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Blanco R, Dómine M, González JL, Loutfi S, Alfaro J, Saldaña J, Rubio J, Campos B, Hidalgo J, Barba A, Márquez D, Martin M, Olaverri A, Nadal E. Pembrolizumab as first-line treatment for advanced NSCLC in older adults: A phase II clinical trial evaluating geriatric and quality-of-life outcomes. Lung Cancer 2023; 183:107318. [PMID: 37557022 DOI: 10.1016/j.lungcan.2023.107318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVES Since specific data on immunotherapy in older adults with advanced non-small cell lung cancer (aNSCLC) are scarce, we designed this study to determine the overall survival (OS) at one year of first-line pembrolizumab in patients older than 70 years with aNSCLC expressing PD-L1. Secondary objectives included progression-free survival, disease-specific survival, response rate, tolerability, quality of life (QoL) changes, and geriatric assessments. MATERIALS AND METHODS A single-arm, open-label, phase II clinical trial was carried out by the Spanish Lung Cancer Group between February 2018 and November 2019 at ten active sites in Spain. We included patients 70 years old and older with histological or cytological documented stage IIIB or IV aNSCLC and PD-L1 expression ≥ 1%. Each subject received 200 mg of intravenous pembrolizumab every three weeks for a maximum of two years. RESULTS 83 patients were recruited for the study and 74 were finally analysed. Most were male (N = 64, 86.5%) and former smokers (N = 51, 68.9%). 24 patients (32.4%) completed at least one year of treatment, 62 (83.7%) discontinued treatment, and 30 (40.5%) experienced disease progression. The median follow-up of our cohort was 18.0 months [range: 0.1-47.7] and 46 patients (62.2%) died during the period of study. The estimated OS at one year was 61.7% (95% CI: 49.6-71.8%) and the median OS of our cohort was 19.2 months (95% CI: 11.3-25.5). QoL tended to improve throughout the study, although the differences were not statistically significant. The main geriatric scores remained stable, except for a worsening in nutritional status (P = 0.004) and an improvement in frailty (P = 0.028). CONCLUSION Our results support treating older adults with aNSCLC expressing PD-L1 with pembrolizumab in monotherapy. The stability of most geriatric scores and the positive trend on the patients' QoL should be highlighted, although our results did not reach statistical significance.
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Affiliation(s)
- Remei Blanco
- Department of Medical Oncology, Consorci Sanitari de Terrassa, Terrassa, Spain.
| | - Manuel Dómine
- Department of Medical Oncology, Hospital Universitario Fundación Jiménez Díaz. IIS-FJD, Madrid, Spain
| | - José Luis González
- Department of Medical Oncology, Hospital Clínico San Carlos, Madrid, Spain
| | - Sami Loutfi
- Department of Geriatrics, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Jordi Alfaro
- Department of Medical Oncology, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Juana Saldaña
- Department of Medical Oncology, Oncobell Program, Institut Català d'Oncologia (ICO), IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Jaime Rubio
- Department of Medical Oncology, Hospital Universitario Fundación Jiménez Díaz. IIS-FJD, Madrid, Spain
| | - Begoña Campos
- Department of Medical Oncology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Julia Hidalgo
- Department of Medical Oncology, Hospital Lluis Alcanyís de Xàtiva, Valencia, Spain
| | - Andrés Barba
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Diego Márquez
- Department of Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Maria Martin
- Department of Medical Oncology, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Amaya Olaverri
- Department of Medical Oncology, Hospital Virgen de la Luz, Cuenca, Spain
| | - Ernest Nadal
- Department of Medical Oncology, Oncobell Program, Institut Català d'Oncologia (ICO), IDIBELL, L'Hospitalet de Llobregat, Spain
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Soler G, Legido R, Perez X, Martinez-Villacampa M, Santos C, Losa F, Ruffinelli J, Mulet N, Teule A, Castany R, Gallego R, Carbonell M, Manzana A, Rios A, Saldaña J, Salazar R. 513P Prospective evaluation of the G8 screening tool for predicting survival in elderly patients with colon cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.623] [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: 11/28/2022] Open
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3
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Mezquita L, Jové M, Nadal E, Kfoury M, Morán T, Ricordel C, Dhooge M, Tlemsani C, Léna H, Teulé A, Álvarez JV, Raimbourg J, Hiret S, Lacroix L, Menéndez M, Saldaña J, Brunet J, Lianes P, Coupier I, Auclin E, Recondo G, Friboulet L, Adam J, Green E, Planchard D, Frébourg T, Capellà G, Rouleau E, Lázaro C, Caron O, Besse B. High Prevalence of Somatic Oncogenic Driver Alterations in Patients With NSCLC and Li-Fraumeni Syndrome. J Thorac Oncol 2020; 15:1232-1239. [PMID: 32179180 DOI: 10.1016/j.jtho.2020.03.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 12/28/2019] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Actionable somatic molecular alterations are found in 15% to 20% of NSCLC in Europe. NSCLC is a tumor observed in patients with germline TP53 variants causing Li-Fraumeni syndrome (LFS), but its somatic molecular profile is unknown. METHODS Retrospective study of clinical and molecular profiles of patients with NSCLC and germline TP53 variants. RESULTS Among 22 patients with NSCLC and LFS (n = 23 lung tumors), 64% were women, median age was 51 years, 84% were nonsmokers, 73% had adenocarcinoma histological subtype, and 84% were diagnosed with advanced-stage disease. These patients harbored 16 distinct germline TP53 variants; the most common was p.R158H (5/22; three in the same family). Personal and family histories of cancer were reported in 71% and 90% of patients, respectively. In most cases (87%, 13/15), lung cancer was diagnosed with a late onset. Of the 21 tumors analyzed, somatic oncogenic driver mutations were found in 19 of 21 (90%), EGFR mutations in 18 (exon 19 deletion in 12 cases, L858R in three cases, and G719A, exon 20 insertion, and missing mutation subtype, each with one case), and ROS1 fusion in one case. A PI3KCA mutation was concurrently detected at diagnosis in three EGFR exon 19-deleted tumors (3/12). The median overall survival was 37.3 months in 14 patients treated with EGFR inhibitors; seven developed resistance, five (71%) acquired EGFR-T790M mutation, and one had SCLC transformation. CONCLUSIONS Driver oncogenic alterations were observed in 90% of the LFS tumors, mainly EGFR mutations; one ROS1 fusion was also observed. The germline TP53 variants and lung cancer carcinogenesis driven by oncogenic processes need further evaluation.
