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Ros J, Matito J, Villacampa G, Comas R, Garcia A, Martini G, Baraibar I, Saoudi N, Salvà F, Martin Á, Antista M, Toledo R, Martinelli E, Pietrantonio F, Boccaccino A, Cremolini C, Dientsmann R, Tabernero J, Vivancos A, Elez E. Plasmatic BRAF-V600E allele fraction as a prognostic factor in metastatic colorectal cancer treated with BRAF combinatorial treatments. Ann Oncol 2023; 34:543-552. [PMID: 36921693 DOI: 10.1016/j.annonc.2023.02.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Combination of a BRAF inhibitor (BRAFi) and an anti-epidermal growth factor receptor (EGFR), with or without a MEK inhibitor (MEKi), improves survival in BRAF-V600E-mutant metastatic colorectal cancer (mCRC) over standard chemotherapy. However, responses are heterogeneous and there are no available biomarkers to assess patient prognosis or guide doublet- or triplet-based regimens. In order to better characterize the clinical heterogeneity observed, we assessed the prognostic and predictive role of the plasmatic BRAF allele fraction (AF) for these combinations. PATIENTS AND METHODS A prospective discovery cohort including 47 BRAF-V600E-mutant patients treated with BRAFi-anti-EGFR ± MEKi in clinical trials and real-world practice was evaluated. Results were validated in an independent multicenter cohort (n= 29). Plasmatic BRAF-V600E AF cut-off at baseline was defined in the discovery cohort with droplet digital PCR (ddPCR). All patients had tissue-confirmed BRAF-V600E mutations. RESULTS Patients with high AF have major frequency of liver metastases and more metastatic sites. In the discovery cohort, median progression-free survival (PFS) and overall survival (OS) were 4.4 and 10.1 months, respectively. Patients with high BRAF AF (≥2%, n = 23) showed worse PFS [hazard ratio (HR) 2.97, 95% confidence interval (CI) 1.55-5.69; P = 0.001] and worse OS (HR 3.28, 95% CI 1.58-6.81; P = 0.001) than low-BRAF AF patients (<2%, n = 24). In the multivariable analysis, BRAF AF levels maintained independent significance. In the validation cohort, high BRAF AF was associated with worse PFS (HR 3.83, 95% CI 1.60-9.17; P = 0.002) and a trend toward worse OS was observed (HR 1.86, 95% CI 0.80-4.34; P = 0.15). An exploratory analysis of predictive value showed that high-BRAF AF patients (n = 35) benefited more from triplet therapy than low-BRAF AF patients (n = 41; PFS and OS interaction tests, P < 0.01). CONCLUSIONS Plasmatic BRAF AF determined by ddPCR is a reliable surrogate of tumor burden and aggressiveness in BRAF-V600E-mutant mCRC treated with a BRAFi plus an anti-EGFR with or without a MEKi and identifies patients who may benefit from treatment intensification. Our results warrant further validation of plasmatic BRAF AF to refine clinical stratification and guide treatment strategies.
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Affiliation(s)
- J Ros
- Medical Oncology Department, Vall d'Hebron Hospital Campus, Barcelona, Spain; Medical Oncology, Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - J Matito
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - G Villacampa
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; The Institute of Cancer Research, London, UK
| | - R Comas
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - A Garcia
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - G Martini
- Medical Oncology, Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - I Baraibar
- Medical Oncology Department, Vall d'Hebron Hospital Campus, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - N Saoudi
- Medical Oncology Department, Vall d'Hebron Hospital Campus, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - F Salvà
- Medical Oncology Department, Vall d'Hebron Hospital Campus, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Á Martin
- Medical Oncology Department, Vall d'Hebron Hospital Campus, Barcelona, Spain
| | - M Antista
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - R Toledo
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - E Martinelli
- Medical Oncology, Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - F Pietrantonio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - A Boccaccino
- Medical Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - C Cremolini
- Medical Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - R Dientsmann
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - J Tabernero
- Medical Oncology Department, Vall d'Hebron Hospital Campus, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - A Vivancos
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - E Elez
- Medical Oncology Department, Vall d'Hebron Hospital Campus, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
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Martini G, Belli V, Napolitano S, Ciaramella V, Ciardiello D, Belli A, Izzo F, Avallone A, Selvaggi F, Menegon Tasselli F, Santaniello W, Franco R, Puig I, Ramirez L, Chicote I, Mancuso F, Caratu G, Serres X, Fasani R, Jimenez J, Ros J, Baraibar I, Mulet N, Della Corte CM, Troiani T, Vivancos A, Dienstmann R, Elez E, Palmer HG, Tabernero J, Martinelli E, Ciardiello F, Argilés G. Establishment of patient-derived tumor organoids to functionally inform treatment decisions in metastatic colorectal cancer. ESMO Open 2023; 8:101198. [PMID: 37119788 DOI: 10.1016/j.esmoop.2023.101198] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND Metastatic colorectal cancer (mCRC) patients tend to have modest benefits from molecularly driven therapeutics. Patient-derived tumor organoids (PDTOs) represent an unmatched model to elucidate tumor resistance to therapy, due to their high capacity to resemble tumor characteristics. MATERIALS AND METHODS We used viable tumor tissue from two cohorts of patients with mCRC, naïve or refractory to treatment, respectively, for generating PDTOs. The derived models were subjected to a 6-day drug screening assay (DSA) with a comprehensive pipeline of chemotherapy and targeted drugs against almost all the actionable mCRC molecular drivers. For the second cohort DSA data were matched with those from PDTO genotyping. RESULTS A total of 40 PDTOs included in the two cohorts were derived from mCRC primary tumors or metastases. The first cohort included 31 PDTOs derived from patients treated in front line. For this cohort, DSA results were matched with patient responses. Moreover, RAS/BRAF mutational status was matched with DSA cetuximab response. Ten out of 12 (83.3%) RAS wild-type PDTOs responded to cetuximab, while all the mutant PDTOs, 8 out of 8 (100%), were resistant. For the second cohort (chemorefractory patients), we used part of tumor tissue for genotyping. Four out of nine DSA/genotyping data resulted applicable in the clinic. Two RAS-mutant mCRC patients have been treated with FOLFOX-bevacizumab and mitomycin-capecitabine in third line, respectively, based on DSA results, obtaining disease control. One patient was treated with nivolumab-second mitochondrial-derived activator of caspases mimetic (phase I trial) due to high tumor mutational burden at genotyping, experiencing stable disease. In one case, the presence of BRCA2 mutation correlated with DSA sensitivity to olaparib; however, the patient could not receive the therapy. CONCLUSIONS Using CRC as a model, we have designed and validated a clinically applicable methodology to potentially inform clinical decisions with functional data. Undoubtedly, further larger analyses are needed to improve methodology success rates and propose suitable treatment strategies for mCRC patients.
