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Pedrosa L, Araujo IK, Cuatrecasas M, Soy G, López S, Maurel J, Sánchez-Montes C, Montironi C, Saurí T, Sendino O, Pérez FM, Ausania F, Fernández-Esparrach G, Espósito FM, Vaquero EC, Ginès A. Targeted transcriptomic analysis of pancreatic adenocarcinoma in EUS-FNA samples by NanoString technology. Front Mol Biosci 2023; 10:1161893. [PMID: 37266332 PMCID: PMC10230066 DOI: 10.3389/fmolb.2023.1161893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/24/2023] [Indexed: 06/03/2023] Open
Abstract
Background: Integration of transcriptomic testing into EUS-FNA samples is a growing need for precision oncology in pancreatic ductal adenocarcinoma (PDAC). The NanoString platform is suitable for transcriptome profiling in low yield RNA samples. Methods: Inclusion of patients that underwent EUS-FNA cytological diagnosis of pancreatic ductal adenocarcinoma using 19G and/or 22G needles and subsequent surgical resection. Formalin-fixed, paraffin-embedded (FFPE) cytological and surgical samples underwent RNA extraction and transcriptomic analysis using a custom 52-gene NanoString panel of stromal PDAC features. Cell type abundance was quantified in FFPE specimens and correlated. Results: 18 PDAC patients were included. Mean EUS-FNA passes was 2 + 0.7. All FFPE passed the RNA quality control for genomic analysis. Hierarchical clustering on the global gene expression data showed that genes were differentially expressed between EUS and surgical samples. A more enriched cancer-associated fibroblasts and epithelial-mesenchymal transition transcriptomic profile was observed across surgical specimens whereas immunological biomarkers were more represented in EUS-FNA samples. Cytological examination confirmed a scanty representation of CAF and more immunological cell abundance in cytological samples in comparison to surgical specimens. Conclusion: Targeted transcriptomic NanoString profiling of PDAC samples obtained by EUS-FNA is a feasible approach for pre-surgical molecular analysis although stromal CAF/EMT mRNA biomarkers are underrepresented.
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Affiliation(s)
- L. Pedrosa
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - I. K. Araujo
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Endoscopy Unit, Gastroenterology Department, ICMDM, Hospital Clínic, Barcelona, Spain
| | - M. Cuatrecasas
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Pathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clínic, Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, University of Barcelona (UB), Barcelona, Spain
| | - G. Soy
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Endoscopy Unit, Gastroenterology Department, ICMDM, Hospital Clínic, Barcelona, Spain
| | - S. López
- Pathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clínic, Barcelona, Spain
| | - J. Maurel
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, University of Barcelona (UB), Barcelona, Spain
- Medical Oncology Department, Translational Genomics and Targeted Therapies in Solid Tumors, ICMHO, Hospital Clínic, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - C. Sánchez-Montes
- Endoscopy Unit, Gastroenterology Department, ICMDM, Hospital Clínic, Barcelona, Spain
| | - C. Montironi
- Pathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clínic, Barcelona, Spain
- Molecular Biology Core, CDB, Hospital Clinic, Barcelona, Spain
| | - T. Saurí
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, University of Barcelona (UB), Barcelona, Spain
- Medical Oncology Department, Translational Genomics and Targeted Therapies in Solid Tumors, ICMHO, Hospital Clínic, Barcelona, Spain
| | - O. Sendino
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Endoscopy Unit, Gastroenterology Department, ICMDM, Hospital Clínic, Barcelona, Spain
| | - F. M. Pérez
- Pathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clínic, Barcelona, Spain
| | - F. Ausania
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, University of Barcelona (UB), Barcelona, Spain
- Department of General and Digestive Surgery, ICMDM, Hospital Clínic, Barcelona, Spain
| | - G. Fernández-Esparrach
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Endoscopy Unit, Gastroenterology Department, ICMDM, Hospital Clínic, Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, University of Barcelona (UB), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - F. M. Espósito
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Medical Oncology Department, Translational Genomics and Targeted Therapies in Solid Tumors, ICMHO, Hospital Clínic, Barcelona, Spain
| | - E. C. Vaquero
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
- Gastroenterology Department, ICMDM, Hospital Clínic, Barcelona, Spain
| | - A. Ginès
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Endoscopy Unit, Gastroenterology Department, ICMDM, Hospital Clínic, Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, University of Barcelona (UB), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
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Lahoz S, Rodriguez Hernandez A, Fernandez-Mañas L, Gorria T, Zambrano R, Esposito F, Sauri Nadal T, Pesantez Coronel D, Riu G, Cuatrecasas M, Jares P, Pedrosa L, Pineda E, Postigo A, Castells A, Prat A, Maurel J, Camps J. 352P Mutations of SMAD4 and FBXW7 predict poor outcome in TP53-driven metastatic colorectal cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Madurga S, Foguet C, Oliveres H, Mas F, Maurel J, Cascante M. 338P A new clinically applicable immune-metabolic signature (IMMETCOLS) reveals metabolic singularities in consensus molecular subtypes (CMS) in colorectal cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Aparicio J, Manrique AV, Capdevila J, Boza FM, Galván P, Richart P, Oliveres H, Paez D, Hernando J, Serrano SG, Vera R, Hernandez X, Gallego RA, Riesco-Martinez M, García de Albeniz X, Maurel J. 416P Randomized phase II trial of second-line FOLFIRI-panitumumab vs FOLFIRI alone in Ras wild type (wt) metastatic colorectal cancer (mCRC) patients beyond progression to first-line FOLFOX-panitumumab: BEYOND study (GEMCAD 17-01). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gómez-España MA, Montes AF, Garcia-Carbonero R, Mercadé TM, Maurel J, Martín AM, Pazo-Cid R, Vera R, Carrato A, Feliu J. SEOM clinical guidelines for pancreatic and biliary tract cancer (2020). Clin Transl Oncol 2021; 23:988-1000. [PMID: 33660222 PMCID: PMC8058005 DOI: 10.1007/s12094-021-02573-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 11/10/2022]
Abstract
Pancreatic cancer (PC) and biliary tract cancer (BTC) are both aggressive and highly fatal malignancies. Nowadays we have a profound knowledge about the molecular landscape of these neoplasms and this has allowed new therapeutic options. Surgery is the only potentially curative therapy in both cancers, but disease recurrence is frequent. In PC, adjuvant treatment with mFOLFIRINOX has improved overall survival (OS) and in BTC adjuvant treatment with capecitabine seems to improve OS and relapse-free survival. Concomitant radio-chemotherapy could also be considered following R1 surgery in both neoplasms. Neoadjuvant treatment represents the best option for achieving an R0 resection in borderline PC. Upfront systemic chemotherapy is the treatment of choice in unresectable locally advanced PC and BTC; then locoregional therapy could be considered after an initial period of at least 3-4 months of systemic chemotherapy. In metastatic PC, FOLFIRINOX or Gemcitabine plus nab-paclitaxel have improved OS compared with gemcitabine alone. In metastatic BTC, cisplatin plus gemcitabine constitute the standard treatment. Progress in the knowledge of molecular biology has enabled the identification of new targets for therapy with encouraging results that could in the future improve the survival and quality of life of patients with PC and BTC.