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Affiliation(s)
- Laura Mezquita
- Thoracic Oncology Group, Cancer Medicine Department, Gustave Roussy, Villejuif, France; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Medical Oncology Department, Hospital Clínic, Barcelona, Spain
| | - Maria Jové
- Medical Oncology Department, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ernest Nadal
- Medical Oncology Department, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Maria Kfoury
- Thoracic Oncology Group, Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - Teresa Morán
- Medical Oncology Department, Catalan Institute of Oncology-Badalona (ICO-Badalona), Institut Germans Trias i Pujol (IGTP), Badalona Applied Research Group in Oncology (B-ARGO), Universitat Autònoma de Barcelona (UAB), Medicine Department, Badalona, Spain
| | - Charles Ricordel
- Department of Respiratory Medicine, Pontchaillou Hospital, Rennes, France; University of Rennes, Rennes, France; Chemistry, Oncogenesis, and Stress Signaling, INSERM, Centre Eugène Marquis, Rennes, France
| | - Marion Dhooge
- Gastroenterology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Camille Tlemsani
- Medical Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Paris Descartes University, USPC, Paris, France
| | - Hervé Léna
- Department of Respiratory Medicine, Pontchaillou Hospital, Rennes, France; University of Rennes, Rennes, France; Chemistry, Oncogenesis, and Stress Signaling, INSERM, Centre Eugène Marquis, Rennes, France
| | - Alex Teulé
- Medical Oncology Department, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jose-Valero Álvarez
- Medical Oncology Department, Complejo Hospitalario de Zamora, Hospital Provincial, Zamora, Spain
| | - Judith Raimbourg
- Medical Oncology Department, Institute de Cancerologie de l'Ouest, Nantes, France
| | - Sandrine Hiret
- Medical Oncology Department, Institute de Cancerologie de l'Ouest, Nantes, France
| | - Ludovic Lacroix
- Medical Biology and Pathology Department, Translational Research Laboratory and BioBank, Gustave Roussy, Villejuif, France
| | - Mireia Menéndez
- Hereditary Cancer Program, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL-CIBERONC), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juana Saldaña
- Medical Oncology Department, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Brunet
- Medical Oncology Department, Catalan Institute of Oncology-Badalona (ICO-Badalona), Institut Germans Trias i Pujol (IGTP), Badalona Applied Research Group in Oncology (B-ARGO), Universitat Autònoma de Barcelona (UAB), Medicine Department, Badalona, Spain
| | - Pilar Lianes
- Medical Oncology Department, Hospital de Mataró, Mataró, Spain
| | - Isabelle Coupier
- Clinical Genetic Unit, Montpeiller Cancer Institut, CHU Montpellier, Montpeiller, France
| | - Edouard Auclin
- Gastrointestinal and Medical Oncology Department, Hôpital Européen Georges Pompidou, Paris, France
| | - Gonzalo Recondo
- INSERM, Gustave Roussy Cancer Campus, Université Paris Saclay, Saint-Aubin, France
| | - Luc Friboulet
- INSERM, Gustave Roussy Cancer Campus, Université Paris Saclay, Saint-Aubin, France
| | - Julien Adam
- Pathology Department, Gustave Roussy, Villejuif, France
| | | | - David Planchard
- Thoracic Oncology Group, Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - Thierry Frébourg
- Normandie Univ, UNIROUEN, INSERM, and Rouen University Hospital, Department of Genetics, Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Gabriel Capellà
- Hereditary Cancer Program, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL-CIBERONC), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Etienne Rouleau
- Medical Biology and Pathology Department, Translational Research Laboratory and BioBank, Gustave Roussy, Villejuif, France
| | - Conxi Lázaro
- Hereditary Cancer Program, Catalan Institute of Oncology (ICO-IDIBELL-ONCOBELL-CIBERONC), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Olivier Caron
- Clinical Genetic Unit, Cancer Medicine Department, Gustave Roussy, Villejuif, France.
| | - Benjamin Besse
- Thoracic Oncology Group, Cancer Medicine Department, Gustave Roussy, Villejuif, France; INSERM, Gustave Roussy Cancer Campus, Université Paris Saclay, Saint-Aubin, France
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Feliu J, Heredia-Soto V, Gironés R, Jiménez-Munarriz B, Saldaña J, Guillén-Ponce C, Molina-Garrido MJ. Management of the toxicity of chemotherapy and targeted therapies in elderly cancer patients. Clin Transl Oncol 2019; 22:457-467. [PMID: 31240462 DOI: 10.1007/s12094-019-02167-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/16/2019] [Indexed: 12/22/2022]
Abstract
The elderly form a very heterogeneous group in relation to their general health state, degree of dependence, comorbidities, performance status, physical reserve and geriatric situation, so cancer treatment in the older patient remains a therapeutic challenge. The physiological changes associated with aging increase the risk of developing a serious toxicity induced by chemotherapy treatment, as well as other undesirable consequences as hospitalizations, dependence and non-compliance with treatment, that can negatively affect survival, quality of life and treatment efficacy. The use of hematopoietic growth factors and other active supportive interventions in the elderly can help prevent and/or alleviate these toxicities. However, we have little data on the efficacy and tolerance of support treatments in the older patient. The objective of this work is to review the most frequent toxicities of oncological treatments in the elderly and their management.