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Affiliation(s)
- G Martini
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - V Belli
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - S Napolitano
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - V Ciaramella
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - D Ciardiello
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - A Belli
- Hepatobiliary Surgical Oncology Unit, Istituto Nazionale Tumori-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, Napoli
| | - F Izzo
- Hepatobiliary Surgical Oncology Unit, Istituto Nazionale Tumori-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, Napoli
| | - A Avallone
- Experimental Clinical Abdominal Oncology Unit, Istituto Nazionale Tumori-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, Napoli
| | - F Selvaggi
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - F Menegon Tasselli
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - W Santaniello
- Hepatobiliary Surgical Oncology Unit, AORN Cardarelli, Naples
| | - R Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - I Puig
- Translational Program, Stem Cells and Cancer Laboratory, Vall D'Hebron Institute of Oncology (VHIO), Barcelona
| | - L Ramirez
- Translational Program, Stem Cells and Cancer Laboratory, Vall D'Hebron Institute of Oncology (VHIO), Barcelona
| | - I Chicote
- Translational Program, Stem Cells and Cancer Laboratory, Vall D'Hebron Institute of Oncology (VHIO), Barcelona
| | - F Mancuso
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - G Caratu
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - X Serres
- Department of Interventional Radiology, Hospital Universitari Vall d'Hebron, Barcelona
| | - R Fasani
- Molecular Oncology Lab, Vall d'Hebron Institute of Oncology, Barcelona
| | - J Jimenez
- Molecular Oncology Lab, Vall d'Hebron Institute of Oncology, Barcelona
| | - J Ros
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona
| | - I Baraibar
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona
| | - N Mulet
- B-ARGO Badalona Applied Research Group in Oncology, Catalan Institute of Oncology, Badalona
| | - C M Della Corte
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - T Troiani
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - A Vivancos
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - R Dienstmann
- Oncology Data Science, Vall d'Hebron Institute of Oncology, Barcelona
| | - E Elez
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona
| | - H G Palmer
- Translational Program, Stem Cells and Cancer Laboratory, Vall D'Hebron Institute of Oncology (VHIO), Barcelona
| | - J Tabernero
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona
| | - E Martinelli
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - F Ciardiello
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - G Argilés
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona; Universitat Autònoma de Barcelona, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, USA.
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Le Tourneau C, Becker H, Claus R, Elez E, Ricci F, Fritsch R, Silber Y, Hennequin A, Tabernero J, Jayadeva G, Luedtke D, He M, Isambert N. Two phase I studies of BI 836880, a vascular endothelial growth factor/angiopoietin-2 inhibitor, administered once every 3 weeks or once weekly in patients with advanced solid tumors. ESMO Open 2022; 7:100576. [PMID: 36108560 DOI: 10.1016/j.esmoop.2022.100576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND BI 836880 is a humanized bispecific nanobody® that inhibits vascular endothelial growth factor and angiopoietin-2. Here, we report results from two phase I, nonrandomized, dose-escalation studies (NCT02674152 and NCT02689505; funded by Boehringer Ingelheim) evaluating BI 836880 in patients with confirmed locally advanced or metastatic solid tumors, refractory to standard therapy, or for which standard therapy was ineffective. PATIENTS AND METHODS Patients aged ≥18 years, with an Eastern Cooperative Oncology Group performance status of 0-2 and adequate organ function received escalating intravenous doses of BI 836880 once every 3 weeks (Q3W; Study 1336.1) or once weekly (QW; Study 1336.6). Primary objectives were maximum tolerated dose (MTD) and recommended phase II dose of BI 836880, based on dose-limiting toxicities (DLTs) during the first cycle. RESULTS Patients received one of five dosages of 40-1000 mg Q3W (29 patients) or 40-240 mg QW (24 patients). One DLT occurred with Q3W treatment [Grade (G) 3 pulmonary embolism (1000 mg)]. Five DLTs occurred in four patients treated QW [G2 proteinuria (120 mg); G3 hypertension (180 mg); G3 proteinuria and G3 hypertension (240 mg); and G4 respiratory distress (240 mg)]. All patients experienced adverse events, most commonly hypertension with Q3W treatment (89.7%; G3 41.4%), and asthenia with QW treatment (62.5%). Two patients treated Q3W (both 1000 mg) and three patients treated QW (120 mg, 2 patients; 180 mg, 1 patient) experienced partial response. CONCLUSIONS The MTD of BI 836880 was 720 mg Q3W and 180 mg QW. BI 836880 was generally manageable and demonstrated preliminary efficacy. CLINICAL TRIAL REGISTRATION ClinicalTrials.govNCT02674152; https://clinicaltrials.gov/ct2/show/NCT02674152 and NCT02689505; https://clinicaltrials.gov/ct2/show/NCT02689505.
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Affiliation(s)
- C Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, INSERM U900 Research Unit, Paris-Saclay University, Paris & Saint-Cloud, France.
| | - H Becker
- Department of Medicine I (Hematology, Oncology and Stem Cell Transplantation), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Claus
- Department of Medicine I (Hematology, Oncology and Stem Cell Transplantation), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Medical Faculty Augsburg University, Augsburg, Germany
| | - E Elez
- Vall d'Hebron Barcelona Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Autonomous University of Barcelona, Barcelona, Spain
| | - F Ricci
- Department of Drug Development and Innovation (D3i), Institut Curie, INSERM U900 Research Unit, Paris-Saclay University, Paris & Saint-Cloud, France
| | - R Fritsch
- Department of Medicine I (Hematology, Oncology and Stem Cell Transplantation), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Y Silber
- Medical Faculty Augsburg University, Augsburg, Germany
| | - A Hennequin
- Centre Georges-François Leclerc, Dijon, France
| | - J Tabernero
- Vall d'Hebron Barcelona Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; UVic-UCC, IOB-Quiron, Barcelona, Spain
| | - G Jayadeva
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein
| | - D Luedtke
- Boehringer Ingelheim Pharma GmbH and Co KG, Biberach, Germany
| | - M He
- Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, USA
| | - N Isambert
- Centre Georges-François Leclerc, Dijon, France
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André T, Van Cutsem E, Elez E, Bennouna J, de la Fouchardière C, Yoshino T, Jensen L, Mendez G, Li J, Goekkurt E, Abdullaev S, Chen T, Lei M, Lonardi S. P-12 A phase 3 study of nivolumab (NIVO), NIVO + ipilimumab (IPI), or chemotherapy for microsatellite instability-high (MSI-H)/mismatch repair-deficient (dMMR) metastatic colorectal cancer (mCRC): CheckMate 8HW. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.104] [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: 11/01/2022] Open
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Siena S, Raghav K, Masuishi T, Yamaguchi K, Nishina T, Elez E, Rodriguez J, Chau I, Di Bartolomeo M, Kawakami H, Suto F, Kobayashi K, Koga M, Inaki K, Kuwahara Y, Takehara I, Grothey A, Yoshino T. 386O Exploratory biomarker analysis of DESTINY-CRC01, a phase II, multicenter, open-label study of trastuzumab deruxtecan (T-DXd, DS-8201) in patients (pts) with HER2-expressing metastatic colorectal cancer (mCRC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lim K, Punie K, Oing C, Thorne E, Murali K, Kamposioras K, O'Connor M, Elez E, Amaral T, Lopez PG, Lambertini M, Devnani B, Westphalen C, Morgan G, Haanen J, Hardy C, Banerjee S. 1561O The future of the oncology workforce since COVID-19: Results of the ESMO Resilience Task Force survey series. Ann Oncol 2021. [PMCID: PMC8454455 DOI: 10.1016/j.annonc.2021.08.1554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Le D, Diaz L, Kim T, Van Cutsem E, Geva R, Jäger D, Hara H, Burge M, O'Neil B, Kavan P, Yoshino T, Guimbaud R, Taniguchi H, Elez E, Al-Batran SE, Boland P, Cui Y, Leconte P, Marinello P, André T. 432P Pembrolizumab (pembro) for previously treated, microsatellite instability–high (MSI-H)/mismatch repair–deficient (dMMR) metastatic colorectal cancer (mCRC): Final analysis of KEYNOTE-164. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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André T, Shiu K, Kim T, Jensen B, Jensen L, Punt C, Smith D, Garcia-Carbonero R, Alcaide García J, Gibbs P, De la Fouchardière C, Rivera Herrero F, Elez E, Bendell J, Le D, Yoshino T, Zhong W, Fogelman D, Marinello P, Diaz L. O-8 Final overall survival for the phase 3 KN177 study: Pembrolizumab versus chemotherapy in microsatellite instability-high/mismatch repair deficient metastatic colorectal cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.012] [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
