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Fernández-Sala X, Barceló-Vidal J, Tusquets I, Conde-Estévez D. Effectiveness and safety of a novel dexamethasone mouthwash formulation in managing stomatitis in cancer patients. Farm Hosp 2020; 45:41-44. [PMID: 33443477 DOI: 10.7399/fh.11460] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To present a new dexamethasone mouthwash formulation and analyze its effectiveness and safety among patients receiving stomatitis-producing antineoplastic agents. METHOD Prospective observational study conducted in a university hospital between March 2017 and November 2019. Consecutive patients starting everolimus were enrolled. Patients were instructed to rinse dexamethasone mouthwash formulation twice daily until discontinuation of everolimus. A second cohort of patients with existing stomatitis induced by high probability of producing stomatitis chemotherapy therapies was also recruited to assess treatment effectiveness. Effectiveness and safety of dexamethasone mouthwash formulation was assessed. RESULTS Dexamethasone mouthwash formulation was prescribed in nine patients as prophylaxis. Six patients were diagnosed with breast cancer, two with neuroendocrine tumor and one with renal cell carcinoma. Four patients developed mild stomatitis (grade 1-2) and three patients discontinued everolimus due to other treatment-related adverse events. In addition, dexamethasone mouthwash formulation was prescribed as treatment in five patients with existing stomatitis. All patients achieved a significant reduction in the severity of stomatitis after starting the dexamethasone mouthwash formulation. In both cohorts, dexamethasone mouthwash formulation was well tolerated and neither dose reduction nor discontinuation related to stomatitis was required. CONCLUSIONS Dexamethasone mouthwash formulation could be considered as a suitable alternative for stomatitis management.
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Affiliation(s)
| | | | - Ignasi Tusquets
- Department of Medical Oncology, Hospital Universitari del Mar, Barcelona. Spain. Hospital del Mar Research Insitute (IMIM), Barcelona. Spain. Universitat Autónoma de Barcelona, Barcelona. Spain..
| | - David Conde-Estévez
- Department of Pharmacy, Hospital Universitari del Mar, Barcelona. Spain. Hospital del Mar Research Insitute (IMIM), Barcelona. Spain. Universitat Autónoma de Barcelona, Barcelona. Spain..
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Pineda-Moncusí M, Vilalta-Carrera A, Ovejero D, Aymar I, Servitja S, Tusquets I, Prieto-Alhambra D, Díez-Pérez A, García-Giralt N, Nogués X. Persistencia a los inhibidores de la aromatasa en la cohorte SIDIAP: mortalidad e influencia de los bifosfonatos. Rev Osteoporos Metab Miner 2020. [DOI: 10.4321/s1889-836x2020000300003] [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: 11/11/2022] Open
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Bianchini G, Smart C, Mansutti M, Lück HJ, Zambelli S, Olier C, Anton A, Bisagni G, Merlini L, Murillo SM, Calvo Martínez L, Chacon JI, Semiglazov V, Thill M, Chan A, Tusquets I, Licata L, Valagussa P, Viale G, Gianni L. Modulation by treatment of tumor infiltrating lymphocytes (TILs) and PDL1 expression in triple-negative breast cancer in the ETNA trial. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
555 Background: We assessed TILs and PDL1 expression before, during and after neoadjuvant treatment in TNBC patients enrolled in the ETNA study, and investigated associations with clinical outcome. Methods: In ETNA patients randomly received paclitaxel or nab-paclitaxel followed by 4 cycles of an anthracycline regimen, including 219 centrally confirmed TNBC. We successfully measured stromal and intratumoral TILs (sTILs, iTILs) and PDL1 status (Ventana SP142, IC≥1%) on biopsies before [n = 186/213 (84.9%)], on d1 cycle 2 (d1c2) of therapy [n = 41/186 (22.0%)], and at surgery [SX, n = 65/129 (34.9%)]. We investigated the expression and modulation over time of TILs and PDL1 and their association with pCR and event-free survival (EFS). Results: Prevalence of PDL1+ was 35.5% (baseline), 20.6% (d1c2) and 30.1% (SX). At each time-point sTILs and iTILs were higher in PDL1+ cases (p≤0.01). An effect of age of the tumor blocks (5-7.5 years) or pre-analytical issues could not be ruled out for the relatively low rate of PDL1 positivity. Paired PDL1 at baseline and d1c2 showed conversion in 25.7% (pos to neg [11.4%] or neg to pos [14.3%]). Comparing PDL1 at baseline and SX, the conversion rate was 30% (pos to neg [8.3%] or neg to pos [21.6%]). sTILs and iTILs significantly increased at cycle 2, more significantly in pCR (p≤0.001) than in RD (p≤0.05) cases, and a not significant trend of decrease was observed at surgery PDL1+ tumors had a higher pCR rate (54.7% vs 32.5%, p = 0.004). PDL1 retained significance (OR 2.00 [1.04-3.88], p = 0.039) after adjustment for sTILs (OR 1.21 [1.03-1.42], p = 0.021). High iTILs and sTILs at d1c2, but not PDL1 status, were predictive of pCR. Notably, adjusting for sTILs, PDL1+ tumors at d1c2 showed a trend for association with lower pCR rate (OR 0.06 [0.01-1.15], p = 0.062). sTILs at cycle 2 was the most informative variable (OR 1.61 [1.28-1.61], p = 0.004) and provided independent information to baseline biomarkers. Baseline PDL1 and biomarkers at cycle 2 were not associated with EFS. In surgical samples with RD, higher sTILs, but not iTILs and PDL1 status, were associated with a trend for a lower risk of recurrence (HR 0.19 [0.02-1.39], p = 0.068). Conclusions: sTILs assessment on core biopsies after one cycle of taxane is a promising early biomarker of pCR. PDL1, as well as sTILs and iTILs, provided independent prediction of pCR and were strongly modulated by treatment. The modulation of PDL1 expression should be considered whenever PDL1 is assessed in view of identifying candidates to atezolizumab in 1st line advanced setting.
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Affiliation(s)
| | | | | | | | | | - Clara Olier
- H Universitario Fundación Alcorcon, GEICAM Spanish Breast Cancer Group, Alcorcón, Spain
| | - Antonio Anton
- Hospital Universitario Miguel Servet, Geicam Spanish Breast Cancer Group, Zaragoza, Spain
| | | | | | | | - Lourdes Calvo Martínez
- Complejo Hospitalario Juan Canalejo, Geicam Spanish Breast Cancer Group, A Coruña, Spain
| | - Jose Ignacio Chacon
- Hospital Virgen de la Salud, Toledo; Geicam Spanish Breast Cancer Group, Spain
| | - Vladimir Semiglazov
- Federal State Budget Institution "National Medical Research Center of Oncology na N.N. Petrov" Ministry of Healthcare of Russian Federation, St. Petersburg, Russian Federation
| | - Marc Thill
- Agaplesion Markus Krankenhaus, Frankfurt Am Main, Germany
| | - Arlene Chan
- Breast Cancer Research Centre-Western Australia and Curtin University, Perth, Australia
| | - Ignasi Tusquets
- Hospital del Mar Research Institute (IMIM), Barcelona; Geicam Spanish Breast Cancer Group, Spain
| | | | | | - Giuseppe Viale
- Division of Pathology, European Institute of Oncology, IRCCS, Milan, Italy
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Pineda-Moncusí M, Garcia-Giralt N, Diez-Perez A, Tusquets I, Servitja S, Albanell J, Prieto-Alhambra D, Nogués X. Thromboembolic, cardiovascular and overall mortality risks of aromatase inhibitors, compared with tamoxifen treatment: an outpatient-register-based retrospective cohort study. Ther Adv Med Oncol 2020; 12:1758835920909660. [PMID: 32231712 PMCID: PMC7097872 DOI: 10.1177/1758835920909660] [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: 05/01/2019] [Accepted: 01/20/2020] [Indexed: 01/12/2023] Open
Abstract
Background: Tamoxifen (TAM) and aromatase inhibitor (AI) therapies have been associated with increased risk of thromboembolic and cardiovascular events, respectively, in addition to other side effects. This study analysed the risk of these events and the overall survival (OS) benefit in breast cancer patients treated with AI, compared with TAM-treated patients, in a large population-based cohort. Methods: This observational cohort study included women diagnosed with breast cancer and treated with TAM or AI. Data were extracted from primary care records in a population database (SIDIAP, System for the Development of Research in Primary Care). Incidence rates of study outcomes are reported. Survival analyses included Kaplan–Meier estimation and Cox proportional hazards models. Sensitivity analysis was carried out, using Fine and Gray models to account for competing risk of death. Confounding was minimized using propensity score adjustment and inverse probability weighting (IPW) adjustment. Results: Data from 3082 postmenopausal women treated with TAM, and 18,455 treated with AI, were available. Adjusted hazard ratios (HRs) [95% confidence interval (CI)] for AI users, compared with TAM group, were 0.93 (95%CI 0.69–1.26) for thromboembolic events (TEEs); 1.13 (95%CI 0.79–1.63) for cardiovascular events, and 0.76 (95%CI 0.70–0.82) for mortality. Additional analyses using competing risk analysis had similar results, while IPW adjustment showed a potential risk of pulmonary embolism (PE) [2.26 (95%CI 1.02–4.97)] in AI-treated patients. Conclusions: AI users had >20% lower all-cause mortality compared with TAM users, without increasing risk to experience cardiovascular and TEEs. This would locate AI therapy on the first line in clinical practice. Thus, AI might be the most preferable option in adjuvant hormonal therapy choice.
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Affiliation(s)
- Marta Pineda-Moncusí
- IMIM (Hospital del Mar Research Institute), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain
| | - Natalia Garcia-Giralt
- IMIM (Hospital del Mar Research Institute), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain
| | - Adolfo Diez-Perez
- IMIM (Hospital del Mar Research Institute), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain
| | - Ignasi Tusquets
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - Sonia Servitja
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - Joan Albanell
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain Universitat Pompeu Fabra, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Botnar Research Centre, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK
| | - Xavier Nogués
- IMIM (Hospital del Mar Research Institute), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain
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Zambelli S, Smart C, Bianchini G, Sassi I, Mansutti M, Anton A, Calvo L, Bisagni G, Bermejo B, Uggè M, Galbardi B, Semiglazov V, Thill M, Chacon JI, Chan A, Murillo SM, Alvarez I, Lahuerta A, Zucchinelli P, Doglioni C, Valagussa P, Tusquets I, Gianni L, Bernardi R. Abstract P5-06-21: Prognostic and predictive value of PML in the ETNA study and the TCGA. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p5-06-21] [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. Although long considered a tumor suppressor gene, PML (promyelocytic leukemia) also plays tumor-promoting functions in specific contexts. In vitro and in vivo studies have demonstrated that PML is upregulated by HIF-1α transcriptional activation in triple-negative breast cancer (TNBC) cells and it is implicated in promoting metastasis downstream of HIF-1α. This pro-metastatic function of PML is inhibited by arsenic trioxide, a pharmacological compound currently in use in acute promyelocytic leukemia. However, the clinical relevance of PML expression in BC has not been extensively investigated. In this study, we evaluated the association of PML expression with clinic-pathological factors and outcome (pathological complete response -pCR- and risk of recurrence) in the ETNA trial, and risk of recurrence in the TCGA. Methods. In the ETNA study (NCT01822314) 695 patients with HER2-negative breast cancer (BC) were randomized to receive neoadjuvant paclitaxel or nab-paclitaxel followed by 4 cycles of an anthracycline regimen. In the ITT study population, the two treatments did not show significantly different rates of pCR nor different Event-Free Survival (EFS) (Gianni JAMA Oncol 2018, Gianni ASCO 2019). A central histologic assessment of ER, PgR, HER2 status and Ki67 was mandatory. We evaluated PML expression by immunohistochemistry using the continuous histoscore (H-score) on pre-treatment core biopsies. The H-score is generated from the estimation of the percentage of cells with no (0), light (1+), moderate (2+) and strong (3+) intensity staining, and the corresponding score is generated with the following algorithm: [1 × (% cells 1+) + 2 × (% cells 2+) + 3 × (% cells 3+)]. We evaluated the association of PML with clinic-pathological features and clinical outcomes (pCR and EFS) in triple negative (TN) and in LuminalB-like (ER+ and/or PgR+, Ki67≥14%) groups. We also investigated the association between PML mRNA expression (RNA-seq) and DFS in HER2-negative BC (TN, n=192; ER+/HER2-, n=702) in the TCGA dataset. Results. In the ETNA study, PML was successfully assessed and valuable in 491 pts (70.6%). The average PML expression was 126.3 (median 120, range 0-295). In the ETNA trial, TNBC showed the highest expression of PML (p<1.0E-10). Within LumB-like tumors, the group with intermediate proliferation (Ki67 14-20%, LumB-int) had higher PML expression than the high proliferation group (Ki67>20%, LumB-high) (p=0.0005). However, within the LumB-high group, higher proliferation (Ki67>40%) showed a higher expression of PML (p=0.025), suggesting a non-linear relationship between PML and proliferation in luminal tumors. In LumB-high, PML was higher in PgR-negative tumors (p=1.0E-5). Finally, PML showed a positive association with higher stromal tumor-infiltrating lymphocytes (sTILs) both in LumB-like and TN group (p=0.019 and p=0.001, respectively). PML expression was not significantly associated with pCR and risk of recurrence in LumB-like nor in TN BC.In the TCGA dataset also PML expression was highest in the TN group (p<1.0E-10). No association was found between PML expression and risk of recurrence in any molecular subgroup. Conclusions. PML expression assessed by IHC in the ETNA trial was not predictive of likelihood of pCR nor of risk of recurrence in LumB-like and TN breast cancer. PML mRNA expression was not prognostic in TN and LumB-like tumors also in the TCGA dataset. Some interesting associations with biological features emerged which warrants biological interpretation of the complex role of PML in breast cancer. Supported in part by an unrestricted grant from Celgene Sarl, Swizerland
Citation Format: Stefania Zambelli, Chanel Smart, Giampaolo Bianchini, Isabella Sassi, Mauro Mansutti, Antonio Anton, Lourdes Calvo, Giancarlo Bisagni, Begona Bermejo, Martina Uggè, Barbara Galbardi, Vladimir Semiglazov, Marc Thill, Jose Ignacio Chacon, Arlene Chan, Serafin Morales Murillo, Isabel Alvarez, Ainhara Lahuerta, Patrizia Zucchinelli, Claudio Doglioni, Pinuccia Valagussa, Ignasi Tusquets, Luca Gianni, Rosa Bernardi. Prognostic and predictive value of PML in the ETNA study and the TCGA [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 P5-06-21.