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Affiliation(s)
- Mª A. Gómez-España
- Medical Oncology Department, Hospital Universitario Reina Sofía, IMIBIC, CIBERONC, Córdoba, Spain
| | - A. F. Montes
- Medical Oncology Department, Complexo Hospitalario Universitario de Ourense (CHUO), Orense, Spain
| | - R. Garcia-Carbonero
- Medical Oncology Department, Hospital Universitario, UCM, CNIO, CIBERONC, 12 de Octubre, IIS imas12, Madrid, Spain
| | - T. M. Mercadé
- Medical Oncology Department, Hospital Universitari Vall D´Hebron, Barcelona, Spain
| | - J. Maurel
- Medical Oncology Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - A. M. Martín
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - R. Pazo-Cid
- Medical Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - R. Vera
- Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - A. Carrato
- Medical Oncology Department, Hospital Universitario Ramón Y Cajal, Alcala University, IRYCIS, CIBERONC, Madrid, Spain
| | - J. Feliu
- Medical Oncology Department, Hospital Universitario La Paz, CIBERONC, IDIPAZ, Madrid, Spain
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Tempero M, Oh DY, Tabernero J, Reni M, Van Cutsem E, Hendifar A, Waldschmidt DT, Starling N, Bachet JB, Chang HM, Maurel J, Garcia-Carbonero R, Lonardi S, Coussens LM, Fong L, Tsao LC, Cole G, James D, Macarulla T. Ibrutinib in combination with nab-paclitaxel and gemcitabine for first-line treatment of patients with metastatic pancreatic adenocarcinoma: phase III RESOLVE study. Ann Oncol 2021; 32:600-608. [PMID: 33539945 DOI: 10.1016/j.annonc.2021.01.070] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [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: 07/14/2020] [Revised: 01/16/2021] [Accepted: 01/20/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND First-line treatment of metastatic pancreatic ductal adenocarcinoma (PDAC) includes nab-paclitaxel/gemcitabine. Ibrutinib, a Bruton's tyrosine kinase inhibitor, exhibits antitumor activity through tumor microenvironment modulation. The safety and efficacy of first-line ibrutinib plus nab-paclitaxel/gemcitabine treatment in patients with PDAC were evaluated. PATIENTS AND METHODS RESOLVE (NCT02436668) was a phase III, randomized, double-blind, placebo-controlled study. Patients (histologically-confirmed PDAC; stage IV diagnosis ≥6 weeks of randomization; Karnofsky performance score ≥70) were randomized to once-daily oral ibrutinib (560 mg) or placebo plus nab-paclitaxel (125 mg/m2) and gemcitabine (1000 mg/m2). Primary endpoints were overall survival (OS) and investigator-assessed progression-free survival (PFS); overall response rate and safety were assessed. RESULTS In total, 424 patients were randomized (ibrutinib arm, n = 211; placebo arm, n = 213). Baseline characteristics were balanced across arms. After a median follow-up of 25 months, there was no significant difference in OS between ibrutinib plus nab-paclitaxel/gemcitabine versus placebo plus nab-paclitaxel/gemcitabine (median of 9.7 versus 10.8 months; P = 0.3225). PFS was shorter for ibrutinib plus nab-paclitaxel/gemcitabine compared with placebo plus nab-paclitaxel/gemcitabine (median 5.3 versus 6.0 months; P < 0.0001). Overall response rates were 29% and 42%, respectively (P = 0.0058). Patients in the ibrutinib arm had less time on treatment and received lower cumulative doses for all agents compared with the placebo arm. The most common grade ≥3 adverse events for ibrutinib versus placebo arms included neutropenia (24% versus 35%), peripheral sensory neuropathy (17% versus 8%), and anemia (16% versus 17%). Primary reasons for any treatment discontinuation were disease progression and adverse events. CONCLUSIONS Ibrutinib plus nab-paclitaxel/gemcitabine did not improve OS or PFS for patients with PDAC. Safety was consistent with known profiles for these agents.
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Affiliation(s)
- M Tempero
- Department of Medicine, University of California San Francisco, San Francisco, USA.
| | - D-Y Oh
- Department of Internal Medicine, Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - J Tabernero
- Department of Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UICC, CIBERONC, Barcelona, Spain
| | - M Reni
- Department of Radiochemotherapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - E Van Cutsem
- Department of Digestive Oncology, University Hospitals Gasthuisberg/Leuven & KU Leuven, Leuven, Belgium
| | - A Hendifar
- Department of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, USA
| | - D-T Waldschmidt
- Department of General, Visceral and Cancer Surgery, University of Cologne, Köln, Germany
| | - N Starling
- Section of GI and Lymphoma Units, Department of Medicine, The Royal Marsden, London, UK
| | - J-B Bachet
- Department of Hepatogastroenterology, UPMC, Sorbonne University, Pitié Salpêtrière Hospital, APHP, Paris, France
| | - H-M Chang
- Division of Oncology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - J Maurel
- Department of Medical Oncology, Translational Genomics and Targeted Therapeutics in Solid Tumors Group, IDIBAPS, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
| | - R Garcia-Carbonero
- Department of Medical Oncology, Hospital Universitario Doce de Octubre, Imas12, UCM, CNIO, CIBERONC, Madrid, Spain
| | - S Lonardi
- Dipartimento di Oncologia Clinical e Sperimentale, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - L M Coussens
- Department of Cell, Developmental & Cancer Biology, Knight Cancer Institute, Oregon Health & Science University, Portland, USA
| | - L Fong
- Department of Medicine, University of California San Francisco, San Francisco, USA
| | - L C Tsao
- Department of Statistics, Pharmacyclics LLC, an AbbVie Company, Sunnyvale, USA
| | - G Cole
- Department of Oncology Development, Pharmacyclics LLC, an AbbVie Company, Sunnyvale, USA
| | - D James
- Department of Clinical Science, Pharmacyclics LLC, an AbbVie Company, Sunnyvale, USA
| | - T Macarulla
- Department of Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UICC, CIBERONC, Barcelona, Spain
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Garcia-Corbacho J, Gonzalez-Navarro E, Victoria Ruiz I, Arrufat A, Moreno Fernández D, Heredia L, Ortiz de Landázuri I, Segarra NV, Mellado B, Sauri T, Maurel J, Gaba L, Pare L, Sanfeliu E, Baste N, Vidal Losada M, Arance Fernandez A, Reguart N, Prat A, Juan M. 109P Subpopulations of peripheral blood lymphocytes and response to immunotherapy across cancer-types. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Gomez OH, Soto VH, Machado I, Mendez M, Cuatrecasas M, Horndler C, Vermeulen L, Hoorn ST, Mendiola M, Martín-Richard M, Ruiz-Casado A, Galvez E, Aparicio J, García IS, Leno R, Fernández-Martos C, Alonso-Orduna V, Montes AF, Maurel J, Feliu J. 474P Prognostic and predictive role of Consensus Molecular Subtypes (CMS) determined by immunohistochemistry in metastatic colorectal cancer (mCRC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Hernandez AR, LaHoz S, Laia F, Puga TG, Moreno R, Esposito F, Oliveres H, Rodriguez SA, Sauri T, Cuatrecasas M, Jares P, Pedrosa L, Pineda E, Castells A, Prat A, Camps J, Maurel J. 476P Mutational profiling allows the stratification of metastatic colorectal cancer patients with poor prognosis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Seguí E, Alonso-Orduna V, Sesma A, Martin-Richard M, Salud A, Fernández-Montes A, Fernández-Martos C, Ruiz-Casado A, Gallego J, Aparicio J, Gálvez E, Manzano H, Alcaide-Garcia J, Gallego R, Falco E, Esposito F, Oliveres H, Torres F, Feliu J, Maurel J. 471P Identification and validation of a new prognostic score in metastatic colorectal cancer (mCRC): GEMCAD score. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ayuso JR, Pérez-Serrano C, Pagés M, Rodríguez-Gómez S, Zambrano TB, Conill C, Maurel J. 427P Value of magnetic resonance diffusion weighted imaging in the identification of complete responder patients with rectal cancer treated with neoadjuvant therapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.538] [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: 11/16/2022] Open
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Ruiz IV, Moreno D, Sole P, Gonzalez BM, Pineda E, Gaba L, Sauri T, Mileo LF, Orrillo M, Maurel J, Oliveres H, Munoz-Mateu M, Losada MV, Saez OM, Chic N, Baste N, Segarra NV, Reyes R, Prat A, Garcia-Corbacho J. 548P Molecular pre-screening using comprehensive gene panels offered by clinical trials (CT). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.662] [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: 12/01/2022] Open
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Maurel J, Faivre AC, Graesslin O, Raimond É. [Pelvic cellulitis on pyogenic streptococcal bartholinitis: Case report]. ACTA ACUST UNITED AC 2020; 48:529-531. [PMID: 32112861 DOI: 10.1016/j.gofs.2020.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Indexed: 11/15/2022]
Affiliation(s)
- J Maurel
- Service de gynécologie-obstétrique, hôpital Maison-Blanche, université Reims-Champagne-Ardennes, 45, rue Cognacq-Jay, 51100 Reims, France.