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Affiliation(s)
- J Feliu
- Medical Oncology Department, H. Universitario La Paz, CIBERONC, Paseo de la Castellana 261, 28046, Madrid, Spain.
| | - V Heredia-Soto
- Medical Oncology Department, H. Universitario La Paz, CIBERONC, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - R Gironés
- Medical Oncology Department, H. Lluís Alcanyís. Xàtiva, Valencia, Spain
| | - B Jiménez-Munarriz
- Medical Oncology Department, H. Universitario Clara Campal, Madrid, Spain
| | - J Saldaña
- Medical Oncology Department, Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain
| | - C Guillén-Ponce
- Medical Oncology Department, H. Universitario Ramón Y Cajal, Madrid, Spain
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5
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Soler G, Ruffinelli Rodriguez J, Legido R, Martinez Villacampa M, Perez F, Pardo-Burdalo B, Marín J, Morilla Ruiz I, Heras Lopez L, Vazquez S, Recalde S, Plana Serrahima M, Santos C, Mulet Margalef N, Teule A, Salazar R, Galan M, Saldaña J. Detection of frailty in elderly colorectal càncer patients: Is G8 a good screening tool? Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.116] [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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6
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Antonio M, Saldaña J, Linares J, Ruffinelli JC, Palmero R, Navarro A, Arnaiz MD, Brao I, Aso S, Padrones S, Navarro V, González-Barboteo J, Borràs JM, Cardenal F, Nadal E. Geriatric assessment may help decision-making in elderly patients with inoperable, locally advanced non-small-cell lung cancer. Br J Cancer 2018; 118:639-647. [PMID: 29381689 PMCID: PMC5846066 DOI: 10.1038/bjc.2017.455] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 11/18/2017] [Accepted: 11/22/2017] [Indexed: 12/23/2022] Open
Abstract
Background: Although concurrent chemoradiotherapy (cCRT) increases survival in patients with inoperable, locally advanced non-small-cell lung cancer (NSCLC), there is no consensus on the treatment of elderly patients. The aim of this study was to determine the prognostic value of the comprehensive geriatric assessment (CGA) and its ability to predict toxicity in this setting. Methods: We enrolled 85 consecutive elderly (⩾75 years) participants, who underwent CGA and the Vulnerable Elders Survey (VES-13). Those classified as fit and medium-fit by CGA were deemed candidates for cCRT (platinum-based chemotherapy concurrent with thoracic radiation therapy), while unfit patients received best supportive care. Results: Fit (37%) and medium-fit (48%) patients had significantly longer median overall survival (mOS) (23.9 and 16.9 months, respectively) than unfit patients (15%) (9.3 months, log-rank P=0.01). In multivariate analysis, CGA groups and VES-13 were independent prognostic factors. Fit and medium-fit patients receiving cCRT (n=54) had mOS of 21.1 months (95% confidence interval: 16.2, 26.0). In those patients, higher VES-13 (⩾3) was associated with shorter mOS (16.33 vs 24.3 months, P=0.027) and higher risk of G3-4 toxicity (65 vs 32%, P=0.028). Conclusions: Comprehensive geriatric assessment and VES-13 showed independent prognostic value. Comprehensive geriatric assessment may help to identify elderly patients fit enough to be treated with cCRT.
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Affiliation(s)
- Maite Antonio
- Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain.,Geriatric Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
| | - Juana Saldaña
- Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain.,Geriatric Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
| | - Jennifer Linares
- Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
| | - José C Ruffinelli
- Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
| | - Ramón Palmero
- Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
| | - Arturo Navarro
- Thoracic Oncology Unit, Department of Radiation Oncology, Institut Català d'Oncologia. Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
| | - Maria Dolores Arnaiz
- Thoracic Oncology Unit, Department of Radiation Oncology, Institut Català d'Oncologia. Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
| | - Isabel Brao
- Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
| | - Samantha Aso
- Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Feixa Llarga, s/n, 08907. L'Hospitalet, Barcelona 08907, Spain
| | - Susana Padrones
- Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Feixa Llarga, s/n, 08907. L'Hospitalet, Barcelona 08907, Spain
| | - Valentí Navarro
- Clinical Research Unit, Institut Català d'Oncologia, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
| | - Jesús González-Barboteo
- Palliative Care Unit, Institut Català d'Oncologia, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
| | - Josep Maria Borràs
- Department of Clinical Sciences, IDIBELL, University of Barcelona, Feixa Llarga, s/n, 08908. L'Hospitalet, Barcelona 08907, Spain
| | - Felipe Cardenal
- Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
| | - Ernest Nadal
- Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain.,Clinical Research in Solid Tumors (CReST) Group, OncoBell Program, IDIBELL, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain
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Molina-Garrido MJ, Guillén-Ponce C, Blanco R, Saldaña J, Feliú J, Antonio M, López-Mongil R, Ramos Cordero P, Gironés R. Delphi consensus of an expert committee in oncogeriatrics regarding comprehensive geriatric assessment in seniors with cancer in Spain. J Geriatr Oncol 2017; 9:337-345. [PMID: 29248435 DOI: 10.1016/j.jgo.2017.11.012] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 11/02/2017] [Accepted: 11/29/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The aim of this work was to reach a national consensus in Spain regarding the Comprehensive Geriatric Assessment (CGA) domains in older oncological patients and the CGA scales to be used as a foundation for widespread use. MATERIAL AND METHODS The Delphi method was implemented to attain consensus. Representatives of the panel were chosen from among the members of the Oncogeriatric Working Group of the Spanish Society of Medical Oncology (SEOM). Consensus was defined as ≥66.7% coincidence in responses and by the stability of said coincidence (changes ≤15% between rounds). The study was conducted between July and December 2016. RESULTS Of the 17 people invited to participate, 16 agreed. The panel concluded by consensus that the following domains should be included in the CGA:(and the scales to evaluate them): functional (Barthel Index, Lawton-Brody scale, gait speed), cognitive (Pfeiffer questionnaire), nutritional (Mini Nutritional Assessment - MNA), psychological/mood (Yesavage scale), social-familial (Gijon scale), comorbidity (Charlson index), medications, and geriatric syndromes (urinary and/or fecal incontinence, low auditory and/or visual acuity, presence of falls, pressure sores, insomnia, and abuse). Also by consensus, the CGA should be administered to older patients with cancer for whom there is a subsequent therapeutic intent and who scored positive on a previous frailty-screening questionnaire. CONCLUSION After 3 rounds, consensus was reached regarding CGA domains to be used in older patients with cancer, the scales to be administered for each of these domains, as well as the timeline to be followed during consultation.