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Affiliation(s)
| | | | | | | | | | - Antonio Anton
- 3Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Lourdes Calvo
- 4Complejo Hospitalario Universitario de A Coruňa, A Coruňa, Spain
| | | | | | | | | | | | - Marc Thill
- 8Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany
| | | | - Arlene Chan
- 10Breast Cancer Research Center- Wa & Curtin University, Perth, Australia
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6
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Pineda-Moncusí M, Garcia-Giralt N, Diez-Perez A, Servitja S, Tusquets I, Prieto-Alhambra D, Nogués X. Increased Fracture Risk in Women Treated With Aromatase Inhibitors Versus Tamoxifen: Beneficial Effect of Bisphosphonates. J Bone Miner Res 2020; 35:291-297. [PMID: 31596961 DOI: 10.1002/jbmr.3886] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/16/2019] [Accepted: 10/01/2019] [Indexed: 12/22/2022]
Abstract
Aromatase inhibitors have been associated with accelerated bone loss and an increased risk of osteoporotic fractures. Currently, bisphosphonates are recommended to reduce fracture risk in these patients. The aim of this study is to evaluate the fracture risk in breast cancer patients receiving aromatase inhibitors, compared to tamoxifen users, and to assess the effectiveness of oral bisphosphonates in reducing fracture risk. We performed an observational cohort study up to 10 years of follow-up. Data were extracted from primary care records in a population database. Women diagnosed with breast cancer between 2006 and 2015 and treated with tamoxifen or aromatase inhibitors (n = 36,472) were stratified according to low (without osteoporosis diagnosis nor bisphosphonates exposure) or high (with osteoporosis and/or treated with bisphosphonates) fracture risk. Cox models were used to calculate hazard ratios (HR [95% CI]) of fracture from the propensity score-matched patients. Sensitivity analyses account for competing risk of death were performed (subdistribution hazard ratio [SHR] [95% CI]). In postmenopausal women, fracture risk in aromatase inhibitor users showed an HR 1.40 [95% CI,1.05 to 1.87] and SHR 1.48 [95% CI, 1.11 to 1.98], compared to tamoxifen. Observing aromatase inhibitors patients at high risk of fracture, bisphosphonate-treated patients had an HR 0.73 [95% CI, 0.51 to 1.04] and SHR 0.69 [95% CI, 0.48 to 0.98] compared to nontreated. In conclusion, fracture risk in postmenopausal women during aromatase inhibitor treatment, in real-life conditions, was >40% compared to tamoxifen, corroborating previous randomized controlled trials results. In high-risk patients, bisphosphonate users had lower significant fracture incidence during aromatase inhibitor therapy than nonbisphosphonate users. Monitoring fracture risk and related risk factors in aromatase inhibitor patients is advisable. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- Marta Pineda-Moncusí
- Hospital del Mar Research Institute (IMIM), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain
| | - Natalia Garcia-Giralt
- Hospital del Mar Research Institute (IMIM), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain
| | - Adolfo Diez-Perez
- Hospital del Mar Research Institute (IMIM), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain.,Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sonia Servitja
- Cancer Research Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Ignasi Tusquets
- Cancer Research Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford, UK.,Grup de Recerca en Malalties Prevalents de L'Aparell Locomotor (GREMPAL) Research Group and CIBERFES, University Institute for Primary Care Research (IDIAP) Jordi Gol, Universitat Autònoma de Barcelona and Instituto de Salud Carlos III, Barcelona, Spain
| | - Xavier Nogués
- Hospital del Mar Research Institute (IMIM), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain.,Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
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7
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Buckland G, Travier N, Arribas L, Del Barco S, Pernas S, Zamora E, Bellet M, Cirauqui B, Margelí M, Muñoz M, Tusquets I, Arcusa A, Javierre C, Moreno F, Valverde Y, Jansen E, Chajès V, Castro C, Agudo A. Changes in dietary intake, plasma carotenoids and erythrocyte membrane fatty acids in breast cancer survivors after a lifestyle intervention: results from a single-arm trial. J Hum Nutr Diet 2019; 32:468-479. [PMID: 30663156 DOI: 10.1111/jhn.12621] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The influence of nutrition on breast cancer prognosis is still inconclusive and therefore dietary interventions incorporating dietary biomarkers are needed to confirm compliance with dietary goals and clarify biological mechanisms. The present study assessed whether a lifestyle intervention in breast cancer survivors could affect dietary biomarkers of fruit and vegetables and fatty acids. METHODS In this phase II single-arm trial, 37 overweight/obese early stage breast cancer patients completed a 12-week diet and exercise intervention. The intervention involved 1-h weekly diet sessions delivered by a dietician and 75-min bi-weekly physical activity sessions of moderate-to-high intensity led by trained monitors. Before and after the intervention, three 24-h dietary recalls were carried out to calculate nutrient intakes and, in addition, blood samples were taken to measure plasma carotenoids, vitamin E and retinol concentrations and erythrocyte membrane fatty acid (EFA) composition. Wilcoxon signed rank tests were used to assess changes in dietary and biomarkers measurements over the intervention period. RESULTS After the intervention, there was a significant increase in the intake of dietary carotenoids (+15.1% compared to baseline) but not plasma carotenoids levels (+6.3%). Regarding the EFA levels, we observed a significant decrease in percentage of saturated fatty acids (-1.4%) and n-6 polyunsaturated fatty acids (-2.9%) and an increase in monounsaturated fatty acids (1.7%) and total and long-chain n-3 polyunsaturated fatty acids (by 13.1% and 13.7%, respectively). A favourable decrease in the ratio of long-chain n-6 to n-3 polyunsaturated fatty acids (-9.1%) was also observed. CONCLUSIONS After a short-term diet and exercise intervention in overweight/obese breast cancer survivors, we observed significant changes in dietary nutrients and fatty acid biomarkers, suggesting positive dietary changes that could be relevant for breast cancer prognosis.
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Affiliation(s)
- G Buckland
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - N Travier
- Unit Breast Cancer Screening Unit, Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - L Arribas
- Clinical Nutrition Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - S Del Barco
- Department of Medical Oncology-ICO, Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain
| | - S Pernas
- Breast Cancer Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - E Zamora
- Department of Breast Cancer Oncology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - M Bellet
- Department of Breast Cancer Oncology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - B Cirauqui
- Department of Medical Oncology-ICO, Hospital Germans Trias i Pujol, Badalona, Spain
| | - M Margelí
- Department of Medical Oncology-ICO, Hospital Germans Trias i Pujol, Badalona, Spain
| | - M Muñoz
- Translational Genomics and Targeted Therapeutics, Institut d'Investigacions Biomèdiques Pi i Sunyer IDIBAPS, Barcelona, Spain
| | - I Tusquets
- Department of Medical Oncology, Hospital del Mar, Barcelona, Spain
| | - A Arcusa
- Department of Medical Oncology, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - C Javierre
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - F Moreno
- Breast Cancer Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Y Valverde
- Breast Cancer Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - E Jansen
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - V Chajès
- Nutrition and Metabolism Department, International Agency for Research on Cancer, Lyon, France
| | - C Castro
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
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8
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Muntasell A, Servitja S, Cabo M, Bermejo B, Pérez-Buira S, Rojo F, Costa-García M, Arpí O, Moraru M, Serrano L, Tusquets I, Martínez MT, Heredia G, Vera A, Martínez-García M, Soria L, Comerma L, Santana-Hernández S, Eroles P, Rovira A, Vilches C, Lluch A, Albanell J, López-Botet M. High Numbers of Circulating CD57 + NK Cells Associate with Resistance to HER2-Specific Therapeutic Antibodies in HER2 + Primary Breast Cancer. Cancer Immunol Res 2019; 7:1280-1292. [PMID: 31189644 DOI: 10.1158/2326-6066.cir-18-0896] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/11/2019] [Accepted: 06/10/2019] [Indexed: 11/16/2022]
Abstract
Natural killer (NK) cells can orchestrate effective antitumor immunity. The presence of tumor-infiltrating NK cells in diagnostic biopsies predicts pathologic complete response (pCR) to HER2-specific therapeutic antibodies in patients with primary breast cancer. Here, we analyzed whether diversity in circulating NK cells might influence tumor infiltration and HER2-specific therapeutic antibody efficacy. We found that numbers of circulating CD57+ NK cells inversely correlated with pCR to HER2-specific antibody treatment in patients with primary breast cancer independently of age, traditional clinicopathologic factors, and CD16A 158F/V genotype. This association was uncoupled from the expression of other NK-cell receptors, the presence of adaptive NK cells, or changes in major T-cell subsets, reminiscent of cytomegalovirus-induced immunomodulation. NK-cell activation against trastuzumab-coated HER2+ breast cancer cells was comparable in patients with high and low proportions of CD57+ NK cells. However, circulating CD57+ NK cells displayed decreased CXCR3 expression and CD16A-induced IL2-dependent proliferation in vitro Presence of CD57+ NK cells was reduced in breast tumor-associated infiltrates as compared with paired peripheral blood samples, suggesting deficient homing, proliferation, and/or survival of NK cells in the tumor niche. Indeed, numbers of circulating CD57+ were inversely related to tumor-infiltrating NK-cell numbers. Our data reveal that NK-cell differentiation influences their antitumor potential and that CD57+ NK cells may be a biomarker useful for tailoring HER2 antibody-based therapeutic strategies in breast cancer.
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Affiliation(s)
- Aura Muntasell
- Immunity and Infection, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.
| | - Sònia Servitja
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Department of Medical Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Mariona Cabo
- Immunity and Infection, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Begoña Bermejo
- Department of Oncology, Hospital Clinico de Valencia-CIBERONC, Valencia, Spain
| | - Sandra Pérez-Buira
- Department of Pathology, IIS "Fundacion Jimenez Diaz University Hospital," Madrid, Spain
| | - Federico Rojo
- Department of Pathology, IIS "Fundacion Jimenez Diaz University Hospital," Madrid, Spain
| | | | - Oriol Arpí
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Manuela Moraru
- HLA-Immunogenetics Department, Instituto Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Laia Serrano
- Department of Pathology, Hospital del Mar, Barcelona, Spain
| | - Ignasi Tusquets
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Department of Medical Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | | | | | - Andrea Vera
- Immunity and Infection, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - María Martínez-García
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Department of Medical Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Laura Soria
- Immunity and Infection, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Laura Comerma
- Department of Pathology, Hospital del Mar, Barcelona, Spain
| | - Sara Santana-Hernández
- Immunity and Infection, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Pilar Eroles
- Department of Oncology, Hospital Clinico de Valencia-CIBERONC, Valencia, Spain.,Biomedical Research Institute, INCLIVA, Valencia, Spain
| | - Ana Rovira
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Department of Medical Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Carlos Vilches
- HLA-Immunogenetics Department, Instituto Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Ana Lluch
- Department of Oncology, Hospital Clinico de Valencia-CIBERONC, Valencia, Spain.,Biomedical Research Institute, INCLIVA, Valencia, Spain.,Universitat de Valencia, Valencia, Spain
| | - Joan Albanell
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain. .,Department of Medical Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Miguel López-Botet
- Immunity and Infection, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
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9
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Jara C, Alvarez I, Vila MM, Rodriguez CA, Martinez P, Batista JN, Alonso Romero JL, Antolín Novoa S, Ruíz S, Guerrero A, Tusquets I, Anton A, Chacon JI, Rodríguez-Lescure Á, Tibau Martorell A, Varela Ferreiro S, Miralles JJ, Bezares S, Rojo F, López-Tarruella S. First results of a prospective registry in unresectable locally advanced or metastatic breast cancer patients: GEICAM/2014-03 (RegistEM). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.1077] [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: 11/20/2022] Open
Abstract
1077 Background: In Spain there is limited prospective data for unresectable locally advanced breast cancer (ULABC) or metastatic breast cancer (MBC) patients (pts) treated as per clinical practice. RegistEM study will provide epidemiological, pathological and clinical data, including treatments given for different disease stages. Understanding the real distribution of the different BC subtypes is the primary objective. Methods: This is a non-interventional cohort study enrolling approximately 1,400 pts with advanced disease diagnosed from January 2016 to December 2018, either after recurrence or as first diagnosis, in 38 Spanish sites. Biological samples (primary tumor, metastatic lesions, blood) are currently being collected. In this first analysis, we include 489 pts who met study criteria before October 31, 2017. All data are described in two subgroups: on the most recent tumor lesion or on the primary breast tumor. Results: At first diagnosis, 67.9%, 31.5% and 0.6% of pts had early BC (EBC), MBC and ULABC, respectively. In the total analysis population, median age at diagnosis of advanced disease was 59.6 years, most of pts were white (98.2%), female (99.4%) and postmenopausal (70%). Family history of BC and ovarian cancer was reported in 5.7% pts. In ~390 pts BC clinical subtypes distribution was luminal B(HER2-)-like (~55%), luminal B(HER2+)-like (~16%), luminal A-like or triple negative (TN) (~10% each) and HER2 enriched-like (~8%). Median time to recurrence (years) in EBC pts was: luminal A-like 5.8, luminal B(HER2-)-like 5.1, luminal B(HER2+)-like 3.9, HER2 enriched-like 2.7 and TN 1.7. Bone (59%), visceral (58%) and lymph node (27%) lesions were the most frequent metastatic locations. The two most frequent therapies in first line consisted in: endocrine therapy (ET) (47%) and ET+biological therapy (BT) (29%) for luminal A-like; ET (32%) and ET+BT (32%) for luminal B(HER2-)-like; chemotherapy (CT)+ET+BT (43%) and CT+BT (24%) for luminal B(HER2+)-like; CT+BT (68%) and CT (16%) for HER2 enriched-like; CT (59%) and CT+BT (34%) for TN. Conclusions: These first data confirm that luminal B (HER2-)-like subtype is the most predominant in MBC.