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Elez E, Ayala F, Felip E, García Campelo R, García Carbonero R, García Donás J, González Del Alba A, González Flores E, Hidalgo J, Isla D, Majem M, Rodríguez Lescure Á, Safont MJ, Santaballa A, Villacampa G, Vera R, Garrido P. Gender influence on work satisfaction and leadership for medical oncologists: a survey of the Spanish Society of Medical Oncology (SEOM). ESMO Open 2021; 6:100048. [PMID: 33556897 PMCID: PMC7872979 DOI: 10.1016/j.esmoop.2021.100048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/20/2022] Open
Abstract
Background Women represent an increasing proportion of the oncology workforce; however, globally this does not translate into leadership roles, reflecting disparities in career opportunities between men and women. The Spanish Society of Medical Oncology (SEOM) undertook a survey to investigate gender disparity in the Spanish oncology context. Design An online survey was made available to SEOM medical oncologists between February and May 2019. It included demographics, professional context and achievements, parenthood and family conciliation issues, workplace gender bias, and approaches to address disparities. Results Of the 316 eligible respondents, 71.5% were women, 59.5% were aged 45 or younger, and 66.1% had children. Among women, 12.4% were division or unit heads, compared with 45.5% of men, with most women (74.3%) being attending medical oncologists, compared with 45.5% of men. More males were professors (34.4% versus 14.2% of females), had a PhD (46.7% versus 28.8%), and/or had led clinical research groups (41.1% versus 9.7%). Spending time overseas after completing a residency was also more common for men than women (34.4% versus 20.4%). Professional satisfaction was similar between genders, driven primarily by patient care and intellectual stimulation. More women (40.7%) considered parenthood to have a strong negative impact on their career, compared with men (9.0%). Main perceived barriers to gender equality included a lack of work–life balance (72.6% women, 44.4% men), bias of peers and superiors (50.0% women, 18.9% men), and different career goals (41.2% women, 24.4% men). Preferred solutions included educational programs and scholarships (52.9%), communication and leadership training (35.8%), childcare at conferences (33.2%), and postmaternity return-to-work incentives (32.0%). Conclusion There is a clear paucity of equal opportunities for female oncologists in Spain. This can be addressed by encouraging professional development and merit recognition particularly for younger female oncologists, and empowering women to be involved in management and leadership of institutions and professional societies. Under-representation of women in leadership roles in oncology is a widely acknowledged issue receiving global attention. This study is a national description of leadership and educational opportunities in terms of gender and family circumstances. Perceptions of gender bias in the workplace gender inequality or family conciliation issues and are described. Initiatives for equal opportunities in oncology are needed supporting female academic career development and recognition.
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Affiliation(s)
- E Elez
- Vall d'Hebron Institute of Oncology (VHIO), Medical Oncology Department, Barcelona, Spain
| | - F Ayala
- Hospital Universitario Morales Meseguer, Murcia, Spain
| | - E Felip
- Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | | | | | - J García Donás
- Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain
| | | | | | - J Hidalgo
- Hospital Lluis Alcanyís de Xativa, Valencia, Spain
| | - D Isla
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - M Majem
- Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | | | - M J Safont
- Consorcio Hospital General Universitario, Valencia, Spain
| | - A Santaballa
- Hospital Universitari I Politècnic la Fe, Valencia, Spain
| | - G Villacampa
- Vall d'Hebron Institute of Oncology (VHIO), Medical Oncology Department, Barcelona, Spain
| | - R Vera
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - P Garrido
- Hospital Universitario Ramón y Cajal, Madrid, Spain.
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Yoshino T, Kim T, Yong W, Shiu KK, Jensen BV, Jensen LH, Smith D, Garcia-Carbonero R, Alcaide-Garcia J, Gibbs P, Fouchardiere CDL, Rivera F, Elez E, Bendell J, Le D, Yang P, Farooqui M, Marinello P, Diaz L, Andre T. 112P Pembrolizumab vs chemotherapy in patients with microsatellite instability-high/mismatch repair deficient metastatic colorectal cancer: Asia subgroup results of the phase III KEYNOTE-177 study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.132] [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] Open
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Yoshino T, Siena S, Di Bartolomeo M, Raghav K, Masuishi T, Loupakis F, Kawakami H, Yamaguchi K, Nishina T, Fakih M, Elez E, Rodriguez J, Ciardiello F, Saxena K, Yamamoto E, Kobayashi K, Bako E, Okuda Y, Grothey A. 84MO A phase II, multicenter, open-label study of trastuzumab deruxtecan (T-DXd; DS-8201) in patients with HER2-expressing metastatic colorectal cancer (mCRC): DESTINY-CRC01. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.104] [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] Open
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12
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Serna G, Ruiz-Pace F, Hernando J, Alonso L, Fasani R, Landolfi S, Comas R, Jimenez J, Elez E, Bullman S, Tabernero J, Capdevila J, Dienstmann R, Nuciforo P. Fusobacterium nucleatum persistence and risk of recurrence after preoperative treatment in locally advanced rectal cancer. Ann Oncol 2020; 31:1366-1375. [PMID: 32569727 PMCID: PMC7542577 DOI: 10.1016/j.annonc.2020.06.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [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: 04/09/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Accumulating evidence has identified Fusobacterium as an important pathogenic gut bacterium associated with colorectal cancer. Nevertheless, only limited data exist about the role of this bacterium in locally advanced rectal cancer (LARC). In this study, we quantified Fusobacterium nucleatum in untreated and post-neoadjuvant chemoradiotherapy (nCRT) samples from LARC patients and investigated its association with therapy response and survival. PATIENTS AND METHODS A total of 254 samples from 143 patients with rectal adenocarcinomas were analyzed for the presence and abundance of F. nucleatum using RNA in situ hybridization and digital image analysis. Assay accuracy was determined using infected cell lines and tumor samples with available quantitative PCR data. We studied the impact of F. nucleatum load on pathologic complete response and relapse-free survival. Treatment-induced changes were evaluated in paired pre- and post-nCRT samples (n = 71). Finally, tumor microenvironment changes during nCRT were assessed in paired samples (n = 45) by immune contexture analysis. RESULTS F. nucleatum tissue levels by RNA in situ hybridization strongly correlated with quantitative PCR (r = 0.804, P < 0.001). F. nucleatum abundance was higher in untreated [median, 7.4; 95% confidence interval (3.7-16.2)] compared with treated [median, 1.6; 95% confidence interval (1.3-2.4)] tumors (P <0.001) with 58% (73/126) and 26% (22/85) positive tumors, respectively (P < 0.001). Baseline F. nucleatum levels were not associated with pathologic complete response. F. nucleatum positivity after nCRT, but not baseline status, significantly increased risk of relapse [hazard ratio = 7.5, 95% confidence interval (3.0-19.0); P < 0.001]. Tumors that turned F. nucleatum-negative after nCRT had a strong increase in CD8+ T cells post-nCRT (P < 0.001), while those that persisted F. nucleatum-positive after nCRT lacked CD8+ T cells induction in post-nCRT samples compared with baseline (P = 0.69). CONCLUSION F. nucleatum persistence post-nCRT is associated with high relapse rates in LARC, potentially linked to suppression of immune cytotoxicity.