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Affiliation(s)
| | - Carmen Guillén-Ponce
- Medical Oncology Department, Hospital Universitario Ramón y Cajal in Madrid, Carretera Colmenar Viejo, Km 9,100, Madrid, Spain
| | - Remei Blanco
- Medical Oncology Department, Consorci Sanitari in Terrassa, Barcelona, Spain.
| | - Juana Saldaña
- Medical Oncology Department, ICO L'Hospital in Barcelona, Spain.
| | - Jaime Feliú
- Medical Oncology Department, Hospital Universitario La Paz in Madrid, Spain.
| | - Maite Antonio
- Medical Oncology Department, ICO L'Hospital in Barcelona, Spain.
| | - Rosa López-Mongil
- Jefe de Sección Clínica de los Servicios Sociales of the Centro Asistencial "Dr. Villacián", Diputación de Valladolid, Spain
| | | | - Regina Gironés
- Medical Oncology Department, Hospital Lluis Alcanys in Xátiva (Valencia), Spain
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8
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Gironés R, Morilla I, Guillen-Ponce C, Torregrosa MD, Paredero I, Bustamante E, Del Barco S, Soler G, Losada B, Visa L, Llabrés E, Fox B, Firvida JL, Blanco R, Antonio M, Aparisi F, Pi-Figueras M, Gonzalez-Flores E, Molina-Garrido MJ, Saldaña J. Geriatric oncology in Spain: survey results and analysis of the current situation. Clin Transl Oncol 2017; 20:1087-1092. [PMID: 29327240 PMCID: PMC6061214 DOI: 10.1007/s12094-017-1813-0] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 11/16/2017] [Indexed: 11/30/2022]
Abstract
Introduction Geriatric oncology (GO) is a discipline that focuses on the management of elderly patients with cancer. The Spanish Society of Medical Oncology (SEOM) created a Working group dedicated to geriatric oncology in February 2016. Objectives The main goal of this study was to describe the current situation in Spain regarding the management of elderly cancer patients through an online survey of medical oncologists. Methods A descriptive survey was sent to several hospitals by means of the SEOM website. A personal e-mail was also sent to SEOM members. Results Between March 2016 and April 2017, 154 answers were collected. Only 74 centers (48%) had a geriatrics department and a mere 21 (14%) medical oncology departments had a person dedicated to GO. The vast majority (n = 135; 88%) had the perception that the number of elderly patients with cancer seen in clinical practice had increased. Eighteen (12%) oncologists had specific protocols and geriatric scales were used at 55 (31%) centers. Almost all (92%) claimed to apply special management practices using specific tools. There was agreement that GO afforded certain potential advantages. Finally, 99% of the oncologists surveyed believed it and that training in GO had to be improved. Conclusions From the nationwide survey promoted by the Spanish Geriatric Oncology Working Group on behalf of SEOM, we conclude that there is currently no defined care structure for elderly cancer patients. There is an increasing perception of the need for training in GO. This survey reflects a reality in which specific needs are perceived.
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Affiliation(s)
- R Gironés
- Medical Oncology Unit. Hospital Lluís Alcanyís, Crta Xàtiva A Silla Km 2, Xàtiva, 46800, Valencia, Spain.
| | - I Morilla
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
| | | | | | - I Paredero
- Hospital Universitario Dr Peset, Valencia, Spain
| | - E Bustamante
- Althaia, Xarxa Assistencial I Universitaria Manresa, Barcelona, Spain
| | - S Del Barco
- Hospital Universitari Dr. Josep Trueta. ICO Girona, Girona, Spain
| | - G Soler
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
| | - B Losada
- Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - L Visa
- Hospital Del Mar, Barcelona, Spain
| | - E Llabrés
- Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain
| | - B Fox
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J L Firvida
- Complejo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | - R Blanco
- Consorci Sanitari de Terrassa, Barcelona, Spain
| | - M Antonio
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
| | - F Aparisi
- Hospital General de Valencia, Valencia, Spain
| | | | | | | | - J Saldaña
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
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Antonio M, Carmona-Bayonas A, Saldaña J, Navarro V, Tebé C, Salazar R, Borràs JM. Factors Predicting Adherence to a Tailored-Dose Adjuvant Treatment on the Basis of Geriatric Assessment in Elderly People With Colorectal Cancer: A Prospective Study. Clin Colorectal Cancer 2017; 17:e59-e68. [PMID: 29054805 DOI: 10.1016/j.clcc.2017.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 03/18/2017] [Accepted: 09/20/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Selecting elderly people with colorectal cancer (CRC) for adjuvant chemotherapy is challenging. Comprehensive geriatric assessment (CGA) can help by classifying them according to their frailty profile. The supposed benefit of chemotherapy is on the basis of the rate of treatment adherence. In this study we evaluated tolerance and adherence to tailored-dose adjuvant therapy on the basis of CGA in a cohort of older patients with high-risk stage II and stage III CRC. PATIENTS AND METHODS This was a prospective study in 193 consecutive patients aged 75 years or older. On the basis of CGA results, we classified patients as fit, medium fit, or unfit, administering standard therapy, adjusted treatment, and best supportive care, respectively. We recorded planned chemotherapy, toxicity, and completion of the treatment. A logistic multivariate analysis was carried out. RESULTS Seventeen (15%) of the 141 candidates for chemotherapy (n = 86 fit and n = 55 medium fit) refused treatment; associated factors included polypharmacy (odds ratio [OR], 5.34; 95% confidence interval [CI], 1.55-18.40) and rectal location (OR, 5.61; 94% CI, 1.45-21.49). Of the 105 (74%) patients receiving chemotherapy, 20 (27%) fit and 4 (13%) medium fit patients experienced Grade 3 to 4 toxicity (P = .11) without association to explanatory variables. Approximately 55% of patients treated with chemotherapy received at least 80% of the planned dose (55% fit and 58% medium fit patients; P = .7). Factors associated with completion of chemotherapy were the absence of toxicity (OR, 7.67; 95% CI, 2.41-24.43) and social support (OR, 2.29; 95% CI, 0.08-1.04). CONCLUSION CGA is useful for selecting elderly patients for adjuvant chemotherapy, adapting the dose to their frailty profile, and identifying adherence-related factors amenable to modification through CGA-based interventions.