| | - A C Faivre
- Service de gynécologie-obstétrique, hôpital Maison-Blanche, université Reims-Champagne-Ardennes, 45, rue Cognacq-Jay, 51100 Reims, France
| | - O Graesslin
- Service de gynécologie-obstétrique, hôpital Maison-Blanche, université Reims-Champagne-Ardennes, 45, rue Cognacq-Jay, 51100 Reims, France
| | - É Raimond
- Service de gynécologie-obstétrique, hôpital Maison-Blanche, université Reims-Champagne-Ardennes, 45, rue Cognacq-Jay, 51100 Reims, France
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Paré L, Pascual T, Seguí E, Teixidó C, Gonzalez-Cao M, Galván P, Rodríguez A, González B, Cuatrecasas M, Pineda E, Torné A, Crespo G, Martin-Algarra S, Pérez-Ruiz E, Reig Ò, Viladot M, Font C, Adamo B, Vidal M, Gaba L, Muñoz M, Victoria I, Ruiz G, Viñolas N, Mellado B, Maurel J, Garcia-Corbacho J, Molina-Vila MÁ, Juan M, Llovet JM, Reguart N, Arance A, Prat A. Association between PD1 mRNA and response to anti-PD1 monotherapy across multiple cancer types. Ann Oncol 2019; 29:2121-2128. [PMID: 30165419 DOI: 10.1093/annonc/mdy335] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background We hypothesized that the abundance of PD1 mRNA in tumor samples might explain the differences in overall response rates (ORR) observed following anti-PD1 monotherapy across cancer types. Patients and methods RNASeqv2 data from 10 078 tumor samples representing 34 different cancer types was analyzed from TCGA. Eighteen immune-related gene signatures and 547 immune-related genes, including PD1, were explored. Correlations between each gene/signature and ORRs reported in the literature following anti-PD1 monotherapy were calculated. To translate the in silico findings to the clinical setting, we analyzed the expression of PD1 mRNA using the nCounter platform in 773 formalin-fixed paraffin embedded (FFPE) tumor samples across 17 cancer types. To test the direct relationship between PD1 mRNA, PDL1 immunohistochemistry (IHC), stromal tumor-infiltrating lymphocytes (sTILs) and ORR, we evaluated an independent FFPE-based dataset of 117 patients with advanced disease treated with anti-PD1 monotherapy. Results In pan-cancer TCGA, PD1 mRNA expression was found strongly correlated (r > 0.80) with CD8 T-cell genes and signatures and the proportion of PD1 mRNA-high tumors (80th percentile) within a given cancer type was variable (0%-84%). Strikingly, the PD1-high proportions across cancer types were found strongly correlated (r = 0.91) with the ORR following anti-PD1 monotherapy reported in the literature. Lower correlations were found with other immune-related genes/signatures, including PDL1. Using the same population-based cutoff (80th percentile), similar proportions of PD1-high disease in a given cancer type were identified in our in-house 773 tumor dataset as compared with TCGA. Finally, the pre-established PD1 mRNA FFPE-based cutoff was found significantly associated with anti-PD1 response in 117 patients with advanced disease (PD1-high 51.5%, PD1-intermediate 26.6% and PD1-low 15.0%; odds ratio between PD1-high and PD1-intermediate/low = 8.31; P < 0.001). In this same dataset, PDL1 tumor expression by IHC or percentage of sTILs was not found associated with response. Conclusions Our study provides a clinically applicable assay that links PD1 mRNA abundance, activated CD8 T-cells and anti-PD1 efficacy.
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Affiliation(s)
- L Paré
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - T Pascual
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - E Seguí
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - C Teixidó
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Pathology Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - M Gonzalez-Cao
- Quironsalud Group, Dr. Rosell Oncology Institute (IOR), Dexeus University Hospital, Barcelona, Spain
| | - P Galván
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - A Rodríguez
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - B González
- Pathology Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - M Cuatrecasas
- Pathology Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - E Pineda
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - A Torné
- Gynecology Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - G Crespo
- Department of Medical Oncology, Hospital Universitario de Burgos, Burgos, Spain
| | - S Martin-Algarra
- Department of Medical Oncology, Clínica Universitaria de Navarra, Pamplona, Spain
| | - E Pérez-Ruiz
- Department of Medical Oncology, Hospital Costa del Sol REDISSEC, Marbella, Spain
| | - Ò Reig
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - M Viladot
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - C Font
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - B Adamo
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - M Vidal
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - L Gaba
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - M Muñoz
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - I Victoria
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - G Ruiz
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - N Viñolas
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - B Mellado
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - J Maurel
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - J Garcia-Corbacho
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - M Á Molina-Vila
- Pangaea Oncology, Laboratory of Molecular Biology, Quirón-Dexeus University Institute, Barcelona, Spain
| | - M Juan
- Immunology Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - J M Llovet
- BCLC Group, Translational Research Lab in Hepatic Oncology, IDIBAPS, Hospital Clínic, CIBERehd, Barcelona, Universitat de Barcelona; Barcelona, Spain; Mount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA; Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - N Reguart
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - A Arance
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - A Prat
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona, Spain.
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Pedrosa L, Moreno R, Esposito F, Jares P, Cuatrecasas M, Pineda E, Español M, Paré L, De la Iglesia N, Benitez D, Camps J, Church S, Cascante M, Thomson T, Prat A, Maurel J. Immune signatures identify three immune clusters in mCRC, with potential clinical implications. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz156.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tempero M, Oh D, Macarulla T, Reni M, Van Cutsem E, Hendifar A, Waldschmidt D, Starling N, Bachet J, Chang H, Maurel J, Lonardi S, Coussens L, Fong L, Tsao L, Cole G, James D, Tabernero J. Ibrutinib in combination with nab-paclitaxel and gemcitabine as first-line treatment for patients with metastatic pancreatic adenocarcinoma: results from the phase 3 RESOLVE study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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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Ghanem I, Trilla L, Gámez A, Mendiola M, Maurel J, Campos-Barros À, Peña C, Cuatrecasas M, G-Pastrián L, García Alfonso P, Feliu J, Fresno J. Whole-exome sequencing of non-metastatic anal squamous cell carcinoma: a prognostic genetic variants analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.162] [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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Reyes R, Ayuso J, Pagés M, Conill C, Darnell A, Pineda E, Gines A, Fernández-Esparrach M, Cuatrecasas M, Moreno R, Lacy A, Pellisé M, Maurel J. Do we need adjuvant therapy in patients with rectal cancer and pathologic complete response, after conventional preoperative chemoradiation and laparoscopic (LapTME) or Transanal total mesorectal excision (TaTME)? Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.313] [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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Trilla L, Ghanem I, Gámez A, Maurel J, Campos-Barros À, G-Pastrián L, Mendiola M, Peña C, Cuatrecasas M, García Alfonso P, Fresno J, Feliu J. Mutational profile of non-metastatic anal squamous cell carcinoma: a restrictive high impact genetic variants analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz156.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Aparicio J, Virgili A, Capdevila J, Muñoz Boza F, Álvarez R, Bosch C, Cámara J, Fernandez-Martos C, Fernandez-Plana J, Gallego J, Gallego R, Hernández-Yagüe X, Macías Declara I, Rodríguez-Salas N, Vera R, Taberner M, Maurel J. Randomized phase II clinical trial to evaluate the efficacy of second-line FOLFIRI-panitumumab in patients with RAS wild-type metastatic colorectal cancer who have received FOLFOX-panitumumab in first-line (BEYOND). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.190] [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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21
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Gómez-España MA, Gallego J, González-Flores E, Maurel J, Páez D, Sastre J, Aparicio J, Benavides M, Feliu J, Vera R. SEOM clinical guidelines for diagnosis and treatment of metastatic colorectal cancer (2018). Clin Transl Oncol 2018; 21:46-54. [PMID: 30565083 PMCID: PMC6339676 DOI: 10.1007/s12094-018-02002-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 12/22/2022]
Abstract
Colorectal cancer (CRC) is the second cause of cancer death in Spain, the objective of this guide published by the Spanish Society of Medical Oncology is to develop a consensus for the diagnosis and management of metastatic disease. The optimal treatment strategy for patients with metastatic CRC should be discussed in a multidisciplinary expert team to select the most appropriate treatment, and integrate systemic treatment and other options such as surgery and ablative techniques depending on the characteristics of the tumour, the patient and the location of the disease and metastases.
