1) Pre- or post-menopausal women with treatment-naïve, centrally assessed, HR-positive/HER2-negative, Ki67 ≥ 20%, and stage II-IIIB breast cancer; (2) Pre-treatment RS result ≥ 18; (3) Patients agree to collect tissue samples at screening, at Cycle 1 Day 14 of treatment, and at surgery. Patients will be allocated, according to the pre-treatment RS result, either to Cohort A (RS 18-25) or Cohort B (RS 26-100) and will receive treatment with palbociclib (125 mg QD, 3/1 schedule) in combination with letrozole (2.5 mg QD, every 28-day cycle), ± LHRH analogs if pre-menopausal status, for 24 weeks. Definitive breast surgery will be performed within 7 days after completion of 6 treatment cycles. The primary objective of the study is to explore the ability of palbociclib in combination with letrozole to induce global molecular changes, measured by either the post-treatment RS result at surgery, or pCR. Secondary objectives include: (1) Concordance rate among post-treatment RS result and RCB, Ki67, and preoperative endocrine prognostic index (PEPI) score; (2) Overall response rate; (3) Safety-related outcome as per Common Terminology Criteria for Adverse Events v. 5.0. Patients will be accrued in a Simon’s two-stage design trial: optimal design in Cohort A and minimax design in Cohort B. With a unilateral type one error (alpha) set at 0.025 and a 0.8 power (type two error beta = 0.2), the required number of evaluable patients are 28. Considering a drop-out rate no lower than 10%, a sample size of 33 patients in each cohort will be needed. First Patient First Visit: Expected on April 2019.
Citation Format: Antonio Llombart Cussac, José Pérez-García, Ángel Guerrero, Begoña Bermejo, Miguel Gil, Vicente Carañana, Serafín Morales, Juan de la Haba, María Fernández, Emilio Alba, Ander Urruticoechea, Lourdes Calvo, Mireia Margeli, Antonio Antón, Manuel Ruíz Borrego, Joan Albanell, Pedro Sánchez Rovira, Meritxell Bellet, Sofia Braga, Passos Coelho, Miguel Abreu, Javier Cortés. Neoadjuvant letrozole and palbociclib in stage II-IIIB HR[+]/HER2[-] breast cancer with Oncotype DX Recurrence Score® (RS) 18-25 or 26-100. Analysis of RS changes at surgery (DxCARTES trial) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr CT219.
Collapse
Affiliation(s)
- Antonio Llombart Cussac
- 1Hospital Arnau de Vilanova, Valencia; Medica Scientia Innovation Research (MedSIR), Barcelona, Spain
| | - José Pérez-García
- 2IOB, Institute of Oncology, QuironSalud Group, Barcelona; Medica Scientia Innovation Research (MedSIR), Barcelona, Spain
| | - Ángel Guerrero
- 3lnstituto Valenciano de Oncología, Valencia; Medica Scientia Innovation Research (MedSIR), Barcelona, Spain
| | - Begoña Bermejo
- 4Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Miguel Gil
- 5Institut Català d’ Oncologia L’Hospitalet, Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | | | - Emilio Alba
- 10Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | | | - Lourdes Calvo
- 12Complejo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Spain
| | | | - Antonio Antón
- 14Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | | | - Meritxell Bellet
- 18Hospital Universitari Vall d’Hebrón, Barcelona; Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Sofia Braga
- 19Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| | | | - Miguel Abreu
- 21Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Javier Cortés
- 22IOB, Institute of Oncology, QuironSalud Group, Madrid & Barcelona; Medica Scientia Innovation Research (MedSIR), Barcelona, Spain
| |
Collapse
|
49
|
López R, Antón A, Aranda E, Carrato A, Constenla M, Cruz JJ, Díaz-Rubio E, Feyjóo M, García-Foncillas J, Gascón P, Guillem V, Lugo I, Rogado Á, Camps C. QIM19-135: The Quality Oncology Practice Initiative Program: Experience in Spain. J Natl Compr Canc Netw 2019. [DOI: 10.6004/jnccn.2018.7175] [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: 11/17/2022]
Abstract
Background: Patient quality care is a discipline that has acquired enormous relevance in today’s healthcare. The Quality Oncology Practice Initiative (QOPI) is a referral worldwide in terms of quality for oncology practices. The ECO Foundation is a foundation of experts representing the major Spanish hospitals involved in the treatment of cancer patients. ECO reached an agreement with ASCO to involve Spanish hospitals in the QOPI program. Methods: 6 rounds of data collection have taken place (Fall 2015 to Round 1 2018). Practices had to register online and submit data into the QOPI platform, and the ECO Foundation offered all centers the necessary support. 17 Spanish hospitals have participated in the 6 rounds, and 7 of them have repeated participation. Core and lung cancer modules were completed. Results: During the 6 rounds, 1,877 charts were submitted by the Spanish practices. In most of the rounds, the highest scores were: pathology report confirming malignancy; number of chemotherapy cycles documented; patient consent for chemotherapy; and 5 measures of the lung cancer module. The lowest scores were: chemotherapy treatment summary provided to patient within 3 months of chemotherapy end; chemotherapy treatment summary provided or communicated to practitioner(s) within 3 months of chemotherapy end; smoking/tobacco use cessation counselling recommended to smokers/tobacco users in past year; and tobacco cessation counselling administered or patient referred in past year. The percentage of participating practices that presented results higher than 70% was successively 64%, 50%, 75%, and 100% in the last 3 rounds. For the 7 hospitals that repeated participation, 3 reported an improvement of their global scores. Regarding QOPI Certification, 3 Spanish hospitals received this accreditation in September 2017 and one in June 2018. Conclusions: These preliminary results are a good starting point for the continued implementation of the QOPI program in Spain, thus providing a well-structured approach to analyze cancer care. The ECO Foundation will continue pursuing excellence and quality with further activities like the QOPI Certification program and Quality Training Program, these being performed for the first time in Spain in 2017 and 2018, respectively.