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Affiliation(s)
- Carlos Jara
- Hospital Universitario Fundación Alcorcón, Medical Oncology Department, GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - Isabel Alvarez
- Hospital Donostia, GEICAM Spanish Breast Cancer Group, San Sebastian, Spain
| | - Mireia Margeli Vila
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, GEICAM Spanish Breast Cancer Group., Badalona, Spain
| | - Cesar Augusto Rodriguez
- Hospital Universitario de Salamanca-IBSAL, GEICAM Spanish Breast Cancer Group, Salamanca, Spain
| | | | - J. Norberto Batista
- Hospital Universitario de Canarias, GEICAM Spanish Breast Cancer Group, La Laguna Tenerife, Spain
| | - Jose Luis Alonso Romero
- Hospital Clinico Universitario Virgen de la Arrixaca, GEICAM Spanish Breast Cancer Group, Murcia, Spain
| | - Silvia Antolín Novoa
- Oncology Service, Complejo Hospitalario Universitario A Coruña, GEICAM Spanish Breast Cancer Group., A Coruña, Spain
| | - Sofía Ruíz
- Unidad de Oncología Intercentros Hospitales Regional y Virgen de la Victoria, GEICAM Spanish Breast Cancer Group, Málaga, Spain
| | - Angel Guerrero
- Instituto Valenciano de Oncología, GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Ignasi Tusquets
- Hospital del Mar, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Barcelona, Spain
| | - Antonio Anton
- Servicio de Oncología Médica, Hospital Universitario Miguel Servet, GEICAM Spanish Breast Cancer Group, Zaragoza, Spain
| | - Jose Ignacio Chacon
- Hospital Virgen de la Salud, GEICAM Spanish Breast Cancer Group, Toledo, Spain
| | | | | | | | | | | | - Federico Rojo
- Fundación Jiménez Díaz,Madrid.Centro de Investigación Biomédica en Red de Oncología, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII.GEICAM Spanish Breast Cancer Group., Madrid, Spain
| | - Sara López-Tarruella
- 20. Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense, 11. Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group., Madrid, Spain
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10
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Gianni L, Mansutti M, Anton A, Calvo Martínez L, Bisagni G, Bermejo B, Semiglazov V, Thill M, Chacon JI, Chan A, Morales S, Alvarez I, Lahuerta A, Zambetti M, Redfern AD, Dent RA, Barlera S, Valagussa P, Tusquets I. Event-free survival analysis of the prospectively randomized phase III ETNA study with neoadjuvant nab-paclitaxel (nab-P) versus paclitaxel (P) followed by anthracycline regimens in women with HER2-negative high-risk breast cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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
515 Background: The ETNA study showed that substituting P with nab-P did not significantly increase the overall rate of pathological complete response (pCR) (P 18.6%, nab-P 22.5%, p = 0.19). The multivariate analysis revealed that tumor subtype (triple negative vs luminal B-like) was the most significant factor (OR 4.85) influencing treatment outcome (Gianni L et al, JAMA Oncol 2018). Methods: This multicenter open label study (NCT01822314) in collaboration with GEICAM and BCRC-WA randomized 695 patients with centrally-confirmed HER2-negative breast cancer to nab-P 125 mg/m2 (346 patients) or P 90 mg/m2 (349 patients). The two drugs were given on weeks 1, 2 and 3 followed by 1-week rest for 4 cycles before 4 cycles of an anthracycline regimen as per investigator choice. The primary endpoint was pCR (absence of invasive cells in breast and nodes). A secondary endpoint is event-free survival (EFS) defined as the time from randomization to the first date of disease progression while on primary therapy or disease recurrence (local, regional, distant, invasive contralateral breast cancer) after surgery or death due to any cause. Results: The ITT analysis of the secondary endpoint EFS at 5 years is reported below: Clinical trial information: NCT01822314. Overall 5-year survival was 84.8% after P and 87.3% for nab-P. No serious adverse events were documented during the follow-up. Conclusions: The improved 5-year EFS after nab-P failed to reach statistical significance (unadjusted P = 0.245). In the analysis by subgroup the numerical improvement was almost exclusively observed in luminal B and not in TN tumors. So far the data do not support substitution of P with nab-P in the schedule and doses adopted in the ETNA trial. Additional analyses will be based on ongoing molecular studies.[Table: see text]
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Affiliation(s)
| | - Mauro Mansutti
- Department of Oncology-ASUI Udine University Hospital, Udine, Italy
| | - Antonio Anton
- Servicio de Oncología Médica, Hospital Universitario Miguel Servet, GEICAM Spanish Breast Cancer Group, Zaragoza, Spain
| | | | - Giancarlo Bisagni
- Oncologia Medica Azienda USL/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Begoña Bermejo
- Hospital Clinico Universitario de Valencia, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Vladimir Semiglazov
- "National Medical Research Center of Oncology na N.N. Petrov" Ministry of Healthcare of Russian Federation, St Petersburg, Russian Federation
| | - Marc Thill
- Agaplesion Markus Krankenhaus, Frankfurt, Germany
| | - Jose Ignacio Chacon
- Hospital Virgen de la Salud, GEICAM Spanish Breast Cancer Group, Toledo, Spain
| | - Arlene Chan
- Breast Cancer Research Centre-WA & Curtin University, Perth, Australia
| | - Serafin Morales
- Medical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | - Isabel Alvarez
- Hospital Donostia, GEICAM Spanish Breast Cancer Group, San Sebastian, Spain
| | | | | | | | | | | | | | - Ignasi Tusquets
- Hospital del Mar, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Barcelona, Spain
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11
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Peremiquel-Trillas P, Benavente Y, Martín-Bustamante M, Casabonne D, Pérez-Gómez B, Gómez-Acebo I, Oliete-Canela A, Diéguez-Rodríguez M, Tusquets I, Amiano P, Mengual L, Ardanaz E, Capelo R, Molina de la Torre AJ, Salas Trejo D, Fernández-Tardón G, Lope V, Jimenez-Moleon JJ, Marcos-Gragera R, Dierssen-Sotos T, Azpiri M, Muñoz M, Guevara M, Fernández-Villa T, Molina-Barceló A, Aragonés N, Pollán M, Castaño-Vinyals G, Alguacil J, Kogevinas M, de Sanjosé S, Costas L. Alkylphenolic compounds and risk of breast and prostate cancer in the MCC-Spain study. Environ Int 2019; 122:389-399. [PMID: 30553564 DOI: 10.1016/j.envint.2018.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/30/2018] [Accepted: 12/04/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Alkylphenolic compounds are chemicals with endocrine disrupting properties that have been widely used in industry with important changes in their usage over time. Few epidemiologic studies have evaluated the effect of alkylphenolic compounds on human health. OBJECTIVES We investigated whether occupational exposure to alkylphenolic compounds is associated with breast and prostate cancer. METHODS We carried out a population-based case-control study including 1513 incident cases of breast cancer, 1095 of prostate cancer, and 3055 controls, frequency matched by sex, age and region. Occupational exposure to alkylphenolic compounds was estimated using a recently developed job-exposure matrix, which considered different scenarios of exposure and different subtypes of alkylphenolic compounds. RESULTS History of occupational exposure to alkylphenolic compounds was modestly associated with breast cancer (OR = 1.23; 95% CI = 1.01-1.48). Within the different scenarios, the occupational use of domestic tensioactives was positively associated with breast cancer (OR = 1.28; 95% CI = 1.02-1.60), while occupational exposure in other scenarios showed mostly a suggestion of a similar positive associations. Exposure to nonylphenol ethoxylates was positively associated with breast cancer (OR = 1.21; 95% CI = 1.00-1.47), while exposure to other compounds was uncommon. In general, we did not observe associations between alkylphenolic compounds and prostate cancer, except for a positive association among men occupationally exposed to cosmetic, hair and personal hygiene products. CONCLUSIONS Our findings suggest a modest association between breast cancer risk and occupational exposure to alkylphenolic compounds, and no associations between these compounds and prostate cancer risk. These findings warrant further corroboration in other studies.
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Affiliation(s)
- Paula Peremiquel-Trillas
- Preventive Medicine and Epidemiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Unit of Molecular Epidemiology and Genetics in Infections and Cancer, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Yolanda Benavente
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain
| | - Mayte Martín-Bustamante
- Institut Català de Seguretat i Salut Laboral, Departament de Treball, Afers Socials i Famílies, Generalitat de Catalunya, Barcelona, Spain
| | - Delphine Casabonne
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain
| | - Beatriz Pérez-Gómez
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Cardiovascular & Metabolic Diseases Unit, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Inés Gómez-Acebo
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain
| | - Anna Oliete-Canela
- Institut Català de Seguretat i Salut Laboral, Departament de Treball, Afers Socials i Famílies, Generalitat de Catalunya, Barcelona, Spain
| | - Marta Diéguez-Rodríguez
- Institut Català de Seguretat i Salut Laboral, Departament de Treball, Afers Socials i Famílies, Generalitat de Catalunya, Barcelona, Spain
| | - Ignasi Tusquets
- Universitat Autònoma de Barcelona, Parc de Salut Mar Hospital del Mar, Barcelona, Spain; Medical Oncology Department, Parc de Salut Mar Hospital del Mar, Barcelona, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Lourdes Mengual
- Department and Laboratory of Urology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Eva Ardanaz
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
| | - Rocío Capelo
- Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente, Universidad de Huelva, Huelva, Spain
| | - Antonio J Molina de la Torre
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS), Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Dolores Salas Trejo
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain; General Directorate Public Health, Valencian Community, Valencia, Spain
| | - Guillermo Fernández-Tardón
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Instituto de Oncología de Asturias (IUOPA), Área de Medicina Preventiva, Universidad de Oviedo, Oviedo, Spain
| | - Virginia Lope
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - José J Jimenez-Moleon
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada, University of Granada, Granada, Spain
| | - Rafael Marcos-Gragera
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Epidemiology Unit and Girona Cancer Registry (UERCG), Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology (ICO), Girona, Spain; Girona Biomedical Research Institute (IDIBGI), University of Girona, Girona, Spain
| | - Trinidad Dierssen-Sotos
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Universidad de Cantabria - IDIVAL, Santander, Spain
| | - Mikel Azpiri
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Montse Muñoz
- Translational Genomics and Targeted Therapeutics in Solid Tumors, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marcela Guevara
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
| | - Tania Fernández-Villa
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS), Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | | | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Marina Pollán
- CIBER Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Castaño-Vinyals
- ISGlobal, Barcelona, Spain; Hospital del Mar Medical Research Institute - IMIM, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Juan Alguacil
- Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente, Universidad de Huelva, Huelva, Spain
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain; Hospital del Mar Medical Research Institute - IMIM, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; National School of Public Health, Athens, Greece
| | | | - Laura Costas
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.
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12
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Pineda-Moncusí M, Servitja S, Casamayor G, Cos ML, Rial A, Rodriguez-Morera J, Tusquets I, Diez-Perez A, Garcia-Giralt N, Nogués X. Bone health evaluation one year after aromatase inhibitors completion. Bone 2018; 117:54-59. [PMID: 30223134 DOI: 10.1016/j.bone.2018.09.010] [Citation(s) in RCA: 7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/13/2018] [Accepted: 09/13/2018] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Breast cancer patients treated with aromatase inhibitors (AIs) experience increased bone loss during their treatment. However, there is little information about bone mineral density (BMD) after completing AI-treatment. The present study aimed to assess BMD changes one year after AI-therapy completion. METHODS Data were collected from 864 postmenopausal women treated with AI during 5 years (5y-AI group), or during 2-3 years after taking tamoxifen therapy (pTAM-AI group). Participants with osteoporosis were treated with oral bisphosphonates (BP). BMD changes in lumbar spine (LS), femoral neck (FN) and total hip (TH) between baseline, end of treatment, and at one year post-treatment were assessed using repeated-measures ANOVA. RESULTS At the end of AI-treatment, 382 patients had available BMD values and 316 also had post-treatment BMD values. As expected, BMD levels were decreased at AI-completion in non-BP treated patients. After one year, LS BMD increased in both groups (5y-AI: +2.11% [95%CI: 1.55 to 2.68], p < 0.001; pTAM-AI: +1.00% [95%CI: 0.49 to 1.51], p < 0.001) compared with the end of AI-therapy, while values at FN and TH remained stable. On the other hand, BMD values of BP-treated patients were increased or maintained at the end of AI-treatment and also at post-treatment. CONCLUSIONS At one year after AI-completion, FN and TH BMD remained reduced in non-BP treated women, while LS BMD was recovered in the 5y-AI group and partially recovered in the pTAM-AI group. BP treatment increased or maintained BMD values at the end of therapy and at one year post-treatment.
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Affiliation(s)
- Marta Pineda-Moncusí
- IMIM (Hospital del Mar Research Institute), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain
| | - Sonia Servitja
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - Guillem Casamayor
- Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Lourdes Cos
- Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Abora Rial
- Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jaime Rodriguez-Morera
- Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ignasi Tusquets
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - Adolfo Diez-Perez
- IMIM (Hospital del Mar Research Institute), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain; Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Natalia Garcia-Giralt
- IMIM (Hospital del Mar Research Institute), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain.
| | - Xavier Nogués
- IMIM (Hospital del Mar Research Institute), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain; Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
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13
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Pineda-Moncusí M, Garcia-Perez MA, Rial A, Casamayor G, Cos ML, Servitja S, Tusquets I, Diez-Perez A, Cano A, Garcia-Giralt N, Nogues X. Vitamin D levels in Mediterranean breast cancer patients compared with those in healthy women. Maturitas 2018; 116:83-88. [DOI: 10.1016/j.maturitas.2018.07.015] [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] [Received: 05/25/2018] [Revised: 07/09/2018] [Accepted: 07/27/2018] [Indexed: 11/26/2022]
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14
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Travier N, Buckland G, Vendrell JJ, Fernandez-Veledo S, Peiró I, Del Barco S, Pernas S, Zamora E, Bellet M, Margeli M, Cirauqui B, Muñoz M, Tusquets I, Arcusa A, Javierre C, Moreno F, Rodriguez A, Agudo A. Changes in metabolic risk, insulin resistance, leptin and adiponectin following a lifestyle intervention in overweight and obese breast cancer survivors. Eur J Cancer Care (Engl) 2018; 27:e12861. [PMID: 29869823 DOI: 10.1111/ecc.12861] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 02/01/2018] [Accepted: 04/17/2018] [Indexed: 12/18/2022]
Abstract
Adiposity and physical activity are modifiable factors that could be important determinants of breast cancer (BC) prognosis through their effects on endogenous reproductive hormones, chronic inflammation and metabolic changes. Therefore, it is necessary to evaluate whether offering lifestyle interventions to BC survivors could affect the levels of certain biomarkers involved in these mechanisms. We designed a pre-post intervention study offering diet and exercise sessions over 12 weeks to 42 overweight/obese BC survivors. Before and after the intervention, we obtained dietary information, anthropometry and cardiorespiratory fitness (CRF) measurements and blood samples to measure metabolic risk, insulin resistance and adipokines biomarkers. Wilcoxon signed-rank tests and Spearman partial correlation coefficients were used to compare pre- and post-measurements and assess the correlations between changes in biomarkers and changes in anthropometry and CRF. Breast cancer survivors showed significant improvements in metabolic risk biomarkers and insulin resistance indicators along with a non-significant leptin decrease and a significant adiponectin decrease. The improvements in metabolic risk biomarkers, insulin resistance indicators and leptin were moderately correlated (0.32 ≤ |r| ≤ 0.55) with the decrease in body mass index and the increase in CRF. Diet and exercise interventions implemented in overweight/obese BC survivors may improve metabolic risk, insulin resistance and leptin biomarkers.
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Affiliation(s)
- Noemie Travier
- Cancer Prevention and Control Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Genevieve Buckland
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Joan J Vendrell
- Diabetes and Metabolic Associated Diseases Research Group, Hospital Joan XXIII, School of Medicine, Rovira i Virgili University, Tarragona, Spain
| | - Sonia Fernandez-Veledo
- Diabetes and Metabolic Associated Diseases Research Group, Hospital Joan XXIII, School of Medicine, Rovira i Virgili University, Tarragona, Spain
| | - Immaculada Peiró
- Clinical Nutrition Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Sonia Del Barco
- Department of Medical Oncology-ICO, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
| | - Sonia Pernas
- Breast Cancer Functional Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Esther Zamora
- Vall d'Hebron Institute of Oncology (VHIO), Breast Cancer Unit, Department of Medical Oncology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Meritxell Bellet
- Vall d'Hebron Institute of Oncology (VHIO), Breast Cancer Unit, Department of Medical Oncology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Mireia Margeli
- Department of Medical Oncology-ICO, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Beatriz Cirauqui
- Department of Medical Oncology-ICO, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Montserrat Muñoz
- Department of Medical Oncology, Hospital Clínic, Barcelona, Spain
| | - Ignasi Tusquets
- Department of Medical Oncology, Hospital del Mar, Barcelona, Spain
| | - Angels Arcusa
- Department of Medical Oncology, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Casimiro Javierre
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Ferran Moreno
- Breast Cancer Functional Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Ana Rodriguez
- Breast Cancer Functional Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
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15
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Pineda-Moncusí M, Rodríguez-Sanz M, Servitja S, Díez-Pérez A, Tusquets I, Nogués X, García-Giralt N. Estudio de la base genética de la reducción del Trabecular Bone Score relacionada con los inhibidores de la aromatasa. Rev Osteoporos Metab Miner 2018. [DOI: 10.4321/s1889-836x2018000200004] [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: 03/29/2023] Open
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16
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Tamborero D, Rubio-Perez C, Deu-Pons J, Schroeder MP, Vivancos A, Rovira A, Tusquets I, Albanell J, Rodon J, Tabernero J, de Torres C, Dienstmann R, Gonzalez-Perez A, Lopez-Bigas N. Cancer Genome Interpreter annotates the biological and clinical relevance of tumor alterations. Genome Med 2018; 10:25. [PMID: 29592813 PMCID: PMC5875005 DOI: 10.1186/s13073-018-0531-8] [Citation(s) in RCA: 302] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 03/13/2018] [Indexed: 12/19/2022] Open
Abstract
While tumor genome sequencing has become widely available in clinical and research settings, the interpretation of tumor somatic variants remains an important bottleneck. Here we present the Cancer Genome Interpreter, a versatile platform that automates the interpretation of newly sequenced cancer genomes, annotating the potential of alterations detected in tumors to act as drivers and their possible effect on treatment response. The results are organized in different levels of evidence according to current knowledge, which we envision can support a broad range of oncology use cases. The resource is publicly available at http://www.cancergenomeinterpreter.org .