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Affiliation(s)
- M A Gómez-España
- Servicio de Oncología Médica, H. Universitario Reina Sofía, IMIBIC, CIBERONC, Av. Menéndez Pidal, s/n, 14004, Córdoba, Spain.
| | - J Gallego
- Servicio de Oncología Médica, Hospital General Universitario, Elche, Spain
| | - E González-Flores
- Servicio de Oncología Médica, H. U. Virgen de las Nieves, Granada, Spain
| | - J Maurel
- Servicio de Oncología Médica, Hospital Clinic, Barcelona, Spain
| | - D Páez
- Servicio de Oncología Médica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J Sastre
- Servicio de Oncología Médica, Hospital Clínico San Carlos, IdISSC, CIBERONC, Madrid, Spain
| | - J Aparicio
- Servicio de Oncología Médica, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - M Benavides
- Servicio de Oncología Médica, H.U. Regional y Virgen de la Victoria, Málaga, Spain
| | - J Feliu
- Servicio de Oncología Médica, H. U. La Paz, UAM, CIBERONC, Madrid, Spain
| | - R Vera
- Servicio de Oncología Médica, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Spain
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Español Rego M, Alonso V, Aparicio J, Elez Fernandez E, Escudero P, Fernández-Martos C, Rodríguez N, Ruiz Casado A, Cid J, Cabezón R, Lozano M, Ginés A, Bianchi L, Garcia-Corbacho J, García de Albéniz X, Maurel J, Benitez Ribas D. AVEVAC: A phase I-II trial with avelumab plus autologous dendritic cell (ADC) vaccine in pre-treated mismatch repair-proficient (MSS) metastatic colorectal cancer (mCRC) patients (GEMCAD 16-02). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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García Albéniz X, Alonso V, Escudero P, Méndez M, Gallego Plazas J, Rodriguez J, Salud Salvia A, Fernández-Plana J, Manzano Alemany H, Zanui M, Falcó E, Feliu Batlle J, Gil-Raga M, Fernández-Martos C, Bohn Sarmiento U, Alonso López M, Calderero Aragón V, Rojo F, Cuatrecasas M, Maurel J. Prospective biomarker study in advanced RAS wild-type colorectal cancer: POSIBA trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.034] [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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24
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Montagut C, Alonso V, Escudero P, Fernández-Martos C, Salud Salvia A, Méndez M, Gallego Plazas J, Rodriguez J, Martín-Richard M, Fernández-Plana J, Aparicio J, Feliu Batlle J, García de Albéniz X, Rojo F, Fernández V, Claes B, Maertens G, Sablon E, Jacobs B, Maurel J. Clinical impact of circulating tumor RAS and BRAF mutation dynamics in metastatic colorectal cancer patients treated with first-line chemotherapy plus anti-EGFR therapy: Combined analysis of two prospective clinical trials. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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Patel UB, Brown G, Machado I, Santos-Cores J, Pericay C, Ballesteros E, Salud A, Isabel-Gil M, Montagut C, Maurel J, Ramón-Ayuso J, Martin N, Estevan R, Fernandez-Martos C. MRI assessment and outcomes in patients receiving neoadjuvant chemotherapy only for primary rectal cancer: long-term results from the GEMCAD 0801 trial. Ann Oncol 2017; 28:344-353. [PMID: 28426108 DOI: 10.1093/annonc/mdw616] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Primary chemotherapy has been tested as a possible approach for patients with high risk features but predicted clear mesorectal margins on preoperative MRI assessment. This study investigates the prognostic relevance of baseline and post-treatment MRI and pathology staging in rectal cancer patients undergoing primary chemotherapy. Patients and methods Forty-six patients with T3 tumour > =2 mm from the mesorectal fascia were prospectively treated with Neoadjuvant Capecitabine, Oxaliplatin and Bevacizumab prior to surgery between 2009 and 2011. The baseline and post-treatment MRI: T, Nodal and Extra-mural venous invasion (EMVI) status were recorded as well as post-treatment MRI Tumour regression grade (TRG) and modified-RECIST assessment of tumour length. The post-treatment pathology (yp) assessments of T3 substage, N, EMVI and TRG status were also recorded. Three-year disease-free survival (DFS) and cumulative incidence of recurrence were estimated by using the Kaplan-Meier product-limit method, and Cox proportional hazards models were used to determine associations between staging and response on MRI and pathology with survival outcomes. Results About 46 patients underwent neoadjuvant chemotherapy alone for high risk margin safe primary rectal cancer. The median follow-up was 41 months, 5 patients died and 11 patients experienced relapse (2 local, 8 distant and 1 both). In total 23/46 patients were identified with MRI features of EMVI at baseline. mrEMVI positive status carried independent prognostic significance for DFS (P = 0.0097) with a hazard ratio of 31.33 (95% CI: 2.3-425.4). The histopathologic factor that was of independent prognostic importance was a final ypT downstage of ypT3a or less, hazard ratio: 14.0 (95% CI: 1.5-132.5). Conclusions mrEMVI is an independent prognostic factor at baseline for poor outcomes in rectal cancer treated with neoadjuvant chemotherapy while ≤ypT3a is associated with an improvement in DFS. Future preoperative therapy evaluation in rectal cancer patients will need to stratify treatment according to baseline EMVI status as a crucial risk factor for recurrence in patients with predicted CRM clear rectal cancer.
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Affiliation(s)
- U B Patel
- Radiology Department, London North-West Healthcare NHS Trust, London
| | - G Brown
- Radiology Department, The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - I Machado
- Department of Pathology, Valencia Institute of Oncology, Valencia, Spain
| | - J Santos-Cores
- Department of Radiology, Fundacion InstitutoValenciano de Oncologia, Valencia, Spain
| | - C Pericay
- Department of Medical Oncology, Corporació Sanitària Parc Taulí, Parc Taulí, 1, Sabadell, Barcelona, Spain
| | - E Ballesteros
- Department of Radiology, Corporación Sanitaria Parc Taulí, Sabadell, Barcelona, Spain
| | - A Salud
- Department of Medical Oncology, Corporació Sanitària Parc Taulí, Parc Taulí, 1, Sabadell, Barcelona, Spain
| | - M Isabel-Gil
- Department of Radiology, Hospital Universitari Arnau de Vilanova, Lleida
| | - C Montagut
- Department of Medical Oncology Department, Hospital del Mar, Barcelona
| | - J Maurel
- Department of Medical Oncology, Corporació Sanitària Parc Taulí, Parc Taulí, 1, Sabadell, Barcelona, Spain
| | - J Ramón-Ayuso
- Department of Radiology, Hospital Clinic de Barcelona, Barcelona
| | - N Martin
- Department of Pivotal, Madrid, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
| | - R Estevan
- Department of Surgery, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
| | - C Fernandez-Martos
- Department of Medical Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
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Mora J, Castañeda A, Perez-Jaume S, Lopez-Pousa A, Maradiegue E, Valverde C, Martin-Broto J, Garcia del Muro X, Cruz O, Cruz J, Martinez-Trufero J, Maurel J, Vaz MA, de Alava E, de Torres C. GEIS-21: a multicentric phase II study of intensive chemotherapy including gemcitabine and docetaxel for the treatment of Ewing sarcoma of children and adults: a report from the Spanish sarcoma group (GEIS). Br J Cancer 2017; 117:767-774. [PMID: 28787430 PMCID: PMC5589997 DOI: 10.1038/bjc.2017.252] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/20/2017] [Accepted: 07/10/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND First Spanish trial of Ewing sarcoma (ES) including adults and children with the aim to test the efficacy of Gemcitabine and Docetaxel (G/D) in newly diagnosed high-risk (HR) patients. METHODS This was a prospective, multicentric, non-randomised, open study for patients ⩽40 years with newly diagnosed ES. HR patients (metastatic, axial-pelvic primaries or bone marrow micrometastasis) received 2 window cycles of G/D. Patients with an objective response (OR) to G/D received 12 monthly cycles of G/D after completion of mP6. The primary end point was the OR rate to the G/D window phase and the event-free survival (EFS) and overall survival (OS) for all patients. The study is registered at ClinicalTrials.gov (identifier: NCT00006734). RESULTS Forty-three patients were enroled, median age 17 years (range, 3-40). After a median follow-up of 43.4 months, the 5-year OS rate is 55.0% (95% CI, 41-74%) with an EFS of 50.0% (95% CI, 36-68%). The 5-year OS and EFS rates for standard risk (SR) patients was 76.0% (95% CI, 57-100%) and 71.0% (CI, 54-94%); for HR 36.0% (CI, 20-65%) and 29.0% (CI, 15-56%). Twelve of 17 (70.6%) high-risk (HR) patients showed an OR (7 PR and 5 SD) to G/D window therapy. The 5-year OS rate for patients ⩽18 years of age was 74.0% (CI, 56-97%) and 31.0% for >18 years (95% CI, 15-66%), P<0.001. Grade 4 adverse events during mP6 occurred in 28/39 of patients (72%) and did not correlate with age. Multivariate survival analyses with <18 vs ⩾18 and risk groups significant differences, P<0.00001. Using a Cox model for OS, both age and risk group were statistically significant (P=0.0011 and P=0.0065, respectively). CONCLUSIONS Age at diagnosis is an independent prognostic factor superior to the presence of metastases with 18 years as the strongest cut-off. The mP6 regimen provided survival curves that plateau at 3 years and G/D produced significant responses in HR-ES that is worth further exploring.