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Affiliation(s)
- G Serna
- Molecular Oncology Group, Spain
| | - F Ruiz-Pace
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - J Hernando
- Medical Oncology Department, Gastrointestinal and Endocrine Tumor Unit, Vall d'Hebron University Hospital, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - S Landolfi
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - R Comas
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - E Elez
- Medical Oncology Department, Gastrointestinal and Endocrine Tumor Unit, Vall d'Hebron University Hospital, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - S Bullman
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - J Tabernero
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - J Capdevila
- Medical Oncology Department, Gastrointestinal and Endocrine Tumor Unit, Vall d'Hebron University Hospital, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - R Dienstmann
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Martini G, Borreil IP, Ramirez L, Chicote I, Mancuso F, Caratu G, Serres-Créixams X, Fasani R, Jimenez J, Montañá FR, Argota IB, Ciardiello D, Margalef NM, Dienstmann R, Vivancos A, Elez E, Palmer H, Tabernero J, Martinez GA. 487P Use of patient-derived tumour organoids to identify acquired treatment resistance and determine optimal post-progression combinations in metastatic colorectal cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.598] [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: 10/23/2022] Open
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14
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Margalef NM, Castillo C, Mosteiro M, Martinez JP, PAdrol I, Aguilar S, Villacampa MM, Rodriguez JR, Losa F, Vega AT, Soler G, Castany R, Capdevila F, Gil-Martin M, Cuadra C, Elez E, Garralda E, Salazar R, Dienstmann R, Santos C. 477P Genomically-matched therapy in refractory CRC according to ESCAT. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.588] [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: 10/23/2022] Open
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15
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Argota IB, Rubio-Pérez C, Martinez GA, Montañá FR, Salvà F, Margalef NM, Urteaga JC, Castaneda DM, Gonzalez NS, Ciardiello D, Tabernero J, Seoane J, Elez E. 499P Heterogeneity in the immune inflamed biomarkers of MSS and MSI colorectal cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Santa Gadea OS, Hernando-Calvo A, Berché R, Matos I, Gardeazabal I, Pedrazzoli AA, Villar MV, Braña I, Casal GA, Galvao de Aguiar V, Pedrola A, Martinez GA, Mercadé TM, Capdevila J, Cedres S, Oaknin A, Elez E, Tabernero J, Dienstmann R, Garralda E. 572P Limited efficacy of immunotherapy combination regimens in patients with unselected “cold” tumours enrolled in early clinical trials. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.686] [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: 10/23/2022] Open
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17
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Galvão V, Montañá FR, Matos I, Viaplana C, Javierre GV, Braña I, Pedrazzoli AA, Villar MV, Santa Gadea OS, Casal GA, Hernando-Calvo A, Carles J, Mercade TM, Couselo EM, Elez E, Felip E, Tabernero J, Dienstmann R, Oliveira M, Garralda E. 1068P Rescue chemotherapy (CT) after immune-oncology (IO) drugs in patients (pts) with refractory solid tumours: A propensity score (PS) matched cohort study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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18
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Hernando-Calvo A, Mancuso F, Braña I, Santa Gadea OS, Vieito M, Casal GA, Galvao de Aguiar V, Pedrazzoli AA, Matos I, Berché R, Worham NA, Saura C, Martinez GA, Elez E, Couselo EM, Felip E, Seoane J, Tabernero J, Vivancos A, Garralda E. 531MO VHIO immune gene-expression signature (VIGex) to enrich patient selection in immunotherapy (IT) phase I clinical trials. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.645] [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: 10/23/2022] Open
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19
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Ciardiello D, Elez E, Tabernero J, Seoane J. Clinical development of therapies targeting TGFβ: current knowledge and future perspectives. Ann Oncol 2020; 31:1336-1349. [PMID: 32710930 DOI: 10.1016/j.annonc.2020.07.009] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [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: 05/12/2020] [Revised: 06/22/2020] [Accepted: 07/14/2020] [Indexed: 01/06/2023] Open
Abstract
Transforming growth factor beta (TGFβ) is a pleiotropic cytokine that plays a key role in both physiologic and pathologic conditions, including cancer. Importantly, TGFβ can exhibit both tumor-suppressive and oncogenic functions. In normal epithelial cells TGFβ acts as an antiproliferative and differentiating factor, whereas in advanced tumors TGFβ can act as an oncogenic factor by creating an immune-suppressive tumor microenvironment, and inducing cancer cell proliferation, angiogenesis, invasion, tumor progression, and metastatic spread. A wealth of preclinical findings have demonstrated that targeting TGFβ is a promising means of exerting antitumor activity. Based on this rationale, several classes of TGFβ inhibitors have been developed and tested in clinical trials, namely, monoclonal, neutralizing, and bifunctional antibodies; antisense oligonucleotides; TGFβ-related vaccines; and receptor kinase inhibitors. It is now >15 years since the first clinical trial testing an anti-TGFβ agent was engaged. Despite the promising preclinical studies, translation of the basic understanding of the TGFβ oncogenic response into the clinical setting has been slow and challenging. Here, we review the conclusions and status of all the completed and ongoing clinical trials that test compounds that inhibit the TGFβ pathway, and discuss the challenges that have arisen during their clinical development. With none of the TGFβ inhibitors evaluated in clinical trials approved for cancer therapy, clinical development for TGFβ blockade therapy is primarily oriented toward TGFβ inhibitor combinations. Immune checkpoint inhibitors are considered candidates, albeit with efficacy anticipated to be restricted to specific populations. In this context, we describe current efforts in the search for biomarkers for selecting the appropriate cancer patients who are likely to benefit from anti-TGFβ therapies. The knowledge accumulated during the last 15 years of clinical research in the context of the TGFβ pathway is crucial to design better, innovative, and more successful trials.