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Affiliation(s)
- David Tamborero
- Research Program on Biomedical Informatics (GRIB), IMIM Hospital del Mar Medical, Research Institute and Pompeu Fabra University, Barcelona, Spain.,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Carlota Rubio-Perez
- Research Program on Biomedical Informatics (GRIB), IMIM Hospital del Mar Medical, Research Institute and Pompeu Fabra University, Barcelona, Spain
| | - Jordi Deu-Pons
- Research Program on Biomedical Informatics (GRIB), IMIM Hospital del Mar Medical, Research Institute and Pompeu Fabra University, Barcelona, Spain.,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Michael P Schroeder
- Research Program on Biomedical Informatics (GRIB), IMIM Hospital del Mar Medical, Research Institute and Pompeu Fabra University, Barcelona, Spain.,Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ana Vivancos
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Ana Rovira
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Department of Oncology, Hospital del Mar- CIBERONC, Barcelona, Spain
| | - Ignasi Tusquets
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Department of Oncology, Hospital del Mar- CIBERONC, Barcelona, Spain.,Autonomous University of Barcelona, Barcelona, Spain
| | - Joan Albanell
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Department of Oncology, Hospital del Mar- CIBERONC, Barcelona, Spain.,Pompeu Fabra University, Barcelona, Spain
| | - Jordi Rodon
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Josep Tabernero
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Carmen de Torres
- Developmental Tumor Biology Laboratory, Institut de Recerca Pediàtrica- Hospital Sant Joan de Déu Barcelona, Barcelona, Spain
| | - Rodrigo Dienstmann
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Abel Gonzalez-Perez
- Research Program on Biomedical Informatics (GRIB), IMIM Hospital del Mar Medical, Research Institute and Pompeu Fabra University, Barcelona, Spain.,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Nuria Lopez-Bigas
- Research Program on Biomedical Informatics (GRIB), IMIM Hospital del Mar Medical, Research Institute and Pompeu Fabra University, Barcelona, Spain. .,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain. .,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
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17
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Muntasell A, Cabo M, Servitja S, Tusquets I, Martínez-García M, Rovira A, Rojo F, Albanell J, López-Botet M. Interplay between Natural Killer Cells and Anti-HER2 Antibodies: Perspectives for Breast Cancer Immunotherapy. Front Immunol 2017; 8:1544. [PMID: 29181007 PMCID: PMC5694168 DOI: 10.3389/fimmu.2017.01544] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [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: 09/29/2017] [Accepted: 10/30/2017] [Indexed: 01/16/2023] Open
Abstract
Overexpression of the human epidermal growth factor receptor 2 (HER2) defines a subgroup of breast tumors with aggressive behavior. The addition of HER2-targeted antibodies (i.e., trastuzumab, pertuzumab) to chemotherapy significantly improves relapse-free and overall survival in patients with early-stage and advanced disease. Nonetheless, considerable proportions of patients develop resistance to treatment, highlighting the need for additional and co-adjuvant therapeutic strategies. HER2-specific antibodies can trigger natural killer (NK) cell-mediated antibody-dependent cellular cytotoxicity and indirectly enhance the development of tumor-specific T cell immunity; both mechanisms contributing to their antitumor efficacy in preclinical models. Antibody-dependent NK cell activation results in the release of cytotoxic granules as well as the secretion of pro-inflammatory cytokines (i.e., IFNγ and TNFα) and chemokines. Hence, NK cell tumor suppressive functions include direct cytolytic killing of tumor cells as well as the regulation of subsequent antitumor adaptive immunity. Albeit tumors with gene expression signatures associated to the presence of cytotoxic lymphocyte infiltrates benefit from trastuzumab-based treatment, NK cell-related biomarkers of response/resistance to HER2-specific therapeutic antibodies in breast cancer patients remain elusive. Several variables, including (i) the configuration of the patient NK cell repertoire; (ii) tumor molecular features (i.e., estrogen receptor expression); (iii) concomitant therapeutic regimens (i.e., chemotherapeutic agents, tyrosine kinase inhibitors); and (iv) evasion mechanisms developed by progressive breast tumors, have been shown to quantitatively and qualitatively influence antibody-triggered NK cell responses. In this review, we discuss possible interventions for restoring/enhancing the therapeutic activity of HER2 therapeutic antibodies by harnessing NK cell antitumor potential through combinatorial approaches, including immune checkpoint blocking/stimulatory antibodies, cytokines and toll-like receptor agonists.
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Affiliation(s)
- Aura Muntasell
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Mariona Cabo
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Sonia Servitja
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Department of Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Ignasi Tusquets
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Department of Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - María Martínez-García
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Department of Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Ana Rovira
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Department of Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain
| | | | - Joan Albanell
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Department of Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain.,Univ. Pompeu Fabra, Barcelona, Spain
| | - Miguel López-Botet
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Univ. Pompeu Fabra, Barcelona, Spain
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18
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González-Martín A, Alba E, Ciruelos E, Cortés J, Llombart A, Lluch A, Andrés R, Álvarez I, Aramendía JM, de la Peña FA, Barnadas A, Batista N, Calvo L, Galve E, García-Palomo A, García-Sáenz JÁ, de la Haba J, López R, López-Vivanco G, Martínez-Jáñez N, de Dueñas EM, Plazaola A, Rodríguez-Lescure Á, Ruiz M, Sánchez-Rovira P, Santaballa A, Seguí MÁ, Tusquets I, Zamora P, Martín M. Nab-Paclitaxel in Metastatic Breast Cancer: Defining the Best Patient Profile. Curr Cancer Drug Targets 2017; 16:415-28. [PMID: 26278712 DOI: 10.2174/1568009615666150817121731] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 05/10/2015] [Accepted: 08/12/2015] [Indexed: 11/22/2022]
Abstract
Around 40% of patients with breast cancer will present with a recurrence of the disease. Chemotherapy is recommended for patients with recurrent hormone-independent or hormone-refractory breast cancer and almost all patients with metastatic breast cancer (MBC) receive chemotherapy during their medical history. Nanoparticle albuminbound (nab)-paclitaxel is a solvent-free, 130-nanometer particle formulation of paclitaxel. Nab-paclitaxel can be administered to all patients for whom the treatment choice is a taxane. In this review, 6 patient profiles for which nabpaclitaxel may be particularly useful are described and analyzed: (i) as first-line treatment of MBC, (ii) as second-line treatment of MBC after oral chemotherapy, (iii) after a standard taxane, (iv) as third-line treatment after a standard taxane and oral chemotherapy, (v) for patients with HER2-positive MBC and (vi) for patients with intolerance to standard taxanes. Nab-paclitaxel is a rational treatment choice for patients with MBC in different settings, as well as for those with prior exposure to a standard taxane.
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Affiliation(s)
- Antonio González-Martín
- Medical Oncology Department, MD Anderson Cancer Center, Madrid, C/ Arturo Soria, 270, 28033 - Madrid. Spain.
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19
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Pineda-Moncusí M, Rodríguez-Sanz M, Díez-Pérez A, Aymar I, Martos T, Servitja S, Tusquets I, García-Giralt N, Nogués X. Análisis genético de enzimas de la vía esteroidal asociadas a efectos adversos musculoesqueléticos de los inhibidores de la aromatasa. Rev Osteoporos Metab Miner 2017. [DOI: 10.4321/s1889-836x2017000200004] [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: 01/20/2023] Open
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20
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Pastor-Barriuso R, Fernández MF, Castaño-Vinyals G, Whelan D, Pérez-Gómez B, Llorca J, Villanueva CM, Guevara M, Molina-Molina JM, Artacho-Cordón F, Barriuso-Lapresa L, Tusquets I, Dierssen-Sotos T, Aragonés N, Olea N, Kogevinas M, Pollán M. Total Effective Xenoestrogen Burden in Serum Samples and Risk for Breast Cancer in a Population-Based Multicase-Control Study in Spain. Environ Health Perspect 2016; 124:1575-1582. [PMID: 27203080 PMCID: PMC5047766 DOI: 10.1289/ehp157] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/01/2016] [Accepted: 05/04/2016] [Indexed: 05/04/2023]
Abstract
BACKGROUND Most studies on endocrine-disrupting chemicals and breast cancer have focused on single compounds and have produced inconclusive findings. OBJECTIVES We assessed the combined estrogenic effects of mixtures of xenoestrogens in serum and their relationship to breast cancer risk. METHODS A total of 186 incident pretreatment breast cancer cases and 196 frequency-matched controls were randomly sampled from a large population-based multicase-control study in Spain. The total effective xenoestrogen burden attributable to organohalogenated xenoestrogens (TEXB-α) and endogenous hormones and more polar xenoestrogens (TEXB-β) was determined in serum samples using high-performance liquid chromatography and E-Screen bioassay. Odds ratios for breast cancer comparing tertiles of serum TEXB-α and TEXB-β were estimated using logistic models, and smooth risk trends were obtained using spline models. RESULTS Cases had higher geometric mean TEXB-α and TEXB-β levels (8.32 and 9.94 Eeq pM/mL, respectively) than controls (2.99 and 5.96 Eeq pM/mL, respectively). The fully adjusted odds ratios for breast cancer (95% confidence intervals) comparing the second and third tertiles of TEXB-α with the first tertile were 1.77 (0.76, 4.10) and 3.45 (1.50, 7.97), respectively, and those for TEXB-β were 2.35 (1.10, 5.03) and 4.01 (1.88, 8.56), respectively. A steady increase in risk was evident across all detected TEXB-α levels and a sigmoidal trend was observed for TEXB-β. Individual xenoestrogens showed weak and opposing associations with breast cancer risk. CONCLUSIONS This is the first study to show a strong positive association between serum total xenoestrogen burden and breast cancer risk, highlighting the importance of evaluating xenoestrogen mixtures, rather than single compounds, when studying hormone-related cancers. CITATION Pastor-Barriuso R, Fernández MF, Castaño-Vinyals G, Whelan D, Pérez-Gómez B, Llorca J, Villanueva CM, Guevara M, Molina-Molina JM, Artacho-Cordón F, Barriuso-Lapresa L, Tusquets I, Dierssen-Sotos T, Aragonés N, Olea N, Kogevinas M, Pollán M. 2016. Total effective xenoestrogen burden in serum samples and risk for breast cancer in a population-based multicase-control study in Spain. Environ Health Perspect 124:1575-1582; http://dx.doi.org/10.1289/EHP157.
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Affiliation(s)
- Roberto Pastor-Barriuso
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mariana F. Fernández
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), University of Granada, Granada, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
| | - Denis Whelan
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- USA-Spain Fulbright Commission for Cultural, Educational and Scientific Exchange, Madrid, Spain
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Javier Llorca
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, Santander, Spain
| | - Cristina M. Villanueva
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Public Health Institute of Navarra, Pamplona, Spain
| | | | | | - Laura Barriuso-Lapresa
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Public Health Institute of Navarra, Pamplona, Spain
| | - Ignasi Tusquets
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Medicine Department, Autonomous University of Barcelona, Barcelona, Spain
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Trinidad Dierssen-Sotos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, Santander, Spain
| | - Nuria Aragonés
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Nicolás Olea
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), University of Granada, Granada, Spain
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Address correspondence to M. Pollán, National Center for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029 Madrid, Spain. Telephone: 34 91 822 26 35. E-mail:
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21
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Gómez-Acebo I, Dierssen-Sotos T, Palazuelos C, Pérez-Gómez B, Lope V, Tusquets I, Alonso MH, Moreno V, Amiano P, Molina de la Torre AJ, Barricarte A, Tardon A, Camacho A, Peiro-Perez R, Marcos-Gragera R, Muñoz M, Michelena-Echeveste MJ, Ortega Valin L, Guevara M, Castaño-Vinyals G, Aragonés N, Kogevinas M, Pollán M, Llorca J. The Use of Antihypertensive Medication and the Risk of Breast Cancer in a Case-Control Study in a Spanish Population: The MCC-Spain Study. PLoS One 2016; 11:e0159672. [PMID: 27508297 PMCID: PMC4979888 DOI: 10.1371/journal.pone.0159672] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/05/2016] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The evidence on the relationship between breast cancer and different types of antihypertensive drugs taken for at least 5 years is limited and inconsistent. Furthermore, the debate has recently been fueled again with new data reporting an increased risk of breast cancer among women with a long history of use of antihypertensive drugs compared with nonusers. METHODS In this case-control study, we report the antihypertensive drugs-breast cancer relationship in 1,736 breast cancer cases and 1,895 healthy controls; results are reported stratifying by the women's characteristics (i.e., menopausal status or body mass index category) tumor characteristics and length of use of antihypertensive drugs. RESULTS The relationship among breast cancer and use of calcium channel blockers (CCB) for 5 or more years had odds ratio (OR) = 1.77 (95% CI, 0.99 to 3.17). Stratifying by BMI, the OR increased significantly in the group with BMI ≥ 25 (OR 2.54, 95% CI, 1.24 to 5.22). CCBs were even more strongly associated with more aggressive tumors, (OR for invasive tumors = 1.96, 95% CI = 1.09 to 3.53; OR for non ductal cancers = 3.97, 95% CI = 1.73 to 9.05; OR for Erbb2+ cancer = 2.97, 95% CI: 1.20 to 7.32). On the other hand, premenopausal women were the only group in which angiotensin II receptor blockers may be associated with breast cancer (OR = 4.27, 95% CI = 1.32 to 13.84) but this could not be identified with any type or stage. Use of angiotensin-converting-enzyme inhibitors, beta blockers and diuretics were not associated with risk. CONCLUSIONS In this large population-based study we found that long term use of calcium channel blockers is associated with some subtypes of breast cancer (and with breast cancer in overweight women).
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Affiliation(s)
- Inés Gómez-Acebo
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- University of Cantabria–IDIVAL, Santander, Spain
| | - Trinidad Dierssen-Sotos
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- University of Cantabria–IDIVAL, Santander, Spain
| | | | - Beatriz Pérez-Gómez
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Virginia Lope
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Ignasi Tusquets
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
- Cancer Research Program IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M. Henar Alonso
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, and University of Barcelona, Barcelona, Spain
| | - Victor Moreno
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, and University of Barcelona, Barcelona, Spain
| | - Pilar Amiano
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, Guipuzkoa, Spain
| | - Antonio José Molina de la Torre
- Área de Medicina Preventiva y Salud Pública, Departamento de Ciencias Biomédicas, Universidad de León, León, España
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS), Universidad de León, León, España
| | - Aurelio Barricarte
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA) Pamplona, Pamplona, Spain
| | - Adonina Tardon
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- IUOPA, Universidad de Oviedo, Oviedo, Spain
| | - Antonio Camacho
- Hospital Juan Ramon Jimenez, Andalusian Health Service, Huelva, España
- Research Center for Health and the Environment (CYSMA), Universidad de Huelva, Huelva, España
| | - Rosana Peiro-Perez
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Area de Cáncer y Salud Pública, Fundación FISABIO- Salud Pública, Valencia, Spain
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia and Descriptive Epidemiology, Genetics and Cancer Prevention Group [Girona Biomedical Research Institute (IdIBGi)], Catalan Institute of Oncology, Girona, Spain
| | - Montse Muñoz
- Translational Genomics and Targeted Therapeutics in Solid Tumors (IDIBAPS), Barcelona, Spain
| | | | | | - Marcela Guevara
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS), Universidad de León, León, España
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Gemma Castaño-Vinyals
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Nuria Aragonés
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Manolis Kogevinas
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Marina Pollán
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Javier Llorca
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- University of Cantabria–IDIVAL, Santander, Spain
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22
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Rojo F, González-Pérez A, Furriol J, Nicolau MJ, Ferrer J, Burgués O, Sabbaghi M, González-Navarrete I, Cristobal I, Serrano L, Zazo S, Madoz J, Servitja S, Tusquets I, Albanell J, Lluch A, Rovira A, Eroles P. Non-canonical NF-κB pathway activation predicts outcome in borderline oestrogen receptor positive breast carcinoma. Br J Cancer 2016; 115:322-31. [PMID: 27404455 PMCID: PMC4973161 DOI: 10.1038/bjc.2016.204] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 08/06/2015] [Revised: 05/26/2016] [Accepted: 06/02/2016] [Indexed: 12/17/2022] Open
Abstract
Background: NF-κB signalling appears deregulated in breast tumours. The purpose of this study was to determine whether the non-canonical NF-κB pathway, is activated in oestrogen receptor positive (ER+) breast cancer, to identify any correlation between its activity and the clinico-pathological phenotype and to explore whether NF-κB2 and RelB subunits and/or any of their target genes might be used as a predictive marker. Methods: Two independent cohorts of ER+ early breast cancer patients treated with adjuvant endocrine therapy were included in the study. Activation of RelB and NF-κB2 subunits was determined in a training set of 121 patients by measuring DNA-binding activities in nuclear extracts from fresh frozen specimens by an ELISA-based assay. Samples of 15 ER− breast cancer patients were also included in the study. In a large validation cohort of 207 patients, nuclear immunostaining of RelB and NF-κB2 on formalin-fixed paraffin-embedded specimens was performed. Statistical correlation within clinico-pathological factors, disease-free survival (DFS) and overall survival (OS) was evaluated. Publicly available gene expression and survival data have been interrogated aimed to identify target genes. Results: Activation of NF-κB2 and RelB was found in 53.7 and 49.2% of the 121 ER+ tumours analysed, with similar levels to ER− breast tumours analysed in parallel for comparisons. In the validation cohort, we obtained a similar proportion of cases with activation of NF-κB2 and RelB (59.9 and 32.4%), with a 39.6% of co-activation. Multiplexing immunofluorescence in breast cancer tissue confirmed an inverse spatial distribution of ER with NF-κB2 and RelB nuclear expression in tumour cells. Interestingly, NF-κB2 and RelB mRNA expression was inversely correlated with ER gene (ESR1) levels (P<0.001, both) and its activation was significantly associated with worse DFS (P=0.005 and P=0.035, respectively) in ER+ breast cancer. Moreover, the co-activation of both subunits showed a stronger association with early relapse (P=0.002) and OS (P=0.001). Finally, higher expression of the non-canonical NF-κB target gene myoglobin was associated with a poor outcome in ER+ breast cancer (DFS, P<0.05). Conclusions: The non-canonical NF-κB pathway activation is inversely associated with oestrogen receptor expression in ER+ breast cancer and predicts poor survival in this subgroup. The myoglobin gene expression has been identified as a possible surrogate marker of the non-canonical NF-κB pathway activation in these tumours.