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Affiliation(s)
- J Mora
- Department of Pediatric Oncology and Hematology, Hospital Sant Joan de Déu, Barcelona 08950, Spain
| | - A Castañeda
- Department of Pediatric Oncology and Hematology, Hospital Sant Joan de Déu, Barcelona 08950, Spain
| | - S Perez-Jaume
- Department of Pediatric Oncology and Hematology, Hospital Sant Joan de Déu, Barcelona 08950, Spain
| | - A Lopez-Pousa
- Department of Medical Oncology, Hospital de Sant Pau, Barcelona 08025, Spain
| | - E Maradiegue
- Department of Pediatric Oncology and Hematology, Hospital Sant Joan de Déu, Barcelona 08950, Spain
| | - C Valverde
- Department of Medical Oncology, Hospital Vall d’Hebron, Barcelona 08035, Spain
| | - J Martin-Broto
- Department of Medical Oncology, Hospital de Son Espases, Palma de Mallorca 07210, Spain
| | - X Garcia del Muro
- Department of Medical Oncology, Institut Català d’Oncologia, IDIBELL, Universitat de Barcelona, Barcelona 08907, Spain
| | - O Cruz
- Department of Pediatric Oncology and Hematology, Hospital Sant Joan de Déu, Barcelona 08950, Spain
| | - J Cruz
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife 38001, Spain
| | - J Martinez-Trufero
- Department of Medical Oncology, Hospital Miguel Servet, Zaragoza 50009, Spain
| | - J Maurel
- Department of Medical Oncology, Hospital Clinic, Barcelona 08036, Spain
| | - M A Vaz
- Department of Medical Oncology, Hospital Ramón y Cajal, Madrid 28034, Spain
| | - E de Alava
- Department of Pathology, Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocío University Hospital/CSIC/University of Sevilla-CIBERONC, Sevilla 41013, Spain
| | - C de Torres
- Department of Pediatric Oncology and Hematology, Hospital Sant Joan de Déu, Barcelona 08950, Spain
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Cubillo Gracian A, Dean A, Muñoz A, Hidalgo M, Pazo-Cid R, Martin M, Macarulla Mercade T, Lipton L, Harris M, Manzano-Mozo J, Maurel J, Guillen-Ponce C, Tebbutt N, Cooray P, Sohal D, Zalupski M, Kolevska T, Stagg R, Goldstein D. YOSEMITE: A 3 arm double-blind randomized phase 2 study of gemcitabine, paclitaxel protein-bound particles for injectable suspension, and placebo (GAP) versus gemcitabine, paclitaxel protein-bound particles for injectable suspension and either 1 or 2 truncated courses of demcizumab (GAD). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pineda E, Salud A, Vila-Navarro E, Safont MJ, Llorente B, Aparicio J, Vera R, Escudero P, Casado E, Bosch C, Bohn U, Pérez-Carrión R, Carmona A, Ayuso JR, Ripollés T, Bouzas R, Gironella M, García-Albéniz X, Feliu J, Maurel J. Dynamic soluble changes in sVEGFR1, HGF, and VEGF promote chemotherapy and bevacizumab resistance: A prospective translational study in the BECOX (GEMCAD 09-01) trial. Tumour Biol 2017. [DOI: 10.1177/1010428317705509] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Estela Pineda
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - A Salud
- Department of Medical Oncology, Arnau de Vilanova Hospital, Lleida, Spain
| | - E Vila-Navarro
- Department of Gastrointestinal and Pancreatic Oncology, CIBERehd-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Clínic Hospital, Barcelona, Spain
| | - MJ Safont
- Department of Medical Oncology, General University Hospital of Valencia, Valencia, Spain
| | - Beatriz Llorente
- Department of Medical Oncology, Hospital Universitario de Burgos, Spain
| | - J Aparicio
- Department of Medical Oncology, La Fe University Hospital, Valencia, Spain
| | - R Vera
- Department of Medical Oncology, De Navarra Hospital, Pamplona, Spain
| | - P Escudero
- Department of Medical Oncology, Lozano Blesa Hospital, Zaragoza, Spain
| | - E Casado
- Department of Medical Oncology, Infanta Sofía Hospital, Madrid, Spain
| | - C Bosch
- Department of Medical Oncology, Pesset Hospital, Valencia, Spain
| | - U Bohn
- Department of Medical Oncology, Doctor Negrin University Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - R Pérez-Carrión
- Department of Medical Oncology, Hospital Universitario Quirón Madrid, Madrid, Spain
| | - A Carmona
- Department of Medical Oncology, Morales Meseguer University Hospital, Murcia, Spain
| | - JR Ayuso
- Department of Radiology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - T Ripollés
- Department of Radiology, Pesset Hospital, Valencia, Spain
| | - R Bouzas
- Department of Radiology, Hospital Alvaro Cunqueiro, Vigo, Spain
| | - M Gironella
- Department of Gastrointestinal and Pancreatic Oncology, CIBERehd-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Clínic Hospital, Barcelona, Spain
| | - X García-Albéniz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J Feliu
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
| | - J Maurel
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain
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Vera R, Dotor E, Feliu J, González E, Laquente B, Macarulla T, Martínez E, Maurel J, Salgado M, Manzano JL. SEOM Clinical Guideline for the treatment of pancreatic cancer (2016). Clin Transl Oncol 2016; 18:1172-1178. [PMID: 27896637 PMCID: PMC5138250 DOI: 10.1007/s12094-016-1586-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 11/15/2016] [Indexed: 12/18/2022]
Abstract
Pancreatic cancer remains an aggressive disease with a 5 year survival rate of 5%. Only 15% of patients with pancreatic cancer are eligible for radical surgery. Evidence suggests a benefit on survival with adjuvant chemotherapy (gemcitabine o fluourouracil) after R1/R0 resection. Adjuvant chemoradiotherapy is also a valid option in patients with positive margins. Borderline resectable pancreatic cancer is defined as the involvement of the mesenteric vasculature with a limited extension. These tumors are technically resectable, but with a high risk of positive margins. Neoadjuvant treatment represents the best option for achieving an R0 resection. In advanced disease, two new chemotherapy treatment schemes (Folfirinox or Gemcitabine plus nab-paclitaxel) have showed improvements in overall survival compared with gemcitabine alone. Progress in pancreatic cancer treatment will require a better knowledge of the molecular biology of this disease, focusing on personalized cancer therapies in the near future.