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Affiliation(s)
- Maite Antonio
- Medical Oncology Department, Institut d'Investigació Biomèdica de Bellvitge, Institut Català d'Oncologia-Hospital Duran i Reynals, University of Barcelona, Barcelona, Spain.
| | | | - Juana Saldaña
- Medical Oncology Department, Institut d'Investigació Biomèdica de Bellvitge, Institut Català d'Oncologia-Hospital Duran i Reynals, University of Barcelona, Barcelona, Spain
| | - Valentí Navarro
- Research Clinical Unit, Institut Català d'Oncologia-Hospital Duran I Reynals, Barcelona, Spain
| | - Cristian Tebé
- Statisical Assessment Service, Institut d'Investigació Biomèdica de Bellvitge and Universitat Rovira i Virgili, Barcelona, Spain
| | - Ramon Salazar
- Medical Oncology Department, Institut d'Investigació Biomèdica de Bellvitge, Institut Català d'Oncologia-Hospital Duran i Reynals, University of Barcelona, Barcelona, Spain
| | - Josep Maria Borràs
- Department of Clinical Sciences, University of Barcelona and Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain
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Antonio M, Saldaña J, Carmona-Bayonas A, Salazar R, Navarro V, Tebé C, Borras J. Factors predicting adherence to a tailored-dose adjuvant treatment based on geriatric assessment in elderly people with colorectal cancer: A prospective study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.018] [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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11
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Antonio M, Saldaña J, Carmona-Bayonas A, Navarro V, Tebé C, Nadal M, Formiga F, Salazar R, Borràs JM. Geriatric Assessment Predicts Survival and Competing Mortality in Elderly Patients with Early Colorectal Cancer: Can It Help in Adjuvant Therapy Decision-Making? Oncologist 2017; 22:934-943. [PMID: 28487465 DOI: 10.1634/theoncologist.2016-0462] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/25/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The challenge when selecting elderly patients with colorectal cancer (CRC) for adjuvant therapy is to estimate the likelihood that death from other causes will preclude cancer events from occurring. The aim of this paper is to evaluate whether comprehensive geriatric assessment (CGA) can predict survival and cancer-specific mortality in elderly CRC patients candidates for adjuvant therapy. MATERIAL AND METHODS One hundred ninety-five consecutive patients aged ≥75 with high-risk stage II and stage III CRC were prospectively included from May 2008 to May 2015. All patients underwent CGA, which evaluated comorbidity, polypharmacy, functional status, geriatric syndromes, mood, cognition, and social support. According to CGA results, patients were classified into three groups-fit, medium-fit, and unfit-to receive standard therapy, adjusted treatment, and best supportive care, respectively. We recorded survival and cause of death and used the Fine-Gray regression model to analyze competing causes of death. RESULTS Following CGA, 85 (43%) participants were classified as fit, 57 (29%) as medium-fit, and 53 (28%) as unfit. The univariate 5-year survival rates were 74%, 52%, and 27%. Sixty-one (31%) patients died due to cancer progression (53%), non-cancer-related cause (46%), and unknown reasons (1%); there were no toxicity-related deaths. Fit and medium-fit participants were more likely to die due to cancer progression, whereas patients classified as unfit were at significantly greater risk of non-cancer-related death. CONCLUSION CGA showed efficacy in predicting survival and discriminating between causes of death in elderly patients with high-risk stage II and stage III resected CRC, with potential implications for shaping the decision-making process for adjuvant therapies. IMPLICATIONS FOR PRACTICE Adjuvant therapy in elderly patients with colorectal cancer is controversial due to the high risk for competing events among these patients. In order to effectively select older patients for adjuvant therapy, we have to weigh the risk of cancer-related mortality and the potential survival benefits with treatment against the patient's life expectancy, irrespective of cancer. This prospective study focused on the prognostic value of geriatric assessment for survival using a competing-risk analysis approach, providing an important contribution on the treatment decision-making process and helping clinicians to identify elderly patients who might benefit from adjuvant chemotherapy among those who will not.
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Affiliation(s)
- Maite Antonio
- Medical Oncology Department, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Institut Català d'Oncologia (ICO)-Hospital Duran i Reynals, University of Barcelona, Spain
| | - Juana Saldaña
- Medical Oncology Department, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Institut Català d'Oncologia (ICO)-Hospital Duran i Reynals, University of Barcelona, Spain
| | | | - Valentín Navarro
- Research Clinical Unit, Institut Català d'Oncologia (ICO)-Hospital Duran I Reynals, Barcelona, Spain
| | - Cristian Tebé
- Statisical Assessment Service, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) and Universitat Rovira i Virgili, Spain
| | - Marga Nadal
- Research Management Unit, Institut Català d'Oncologia (ICO)-Hospital Duran I Reynals, Barcelona, Spain
| | - Francesc Formiga
- Internal Medicine Service, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, University of Barcelona, Spain
| | - Ramon Salazar
- Medical Oncology Department, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Institut Català d'Oncologia (ICO)-Hospital Duran i Reynals, University of Barcelona, Spain
| | - Josep Maria Borràs
- Department of Clinical Sciences, University of Barcelona and Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
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12
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Antonio M, Saldaña J, Carmona-Bayonas A, Navarro V, Tebe C, Formiga F, Salazar R, Borras J. Geriatric assessment predicts survival and competing mortality in colorectal cancer elderly patients. Can it help in adjuvant therapy decision? Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.93] [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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13
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Ripoll J, Avinyó A, Pellicer M, Saldaña J. Impact of density-dependent migration flows on epidemic outbreaks in heterogeneous metapopulations. Phys Rev E Stat Nonlin Soft Matter Phys 2015; 92:022809. [PMID: 26382456 DOI: 10.1103/physreve.92.022809] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Indexed: 06/05/2023]
Abstract
We investigate the role of migration patterns on the spread of epidemics in complex networks. We enhance the SIS-diffusion model on metapopulations to a nonlinear diffusion. Specifically, individuals move randomly over the network but at a rate depending on the population of the departure patch. In the absence of epidemics, the migration-driven equilibrium is described by quantifying the total number of individuals living in heavily or lightly populated areas. Our analytical approach reveals that strengthening the migration from populous areas contains the infection at the early stage of the epidemic. Moreover, depending on the exponent of the nonlinear diffusion rate, epidemic outbreaks do not always occur in the most populated areas as one might expect.