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Affiliation(s)
- Federico Rojo
- Pathology Department, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
| | | | - Jessica Furriol
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
| | - Ma Jesús Nicolau
- Pathology Department Hospital General Universitario de Castellón, 12004 Castellón, Spain
| | - Jaime Ferrer
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
| | - Octavio Burgués
- Pathology Department, Hospital Clinico Universitario, 46010 Valencia, Spain
| | - MohammadA Sabbaghi
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), 08003 Barcelona, Spain.,Medical Oncology Department, Hospital del Mar, 08003 Barcelona, Spain
| | | | - Ion Cristobal
- Pathology Department, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Laia Serrano
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), 08003 Barcelona, Spain
| | - Sandra Zazo
- Pathology Department, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Juan Madoz
- Pathology Department, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Sonia Servitja
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), 08003 Barcelona, Spain.,Medical Oncology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Ignasi Tusquets
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), 08003 Barcelona, Spain.,Medical Oncology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Joan Albanell
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), 08003 Barcelona, Spain.,Medical Oncology Department, Hospital del Mar, 08003 Barcelona, Spain.,Universitat Pompeu Fabra, 08002 Barcelona, Spain
| | - Ana Lluch
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain.,Oncology and Hematology Department, Hospital Clinico Universitario, 46010 Valencia, Spain
| | - Ana Rovira
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), 08003 Barcelona, Spain.,Medical Oncology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Pilar Eroles
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
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Rodríguez-Sanz M, Prieto-Alhambra D, Servitja S, Garcia-Giralt N, Garrigos L, Rodriguez-Morera J, Albanell J, Martínez-García M, González I, Diez-Perez A, Tusquets I, Nogués X. AI-related BMD variation in actual practice conditions: A prospective cohort study. Endocr Relat Cancer 2016; 23:303-12. [PMID: 26911377 DOI: 10.1530/erc-16-0025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 02/24/2016] [Indexed: 01/23/2023]
Abstract
The aim of the study was to evaluate the progression of bone mineral density (BMD) during 3 years of aromatase inhibitors (AI) therapy in actual practice conditions. This prospective, clinical cohort study of Barcelona-Aromatase induced Bone Loss in Early breast cancer (B-ABLE) assessed BMD changes during 3 years of AI treatment in women with breast cancer. Patients with osteoporosis (T score < -2.5 or T score ≤ -2.0) and a major risk factor and/or prevalent fragility fractures were treated with oral bisphosphonates (BPs). Of 685 women recruited, 179 (26.1%) received BP treatment. By the third year of AI therapy, this group exhibited increased BMD in the lumbar spine (LS; 2.59%) and femoral neck (FN; 2.50%), although the increase was significant only within the first year (LS: 1.99% and FN: 2.04%). Despite BP therapy, however, approximately 15% of these patients lost more than 3% of their baseline bone mass. At 3 years, patients without BP experienced BMD decreases in the LS (-3.10%) and FN (-2.79%). In this group, BMD changes occurred during the first (LS: -1.33% and FN: -1.25%), second (LS: -1.19% and FN: -0.82%), and third (LS: -0.57% and FN: -0.65%) years of AI treatment. Increased BMD (>3%) was observed in just 7.6% and 10.8% of these patients at the LS and FN, respectively. Our data confirm a clinically relevant bone loss associated with AI therapy amongst nonusers of preventative BPs. We further report on the importance of BMD monitoring as well as calcium and 25-hydroxy vitamin D supplementation in these patients.
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Affiliation(s)
- María Rodríguez-Sanz
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Barcelona, Spain
| | - Daniel Prieto-Alhambra
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Barcelona, Spain IDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, Spain Nuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK MRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UK
| | - Sonia Servitja
- Cancer Research ProgramIMIM (Hospital del Mar Research Institute), Medical Oncology Department, Hospital del Mar, Autonomous University of Barcelona, Barcelona, Spain
| | - Natalia Garcia-Giralt
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Barcelona, Spain
| | - Laia Garrigos
- Cancer Research ProgramIMIM (Hospital del Mar Research Institute), Medical Oncology Department, Hospital del Mar, Autonomous University of Barcelona, Barcelona, Spain
| | - Jaime Rodriguez-Morera
- Internal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Albanell
- Cancer Research ProgramIMIM (Hospital del Mar Research Institute), Medical Oncology Department, Hospital del Mar, Autonomous University of Barcelona, Barcelona, Spain
| | - Maria Martínez-García
- Cancer Research ProgramIMIM (Hospital del Mar Research Institute), Medical Oncology Department, Hospital del Mar, Autonomous University of Barcelona, Barcelona, Spain
| | - Iria González
- Cancer Research ProgramIMIM (Hospital del Mar Research Institute), Medical Oncology Department, Hospital del Mar, Autonomous University of Barcelona, Barcelona, Spain
| | - Adolfo Diez-Perez
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Barcelona, Spain Internal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ignasi Tusquets
- Cancer Research ProgramIMIM (Hospital del Mar Research Institute), Medical Oncology Department, Hospital del Mar, Autonomous University of Barcelona, Barcelona, Spain
| | - Xavier Nogués
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Barcelona, Spain Internal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
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24
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Rodríguez-Sanz M, Prieto-Alhambra D, Servitja S, García-Giralt N, Garrigos L, Albanell J, Martínez-García M, González I, Martos T, Díez-Pérez A, Tusquets I, Nogués X. Evolución de la DMO durante el tratamiento con inhibidores de aromatasa y su relación con el gen CYP11A1: estudio prospectivo de la cohorte B-ABLE. Rev Osteoporos Metab Miner 2015. [DOI: 10.4321/s1889-836x2015000400004] [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: 11/11/2022] Open
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25
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Lope V, García-Esquinas E, Pérez-Gómez B, Altzibar JM, Gracia-Lavedan E, Ederra M, Molina de la Torre AJ, LLorca FJ, Tardón A, Moreno V, Bayo J, Salas-Trejo D, Marcos-Gragera R, Pumarega J, Dierssen-Sotos T, Lera JPB, de Miguel Medina MAC, Tusquets I, Amiano P, Boldo E, Kogevinas M, Aragonés N, Castaño-Vinyals G, Pollán M. Perinatal and childhood factors and risk of breast cancer subtypes in adulthood. Cancer Epidemiol 2015; 40:22-30. [PMID: 26613540 DOI: 10.1016/j.canep.2015.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 11/04/2015] [Accepted: 11/06/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Accumulated exposure to hormones and growth factors during early life may influence the future risk of breast cancer (BC). This study examines the influence of childhood-related, socio-demographic and anthropometric variables on BC risk, overall and by specific pathologic subtypes. METHODS This is a case-control study where 1539 histologically-confirmed BC cases (23-85 years) and 1621 population controls, frequency matched by age, were recruited in 10 Spanish provinces. Perinatal and childhood-related characteristics were directly surveyed by trained staff. The association with BC risk, globally and according to menopausal status and pathologic subtypes, was evaluated using logistic and multinomial regression models, adjusting for tumor specific risk factors. RESULTS Birth characteristics were not related with BC risk. However, women with high socioeconomic level at birth presented a decreased BC risk (OR=0.45; 95% CI=0.29-0.70), while those whose mothers were aged over 39 years at their birth showed an almost significant excess risk of hormone receptor positive tumors (HR+) (OR=1.35; 95% CI=0.99-1.84). Women who were taller than their girl mates before puberty showed increased postmenopausal BC risk (OR=1.26; 95% CI=1.03-1.54) and increased HR+ BC risk (OR=1.26; 95% CI=1.04-1.52). Regarding prepubertal weight, while those women who were thinner than average showed higher postmenopausal BC risk (OR=1.46; 95% CI=1.20-1.78), associated with HR+ tumors (OR=1.34; 95% CI=1.12-1.61) and with triple negative tumors (OR=1.56; 95% CI=1.03-2.35), those who were heavier than average presented lower premenopausal BC risk (OR=0.64; 95% CI=0.46-0.90) and lower risk of epidermal growth factor receptor positive tumors (OR=0.61; 95% CI=0.40-0.93). CONCLUSION These data reflect the importance of hormones and growth factors in the early stages of life, when the mammary gland is in development and therefore more vulnerable to proliferative stimuli.
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Affiliation(s)
- Virginia Lope
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain.
| | - Esther García-Esquinas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Arzobispo Morcillo 4, 28029 Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain
| | - Jone M Altzibar
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Public Health Division of Gipuzkoa, Avenida de Navarra 4, 20013 Donostia, San Sebastián, Spain; Biodonostia Research Institute, Doctor Begiristain s/n, 20014 Donostia, San Sebastián, Spain
| | - Esther Gracia-Lavedan
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Centre for Research in Environmental Epidemiology (CREAL). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - María Ederra
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Early Detection Section, Public Health Institute of Navarra, Leyre 15, 31003 Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Irunlarrea 3, 31008 Pamplona, Spain
| | | | - Francisco Javier LLorca
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Universidad de Cantabria-IDIVAL. Avenida Cardenal Herrera Oria s/n, 39011, Santander, Spain
| | - Adonina Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Instituto Universitario de Oncología, Universidad de Oviedo, Facultad de Medicina, Planta 7, Campus de El Cristo B, 33006 Oviedo, Asturias, Spain
| | - Víctor Moreno
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; IDIBELL-Catalan Institute of Oncology, Gran Via km 2.7, 08907L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge, Pavelló de Govern, Feixa Llarga s/n 08907, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Juan Bayo
- Servicio de Oncología Médica, Hospital Juan Ramón Jiménez, Avenida de la Orden s/n, 21005 Huelva, Spain; Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Campus Universitario de El Carmen, 21071 Huelva, Spain
| | - Dolores Salas-Trejo
- General Directorate Public Health, and FISABIO, Avenida de Catalunya, 21, 46020 Valencia, Spain
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), Carrer del Sol 15, 17004 Girona, Spain
| | - José Pumarega
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer (GRECMC), Hospital del Mar Medical Research Institute (IMIM), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Trinidad Dierssen-Sotos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Universidad de Cantabria-IDIVAL. Avenida Cardenal Herrera Oria s/n, 39011, Santander, Spain
| | - Juan Pablo Barrio Lera
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Universidad de León, 24071 León, Spain
| | - M A Concepción de Miguel Medina
- Navarra Institute for Health Research (IdiSNA), Irunlarrea 3, 31008 Pamplona, Spain; Pathology Department, Navarra Hospital Complex, Irunlarrea 3, 31008 Pamplona, Spain
| | - Ignasi Tusquets
- Servei d'Oncologia Mèdica, Hospital del Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain; Cancer Research Program IMIM (Hospital del Mar Medical Research Institute). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Autònoma de Barcelona, Plaza Cívica s/n, 08193 Bellaterra, Barcelona, Spain
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Public Health Division of Gipuzkoa, Avenida de Navarra 4, 20013 Donostia, San Sebastián, Spain; Biodonostia Research Institute, Doctor Begiristain s/n, 20014 Donostia, San Sebastián, Spain
| | - Elena Boldo
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Centre for Research in Environmental Epidemiology (CREAL). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Nuria Aragonés
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Centre for Research in Environmental Epidemiology (CREAL). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain
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Servitja S, Martos T, Rodriguez Sanz M, Garcia-Giralt N, Prieto-Alhambra D, Garrigos L, Nogues X, Tusquets I. Skeletal adverse effects with aromatase inhibitors in early breast cancer: evidence to date and clinical guidance. Ther Adv Med Oncol 2015; 7:291-6. [PMID: 26327926 DOI: 10.1177/1758834015598536] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Aromatase inhibitors (AIs) are routinely used in the adjuvant treatment of women with hormone receptor-positive early breast cancer. Patients who receive AIs have an increased risk of bone loss and arthralgia compared with those treated with tamoxifen. In addition to the effects of AIs, the population of women with early breast cancer has a high prevalence of 25-hydroxyvitamin D (25(OH)D) insufficiency. In our experience 88% of patients had concentrations lower than 30 ng/ml. Vitamin D supplementation should be adapted to the baseline concentration. Another relevant finding in our research program was the close relationship between 25(OH)D levels and intensity of AI-related arthralgia (AIrA). A target concentration of 40 ng/ml 25(OH)D may prevent development of AIrA. We also demonstrate that AIrA is genetically determined: single nucleotide polymorphisms located in genes encoding key factors for the metabolism of estrogens and vitamin D (CYP17A1, VDR, and CYP27B1) are associated with self-reported arthralgia during AI therapy. We recommend establishing an individualized protocol of bone-health surveillance based on baseline and evolutionary clinical variables.