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Affiliation(s)
- R. Vera
- Department of Medical Oncology, Complejo Hospitalario de Navarra, c/Irunlarrea-3, 31008 Pamplona, Spain
| | - E. Dotor
- Consorcio Sanitario de Terrassa, Barcelona, Spain
| | - J. Feliu
- Hospital Universitario la Paz, Madrid, Spain
| | - E. González
- Complejo Hospitalario Universitario de Granada Virgen de las Nieves, Granada, Spain
| | - B. Laquente
- ICO-Hospitalet de LLobregat, Hospital Duran i Reynals, Hospitalet de Llobregat, Spain
| | | | - E. Martínez
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - J. Maurel
- Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - M. Salgado
- Complexo Hospitalario de Orense (CHUO), Ourense, Spain
| | - J. L. Manzano
- ICO-Badalona, Hospital Germans Trias i Pujol, Barcelona, Spain
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Chic N, Bruixola G, Reig O, Beveridge RD, Buxo E, Pineda E, Prat A, Aparicio J, Maurel J. Neutrophil-to-lymphocyte ratio as a biomarker for prognosis in localized colorectal carcinoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.145] [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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Alonso V, Emperador PE, Urena MM, Gallego J, Rodriguez J, Fernández J, Salud A, Falcó E, Manzano H, Zanui M, Gil M, Sarmiento UB, Martos CF, Calderero V, Ferrer A, Cuatrecasas M, Rojo F, Feliu J, Maurel J, García-Albéniz X. Prospective evaluation of BRAF, PI3K and PTEN as predictive and prognostic biomarkers in first-line advanced KRAS wild-type colorectal cancer treated with FOLFOX or FOLFIRI plus bi-weekly cetuximab. GEMCAD 10-02. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.88] [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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Maurel J, Martos CF, Richard MM, Alonso V, Méndez CM, Salud A, Pericay C, Aparicio J, Gallego J, Carmona A, Casado E, Manzano H, Horndler C, Rubini M, Cuatrecasas M, García-Albéniz X, Feliu J. PULSE, a phase 2 study of mFOLFOX6-panitumumab (P) with biomarker stratification as first-line chemotherapy (CT), in patients (pts) with KRAS (exon 2) metastatic colorectal cancer (mCRC). A GEMCAD 09-03 study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.47] [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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Fernandez-Martos C, Garcia-Albeniz X, Pericay C, Maurel J, Aparicio J, Montagut C, Safont M, Salud A, Vera R, Massuti B, Escudero P, Alonso V, Bosch C, Martin M, Minsky B. Chemoradiation, surgery and adjuvant chemotherapy versus induction chemotherapy followed by chemoradiation and surgery: long-term results of the Spanish GCR-3 phase II randomized trial. Ann Oncol 2015; 26:1722-8. [DOI: 10.1093/annonc/mdv223] [Citation(s) in RCA: 205] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/02/2015] [Indexed: 12/17/2022] Open
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Delisle E, Rousseau C, Broche B, Leparc-Goffart I, L’Ambert G, Cochet A, Prat C, Foulongne V, Ferré JB, Catelinois O, Flusin O, Tchernonog E, Moussion IE, Wiegandt A, Septfons A, Mendy A, Moyano MB, Laporte L, Maurel J, Jourdain F, Reynes J, Paty MC, Golliot F. Chikungunya outbreak in Montpellier, France, September to October 2014. Euro Surveill 2015; 20. [DOI: 10.2807/1560-7917.es2015.20.17.21108] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
In October 2014, an outbreak of 12 autochthonous chikungunya cases, 11 confirmed and 1 probable, was detected in a district of Montpellier, a town in the south of France colonised by the vector Aedes albopictus since 2010. A case returning from Cameroon living in the affected district was identified as the primary case. The epidemiological investigations and the repeated vector control treatments performed in the area and around places frequented by cases helped to contain the outbreak. In 2014, the chikungunya and dengue surveillance system in mainland France was challenged by numerous imported cases due to the chikungunya epidemic ongoing in the Caribbean Islands. This first significant outbreak of chikungunya in Europe since the 2007 Italian epidemic, however, was due to an East Central South African (ECSA) strain, imported by a traveller returning from West Africa. Important lessons were learned from this episode, which reminds us that the threat of a chikungunya epidemic in southern Europe is real.
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Affiliation(s)
- E Delisle
- Regional office of the French Institute for Public Health Surveillance (Cire Languedoc-Roussillon), Montpellier, France
| | - C Rousseau
- Regional office of the French Institute for Public Health Surveillance (Cire Languedoc-Roussillon), Montpellier, France
| | - B Broche
- Regional Health Agency of Languedoc-Roussillon, Montpellier, France
| | - I Leparc-Goffart
- Institut de Recherche Biomédicale des Armées, National Reference Laboratory for arboviruses, Marseille, France
| | - G L’Ambert
- Entente Interdépartementale pour la Démoustication du littoral Méditerranéen (EID Méditerranée), Public mosquito control operator, Montpellier, France
| | - A Cochet
- Regional office of the French Institute for Public Health Surveillance (Cire Languedoc-Roussillon), Montpellier, France
| | - C Prat
- Institut de Recherche Biomédicale des Armées, National Reference Laboratory for arboviruses, Marseille, France
| | - V Foulongne
- Montpellier University Hospital, Montpellier, France
| | - J B Ferré
- Entente Interdépartementale pour la Démoustication du littoral Méditerranéen (EID Méditerranée), Public mosquito control operator, Montpellier, France
| | - O Catelinois
- Regional office of the French Institute for Public Health Surveillance (Cire Languedoc-Roussillon), Montpellier, France
| | - O Flusin
- Institut de Recherche Biomédicale des Armées, National Reference Laboratory for arboviruses, Marseille, France
| | - E Tchernonog
- Montpellier University Hospital, Montpellier, France
| | - I E Moussion
- Regional Health Agency of Languedoc-Roussillon, Montpellier, France
| | - A Wiegandt
- Regional Health Agency of Languedoc-Roussillon, Montpellier, France
| | - A Septfons
- French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), Saint-Maurice, France
| | - A Mendy
- Regional Health Agency of Languedoc-Roussillon, Montpellier, France
| | - M B Moyano
- Regional Health Agency of Languedoc-Roussillon, Montpellier, France
| | - L Laporte
- Regional Health Agency of Languedoc-Roussillon, Montpellier, France
| | - J Maurel
- Regional Health Agency of Languedoc-Roussillon, Montpellier, France
| | - F Jourdain
- National Centre of Expertise on Vectors, Montpelier, France
| | - J Reynes
- Montpellier University Hospital, Montpellier, France
| | - M C Paty
- National Centre of Expertise on Vectors, Montpelier, France
| | - F Golliot
- Regional office of the French Institute for Public Health Surveillance (Cire Languedoc-Roussillon), Montpellier, France
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Martin Broto J, Calabuig S, Rubio J, Gutierrez A, Duran J, Garcia F, Martinez-Trufero J, Maurel J, García Del Muro X, Cruz J, Cubedo R, Poveda A, Valverde Morales C, De Sande González L, De Juan A, Lopez-Guerrero J. Integrating Genotype in Risk Classification for Gist Recurrence. a Spanish Group for Sarcoma Research (Geis) Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu354.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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36
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Alonso-Orduna V, Marmol M, Escudero P, Salud A, Safont M, Méndez J, Girón CG, Martín M, Fernandez-Martos C, Albéniz XG, Feliu J, Maurel J. A Validation of Current Prognostic Scores in Metastatic Colorectal Cancer (Mcrc) and a New Prognostic Score (A Gemcad Study). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Maurel J, Lopez-Pousa A, Calabuig S, Bagué S, Del Muro XG, Sanjuan X, Rubió J, Cuatrecasas M, Martinez-Trufero J, Horndler C, Fra J, Morales CV, Redondo A, Poveda A, Sevilla I, Lainez N, Rubini M, Albéniz XG, Broto JM, De Álava E. Prognosis of Phosphorylated-Insulin Growth Factor Receptor (P-Igf-1R) and Metalloproteinase-3 (Mmp3) Expression in Advanced Gastrointestinal Stromal Tumors (Gist) Patients Treated with Imatinib. a Geis Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.61] [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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Martin-Richard M, Gallego R, Pericay C, Garcia Foncillas J, Queralt B, Casado E, Barriuso J, Iranzo V, Juez I, Visa L, Saigi E, Barnadas A, Garcia-Albeniz X, Maurel J. Multicenter phase II study of oxaliplatin and sorafenib in advanced gastric adenocarcinoma after failure of cisplatin and fluoropyrimidine treatment. A GEMCAD study. Invest New Drugs 2014; 31:1573-9. [PMID: 24077981 DOI: 10.1007/s10637-013-0020-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 08/23/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cisplatin and fluoropyrimidine (CF) are standard first- line treatment in advanced gastric cancer, but no second-line treatment has yet been established. We present a phase II study in which we evaluated the efficacy and toxicity of the combination of Sorafenib (S), and Oxaliplatin as second-line therapy. METHODS Patients with progressive gastric adenocarcinoma after CF- first-line, ECOG 0-2, and measurable disease were included. The primary objective was PFS. Treatment doses were Oxaliplatin 130 mg/m²/3 weeks and Sorafenib 800 mg/bid/d. RESULTS We included 40 patients. CR was 2.5% and SD was 47.2%. Grade 3-4 toxic effects were neutropenia (9.8%), thrombocytopenia (7.3%), neurotoxicity (4.9%) and diarrhea (4.9%). Median PFS was 3 months (95%CI: 2.3-4.1) and median OS was 6.5 months (95% CI: 5.2-9.6). Time to progression (TTP) to first line therapy was a prognosis factor. Median OS was 9.7 months when time-to-progression during first-line chemotherapy was >6 months and 5.6 m when it was <6 months (p = 0.04). CONCLUSIONS Time-to-progression under a CF-based first-line therapy determines subgroups of GC patients with different prognosis. The combination of Oxaliplatin-Sorafenib in advanced GC patients previously treated with CF appears safe, but our results do not support the implementation of a phase III trial.