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Affiliation(s)
- D Ciardiello
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Department of Medicina di Precisione, Università degli studi della Campania, Luigi Vanvitelli, Naples, Italy
| | - E Elez
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - J Tabernero
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain; CIBERONC, Barcelona, Spain
| | - J Seoane
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain; CIBERONC, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
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Harding J, Hofheinz R, Elez E, Kuboki Y, Geng J, Schmohl M, Dowling E, Feng Y, Rasco D. P-169 A first-in-human phase Ia/b, open-label, multicentre, dose-escalation study of BI 905711 in patients with advanced gastrointestinal cancers. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.251] [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: 10/23/2022] Open
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21
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Garcia IM, Moreno A, Arenillas C, Carbo CH, Munoz-Cosuelo E, Martin-Liberal J, Braña I, Villar MV, Azaro A, Gadea OSS, Gonzalez IG, Javier R, Roger B, Elez E, Felip E, Dienstmann R, Gros A, Tabernero J, Toledo R, Garralda E. Early changes in plasma cell-free DNA (cfDNA) as a predictive biomarker of immune checkpoint inhibitors (ICIs) efficacy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz447.020] [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: 11/12/2022] Open
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22
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Nuciforo P, Jimenez J, Fasani R, Ruiz F, Sevillano C, Sanchez G, Martinez P, Serres X, Saura C, Elez E, Felip E, Oaknin A, Brana I, Muñoz-Couselo E, Macarulla Mercade T, Alsina Maqueda M, Carles J, Dienstmann R, Tabernero J, Garralda E. Prospective pathological experience with research biopsies in the context of clinical trials at Vall d’Hebron Institute of Oncology. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.013] [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: 11/12/2022] Open
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23
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Martini G, Elez E, Mancuso F, España MAG, Caratù G, Matito J, Martinez GA, Margalef NM, Morales MJO, Montana FJR, Garcia A, Comas R, Vivas CS, Perez-Lopez R, Nuciforo P, Casanovas O, Dienstmann R, Tabernero J, Aguilar EA, Vivancos A. RAS mutant allele fraction in plasma predicts benefit to anti-angiogenic based first-line treatment in metastatic colorectal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.052] [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
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24
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Cardone C, Blauensteiner B, Moreno-Viedma V, Vitiello P, Martini G, Ciardiello D, Simeon V, Rachiglio A, Rizzi D, Maiello E, Latiano T, Cremolini C, Argiles Martinez G, Elez E, Falcone A, Tabernero J, Normanno N, Sibilia M, Ciardiello F, Martinelli E. AXL expression predicts poor prognosis and lack of efficacy of anti-angiogenic and anti-epidermal growth factor receptor (EGFR) agents in patients (pts) with RAS wild type (WT) metastatic colorectal cancer (mCRC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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25
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Diaz L, Le D, Maio M, Ascierto P, Geva R, Motola-Kuba D, André T, Van Cutsem E, Gottfried M, Elez E, Delord JP, Jäger D, Kim T, Guimbaud R, Yoshino T, Chen M, Norwood K, Marinello P, Marabelle A. Pembrolizumab in microsatellite instability high cancers: Updated analysis of the phase II KEYNOTE-164 and KEYNOTE-158 studies. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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26
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Ligero M, Garcia-Ruiz A, Viaplana C, Raciti M, Matos I, Liberal JM, Hierro C, Gonzalez M, Barrera RM, Suárez C, Elez E, Brana I, Muñoz-Couselo E, Oaknin A, Felip E, Tabernero J, Carles J, Dienstmann R, Garralda E, Lopez RP. Artificial intelligence combining radiomics and clinical data for predicting response to immunotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Borrero-Palacios A, Cebrián A, Gómez Del Pulgar MT, García-Carbonero R, Garcia-Alfonso P, Aranda E, Elez E, López-López R, Cervantes A, Valladares M, Nadal C, Viéitez JM, Guillén-Ponce C, Rodríguez J, Hernández I, García JL, Vega-Bravo R, Puime-Otin A, Martínez-Useros J, Del Puerto-Nevado L, Rincón R, Rodríguez-Remírez M, Rojo F, García-Foncillas J. Author Correction: Combination of KIR2DS4 and FcγRIIa polymorphisms predicts the response to cetuximab in KRAS mutant metastatic colorectal cancer. Sci Rep 2019; 9:7706. [PMID: 31097738 PMCID: PMC6522500 DOI: 10.1038/s41598-019-43809-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- A Borrero-Palacios
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - A Cebrián
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain.
| | - M T Gómez Del Pulgar
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | | | - P Garcia-Alfonso
- Medical Oncology Department, Hospital Gral. Univ. Gregorio Marañón, Madrid, Spain
| | - E Aranda
- Medical Oncology Department, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - E Elez
- Medical Oncology Department, Hospital Vall d'Hebrón, Barcelona, Spain
| | - R López-López
- Medical Oncology Department, Complexo Hospitalario Universitario Santiago de Compostela, Galicia, Spain
| | - A Cervantes
- Medical Oncology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - M Valladares
- Medical Oncology Department, Complejo Hospitalario Universitario A Coruña, Galicia, Spain
| | - C Nadal
- Medical Oncology Department, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - J M Viéitez
- Medical Oncology Department, Hospital Universitario Central de Asturias, Asturias, Spain
| | - C Guillén-Ponce
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J Rodríguez
- Medical Oncology Department, Clínica Universitaria de Navarra, Navarra, Spain
| | - I Hernández
- Medical Oncology Department, Complejo Hospitalario de Navarra, Navarra, Spain
| | - J L García
- Oncology, Medical Unit, Merck S.L, an affiliate of Merck KGaA, Darmstadt, Germany
| | - R Vega-Bravo
- Anatomopathology Department, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - A Puime-Otin
- Anatomopathology Department, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - J Martínez-Useros
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - L Del Puerto-Nevado
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - R Rincón
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - M Rodríguez-Remírez
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - F Rojo
- Anatomopathology Department, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - J García-Foncillas
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain.