Collapse
Affiliation(s)
- Rafael López
- aFundación ECO, Madrid, Spain
- bHospital Clínico Universitario de Santiago de Compostela, Santiago, Spain
| | - Antonio Antón
- aFundación ECO, Madrid, Spain
- cHospital Universitario Miguel Servet, Zaragoza, Spain
| | - Enrique Aranda
- aFundación ECO, Madrid, Spain
- dHospital Reina Sofía de Córdoba, Córdoba, Spain
| | - Alfredo Carrato
- aFundación ECO, Madrid, Spain
- eHospital Ramón y Cajal, IRYCIS, CIBERONC, Universidad de Alcalá, Madrid, Spain
| | - Manuel Constenla
- aFundación ECO, Madrid, Spain
- fComplejo Hospitalario Universitario Pontevedra, Pontevedra, Spain
| | - Juan Jesús Cruz
- aFundación ECO, Madrid, Spain
- gHospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Eduardo Díaz-Rubio
- aFundación ECO, Madrid, Spain
- hReal Academia de Medicina, IdISCC, CIBERONC, Madrid, Spain
| | - Margarita Feyjóo
- aFundación ECO, Madrid, Spain
- iHospital Universitario La Moraleja, Sanitas, Madrid, Spain
| | | | - Pere Gascón
- aFundación ECO, Madrid, Spain
- kHospital Universitario Clinic, Barcelona, Spain
| | - Vicente Guillem
- aFundación ECO, Madrid, Spain
- lInstituto Valenciano de Oncología, Valencia, Spain
| | | | | | - Carlos Camps
- aFundación ECO, Madrid, Spain
- mHospital General de Valencia, Universitat de Valencia (CIBERONC), Valencia, Spain
| |
Collapse
|
50
|
Lope V, Martín M, Castelló A, Ruiz A, Casas AM, Baena-Cañada JM, Antolín S, Ramos-Vázquez M, García-Sáenz JÁ, Muñoz M, Lluch A, de Juan-Ferré A, Jara C, Sánchez-Rovira P, Antón A, Chacón JI, Arcusa A, Jimeno MA, Bezares S, Vioque J, Carrasco E, Pérez-Gómez B, Pollán M. Overeating, caloric restriction and breast cancer risk by pathologic subtype: the EPIGEICAM study. Sci Rep 2019; 9:3904. [PMID: 30846706 PMCID: PMC6405854 DOI: 10.1038/s41598-019-39346-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 01/18/2019] [Indexed: 12/31/2022] Open
Abstract
This study analyzes the association of excessive energy intake and caloric restriction with breast cancer (BC) risk taking into account the individual energy needs of Spanish women. We conducted a multicenter matched case-control study where 973 pairs completed lifestyle and food frequency questionnaires. Expected caloric intake was predicted from a linear regression model in controls, including calories consumed as dependent variable, basal metabolic rate as an offset and physical activity as explanatory. Overeating and caloric restriction were defined taking into account the 99% confidence interval of the predicted value. The association with BC risk, overall and by pathologic subtype, was evaluated using conditional and multinomial logistic regression models. While premenopausal women that consumed few calories (>20% below predicted) had lower BC risk (OR = 0.36; 95% CI = 0.21–0.63), postmenopausal women with an excessive intake (≥40% above predicted) showed an increased risk (OR = 2.81; 95% CI = 1.65–4.79). For every 20% increase in relative (observed/predicted) caloric intake the risk of hormone receptor positive (p-trend < 0.001) and HER2+ (p-trend = 0.015) tumours increased 13%, being this figure 7% for triple negative tumours. While high energy intake increases BC risk, caloric restriction could be protective. Moderate caloric restriction, in combination with regular physical activity, could be a good strategy for BC prevention.
Collapse
Affiliation(s)
- Virginia Lope
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Miguel Martín
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Adela Castelló
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Amparo Ruiz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Instituto Valenciano de Oncología, Valencia, Spain
| | - Ana Mª Casas
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Hospital Virgen del Rocío, Sevilla, Spain
| | | | - Silvia Antolín
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Manuel Ramos-Vázquez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Centro Oncológico de Galicia, A Coruña, Spain
| | - José Ángel García-Sáenz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Hospital Clínico San Carlos, Madrid, Spain
| | - Montserrat Muñoz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Hospital Clinic i Provincial, Barcelona, Spain
| | - Ana Lluch
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain.,Hospital Clínico de Valencia, Valencia, Spain
| | - Ana de Juan-Ferré
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Hospital Marqués de Valdecilla, Santander, Spain
| | - Carlos Jara
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Fundación Hospital de Alcorcón, Madrid, Spain
| | - Pedro Sánchez-Rovira
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Complejo Hospitalario de Jaén, Jaén, Spain
| | - Antonio Antón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - José Ignacio Chacón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Hospital Virgen de la Salud, Toledo, Spain
| | - Angels Arcusa
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Consorci Sanitari de Terrassa, Barcelona, Spain
| | | | | | - Jesús Vioque
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Universidad Miguel Hernández, ISABIAL, Alicante, Spain
| | - Eva Carrasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Beatriz Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Marina Pollán
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. .,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain. .,GEICAM Spanish Breast Cancer Group, Madrid, Spain.
| |
Collapse
|