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Custodio A, Moreno-Rubio J, Aparicio J, Gallego-Plazas J, Yaya R, Maurel J, Higuera O, Burgos E, Ramos D, Calatrava A, Andrada E, López R, Moreno V, Madero R, Cejas P, Feliu J. Pharmacogenetic predictors of severe peripheral neuropathy in colon cancer patients treated with oxaliplatin-based adjuvant chemotherapy: a GEMCAD group study. Ann Oncol 2014; 25:398-403. [DOI: 10.1093/annonc/mdt546] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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40
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Cohn AL, Tabernero J, Maurel J, Nowara E, Sastre J, Chuah BYS, Kopp MV, Sakaeva DD, Mitchell EP, Dubey S, Suzuki S, Hei YJ, Galimi F, McCaffery I, Pan Y, Loberg R, Cottrell S, Choo SP. A randomized, placebo-controlled phase 2 study of ganitumab or conatumumab in combination with FOLFIRI for second-line treatment of mutant KRAS metastatic colorectal cancer. Ann Oncol 2013; 24:1777-1785. [PMID: 23510984 DOI: 10.1093/annonc/mdt057] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Targeted agents presently available for mutant KRAS metastatic colorectal cancer (mCRC) are bevacizumab and aflibercept. We evaluated the efficacy and safety of conatumumab (an agonistic monoclonal antibody against human death receptor 5) and ganitumab (a monoclonal antibody against the type 1 insulin-like growth factor receptor) combined with standard FOLFIRI chemotherapy as a second-line treatment in patients with mutant KRAS mCRC. PATIENTS AND METHODS Patients with mutant KRAS metastatic adenocarcinoma of the colon or rectum refractory to fluoropyrimidine- and oxaliplatin-based chemotherapy were randomized 1 : 1 : 1 to receive intravenous FOLFIRI plus conatumumab 10 mg/kg (Arm A), ganitumab 12 mg/kg (Arm B), or placebo (Arm C) Q2W. The primary end point was progression-free survival (PFS). RESULTS In total, 155 patients were randomized. Median PFS in Arms A, B, and C was 6.5 months (HR, 0.69; P = 0.147), 4.5 months (HR, 1.01; P = 0.998), and 4.6 months, respectively; median overall survival was 12.3 months (HR, 0.89; P = 0.650), 12.4 months (HR, 1.27; P = 0.357), and 12.0 months; and objective response rate was 14%, 8%, and 2%. The most common grade ≥3 adverse events in Arms A/B/C included neutropenia (30%/25%/18%) and diarrhea (18%/2%/10%). CONCLUSIONS Conatumumab, but not ganitumab, plus FOLFIRI was associated with a trend toward improved PFS. Both combinations had acceptable toxicity.
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Affiliation(s)
- A L Cohn
- Rocky Mountain Cancer Center, Denver, USA.
| | - J Tabernero
- Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona
| | - J Maurel
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - E Nowara
- Maria Skodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - J Sastre
- Hospital Clinico San Carlos, Servicio de Oncologíca Medíca, Madrid, and Instituto Carlos III, Spanish Ministry of Science and Innovation, Madrid, Spain
| | - B Y S Chuah
- Department of Internal Medicine, National University Hospital, Singapore, Singapore
| | - M V Kopp
- Samara Regional Oncology Dispensary, Samara
| | - D D Sakaeva
- Clinical Oncology Dispensary of the Republic of Bashkortostan, Ufa, Russia
| | - E P Mitchell
- Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia
| | - S Dubey
- Amgen Inc., South San Francisco
| | | | | | | | | | | | | | | | - S-P Choo
- Medical Oncology, National Cancer Centre Singapore, Singapore
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Broto JM, Del Muro XG, Lopez-Pousa A, De Penas RL, Maurel J, Cubedo R, Redondo A, Martinez-Trufero J, Jurado JC, Poveda A. Randomized, Open, Prospective, Phase II Clinical Trial of Doxorubicin (DOXO) vs. Trabectedin Plus Doxo in the First-Line Treatment of Patients (PTS) with Advanced Non-Operable and/or Metastatic Soft Tissue Sarcomas (STS): Geis-20 Study. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34065-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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42
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Visa L, Samper E, Rickmann M, Postigo A, Sanchez-Tilo E, Fernandez-Cruz L, Maurel J, Molero X, Vaquero E. ZEB1 and ZEB2 Mediate Pancreatic Fibroblast Induced Epithelial-To Mesenchymal Transition (EMT) in Pancreatic Cancer. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32726-5] [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: 10/25/2022] Open
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Pera M, Gallego R, Montagut C, Martín-Richard M, Iglesias M, Conill C, Reig A, Balagué C, Pétriz L, Momblan D, Bellmunt J, Maurel J. Phase II trial of preoperative chemoradiotherapy with oxaliplatin, cisplatin, and 5-FU in locally advanced esophageal and gastric cancer. Ann Oncol 2012; 23:664-670. [PMID: 21652581 DOI: 10.1093/annonc/mdr291] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Based on a phase I study showing the feasibility of combining of oxaliplatin, cisplatin, and 5-fluorouracil (5-FU) (OCF) with radiation therapy (RT) in esophageal cancer, the efficacy of this regimen in esophageal, gastroesophageal (GE), and gastric (G) cancer was assessed in this phase II multicenter study. PATIENTS AND METHODS Patients with resectable tumors were eligible. Treatment included two cycles of oxaliplatin 85 mg/m(2), cisplatin 55 mg/m(2), and continuously infused 5-FU 3 g/m(2) in 96 h and concurrent RT (45 Gy), followed by surgery after 6-8 weeks. Primary end point was complete pathologic response (pCR). RESULTS Forty-one patients were enrolled. Tumor location was esophagus 39% (squamous 10/adenocarcinoma 6), GE junction 32%, and stomach 29%. G3-G4 adverse events included asthenia (27%) and neutropenia (14%). One toxic death occurred. Thirty-one patients (75.6%) underwent surgery (R0 in 94%). Pathologic response was achieved in 58% of patients, with pCR in 50% and 16% of esophageal and GE/G cancer, respectively. pCR was achieved in 67% of squamous cell carcinoma. Survival: median follow-up, 50.4 months; median progression-free survival and overall survival were 23.2 and 28.4 months, respectively. CONCLUSION Preoperative OCF plus RT showed an acceptable toxicity and promising activity especially in squamous cell esophageal cancer.