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Borrero-Palacios A, Cebrián A, Gómez Del Pulgar MT, García-Carbonero R, Garcia-Alfonso P, Aranda E, Elez E, López-López R, Cervantes A, Valladares M, Nadal C, Viéitez JM, Guillén-Ponce C, Rodríguez J, Hernández I, García JL, Vega-Bravo R, Puime-Otin A, Martínez-Useros J, Del Puerto-Nevado L, Rincón R, Rodríguez-Remírez M, Rojo F, García-Foncillas J. Combination of KIR2DS4 and FcγRIIa polymorphisms predicts the response to cetuximab in KRAS mutant metastatic colorectal cancer. Sci Rep 2019; 9:2589. [PMID: 30796344 PMCID: PMC6385198 DOI: 10.1038/s41598-019-39291-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 12/13/2018] [Indexed: 12/20/2022] Open
Abstract
Cetuximab is a standard-of-care treatment for RAS wild-type metastatic colorectal cancer (mCRC) but not for those harbor a KRAS mutation since MAPK pathway is constitutively activated. Nevertheless, cetuximab also exerts its effect by its immunomodulatory activity despite the presence of RAS mutation. The aim of this study was to determine the impact of polymorphism FcγRIIIa V158F and killer immunoglobulin-like receptor (KIR) genes on the outcome of mCRC patients with KRAS mutations treated with cetuximab. This multicenter Phase II clinical trial included 70 mCRC patients with KRAS mutated. We found KIR2DS4 gene was significantly associated with OS (HR 2.27; 95% CI, 1.08–4.77; P = 0.03). In non-functional receptor homozygotes the median OS was 2.6 months longer than in carriers of one copy of full receptor. Multivariate analysis confirmed KIR2DS4 as a favorable prognostic marker for OS (HR 6.71) in mCRC patients with KRAS mutation treated with cetuximab. These data support the potential therapeutic of cetuximab in KRAS mutated mCRC carrying non-functional receptor KIR2DS4 since these patients significantly prolong their OS even after heavily treatment. KIR2DS4 typing could be used as predictive marker for identifying RAS mutated patients that could benefit from combination approaches of anti-EGFR monoclonal antibodies and other immunotherapies to overcome the resistance mediated by mutation in RAS.
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Affiliation(s)
- A Borrero-Palacios
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - A Cebrián
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain.
| | - M T Gómez Del Pulgar
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | | | - P Garcia-Alfonso
- Medical Oncology Department, Hospital Gral. Univ. Gregorio Marañón, Madrid, Spain
| | - E Aranda
- Medical Oncology Department, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - E Elez
- Medical Oncology Department, Hospital Vall d'Hebrón, Barcelona, Spain
| | - R López-López
- Medical Oncology Department, Complexo Hospitalario Universitario Santiago de Compostela, Galicia, Spain
| | - A Cervantes
- Medical Oncology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - M Valladares
- Medical Oncology Department, Complejo Hospitalario Universitario A Coruña, Galicia, Spain
| | - C Nadal
- Medical Oncology Department, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - J M Viéitez
- Medical Oncology Department, Hospital Universitario Central de Asturias, Asturias, Spain
| | - C Guillén-Ponce
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J Rodríguez
- Medical Oncology Department, Clínica Universitaria de Navarra, Navarra, Spain
| | - I Hernández
- Medical Oncology Department, Complejo Hospitalario de Navarra, Navarra, Spain
| | - J L García
- Oncology, Medical Unit, Merck S.L, an affiliate of Merck KGaA, Darmstadt, Germany
| | - R Vega-Bravo
- Anatomopathology Department, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - A Puime-Otin
- Anatomopathology Department, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - J Martínez-Useros
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - L Del Puerto-Nevado
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - R Rincón
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - M Rodríguez-Remírez
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - F Rojo
- Anatomopathology Department, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain
| | - J García-Foncillas
- Translational Oncology Division, Oncohealth Institute, Hospital Universitario "Fundación Jimenez Diaz", Madrid, Spain.
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Van Cutsem E, Cuyle P, Huijberts S, Schellens J, Elez E, Yaeger R, Fakih M, Montagut C, Peeters M, Desai J, Yoshino T, Ciardiello F, Wasan H, Maharry K, Christy-Bittel J, Gollerkeri A, Kopetz S, Grothey A, Tabernero J. BEACON CRC study safety lead-in: Assessment of the BRAF inhibitor encorafenib + MEK inhibitor binimetinib + anti–epidermal growth factor receptor antibody cetuximab for BRAFV600E metastatic colorectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Vidal J, Dalmeses A, Vivas CS, Garcia-Carbonero R, García-Alfonso P, Carrato A, Elez E, Ortiz M, Losa F, Massutí B, Valladares-Ayerbes M, Manzano J, de Prado JV, Gallego J, Grávalos C, Varela M, Azuara D, Tabernero J, Salazar R, Aranda E, Bellosillo B, Montagut C. Ultra-selection of metastatic colorectal cancer patients using next generation sequencing platform to improve clinical efficacy of anti-EGFR therapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Grasselli J, Elez E, Caratù G, Matito J, Santos C, Macarulla T, Vidal J, Garcia M, Viéitez JM, Paéz D, Falcó E, Lopez Lopez C, Aranda E, Jones F, Sikri V, Nuciforo P, Fasani R, Tabernero J, Montagut C, Azuara D, Dienstmann R, Salazar R, Vivancos A. Concordance of blood- and tumor-based detection of RAS mutations to guide anti-EGFR therapy in metastatic colorectal cancer. Ann Oncol 2018; 28:1294-1301. [PMID: 28368441 PMCID: PMC5834108 DOI: 10.1093/annonc/mdx112] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Circulating tumor DNA (ctDNA) is a potential source for tumor genome analysis. We explored the concordance between the mutational status of RAS in tumor tissue and ctDNA in metastatic colorectal cancer (mCRC) patients to establish eligibility for anti-epidermal growth factor receptor (EGFR) therapy. Patients and methods A prospective-retrospective cohort study was carried out. Tumor tissue from 146 mCRC patients was tested for RAS status with standard of care (SoC) PCR techniques, and Digital PCR (BEAMing) was used both in plasma and tumor tissue. Results ctDNA BEAMing RAS testing showed 89.7% agreement with SoC (Kappa index 0.80; 95% CI 0.71 − 0.90) and BEAMing in tissue showed 90.9% agreement with SoC (Kappa index 0.83; 95% CI 0.74 − 0.92). Fifteen cases (10.3%) showed discordant tissue-plasma results. ctDNA analysis identified nine cases of low frequency RAS mutations that were not detected in tissue, possibly due to technical sensitivity or heterogeneity. In six cases, RAS mutations were not detected in plasma, potentially explained by low tumor burden or ctDNA shedding. Prediction of treatment benefit in patients receiving anti-EGFR plus irinotecan in second- or third-line was equivalent if tested with SoC PCR and ctDNA. Forty-eight percent of the patients showed mutant allele fractions in plasma below 1%. Conclusions Plasma RAS determination showed high overall agreement and captured a mCRC population responsive to anti-EGFR therapy with the same predictive level as SoC tissue testing. The feasibility and practicality of ctDNA analysis may translate into an alternative tool for anti-EGFR treatment selection.