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Affiliation(s)
- J Ripoll
- Departament d'Informàtica, Matemàtica Aplicada i Estadística, Universitat de Girona, 17071 Girona, Catalunya, Spain
| | - A Avinyó
- Departament d'Informàtica, Matemàtica Aplicada i Estadística, Universitat de Girona, 17071 Girona, Catalunya, Spain
| | - M Pellicer
- Departament d'Informàtica, Matemàtica Aplicada i Estadística, Universitat de Girona, 17071 Girona, Catalunya, Spain
| | - J Saldaña
- Departament d'Informàtica, Matemàtica Aplicada i Estadística, Universitat de Girona, 17071 Girona, Catalunya, Spain
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Peiró I, Arribas L, Fort E, Saldaña J, Antonio M, Formiga F, Fernández P, Lozano A, González J, Barbero E. [National Meeting in Working Multisdisciplinary Oncogeriatrics for development of a sensus document: present and future role of the Nutrition in units Oncogeriatrics]. NUTR HOSP 2013; 27:1670. [PMID: 23478725 DOI: 10.3305/nh.2012.27.5.5954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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15
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Antonio M, Saldaña J, Formiga F, Lozano A, González-Barboteo J, Fernández P, Arias F, Arribas L, Barbero E, Bescós MDM, Boya MJ, Bueso P, Casas A, Dotor E, Fort E, García-Alfonso P, Herruzo I, Llonch M, Morlans G, Murillo MT, Ossola G, Peiró I, Saiz F, Sanz J, Serra JA, Trelis J, Yuste A. [1st National Meeting of Multidisciplinary Work in Oncogeriatrics: expert consensus document]. Rev Esp Geriatr Gerontol 2012; 47:279-283. [PMID: 23044361 DOI: 10.1016/j.regg.2012.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 05/21/2012] [Indexed: 06/01/2023]
Abstract
On 2nd of June 2011 the Institut Català d' Oncologia l'Hospitalet--Hospital Duran i Reynals hosted the first Meeting of Multidisciplinary Work in Oncogeriatrics. The reason for the meeting, which follows on from an initiative of the Medical Societies of Radiotherapy, Oncology, Geriatrics and Gerontology and Palliative Care and Medical Oncology, was to initiate a joint line of work among the different specialties that generally take part in the handling of the elderly patient suffering from oncologic pathologies. This document summarises the different subjects covered during the Meeting.
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Affiliation(s)
- Maite Antonio
- Comisión de Onco-Geriatría, Institut Català d'Oncologia l'Hospitalet, Hospital Duran i Reynals, Barcelona, España.
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16
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Gironés R, Díaz-Beveridge R, Torregrosa D, López P, Gómez-Codina J, Yuste A, Saldaña J, Rosell R. P.16 Social support of elderly lung cancer patients. Crit Rev Oncol Hematol 2007. [DOI: 10.1016/s1040-8428(13)70189-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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17
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Garcia M, Perez X, Saldaña J, Cardenal F, Germà JR. Are trends in recruitment of older patients in clinical trials (CT) changing? J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.16007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
16007 Background: It has been widely reported that older patients are underrepresented in CT. This barrier has been extensively studied and some efforts have been made to increase older patient participation. This study was performed to characterize and evaluate the enrolment of elderly patients in CT in a cancer centre (Barcelona, Spain). Methods: A database-based analysis of patients entered in CT of any cancer type in a single institution between 1998 and 2005 was performed. (1) During the first 6-month period in 2005 we selected opened age-unspecified trials (AUT). Rates of patients of 74 Y entered in those trials (between 2001–2005) were analysed and compared with the corresponding rates on target population (new patients seen in Oncology Department in the first 6-month period in 2005). (2) Averages of age of CT patients in two periods of time: 1998–1999 and 2004–2005 were compared. Chi-squared and T-student analyses were used. Results: 2029 patients were entered in CT between 1998–2005. There were 1006 FTSP patients during the first 6-month period of 2005. The number of patients entered in AUT (19 trials among 71 opened [27%]) between 2001–2005 was 277. Table 1 summarizes the data by age groups. Statistically significant differences were found only between >74 y patients in CT and FTSP populations. Average age was 57.4 during 1998–1999, and 60.5 during 2004–2005 (p: 0.004). Conclusions: The number of patients >74 Y accrued in CT in a single cancer centre has clearly increased over time, maybe due to the rise of life expectancy, better patient care and the efforts in improving recruitment rates. In spite of the increase, this patient population remains underrepresented in general cancer CT. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- M. Garcia
- Institut Català d’Oncologia, Barcelona, Spain; Institut Català d’Oncologia, L’Hospitalet, Barcelona, Spain
| | - X. Perez
- Institut Català d’Oncologia, Barcelona, Spain; Institut Català d’Oncologia, L’Hospitalet, Barcelona, Spain
| | - J. Saldaña
- Institut Català d’Oncologia, Barcelona, Spain; Institut Català d’Oncologia, L’Hospitalet, Barcelona, Spain
| | - F. Cardenal
- Institut Català d’Oncologia, Barcelona, Spain; Institut Català d’Oncologia, L’Hospitalet, Barcelona, Spain
| | - J. R. Germà
- Institut Català d’Oncologia, Barcelona, Spain; Institut Català d’Oncologia, L’Hospitalet, Barcelona, Spain
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18
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Davyt D, Fernandez R, Suescun L, Mombrú AW, Saldaña J, Domínguez L, Coll J, Fujii MT, Manta E. New sesquiterpene derivatives from the red alga Laurencia scoparia. Isolation, structure determination, and anthelmintic activity. J Nat Prod 2001; 64:1552-1555. [PMID: 11754610 DOI: 10.1021/np0102307] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Eleven sesquiterpenes (1-11) and one long chain aldehyde (12) have been isolated from the dichloromethane extract of the red alga Laurencia scoparia. Four of them are new natural products. Scopariol (1) is a new natural product with an unusual rearranged chamigrane-type structure. The other three are beta-chamigrenes: isorigidol (2), (+)-3-(Z)-bromomethylidene-10 beta-bromo-beta-chamigrene (3), and (-)-3-(E)-bromomethylidene-10 beta-bromo-beta-chamigrene (4). The in vitro activity of compounds 1-12 against the parasitant stage of Nippostrongylus brasiliensis (L4) has been studied.