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Affiliation(s)
- Sonia Servitja
- Medical Oncology Department, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Tamara Martos
- Medical Oncology Department, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Maria Rodriguez Sanz
- Internal Medicine Department and URFOA-IMIM Department, Instituto de Salud Carlos III FEDER, Barcelona, Spain
| | - Natalia Garcia-Giralt
- Internal Medicine Department and URFOA-IMIM Department, Instituto de Salud Carlos III FEDER, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Internal Medicine Department and URFOA-IMIM Department, Instituto de Salud Carlos III FEDER, Barcelona, Spain, and Nuffield Department of Orthopaedics, University of Oxford, Oxford, UK
| | - Laia Garrigos
- Medical Oncology Department, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Xavier Nogues
- Internal Medicine Department and URFOA-IMIM Department, Instituto de Salud Carlos III FEDER, Barcelona, Spain
| | - Ignasi Tusquets
- Medical Oncology Department, Parc de Salut Mar, Cancer Research Program, Hospital del Mar Medical Research Institute, Passeig Maritim 25, 08003 Barcelona, Spain
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López Garcýa B, Ortonobes Roig S, Servitja S, Grau S, Tusquets I, Salas E, Albanell J, Conde-Estévez D. 1624 Antibiotic lock therapy with vancomycin and daptomycin for cathether salvage in long-term catheter. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30712-2] [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: 11/30/2022]
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Rodríguez-Sanz M, García-Giralt N, Prieto-Alhambra D, Servitja S, Balcells S, Pecorelli R, Díez-Pérez A, Grinberg D, Tusquets I, Nogués X. CYP11A1 expression in bone is associated with aromatase inhibitor-related bone loss. J Mol Endocrinol 2015; 55:69-79. [PMID: 26108486 DOI: 10.1530/jme-15-0079] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2015] [Indexed: 11/08/2022]
Abstract
Aromatase inhibitors (AIs) used as adjuvant therapy in postmenopausal women with hormone receptor-positive breast cancer cause diverse musculoskeletal side effects that include bone loss and its associated fracture. About half of the 391 patients treated with AIs in the Barcelona-Aromatase induced bone loss in early breast cancer cohort suffered a significant bone loss at lumbar spine (LS) and/or femoral neck (FN) after 2 years on AI-treatment. In contrast, up to one-third (19.6% LS, 38.6% FN) showed no decline or even increased bone density. The present study aimed to determine the genetic basis for this variability. SNPs in candidate genes involved in vitamin D and estrogen hormone-response pathways (CYP11A1, CYP17A1, HSD3B2, HSD17B3, CYP19A1, CYP2C19, CYP2C9, ESR1, DHCR7, GC, CYP2R1, CYP27B1, VDR and CYP24A1) were genotyped for association analysis with AI-related bone loss (AIBL). After multiple testing correction, 3 tag-SNPs (rs4077581, s11632698 and rs900798) located in the CYP11A1 gene were significantly associated (P<0.005) with FN AIBL at 2 years of treatment. Next, CYP11A1 expression in human fresh bone tissue and primary osteoblasts was demonstrated by RT-PCR. Both common isoforms of human cholesterol side-chain cleavage enzyme (encoded by CYP11A1 gene) were detected in osteoblasts by western blot. In conclusion, the genetic association of CYP11A1 gene with AIBL and its expression in bone tissue reveals a potential local function of this enzyme in bone metabolism regulation, offering a new vision of the steroidogenic ability of this tissue and new understanding of AI-induced bone loss.
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Affiliation(s)
- M Rodríguez-Sanz
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain
| | - N García-Giralt
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain
| | - D Prieto-Alhambra
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Ai
| | - S Servitja
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain
| | - S Balcells
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain
| | - R Pecorelli
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain
| | - A Díez-Pérez
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain
| | - D Grinberg
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain
| | - I Tusquets
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain
| | - X Nogués
- IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain IMIM (Hospital del Mar Research Institute)Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), ISCIII, Carrer del Doctor Aiguader 88, 08003 Barcelona, SpainInternal Medicine DepartmentHospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainIDIAP Jordi Gol Primary Care Research InstituteUniversitat Autònoma de Barcelona, Barcelona, SpainNuffield Department of OrthopaedicsRheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UKMRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton, UKMedical Oncology DepartmentIMIM (Hospital del Mar Research Institute), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, SpainDepartament de GenèticaUniversitat de Barcelona, IBUB, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain
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Conde-Estévez D, Echeverría-Esnal D, Tusquets I, Albanell J. Potential clinical relevant drug-drug interactions: comparison between different compendia, do we have a validated method? Ann Oncol 2015; 26:1272. [PMID: 25791633 DOI: 10.1093/annonc/mdv151] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Affiliation(s)
- D Conde-Estévez
- Department of Pharmacy, Hospital del Mar.Barcelona; Hospital del Mar Medical Research Institute (IMIM), Barcelona.
| | | | - I Tusquets
- Hospital del Mar Medical Research Institute (IMIM), Barcelona; Department of Medical Oncology, Hospital del Mar.Barcelona; Medical Oncology Department, Universitat Autònoma de Barcelona, Barcelona
| | - J Albanell
- Hospital del Mar Medical Research Institute (IMIM), Barcelona; Department of Medical Oncology, Hospital del Mar.Barcelona; Medical Oncology Department, Pompeu Fabra University, Barcelona, Spain
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Armengol-Alonso A, Tusquets I, Servitja S, Fernández-Morales L, Segui-Palmer M, Campayo M, González-Farré X, Fernández P, Gascón P, Muñoz M. Association Between Insulin Resistance (Ir) and Pathologic Complete Response (Pcr) to Neoadjuvant Chemotherapy (Nac) Among No Diabetic Women with Localized Infiltrating Breast Cancer (Libc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu328.13] [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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Tusquets I. Osteoarticular Toxicity. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu310.5] [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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García-Parra J, Dalmases A, Morancho B, Arpí O, Menendez S, Sabbaghi M, Zazo S, Chamizo C, Madoz J, Eroles P, Servitja S, Tusquets I, Yelamos J, Lluch A, Arribas J, Rojo F, Rovira A, Albanell J. Poly (ADP-ribose) polymerase inhibition enhances trastuzumab antitumour activity in HER2 overexpressing breast cancer. Eur J Cancer 2014; 50:2725-34. [PMID: 25128455 DOI: 10.1016/j.ejca.2014.07.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 06/12/2014] [Accepted: 07/07/2014] [Indexed: 11/30/2022]
Abstract
AIM Poly (ADP-ribose) polymerase (PARP) inhibitors have shown promising results in Breast Cancer (BRCA) deficient breast cancer, but not in molecularly unselected patient populations. Two lines of research in this field are needed: the identification of novel subsets of patients that could potentially benefit from PARP inhibitors and the discovery of suitable targeted therapies for combination strategies. METHODS We tested PARP inhibition, alone or combined with the anti-HER2 antibody trastuzumab on HER2+ breast cancer. We used two PARP inhibitors in clinical development, olaparib and rucaparib, as well as genetic downmodulation of PARP-1 for in vitro studies. DNA damage was studied by the formation of γH2AX foci and comet assay. Finally, the in vivo anti-tumour effect of olaparib and trastuzumab was examined in nude mice subcutaneously implanted with BT474 cells. RESULTS In a panel of four HER2 overexpressing breast cancer cell lines, both olaparib and rucaparib significantly decreased cell growth and enhanced anti-tumour effects of trastuzumab. Cells exposed to olaparib and trastuzumab had greater DNA damage than cells exposed to each agent alone. Mechanistic exploratory assays showed that trastuzumab downmodulated the homologous recombination protein proliferating cell nuclear antigen (PCNA). Combination treatment in the BT474 xenograft model resulted in enhanced growth inhibition, reduced tumour cell proliferation, and increased DNA damage and apoptosis. CONCLUSION Taken together, our results show that PARP inhibition has antitumour effects and increases trastuzumab activity in HER2 overexpressing breast cancer. These findings make this novel combination a promising strategy for clinical development.
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Affiliation(s)
- Jetzabel García-Parra
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Alba Dalmases
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Beatriz Morancho
- Preclinical Research Program, Valld'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Oriol Arpí
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Silvia Menendez
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - MohammadA Sabbaghi
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Sandra Zazo
- Pathology Department, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | | | - Juan Madoz
- Pathology Department, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Pilar Eroles
- Institute of Health Research INCLIVA, Valencia, Spain
| | - Sonia Servitja
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Ignasi Tusquets
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Medical Oncology Department, Hospital del Mar, Barcelona, Spain; Autonomous University of Barcelona, Spain
| | - Jose Yelamos
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Immunology Department, Hospital del Mar, Barcelona, Spain
| | - Ana Lluch
- Oncology and Hematology Department, Hospital Clinico Universitario, Valencia, Spain; Valencia Central University, Spain
| | - Joaquin Arribas
- Preclinical Research Program, Valld'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Department of Biochemistry and Molecular Biology, Universitat Autonoma de Barcelona, Bellaterra, Spain; Institució Catalana de Recerca I Estudis Avançats (ICREA), Barcelona, Spain
| | - Federico Rojo
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jiménez Díaz, Madrid, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Ana Rovira
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Joan Albanell
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Medical Oncology Department, Hospital del Mar, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain.
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Lluch A, Álvarez I, Muñoz M, Seguí MÁ, Tusquets I, García-Estévez L. Treatment innovations for metastatic breast cancer: Nanoparticle albumin-bound (NAB) technology targeted to tumors. Crit Rev Oncol Hematol 2014; 89:62-72. [DOI: 10.1016/j.critrevonc.2013.08.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 07/11/2013] [Accepted: 08/09/2013] [Indexed: 01/28/2023] Open
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Rojo F, Domingo L, Sala M, Zazo S, Chamizo C, Menendez S, Arpi O, Corominas JM, Bragado R, Servitja S, Tusquets I, Nonell L, Macià F, Martínez J, Rovira A, Albanell J, Castells X. Gene expression profiling in true interval breast cancer reveals overactivation of the mTOR signaling pathway. Cancer Epidemiol Biomarkers Prev 2013; 23:288-99. [PMID: 24347552 DOI: 10.1158/1055-9965.epi-13-0761] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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] Open
Abstract
BACKGROUND The development and progression of true interval breast cancers (tumors that truly appear after a negative screening mammogram) is known to be different from screen-detected cancers. However, the worse clinical behavior of true interval cancers is not fully understood from a biologic basis. We described the differential patterns of gene expression through microarray analysis in true interval and screen-detected cancers. METHODS An unsupervised exploratory gene expression profile analysis was performed on 10 samples (true interval cancers = 5; screen-detected cancers = 5) using Affymetrix Human Gene 1.0ST arrays and interpreted by Ingenuity Pathway Analysis. Differential expression of selected genes was confirmed in a validation series of 91 tumors (n = 12; n = 79) by immunohistochemistry and in 24 tumors (n = 8; n = 16) by reverse transcription quantitative PCR (RT-qPCR), in true interval and screen-detected cancers, respectively. RESULTS Exploratory gene expression analysis identified 1,060 differentially expressed genes (unadjusted P < 0.05) between study groups. On the basis of biologic implications, four genes were further validated: ceruloplasmin (CP) and ribosomal protein S6 kinase, 70 kDa, polypeptide 2 (RPS6KB2), both upregulated in true interval cancers; and phosphatase and tensin homolog (PTEN) and transforming growth factor beta receptor III (TGFBR3), downregulated in true interval cancers. Their differential expression was confirmed by RT-qPCR and immunohistochemistry, consistent with mTOR pathway overexpression in true interval cancers. CONCLUSIONS True interval and screen-detected cancers show differential expression profile both at gene and protein levels. The mTOR signaling is significantly upregulated in true interval cancers, suggesting this pathway may mediate their aggressiveness. IMPACT Linking epidemiologic factors and mTOR activation may be the basis for future personalized screening strategies in women at risk of true interval cancers.
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Affiliation(s)
- Federico Rojo
- Authors' Affiliations: Departments of Pathology and Immunology, IIS-Fundación Jiménez Díaz, Madrid; Cancer Research Program; Microarray Core Facility (SAM), IMIM (Hospital del Mar Medical Research Institute); Department of Epidemiology and Evaluation, Hospital del Mar; Research Network on Health Services in Chronic Diseases (REDISSEC); Departments of Pathology, Medical Oncology, and Radiology Department, Hospital del Mar; and Universitat Pompeu Fabra, Barcelona, Spain
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Garcia-Giralt N, Rodríguez-Sanz M, Prieto-Alhambra D, Servitja S, Torres-del Pliego E, Balcells S, Albanell J, Grinberg D, Diez-Perez A, Tusquets I, Nogués X. Genetic determinants of aromatase inhibitor-related arthralgia: the B-ABLE cohort study. Breast Cancer Res Treat 2013; 140:385-95. [DOI: 10.1007/s10549-013-2638-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 07/09/2013] [Indexed: 10/26/2022]
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Estévez L, Alvarez I, Tusquets I, Seguí M, Muñoz M, Fernández Y, Lluch A. Finding the right dose of fulvestrant in breast cancer. Cancer Treat Rev 2013; 39:136-41. [DOI: 10.1016/j.ctrv.2012.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 06/06/2012] [Accepted: 06/09/2012] [Indexed: 11/28/2022]
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Tusquets I, De la Piedra C, Manso L, Crespo C, Gómez P, Calvo L, Ruiz M, Martínez P, Perelló A, Antón A, Codes M, Margelí M, Murias A, Salvador J, Seguí MA, De Juán A, Gavilá J, Luque M, Pérez D, Zamora P, Arizcum A, Chacón JI, Heras L, Barnadas A. Abstract P1-07-18: Association between Bone Turnover Markers in patients with breast cancer and bone metastases on treatment with bisphosphonates (ZOMAR study). Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p1-07-18] [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 presence of bone metastases (BMe) alters the balance of bone remodeling and consequently, levels of bone turnover markers (BTM). Increased levels of these biomarkers are related to the risk of skeletal-related events (SREs), disease progression and death. Treatment with bisphosphonates reduces the probability of SREs through osteoclastic activity inhibition. The aim of this study was to determine the relation between BTM, bone metastasis development and SREs, disease progression and death in patients with breast cancer (BC) and BMe.
Patients and methods: Observational, prospective and multicenter study. Patients with BC and BMe; no previous bone treatment in the last 6 months prior to study entry. Urinary aminoterminal telopeptide of collagen I (NTX, Osteomark NTx Urine, Wampole Laboratories, USA); urinary alpha-alpha-isomer of carboxyterminal telopeptide of collagen I (αα-CTX, ALPHA Crosslaps EIA, ids, UK) and serum bone alkaline phosphatase (BALP, OSTASE BAP, ids, UK) were determined at baseline (V0) and every 3 mo along 18 months (V6). Patients were treated with zoledronic acid (ZA) at inclusion and every 3–4 weeks.
Results: 234 patients with BC and BMe were analyzed. BTM results were available for 219 patients at basal visit (V0) and every 3 mo of treatment along 18 months (V6). Population basal characteristics (234 patients): mean age: 59.8 years; ER+: 80.3%; PR+: 64.9%; HER 2+: 18.3%. Patients with pathologic baseline levels were: 49.8% NTX, 39.6% αα-CTX and 83.4% BALP. A significant decrease was observed in BTM at V2 vs V0 after 6 months: 13.7%, 8.4% and 58.4% presented pathologic values of NTX, αα-CTX and BALP respectively. Normalized levels remained steady throughout 18 mo follow-up, finding significant decrease for each BMT for each time point except at V6 for αα-CTX. Regarding association between BTM and SREs, progression and exitus, a significant association was observed between pathologic levels of BTM throughout follow-up: with SRE at V3, V4 for NTX; with disease progression at V3, V4, V5, V6 for NTX, at V2 for αα–CTX and at each follow up visit for BALP; and with death at V1,4,5 for NTX, at V5 for αα–CTX and at V1,2,3,4,5 for BALP.
Conclusions: Addition of ZA to standard systemic therapy reduced BTM levels during the first 3 months of treatment and normalized levels remained steady throughout 18 months follow up except at Month 18 for αα-CTX. Pathological levels of BTM were significantly associated with SRE, disease progression and death.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-07-18.