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Affiliation(s)
- J Grasselli
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology, Barcelona.,Department of Medical Oncology, Catalan Institute of Oncology, Universitat de Barcelona, L'Hospitalet, Barcelona
| | - E Elez
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology, Barcelona.,Department of Medical Oncology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona
| | - G Caratù
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology, Barcelona
| | - J Matito
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology, Barcelona
| | - C Santos
- Department of Medical Oncology, Catalan Institute of Oncology, Universitat de Barcelona, L'Hospitalet, Barcelona
| | - T Macarulla
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology, Barcelona.,Department of Medical Oncology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona
| | - J Vidal
- Department of Medical Oncology, Del Mar University Hospital, Barcelona
| | - M Garcia
- Department of Medical Oncology, Catalan Institute of Oncology, Universitat de Barcelona, L'Hospitalet, Barcelona
| | - J M Viéitez
- Department of Medical Oncology, Asturias University Hospital, Oviedo
| | - D Paéz
- Department of Medical Oncology, Santa Creu i Sant Pau University Hospital, Barcelona
| | - E Falcó
- Department of Medical Oncology, Son Llatzer University Hospital, Palma de Mallorca
| | - C Lopez Lopez
- Department of Medical Oncology, Marques de Valdecilla University Hospital, Santander
| | - E Aranda
- Department of Medical Oncology, Reina Sofía University Hospital, Córdoba, Spain
| | - F Jones
- Sysmex Inostics, Mundelein, USA
| | - V Sikri
- Sysmex Inostics, Mundelein, USA
| | - P Nuciforo
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology, Barcelona
| | - R Fasani
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology, Barcelona
| | - J Tabernero
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology, Barcelona.,Department of Medical Oncology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona
| | - C Montagut
- Department of Medical Oncology, Del Mar University Hospital, Barcelona
| | - D Azuara
- Traslational Research Laboratory, Catalan Institute of Oncology, L'Hospitalet, Barcelona
| | - R Dienstmann
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology, Barcelona.,Oncology Data Science Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - R Salazar
- Department of Medical Oncology, Catalan Institute of Oncology, Universitat de Barcelona, L'Hospitalet, Barcelona
| | - A Vivancos
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology, Barcelona
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Abstract
The MAPK cascade plays a crucial role in tumor cell proliferation and survival. Accumulating evidence suggests that mutations in the BRAF oncogene are not only associated with poor prognosis but also linked with less benefit when treated with anti-epidermal growth factor receptor antibodies in metastatic colorectal cancer (mCRC). Targeting this molecular aberration has thus become a matter of particular interest in mCRC drug development. In contrast to other malignances such as BRAF mutant melanoma, efficacy observed with BRAF inhibitors in monotherapy in mCRC is poor. Several mechanisms of resistance have been identified leading to the development of different treatment strategies that have shown promising activity in early clinical trials. Hence, rational combination of targeted therapies is expected to further increase the efficacy of selective BRAF inhibitors. Herein, we discuss the main clinical and molecular characteristics of BRAF mutant colorectal cancer and its translation into the clinic, with a focus on developmental therapeutics and combination strategies. In addition, we contextualize the available data with potential future approaches that include the extended access to next-generation sequencing platforms and gene expression strategies for molecular subtyping. These approaches will facilitate the identification of certain patient profiles providing more therapeutic possibilities.
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Affiliation(s)
- E Sanz-Garcia
- Medical Oncology Department, Vall D'Hebron University Hospital, Barcelona;; Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - G Argiles
- Medical Oncology Department, Vall D'Hebron University Hospital, Barcelona;; Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - E Elez
- Medical Oncology Department, Vall D'Hebron University Hospital, Barcelona;; Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - J Tabernero
- Medical Oncology Department, Vall D'Hebron University Hospital, Barcelona;; Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
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Huijberts S, Schellens J, Elez E, Cuyle PJ, Van Cutsem E, Yaeger R, Fakih M, Montagut C, Peeters M, Desai J, Yoshino T, Ciardiello F, Wasan H, Grothey A, Maharry K, Gollerkeri A, Kopetz S. BEACON CRC: safety lead-in (SLI) for the combination of binimetinib (BINI), encorafenib (ENCO), and cetuximab (CTX) in patients (pts) with BRAF-V600E metastatic colorectal cancer (mCRC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mehnert J, Rugo H, O'Neil B, Santoro A, Schellens J, Cohen R, Doi T, Ott P, Pishvaian M, Puzanov I, Aung K, Hsu C, Le Tourneau C, Soria JC, Elez E, Tamura K, Gould M, Zhao G, Stein K, Piha-Paul S. Pembrolizumab for patients with PD-L1–positive advanced carcinoid or pancreatic neuroendocrine tumors: Results from the KEYNOTE-028 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx368] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Salazar R, Azuara D, Viéitez J, Paez D, Santos C, Falcó E, Elez E, López López C, Valladares-Ayerbes M, Robles L, Garcia-Alfonso P, Buges C, Duran Ogaya G, Salud Salvia M, Navarro V, Capella G, Aranda Aguilar E. ULTRA clinical trial: Prospective comparative clinical outcome analysis of three different RAS/BRAF sensitivity mutational cut-offs. A Phase II study of the Spanish TTD Group. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Diaz L, Marabelle A, Kim T, Geva R, Van Cutsem E, André T, Ascierto P, Maio M, Delord JP, Gottfried M, Guimbaud R, Jaeger D, Elez E, Yoshino T, Joe A, Lam B, Ding J, Pruitt S, Kang S, Le D. Efficacy of pembrolizumab in phase 2 KEYNOTE-164 and KEYNOTE-158 studies of microsatellite instability high cancers. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx367.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Corcoran R, André T, Yoshino T, Bendell J, Atreya C, Schellens J, Ducreux M, McRee A, Siena S, Middleton G, Gordon M, Humblet Y, Muro K, Elez E, Yaeger R, Sidhu R, Squires M, Jaeger S, Rangwala F, Van Cutsem E. Efficacy and circulating tumor DNA (ctDNA) analysis of the BRAF inhibitor dabrafenib (D), MEK inhibitor trametinib (T), and anti-EGFR antibody panitumumab (P) in patients (pts) with BRAF V600E–mutated (BRAFm) metastatic colorectal cancer (mCRC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.04] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Azuara D, Garcia-Carbonero R, Alfonso PG, Santos-Vivas C, Navarro V, Varela M, Carrato A, Elez E, Cano M, Losa F, Montagut C, Sureda BM, Manzano J, Vieitez J, Valladares-Ayerbes M, Sanjuan X, Capellá G, Tabernero J, Aranda E, Salazar R. Extended genotyping of RAS/BRAF for improved selection of metastatic CRC patients to anti-EGFR therapy: Comparison of three platforms. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.05] [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
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Grasselli J, Elez E, Martinez GA, Sanz-Garcia E, Macarulla T, Capdevila J, Alsina M, Sauri T, Hierro C, Verdaguer H, Matos I, Garcia A, Nuciforo P, Landolfi S, Palmer HG, Dienstmann R, Vivancos A, Tabernero J. Molecular, clinical and prognostic characterization of double KRAS/PIK3CA (dKP) mutated metastatic colorectal cancer (mCRC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Verdaguer H, Sauri T, Ruiz F, Vivancos A, Nuciforo P, Capdevila J, Elez E, Alsina M, Martinez GA, Hierro C, Grasselli J, Matos I, Tabernero J, Dienstmann R, Macarulla T. Prognostic impact of KRAS mutation in metastatic (met) pancreatic cancer patients (pts). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.80] [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: 11/14/2022] Open