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Affiliation(s)
- D Davyt
- Cátedra de Química Farmacéutica, Facultad de Química, Universidad de la República, Avenida Gral. Flores 2124, Montevideo, Uruguay
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19
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Gamenara D, Pandolfi E, Saldaña J, Domínguez L, Martínez MM, Seoane G. Nematocidal activity of natural polyphenols from bryophytes and their derivatives. Arzneimittelforschung 2001; 51:506-10. [PMID: 11455684 DOI: 10.1055/s-0031-1300071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The nematocidal in vitro activity of three natural perotetins (phenolic bisbibenzyiethers) and eleven diphenyl ethers used as synthetic precursors has been assayed using two different experimental models, Caenorhabditis elegans and Nippostrongylus brasiliensis. Nine compounds showed some activity against C. elegans and nine against N. brasiliensis. For the former model, three compounds displayed an activity similar to that of the standards, whereas for N. brasiliensis none of the tested compounds was as active as the standards. From the in vitro results, five compounds (3, 4, 8, 9, 13) could be selected as lead compounds to continue the search for improved activity.
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Affiliation(s)
- D Gamenara
- Departamento de Química Orgánica, Facultad de Química, Universidad de la República, Montevideo, Uruguay
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20
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Saldaña J, Marín M, Fernández C, Domínguez L. In vitro taurocholate-induced segmentation and clustering of Mesocestoides vogae (syn. corti) tetrathyridia (Cestoda) – inhibition by cestocidal drugs. Parasitol Res 2001; 87:281-6. [PMID: 11355676 DOI: 10.1007/pl00008579] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Mesocestoides vogae (syn. M. corti) tetrathyridia were cultured in the presence of sodium taurocholate, for the purpose of exploring the suitability of this organism for the in vitro assay of cestocidal drugs. Parasite clustering and segmentation were observed as taurocholate-dependent effects in biphasic and monophasic media, respectively. Interestingly, representative members of two major classes of known cestocidal agents (namely, albendazole and praziquantel) blocked these effects. Furthermore, it was possible to determine a specific concentration of the drugs that inhibited clustering and segmentation (minimum inhibitory concentration). In contrast, no inhibition was obtained in the presence of anthelmintics without cestocidal activity. These observations open the way for further studies focused at understanding how the activity of the drugs is involved in the suppression of the taurocholate-induced effects.
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Affiliation(s)
- J Saldaña
- Departamento de Farmacia, Facultad de Química, Universidad de la República, Montevideo, Uruguay
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21
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Domínguez L, Saldaña J, Chernin J. Use of L4 larvae of Nippostrongylus brasiliensis for the in vivo screening of anthelmintic drugs. Can J Vet Res 2000; 64:160-3. [PMID: 10935881 PMCID: PMC1189607] [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: 02/17/2023]
Abstract
Five groups of Wistar rats were subcutaneously infected with 5,000 L3 stage larvae of Nippostrongylus brasiliensis. Four groups were dosed orally with 5, 10, 15, and 20 mg/kg body weight of albendazole at 5 h postinfection, and one group served as an untreated control. The animals were euthanized and the intestines were dissected out 72 h postinfection and were incubated on a Baermann's apparatus to recover L4 stage larvae. No larvae were recovered from the 20 mg/kg albendazole-treated group, and means of 15, 33, and 175 L4 larvae were recovered from the 15, 10, and 5 mg/kg albendazole-treated groups, respectively. Levamisole and fenbendazole were also tested using the same procedure. Means of 100 and 1,887 L4 larvae were obtained from the 50 and 10 mg/kg of levamisole-treated groups respectively; while, 191 and 583 L4 larvae were recovered from rats treated with 50 and 10 mg/kg of fenbendazole, respectively. These results indicate that the L4 stage of N. brasiliensis could be useful for in vivo screening of new nematocide drugs.
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Affiliation(s)
- L Domínguez
- Cátedra de Farmacología y Biofarmacia, Departamento de Farmacia, Facultad de Química, Universidad de la República Uruguay.
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22
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Ochoa C, Rodríguez M, Domínguez L, Saldaña J, Di Maio R, Alonso-Villalobos P, Martínez Grueiro MM. Nematocide activity of 6,7-diarylpteridines in three experimental models. J Helminthol 1999; 73:333-6. [PMID: 10654402] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The in vitro nematocide activity of seventeen 6,7-diarylpteridines has been tested using three different experimental models, Caenorhabditis elegans, Nippostrongylus brasiliensis and Heligmosomoides polygyrus. The method of evaluation of inhibition in the secretion of acetylcholinesterase by H. polygyrus seems to be the most indicated to avoid false positives. The in vivo activities, against Trichinella spiralis, of the most in vitro active pteridines have been assayed. All pteridine derivatives bearing 6,7-di-p-bromophenyl substituents have shown in vitro nematocide activities in the three experimental models used. Amongst all the pteridines tested in vivo, only 2,4-pteridinedithione derivatives exhibited moderate activity.
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Affiliation(s)
- C Ochoa
- Instituto de Química Médica (CSIC), Madrid, Spain.
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23
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Davyt D, Entz W, Fernandez R, Mariezcurrena R, Mombrú AW, Saldaña J, Domínguez L, Coll J, Manta E. A new indole derivative from the red alga Chondria atropurpurea. Isolation, structure determination, and anthelmintic activity. J Nat Prod 1998; 61:1560-1563. [PMID: 9868166 DOI: 10.1021/np980114c] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Chondriamide C (3), a new bis(indole) amide, was isolated from the red alga Chondria atropurpurea, and its structure was established from spectroscopic data and chemical transformations. A new natural product, 3-indoleacrylamide (4), and the previously described chondriamides A and B (1, 2) and 3-indoleacrylic acid (5) were also isolated. The anthelmintic activities of compounds 1, 3, 4, and 6 (the O,N1,N1'-trimethyl derivative of compound 2) against Nippostrongylus brasiliensis in vitro were evaluated.
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Affiliation(s)
- D Davyt
- Facultad de Química, Universidad de la República, Av. Gral. Flores, 2124 Montevideo, Uruguay
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Domínguez L, Savio E, Saldaña J, Malanga A, Quevedo D, Camarote C, Ochoa A, Fagiolino P. Lipidic matrix of albendazole sulphoxide: is it an alternative for systemic infections? Boll Chim Farm 1998; 137:383-6. [PMID: 9880943] [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: 02/09/2023]
Abstract
As albendazole sulphoxide (ABZS) shows better dissolution properties than albendazole (ABZ), a lipidic matrix with this drug was formulated in order to evaluate if its absorption and so systemic infection chemotherapy could be improved. A cross-over, randomised study in 8 healthy volunteers was carried out, after single administration of 1 g of albendazole or albendazole sulphoxide in lipidic matrix of Gelucire 44/14 (ABZLM and ABZSLM). Absorption was followed performing albendazole sulphoxide dosage in urine samples by high pressure liquid chromatography analysis, during 48 hours. Significant differences were found (p = 0.02) between the urinary recoveries (% E48), being 1.74% and 0.19% the percentage of dose recovered when ABZSLM or of ABZLM were respectively administered. In a previous study of our group similar values were obtained of urinary recovery percentages after albendazole sulphoxide powder administered to another group of healthy volunteers. Lipidic matrix does not improve the physicochemical properties of albendazole sulphoxide powder.