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Affiliation(s)
- I Tusquets
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - C De la Piedra
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - L Manso
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - C Crespo
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - P Gómez
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - L Calvo
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - M Ruiz
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - P Martínez
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - A Perelló
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - A Antón
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - M Codes
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - M Margelí
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - A Murias
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - J Salvador
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - MA Seguí
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - A De Juán
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - J Gavilá
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - M Luque
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - D Pérez
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - P Zamora
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - A Arizcum
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - JI Chacón
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - L Heras
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
| | - A Barnadas
- Hospital del Mar, Barcelona, Spain; Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitario Vall d'Hebrón, Barcelona, Spain; Hospital Universitario A Coruña Juan Canalejo, A Coruña, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital de Basurto, Vizcaya, Spain; Hospital Son Dureta, Palma de Mallorca, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen Macarena, Sevilla, Spain; H. Universitario Trias y Pujol, Barcelona, Spain; Hospital Universitario Insular de Gran Canaria, Gran Canaria, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Parc Taulí Sabadell, Barcelona, Spain; Hospital Marqués Valdecilla, Santander, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Hospital General de Asturias, Oviedo, Spain; Hospital Costa del Sol, Málaga, Spain; Hospital La Paz, Madrid, Spain; Hospital Palencia Río Carrio
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Font R, Espinas JA, Gil-Gil M, Barnadas A, Ojeda B, Tusquets I, Segui MA, Margelí M, Arcusa A, Prat A, Garcia M, Borras JM. Prescription refill, patient self-report and physician report in assessing adherence to oral endocrine therapy in early breast cancer patients: a retrospective cohort study in Catalonia, Spain. Br J Cancer 2012; 107:1249-56. [PMID: 22955858 PMCID: PMC3494419 DOI: 10.1038/bjc.2012.389] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
AIMS To compare different methods in order to assess adherence and persistence with oral endocrine therapy in women diagnosed with breast cancer (BC) in Catalonia. MATERIALS AND METHODS This study covered all women newly diagnosed with stage I, II or IIIa BC and positive hormone receptors at six hospitals in Catalonia (Spain) in 2004. Adherence was assessed on the basis of physician report and patient self-report using a telephone questionnaire. Persistence was measured by refill prescriptions. We used the Kappa index to compare adherence measures and logistic regression to evaluate adherence-related risk factors. RESULTS The study covered a total of 692 women. Adherence ranged from 92% (self-report) to 94.7% (physician report), depending on the measure used; persistence was 74.7% at 5 years of follow-up. Low concordance between measures was observed (Kappa range: 0.018-0.267). Patients aged 50-74 years showed higher adherence than those aged <50 years. Adherence was also associated with: adjuvant chemotherapy and sequential hormonal therapy. CONCLUSIONS Concordance between the different measures was remarkably low, indicating the need for further research. Adherence is an issue in the management of BC patients taking oral drugs, and should be assessed in clinical practice.
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Affiliation(s)
- R Font
- Catalonian Cancer Strategy Unit, Department of Health, Catalonian Regional Authority, L'Hospitalet de Llobregat, Barcelona, Spain
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Carracedo A, Salido M, Corominas JM, Rojo F, Ferreira BI, Suela J, Tusquets I, Corzo C, Segura M, Espinet B, Cigudosa JC, Arumi M, Albanell J, Serrano S, Solé F. Are ER+PR+ and ER+PR- breast tumors genetically different? A CGH array study. Cancer Genet 2012; 205:138-46. [PMID: 22559974 DOI: 10.1016/j.cancergen.2012.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 12/03/2011] [Accepted: 01/03/2012] [Indexed: 11/29/2022]
Abstract
The estrogen receptor (ER) is a well-known predictor of breast cancer response to endocrine therapy. ER+ progesterone receptor (PR)- breast tumors have a poorer response to endocrine therapy and a more aggressive phenotype than ER+PR+ tumors. A comparative genomic hybridization array technique was used to examine 25 ER+PR+ and 23 ER+PR- tumors. Tissue microarrays composed of 50 ER+PR+ and 50 ER+PR- tumors were developed to validate the comparative genomic hybridization array results. The genes of interest were analyzed by fluorescence in situ hybridization. The ER+PR- group had a slightly different genomic profile when compared with ER+PR+ tumors. Chromosomes 17 and 20 contained the most overlapping gains, and chromosomes 3, 8, 9, 14, 17, 21, and 22 contained the most overlapping losses when compared with the ER+PR+ group. The gained regions, 17q23.2-q23.3 and 20q13.12, and the lost regions, 3p21.32-p12.3, 9pter-p13.2, 17pter-p12, and 21pter-q21.1, occurred at different alteration frequencies and were statistically significant in the ER+PR- tumors compared with the ER+PR+ tumors. ER+PR- breast tumors have a different genomic profile compared with ER+PR+ tumors. Differentially lost regions in the ER+PR- group included genes with tumor suppressor functions and genes involved in apoptosis, mitosis, angiogenesis, and cell spreading. Differentially gained regions included genes such as MAP3K3, RPS6KB1, and ZNF217. Amplification of these genes could contribute to resistance to apoptosis, increased activation of the PI3K/Akt/mTOR pathway, and the loss of PR in at least some ER+PR- tumors.
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Affiliation(s)
- Alma Carracedo
- Pathology Service, Molecular Cytogenetics Laboratory, Hospital del Mar, IMIM, Barcelona, Spain
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40
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Rojo F, García-Parra J, Zazo S, Tusquets I, Ferrer-Lozano J, Menendez S, Eroles P, Chamizo C, Servitja S, Ramírez-Merino N, Lobo F, Bellosillo B, Corominas JM, Yelamos J, Serrano S, Lluch A, Rovira A, Albanell J. Nuclear PARP-1 protein overexpression is associated with poor overall survival in early breast cancer. Ann Oncol 2012; 23:1156-1164. [PMID: 21908496 DOI: 10.1093/annonc/mdr361] [Citation(s) in RCA: 123] [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: 10/06/2023] Open
Abstract
BACKGROUND Poly(ADP-ribose)polymerase-1 (PARP-1) is a highly promising novel target in breast cancer. However, the expression of PARP-1 protein in breast cancer and its associations with outcome are yet poorly characterized. PATIENTS AND METHODS Quantitative expression of PARP-1 protein was assayed by a specific immunohistochemical signal intensity scanning assay in a range of normal to malignant breast lesions, including a series of patients (N = 330) with operable breast cancer to correlate with clinicopathological factors and long-term outcome. RESULTS PARP-1 was overexpressed in about a third of ductal carcinoma in situ and infiltrating breast carcinomas. PARP-1 protein overexpression was associated to higher tumor grade (P = 0.01), estrogen-negative tumors (P < 0.001) and triple-negative phenotype (P < 0.001). The hazard ratio (HR) for death in patients with PARP-1 overexpressing tumors was 7.24 (95% CI; 3.56-14.75). In a multivariate analysis, PARP-1 overexpression was an independent prognostic factor for both disease-free (HR 10.05; 95% CI 5.42-10.66) and overall survival (HR 1.82; 95% CI 1.32-2.52). CONCLUSIONS Nuclear PARP-1 is overexpressed during the malignant transformation of the breast, particularly in triple-negative tumors, and independently predicts poor prognosis in operable invasive breast cancer.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Animals
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/diagnosis
- Breast Neoplasms/metabolism
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Cell Nucleus/metabolism
- Cell Nucleus/pathology
- Cells, Cultured
- Disease Progression
- Embryo, Mammalian
- Female
- Gene Expression Regulation, Neoplastic/drug effects
- Humans
- Mice
- Mice, Knockout
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Staging
- Poly (ADP-Ribose) Polymerase-1
- Poly(ADP-ribose) Polymerase Inhibitors
- Poly(ADP-ribose) Polymerases/genetics
- Poly(ADP-ribose) Polymerases/metabolism
- Prognosis
- RNA, Small Interfering/pharmacology
- Survival Analysis
- Up-Regulation/drug effects
- Up-Regulation/genetics
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Affiliation(s)
- F Rojo
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Department of Pathology, Hospital del Mar, Barcelona; Department of Pathology, IIS-Fundación Jiménez Díaz, Madrid
| | - J García-Parra
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Medical Oncology Department, Hospital del Mar, Barcelona
| | - S Zazo
- Department of Pathology, IIS-Fundación Jiménez Díaz, Madrid
| | - I Tusquets
- Medical Oncology Department, Hospital del Mar, Barcelona
| | - J Ferrer-Lozano
- Department of Oncology and Hematology, Hospital Clinico Universitario, Valencia
| | - S Menendez
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Medical Oncology Department, Hospital del Mar, Barcelona
| | - P Eroles
- Department of Oncology and Hematology, Hospital Clinico Universitario, Valencia
| | - C Chamizo
- Department of Pathology, IIS-Fundación Jiménez Díaz, Madrid
| | - S Servitja
- Medical Oncology Department, Hospital del Mar, Barcelona
| | | | - F Lobo
- Department of Oncology, IIS-Fundación Jiménez Díaz, Madrid
| | - B Bellosillo
- Department of Pathology, Hospital del Mar, Barcelona
| | - J M Corominas
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Department of Pathology, Hospital del Mar, Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona
| | - J Yelamos
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Immunology Department, Hospital del Mar, Barcelona
| | - S Serrano
- Department of Pathology, Hospital del Mar, Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona
| | - A Lluch
- Department of Oncology and Hematology, Hospital Clinico Universitario, Valencia; Department of Medicine, Valencia Central University, Valencia, Spain
| | - A Rovira
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Medical Oncology Department, Hospital del Mar, Barcelona
| | - J Albanell
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Medical Oncology Department, Hospital del Mar, Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona.
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41
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Prieto-Alhambra D, Servitja S, Javaid MK, Garrigós L, Arden NK, Cooper C, Albanell J, Tusquets I, Diez-Perez A, Nogues X. Vitamin D threshold to prevent aromatase inhibitor-related bone loss: the B-ABLE prospective cohort study. Breast Cancer Res Treat 2012; 133:1159-67. [PMID: 22434523 DOI: 10.1007/s10549-012-2013-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 02/28/2012] [Indexed: 12/31/2022]
Abstract
Aromatase inhibitor (AI)-related bone loss is associated with increased fracture rates. Vitamin D might play a role in minimising this effect. We hypothesised that 25-hydroxy-vitamin D concentrations [25(OH)D] after 3 months supplementation might relate to bone loss after 1 year on AI therapy. We conducted a prospective cohort study from January 2006 to December 2011 of a consecutive sample of women initiating AI for early breast cancer who were ineligible for bisphosphonate therapy and stayed on treatment for 1 year (N = 232). Serum 25(OH)D was measured at baseline and 3 months, and lumbar spine (LS) bone mineral density at baseline and 1 year. Subjects were supplemented with daily calcium (1 g) and vitamin D(3) (800 IU) and additional oral 16,000 IU every 2 weeks if baseline 25(OH)D was <30 ng/ml. Linear regression models were fitted to adjust for potential confounders. After 1 year on AI therapy, 232 participants experienced a significant 1.68 % [95 % CI 1.15-2.20 %] bone loss at LS (0.017 g/cm(2) [0.012-0.024], P < 0.0001). Higher 25(OH)D at 3 months protected against LS bone loss (-0.5 % per 10 ng/ml [95 % CI -0.7 to -0.3 %], adjusted P = 0.0001), and those who reached levels ≥40 ng/ml had reduced bone loss by 1.70 % [95 % CI 0.4-3.0 %; adjusted P = 0.005] compared to those with low 25(OH)D levels (<30 ng/ml). We conclude that improved vitamin D status using supplementation is associated with attenuation of AI-associated bone loss. For this population, the current Institute of Medicine target recommendation of 20 ng/ml might be too low to ensure good bone health.
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Affiliation(s)
- Daniel Prieto-Alhambra
- URFOA-IMIM, Parc de Salut Mar, Parc de Recerca Biomèdica de Barcelona, C/Dr Aiguader, 88, 2nd Floor, 08003 Barcelona, Spain.
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42
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Albanell J, González A, Ruiz-Borrego M, Alba E, García-Saenz JA, Corominas JM, Burgues O, Furio V, Rojo A, Palacios J, Bermejo B, Martínez-García M, Limon ML, Muñoz AS, Martín M, Tusquets I, Rojo F, Colomer R, Faull I, Lluch A. Prospective transGEICAM study of the impact of the 21-gene Recurrence Score assay and traditional clinicopathological factors on adjuvant clinical decision making in women with estrogen receptor-positive (ER+) node-negative breast cancer. Ann Oncol 2012; 23:625-631. [PMID: 21652577 DOI: 10.1093/annonc/mdr278] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This study examined the impact of the Recurrence Score (RS) in Spanish breast cancer patients and explored the associations between clinicopathological markers and likelihood of change in treatment recommendations. PATIENTS AND METHODS Enrollment was offered consecutively to eligible women with estrogen receptor-positive; human epidermal growth factor receptor 2-negative, node-negative breast cancer. Oncologists recorded treatment recommendation and confidence in it before and after knowing the patient's RS. RESULTS Treatment recommendation changed in 32% of 107 patients enrolled: in 21% from chemohormonal (CHT) to hormonal therapy (HT) and in 11% from HT to CHT. RS was associated with the likelihood of change from HT to CHT (P < 0.001) and from CHT to HT (P < 0.001). Confidence of oncologists in treatment recommendations increased for 60% of cases. Higher tumor grade (P = 0.007) and a high proliferative index (Ki-67) (P = 0.023) were significantly associated with a greater chance of changing from HT to CHT, while positive progesterone receptor status (P = 0.002) with a greater probability of changing from CHT to HT. CONCLUSIONS Results from the first prospective European study are consistent with published experience and use of the RS as proposed in European clinical practice guidelines and provide evidence on how Oncotype DX and clinicopathological factors are complementary and patient selection may be improved.
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Affiliation(s)
- J Albanell
- Medical Oncology Service, Hospital del Mar, Barcelona; Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona.
| | - A González
- Medical Oncology Service, MD Anderson, Madrid
| | - M Ruiz-Borrego
- Medical Oncology Service, Hospital Virgen del Rocío, Sevilla
| | - E Alba
- Medical Oncology Service, Hospital Virgen de la Victoria, Málaga
| | | | - J M Corominas
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona; Pathology Service, Hospital del Mar, Barcelona
| | - O Burgues
- Pathology Service, Hospital Clínico, Valencia
| | - V Furio
- Pathology Service, Hospital Clínico, Madrid
| | - A Rojo
- Pathology Service, MD Anderson, Madrid
| | - J Palacios
- Pathology Service, Hospital Virgen del Rocío, Sevilla
| | - B Bermejo
- Department of Hematology and Oncology, Hospital Clínico de Valencia, Valencia
| | - M Martínez-García
- Medical Oncology Service, Hospital del Mar, Barcelona; Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona
| | - M L Limon
- Medical Oncology Service, Hospital Virgen del Rocío, Sevilla
| | - A S Muñoz
- Medical Oncology Service, Hospital Virgen de la Victoria, Málaga
| | - M Martín
- Medical Oncology Service, Hospital Gregorio Marañón Madrid, Madrid
| | - I Tusquets
- Medical Oncology Service, Hospital del Mar, Barcelona; Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona
| | - F Rojo
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Pathology Service, Fundación Jiménez Díaz, Madrid
| | - R Colomer
- Medical Oncology Service, MD Anderson, Madrid
| | | | - A Lluch
- Department of Hematology and Oncology, Hospital Clínico de Valencia, Valencia
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43
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Servitja S, Nogués X, Prieto-Alhambra D, Martínez-García M, Garrigós L, Peña MJ, de Ramon M, Díez-Pérez A, Albanell J, Tusquets I. Bone health in a prospective cohort of postmenopausal women receiving aromatase inhibitors for early breast cancer. Breast 2011; 21:95-101. [PMID: 21924904 DOI: 10.1016/j.breast.2011.09.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2011] [Revised: 08/30/2011] [Accepted: 09/01/2011] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Baseline bone health in postmenopausal women is poorly characterized in prospective series of early breast cancer (EBC) patients candidates to aromatase inhibitor (AI) therapy. Our objective is to comprehensively evaluate bone health in a prospective clinical cohort of patients recruited prior to adjuvant AI therapy, with the aim of establishing potential AI impact on bone loss and fractures. METHODS From January 2006 to April 2010, we consecutively included 343 women with EBC who were about to start adjuvant AI therapy. Participants were assessed at baseline (before AI initiation) and at 3 months, with annual assessments thereafter. Bone mineral density (BMD), spine X-ray, bone metabolism (vitamin D [25(OH)D], bone turnover markers [BTM]), arthralgia and quality of life are measured. RESULTS Mean age was 61.9 years; 197 (57.4%) had been previously treated with tamoxifen; 145 (42.3%) were taking exemestane, 187 (54.5%) letrozole, and 11 (3.2%) anastrozole. Analysis of baseline data shows only 59 women (17.7%) had normal BMD; 200 (60.1%) had osteopenia and 74 (22.2%) had osteoporosis; 39 women (11.4%) had a prevalent fracture, 293 (89.1%) had 25(OH)D insufficiency (<30 ng/ml), and 61 (18.5%) severe deficiency (<10 ng/ml). Low 25(OH)D concentrations were associated with lower BMD and 233 (67.9%) participants had some degree of arthralgia. CONCLUSIONS Low bone mass, prevalent fractures and vitamin D insufficiency were highly prevalent among candidates to adjuvant AI for EBC. Therefore, it is crucial to assess BMD, prevalent fractures and 25(OH)D concentrations before starting AI therapy and during follow-up.