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Sauri T, Awada A, Calvo E, Moreno V, Szyldergemajn S, Elez E, Barthelemy P, Boni V, Doger B, Teruel CF, Soto-Matos A, Tabernero J, Aftimos P. Lurbinectedin (PM01183) administered once (D1) every 3 weeks (q3w) in combination with capecitabine (XEL) in patients (pts) with metastatic breast (MBC), colorectal (CRC) or pancreatic (PaC) cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw368.35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wilson R, Middleton M, Houlden J, Van Schaeybroeck S, Rolfo C, Elez E, Taieb J, André T, Bardelli A, Laurent-Puig P, Tabernero J, Peeters M, Maughan T, Roberts C, Love S, Lawler M, Salto-Tellez M, Grayson M, Popovici V, Di Nicolantonio F. MErCuRIC1: A phase 1a study of MEK1/2 inhibitor PD-0325901 with cMET inhibitor crizotinib in patients with advanced solid tumours. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.28] [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
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Tabernero J, van Geel R, Guren T, Yaeger R, Spreafico A, Faris J, Yoshino T, Yamada Y, Kim Tae W, Bendell J, Schuler M, Lenz HJ, Eskens F, Desai J, Hochster H, Avsar E, Demuth T, Sandor V, Elez E, Schellens J. O-026 Combination of encorafenib and cetuximab with or without alpelisib in patients with advanced BRAF-mutant colorectal cancer (BRAFm CRC): phase 2 results. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw198.25] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Grasselli J, Elez E, Caratù G, Matito J, Santos C, Macarulla T, Vidal J, Garcia M, Viéitez J, Paéz D, Falcó E, Lopez CL, Aranda E, Jones F, Sikri V, Nuciforo P, Dienstmann R, Montagut C, Tabernero J, Azuara D, Salazar R, Vivancos A. O-024 Circulating tumor DNA extended RAS mutational analysis as a surrogate of mutational status of tumor samples in metastatic colorectal cancer and its impact on patient selection for anti-EGFR therapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw198.24] [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: 11/12/2022] Open
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Elez E, Hendlisz A, Delaunoit T, Sastre J, Cervantes A, Varea R, Chao G, Wallin J, Tabernero J. Phase II study of necitumumab plus modified FOLFOX6 as first-line treatment in patients with locally advanced or metastatic colorectal cancer. Br J Cancer 2016; 114:372-80. [PMID: 26766738 PMCID: PMC4815776 DOI: 10.1038/bjc.2015.480] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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] [Revised: 12/04/2015] [Accepted: 12/14/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND This single-arm phase II study investigated the EGFR monoclonal antibody necitumumab plus modified FOLFOX6 (mFOLFOX6) in first-line treatment of locally advanced or metastatic colorectal cancer (mCRC). METHODS Patients received 800-mg intravenous necitumumab (day 1; 2-week cycles), followed by oxaliplatin 85 mg m(-2), folinic acid 400 mg m(-2), and 5-fluorouracil (400 mg m(-2) bolus then 2400 mg m(-2) over 46 h). Radiographic evaluation was performed every 8 weeks until progression. Primary endpoint was objective response rate. RESULTS Forty-four patients were enrolled and treated. Objective response rate was 63.6% (95% confidence interval 47.8-77.6); complete response was observed in four patients; median duration of response was 10.0 months (7.0-16.0). Median overall survival (OS) and progression-free survival (PFS) were 22.5 (11.0-30.0) and 10.0 months (7.0-12.0), respectively. Clinical outcome was better in patients with KRAS exon 2 wild type (median OS 30.0 months (23.0-NA); median PFS 12.0 (8.0-20.0)), compared with KRAS exon 2 mutant tumours (median OS 7.0 months (5.0-37.0); median PFS 7.0 (4.0-18.0)). The most common grade ⩾3 adverse events were neutropenia (29.5%), asthenia (27.3%), and rash (20.5%). CONCLUSION First-line necitumumab+mFOLFOX6 was active with manageable toxicity in locally advanced or mCRC; additional evaluation of the impact of tumour RAS mutation status is warranted.
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Affiliation(s)
- E Elez
- Vall d'Hebron Institute of Oncology Barcelona, Spain and Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
| | - A Hendlisz
- Institut Jules Bordet, 1000 Brussels, Belgium
| | - T Delaunoit
- Centres Hospitaliers Jolimont, 7100 Haine Saint-Paul, Belgium
| | - J Sastre
- Hospital Universitario San Carlos, 28040 Madrid, Spain
| | - A Cervantes
- Biomedical Research Institute INCLIVA, University of Valencia, 46010 Valencia, Spain
| | - R Varea
- Eli Lilly and Company, 28108 Madrid, Spain
| | - G Chao
- Eli Lilly and Company, 08807 Bridgewater, NJ, USA
| | - J Wallin
- Eli Lilly and Company, 16973 Stockholm, Sweden
| | - J Tabernero
- Vall d'Hebron Institute of Oncology Barcelona, Spain and Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
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Sauri T, Macarulla T, Sanz-Garcia E, Moreno D, Vilaro M, Vivancos A, Elez E, Argil és G, Grasselli J, Capdevila J, Alsina M, Hierro C, Matos I, Dientsmann R, Nuciforo P, Tabernero J. 2399 Impact of KRAS mutations on clinical outcomes in advanced refractory pancreatic cancer patients. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31315-6] [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]
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Sotelo L, Sastre J, García-Paredes B, Cabezas-Camarero S, Vieitez J, Alonso V, Grávalos C, Escudero P, Vera R, Aranda E, García-Alfonso P, Gallego-Plazas J, Lopez C, Pericay C, Arrivi A, Vicente P, Ballesteros P, Elez E, Lopez-Ladron A, Diaz-Rubio E. 2033 Stage III colorectal cancer (CRC) in Spain: A retrospective analysis from 35 centres. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30956-x] [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]
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Segelov E, Thavaneswaran S, Waring P, Desai J, Mann K, Elez E, Chantrill L, Pavlakis N, Nott L, Underhill C, Khasraw M, Wasan H, Ciardiello F, Jefford M, Joubert W, Haydon A, Karapetis C, Price T, Wilson K, Shapiro J. 32LBA The AGITG ICECREAM Study: The Irinotecan Cetuximab Evaluation and Cetuximab Response Evaluation Amongst Patients with a G13D Mutation – analysis of outcomes in patients with refractory metastatic colorectal cancer harbouring the KRAS G13D mutation. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(15)30078-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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O'Neil B, Wallmark J, Lorente D, Elez E, Raimbourg J, Gomez-Roca C, Ejadi S, Piha-Paul S, Moss R, Siu L, Dotti K, Santoro A, Gould M, Yuan S, Koshiji M, Han S. 502 Pembrolizumab (MK-3475) for patients (pts) with advanced colorectal carcinoma (CRC): Preliminary results from KEYNOTE-028. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30304-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Elez E, Schellens J, van Geel R, Bendell J, Spreafico A, Schuler M, Yoshino T, Delord JP, Yamada Y, Lolkema M, Faris J, Eskens F, Sharma S, Yaeger R, Lenz HJ, Wainberg Z, Avsar E, Chatterjee A, Jaeger S, Demuth T, Tabernero J. LBA-08 Results of a phase 1b study of the selective BRAF V600 inhibitor encorafenib in combination with cetuximab alone or cetuximab + alpelisib for treatment of patients with advanced BRAF-mutant metastatic colorectal cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv262.08] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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