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Affiliation(s)
- M Pera
- Section of Gastrointestinal Surgery, Hospital Universitario del Mar and Institut de Recerca Hospital del Mar (IMIM), Universitat Autónoma de Barcelona, Barcelona.
| | - R Gallego
- Department of Medical Oncology and Radiation Therapy, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona Medical School, Barcelona
| | - C Montagut
- Service of Medical Oncology, Hospital Universitario del Mar and Institut de Recerca Hospital del Mar (IMIM), Barcelona
| | | | | | - C Conill
- Department of Medical Oncology and Radiation Therapy, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona Medical School, Barcelona
| | - A Reig
- Services of Radiotherapy, Hospital Universitario del Mar and Institut de Recerca Hospital del Mar (IMIM), Barcelona
| | | | - L Pétriz
- Services of Radiation Therapy, Hospital de Sant Pau, Barcelona
| | - D Momblan
- Service of Gastrointestinal Surgery, Hospital Clinic, Barcelona, Spain
| | - J Bellmunt
- Service of Medical Oncology, Hospital Universitario del Mar and Institut de Recerca Hospital del Mar (IMIM), Barcelona
| | - J Maurel
- Department of Medical Oncology and Radiation Therapy, Hospital Clínic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona Medical School, Barcelona
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Fuster D, Ayuso JR, Poveda A, Cubedo R, Casado A, Martínez-Trufero J, López-Pousa A, Del Muro XG, Lomeña F, Maurel J, Pons F. Value of FDG-PET for monitoring treatment response in patients with advanced GIST refractory to high-dose imatinib. A multicenter GEIS study. Q J Nucl Med Mol Imaging 2011; 55:680-687. [PMID: 21150863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM The aim of this study was to evaluate the utility of positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) in monitoring response in refractory GIST. METHODS This multicenter study prospectively evaluated 21 patients with locally advanced and/or metastatic GIST refractory to with high-dose imatinib (800 mg/day) treated with doxorubicin 15-20 mg/m2/weekly for 4 cycles, followed by imatinib maintenance (400 mg/day). CT and FDG-PET were performed at baseline and after completion of therapy. RESULTS Mean baseline tumor size on CT was 5.9 cm. Median progression-free survival (PFS) was 219 days (range 62-1108). Three out of 21 patients (14%) had partial responses (PR) under RECIST criteria, 12 patients (57%) remained stable (SD) and 6 showed progression (PD) of the disease during treatment (29%). Six patients had PR by FDG-PET, 15 showed SD (n=9) or PD (n=6) based on EORTC criteria. Patients with a PFS <6 mo showed a significantly higher ∑SUVmax at baseline (26.04±13.4) than those with PFS≥6 mo (9.82±5.0) (P<0.05). A correlation was found between PET response and PFS: PR 14±6.1 mo, SD 5.5±0.8 mo and PD 3.5±4.1 mo (P<0.05). A residual SUVmax <5 after treatment correlated with improved PFS (314±315 days vs 131±91 days) (P<0.01). Survival curves showed a significant association between PET response and PFS (P<0.05). Patients with wild-type genotype KIT (KIT-WT) showed a significantly lower baseline SUVmax (5.36±1.4) than non-WT KIT (8.40±3.6) (P<0.05). CONCLUSION FDG-PET is useful in assessing response of GIST refractory to imatinib and correlates with the presence of KIT-WT. Baseline ∑SUVmax can predict response to treatment in this series.
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Affiliation(s)
- D Fuster
- Nuclear Medicine, Hospital Clínic Barcelona, Barcelona, Spain.
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López-Pousa A, Martín J, Montalar J, de las Peñas R, García del Muro J, Cruz J, Maurel J, Escudero P, Casado A, Buesa JM. Phase II Trial of Doxorubicin Plus Escalated High-Dose Ifosfamide in Patients With Advanced Soft Tissue Sarcomas of the Adult: A Study of the Spanish Group for Research on Sarcomas (GEIS). Sarcoma 2011; 2006:26986. [PMID: 17251655 PMCID: PMC1698138 DOI: 10.1155/srcm/2006/26986] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2005] [Revised: 05/22/2006] [Accepted: 06/06/2006] [Indexed: 11/24/2022] Open
Abstract
Background. To explore the tolerance and the activity of
high-dose ifosfamide (IFOS) combined with doxorubicin (DXR) at 50
mg/m2 every 4 weeks in patients with soft tissue
sarcomas. Methods. DXR was given IV bolus and IFOS by
continuous infusion at 2 g/m2/day. Initial IFOS dose (12
g/m2) was adjusted to 10, 13, or 14 g/m2
according to toxicity. Results. Seventy patients received
277 cycles (median 3 cycles, range 1–10), 34% with IFOS dose
increased, 30% decreased, and 48% delivered at 12
g/m2. Toxicity grade 4 occurred on granulocytes (67%
of patients) or platelets (19%), 54% had febrile
neutropenia, 31% grade 3/4 asthenia, and 26% abandoned the
study due to toxicity. Three toxic deaths occurred. In 57 non-GIST
patients objective activity was 45.6% (95% CI, 32 to
58%). Conclusion. At least 4 cycles were tolerated by
71% of patients, most receiving DXR 50 mg/m2 plus
IFOS 10–12 g/m2, with substantial toxicity.
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Affiliation(s)
- A. López-Pousa
- Medical Oncology Department, Hospital Sant Pau, 08025 Barcelona, Spain
| | - J. Martín
- Medical Oncology Department, Hospital Son Dureta, 07014 Palma de Mallorca, Spain
| | - J. Montalar
- Medical Oncology Department, Hospital Clínico La Fe, 46009 Valencia, Spain
| | - R. de las Peñas
- Medical Oncology Department, Hospital Provincial, 12002 Castellón, Spain
| | - J. García del Muro
- Medical Oncology Department, Instituto Catalán de Oncología, 08907 Barcelona, Spain
| | - J. Cruz
- Medical Oncology Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain
| | - J. Maurel
- Medical Oncology Department, Hospital Clínic, 08036 Barcelona, Spain
| | - P. Escudero
- Medical Oncology Department, Hospital Clínico, 50009 Zaragoza, Spain
| | - A. Casado
- Medical Oncology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - J. M. Buesa
- Medical Oncology Department, Hospital Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), 33006 Oviedo, Spain
- *J. M. Buesa: ,
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Fernandez-Martos C, Pericay C, Salud A, Massuti B, Alonso V, Safont MJ, Vera R, Escudero MP, Maurel J, Aparicio J. Three-year outcomes of GCR-3: A phase II randomized trial comparing conventional preoperative chemoradiation (CRT) followed by surgery and postoperative adjuvant chemotherapy (CT) with induction CT followed by CRT and surgery in locally advanced rectal cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3552] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Aparicio J, Garcia-Mora C, Martin-Richard M, Petriz L, Feliu J, Sanchez-Santos E, Ayuso JR, Conill C, Maurel J. A phase I dose-finding study of sorafenib (S) in combination with gemcitabine (G) and radiotherapy (RT) in patients (pts) with unresectable pancreatic carcinoma (UPC): A GEMCAD study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Maurel J, Garcia-Albeniz X, Méndez Méndez C, Martin-Richard M, Pericay C, Vera R, Aparicio J, Rubini M, Cuatrecasas M. PULSE: An open-label, phase II study assessing double positivity (phospho-insulin-growth factor receptor-1 [pIGF-IR] and matrilysin [MMP7]) expression as a predictive marker of resistance in previously untreated metastatic colorectal cancer (mCRC) wild-type KRAS patients (pts) treated with panitumumab plus mFOLFOX6—A GEMCAD study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps164] [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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Rubió J, Martinez-Trufero J, Lopez-Pousa A, Garcia del Muro X, Fra J, Redondo A, Lainez N, Poveda A, Casado A, Valverde CM, De Juan A, Sevilla I, Andres R, Cruz J, Safont MJ, Martin Broto J, Garcia-Albeniz X, Maurel J. Retrospective analysis of surgery in metastatic GIST patients sensitive to imatinib: A Spanish Group for Research on Sarcoma (GEIS) study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10055] [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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Lopez-Pousa A, Bui Nguyen B, Garcia del Muro X, Martin Broto J, Balañá C, Lavernia J, Cruz J, Maurel J, Andres R, Valverde CM, Fra J, Martinez-Trufero J, Lopez-Martin JA, Sevilla I, Cubedo R, Blay J. A phase II study of a new formulation of nonpegylated liposomal doxorubicin (doxorubicin GP-pharm) as first-line treatment in patients with advanced soft-tissue sarcomas (STS) who are age 65 or older: A GEIS trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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