1
|
Fernandez-Martos C, Romero I, Aparicio J, Bosch C, Girones R, Campos JM, Garcera S, Safont MJ, Maeztu I, Climent MA. Preoperative uracil/tegafur and concomitant radiotherapy in locally advanced rectal (LAR) cancer: Updated results with a median follow-up of 5 years and analysis of prognostic factors (PF). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
3573 Background: Preop chemoradiotherapy (CRT) with CI 5-FU is a standard of care for LAR cancer. Oral fluoropyrimidines, an attractive alternative to intravenous 5-FU, are perceived by patients as more convenient. Methods: We performed a phase II study in patients with potentially resectable tumors, localized in middle or distal rectum, ultrasonographically staged as T3 or T4 or N+ who were treated with UFT (400 mg/m2/d, 5 days a week for 5 weeks) and concomitant RT to the pelvis (45 Gy; 1.8 Gy/d over 5 weeks). Pts underwent surgery 5 to 6 weeks later followed by four cycles of 5-FU/LV (Mayo Clinic Scheme). Early end points of efficacy (pCR, downstaging, sphincter preserving surgery) and toxicity have already been reported (JCO 2004;22:3016). We now present data on secondary objectives (RFS, DFS and OS) and univariate and multivariate analysis of clinical and pathological PF. Results: 94 patients were included and complete information on 88 (94%) is availablewith a median follow-up of 5 years (60.4 months). Actuarial Kaplan-Meier DFS, RFS and OS are 61%, 66%, and 70 %. Patterns of failure are 7% pelvic and 25% distant. Univariate analysis results are shown in the table . Survival rate was also higher among patients with no or few residual disease after CRT but did not reach statistical significance. In Cox multivariate analysis both ypT and ypN are independent PF for DFS and RFS but only ypT is an independent PF for OS. Conclusions: This approach with preop UFT/RT reproduces the results that have been accomplished with 5-FU. ypT and ypN could be helpful to identify different risk groups and to select adjuvant treatments. [Table: see text] No significant financial relationships to disclose.
Collapse
Affiliation(s)
- C. Fernandez-Martos
- Fundacion Instituto Valenciano De Oncologia, Valencia, Spain; Hospital U. La Fe, Valencia, Spain; Hospital U. Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyiz, Jativa, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de la Ribera, Alcira, Spain; Hospital General Universitario, Valencia, Spain; Hospital Virgen de los Lirios, Alcoy, Spain
| | - I. Romero
- Fundacion Instituto Valenciano De Oncologia, Valencia, Spain; Hospital U. La Fe, Valencia, Spain; Hospital U. Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyiz, Jativa, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de la Ribera, Alcira, Spain; Hospital General Universitario, Valencia, Spain; Hospital Virgen de los Lirios, Alcoy, Spain
| | - J. Aparicio
- Fundacion Instituto Valenciano De Oncologia, Valencia, Spain; Hospital U. La Fe, Valencia, Spain; Hospital U. Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyiz, Jativa, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de la Ribera, Alcira, Spain; Hospital General Universitario, Valencia, Spain; Hospital Virgen de los Lirios, Alcoy, Spain
| | - C. Bosch
- Fundacion Instituto Valenciano De Oncologia, Valencia, Spain; Hospital U. La Fe, Valencia, Spain; Hospital U. Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyiz, Jativa, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de la Ribera, Alcira, Spain; Hospital General Universitario, Valencia, Spain; Hospital Virgen de los Lirios, Alcoy, Spain
| | - R. Girones
- Fundacion Instituto Valenciano De Oncologia, Valencia, Spain; Hospital U. La Fe, Valencia, Spain; Hospital U. Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyiz, Jativa, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de la Ribera, Alcira, Spain; Hospital General Universitario, Valencia, Spain; Hospital Virgen de los Lirios, Alcoy, Spain
| | - J. M. Campos
- Fundacion Instituto Valenciano De Oncologia, Valencia, Spain; Hospital U. La Fe, Valencia, Spain; Hospital U. Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyiz, Jativa, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de la Ribera, Alcira, Spain; Hospital General Universitario, Valencia, Spain; Hospital Virgen de los Lirios, Alcoy, Spain
| | - S. Garcera