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Affiliation(s)
- L Domínguez
- Laboratory of Pharmacology and Biopharmaceutics, Faculty of Chemistry, Montevideo, Uruguay
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25
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Savio E, Domínguez L, Malanga A, Quevedo D, Saldaña J, Camarote C, Ochoa A, Fagiolino P. Lipidic matrix of albendazole: an alternative for systemic infections. Boll Chim Farm 1998; 137:345-9. [PMID: 9859596] [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: 02/09/2023]
Abstract
Albendazole is a poorly water soluble drug, with low oral bioavailability, used in pharmacological treatment of a systemic disease as hydatid parasitosis. Lipidic matrices of Gelucires (44/14 and 35/02) were developed. After "in vitro" studies, one formulation was chosen for a single dose study in 8 healthy volunteers, with a cross-over and randomised design, taking a commercially available tablet as reference. Drug absorption was followed by albendazole sulphoxide dosage in urine by high pressure liquid chromatography. Neither albendazole nor albendazole sulphoxide were recovered in urine after tablet administration while 0.18% (+/- 0.06) of dose was recovered after lipidic matrix administration in the first 24 hours. Besides ageing control were performed up to 18 months post-elaboration. Lipidic matrix with Gelucire 44/14 was revealed as a promising attempt for oral pharmaceutical form in albendazole systemic treatment.
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Affiliation(s)
- E Savio
- Laboratory of Pharmacology and Biopharmaceutics, Faculty of Chemistry, Montevideo, Uruguay
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Gordon S, Costa L, Incerti M, Manta E, Saldaña J, Domínguez L, Mariezcurrena R, Suescun L. Synthesis and in vitro anthelmintic activity against Nippostrongylus brasiliensis of new 2-amino-4-hydroxy-delta-valerolactam derivatives. Farmaco 1997; 52:603-8. [PMID: 9580122] [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: 02/07/2023]
Abstract
The synthesis of a series of 2-amino-4-hydroxy-delta-valerolactam derivatives is described (compounds 4 to 10). These compounds showed a high anthelmintic in vitro activity against the Nippostrongylus brasiliensis model.
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Affiliation(s)
- S Gordon
- Cátedra de Química Farmacéutica, Fac. de Química, Universidad de la República, Montevideo, Uruguay
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27
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Eres N, Flor A, Saldaña J, Capdevila JA. [Colonic ulcers caused by Campylobacter jejuni in a patient with HIV infection]. Enferm Infecc Microbiol Clin 1996; 14:331. [PMID: 8924483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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28
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Herrera MF, López-Graniel CM, Saldaña J, Gamboa-Domínguez A, Richaud-Patín Y, Vargas-Vorackova F, Angeles-Angeles A, Llorente L, Castillo C, Pérez B, Rivera R, González O, Rull J. Papillary thyroid carcinoma in Mexican patients: clinical aspects and prognostic factors. World J Surg 1996; 20:94-9; discussion 99-100. [PMID: 8588421 DOI: 10.1007/s002689900017] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [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: 01/31/2023]
Abstract
The present study characterizes papillary thyroid carcinoma (PTC) in a Mexican patient sample and evaluates potential prognostic factors for recurrence. Clinical records of 229 patients with PTC were analyzed. Surgical specimens were rereviewed and DNA ploidy determined. Cox logistic regression was used to explore prognostic factors. Mean age +/- SD of the patients was 42 +/- 16 years, with a male/female ratio of 24:205. A thyroid mass was the initial manifestation in 99%. Extrathyroid invasion occurred in 45% and nodal metastases in 38%. Mean size +/- SD of the tumors was 3 +/- 2 cm. By flow cytometry 88% of the tumors were DNA euploid and 12% aneuploid. Complete tumor resection was achieved in 83% with an operative mortality of 0.4%. Postoperative hormone suppression was administered in 65% and remnant 131I thyroid ablation in 84%. The 10-year recurrence-free survival was 85%. In the group of patients with tumors totally removed and without distant metastases, none of the 14 evaluated variables demonstrated statistical significance as an independent prognostic factor for recurrence. However, the group of patients in whom a combination of the following factors was present--age > or = 40 years, tumor size > or = 3 cm, local invasion, and lymph node metastases--showed a higher incidence of tumor recurrence.
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Affiliation(s)
- M F Herrera
- Department of Surgery, Instituto Nacional de la Nutrición, Tlalpan, Mexico, D.F. Mexico
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Herrera MF, López CM, Saldaña J, Pérez B, Rivera R, González O, Angeles A, Letayf V. [Trends in thyroid surgery at the Instituto Nacional de la Nutrición Salvador Zubirán]. Rev Invest Clin 1995; 47:13-9. [PMID: 7777711] [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: 01/27/2023]
Abstract
The diagnosis and treatment of thyroid disease has significantly changed with time. With the aim of analysing changes in thyroid surgery in our institution, a representative sample of patients from the first three years in four decades (1960-1992) were comparatively analysed. In the sixties, the diagnosis of thyroid cancer was made during surgery; by contrast, this diagnosis was correctly done by fine needle aspiration (FNA) in most patients of the last decade. Thyroid lobectomy, infrequently used in the treatment of differentiated thyroid carcinoma in earlier times, has now been abandoned and currently most patients undergo total or near-total thyroidectomy. Complications such as hypoparathyroidism and recurrent laryngeal nerve paralysis have importantly decreased with time and were not seen in the last decade. A trend toward an earlier diagnosis of thyroid carcinoma was also observed. In summary, the number of thyroidectomies for benign diseases has been importantly reduced by the use of FNA with the proportional increment of surgery for malignant disease.
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Affiliation(s)
- M F Herrera
- Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F
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