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Affiliation(s)
- Sònia Servitja
- Medical Oncology Department, Breast Cancer Unit, Parc de Salut Mar-Barcelona, Molecular Therapeutics and Biomarkers in Breast Cancer, Cancer Research Program, Autonomous University of Barcelona, Spain.
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Manso L, Tusquets I, De la Piedra C, Crespo C, Gomez P, Calvo L, Galve E, Borrego MR, Rifá J, Barnadas A. 5022 POSTER DISCUSSION Association Between Circulating Tumour Cells and Bone Turnover Markers in Patients With Breast Cancer and Bone Metastases on Treatment With Bisphosphonates (ZOMAR Study). Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71464-2] [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: 10/17/2022]
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Barnadas A, De la Piedra C, Crespo C, Gomez Pardo P, Calvo L, Calvo EG, Ruiz-Borrego M, Rifa J, Manso L, Anton A, Codes M, Margeli M, Murias A, Salvador J, Seguí-Palmer MA, De Juan A, Gavila J, Perez D, Luque M, Tusquets I. Association between bone turnover markers and skeletal-related events in patients with breast cancer and bone metastases on treatment with bisphosphonates: ZOMAR study results at nine months of follow-up. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.594] [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: 11/20/2022] Open
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Servitja S, Prieto-Alhambra D, Martinez-Garcia M, Garrigos L, Pena MJ, Diez-Perez A, Albanell J, Nogues X, Tusquets I. Vitamin D repletion and prevention of bone loss in nonosteoporotic women with breast cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9026] [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: 11/20/2022] Open
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47
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Estévez LG, Álvarez I, Seguí MÁ, Muñoz M, Margelí M, Miró C, Rubio C, Lluch A, Tusquets I. Current perspectives of treatment of ductal carcinoma in situ. Cancer Treat Rev 2010; 36:507-17. [DOI: 10.1016/j.ctrv.2010.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 03/15/2010] [Accepted: 03/21/2010] [Indexed: 11/16/2022]
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48
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Nogues X, Servitja S, Peña MJ, Prieto-Alhambra D, Nadal R, Mellibovsky L, Albanell J, Diez-Perez A, Tusquets I. Vitamin D deficiency and bone mineral density in postmenopausal women receiving aromatase inhibitors for early breast cancer. Maturitas 2010; 66:291-7. [PMID: 20399042 DOI: 10.1016/j.maturitas.2010.03.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 03/15/2010] [Accepted: 03/16/2010] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Aromatase inhibitors (AI) treatment leads to an increased risk of bone loss and fractures. In a group of women with early breast cancer (EBC) and baseline Vitamin D deficiency (<30 ng/ml) who are treated with AI, we aim to describe: serum levels of Vitamin D, bone mineral density (BMD), calcium intake, and the increase of serum 25(OH)D accomplished in 3 months of treatment with Vitamin D supplements. STUDY DESIGN Prospective, non-randomized clinical trial. METHODS In 232 consecutively included women with EBC in treatment with AI, we assessed baseline calcium intake, serum levels of 25(OH)D, BMD and, spine X-ray. All received Calcium and Vitamin D supplements, and those with vitamin deficiency received 16,000 IU Vitamin D every 2 weeks. Serum levels of 25(OH)D were newly assessed after treatment. All the baseline evaluation was performed before starting AI treatment. RESULTS Mean age at baseline (+/-SD) was 63.2+/-8.8 years. In 150 (64.9%) cases, the women had been treated previously with tamoxifen; 101 (43.7%) started exemestane, 119 (51.5%) letrozole, and 11 (4.8%) anastrozole. The AI were initiated within 6 weeks after surgery or after the last cycle of chemotherapy. At baseline, 88.1% had 25(OH)D levels <30 ng/ml, 21.2% had severe deficiency (<10 ng/ml), and 25% of the participants had osteoporosis. Mean daily calcium intake was low (841+/-338). We found a significant association between 25(OH)D levels and BMD at baseline, which remained significant in femoral neck BMD after multivariate adjustment. Plasma 25(OH)D levels improved significantly at 3 months follow-up in those treated with high dose Vitamin D supplements: mean increase 32.55 ng/ml (95%CI 28.06-37.03). CONCLUSIONS Our study suggests a high prevalence of commonly unrecognized Vitamin D deficiency in women with EBC treated with AI, a known osteopenic agent. Our results support the need for a routine assessment of 25(OH)D levels and, when necessary, supplementation in these patients.
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Affiliation(s)
- Xavier Nogues
- Internal Medicine Department, URFOA-IMIM, RETICEF, Hospital del Mar, Autonomous University of Barcelona, Barcelona, Spain.
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49
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Nogués X, Servitja S, Peña M, Martinez M, Nadal R, Garrigos L, Diez Perez A, Albanell J, Tusquets I. Bone Health in Postmenopausal Women Treated with Adjuvant Aromatase Inhibitors for Early Breast Cancer: 12 Months Follow-Up. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-3175] [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: 11/16/2022]
Abstract
Abstract
Background:The use of aromatase inhibitors (AI) in the adjuvant setting for postmenopausal women with receptor-positive breast cancer is well established. The AI treatment has been associated with decline in bone mineral density (BMD), and increased bone turnover markers. We designed a prospective study to evaluate the effect of oral bisphosphonates (BP) on vertebral and non vertebral fractures (VF), bone turnover markers (bTM), BMD, and quality of life (QoL) in postmenopausal women receiving adjuvant AI for hormone receptor positive early breast cancer.Material and methods:Postmenopausal, receptor-positive breast cancer women treated with AI as initial therapy [Letrozol (LET)] or after 2 or 5 years of tamoxifen [switched to exemestane (EXE)] were included. Patients were stratified by lumbar spine, femoral neck and total hip BMD to receive open-label treatment with BP, alendronate or risedronate, (if osteoporosis [T-score<-2,5] or osteopenia [T-score<-2.0] and 1 major risk factor, defined as group of high risk of fracture) or calcium and vitamin D supplementation (if normal BMD or T-score>-2.0 and no major risk factor). Levels of 25-OH vitamin D, N-telopeptide (NTx), bone alkaline phosphatase (bALP) and osteocalcin (OC) were measured at baseline, 3, 12 and 24 moths, and BMD and thoracic and lumbar spine X-rays were assesed at baseline, 1 and 2 years. QoL was evaluated by ECOS-16 questionnaire and a visual analogue scale used to evaluate arthralgia. Results:from 03/2006 to 03/2009, 261 patients have been included and 117 have completed >12 month follow up. All the bTM increased after 12 months of AI treatment and a significant decrease on BMD was also observed (Table 1). This effect is reverted with oral BP treatment, maintaining the BMD level and reducing the bTM. With the AI introduction QoL of patients became worse, and the BP treatment did not improve neither arthralgia nor bone pain. Osteoporotic fractures were recorded at baseline in 12.3% of women (4.2% VF and 7.7% non VF).Conclusions:AI treatment increased bone turnover, decreased BMD and QoL. Of note, BP use decreased bone turnover, has neutral effect in BMD and does not improve QoL. This study suggests that the current recommendation of the use of BP should be revisited to consider including all postmenopausal women treated with adjuvant AI to avoid increased bone turnover and bone mass decrease.Table 1. BMD at baseline, 12 months and changes Without BP (n=76) With BP (n=41) BMD value (g/cm2)AIBasal12 month% change / pBasal12 month% change / pFemoral NeckLET0.7650.751- 1.96 / 0.020.6480.657+ 1.61 / NS EXE0.7560.749- 0.6 / NS0.6260.644+ 2.63 / 0.013Lumbar spineLET0.9900.969- 2.36 / 0.00010.8150.813- 0.17 / NS EXE0.9570.940- 1.57 / 0.0430.8110.814+ 0.86 / NS
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3175.
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Affiliation(s)
- X. Nogués
- 1Hospital del Mar. Autonomous University of Barcelona, Spain
| | - S. Servitja
- 2Hospital del Mar. Autonomous University of Barcelona, Spain
| | - M. Peña
- 1Hospital del Mar. Autonomous University of Barcelona, Spain
| | - M. Martinez
- 2Hospital del Mar. Autonomous University of Barcelona, Spain
| | - R. Nadal
- 2Hospital del Mar. Autonomous University of Barcelona, Spain
| | - L. Garrigos
- 2Hospital del Mar. Autonomous University of Barcelona, Spain
| | - A. Diez Perez
- 1Hospital del Mar. Autonomous University of Barcelona, Spain
| | - J. Albanell
- 2Hospital del Mar. Autonomous University of Barcelona, Spain
| | - I. Tusquets
- 2Hospital del Mar. Autonomous University of Barcelona, Spain
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50
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Mayordomo JI, Baena JM, Cirera L, Sanchez-Rovira P, Godes MJ, Galan A, Jimenez-Orozco E, Muñoz M, Tusquets I, Sanchez MJ. Final results of a randomized trial on the role of maintenance chemotherapy with weekly paclitaxel for patients with metastatic breast cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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
1001 Background: Chemotherapy for patients with metastatic breast cancer is not curative. Anthracyclines and taxanes are among the most active drugs. Optimal duration of chemotherapy in women with metastatic breast cancer is an open issue. Should they receive chemotherapy to progression or should chemotherapy be stopped after a fixed number of courses? The excellent safety profile of weekly paclitaxel prompted us to evaluate its role as maintenance treatment in this setting. The primary objective was to determine if addition of maintenance weekly paclitaxel prolongs progression-free survival in women with metastatic breast cancer on first-line chemotherapy. Secondary objectives included overall survival and toxicity. Methods: Following Ethical Committee approval and informed consent, from 2002 to 2006 180 women with metastatic breast cancer and no prior chemotherapy for metastatic disease were randomized 1:1 in the TASMAN phase III trial to: 3 courses of epirubicin 100 mg/m2 day 1 q 21 days, followed by 3 courses of paclitaxel 225 mg/m2 day 1 q 21 days, without further chemotherapy or hormonal therapy until progression (arm A), or 3 courses of epirubicin followed by 3 courses of paclitaxel and then maintenance with paclitaxel 60 mg/m2 day 1 q 7 days until progression or unacceptable toxicity (arm B). Results: Median age: 51 years (range: 30–73). Median performance status (ECOG): 0 (0–2). Sites of metastases: bone (36%), liver (20%), pleura and/or lung (19%), skin and/or lymph nodes (18%). No grade 3–4 toxicities were seen with maintenance chemotherapy. As of January 1, 2009, 18 patients remained progression-free and 48 were alive, with a minimum follow-up of 2 years. Median progression-free survival was 8 months for arm A versus 12 months for arm B (p = 0.1, logrank). Median overall survival was 24 months for each arm (p = 0.7). Conclusions: Maintenance chemotherapy with weekly paclitaxel following first-line chemotherapy with anthracycline and taxane is well tolerated but does not significantly increase progression-free survival. No significant financial relationships to disclose.
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Affiliation(s)
- J. I. Mayordomo
- Hospital Clinico Universitario, Zaragoza, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital Mutua de Terrassa, Terrassa, Spain; Complejo Hospitalario de Jaén, Jaén, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Puerto de Sagunto, Sagunto, Spain; Hospital General de Jerez, Jerez de la Frontera, Spain; Hospital Clinic, Barcelona, Spain; Hospital del Mar, Barcelona, Spain; Hospital Clinico San Cecilio, Granada, Spain
| | - J. M. Baena
- Hospital Clinico Universitario, Zaragoza, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital Mutua de Terrassa, Terrassa, Spain; Complejo Hospitalario de Jaén, Jaén, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Puerto de Sagunto, Sagunto, Spain; Hospital General de Jerez, Jerez de la Frontera, Spain; Hospital Clinic, Barcelona, Spain; Hospital del Mar, Barcelona, Spain; Hospital Clinico San Cecilio, Granada, Spain
| | - L. Cirera
- Hospital Clinico Universitario, Zaragoza, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital Mutua de Terrassa, Terrassa, Spain; Complejo Hospitalario de Jaén, Jaén, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Puerto de Sagunto, Sagunto, Spain; Hospital General de Jerez, Jerez de la Frontera, Spain; Hospital Clinic, Barcelona, Spain; Hospital del Mar, Barcelona, Spain; Hospital Clinico San Cecilio, Granada, Spain
| | - P. Sanchez-Rovira
- Hospital Clinico Universitario, Zaragoza, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital Mutua de Terrassa, Terrassa, Spain; Complejo Hospitalario de Jaén, Jaén, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Puerto de Sagunto, Sagunto, Spain; Hospital General de Jerez, Jerez de la Frontera, Spain; Hospital Clinic, Barcelona, Spain; Hospital del Mar, Barcelona, Spain; Hospital Clinico San Cecilio, Granada, Spain
| | - M. J. Godes
- Hospital Clinico Universitario, Zaragoza, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital Mutua de Terrassa, Terrassa, Spain; Complejo Hospitalario de Jaén, Jaén, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Puerto de Sagunto, Sagunto, Spain; Hospital General de Jerez, Jerez de la Frontera, Spain; Hospital Clinic, Barcelona, Spain; Hospital del Mar, Barcelona, Spain; Hospital Clinico San Cecilio, Granada, Spain
| | - A. Galan
- Hospital Clinico Universitario, Zaragoza, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital Mutua de Terrassa, Terrassa, Spain; Complejo Hospitalario de Jaén, Jaén, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Puerto de Sagunto, Sagunto, Spain; Hospital General de Jerez, Jerez de la Frontera, Spain; Hospital Clinic, Barcelona, Spain; Hospital del Mar, Barcelona, Spain; Hospital Clinico San Cecilio, Granada, Spain
| | - E. Jimenez-Orozco
- Hospital Clinico Universitario, Zaragoza, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital Mutua de Terrassa, Terrassa, Spain; Complejo Hospitalario de Jaén, Jaén, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Puerto de Sagunto, Sagunto, Spain; Hospital General de Jerez, Jerez de la Frontera, Spain; Hospital Clinic, Barcelona, Spain; Hospital del Mar, Barcelona, Spain; Hospital Clinico San Cecilio, Granada, Spain
| | - M. Muñoz
- Hospital Clinico Universitario, Zaragoza, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital Mutua de Terrassa, Terrassa, Spain; Complejo Hospitalario de Jaén, Jaén, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Puerto de Sagunto, Sagunto, Spain; Hospital General de Jerez, Jerez de la Frontera, Spain; Hospital Clinic, Barcelona, Spain; Hospital del Mar, Barcelona, Spain; Hospital Clinico San Cecilio, Granada, Spain
| | - I. Tusquets
- Hospital Clinico Universitario, Zaragoza, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital Mutua de Terrassa, Terrassa, Spain; Complejo Hospitalario de Jaén, Jaén, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Puerto de Sagunto, Sagunto, Spain; Hospital General de Jerez, Jerez de la Frontera, Spain; Hospital Clinic, Barcelona, Spain; Hospital del Mar, Barcelona, Spain; Hospital Clinico San Cecilio, Granada, Spain
| | - M. J. Sanchez
- Hospital Clinico Universitario, Zaragoza, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital Mutua de Terrassa, Terrassa, Spain; Complejo Hospitalario de Jaén, Jaén, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Puerto de Sagunto, Sagunto, Spain; Hospital General de Jerez, Jerez de la Frontera, Spain; Hospital Clinic, Barcelona, Spain; Hospital del Mar, Barcelona, Spain; Hospital Clinico San Cecilio, Granada, Spain
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