- Fundacion Instituto Valenciano De Oncologia, Valencia, Spain; Hospital U. La Fe, Valencia, Spain; Hospital U. Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyiz, Jativa, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de la Ribera, Alcira, Spain; Hospital General Universitario, Valencia, Spain; Hospital Virgen de los Lirios, Alcoy, Spain
| | - M. J. Safont
- Fundacion Instituto Valenciano De Oncologia, Valencia, Spain; Hospital U. La Fe, Valencia, Spain; Hospital U. Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyiz, Jativa, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de la Ribera, Alcira, Spain; Hospital General Universitario, Valencia, Spain; Hospital Virgen de los Lirios, Alcoy, Spain
| | - I. Maeztu
- Fundacion Instituto Valenciano De Oncologia, Valencia, Spain; Hospital U. La Fe, Valencia, Spain; Hospital U. Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyiz, Jativa, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de la Ribera, Alcira, Spain; Hospital General Universitario, Valencia, Spain; Hospital Virgen de los Lirios, Alcoy, Spain
| | - M. A. Climent
- Fundacion Instituto Valenciano De Oncologia, Valencia, Spain; Hospital U. La Fe, Valencia, Spain; Hospital U. Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyiz, Jativa, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de la Ribera, Alcira, Spain; Hospital General Universitario, Valencia, Spain; Hospital Virgen de los Lirios, Alcoy, Spain
| |
Collapse
|
2
|
Garrido P, Massutí B, Cardenal F, Moran T, Alberola V, Maeztu I, Dómine M, Isla D, Arellano A, Ramos A. Induction (I) or consolidation (C) chemotherapy with docetaxel (D) and gemcitabine (G) plus concomitant chemoradiotherapy (CT/TRT) with docetaxel and carboplatin (Cb) for unresectable stage III non-small cell lung cancer (NSCLC) patients (p). Initial report of the randomized phase II trial SLCG 0008. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P. Garrido
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - B. Massutí
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - F. Cardenal
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - T. Moran
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - V. Alberola
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - I. Maeztu
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - M. Dómine
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - D. Isla
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - A. Arellano
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - A. Ramos
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| |
Collapse
|
3
|
Cortes-Funes H, Gomez C, Rosell R, Valero P, Garcia-Giron C, Velasco A, Izquierdo A, Diz P, Camps C, Castellanos D, Alberola V, Cardenal F, Gonzalez-Larriba JL, Vieitez JM, Maeztu I, Sanchez JJ, Queralt C, Mayo C, Mendez P, Moran T, Taron M. Epidermal growth factor receptor activating mutations in Spanish gefitinib-treated non-small-cell lung cancer patients. Ann Oncol 2005; 16:1081-6. [PMID: 15851406 DOI: 10.1093/annonc/mdi221] [Citation(s) in RCA: 196] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND North American and Japanese non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) activation via tyrosine kinase (TK) mutations respond dramatically to gefitinib treatment. To date, however, the frequency and effect of EGFR TK mutations have not been examined in European patients. PATIENTS AND METHODS Eighty-three Spanish advanced NSCLC patients who had progressed after chemotherapy, were treated with compassionate use of gefitinib. Patients were selected on the basis of available tumor tissue. Tumor genomic DNA was retrieved from paraffin-embedded tissue obtained by laser capture microdissection. EGFR mutations in exons 19 and 21 were examined by direct sequencing. RESULTS EGFR mutations were found in 10 of 83 (12%) of patients. All mutations were found in adenocarcinomas, more frequently in females (P=0.007) and non-smokers (P=0.01). Response was observed in 60% of patients with mutations and 8.8% of patients with wild-type EGFR (P=0.001). Time to progression for patients with mutations was 12.3 months, compared with 3.6 months for patients with wild-type EGFR (P=0.002). Median survival was 13 months for patients with mutations and 4.9 months for those with wild-type EGFR (P=0.02). CONCLUSIONS EGFR TK mutational analysis is a novel predictive test for selecting lung adenocarcinoma patients for targeted therapy with EGFR TK inhibitors.
Collapse
|